Conditions A-Z - Heart Attack (Myocardial Infarction)

Heart attack statistics:

It is a myth that heart disease is a man's disease. In fact, one in 8 women aged 45 to 64 has heart disease. One in four women over the age of 65 has heart disease. Currently, 7.2 million women have heart disease, states the American Heart Association (AHA). Consider the following facts about cardiovascular disease in women:

  • Coronary heart disease is the single largest cause of death for females in the United States.
  • Almost 16 percent of girls ages six to 19 are overweight, which is a risk factor for heart disease. About 25 percent of girls in grades nine through 12 report using tobacco, which is a risk factor for heart disease.
  • At menopause, a woman's heart disease risk starts to increase significantly. Each year, about 88,000 women ages 45 to 64 have a heart attack. Beginning at age 45, more women than men have elevated cholesterol.
  • Each year, about 372,000 women age 65 and older have a heart attack. About 21 million women age 60 and older have high blood pressure. The average age for women to have a first heart attack is about 70, and women are more likely than men to die within a few weeks of a heart attack.
  • About 35 percent of women who have had a heart attack will have another within six years.
Picture of female heart attack victim, clenching her chest

What is a heart attack (myocardial infarction or MI)?

A heart attack, or myocardial infarction, occurs when one or more regions of the heart muscle experience a severe or prolonged decrease in oxygen supply caused by blocked blood flow to the heart muscle.

The blockage is often a result of atherosclerosis - a buildup of plaque, known as cholesterol, other fatty substances, and a blood clot. Plaque ruptures and eventually a blood clot forms. The cause of a heart attack is a blood clot that forms within the plaque-obstructed area.

If the blood and oxygen supply is cut off severely or for a long period of time, muscle cells of the heart suffer severe and devastating damage and die. The result is damage or death to the area of the heart that became affected by reduced blood supply.

What are the risk factors for heart attack?

There are two types of risk factors for heart attack, including the following:

Inherited (or genetic):

Acquired:

Inherited or genetic risk factors are risk factors you are born with that cannot be changed, but can be improved with medical management and lifestyle changes. Acquired risk factors are caused by activities that we choose to include in our lives that can be managed through lifestyle changes and clinical care.

Who is most at risk - inherited (genetic) factors?

  • women with inherited hypertension - high blood pressure
  • women with inherited low levels of HDL (high-density lipoproteins), high levels of LDL (low-density lipoprotein) blood cholesterol or high levels of triglycerides
  • women with a family history of heart disease (especially with onset before age 55)
  • aging women
  • women with type 1 diabetes
  • women, after the onset of menopause - generally, men are at risk at an earlier age than women, but after the onset of menopause, women are equally at risk.

Who is most at risk - acquired risk factors?

  • women with acquired hypertension - high blood pressure
  • women with acquired low levels of HDL (high-density lipoproteins), high levels of LDL (low-density lipoprotein) blood cholesterol or high levels of triglycerides
  • cigarette smokers
  • women who are under a lot of stress
  • women who drink more than two alcoholic beverages per day
  • women who lead a sedentary lifestyle
  • women overweight by 30 percent or more
  • women who eat a diet high in saturated fat
  • women with Type II diabetes

A heart attack can happen to anyone - it is only when we take the time to learn which of the risk factors apply to us specifically, that we then can take take steps to eliminate or reduce them.

Managing heart attack risk factors:

Managing your risks for a heart attack begins with:

  • examining which of the risk factors apply to you, and then taking steps to eliminate or reduce them.
  • becoming aware of conditions like hypertension or abnormal cholesterol levels, which may be "silent killers."
  • modifying risk factors that are acquired (not inherited) through lifestyle changes. Consult your physician as the first step in starting right away to make these changes.
  • consulting your physician soon to determine if you have risk factors that are genetic or inherited and cannot be changed, but can be managed medically and through lifestyle changes.

What are the warning signs of a heart attack?

The following are the most common symptoms of a heart attack. However, each individual may experience symptoms differently. Symptoms may include:

  • severe pressure, fullness, squeezing, pain and/or discomfort in the center of the chest that lasts for more than a few minutes
  • pain or discomfort that spreads to the shoulders, neck, arms, or jaw
  • chest pain that increases in intensity
  • chest pain that is not relieved by rest or by taking nitroglycerin
  • chest pain that occurs with any/all of the following (additional) symptoms:
    • sweating, cool, clammy skin, and/or paleness
    • shortness of breath
    • nausea or vomiting
    • dizziness or fainting
    • unexplained weakness or fatigue
    • rapid or irregular pulse

Although chest pain is the key warning sign of a heart attack, it may be confused with indigestion, pleurisy, pneumonia, or other disorders.

The symptoms of a heart attack may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

Responding to heart attack warning signs:

If you or someone you know exhibits any of the above warning signs, act immediately. Call 911, or your local emergency number.

Treatment for a heart attack:

The goal of treatment for a heart attack is to relieve pain, preserve the heart muscle function, and prevent death.

Treatment in the emergency department may include:

Picture of an emergency room sign at the hospital
  • intravenous therapy - nitroglycerin, morphine
  • continuous monitoring of the heart and vital signs
  • oxygen therapy - to improve oxygenation to the damaged heart muscle
  • pain medication - by decreasing pain, the workload of the heart decreases; thus, the oxygen demand of the heart decreases
  • cardiac medication - such as beta-blockers or calcium channel blockers to promote blood flow to the heart, improve the blood supply, prevent arrhythmias, and decrease heart rate and blood pressure
  • fibrinolytic therapy - intravenous infusion of a medication which dissolves the blood clot, thus, restoring blood flow
  • antithrombin/antiplatelet therapy - used to prevent further blood clotting
  • antihyperlipidemics - medications used to lower lipids (fats) in the blood, particularly Low Density Lipid (LDL) cholesterol. Statins are a group of antihyperlipidemic medications, and include simvastatin (Zocor®), atorvastatin (Lipitor®), and pravastatin (Pravachol®), among others. Bile acid sequestrants - colesevelam, cholestyramine and colestipol - and nicotinic acid (niacin) are two other types of medications that may be used to reduce cholesterol levels.

Once the condition has been diagnosed and the patient stabilized, additional procedures to restore coronary blood flow may be utilized. Those procedures include:

  • coronary angioplasty - with this procedure, a balloon is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is performed in other blood vessels, Percutaneous Transluminal Coronary Angioplasty (PTCA) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. There are several types of PTCA procedures, including:

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