Heart Attack: Symptoms, Causes, and What to Do.

Author: Isaac ONI B.Pharm

Medical Reviewer: Azuka Chinweokwu Ezeike MBBS, FWACS (Obstetrics and Gynaecology), FMCOG, MSc. (Public Health)

Highlights

• A heart attack occurs when a clot or plaque blocks blood flow to part of the heart.

• Key symptoms include chest pain spreading to the arm or jaw, shortness of breath, and cold sweats.

• Treatment involves prescribed blood thinners or surgery to restore the heart's blood flow.

• In an emergency, call for help, take low-dose aspirin if safe, and stay calm.

• Prevent heart attacks through healthy eating, quitting smoking, managing blood pressure, and reducing stress.

Introduction

A heart attack is one of the most urgent medical emergencies you can experience. It happens when blood flow to a part of your heart muscle is suddenly blocked, cutting off the oxygen supply it needs to function properly [1]. Your heart cells and tissues rely on a supply of oxygen-rich blood, and when that flow is disrupted, a heart attack occurs.

What is a Heart Attack?

A heart attack occurs when a coronary artery, the blood vessel responsible for carrying oxygenated blood to the heart, becomes blocked, usually by a blood clot formed over a ruptured fatty deposit known as plaque [2].  Plaques are the buildup of fatty deposits, cholesterol and other substances on the artery walls. These narrow the arteries, making blood flow difficult. When this happens, oxygen supply to the heart muscle is cut off or drops, causing damage to the heart tissues.

The heart needs a continuous oxygen supply and nutrients to beat effectively; therefore, any prolonged interruption leads to permanent damage to the heart cells and tissues (muscles), often resulting in heart failure or irregular heartbeatA heart attack can be classified as either STEMI or NSTEMI depending on electrocardiogram (ECG) findings and the extent of arterial blockage.

Heart Attack vs Cardiac Arrest?

Many think that a heart attack is the same as cardiac arrest. It is important to note that a heart attack is not the same as cardiac arrest. A cardiac arrest is defined as when your heart suddenly and unexpectedly stops beating due to an electrical disturbance that disrupts its rhythm. 

Key symptoms of a heart attack are chest pain, shortness of breath, sweating, and nausea, while the key signs of cardiac arrest are loss of consciousness and absence of pulse. However, a heart attack can cause sudden cardiac arrest. A cardiac arrest needs immediate Cardiopulmonary Resuscitation (CPR), whereas a heart attack does not unless complications arise.

Causes of a Heart Attack

Several factors contribute to the blockage of coronary arteries, which leads to a heart attack:

• Atherosclerosis: This refers to the buildup of plaque inside the arteries. As mentioned above, plaques narrow arteries, leading to a reduction in blood flow and oxygen supply.

• Blood clot (thrombosis): A clot may suddenly form and block the artery. Arterial thrombosis is the most common cause of heart attacks and strokes. Thrombosis is usually caused by lifestyle factors such as smoking, high blood pressure, high cholesterol, obesity, and lack of exercise.

• Coronary artery spasm: Sometimes, temporary tightening of arteries can restrict blood flow to the heart [3], leading to mild episodes of heart attacks. 

Risk Factors for Heart Attack

Several factors could increase the likelihood of having a heart attack. You should watch out for the following:

• High blood pressure

• High cholesterol levels

• Diabetes

• Smoking

• Obesity and sedentary lifestyle

• Stress and poor diet

• Genetic predisposition: Family history of heart disease increases the risk [4].

While the above are major risk factors, secondary risk factors are obstructive sleep apnea, certain autoimmune diseases, chronic kidney disease (CKD), and menopause in women.

Symptoms of a Heart Attack

Heart attack symptoms can appear suddenly or gradually.

 Key warning signs to watch out for include:

• Chest pressure, tightness, or pain (angina)

• Pain radiating to the neck, jaw, shoulders, or arms

• Shortness of breath• Cold sweats

• Lightheadedness or dizziness

• Fatigue (more common in women).

Note: Some heart attacks, especially in older adults or people with diabetes, may cause mild or no observable chest pain [5].

What To Do If You Suspect a Heart Attack

Below is a step-wise approach you can adopt if you have a heart attack• Call your local emergency services immediately. Don’t delay this process, as every minute counts [1].

• Chew or swallow aspirin(unless in the presence of medical conditions such as ulcer, allergy, already on a blood thinner, or have an existing blood clotting disorder). Recommended dosage is 300mg. It helps to thin the blood and promote blood flow through the arteries [6].

• Stay calm and sit upright.

• Loosen tight clothing and maintain open airflow.

• Do not drive yourself to the hospital; instead, call for help.  This is a common mistake many make.

Emergency Treatment in the Hospital

When you get to the hospital, tests such as an ECG and blood troponin level checks are carried out immediately to confirm whether you are having a heart attack. Other tests that can be carried out are:

• Echocardiogram (Echo), 
• Coronary angiogram,
• Positron Emission Tomography (PET) scan, 
• Cardiac Computerized Tomography (CT) scan
• Magnetic Resonance Imaging (MRI). 

The main goal of your treatment is to quickly restore blood flow to your heart, which includes:

• Thrombolytic therapy: Drugs referred to as “Clot-busting”, such as Streptokinase and Alteplase, can be administered to help dissolve blockages in the coronary arteries.

• Angioplasty and stenting: A catheter opens the artery, and a small mesh stent keeps it open to aid blood flow and oxygen supply [7]

• Coronary artery bypass graft (CABG): This is a surgical procedure that is used to create a new path for blood flow to the heart. 

Medications Administered After Discharge from Hospital

• Antiplatelets or blood thinners (e.g. aspirin, clopidogrel) work by preventing blood cells called platelets from clumping to form a clot that might prevent blood flow through the coronary arteries. 

• Beta-blockers, to make the heart beat more slowly and with less force. The overall effect of this is a lowering of blood pressure, which is a risk factor for heart attacks. 

• Angiotensin Converting Enzymes (ACE) inhibitors or Angiotensin Receptor Blockers (ARBs), which prevent the narrowing of blood vessels. 

• Statins, to cut down cholesterol or lipid levels.

Life After a Heart Attack

1. Recovery and Rehabilitation

After you are discharged, you will be advised to join a cardiac rehabilitation program. This program includes exercise, dietary counselling, especially on controlling your sodium intake, and emotional support [8]. Taking part in these programs can greatly reduce your risk of having another heart attack.Also, your doctor will provide guidance on when it is best to return to work, as well as sexual activity counselling. 

2. Medication Adherence

Medication adherence is crucial to recovery and preventing future attacks. Missing doses, however, can increase the risk of future attacks. 

3. Emotional Health and Support

Most people who have gone through any episode of a heart attack often have anxiety and depression. Speaking with a therapist, joining emotional support groups, or involving family in recovery can improve mental health and treatment outcomes [9].

How To Prevent a Heart Attack

Prevention begins with the everyday life choices we make. A heart attack, to a large extent, is a medical condition that is triggered by lifestyle decisions. Preventing it depends a lot on lifestyle modifications. According to the World Health Organization [10] and large studies like INTERHEART [4], data have it that up to 80% of heart attacks are preventable if the right measures and lifestyle adjustments are put in place early enough. 

Lifestyle Changes

• Eat heart-healthy foods: Take more fruits, vegetables, whole grains, and lean proteins.

• Exercise regularly: 30 minutes of moderate activity most days [10]. Aerobic exercise is highly advised.

• Maintain a healthy weight: Watching your calorie intake can help prevent obesity and other metabolic syndromes, which are predisposing factors.

• Smoking cessation and limiting alcohol intake.

• Manage stress: Try mind or soul-lifting routines like yoga, music or meditation.

• Get regular health checks: Monitor cholesterol, blood pressure, and blood sugar. Some of these tests, such as blood pressure monitoring, cholesterol and blood sugar, can be done at the comfort of one's home with personal home kits.

Conclusion

A heart attack is life-threatening. Awareness, early recognition is important.  Lifestyle changes such as maintaining a healthy weight, eating heart-friendly foods, and regular exercise improve survival rate, recovery outcomes and prevention. 

References

1. American Heart Association. Heart attack: Symptoms and treatment [Internet]. 2023 [cited 2025 Oct 10]. Available from: https://www.heart.org/en/health-topics/heart-attack

2. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD. Fourth universal definition of myocardial infarction. Circulation. doing2018 Nov 13;138(20):e618-e651. Available from: https://pubmed.ncbi.nlm.nih.gov/30571511/

3. Crea F, Lanza GA. Angina pectoris and normal coronary arteries: cardiac syndrome X. Heart. 2004 Apr;90(4):457-63. doi: 10.1136/hrt.2003.020594. PMID: 15020531; PMCID: PMC1768150. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC1768150/

4. Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al. PURE Investigators. Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med. 2014 Aug 28;371(9):818-27. Available from: https://pubmed.ncbi.nlm.nih.gov/25162888/

5. Scirica BM. Prevalence, incidence, and implications of silent myocardial infarctions in patients with diabetes mellitus. Circulation. 2013 Mar 5;127(9):965-7. doi: 10.1161/CIRCULATIONAHA.113.001180. PMID: 23459575. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.001180?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

6. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction. Circulation. 2004 Aug 3;110(5):588-636. Available from: https://pubmed.ncbi.nlm.nih.gov/15289388/

7. O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol. 2013;61(4):e78–140. Available from: https://pubmed.ncbi.nlm.nih.gov/23247304/

8. Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. J Am Coll Cardiol. 2016;67(1):1–12. Available from: https://pubmed.ncbi.nlm.nih.gov/26730878/

9. Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome. Circulation. 2014;129(12):1350–69. Available from: https://pubmed.ncbi.nlm.nih.gov/24566200/

10. World Health Organization. Cardiovascular diseases (CVDs) [Internet]. 2021 [cited 2025 Oct 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published Occtober 25, 2025