A heart attack is an acute disease caused by a blockage of the coronary arteries. Here, a blood clot causes an interruption in the blood supply to the heart, which can cause severe chest pain, shortness of breath, nausea or dizziness. People with risk factors such as high blood pressure or high cholesterol are more likely to suffer a myocardial infarction. If a heart attack is suspected, rapid action is required.

Herzinfarkt

Overview

A heart attack, also known as a myocardial infarction, is a medical emergency in which at least one coronary artery of the person affected is closed. In most cases, the culprit is a blood clot deposited at an arteriosclerotic constriction. As a result, part of the heart muscle is no longer supplied with oxygen and dies rapidly if the circulation disorder is not remedied quickly.

Immediate medical attention is required for this condition in order to minimise damage to the heart and ensure the patient’s survival. After a heart attack, scar tissue forms in the heart muscle which can lead to cardiac arrhythmia or heart failure.

Causes and risk factors

A heart attack occurs when one or more coronary arteries that supply blood to the heart are blocked by atherosclerosis (calcification of the arteries) or a blood clot. This can lead to sudden, severe pain and other symptoms.

Risk factors include:

Disease progression

A heart attack can be felt in different ways. In some cases, it announces itself hours, days or even weeks in advance through recurrent chest pain (angina pectoris).

In other cases, it appears suddenly and without warning. After a heart attack, the heart may be permanently damaged, which impairs the function of the heart and can lead to further health problems.

Symptoms 

While the symptoms of a heart attack vary according to gender and individual predisposition, there are a number of typical signs that may indicate this serious disease.

Before the heart attack

Heart attack patients often suffer from angina pectoris, a temporary circulation disorder of the heart caused by arterial calcification (arteriosclerosis) of the coronary arteries, even before the actual infarction takes place.

Acute coronary syndrome

Unlike with angina pectoris, the typical symptoms of a heart attack are usually more pronounced:

  • Severe chest pain or tightness in the chest, often accompanied by shortness of breath, nausea, sweating and mortal fear. This combination of symptoms is also known in the medical world as acute coronary syndrome.
  • Mild pain that does not get better through rest and which lasts for more than 15 minutes often radiates into the throat, shoulders and arms.

Common symptoms

  • Pain or discomfort in the chest, often described as a feeling of pressure or tightness in the middle of the chest.
  • Pain in the upper body that can radiate into the arms, back, neck, jaw or abdomen.
  • Sudden onset of breathlessness.
  • Cold sweating, nausea or dizziness.

Specific symptoms in women

  • Women often experience more subtle signs of a heart attack that can be easily overlooked, such as unusual tiredness, sleep disruptions and anxiety.
  • The first signs of a heart attack may be an unpleasant feeling in the chest and persistent pain in the upper body, which differ from the usual symptoms and do not go away. It is important to seek immediate medical attention if these symptoms occur.

Diagnosis

Immediate hospitalisation is required if a heart attack is suspected. Early diagnosis and treatment are critical for patient survival and prognosis.

ECG examination

The electrocardiogram (ECG) is one of the first examinations performed for suspected heart attacks. It records the electrical activity of the heart and can show typical changes indicating a heart attack.

Troponin test

In addition to the ECG test, a blood test is carried out to determine the troponin level. Troponin is a protein that is found in the heart muscle cells and released into the bloodstream when the heart muscle is damaged. In the event of a heart attack, an elevated level of troponin in the blood can be detected shortly after the event, which is a strong indication of a heart attack.

These diagnostic measures allow medical staff to act quickly and take the necessary steps to save the affected heart muscle tissue and prevent further complications.

Treatment

The most important goal after diagnosing a heart attack is to rapidly restore blood flow to the heart muscle in order to prevent further damage. Depending on the individual situation of the patient, different treatment options are available:

Thrombolysis

Medication dissolves the blood clot that caused the heart attack. This method is often used when surgery is not immediately possible.

Balloon dilation and stent implantation

During balloon dilation, a catheter is inserted into the closed vessel with a small balloon in order to expand it. A stent is often used to keep the vessel open.

Bypass surgery

For more complex blockages, the blood vessels can be moved around the blocked area through bypass surgery.

Long-term treatment

Medication such as blood pressure reducers, cholesterol lowerers and blood thinners are often used to prevent further heart attacks.

Prevention

The following measures can help to prevent a heart attack:

  • Regular physical exercise
  • A healthy diet
  • Weight control
  • Quitting smoking
  • Regular medical examinations to monitor heart health

Emergency first aid

If you think a person is having a heart attack, do the following:

  • Call 144 to report the emergency
  • Explain that you think the person is having a heart attack
  • Give the name, address, and age of the patient
  • Position the patient on a hard surface with their upper body slightly elevated
  • Open tight clothes, ties or bras
  • Ask passers-by to help flag down the ambulance so that you can stay with the patient and help keep them calm
Heart attack - what are the symptoms?

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