Heart Attack

To do its job—pump blood to every part of the body—the heart needs its own supply of oxygen-rich blood. That pipeline is provided by the coronary arteries. No wider than strands of spaghetti, these arteries deliver blood to hard-working heart muscle cells. A heart attack occurs when blood flow through a coronary artery is suddenly blocked. A blood clot can block flow; so can a sudden spasm of the artery.

Each coronary artery supplies blood to a specific part of the heart. A blockage damages that part of the heart. Depending on the location and amount of heart muscle affected, a blockage can seriously interfere with the heart's ability to pump blood. Since some of the coronary arteries supply areas of the heart that regulate heartbeat, blockages there can cause potentially deadly abnormal heartbeats.

The most common symptom of a heart attack is chest pain, usually described as crushing, squeezing, pressing, heavy, stabbing, or burning. The pain or feeling tends to be focused either in the center of the chest or just below the center of the rib cage, but it can spread to the arms, abdomen, neck, lower jaw or neck. Other symptoms can include sudden weakness, sweating, nausea, vomiting, breathlessness, or lightheadedness.

If you think that you, or someone you are with, is having a heart attack, call 911 right away. The sooner you call, the sooner treatment can begin — "time is muscle," as emergency room doctors say. The most effective treatments are artery-opening angioplasty with stent placement or an infusion of a clot-busting drug.

Heart Attack Articles

Ask the doctor: Should I switch to generic Lipitor?

After a heart attack six years ago, I went on Lipitor because my doctor said it was proven to reduce the risk of a second heart attack. Three years ago, I switched to a generic to save money. Now that Lipitor is going generic, should I switch back? (Locked) More »

You could be one in a million

Dr. Thomas Lee, the editor in chief of the Harvard Heart Letter, introduces an issue focused on the Million Hearts initiative, which aims to reduce heart disease. More »

Angioplasty a day after a heart attack not worth it

In 2006, the Occluded Artery Trial (OAT) determined that performing angioplasty — an invasive and expensive procedure — delivered no tangible benefit to people who'd had a heart attack more than 24 hours earlier and who no longer had symptoms. In 2007, the American College of Cardiology and the American Heart Association endorsed the OAT findings and issued this guideline: angioplasty to unclog an artery implicated in a heart attack, when performed more than 24 hours after the event, is not appropriate as long as the person is stable. More »

December 2011 references and further reading

Deyell M, Buller C, Miller L, Wang T, Dai D, Lamas G, Srinivas V, Hochman J. Impact of National Clinical Guideline Recommendations for Revascularization of Persistently Occluded Infarct-Related Arteries on Clinical Practice in the United States. Archives of Internal Medicine 2011; 171: 1636-1643. Terkelsen C, Jensen L, Tilsted H, Trautner S, Johnsen S, Vach W, Bøtker H, Thuesen L, Lassen J. Health care system delay and heart failure in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: follow-up of population-based medical registry data. Annals of Internal Medicine 2011;155:361-7. Greenspon A, Patel J, Lau E, Ochoa J, Frisch D, Ho R, Pavri B, Kurtz S. 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008. Journal of the American College of Cardiology 2011; 58:1001-6. (Locked) More »

Putting heart attack, stroke triggers in perspective

Certain activities and situations can trigger heart attacks in those at risk, but researchers are showing how these risks need to be placed in the proper context. The impact of triggers depends largely on cardiovascular health. They are far more likely to cause a heart attack, stroke, or cardiac arrest in a person with heart disease than in someone with a healthy heart and arteries. Physical condition also matters. Exercise or physical exertion is much more likely to trigger a heart attack in someone who leads a sedentary life than in someone who exercises regularly. It's almost impossible to avoid cardiovascular triggers, but you can reduce or inactivate their effects. (Locked) More »

Can a hospital stay make you anemic?

Receiving hospital treatment for a heart attack may lead to anemia. There isn't much you can do to avoid developing anemia during a hospital stay other than asking doctors and nurses to minimize the amount of blood drawn for tests. Preventing the problem is better than trying to fix it, because if you do develop anemia while hospitalized, it isn't clear if treating the anemia — with either iron pills or a drug that stimulates the bone marrow to make more red blood cells — will improve quality of life or post–heart attack survival. (Locked) More »

Update on aspirin

For people who have not had a heart attack, the question of whether or not to take a daily aspirin is a matter of weighing potential benefits against potential harm. More »

July 2011 references and further reading

Morbidity and Mortality Chart Book, National Heart, Lung, and Blood Institute, 2009. Myers MG, Godwin M, Dawes M, et al. Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial. BMJ 2011; 342:d286. van der Wel MC, Buunk IE, van Weel C, Thien TA, Bakx JC. A novel approach to office blood pressure measurement: 30-minute office blood pressure vs daytime ambulatory blood pressure. Annals of Family Medicine 2011; 9:128-35. (Locked) More »