Heart attacks are caused by heart disease, which is the number one cause of death among both men and women in the United States. According to the American Heart Association, every year in the United States roughly 785,000 people will have their first heart attack. And approximately 470,000 who have had a heart attack before will have another one.
While much work needs to be done to prevent heart disease and heart attacks from happening in the first place, the good news is that heart attack treatment has advanced tremendously in the past 60 years. Based on data from an extensive, long-term study called the Framingham Heart Study, death from coronary artery disease (CAD) – the disease process behind heart attacks – dropped by 59 percent from 1950 to 1999. And in the ten years between 1997 and 2007, the death rate from CAD dropped another 26.3%. This dramatic drop in mortality from CAD is due to advances in medical therapy, including increased understanding of risk factors for CAD, pharmacologic treatment of CAD, and improved modes of opening blocked arteries.
You may be someone who is recovering from a heart attack or someone who is concerned about your personal risk for a heart attack. Or you may be a caregiver who is helping a loved one who has heart disease. Regardless of your starting point, the information in this section can help you better understand what heart attacks are – their causes, symptoms, diagnosis, and treatment – and what you will need for recovery and to lead a heart-healthy lifestyle moving forward.
The Mechanics of a Heart Attack
You may also hear heart attacks described by medical terms such as myocardial infarction (MI) or acute coronary syndrome (ACS). The latter, ACS, describes both a heart attack and unstable angina (chest pain), which is a warning sign that blood flow to your heart is being cut off.
A heart attack results when a complete occlusion suddenly forms in the arteries that supply blood to your heart – the coronary arteries. Blockages are caused by a disease process throughout the arteries in your body called atherosclerosis, in which plaque – a fatty substance – builds up in the arteries. This plaque narrows the arteries, leaving less room for blood to flow. A plaque can be topped with a thin, fibrous cap that ruptures. With rupture, exposure of atherosclerotic debris to the bloodstream can cause platelets (a component of blood that assists with clotting) and red blood cells to collect at the site of the rupture, cutting off blood flow to the artery. Alternatively, part of the plaque may break off and flow downstream in the blood. This piece of plaque can then lodge in a narrowed portion of the artery and blood will begin to clot around it. This blood clot (thrombosis) can partially or completely cut off blood flow through the artery. When blood flow is cut off, this is called ischemia.
Your heart is a muscle. Blood carries vital oxygen and nutrients to the heart muscle, and without blood, the heart muscle begins to die. That is why every second counts when it comes to heart attack treatment. An extensive blockage, especially in a major blood vessel, such as the left anterior descending artery, can cause a large heart attack. Large heart attacks that are not treated early and aggressively can lead to heart failure. The risk of death within five years of being diagnosed with certain types of heart failure can be 50 percent or more, worse than many forms of cancer.
It is better to go to the hospital and learn that you are not having a heart attack than to stay home and have one. That’s because the consequences of an untreated heart attack are so great. If your symptoms persist for more than 15 minutes, you are at more risk that heart muscle cells will die. It is critical for you and your heart that you receive immediate medical attention. To receive the best care, you have about 90 minutes from the onset of the heart attack for an interventional cardiologist or surgeon to restore the flow of blood to the heart before critical heart tissue dies or is damaged.
Read on for detailed information about the different types of heart attacks and their causes, symptoms, diagnosis, and treatment . Also find questions you can ask your physician about heart attack, what you can do to increase your odds of surviving a heart attack, and what recovery from heart attack will involve.
Know that today your chances of surviving a heart attack – and surviving it well – are greater than ever, and that patients and physicians are a team working together for heart health. Recognition of the symptoms of a heart attack and seeking prompt medical attention are crucial in improving one’s odds of surviving a heart attack, so the first and probably most important link in the battle against CAD is seeking PROMPT medical attention when there is any suspicion of a heart attack.