A heart attack happens when the blood flow to the heart is blocked. This blockage is usually due to a buildup of cholesterol, fat, and other substances that result in the formation of plaque in the arteries that supply blood to the heart, commonly known as coronary arteries.1
Sometimes, a plaque can burst and form a clot that blocks blood flow through that artery. This disruption in the blood flow can cause damage or destroy a certain part of the heart muscle. If a part of the heart muscle dies, a person can experience chest pain accompanied by electrical instability of the heart muscle tissue, causing a heart attack.2
A heart attack, also known as a myocardial infarction, can prove to be fatal, but over the years, advances in treatment have significantly improved the chances of survival after a heart attack. In the following sections, we will take a closer look at the causes and effects of heart attacks.
Overview of a Heart Attack
When a person has a heart attack, the blood supply that provides oxygen and nutrients to the heart and its muscles get cut off, leading to the eventual death of the heart muscles. Heart attacks are one of the leading causes of death in the world today, and it is estimated that one heart attack happens every 40 seconds in the United States.3,4
A heart attack is sometimes also referred to as a cardiac infarction or coronary thrombosis. The term infarction refers to a condition when the blood supply to a particular part gets cut off, and the tissue in that part starts dying.
Without treatment, these heart muscles will go on to experience irreversible damage. If a substantial part of the heart gets damaged, the heart will eventually stop beating, a condition known as cardiac arrest resulting in death.5
Some people exercise certain warning signs before having a heart attack, while others do not experience any symptoms.6 However, in most cases, if a person pays attention, there are several clear indications that you are about to get a heart attack. A feeling of tightness, pressure, pain, squeezing sensation or aching in the arms or chest that lowly spreads to the jaw, neck, or the back are some of the clear signs that a person has a heart attack.
Here are some of the symptoms that indicate a heart attack is occurring:
- Intense chest pain
- Upper body pain
- Trouble breathing or shortness of breath
- Face seems to be turning grey in color
- An overall feeling of dread that your life is about to end
- A general feeling of unease
- Feeling sweaty and clammy
Changing your position is not going to provide relief from the pain experienced during a heart attack. The pain felt during a heart attack is usually constant, though it may seem like it is coming and going. A heart attack should be treated as a medical emergency. If you feel you may be experiencing the symptoms of a heart attack, you should immediately seek medical attention.
A heart attack is often confused with a cardiac arrest. Both these conditions should be treated as medical emergencies. While a heart attack involves the blockage of an artery that supplies the heart, a cardiac arrest happens when the heart stops pumping the blood around the body. It is possible for a heart attack to cause a cardiac arrest.
Causes of Heart Attack
As mentioned above, a heart attack happens when one or more of the coronary (heart) arteries become blocked. Over time, a buildup of fatty deposits known as plaques can cause narrowing of the arteries, a condition known as atherosclerosis.7,8 Atherosclerosis is one of the most common causes of a heart attack. This condition is also known as coronary artery disease or coronary heart disease and is usually the cause of most heart attacks.9
If you have coronary heart disease, then just before a heart attack, one of these plaques tend to burst, which leads to the formation of a blood clot at that site. This clot may further block the supply of blood to the heart, which triggers a heart attack.
Your risk of developing coronary heart disease is increased by the following factors:10,11
- Diet: Consuming large quantities of saturated and unhealthy fats increases the chances of having a heart attack. Regular consumption of processed and junk foods also increases this risk.
- Age: It has been found that men over the age of 45 and women over the age of 55 are more likely to experience a heart attack than younger men and women.12
- Smoking: Smoking and long-term exposure to second-hand smoke is also a risk factor for heart attack.13
- High blood pressure or hypertension: If you have high blood pressure for a long time, it can damage your arteries over time. Higher blood pressure that is accompanied by other conditions, such as high cholesterol, diabetes, or obesity, increases the risk of heart attack even more.14
- High cholesterol or triglyceride levels: A high level of the bad cholesterol (low-density lipoprotein or LDL) is also known to cause narrowing of the arteries. Having high levels of triglycerides in the bloodstream also increases the risk of a heart attack.15
- Being obese or overweight: Obesity is directly linked with increased blood cholesterol levels, high triglyceride levels, diabetes, and high blood pressure. Studies have found that losing even ten percent of your body weight can significantly lower the risk of heart attack and other conditions.16
- Diabetes: In people who have diabetes for a long time, the high level of blood glucose can damage the arteries and nerves that control their heart and blood vessels. It has been found that the longer you have diabetes, the higher are the chances that you will develop heart disease.17 In fact, people with diabetes tend to develop heart disease at a much younger age than those who don’t have diabetes. Adults with diabetes are also nearly twice as likely to die from a heart attack or other heart-related condition than people without diabetes.18
- Lack of physical activity: Living a sedentary life can contribute to obesity and high blood cholesterol levels. Studies have shown that people to exercise regularly have better heart health and also lower blood pressure, cholesterol, and a lower risk of many chronic lifestyle diseases such as diabetes.19
- Family history of heart attacks or heart disease: If your parents, grandparents, or siblings have experienced a heart attack early in their life, then you are at an increased risk of having a heart attack.20
- Metabolic syndrome: This is a cluster of health conditions that occur together, and they increase the risk of having a heart attack or stroke. These conditions include high blood sugar, high blood pressure, abnormal cholesterol or triglyceride levels, and having excess fat around the waist. The more conditions you develop, the higher the risk of developing a serious disease such as diabetes or heart disease.21
- Illicit drug use: Using illegal stimulant drugs such as amphetamines, methamphetamines, or cocaine, increases the risk of having a heart attack. This is because these illicit drugs can trigger a spasm in the coronary arteries, causing a heart attack. Such drugs can also cause the narrowing of the coronary arteries, restricting the blood supply to the heart. Heart attack due to the use of cocaine is known to be one of the most common causes of sudden death in young people in the United States.22
- Stress: Different people respond to stress differently. Some people may react in ways that increase the risk of having a heart attack. Stress is also a risk factor for high blood pressure.
- Certain autoimmune conditions: Autoimmune diseases such as rheumatoid arthritis or lupus increases the risk of having a heart attack.23
Effects of a Heart Attack
Once you have a heart attack, it can disrupt the heart’s normal rhythm, and even stop it altogether sometimes. These abnormal rhythms are known as arrhythmias, and you will need regular medical treatment to keep them in check. Cardiac arrhythmias should never be taken lightly, and your doctor is likely to prescribe medications to control the rate of arrhythmia. In some cases, you might also need to undergo a procedure known as cardioversion, which uses electricity to shock the heart back into its normal rhythm.24
When the heart does not get a supply of blood during the heart attack, it may cause tissue death. This weakens the heart and can lead to life-threatening conditions in the future, including heart failure. Heart attacks are also known to affect the valves of the heart, causing leaks.
The amount of time it takes for you to receive treatment after having a heart attack, along with the area of the heart that suffers damage, both determine the long-term effects of a heart attack on your heart and overall health.
Even though many of the risk factors are out of your control, there are still certain basic steps you can take to prevent a heart attack and keep your heart healthy. Remember that smoking is one of the major causes of heart disease. So if you are a smoker, you should think about quitting at the earliest.
Maintaining a healthy diet, exercising regularly, and watching your alcohol intake are other important methods of reducing the risk of a heart attack.
If you have diabetes, then taking your medications on time, checking your blood glucose levels regularly, and following your doctor’s instructions will help you remain healthy. If you already have an existing heart condition, then working closely with your doctor and following your treatment protocol will go a long way in reducing the risk of a heart attack.
- Ku, D.N., 1997. Blood flow in arteries. Annual review of fluid mechanics, 29(1), pp.399-434.
- Schwartz, B.G., Mayeda, G.S., Burstein, S., Economides, C. and Kloner, R.A., 2010. When and why do heart attacks occur?
- Cardiovascular triggers and their potential role. Hospital Practice, 38(3), pp.144-152.
- Nhlbi.nih.gov. 2020. Coronary Heart Disease | NHLBI, NIH. [online] Available at: <https://www.nhlbi.nih.gov/health/health-topics/topics/cad/> [Accessed 1 August 2020].
- Centers for Disease Control and Prevention. 2020. Heart Attack Symptoms, Risk Factors, And Recovery | Cdc.Gov. [online] Available at: <https://www.cdc.gov/heartdisease/heart_attack.htm> [Accessed 1 August 2020].
- Wilber, D.J., Garan, H., Finkelstein, D., Kelly, E., Newell, J., McGovern, B. and Ruskin, J.N., 1988. Out-of-hospital cardiac arrest. New England Journal of Medicine, 318(1), pp.19-24.
- Ornato, J.P. and Hand, M.M., 2001. Cardiology patient page: Warning signs of a heart attack. Circulation, 103(25), pp.e124-e125.
- Libby, P., 2002. Atherosclerosis: the new view. Scientific American, 286(5), pp.46-55.
- Falk, E., 2006. Pathogenesis of atherosclerosis. Journal of the American College of Cardiology, 47(8 Supplement), pp.C7-C12.
- Castelli, W.P., 1988. Cholesterol and lipids in the risk of coronary artery disease–the Framingham Heart Study. The Canadian journal of cardiology, 4, p.5A.
- Bunker, S.J., Colquhoun, D.M., Esler, M.D., Hickie, I.B., Hunt, D., Jelinek, V.M., Oldenburg, B.F., Peach, H.G., Ruth, D., Tennant, C.C. and Tonkin, A.M., 2003. “Stress” and coronary heart disease: psychosocial risk factors. Medical Journal of Australia, 178(6), pp.272-276.
- Grundy, S.M., 1999. Primary prevention of coronary heart disease: integrating risk assessment with intervention. Circulation, 100(9), pp.988-998.
Rissanen, A.M., 1979. Familial occurrence of coronary heart disease: effect of age at diagnosis. The American journal of cardiology, 44(1), pp.60-66.
- He, J., Vupputuri, S., Allen, K., Prerost, M.R., Hughes, J. and Whelton, P.K., 1999. Passive smoking and the risk of coronary heart disease—a meta-analysis of epidemiologic studies. New England Journal of Medicine, 340(12), pp.920-926.
- MacMahon, S., Peto, R., Collins, R., Godwin, J., Cutler, J., Sorlie, P., Abbott, R., Neaton, J., Dyer, A. and Stamler, J., 1990. Blood pressure, stroke, and coronary heart disease: part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. The Lancet, 335(8692), pp.765-774.
- Kuklina, E.V., Yoon, P.W. and Keenan, N.L., 2010. Prevalence of coronary heart disease risk factors and screening for high cholesterol levels among young adults, United States, 1999–2006. The Annals of Family Medicine, 8(4), pp.327-333.
- Manson, J.E., Colditz, G.A., Stampfer, M.J., Willett, W.C., Rosner, B., Monson, R.R., Speizer, F.E. and Hennekens, C.H., 1990. A prospective study of obesity and risk of coronary heart disease in women. New England journal of medicine, 322(13), pp.882-889.
- Huo, X., Gao, L., Guo, L., Xu, W., Wang, W., Zhi, X., Li, L., Ren, Y., Qi, X., Sun, Z. and Li, W., 2016. Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. The lancet Diabetes & endocrinology, 4(2), pp.115-124.
- Cdc.gov. 2020. National Diabetes Statistics Report | Data & Statistics | Diabetes | CDC. [online] Available at: <https://www.cdc.gov/diabetes/data/statistics/statistics-report.html> [Accessed 1 August 2020].
- Hillman, C.H., Erickson, K.I. and Kramer, A.F., 2008. Be smart, exercise your heart: exercise effects on brain and cognition. Nature reviews neuroscience, 9(1), pp.58-65.
- Barrett-Connor, E.L.I.Z.A.B.E.T.H. and Khaw, K.T., 1984. Family history of heart attack as an independent predictor of death due to cardiovascular disease. Circulation, 69(6), pp.1065-1069.
- Lorenzo, C., Williams, K., Hunt, K.J. and Haffner, S.M., 2006. Trend in the prevalence of the metabolic syndrome and its impact on cardiovascular disease incidence: the San Antonio Heart Study. Diabetes care, 29(3), pp.625-630.
- Wong, L.S. and Alexander, B.K., 1991. “Cocaine-related” deaths: media coverage in the war on drugs. Journal of Drug Issues, 21(1), pp.105-119.
- Ercolini, A.M. and Miller, S.D., 2009. The role of infections in autoimmune disease. Clinical & Experimental Immunology, 155(1), pp.1-15.
- Huikuri, H.V., Castellanos, A. and Myerburg, R.J., 2001. Sudden death due to cardiac arrhythmias. New England Journal of Medicine, 345(20), pp.1473-1482.
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