Heart Attack

What is a heart attack?

Most heart attacks occur as a result of coronary heart disease.  Coronary heart disease occurs when the coronary arteries (the arteries that supply blood and oxygen to the heart muscle) become narrowed by a gradual build-up of fatty materials within their walls.  This fatty material is called atheroma.  

If the atheroma becomes unstable, it may break off and leas to a blood clot forming.  If the blood clot blocks the coronary artery, the heart muscle is starved of blood and oxygen, and may become permanently damaged.  This is called a heart attack.  A heart attack is sometimes called acute coronary syndrome, myocardial infarction or coronary thrombosis. 

During a heart attack, life-threatening heart rhythms may develop.  This is why a heart attack is a medical emergency.  If you ever think you are having a heart attack, call 999 immediately.

What are the symptoms?

The symptoms of a heart attack vary from one person to another.  They can range from a severe pain in the centre of the chest, to having mild chest discomfort that makes you feel generally unwell.

If you experience any of these symptoms, don't ignore them.  Call 999.

The common or classic symptoms of a heart attack include:

• central chest pain 
• the pain can spread to the arms, neck or jaw
• some people can feel feel sick or sweaty as well as having central chest pain
• some people can feel short of breath as well as having central chest pain

The less common symptoms of a heart attack include:

• a dull pain, ache or 'heavy' feeling in the chest
• a mild discomfort in the chest that makes you feel generally unwell
• the pain in the chest can spread to the back or stomach
• some people say that the chest pain feels like a bad episode of indigestion
• some people can feel a bit light-headed or dizzy as well as having chest pain

If you think you are having a heart attack call 999 immediately. It could save your life.

How is a heart attack diagnosed?

The ambulance staff will assess your condition, will start any treatment necessary and get you to hospital.  When you get to the hospital you will have a rapid assessment by the doctors and nurses. This involves the following:

• an assessment of your symptoms and medical history
• a physical examination including monitoring your heart rate and blood pressure
• an electrocardiogram (ECG) to help diagnose your condition
• blood tests to help check for any damage to the heart muscle

During the time that you are in hospital, other tests may be carried out to assess your heart and help to decide the best form of ongoing treatment. For more information about the different tests please see our tests section.

How are heart attacks treated?

You will have treatment to help relieve any pain or discomfort that you may have. This may include painkillers, oxygen and aspirin. You will also be given a combination of medication, which you will be advised to continue taking after you go home.

Other treatment you are likely to have depends on the results of your tests and overall assessment of your condition. The most common types of treatment that are given to people with a heart attack are:

• Thrombolysis: a treatment that helps dissolve the clot that is blocking the artery and helps to restore the blood supply to the heart. It involves injecting a drug in to the blood stream. Thrombolysis is sometimes called a clot buster.
• Coronary angioplasty: a treatment to widen the artery.

Some people may also be advised that they need a heart bypass operation. 

For more information on all the above treatments, please see our treatments section and our heart attack booklet.

Recovery after a heart attack

A heart attack can be a frightening experience and it is natural to worry about your recovery.  Many people make a full recovery and within a few months are able to return to their normal activities. However, some people may find that they may not be able to do as much as they did before. Going to a cardiac rehabilitation course will increase the chances of you getting back to normal as quickly as possible. For more information see our recovery section and our booklets heart attack and cardiac rehabilitation.

Can a heart attack be prevented?

Coronary heart disease and heart attacks can often be prevented. Even if you have had a heart attack there are several things you can do to reduce the risk of heart problems in the future.

These include:

• stopping smoking
• controlling high blood pressure
• reducing blood cholesterol levels
• keeping physically active
• achieving and maintaining a healthy weight
• if you have diabetes, controlling your blood glucose as much as possible

Please see our keeping your heart healthy section for more information.

Further information

Heart attack booklet
Looking forward: Life after a heart attack DVD
Cardiac rehabilitation booklet
Rehabilitation CD/cassette

Please also see our Doubt Kills website for information on the Doubt Kills campaign. The campaign aims to raise awareness of heart attack symptoms, and to encourage people to call 999 when they experience them.

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