A heart attack, also known as a myocardial infarction, occurs when blood flow to a part of the heart is blocked, depriving the heart muscle of oxygen. This blockage, if not quickly resolved, can lead to damage or death of the heart muscle. Coronary artery disease is the most common cause of heart attacks.
In coronary artery disease, the arteries that supply blood to your heart become narrowed or blocked by the buildup of plaque. Plaque is made up of cholesterol and other fatty substances. This buildup process, called atherosclerosis, can take many years. When plaque accumulates inside the coronary arteries, it can restrict blood flow to the heart muscle.
Sometimes, the surface of this plaque can rupture or break open. When this happens, a blood clot can form at the site of the rupture, further narrowing or completely blocking the artery. This sudden blockage significantly reduces or completely cuts off blood supply to a portion of the heart muscle, triggering a heart attack.
Heart attacks are categorized based on how they appear on an electrocardiogram (ECG or EKG), a test that records the electrical activity of your heart. These ECG changes help doctors determine the type of heart attack and the necessary treatment approach.
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ST-Elevation Myocardial Infarction (STEMI): A STEMI usually indicates a complete blockage of a major coronary artery. The ECG will show a characteristic ST-segment elevation. STEMIs are considered more severe and require immediate, invasive interventions to restore blood flow.
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Non-ST-Elevation Myocardial Infarction (NSTEMI): An NSTEMI often signifies a partial blockage of a coronary artery. While the ECG changes are different from a STEMI (no ST-segment elevation), it is still a serious condition. However, it’s important to note that some NSTEMIs can also involve a complete blockage.
While blocked arteries due to coronary artery disease are the primary cause of heart attacks, other factors can also lead to this life-threatening condition:
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Coronary Artery Spasm: This involves a sudden, temporary tightening or spasm of the muscles in a coronary artery. This spasm can severely narrow or even temporarily block the artery, reducing blood flow to the heart muscle. Coronary artery spasms, also known as Prinzmetal’s angina or variant angina, can occur even in arteries that are not significantly blocked by plaque, although underlying early atherosclerosis or risk factors like smoking are often present.
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Certain Infections: Some infections, like COVID-19 and other viral infections, can cause inflammation and damage to the heart muscle (myocarditis). This inflammation can sometimes lead to a heart attack.
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Spontaneous Coronary Artery Dissection (SCAD): SCAD is a rare but serious condition where a tear develops in the wall of a coronary artery. This tear can slow or block blood flow through the artery, leading to a heart attack. SCAD is not typically related to plaque buildup and can occur in otherwise healthy individuals.
Understanding what a heart attack is, its causes, and the different types is crucial for recognizing the seriousness of this medical emergency. If you suspect you or someone you know is having a heart attack, it’s vital to seek immediate medical attention. Prompt treatment is essential to minimize damage to the heart muscle and improve the chances of survival and recovery.
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