Heart attack

Your heart is a muscular pump that needs a continuous supply of oxygen. It gets oxygen from your blood, which flows to the heart muscle through arteries on its surface. These arteries are called coronary arteries.

A heart attack happens when there is a sudden complete blockage of an artery that supplies blood to an area of your heart. As a result, some of your heart muscle begins to die. Without early medical treatment, this damage can be permanent.

A heart attack is sometimes referred to as a myocardial infarction (MI), acute myocardial infarction, coronary occlusion or coronary thrombosis.

What happens during a heart attack?

The underlying cause of a heart attack is coronary heart disease (CHD).

Some people may not know they have CHD until they have a heart attack. For others, a heart attack can happen after weeks, months or years of treatment for CHD.

CHD is the slow build-up of fatty deposits on the inner wall of the arteries that supply your heart muscle with blood. These fatty deposits, called plaque, gradually clog and narrow the inside channel of the arteries.

A heart attack usually begins when an area of plaque cracks.

Blood cells and other parts of your blood stick over the damaged area and form a clot that suddenly and completely blocks the blood flow to your heart muscle.

If your artery remains blocked, the lack of blood permanently damages the area of your heart muscle supplied by that artery.

Learn more about the warning signs of a heart attack and download an action plan from the Heart Foundation (external site).

Signs and symptoms

Heart attack warning signs vary. Know the warning signs of a heart attack and what to do if you or someone around you experience the warning signs.

With a heart attack, every minute counts.

Warning signs include:

• discomfort or pain in the centre of your chest
• discomfort in your arms, shoulders, neck or jaw
• shortness of breath
• nausea (feeling sick)
• a cold sweat
• feeling dizzy or light-headed.

If you have chest pain or other warning signs of a heart attack that are severe, get worse quickly, or last more than 10 minutes, get help fast by dialling triple zero (000) to call an ambulance now. If this number does not work on your mobile phone try 112.

Diagnosis of heart attack

If you are rushed to hospital with a suspected heart attack, your health care team will do a number of tests to find out if you are having a heart attack. These tests will help them to decide the best treatment for you:

• Electrocardiogram (ECG). During an ECG test, electrical leads are placed on your chest, arms and legs. These leads detect small electrical signals and produce a tracing on graph paper that illustrates the electrical impulses travelling through your heart muscle.
• Blood tests
• Chest X-ray
• Angiogram. This is a special X-ray that shows whether or not your coronary arteries are narrowed or blocked. Under a local anaesthetic, a small tube (catheter) is inserted into an artery in your arm or groin and guided into the heart. Dye is injected through the catheter into the coronary arteries and X-rays are taken. The X-rays give detailed information about the condition of these arteries.

Treatment for heart attack

Too many people lose their lives because they wait too long to get treatment for heart attack.

Calling triple zero (000) for an ambulance may reduce the damage to your heart and increase your chance of survival.

• Ambulance paramedics are trained to use special lifesaving equipment and to start early treatments for heart attack inside the ambulance.
• In hospital, you will receive treatments that help to reduce damage to your heart.

Thrombolysis

This heart attack treatment involves the use of special clot-dissolving medicines that are administered directly into your blood stream.

Angioplasty and stent implantation

Coronary angioplasty is a procedure that aims to restore blood flow to your heart by using a special balloon to open a blocked artery from the inside. After angioplasty is performed to open up a blocked coronary artery, a special expandable metal tube (stent) is usually put into the site, expanded, and left in place to keep your artery open.

Bypass surgery

Coronary artery bypass graft surgery (often shortened to CABG and pronounced cabbage) is an operation in which blood flow is redirected around a narrowed area in one or more of your coronary arteries, allowing blood to flow more freely to your heart muscle.

Defibrillators

There is a high risk of dangerous changes to your heartbeat after the start of a heart attack. The most serious changes stop your heart beating and cause a cardiac arrest. The best treatment for cardiac arrest involves using a defibrillator to give your heart a controlled electric shock that may make it start beating again.

Implantable cardiac defibrillators (ICDs)

After recovering from a heart attack, some people may develop, or be at high risk of developing, abnormal heart rhythms (arrhythmias) that could be life-threatening.

Sometimes a small device can be put into your chest and connected to your heart to treat an arrhythmia if it occurs.

This device is called an implantable cardiac defibrillator (ICD).

Visit the Heart Foundation (external site) for more information on treatments for heart attack.

Managing your condition

Modern treatments and healthy lifestyle choices can help your heart attack recovery, greatly reduce your risk of further heart problems, and relieve or control symptoms such as angina.

To reduce your risk and aid your recovery:

• take your medicines as prescribed by your doctor
• be smoke-free
• enjoy healthy eating
• be physically active
• control your blood pressure and cholesterol
• achieve and maintain a healthy body weight
• maintain your psychological and social health.

If you have diabetes, you should generally aim to keep your blood glucose levels within the normal non-diabetic range and follow individual advice from your doctor or accredited diabetes educator.

Remember that if you have already had a heart attack, you are at higher risk of having another in the future. Make sure you know the warning signs and talk to your doctor about an action plan to follow if you experience chest pain or other symptoms of heart attack.

Medicines

There are many medicines that treat heart attack, angina and other heart conditions. Your cardiologist, along with your doctor, will decide the best medicines for you to take at home to help you manage your heart condition.

Cardiac rehabilitation

The Heart Foundation (external site) and the World Health Organization recommend that people who have had a heart attack, heart surgery, coronary angioplasty, angina or other heart or blood vessel disease attend an appropriate cardiac rehabilitation and prevention program.

These programs help you to make practical, potentially life-saving changes to the way in which you live. They can help you and your family deal with physical, emotional, psychological, marital, sexual and work-related issues. The right rehabilitation program will help most people to reduce their risk of further heart problems.

Cardiac rehabilitation programs complement the advice that your GP and/or cardiologist gives you.

Remember

• A heart attack happens when there is a sudden complete blockage of an artery that supplies blood to an area of your heart.
• Without early medical treatment, this damage can be permanent.
• Ambulance paramedics are trained to use special lifesaving equipment and to start early treatments for heart attack inside the ambulance.
• In hospital, you will receive treatments that help to reduce damage to your heart.

This information provided by

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.