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Heart Attack

How Up-To-Date is Your Doc?

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

How Does Your Doctor Keep Up-To-Date on Medical Issues?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.

The heart is a muscle like any other in the body. It needs blood flow to supply oxygen to allow it to do work. When there isn't enough oxygen, the muscle starts to suffer, and when there is no oxygen, the muscle starts to die.

Heart muscle gets its blood supply from arteries that start in the aorta and run on the surface of the heart, known as the coronary arteries. 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.

Heart Attack Causes

Over time, cholesterol buildup can occur in these blood vessels in the form of plaque. This narrows the artery and can restrict the amount of blood that can flow through it. 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 hurt if you lift too much, or legs that ache when you run too fast; the heart muscle will ache if it doesn't get adequate blood supply. This ache is called angina.

If the plaque ruptures, a small blood clot can form within the blood vessel and acutely block the blood flow. 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).

Picture of Heart Attack (Myocardial Infarction)



Next: Heart Attack Risk Factors »

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Heart attack - Symptoms at Onset of Disease

The eMedicineHealth physician editors ask:

The symptoms of heart attack can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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Heart Attack

Angina »

Angina Pectoris Overview

If you are having pain or pressure in the middle of your chest, left neck, left shoulder, or left arm, go immediately to the nearest hospital emergency department. Do not drive yourself. Call 911 for emergency transport.

Angina, or angina pectoris, is the medical term used to describe the temporary chest discomfort that occurs when the heart is not getting enough blood.

  • The heart is a muscle (myocardium) and gets its blood supply from the coronary arteries.

  • Blood carries the oxygen and nutrients the heart muscle needs to keep pumping.

  • When the heart does not get enough blood, it can no longer function at its full capacity.

  • When physical exertion, strong emotions, extreme temperatures, or eating increase the demand on the heart, a person with angina feels temporary pain, pressure, fullness, or squeezing in the center of the chest or in the...



Read the Angina article »



Read What Your Physician is Reading on eMedicine

Myocardial Infarction »

Myocardial infarction (MI) is the irreversible necrosis of heart muscle secondary to prolonged ischemia.

Read More on eMedicine »

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