Heart attack

You or someone else has heart attack 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 goes 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 or sweating

A heart attack happens when the blood supply to part of the heart muscle is reduced. Without enough blood, the heart can be damaged.

Sometimes chest pain comes on suddenly, and it isn't clear whether unstable angina or a heart attack is behind it. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS).

Doctors can't tell that you're having a heart attack just from how you feel, so you'll need some tests. These can include:

• an electrocardiogram (ECG), to check your heart's rhythm and electrical activity
• blood tests, to check troponin levels (troponin is 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.

When someone has a heart attack, getting blood flowing to the heart again quickly matters a great deal. It limits the damage to the heart muscle and starts to ease the symptoms.

Your treatment plan will depend on:

• the type of heart attack you've had
• your own situation

Treatment for a heart attack may consist of:

• anti-emetics, to stop sickness and nausea
• antiplatelet therapy, medicine 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 medicine. Your doctor will try to find the best drugs for you with the fewest side effects.

Problems can sometimes follow a heart attack. The two most common are:

• arrhythmias, which are problems with your heart's natural electrical rhythm
• heart failure, which is when the heart isn't pumping blood around the body as well as it should

Many of these problems clear up quite quickly on their own. Sometimes, though, they linger, and medicine can often help.

How long you stay in hospital after a heart attack depends on your circumstances and the treatment you have. Ask your medical team about anything that's happening, and don't feel afraid to do so.

When you leave hospital, you should be referred to a cardiac rehabilitation programme.

After a heart attack, you should receive an assessment to work out your own goals and needs.

Rehabilitation is usually a mix of exercise and education sessions. These give you 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 advise you on practical issues, including:

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

The British Heart Foundation, a charity based in the UK, has further information on cardiac rehabilitation.