We’ve made huge progress in diagnosing and treating heart attacks. In the 1960s, more than 7 out of 10 heart attacks in the UK were fatal. We’ve reversed that trend, and now, at least 7 out of 10 people survive.
A heart attack happens when there’s a sudden loss of blood flow to a part of the heart muscle. Most heart attacks are caused by coronary heart disease.
The first coronary care units
BHF Professor Dr Desmond Julian at the Edinburgh Royal Infirmary pioneered the idea of coronary care units - hospital wards for specialised care of heart patients. The first coronary care unit opened in 1964. A year later in this unit, death rates following heart attacks in hospital almost halved.
Getting to the heart of the problem
Before the mid 1970s, nobody fully understood the cause of heart attacks. Treatment was bedrest, and pain relief - most patients found their health deteriorating quickly after a heart attack.
BHF Professor Michael Davies at St George’s Hospital Medical School was one of the first scientists to clearly show that blood clots in the coronary arteries cause heart attacks. This revolutionary breakthrough paved the way for scientists around the world to investigate how blood clots form, and to develop life-saving drugs to combat them.
It wasn’t enough to know what caused heart attacks – we also needed to find out how to treat them. BHF Professor Rory Collins led a team of researchers in Oxford in the late 1980s, who tested the effect of two medicines in thousands of heart attack patients. They suspected giving patients streptokinase - a clot-busting medicine - alongside aspirin, as soon as possible following a heart attack, would save more lives than either treatment given alone.
They were right, and heart attack deaths fell by around 40%. The clinical trial, called ISIS2, also found the earlier this combination of medicines was given after a heart attack, the better the outcome for the patient.
This treatment is still in use today, and gives thousands of people every year a better chance of surviving a heart attack. But it was all down to pioneering work by our scientists.
Improving diagnosis for women
During a heart attack, blood flow to the heart muscle becomes restricted or blocked completely. This damages the heart by starving it of oxygen, leading to the release of a protein into the blood called troponin.
With a simple blood test, troponin is measured as soon as the person arrives at A&E with a suspected heart attack, and again three hours later. Measuring troponin levels is one of the most commonly used tests in diagnosing heart attacks and has been used by medical professionals for many years.
Professor Nicholas Mills, a BHF Senior Research Fellow at the University of Edinburgh, led a study in 2015 using a higher sensitivity troponin test that’s able to detect lower amounts of this protein in the blood of heart attack patients. Using this improved test, his team found they could lower the threshold of troponin levels used to help diagnose a heart attack in women. This means that using the new test, 1 in 5 women are diagnosed as having a heart attack compared with the standard test, where just 1 in 10 women are diagnosed.
More work to do
Over the last 50 years, we’ve made incredible progress in diagnosing and treating heart attacks. But there’s still a great deal of work to be done. Despite enormous advances, 3 in 10 people in the UK don’t survive a heart attack. We’re working hard to change this, but need your support to continue our life-saving research.
Read more about our ongoing work