The term "heart attack" describes an acute condition in which a coronary artery is blocked by a blood clot, interrupting blood flow to the heart muscle. A heart attack usually develops as a result of coronary heart disease (CHD) or is exacerbated by comorbidities such as atherosclerosis and diabetes . Typical signs of a heart attack include severe chest pain, shortness of breath, nausea, and a feeling of tightness in the chest. Early detection of an acute heart attack and prompt initiation of appropriate treatment are crucial for the patient’s prognosis. For diagnosis, the cardiac catheterization is often used for diagnosis, while therapeutic procedures such as PCTA or a bypass surgery are performed.
The severity of a heart attack depends on the size of the blocked blood vessel. The larger the vessel, the more severe the consequences. A large heart attack can place such a heavy strain on the heart that circulation fails. This poses just as acute a threat to life as when the heart attack is accompanied by a cardiac arrhythmia (ventricular fibrillation). If a heart attack is suspected, emergency services must therefore be called immediately!
A heart attack refers to the death of heart muscle cells when the heart muscle tissue is no longer supplied with sufficient oxygen. The cause is usually an occlusion in which one of the coronary arteries is blocked.
The heart muscle relies on a continuous, adequate supply of oxygen. If this supply is interrupted, the cells die. A heart attack is the direct result.
The extent of the infarction depends on the size of the affected vessel and the duration of the oxygen deprivation. The longer this condition persists, the more severe the consequences of a heart attack.
In most cases, a heart attack is caused by atherosclerosis. This involves the buildup of plaque in the blood vessels, which gradually narrows them. These deposits consist of fats, connective tissue, and blood platelets, among other things. If such a plaque ruptures, a blood clot forms that can completely block the coronary artery. A heart attack is the result of this process.
The most common underlying condition is coronary heart disease (CHD). This heart disease leads to chronic narrowing of the coronary arteries. Many people affected already suffer from angina pectoris beforehand.
Other possible causes include thrombosis, embolisms, or vasospasms.
A key risk factor is an unhealthy lifestyle. Being overweight and having high cholesterol levels promote the formation of plaques. Hypertension (high blood pressure) further damages the vessel walls. Smoking and a lack of physical activity also contribute to the further narrowing of the blood vessels.
People with diabetes mellitus, in particular, have an increased risk of a heart attack. In Germany, approximately 300,000 people suffer a heart attack each year.
The symptoms of a heart attack can vary. Typical signs include severe chest pain that lasts longer than five minutes and often radiates to the left arm, jaw, or upper abdomen.
Other classic symptoms include:
However, these typical symptoms do not always occur. Heart attacks in women often present with atypical symptoms. These include pain in the upper abdomen, nausea, fatigue, and shortness of breath.
Only one-third of women report classic symptoms such as chest pain. Often, the symptoms are less distinct or develop gradually.
In people with diabetes mellitus, too, the symptoms of a heart attack are often less pronounced. Due to nerve damage, these patients perceive the initial symptoms only to a limited extent.
Being able to recognize a heart attack is crucial. If a heart attack is suspected, medical help should be sought immediately.
The most important diagnostic test for a heart attack is the ECG. Thanks to the electrocardiogram, both the location and the extent of the heart attack can be determined. During the examination, special electrodes are attached to the patient’s chest, allowing the doctor—usually a cardiologist—to monitor the heartbeat and the electrical activity in the heart muscle. This helps determine whether any arrhythmias are present.
The results also provide information on whether the heart attack is acute or occurred some time ago. Since heart attacks cannot always be detected immediately on an ECG, several tests are performed at intervals of a few hours if a myocardial infarction is suspected.
If no typical changes are visible on the ECG, an ultrasound examination can provide further information about the condition of the heart. In addition, a blood test is ordered. The dying heart muscle cells release enzymes that can also be detected in elevated concentrations in the blood after a slight delay.
A cardiac catheterization provides a very precise diagnosis. During this procedure, a flexible plastic tube is advanced through an artery in the leg to the heart. A contrast agent is injected through the catheter, making the heart and blood vessel structures visible on the X-ray monitor. This method not only allows a blocked vessel to be detected but also enables it to be reopened at the same time.
A heart attack is treated as a medical emergency. The goal is to quickly reopen the affected coronary artery to improve blood flow.
Prompt and appropriate treatment reduces the risk of complications and improves the prognosis.
The course of a heart attack depends heavily on how quickly treatment is administered. If blood flow is restored in time, damage to the heart muscle can be limited.
Among the most common complications are arrhythmias, which can be life-threatening, especially during the acute phase.
A previous heart attack can cause long-term limitations. The risk of another heart attack remains elevated.
Atherosclerosis, the most common cause of myocardial infarction, is best prevented by reducing risk factors. Quitting smoking, eating a healthy and balanced diet, and getting enough exercise keep the heart healthy. Overweight individuals should definitely consider losing weight. Patients with high blood pressure, elevated cholesterol levels, or diabetes mellitus are advised to ensure they receive optimal treatment and take their prescribed medications correctly.
Diagnosis and treatment are carried out by specialists in cardiology.
The current scientific basis includes, among other things, the Universal Definition of Myocardial Infarction, which establishes diagnostic criteria.
Symptoms of a heart attack often include severe chest pain, shortness of breath, nausea, and a feeling of tightness.
A heart attack is life-threatening because the heart muscle is no longer receiving enough oxygen, which can cause the tissue to die.
If you suspect a heart attack, call emergency services immediately, as every minute counts.
The risk of a heart attack is significantly higher among smokers, people with diabetes, high blood pressure, and high cholesterol levels.
To accurately diagnose a heart attack, an ECG and blood tests are usually performed, along with other examinations.
The consequences of a heart attack range from permanent limitations to serious complications affecting the heart and lungs, as well as heart rhythm disorders. If left untreated, a heart attack can be fatal.
