Heart Attack

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Heart Attack Overview
• Heart Attack Causes
• Heart Attack Risk Factors
• Heart Attack Symptoms and Signs
• When to Seek Medical Care
• Heart Attack Diagnosis
• Heart Attack Treatment
• Self-Care at Home
• Heart Attack Emergency Medical Treatment
• Heart Attack Follow-Up
• Heart Attack Prevention
• For More Information
• Synonyms and Keywords
• Authors and Editors
• Read more on Heart Attack from Healthwise
• Viewer Comments: Heart attack - Symptoms at Onset of Disease
• Viewer Comments: Heart Attack - Treatment

How Up-To-Date is Your Doc?

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Every year the rules change. The one constant about sports is that during the off season and sometimes during the year, the commissioner, the president, or the owners will sit down and tinker with the way the game is played. Doesn't matter which sport, it happens to all of them. The referees and players get updates and adapt their play to the new rules. Ever diligent, the fan follows along, learns, and adapts to the changes. How else can the referee or umpire be second-guessed, except by those who really care about the game?

But the rules change for the world outside sports as well, and never more frequently or dramatically than in medicine. Every aspect of medicine from diagnosis to treatment, medications to technology, is exposed to newer and potentially better ways of doing things.

Heart attack is a good example of what was - and what is. Twenty-five years ago the treatment for a myocardial infarction or heart attack was hospitalization for two or three weeks followed by a gentle exercise program that limited walking to a few feet per day. Now patients who had bypass surgery are up and walking out of the hospital in four or five days.

Read more about the how your doctor keeps informed »

Heart Attack Overview

If you believe that you are having the symptoms of a heart attack, please call 911 immediately and seek medical attention.

The heart is a muscle like any other in the body. Arteries supply it with oxygen-rich blood so that it can contract and push blood to the rest of the body. When there isn't enough oxygen flow to a muscle, its function begins to suffer. Block the oxygen supply completely, and the muscle starts to die.

• Heart muscle gets its blood supply from arteries that originate in the aorta just as it leaves the heart.
  
  
• The coronary arteries run along the surface of the heart and supply oxygen-rich blood to the heart muscle.
  
  
• The right coronary artery supplies the right ventricle of the heart and the inferior (lower) portion of the left ventricle.
  
  
• The left anterior descending coronary artery supplies the majority of the left ventricle, while the circumflex artery supplies the back of the left ventricle.
  
  
• The ventricles are the lower chambers of the heart; the right ventricle pumps blood to the lungs and left pumps it to the rest of the body.

Heart Attack Causes

Over time, plaque can build up along the course of an artery and narrow the channel through which blood flows. Plaque is made up of cholesterol buildup and eventually may calcify or harden, with calcium deposits. If the artery becomes too narrow, it cannot supply enough blood to the heart muscle when it becomes stressed. Just like arm muscles that begin to ache or hurt when heavy things are lifted, or legs that ache when you run too fast; the heart muscle will ache if it doesn't get adequate blood supply. This ache or pain is called angina. It is important to know that angina can manifest in many different ways and does not always need to be experienced as chest pain.

If the plaque ruptures, a small blood clot can form within the blood vessel, acting like a dam and acutely blocking the blood flow beyond the clot. When that part of the heart loses its blood supply completely, the muscle dies. This is called a heart attack, or an MI - a myocardial infarction (myo=muscle +cardial=heart; infarction=death due to lack of oxygen).