Understanding heart attacks

As a large, muscular pump, the heart relies on a constant supply of oxygen-rich blood to function. Without a blood supply, heart muscle begins to die. This is exactly what happens during a heart attack.

Myocardial infarction, the medical term for heart attack, literally means "heart tissue damage or death." Heart attacks most commonly occur when one or more of the coronary arteries — a network of blood vessels that supply blood to the heart — become blocked. Heart muscle becomes starved for oxygen and nutrients.

More than 1.2 million Americans suffer a heart attack each year. Approximately one-third of those who experience heart attack will die from it.

Fortunately, you can take several steps to prevent heart attack — starting with healthy lifestyle choices and seeking preventive medical care.

The leading cause of heart attack

The leading cause of heart attack is coronary artery disease — narrowing or blockage of the coronary arteries. This narrowing process is the result of buildup of fatty substances, called plaques, on artery walls. The medical term for this process is atherosclerosis, which originates from the Greek words athero (gruel, or paste) and sclerosis (hardness).

How do plaques form, and how do arteries become clogged? Throughout your life, fats build up in streaks on artery walls. Our body's natural healing response is to release chemicals that trap and seal these fatty deposits into place.

Unfortunately, these chemicals also attract other substances — inflammatory cells, cellular waste products, proteins and calcium. This is plaque. A hard covering forms around plaque deposits; on the inside, they can be soft.

In time, plaque can rupture, exposing a deposit's fatty interior. In response, blood-clotting particles called platelets will try to re-seal the rupture. As a blood clot forms within a blood vessel, there's a chance it can block blood flow to the heart, or break away from the blood vessel and travel to a smaller artery around the heart. The result is heart attack.

Coronary spasm

A less common cause of heart attack is a spasm of a coronary artery, when a coronary artery closes off (constricts) intermittently, greatly diminishing blood supply to the heart muscle. If coronary artery spasm occurs for a long period of time, a heart attack can occur. It may occur at rest and can even occur in people without significant coronary artery disease.

Heart attack treatments

Several treatments are available for heart attack patients. Among the most common are:

• Angioplasty and stent placement: A thin, flexible catheter is guided along a blood vessel toward the blocked artery. A tiny balloon is inflated at the catheter's tip, stretching the clogged artery open and flattening plaque to restore blood flow. To keep the blood vessel open, a stent — a miniature wire mesh tube — may be placed in the blood vessel.
• Coronary artery bypass surgery: A blood vessel is harvested from another part of the patient's body and used to go around — or bypass — the blocked coronary artery. Coronary artery bypass surgery is typically performed on patients who have more severe blockages, or several blockages.
• Clot-busting drugs: You may be given thrombolytic agents, such as tissue plasminogen activator (tPA), which dissolve blood clots, reduce the severity of damage to the heart muscle and ultimately save lives. These drugs are administered by IV drip and do not require surgery.

HonorHealth's commitment to heart attack treatment

Surviving and recovering from a heart attack depends on two factors:

• The size of heart muscle affected by a blocked artery.
• How quickly the blockage is treated.

HonorHealth's emergency cardiac care specialists live by the slogan "time is muscle." The sooner we can provide emergency care that restores blood flow to your heart, the more likely you’ll survive without lasting heart damage.

One critical measure of emergency heart care is "door-to-balloon time" — the time that elapses between your arrival in an emergency department and the moment a coronary artery is re-opened with a balloon catheter, if appropriate. HonorHealth has refined its processes to consistently perform far better than the national standard of 90 minutes.

Likewise, four HonorHealth medical centers are certified Cardiac Arrest Centers, meaning that we provide specialized cardiac care that increases survival rates. One example is reducing patients' core temperature immediately following cardiac arrest, aiding chances of survival and full neurological recovery.