Heart attacks, also known as myocardial infarctions, are very common in the United States. According to the Centers for Disease Control and Prevention (CDC), a heart attack occurs approximately every 40 seconds.
Chest pain is the most common warning sign of a heart attack. However, other symptoms may also occur, such as dizziness, nausea, and shortness of breath. Symptoms can be severe or mild and often vary from person to person. Some people may not notice any clear warning signs at all.
This article provides a detailed overview of the causes, symptoms, risk factors, diagnosis, treatment, and prevention of heart attacks.
A heart attack occurs when blood flow to the heart is blocked or significantly reduced. If the heart muscle does not receive enough oxygen-rich blood, the affected area becomes damaged, and prolonged lack of oxygen causes heart muscle cells to die.
When the heart does not receive the blood and oxygen it needs to function properly, the risk of heart failure and other serious complications increases.
A heart attack is a life-threatening medical emergency. The sooner medical treatment restores normal blood flow to the heart, the greater the chance of a successful outcome.
Common heart attack symptoms include:
chest pain or discomfort
shortness of breath
pain in the arm, shoulder, neck, or jaw
nausea or vomiting
sweating
dizziness or lightheadedness
extreme fatigue
pain in the upper body
breathing difficulties
Anyone experiencing any of these symptoms should seek emergency medical assistance immediately.
Many people experience a range of heart attack symptoms regardless of sex or gender. However, symptom presentation, biology, and outcomes may differ between men and women.
A 2019 study found that chest pain was the most common symptom in both men and women. Women often describe the pain as pressure, tightness, or squeezing in the chest, while men tend to describe it as a heavy weight on the chest.
According to the American Heart Association (AHA), women are slightly more likely than men to experience the following symptoms:
shortness of breath
nausea or vomiting
pain in the upper back or jaw
dizziness or lightheadedness
extreme fatigue
Higher estrogen levels may reduce the risk of heart attack, which is why women face a higher risk after menopause compared to before menopause.
However, women who experience heart attacks are also at a higher risk of being underdiagnosed and undertreated.
For example, a 2018 study conducted in Switzerland found that women experiencing typical heart attack symptoms tended to wait longer before seeking emergency medical care. Researchers also found that women were more likely to experience delays in treatment once they reached emergency departments.
The most common cause of heart attacks is coronary artery disease, a condition in which plaque builds up in the arteries that supply blood to the heart. This buildup is known as atherosclerosis.
There are two main types of heart attacks:
Type 1 heart attack occurs when a plaque inside an artery ruptures and releases cholesterol and other substances into the bloodstream, forming a blood clot that blocks the artery.
Type 2 heart attack occurs when the heart does not receive enough oxygen-rich blood, but the artery is not completely blocked.
Other possible causes of heart attacks include:
ruptured blood vessels
coronary artery spasms
improper use of medications
hypoxia (low oxygen levels in the blood)
The risk of a heart attack can increase due to several factors. Some risk factors, such as age and family history, cannot be changed. Others can be managed.
smoking
high cholesterol levels
obesity
lack of physical activity
chronic stress
diabetes or prediabetes
a diet high in trans fats and saturated fats
excessive alcohol consumption
sleep apnea
Heart disease is the leading cause of death in most racial and ethnic groups in the United States and the most common cause of heart attacks.
According to the CDC, heart disease accounts for 23.7% of deaths among non-Hispanic White Americans and 23.5% among non-Hispanic Black Americans, both slightly higher than the overall population average of 23.4%.
If you are over the age of 65, your risk of experiencing a heart attack is higher than that of younger individuals, according to the National Institute on Aging. This is particularly true for women.
Additionally, having a family history of heart disease, high blood pressure, high cholesterol, obesity, or diabetes increases your risk.
Doctors usually diagnose a heart attack through a physical examination and a review of medical history. An electrocardiogram (ECG) is commonly used to assess the heart’s electrical activity.
An echocardiogram, which uses sound waves to create images of the heart chambers and valves, can help determine how blood flows through the heart and identify damaged areas.
A doctor may also order cardiac catheterization, a procedure in which a thin, flexible tube (catheter) is inserted into a blood vessel. This allows doctors to examine areas in and around the heart where plaque may have accumulated. Dye may be injected into the arteries, followed by X-rays to visualize blood flow and detect blockages.
The healthcare team will also likely take blood samples to check for signs of heart muscle damage.
The most commonly used blood test measures troponin T, a protein found in heart muscle. Elevated troponin levels are associated with heart attacks.
If you have had a heart attack, your doctor may recommend surgical or non-surgical procedures to reduce pain and prevent future heart attacks.
Stent placement – a wire mesh tube inserted into an artery to keep it open after angioplasty
Angioplasty – a procedure that opens blocked arteries using a balloon or removes plaque buildup
Coronary artery bypass surgery – reroutes blood around a blocked artery
Heart valve surgery – repairs or replaces damaged valves
Pacemaker implantation – helps regulate abnormal heart rhythms
Heart transplantation – considered when extensive heart tissue damage occurs
Doctors may also prescribe medications, including:
aspirin
clot-dissolving drugs
antiplatelet and anticoagulant medications
pain relievers
nitroglycerin
blood pressure medications
beta blockers
Prompt treatment is critical. The sooner blood flow is restored, the better the outcome.
If you are with someone experiencing heart attack symptoms, call emergency services immediately and follow their instructions.
If the person is unresponsive and has no pulse, cardiopulmonary resuscitation (CPR) or the use of an automated external defibrillator (AED) can save their life.
AEDs are available in many workplaces and public places. If one is not available, do not delay CPR. Rescue breathing and chest compressions help circulate oxygenated blood until emergency services arrive.
The faster emergency care is provided, the less damage the heart muscle is likely to sustain.
Heart attacks can lead to several complications. Disruption of the heart’s normal rhythm may cause arrhythmias, which can result in cardiac arrest.
If heart tissue dies due to lack of blood flow, the heart may weaken, leading to heart failure.
Heart attacks can also damage heart valves, causing leakage.
Long-term effects depend on how quickly treatment was initiated and how much heart tissue was damaged.
Although some risk factors cannot be controlled, several steps can help protect heart health:
Eat a healthy, balanced diet rich in lean proteins, whole grains, fruits, vegetables, low-fat dairy, nuts, and seeds
Exercise regularly (at least 150 minutes per week)
Quit smoking
Limit alcohol consumption
Monitor cholesterol levels
Manage diabetes
Follow your doctor’s treatment plan
These steps play an important role in reducing the risk of heart disease and heart attacks.
According to the CDC, approximately 805,000 people in the United States experience a heart attack each year, most of them for the first time. While most survive, recognizing symptoms and acting quickly is essential.
Although chest pain is the most common symptom, it is not the only warning sign. If you suspect a heart attack, call emergency medical services immediately. Early treatment greatly improves outcomes.
Several tests can confirm whether a heart attack has occurred, and effective treatments are available to restore blood flow and reduce complications.
If you have any heart attack risk factors, speak with your doctor about steps you can take to reduce your risk.
