Heart attack

Heart attack

Phone 999 immediately if:

You or someone else has symptoms like:

• central chest pain or discomfort in the chest that doesn’t go away – it may feel like pressure, tightness or squeezing
• pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach
• unconsciousness
• seizures or fitting
• difficulty breathing (snoring or rasping)
• rapid heart beat
• low or undetectable heart beat
• chest pain and breathlessness, nausea, sweating or coughing up blood

What is a heart attack?

A heart attack happens when there’s a reduction in blood supply to part of the heart muscle. This lack of blood flow can cause damage to the heart.

Sometimes, when chest pain occurs suddenly, it’s unclear if it’s due to unstable angina or a heart attack. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS).

Further information on causes and risk factors for a heart attack.

Diagnosing a heart attack

In order to find out if you’re having a heart attack, you’ll need to have some tests. These tests can include:

• an electrocardiogram (ECG) – to check your heart’s rhythm and electrical activity
• blood tests – to check troponin levels, a protein that’s released into the blood stream when the heart muscle is damaged
• an assessment of blood pressure
• an assessment of blood oxygen levels
• a chest X-ray
• an echocardiogram – to assess the structure and function of your heart
• a coronary angiogram – to identify any blood vessels that are narrowed or blocked

Based on your test results, your clinical team will decide your treatment plan.

Treating a heart attack

When someone has a heart attack, it’s important to restore blood flow quickly. This’ll minimise damage to the heart muscle and start to alleviate symptoms.

Your treatment plan will depend on:

• the type of heart attack you’ve had
• your individual situation

Types of treatment

Treatment for a heart attack may consist of:

• anti-emetics – to stop sickness and nausea
• antiplatelet therapy – medication that thins the blood and gets rid of blood clots
• coronary angioplasty – a procedure to widen coronary arteries that are blocked or narrow
• oxygen therapy – to help with your breathing and oxygen levels
• pain-relieving drugs – like morphine
• reperfusion treatment – to help restore blood flow and maintain the heart’s pumping action
• thrombolysis – a ‘clot-busting drug’ to help restore blood flow to your heart

People who’ve had a heart attack will need to take several different types of medication. Your doctor will try to find the best drugs for you with the fewest side effects.

Complications of a heart attack

Sometimes there are complications following a heart attack. The most common complications after a heart attack are:

• arrhythmias – problems with your heart’s natural electrical rhythm
• heart failure – when the heart isn’t pumping blood around the body as well as it should

Many problems resolve themselves quite quickly. However, sometimes problems linger and can often be helped by medication.

Recovering from a heart attack

How long you stay in hospital will depend upon your circumstances and treatment. Don’t be afraid to ask your medical team about what’s happening.

On discharge, you should be referred onto a cardiac rehabilitation programme.

Cardiac rehabilitation

You should receive an assessment to determine your individual goals and needs after a heart attack.

Rehabilitation is usually a mix of exercise and education sessions. This helps to provide you with the information, advice and support to:

• understand your condition and medication
• recover from your heart attack, procedure or surgery
• make lifestyle changes to improve your heart health

Your cardiac rehabilitation team can also give you advice on practical issues after a heart attack, including:

• driving
• mental wellbeing
• relationships
• sexual relationships
• returning to work
• long term recovery