Heart Attack

What is a heart attack?

A heart attack happens when one of your coronary arteries – the blood vessels which take blood to your heart – becomes blocked.

This is usually a result of coronary heart disease, a condition where a fatty substance (plaque) builds up in the coronary arteries. This narrows the artery and restricts blood flow, and can lead to a blood clot which completely blocks the artery.

Without enough blood and oxygen reaching the heart muscle, it can be seriously damaged, causing a heart attack.

What are the symptoms of a heart attack?

The most common sign of a heart attack is chest pain that doesn’t go away, which may feel like pressure, tightness or squeezing. This sensation often starts in the middle of your chest and may travel to your neck, jaw, ears, arms or wrists. Although this is the most common sign, not everyone experiences it.

Other symptoms which may indicate you’re having a heart attack include:

• Pain in the neck, jaw or back and down the left arm or down both arms
• Feeling or being sick
• Feeling sweaty and clammy
• Looking very grey and pale
• Feeling generally unwell and scared
• Restlessness or anxiety
• Feeling short of breath
• Feeling dizzy

The symptoms of a heart attack can often be different in men and women. Women are more likely to experience symptoms other than chest pain, and slightly less likely to feel chest pain. Women are also more likely to think that their symptoms are not serious.

It is crucial that if you – or someone you know – shows one or more signs of a heart attack, you call 999 right away.

How is a heart attack diagnosed and treated?

Medical staff will carry out tests to find out if you have had a heart attack. These include blood tests to measure the amount of certain proteins in your blood, and an ECG (electrocardiogram) to show the amount of damage to your heart muscle and where the damage is.

These tests should be carried out as soon as possible so that you can receive the right sort of treatment for your circumstances. Early treatment of a heart attack is important to get the blood flowing to the affected part of the heart again and limit the amount of damage to your heart muscle.

The main types of treatment include:

• Primary (or emergency) angioplasty – the narrowed areas of the artery are stretched using a balloon and a stent is fitted to keep the artery open
• Thrombolysis – clot-busting medicine helps to dissolve any blood clots which are blocking your arteries
• Thrombectomy – a surgery where a clot or blockage in your artery is removed

What happens after a heart attack?

After a heart attack, it is likely you will stay in hospital for around 3-5 days so your condition can be stabilised and monitored.
Some people develop other conditions linked to their heart attack, including:

• Increased blood sugar levels, which can be treated with insulin.
• Arrythmias, a change to your heart’s usual rhythm, which can be treated with a pacemaker if they are severe enough to be dangerous.
• Chest pain or angina, which is caused by insufficient blood supply to your heart muscle.
• Heart failure, when the damage to your heart muscle is so significant that it cannot pump enough blood to supply your body fully.
• High blood pressure, which can be treated with medication and diet.

For most people, your heart will settle down after a couple of days. The immediate risk of another heart attack lessens, and intensive monitoring can be stopped. Your doctor will advise when it is safe for you to return home from hospital.

It is normal to feel tired, overwhelmed, and anxious after a heart attack. You may find that you don’t remember a lot of what the doctors and nurses told you, especially during the first few days. Don’t be afraid to ask questions of staff. It can help to talk to your family about what has been happening too.

Before you leave hospital, your doctor will talk to you about any medications you may need to take. They will also give you information about support services available in your local area, such as cardiac rehabilitation.

Recovering after a heart attack

It is natural to feel worried, scared, frustrated or isolated as you begin your recovery at home. If you can, try to have someone with you at home for the first few days or weeks, depending on how you feel. Or arrange to stay with friends or family for a few days.

When you first get home, try to take things easy and get plenty of rest. Avoid any activities that make you feel out of breath. It’s ok to have a few visitors or take a walk round your house or garden, but avoid playing sports or doing housework such as hoovering.

About 10 days after a heart attack, most people will be ready to start doing some gentle physical activity. The key is to start slowly and gradually build up the amount you can do. How quickly you are able to do this will depend on the condition of your heart and on how active you were before your heart attack.

Just like the physical aspects of recovery, recovering from the emotional impact of a heart attack can take time. There may be lots of thoughts and questions going through your mind, and you may wonder what the future is going to be like.

It is normal to feel anxious and stressed, and you may also feel frustrated, vulnerable or scared. If you have previously been fit and healthy, you may find it particularly difficult to be dependent on other people. It is also common to feel afraid that it might happen again.

Try not to bottle up how you are feeling. Ask for help or advice if you need to.

To find out more about how to manage your condition and live well at home, read our Emotional and Mental Wellbeing advice.

Life after a heart attack

After the shock of the actual heart attack and the initial recovery you may wonder ‘what happens now’?

This is the time to start rebuilding your life – to start enjoying everyday activities once more and get back to doing the things you love.

Visit our Living with a Heart Condition section for more information about how to manage your condition at home, how to stay well and reduce your risk of future heart disease.