Heart Attack (Myocardial Infarction)

A heart attack (also known as a myocardial infarction or MI) happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can’t get oxygen. If blood flow isn’t restored quickly, the section of heart muscle begins to die.

Heart attack treatment works best when it’s given right after symptoms occur. If you think you or someone else is having a heart attack, even if you’re not sure, call 9–1–1 right away.

Heart attacks most often occur as a result of ischemic heart disease, also called coronary heart disease or coronary artery disease. Ischemic heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.

Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.

If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.

Why Choose Cooper To Diagnose and Treat Heart Attack

The Cooper Heart Institute is the most comprehensive heart care center in southern New Jersey, providing world-class cardiac care — in your neighborhood. Our physicians are experts in the treatment of heart disease and leaders in cardiology research. Utilizing the latest technology available to pinpoint and treat all types of heart problems, we produce superior outcomes for our patients.

  • Nationally and internationally renowned clinical and interventional cardiologists 
  • The most advanced minimally invasive techniques
  • Largest volume of cardiothoracic surgery in the region
  • Recognized by the Society of Thoracic Surgeons for superior surgical outcomes 
  • Women’s Heart program with the largest female cardiology group in South Jersey
  • State-of-the-art diagnostic capabilities
  • Individualized care designed to meet your needs

Warning Signs and Symptoms of Heart Attack

Many people aren't sure what's wrong when they are having symptoms of a heart attack. Some of the most common warning symptoms of a heart attack for both men and women are:

  • Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
  • Upper body discomfort. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).
  • Shortness of breath. This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity.

Other possible symptoms of a heart attack include:

  • Breaking out in a cold sweat
  • Feeling unusually tired for no reason, sometimes for days (especially if you are a woman)
  • Nausea (feeling sick to the stomach) and vomiting
  • Light-headedness or sudden dizziness
  • Any sudden, new symptom or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual)

The symptoms of angina can be similar to the symptoms of a heart attack. Angina is chest pain that occurs in people who have ischemic heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and goes away with rest.

Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack.

The more signs and symptoms you have, the more likely it is that you're having a heart attack.

The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one. 

Reducing Your Risk for a Heart Attack

Lowering your risk factors for ischemic heart disease can help you prevent a heart attack. Even if you already have heart disease, you still can take steps to lower your risk for a heart attack. These steps involve making heart-healthy lifestyle changes and getting ongoing medical care for related conditions that make a heart attack more likely. Talk to your doctor about whether you may benefit from aspirin primary prevention, or using aspirin to help prevent your first heart attack.

 Adopt a Heart-Healthy Lifestyle

A heart-healthy lifestyle can help prevent a heart attack and includes:

  • heart-healthy eating
  • being physically active
  • quitting smoking
  • managing stress
  • managing your weight

Treat Related Conditions

Treating conditions that make a heart attack more likely also can help lower your risk for a heart attack. These conditions may include:

  • Diabetes (high blood sugar). If you have diabetes, try to control your blood sugar level through diet and physical activity (as your doctor recommends). If needed, take medicine as prescribed.
  • High blood cholesterol. Your doctor may prescribe a statin medicine to lower your cholesterol if diet and exercise aren’t enough.
  • High blood pressure. Your doctor may prescribe medicine to keep your blood pressure under control.
  • Chronic kidney disease. Your doctor may prescribe medicines to control your high blood pressure or high blood sugar levels.
  • Peripheral artery disease. Your doctor may recommend surgery or procedures to unblock the affected arteries.

Have an Emergency Action Plan

Make sure that you have an emergency action plan in case you or someone in your family has a heart attack. This is very important if you’re at high risk for, or have already had, a heart attack.

Write down a list of medicines you are taking, medicines you are allergic to, your health care provider’s phone numbers (both during and after office hours), and contact information for a friend or relative. Keep the list in a handy place.

Talk with your doctor about the signs and symptoms of a heart attack, when you should call 9–1–1, and steps you can take while waiting for medical help to arrive.

Diagnosing and Treating a Heart Attack

Certain treatments usually are started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:

  • Aspirin to prevent further blood clotting
  • Nitroglycerin to reduce your heart’s workload and improve blood flow through the coronary arteries
  • Oxygen therapy
  • Treatment for chest pain

Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are clot-busting medicines and percutaneous coronary intervention, also known as coronary angioplasty, a procedure used to open blocked coronary arteries.

Thrombolytic medicines, also called clot busters, are used to dissolve blood clots that are blocking the coronary arteries. To work best, these medicines must be given within several hours of the start of heart attack symptoms. Ideally, the medicine should be given as soon as possible.

Percutaneous coronary intervention is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube (catheter) with a balloon or other device on the end is threaded through a blood vessel, usually in the groin (upper thigh), to the narrowed or blocked coronary artery. Once in place, the balloon located at the tip of the catheter is inflated to compress the plaque and related clot against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps to keep the blood vessel open to prevent blockages in the artery in the months or years after the procedure.

Coronary artery bypass grafting also may be used to treat a heart attack. During coronary artery bypass grafting, a surgeon removes a healthy artery or vein from your body. The artery or vein is then connected, or grafted, to bypass the blocked section of the coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart muscle.

Recovering From a Heart Attack

After the immediate treatment period, your doctor may prescribe one or more of the following medicines for you to take on an ongoing basis:

  • ACE inhibitors. ACE inhibitors lower blood pressure and reduce strain on your heart. They also help slow down further weakening of the heart muscle.
  • Anticlotting medicines. Anticlotting medicines stop platelets from clumping together and forming unwanted blood clots. Examples of anticlotting medicines include aspirin and clopidogrel.
  • Anticoagulants. Anticoagulants, or blood thinners, prevent blood clots from forming in your arteries. These medicines also keep existing clots from getting larger.
  • Beta blockers. Beta blockers decrease your heart’s workload. These medicines also are used to relieve chest pain and discomfort and to help prevent another heart attack. Beta blockers also are used to treat arrhythmias (irregular heartbeats).
  • Statin medicines. Statins control or lower your blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having another heart attack or stroke.

You also may be given medicines to relieve pain and anxiety, and treat arrhythmias. Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. 

Make Heart-Healthy Lifestyle Changes

Treatment for a heart attack usually includes making heart-healthy lifestyle changes. Taking these steps can lower your chances of having another heart attack. Your doctor may recommend:

  • Heart-healthy eating
  • Aiming for healthy weight
  • Managing stress
  • Physical activity
  • Quitting smoking

 Cardiac Rehabilitation

Your doctor may recommend cardiac rehabilitation (cardiac rehab) to help you recover from a heart attack and to help prevent another heart attack. Nearly everyone who has had a heart attack can benefit from rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.

The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.

Rehab has two parts:

  • Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and how to deal with your fears about the future.
  • Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.

Make an Appointment With a Cooper Cardiologist

To make an appointment with a Cooper Heart Institute physician or to schedule diagnostic testing, call 800.8.COOPER (800.826.6737).