Heart Attack

Scripps cardiothoracic surgeon Scot Brewster, MD, and colleagues review a heart attack patient's imaging results.

Dr. Scot Brewster, Cardiothoracic Surgery, Scripps

About every 40 seconds, someone in the United States has a heart attack. Without immediate expert treatment, a heart attack can be fatal. Our cardiovascular teams have decades of highly specialized experience in helping patients treat and manage serious heart problems.


U.S. News & World Report has consistently ranked Scripps as one of America's Best Hospitals in the nation, and the best in San Diego, for cardiology and heart surgery.

About heart attack

A heart attack happens when the flow of blood that carries oxygen to the heart is reduced or completely stopped. Usually, blood flow is disrupted because fat, cholesterol and other substances build up in the arteries that bring blood to the heart. This buildup, called plaque, eventually becomes so thick that blood can no longer flow freely through the arteries. Sometimes, plaque will break off and a blood clot will form around it, which also narrows the artery. This narrowing of the arteries is known as atherosclerosis.


A condition called ischemia occurs when the heart does not get enough oxygen and nutrients. Ischemia can cause a heart attack, or myocardial infarction (MI). In some cases, a heart attack can be caused by a spasm of a coronary artery that restricts blood flow to the heart, but this is not common. 


A heart attack is not the same as cardiac arrest. Sudden cardiac arrest is caused by a malfunction of the heart’s electrical system and is not related to a blocked blood flow.


Continue reading to learn more about heart attack.

There are several known risk factors for heart attack. Some of these can be controlled, while others cannot. The more risk factors you have, the greater your risk. If you have had a heart attack in the past, your risk of having another one is higher.


Uncontrollable risk factors include:


Age

Most people who die of coronary heart disease are 65 or older.


Gender

Men have a higher risk of heart attack than women, and have them at an earlier age.


Family history

If your parents have heart disease, you are more likely to develop it as well.


Some types of heart disease can be inherited, putting family members at risk of developing heart problems. Scripps has genetics counselors on staff to help patients identify potential heart trouble and take proactive steps to address it.


Controllable risk factors include:


Smoking tobacco

Smoking significantly raises your risk of cardiovascular disease. If you do not smoke, but are exposed to secondhand smoke, you may have a greater risk as well.


High blood pressure

You have high blood pressure or hypertension if your blood pressure is above 130/80. 


High blood cholesterol

High cholesterol levels can lead to atherosclerosis, or narrowing of the arteries that carry blood to the heart.


Diabetes

Having type 2 diabetes increases your risk of cardiovascular disease.


Being overweight

Excess body fat raises the risk of heart attack, especially if the body fat is carried around the waist. Being overweight or obese also contributes to other risk factors, such as diabetes and high blood pressure.


Inactive lifestyle

Lack of physical activity can raise your risk and may contribute to other risk factors, such as high blood pressure and obesity.


If you have risk factors for heart attack, talk with your doctor about ways to manage your risk. Lifestyle changes, medication and other tools can help you prevent heart disease.

Some signs and symptoms of heart attack are severe and come on suddenly, while others are mild and develop slowly. Moreover, men and women may have different symptoms. Women tend to have subtler symptoms that may begin up to a month before the heart attack.


Warning signs of heart attack for both men and women include:


  • Chest discomfort, such as pressure, pain or squeezing in the center of the chest that lasts for longer than a few minutes or goes away and returns
  • Shortness of breath
  • Pain or discomfort in the neck, jaw, back, stomach or arm


Warning signs of heart attack for women also include:


  • Fatigue or weakness
  • Unusual sweating, nausea or vomiting
  • Sudden dizziness
  • Insomnia or sleep problems


If you experience any of these symptoms, don’t ignore them or wait to see if they come back. Call 9-1-1 immediately. The sooner you get treatment for a heart attack, the more likely you are to recover. 

Scripps cardiology teams use a variety of technologies and procedures to detect and diagnose heart attack. These may include:


  • Blood tests to measure levels of cardiac enzymes that indicate heart muscle damage
  • An electrocardiogram (EKG or ECG) to record the heart’s electrical functions, such as heart rate, heartbeat rhythm, and strength and timing of electrical signals as they pass through each part of the heart
  • Chest X-ray to provide a picture of the heart, lungs and major blood vessels
  • Echocardiogram (ECHO) that uses sound waves to create moving pictures of the heart — particularly its chambers and valves — and can detect possible blood clots, fluid buildup or other problems
  • Cardiac catheterization (angiogram) that uses liquid dye inserted through a catheter to check the blood vessels that supply the heart with blood

Learn more about heart attack signs and symptoms

Learn more about heart attack signs and symptoms

Scripps cardiologist, Poulina Uddin, MD, explains different heart attack symptoms in men and women and what you should do if you think you're having a heart attack.

Treatments for heart attack

Scripps provides 24-hour care for heart attack patients by board-certified cardiologists and heart surgeons. Our multidisciplinary heart teams may also include an electrophysiologist physician, cardiology nurses, social workers and several other specially trained clinicians and practitioners.


If our diagnostic tests confirm that you have had a heart attack, we’ll determine the best methods to quickly restore blood flow to your heart to minimize damage. Your treatment plan may include medication and/or surgical procedures.

Medications to restore blood flow to the heart or prevent further damage can include:


  • Aspirin to reduce blood clotting and help maintain blood flow through the affected artery
  • Thrombolytics known as clotbusters to help dissolve a blood clot that's blocking blood flow
  • Antiplatelet agents to help control blood clots and prevent new ones from forming
  • Blood thinners to reduce the formation of new clots
  • Nitroglycerin to widen the blood vessels
  • ACE inhibitors to block the action of an enzyme that causes blood vessels to narrow
  • Angiotensin II receptor blockers (ARBs) to block the action of chemicals that narrow blood vessels
  • Beta-blockers that can slow heart rate and lower blood pressure

Scripps cardiac surgeons perform traditional open heart and minimally invasive heart surgery to treat blocked arteries. Coronary artery bypass graft surgery, also known as CABG or bypass surgery, bypasses a blocked coronary artery by surgically placing a new healthy vessel from another part of the body around it. The surgery can be performed as traditional open heart surgery, minimally invasive or robot-assisted surgery.

Interventional cardiology

Scripps cardiology teams have extensive experience with new minimally invasive techniques to treat heart attack. Our interventional cardiology specialists treat heart attack and other conditions through the insertion of a thin flexible tube into arteries of the leg or wrist. A tiny wire is passed through the catheter to access the heart and arteries to remove plaque and fatty deposits, repair defects or insert devices to keep arteries open.


Our cardiac catheterization experts offer a range of heart attack procedures and treatments, including:


  • Angioplasty and stent placement for the heart (also known as percutaneous coronary intervention or PCI) to open narrowed or blocked arteries with stents (tiny tubular support devices) to restore healthy blood flow to the heart
  • Carotid angioplasty and stenting (also known as CAS) to open narrowed or blocked carotid arteries in the neck with stents
  • Rotational atherectomy to remove calcified lesions from arteries using a miniature device called a Rotablator
  • Percutaneous balloon valvuloplasty to open a narrowed or blocked heart valve using with the insertion and placement of a miniature balloon

Scripps offers cardiac rehabilitation programs to help you recover faster after a heart attack and learn to make lifestyle changes, including an exercise program and healthy diet, to help prevent future heart problems. 


Scripps also offers wellness and heart health classes free of charge to the public, and we partner with WomenHeart, a national program that provides education and support for women living with heart disease.

Scripps Center for Integrative Medicine offers a customized Lifestyle Change Program which combines complementary therapies with medical therapies in a holistic mind-body approach.

Research and clinical trials

Scripps is consistently on the leading edge of cardiovascular research and clinical trials, working to bring the most innovative treatments and care options to patients. Locally and regionally, we’ve led the way with many firsts for cardiovascular breakthroughs.


Our physicians and scientists are actively involved in research and studies to provide greater understanding of heart disease and enable faster availability of new treatments to patients. If you are interested in participating in clinical trials, please discuss options and possible matches with your physician.