(Acute Myocardial Infarction [AMI]; Myocardial Infarction [MI];
ST-Segment-Elevation MI [STEMI]; Transmural Myocardial infarction)
A heart attack occurs when blood flow to the heart muscle is
interrupted. Oxygen cannot get to the heart muscle, causing tissue
damage or tissue death.
Copyright © Nucleus Medical Media, Inc.
A heart attack may be caused by:
Thickening of the walls of the arteries
feeding the heart muscle (coronary
Accumulation of fatty plaques in the
Narrowing of the coronary arteries
Spasm of the coronary arteries
Development of a blood clot in the
Embolism that affects the coronary
These factors increase your chance of developing heart
attack. Tell your doctor if you have any of these:
High blood pressure
High blood cholesterol (specifically,
high LDL cholesterol, and low HDL
High blood triglycerides
Family members with heart disease
Squeezing, heavy chest pain, especially
Exercise or exertion
A large meal
Pain in the left shoulder, left arm, or
Shortness of breath
Sweating, clammy skin
Loss of consciousness
Anxiety, especially feeling a sense of
doom or panic without apparent reason
Unusual symptoms of heart attack (may occur more
frequently in women):
Back and shoulder pain
If you think you are having a heart attack, call 911
Tests may include:
Blood tests—to look for certain enzymes found in the
blood within hours or days after a heart attack
Urine tests—to look for certain substances found in the
urine within hours or days after a heart attack
Electrocardiogram (EKG) —records the heart's activity by
measuring electrical currents through the heart muscle,
changes can show if there is blockage or damage
Echocardiogram —uses high-frequency sound waves
(ultrasound) to examine the size, shape, function, and
motion of the heart
Stress test —records the heart's electrical activity
under increased physical stress, usually done days or
weeks after the heart attack
Nuclear scanning—uses radioactive material to show areas
of the heart muscle where there is diminished blood flow
Electron-beam computed tomography (EBCT) —a type of
x-ray that uses a computer to make detailed pictures of
the heart, coronary arteries, and surrounding structures
Coronary angiography —uses dye and x-rays to look for
narrowing or blockage in the coronary arteries
Within the first six hours after
a heart attack, you may be given
medicines to break up blood
clots in the coronary arteries.
Other medicines that may be
given include those that block
the function of platelets.
Aspirin and other antiplatelet agents
Beta-blockers and/or ACE inhibitor medicines
Cholesterol-lowering medicines (eg, statin drugs)
If you have severe blockages,
you may need surgery, such as:
Physical or Rehabilitative Therapy
During recovery, you may need
physical or rehabilitative
therapy to help you regain your
Treatment for Depression
You may feel depressed after
having a heart attack. Therapy
and medicine can help relieve
If you have a heart attack, follow your
doctor's instructions .
Preventing or treating coronary artery disease may help prevent
a heart attack.
Maintain a healthy weight .
Begin a safe exercise program . Follow your
If you smoke, quit .
Eat a healthy diet . Your diet should be low in
saturated fat and rich in whole grains , fruits,
and vegetables .
Properly treat long-term conditions, like high
blood pressure , diabetes, and high cholesterol
Manage stress .
Ask your doctor about taking a small, daily dose
Although most people are able to
tolerate such a low dose of
aspirin, even this small amount
can rarely lead to serious
bleeding, particularly from the
gastrointestinal (GI) tract .
Aspirin may not work as well
when combined with other pain
American Heart Association http://www.americanheart.org/
Heart and Stroke Foundation http://www.heartandstroke.com/
College of Family Physicians Canada http://www.cfpc.ca/Home/
Heart and Stroke Foundation http://ww2.heartandstroke.ca/
About heart attacks. American Heart Association website. Available at:
. Accessed August 7, 2012.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website.
Available at: http://www.ebscohost.com/dynamed/ . Updated June 7, 2012.
Accessed August 7, 2012.
What is a heart attack? National Heart Lung and Blood Institute website.
Updated march 1, 2011. Accessed August 7, 2011.
7/6/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php : Antithrombotic Trialists'
(ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the
primary and secondary prevention of vascular disease: collaborative
meta-analysis of individual participant data
from randomized trials. Lancet. 2009;373:1849-1860.
Reviewer: Michael J. Fucci, DO
Review Date: 09/2012
Update Date: 00/91/2012