Every minute that passes during a heart attack, irreplaceable heart cells die. Quick recognition and immediate response saves lives and preserves the heart. The ClinicsJo Editorial Team reviews what everyone should know.
What Is a Heart Attack?
A heart attack (myocardial infarction) occurs when a coronary artery supplying the heart muscle becomes blocked, killing part of the muscle from oxygen deprivation. The cause is usually a blood clot forming over a ruptured cholesterol plaque in the artery.
Angina vs Heart Attack
- Angina: temporary chest pain from oxygen shortage during effort, relieved by rest or nitroglycerin. No tissue dies.
- Heart attack: severe and persistent pain that doesn't resolve, heart cells die. A true emergency.
Classic Signs
- Chest pain or pressure: "like an elephant sitting on my chest." May radiate to the left arm, neck, jaw, back, or abdomen.
- Shortness of breath.
- Cold sweat.
- Nausea and vomiting.
- Dizziness.
- Severe anxiety ("sense of impending doom").
- Palpitations.
- Sudden severe fatigue.
Atypical Symptoms (Common in Women, Elderly, Diabetics)
- Shortness of breath without chest pain.
- Jaw or back pain only.
- Nausea only (resembling indigestion).
- Unexplained fatigue.
- Dizziness and fainting.
- Right arm pain.
- Sudden insomnia.
- GI upset.
Medical warning: 40% of women's heart attacks lack classic chest pain. Don't ignore sudden shortness of breath or severe fatigue, especially after age 50.
First Aid
- Call emergency services immediately. Don't drive yourself — the ambulance starts resuscitation en route.
- Sit or lie down with head elevated.
- Chew 300 mg aspirin (if no allergy). This reduces the clot.
- If you have prescribed nitroglycerin: place a pill under the tongue.
- Loosen tight clothing.
- Stay as calm as possible.
- If the heart stops: begin CPR immediately.
CPR
- Check consciousness and breathing.
- Call emergency services.
- Start chest compressions:
- Center of chest between the nipples.
- Push hard (5 cm deep).
- Rate 100–120/min (rhythm of "Stayin' Alive").
- Don't stop until the ambulance arrives.
- If trained: 30 compressions, then 2 breaths.
Risk Factors
Modifiable
- Smoking.
- High blood pressure.
- High cholesterol.
- Diabetes.
- Obesity.
- Physical inactivity.
- Stress.
- Poor diet.
- Alcohol.
Non-Modifiable
- Age (men >45, women >55).
- Sex.
- Family history.
Diagnosis
- ECG immediately.
- Cardiac enzymes (troponin) — reveal cell death.
- Echo.
- Diagnostic catheterization.
Treatment
In the ER
- Oxygen.
- Aspirin.
- Clopidogrel.
- Heparin.
- Morphine analgesia.
- Nitroglycerin.
- Beta-blockers.
Opening the Artery
- Catheterization + stent (PCI): the gold standard — should be done within 90–120 minutes of hospital arrival ("door to balloon").
- Thrombolytic drugs: if catheterization isn't possible.
- Bypass surgery (CABG): in multi-vessel disease.
After the Attack
- Aspirin + clopidogrel for at least 12 months.
- Statin.
- Beta-blocker.
- ACE inhibitor.
- Cardiac rehabilitation.
Prevention
- Quit smoking immediately (benefit at one year is as if you never smoked).
- Control blood pressure, sugar, cholesterol.
- Mediterranean diet.
- 150 minutes of exercise weekly.
- Healthy weight.
- Reduce stress.
- 7–8 hours of sleep.
- Daily aspirin 75–100 mg (only for selected candidates, under supervision).
- Regular screening after age 40.
Planning Life After a Heart Attack
- 12-week cardiac rehabilitation program.
- Comprehensive lifestyle change.
- Lifelong medication adherence.
- Routine follow-up with a cardiologist.
- Psychological support (depression is common after MI).
- Avoid heavy exertion for weeks.
- Return to work after 2–6 weeks depending on job type.
If you suspect a heart attack — yours or someone close — call emergency services immediately. For follow-up after a heart attack, book with a cardiologist on ClinicsJo.
