Heart attack (myocardial infarction)

A heart attack is one of the most known cardiovascular conditions and is associated with a high mortality rate. This means it’s a time-critical medical emergency that requires immediate medical attention.  

 Our expert cardiologists specialise in the diagnosis and urgent treatment of heart attacks. They also offer comprehensive cardiovascular assessments (risk stratification), helping to prevent future heart attacks and strokes.

What is a heart attack?

Myocardial infarction, or a heart attack, is a medical emergency where a clot blocks the blood supply to your heart. The lack of blood supply can severely damage the heart and can be life-threatening.

Always call 999 if you suspect you’re having a heart attack. 

Who is at risk of a heart attack?

You’re more at risk of a heart attack if you have coronary heart disease (the usual cause of heart attacks). 

Risk factors for developing coronary heart disease include: 

• age 
• being overweight 
• depression and mental health disorders 
• diabetes 
• family history of cardiovascular disease (heart attacks and stroke)  
• high blood pressure (hypertension) 
• high cholesterol 
• inflammatory and autoimmune disease  
• menopause 
• smoking or being an ex-smoker

You may also have a higher risk of myocardial infarction with a family history of the condition.

Types of heart attack 

Many kinds of heart attacks exist, and doctors will determine which type you had when you arrive at the hospital.  

Heart attacks are a type of acute coronary syndrome (ACS), which describes a significant blockage in your coronary arteries. 

The 4 types of ACS are:

• non-ST segment elevation myocardial infarction (NSTEMI) – some loss of blood supply to the heart causes damage 
• reduction in blood supply to the heart increases the risk of heart failure and arrhythmia that can be life threatening
• ST segment elevation myocardial infarction (STEMI) – a prolonged interruption to your heart’s blood supply 
• unstable angina – you have chest pain symptoms but no damage to your heart. However, potential restrictions to the blood supply to your heart may put you at risk of a heart attack in the future

Heart attack symptoms 

The symptoms of a heart attack can vary from person to person, so it’s essential to know how they could feel. 

Possible symptoms of a heart attack include: 

• chest aches  
• chest pain or pressure (a feeling of heaviness, tightness or squeezing in your chest) 
• coughing, wheezing and burping 
• dizziness  
• nausea and vomiting 
• pain that spreads from your chest to your arms, jaw, back, neck or stomach 
• severe feelings of anxiety (like a panic attack) 
• shortness of breath  
• sweating

Some heart attack symptoms, like chest pain, can be relatively mild and feel similar to other conditions, such as indigestion. However, if you’re ever concerned about your heart health, you must seek medical attention as soon as possible.

What causes a heart attack?

A heart attack occurs when the heart’s blood supply is significantly reduced. But there are many reasons why this interruption to your blood supply can occur. 

Coronary heart disease is the leading cause of heart attacks. In this cardiovascular condition, fat deposits like cholesterol as well as other debris block your coronary arteries (the blood vessels supplying blood to the heart). 

If one of the deposits (plaques) bursts or breaks away, it can cause a blood clot to form, which could block the blood supply to your heart and lead to a heart attack. 

Other causes of a heart attack may include:

• a blood clot elsewhere in the body that ends up in your coronary arteries 
• eating disorders (these can damage your heart over time) 
• lack of oxygen (hypoxia) 
• spasm of the coronary arteries 
• trauma or injury that damages your coronary arteries 
• type 2 Mi (heart attack caused by other acute illnesses, like chest infections)

Complications of a heart attack 

Complications of a heart attack can range from mild to life-threatening. Some people have a heart attack and no associated complications. It’s called an uncomplicated heart attack. However, other people can develop life-threatening complications or death.  

Some of the other complications associated with a heart attack include: 

• arrhythmia (irregular heartbeat and rhythm) 
• cardiogenic shock (similar to heart failure, but your heart has been severely damaged and cannot pump blood to maintain your bodily functions) 
• heart failure (your heart struggles to pump blood effectively) 
• heart rupture (a rare complication where the heart muscles, walls or valves burst) 
• leaky valves (the muscles that hold valve rupture or weaken)  

Diagnosing a heart attack

Cardiologists usually diagnose a heart attack while you’re having it or just after. If you suspect you’re having a heart attack, doctors will perform immediate diagnostic tests to confirm.  

An electrocardiogram (ECG) is typically done when you’re admitted to the hospital. An ECG measures your heart’s electrical activity. This painless test only takes a few minutes to complete.  

Your cardiologist may perform blood tests as a heart attack can cause specific proteins (cardiac troponin) to be present in your blood. They can use the cardiac troponin level in your blood to diagnose the type of heart attack you’ve had.

Heart attack treatment 

Heart attack treatment depends on the severity of your myocardial infarction, but you will always need immediate medical care.  

Supplementary oxygen may be the first line of treatment. It helps increase the oxygen circulating in your blood and reduce the strain on your heart.  

Cardiologists may also initially prescribe medications like blood thinners. Other medications may be needed for management of the effects of a heart attack including drugs to control rhythm and improve heart function.

Your doctor might give you pain relief medication during your heart attack to alleviate any discomfort. They can also prescribe beta-blockers, as these can slow your heart rate and support your recovery from the damage of a heart attack. Statins can also help to stabilise the plaque build-up in your coronary arteries and reduce the likelihood of another heart attack.  

Sometimes, treatment can involve a coronary angioplasty. This minimally invasive procedure improves blood flow to your heart using a catheter (thin tube) with a balloon on one end to gently stretch narrowed arteries. Often, a stent is deployed to open the coronary artery.   

We offer Shockwave IVL laser therapy, a revolutionary procedure for treating calcification in your coronary arteries. We gently insert a catheter into your narrowed coronary arteries and deliver an energy shockwave or laser to break down the build-up of plaque. We may also inflate a special balloon to dilate (stretch) your coronary artery as in a typical coronary angioplasty.  

Coronary artery bypass grafting is a treatment that helps to divert blood flow through narrowed arteries, particularly if stents cannot be used or long terms surgery benefits outweigh stents.  This treatment reduces your risk of a heart attack and supports healthy circulation.  

We also provide cardiac rehabilitation. This personalised programme includes exercises, advice and support to help you care for your heart after cardiac procedures like coronary angioplasty or a pacemaker fitting.

Our specialists will provide advice on preventing heart disease and adapting healthier life style. Studies show prevention by far reduces the incidence of cardiovascular events including heart attacks.

Heart attacks in women

Heart disease is the leading cause of death of women in the UK, yet symptoms often go unrecognised leading to delays in seeking treatment. While both men and women experience chest pain or pressure during a heart attack, women are more likely to have symptoms such as nausea, pain in the neck, jaw, throat, abdomen or back.

They may also experience sweating and vomiting. Women often report atypical symptoms of what is perceived to be heart attack and hence are misdiagnosed or present late. Women also often have a different risk factor profile to men. 

Spontaneous coronary artery dissection (SCAD) is a rare and potentially life-threatening condition that presents as a heart attack primarily affecting young and healthy women with no obvious cardiovascular risk factors. It occurs when a tear forms in the wall of a coronary artery, allowing blood to leak between the layers of the artery wall.

This can create a compression of the true vessel lumen where blood flows and restricts blood flow to the heart, potentially leading to a heart attack or cardiac arrest. SCAD often occurs suddenly and without warning. Around 80% of cases involve women, most commonly those in their 40s and 50s. Although rare, men can still experience SCAD.  

Women have several different risk factors due to hormonal and physical changes. Menopause can increase the risk of heart disease, as the ovaries produces less oestrogen. Oestrogen is a hormone that protects the heart by keeping blood vessels healthy and regulating cholesterol.  

Pregnancy is also a significant factor, due the extra strain on the heart, and can cause, expose or challenge an underlying condition. If you have an issue with your heart, it’s important to plan your care to ensure a healthy pregnancy and safe delivery for you and your baby.  

Ongoing chest pain or breathlessness should be discussed with a specialist, as it could be caused by a heart or lung problem.  

If you experience any of the symptoms below, you should seek help and ring 999 immediately, as this could be a sign of a heart attack: 

• pain that spreads to the arms, back, neck, jaw or tummy 
• shortness of breath 
• sudden chest pain or heaviness 
• sweating and feeling or being sick