A heart attack occurs when the coronary arteries become completely blocked by plaque rupture and thrombosis (blood clot formation), preventing blood flow to the heart muscle. If blood flow isn't restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

Heart Attack Symptoms and Diagnosis

The most notable symptoms of a heart attack include:

  • Crushing pressure in your chest
  • Pain in your shoulder or arm
  • Shortness of breath, with or without chest discomfort
  • Sweating

A heart attack may also occur with less intense symptoms, such as:

  • Chest discomfort: Most heart attacks involve discomfort in the center of the chest lasting more than a few minutes, or that goes away and returns. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach
  • Nausea
  • Vomiting
  • Heart palpitations
  • Fatigue
  • Lightheadedness
Risk Factors
  • Smoking
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Inactivity/lack of regular exercise
  • Stress
  • Sleep apnea
  • Family history of heart disease: your risk increases if your father or brother had a heart attack before age 55, or if your mother had a heart attack before age 65.
  • Age: A man’s risk for heart attack increases sharply after age 45. For women, the risk jumps after age 55.
  • Metabolic syndrome: Includes high blood pressure, high triglycerides, elevated insulin levels and excess body fat around the waist.
  • High levels of C-reactive protein: A marker for inflammation, research suggests that high levels of CRP in the blood may raise the risk of developing CAD or having a heart attack.

If you are having a heart attack or suspect you are having one, your diagnosis likely will take place in an emergency room. You will have your blood pressure, pulse and temperature checked and will be asked about your symptoms. You will be hooked up to a heart monitor and a number of tests will be conducted immediately:

  • Blood tests, to check levels of certain fats, cholesterol, sugar and proteins in the blood.
  • Electrocardiogram (EKG or ECG)
  • Echocardiogram
  • Coronary angiogram or catheterization

Heart Attack Treatment at BIDMC

Coronary artery disease, in some cases, can be managed with lifestyle changes aimed to reduce risk factors, such as:

  • Quitting smoking
  • Modifying your diet
  • Keeping your blood pressure under control
  • Exercising (check with your doctor before beginning an exercise program)
  • Reducing stress

If lifestyle changes aren't enough to control your coronary artery disease, you may need medication to help your heart and arteries function better. Medications may include:

  • Cholesterol-lowering drugs, or statins
  • Aspirin or other blood thinner
  • Beta-blockers
  • Nitroglycerin

If you have a severe blockage in one or more arteries, angioplasty (percutaneous coronary intervention, or PCI) can:

  • Improve blood flow to your heart
  • Relieve chest pain
  • Possibly prevent another heart attack

Coronary artery bypass graft (CABG) surgery, open-heart surgery, is often performed when multiple coronary arteries are blocked or when blockages are not suitable for angioplasty or stenting. CABG surgery involves the usage of arteries or veins from other areas in your body to route blood flow around your narrowed coronary arteries. CABG can:

  • Improve blood flow to the heart
  • Relieve chest pain
  • Possibly prevent another heart attack

CABG can sometimes be performed as a minimally invasive procedure if a patient has just one blocked artery that needs bypassing.

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Our expert cardiologists offer prompt treatment for patients who have suffered heart attacks, as well as preventative care and management of coronary artery disease.

Interventional Heart Care

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Our cardiac surgeons perform more than 450 coronary artery bypass graft surgeries each year to treat coronary artery disease and possibly prevent future heart attacks.

Cardiac Surgery Services