Heart Attack: When the Flow of Oxygen-Rich Blood Gets Blocked

By Sarah Samaan, Rosanne Rust, Cynthia Kleckner

Although it would seem logical, a heart attack isn’t usually the consequence of slow and steady cholesterol buildup. It’s often caused by inflammation, which causes the cholesterol plaque to become unstable. Your body, detecting an injury, tries to form a clot at the affected site. This process of clotting and sudden blockage of the artery is what leads to a heart attack.

This process explains why someone can have a normal stress test or EKG and then a few weeks later show up in the ER with a heart attack. The test didn’t necessarily miss the problem, although that sometimes happens. Instead, the problem may not have been as severe at the time of the checkup.

Because inflammation of already-diseased arteries is a key trigger of heart attacks, the key to reducing the risk of heart attack is twofold: prevent plaque from forming in the first place and do everything possible to reduce inflammation of the heart arteries.

That’s where you can make a huge difference. In fact, up to 70 percent of heart disease is directly related to your lifestyle choices, including diet, exercise, weight, and smoking. Stress and sleep quality are also important contributors.

Distinguishing between chest pain and a heart attack

Chest pain, or angina, occurs with exertion or stress and generally resolves within a few minutes after stopping the activity. These symptoms usually last a few minutes and may include unexpected shortness of breath and discomfort in the chest, back, arms, neck, or jaw.

Angina usually indicates a narrowed artery. Although it can be a chronic, stable problem, if the symptoms are new, angina may be an early warning sign of a heart attack, requiring prompt medical attention. Angina is often treated by opening up a blocked blood vessel, but sometimes medical treatment is all that’s required.

Pain or discomfort from a heart attack is similar to angina pain, but it doesn’t go away with rest. That’s because it’s due to a complete, or nearly complete, blockage of a heart artery, such that little or no blood can get through. In most cases, the discomfort gets progressively worse and may be accompanied by nausea or sweating. These symptoms require urgent medical attention.

Recognizing heart attack symptoms

The symptoms of a heart attack can vary widely, but the following symptoms are typical and usually occur together:

  • Left-sided chest pain, sometimes radiating to the left arm

  • Shortness of breath

  • Breaking out in a cold sweat

  • Nausea

Men are more likely than women to experience these typical symptoms, but nontypical symptoms are by no means limited to women. The following nontypical symptoms may happen in combination or you may have just one or two symptoms:

  • Right-sided chest pain

  • Back pain

  • Arm pain alone

  • Jaw or neck pain

  • Severe unexplained fatigue

Although many people experience brief, or less severe, symptoms with exertion in the weeks or months leading up to a heart attack, some people have no warning symptoms at all.

Knowing what to do if you think you’re having a heart attack

When a heart attack strikes, remember “time is muscle.” What that means is that the longer you wait, the greater the amount of heart muscle that’s likely to be permanently damaged. If you can get to help within a few hours (and ideally much less time than that), your cardiologist is more likely to be able to restore the life-sustaining blood flow to your heart.

Women are notoriously slow to get to the ER compared to men, and this is one reason why women’s heart attacks tend to be more devastating.

If you think you or someone else is experiencing a heart attack:

  • Call 911.

  • Don’t attempt to drive yourself to the hospital, because a heart attack can cause sudden collapse.

  • Unless you’re allergic to it or unable to swallow, take a full-strength aspirin. If you can chew it, all the better, because it will get into your bloodstream sooner and help to limit any potential blood clot.

  • If the individual collapses, start CPR until emergency responders arrive.

Don’t know CPR? Stop everything right now and sign up for a class! It’s easy, and you could save a life. (Don’t be squeamish! Mouth-to-mouth resuscitation is no longer part of basic CPR.)