What is a heart attack?

A heart attack occurs when a coronary artery becomes blocked due to the combination of atherosclerosis (the process by which cholesterol deposits (plaques) build up in the arterial wall causing arteries to narrow) and the sudden development of a blood clot (a thrombosis). The sudden blockage of the artery means that the part of the heart muscle that was supplied by the particular coronary artery is at once deprived of oxygen carried in the blood. Muscle can't survive without blood and the affected area of the heart muscle dies. If only a small area is involved, you have a good chance of recovery. If more muscle is affected then it can cause sudden death in some cases and incomplete recovery in others as the heart has lost some of its pumping power. Sometimes a heart attack is followed by an abnormal rhythm to the heartbeat (arrhythmia), or a cardiac arrest, in which the heart stops altogether.

Although heart attacks can be fatal, 60% of people who have a heart attack survive due to prompt medical attention. When a heart attack strikes no-one is helpless. Anyone may be the first link in the chain of emergency services. By responding quickly, the chances of survival are greatly increased.

What to do in the event of a heart attack?

The symptoms of a heart attack actually signal the start of a process that can take hours to unfold. But the greatest risk to life occurs early on in this process, so prompt action is vital.

A heart attack is usually felt as a sudden, crushing chest pain. However, it may begin more slowly. The pain sometimes spreads up the neck, jaw, both arms, back, and stomach (where symptoms can be mistaken for indigestion). Some people suffer nausea or vomiting, shortness of breath, or feel fullness (as after a heavy meal). Their skin is often pale, and they may break out in a cold sweat. The sufferer feels weak and may experience a strong sense of foreboding. If you are able to, give an aspirin. Taking aspirin helps to prevent the formation of blood clots - which are part of the heart attack process.

If you, or someone close to you, has symptoms like these lasting 15 minutes or more, dial 999 for an ambulance and tell them that you think it may be a heart attack. Do not take chances. If the pain is severe, call 999 and ask for an ambulance right away, you do not need to wait 15 minutes. Always state 'heart attack' when phoning for help, as an ambulance will be sent that is fully equipped to deal with a suspected heart attack. Time is very important, as if life-saving treatment can be given promptly, the amount of damage to the heart can be reduced.

Occasionally, a heart attack is 'silent' and produces little discomfort. You may only know you have had one during a routine medical examination.

Excellent details on how to respond if someone is having a heart attack are available from The British Heart Foundation. If you do not know how to do CPR, learning how might save someone's life. For further details contact British Red Cross, St. John's Ambulance or your local hospital. Heartstart UK (details below) arranges training in emergency life-saving techniques.

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