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

The blockage is often a result of atherosclerosis - a buildup of plaque, known as cholesterol, and other fatty substances. Plaque inhibits and obstructs the flow of blood and oxygen to the heart, thus reducing the flow to the rest of the body. 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.

Inherited (or genetic):

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:

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.

The following are the most common syptoms 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 shoulder, neck, arm, or jaw
• chest pain that increases in intensity
• chest pain that is not relieved by rest or by taking cardiac prescription medication
• 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.

how is heart attack treated?

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:

• 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, prevent blood clotting, improve the blood supply, prevent arrhythmias, and decrease heart rate and blood pressure
• fibrinolytic therapy - intravenous infusion of a medication which dissolves the blockage, thus, restoring blood flow
• antithrombin/antiplatelet therapy - used to prevent further blood clotting

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 catheter 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:
• balloon angioplasty - a small balloon is inflated inside the blocked artery to open the blocked area.
• atherectomy - the blocked area inside the artery is cut away by a tiny device on the end of a catheter.
• laser angioplasty - a laser used to "vaporize" the blockage in the artery.
• coronary artery stent - a tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.
• coronary artery bypass - most commonly referred to as simply "bypass surgery," this surgery is often performed in people who have angina (chest pain) and coronary artery disease (where plaque has built up in the arteries.)