Other terms used for a heart attack include myocardial infarction, cardiac infarction, and coronary thrombosis (Infarction refers to the process whereby an area of dead tissue is caused by a loss of blood supply).

According to the American Heart Association:

• During a heart attack, the heart muscle that loses its blood supply starts to suffer injury.
• How much damage occurs depends on the size of the area that is supplied by the blocked artery, as well as the length of time between injury and treatment.
• The damaged heart muscle heals by forming scar tissue. The healing process may take several weeks.
• Despite severe injury to a part of the heart, the rest of the organ carries on working.
• However, as part of the heart has been damaged, it will probably be weaker and will not pump as much blood as it used to.
• With the right treatment and lifestyle changes, further damage can be prevented or limited.

Symptoms of a heart attack

The following are signs and symptoms for diagnosing a heart attack:

• Chest discomfort, mild pain
• Coughing
• Nausea
• Vomiting
• Crushing chest pain
• Pressure tightness, pain, squeezing or aching in the chest or arms that spreads to the neck, jaw, or back
• Dizziness
• Dyspnea (shortness of breath)
• Face seems gray
• A feeling of terror that your life is coming to its end
• Feeling really awful (general feeling)
• Restlessness
• Feeling clammy and sweaty
• Shortness of breath

The emergency services should be called immediately.

The pain of a heart attack is not alleviated by changing position; the pain is normally constant, but it may sometimes come and go. Patients describe the pain as one of pressure, like a clamp squeezing inside your chest. The pain can last from a few minutes to many hours.

Causes of a heart attack

The following are possible factors associated with increased risk of heart attack.

• Age: Risk increases when a man is over 45, and a woman is over 55.
• Angina: An illness where not enough oxygen reaches the heart, causing chest pain resembling a heart attack, but it resolves after taking medication. Angina raises the risk of a heart attack.
• High blood cholesterol levels: Increases the risk of developing blood clots in the arteries.
• Diabetes: People with diabetes have a higher risk of developing several diseases and conditions, many of them contribute to a higher risk of heart attack.
• Diet: Someone who consumes large quantities of, for example, saturated fats, will eventually have a higher risk of having a heart attack.
• Genes: You can inherit a higher risk of heart attack.
• Heart surgery: Patients who have had heart surgery have a higher risk.
• Hypertension (high blood pressure).
• Obesity, overweight.
• Physical inactivity: More active people have a lower risk.
• Previous heart attack: Anybody who has already had a heart attack is more likely to have another one, compared with people who have not.
• Smoking.
• HIV: People who are HIV positive have a 50 percent higher risk of heart attack.
• Work stress: Individuals with stressful jobs, or shift workers have an increased risk of heart attack.

Diagnosis of heart attacks

Any doctor, nurse, or health care professional, will send a patient straight to hospital if they suspect they may have a heart attack. In hospital, several tests might be done:

• ECG (Electrocardiograph): Monitors the electrical activity of the heart muscles
• Cardiac enzyme tests: Blood tests detect enzymes produced during a heart attack
• Chest X-ray: To look for swelling of the heart

Treatments for a heart attack

The faster the heart attack patient can be treated, the more successful his/her treatment will be. These days, the majority of heart attacks can be treated effectively. It is crucial to remember that the patient's survival depends largely on how quickly they can be taken to hospital.

Treatments during a heart attack

CPR (cardio-pulmonary resuscitation)

Some heart attack patients stop breathing; they do not move or respond when spoken to or touched, they may also be coughing. If this is the case, CPR should be started straight away. This involves:

• Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.
• Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.
• Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.
• Thrombolytics - these dissolve blood clots.
• Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.

Treatments following a heart attack

Most patients will need several different medications after their heart attack. The aim being to prevent future heart attacks from occurring.

• Aspirin and other antiplatelets: Antiplatelets lower the chances of blood clotting
• Beta-blockers: Make the heart beat slower and with less force
• ACE (Angiotensin-converting enzyme) inhibitors: Ease the workload on the heart by opening up blood vessels and lowering blood pressure
• Statins: Lower blood cholesterol levels
• Procedures after a heart attack: If the patient's heart has been severely damaged they may need a procedure. The most common two are:
  • Angioplasty: This procedure opens up the coronary artery. A small wire enters the artery and is pushed until it reaches the clot in the coronary artery. A small balloon at the end of the wire is placed at the narrowest part of the artery and inflated, squashing the clot. A flexible metal mesh, called a stent, is then placed there to keep the artery open.
  • CABG (Coronary artery bypass graft): The damaged blood vessel is bypassed with grafts taken from blood vessels elsewhere in the body. The bypass effectively goes around the blocked area of the artery, allowing blood to pass through into the heart muscle.