| A heart attack occurs when a part of the heart muscle dies because the blood supply to one of the arteries supplying the heart is suddenly cut off by a blood clot. Rarely, this can also be caused by severe spasm of the blood vessel. |
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| The diagnosis of a heart attack is based on history of chest pain, changes on the electrocardiogram (ECG) and blood tests showing elevations in cardiac enzymes. |
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| The pain of a heart attack is classically located in the centre of the chest or slightly to the left. Often described as crushing, squeezing or burning, it may radiate to the left arm, throat or jaw. Sometimes it may be located in the upper abdomen, where the ribs join the breastbone. It may be accompanied by cold sweat, breathing difficulty, nausea, pounding of the heart, and even fainting. The pain usually lasts for more than 20 minutes and is not relieved by rest or nitroglycerin tablets. |
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| During a heart attack, sudden death may occur because of ventricular fibrillation (sudden cardiac death). This is most frequent within the first hour. Hence it is most important to call for an ambulance or get the patient to the hospital in the shortest possible time. If collapse occurs before arrival of the paramedics, bystander cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator can save the life of the patient. |
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| Survival is influenced by the amount of damaged heart muscle. The sooner that blood flow can be restored, the lesser the amount of damage and the higher the survival and the lower the complication rate. Blood flow can be restored by administration of clot busting medication or by emergency angioplasty. In angioplasty a balloon catheter is introduced into the artery, any blood clots are sucked out and a stent can be placed at the site of obstruction. |
