Published by Bupa's Health Information Team, May 2011.
This factsheet is for people who have had a heart attack, or who would like information about it.
A heart attack, also known as myocardial infarction or coronary thrombosis, happens when a coronary artery (a blood vessel that supplies the heart with blood) carrying oxygen-rich blood to the heart is blocked. If the blood supply is completely blocked, part of the heart muscle may be starved of oxygen, can become damaged and may die.
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About 111,000 people have a heart attack each year in England. The risk of having a heart attack increases as you get older and is more common among men than women.
You’re more likely to have a heart attack if you:
If you have a heart attack, you will most likely feel pain or discomfort in the centre of your chest. This central chest pain is often described as a sensation of heaviness, tightness or squeezing, and may come on suddenly causing you to collapse. The pain may feel like bad indigestion.
Other symptoms may include:
The symptoms of a heart attack can vary from person to person. Sometimes you may not have any obvious symptoms, especially if you’re elderly or have diabetes.
During a heart attack, life-threatening heart rhythms may develop, which is why a heart attack is a medical emergency.
If you suspect that you or someone you’re with is having a heart attack, call for emergency help immediately.
Complications from a heart attack can vary widely from person to person. Some people may have few complications, whereas others may have many.
In the first few days of surviving a heart attack you may have an irregular heart beat, known as arrhythmia. You may also get angina, which is pain or discomfort in the chest after having a heart attack.
A heart attack can damage your heart muscle and cause your heart’s pumping action to be weaker, making it more difficult to pump enough blood and oxygen around the body. This is known as heart failure. The larger the area of your heart muscle damaged by a heart attack, the more likely you are to have heart failure.
It’s also common for people to feel low or depressed after having a heart attack. You may be worried about having another heart attack or concerned about your recovery. If you’re worried about how you’re feeling, speak to your GP for advice.
It’s very rare but other complications may include blood clots in the lungs, rupture of the heart muscle, inflammation of the membrane covering the heart (pericarditis), or a bulging weakness in the heart muscle (aneurysm).
The underlying cause of most heart attacks is atherosclerosis - this is where the coronary arteries become narrowed over many years by fatty deposits (plaques). These plaques are thought to split open (rupture), releasing substances that cause the blood flowing in the coronary artery to clot. The plaque and blood clot (thrombus) can together completely block the coronary artery, stopping blood flow to your heart and causing a heart attack.
When you get to hospital, a doctor or nurse will ask you about your symptoms and examine you. He or she will also ask you about your medical history. You may have:
Emergency medical treatment is vital – getting to hospital quickly and receiving specialist care greatly improves your chance of survival. If you have some aspirin, chew a single tablet, unless you know that you’re allergic to it. Aspirin reduces blood clots and can help to prevent the clot that is blocking the artery from spreading.
In response to an emergency call for a suspected heart attack, the ambulance service will send a paramedic as soon as possible. Sit and rest in a position that is most comfortable until the paramedics arrive. He or she will give you initial treatment and provide transport to a hospital quickly and safely for further treatment. You may also be given oxygen and medicines for pain relief.
During or after a heart attack, you may have an irregular heart beat, known as arrhythmia. The most serious form of this is called ventricular fibrillation. This is when the electrical activity of the heart becomes chaotic and the heart stops pumping, and quivers or ‘fibrillates’ instead. This is known as a cardiac arrest and the paramedic may need to use a defibrillator, which gives a large electric shock through the wall of your chest and can restore a regular heartbeat.
Your treatment will depend on how severe your heart attack was. Once you arrive at hospital, your doctor will decide on the best treatment for you.
There are two commonly used ways to restore blood flow in a blocked artery.
Sometimes a coronary angioplasty isn’t possible, for example if the blockages in your arteries are too long for a stent or they’re difficult to get to, and you may be offered a coronary artery bypass graft (CABG) instead. CABG is an operation to bypass a narrowed section of your coronary artery using a blood vessel from your chest, leg or arm. This diverts the flow of blood around the narrowed or blocked coronary artery.
After a heart attack, you may need to take medicines regularly for a long time. Medicines you may be prescribed include aspirin, antiplatelets (eg clopidogrel or prasugrel), statins (eg simvastatin), angiotensin-converting enzyme (ACE) inhibitors (eg ramipril), and beta-blockers (eg propranolol). A fish oil capsule (Omacor) may also be given.
Your risk of further heart attacks can be reduced by taking these medicines. Always read the patient information leaflet that comes with your medicine.
For the best possible recovery after a heart attack, you can start a cardiac rehabilitation programme. These usually include an exercise regime devised by a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility), along with advice on relaxation, lifestyle and treatment choices. A cardiac rehabilitation programme usually lasts between 11 and 16 sessions and ideally begins when you’re admitted to hospital and continues after you leave.
You can reduce your risk of having a heart attack by adopting a healthy lifestyle. This includes:
Even if you have previously had a heart attack, these measures can still reduce your chances of having another one.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
A health assessment that identifies the main risk factors for heart disease, with advice on how to look after your heart and manage your risk. Find out more about Bupa Coronary Health.
See a Private GP in confidence to discuss any concerns you may have about your health or your family's health or call 0845 600 3458 quoting ref. HFS GP.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: May 2011