Myocardial Infarction (Heart Attack)
If you experience intense chest pain and think you may be having a heart attack, seek medical attention immediately. Acting quickly can save your life.
A myocardial infarction, also known as a heart attack, occurs when the blood flow that supplies oxygen to the heart muscle is suddenly interrupted. The cells in the affected area do not receive enough oxygen (hypoxia), and if blood flow is not restored quickly, the heart muscle begins to die (necrosis). The heart muscle receives oxygen and nutrients through its own arteries, called the coronary arteries.
Myocardial infarction is one of the leading causes of death worldwide in both men and women. In Spain, according to data from the National Statistics Institute (INE), 13,927 people died from acute myocardial infarction in 2020 (38 people per day).
Causes of Myocardial Infarction
Most heart attacks occur when one of the coronary arteries becomes suddenly blocked by a blood clot. This blockage is usually due to the buildup of fatty plaques containing cholesterol (atheroma). When one of these plaques ruptures, a clot forms rapidly on its surface and may completely obstruct blood flow through the artery.
If the affected part of the heart stops receiving blood, it cannot contract properly. If heart muscle cells do not receive oxygen and nutrients for several hours, they die and do not regenerate.
Prevention
Although anyone can suffer a heart attack, not everyone has the same risk. Certain personal conditions and circumstances—known as cardiovascular risk factors—increase the likelihood of having one. In most cases, at least one preventable and potentially reversible risk factor can be identified.
Cardiovascular check-ups help evaluate an individual’s risk profile and guide preventive measures to reduce the likelihood of a heart attack.
Risk Factors for Myocardial Infarction
- Age: Men over 45 and women over 55 are at higher risk.
- Smoking.
- High blood pressure.
- High cholesterol and/or triglycerides.
- Overweight and obesity.
- Diabetes: High blood glucose increases the risk.
- Family history of heart attacks.
- Sedentary lifestyle.
- Unhealthy diet: High in sugar, animal fats, processed foods, and salt.
- Stress.
- Drug use: Cocaine and methamphetamines can trigger a heart attack.
Symptoms of Myocardial Infarction
A heart attack is characterized by the sudden onset of intense chest pain (center of the chest), which may radiate to the back, jaw, or left arm. It is often accompanied by:
- General discomfort
- Shortness of breath
- Dizziness
- Sweating
- Nausea
Myocardial Infarction Is a Medical Emergency
Once a patient with suspected acute myocardial infarction is identified, emergency protocols are initiated immediately to ensure survival and preserve heart function. Some treatments begin even before confirmation of the diagnosis.
Emergency measures may include:
- Oxygen administration
- Antiplatelet medications (to prevent clot formation)
- Fibrinolytic drugs (to dissolve clots)
- Nitroglycerin (to relieve pain and improve blood flow)
The specific treatment depends on whether the blockage is partial or complete and on the patient’s clinical condition.
Recanalization of the Blocked Artery
Treatment aims to restore blood flow as quickly as possible:
1. Thrombolytic Therapy
Intravenous medications are given to dissolve the clot.
2. Cardiac Catheterization and Coronary Angioplasty
A thin, flexible catheter is inserted—usually through the groin or arm—and guided to the heart.
During angioplasty, a small balloon at the tip of the catheter is inflated at the site of the blockage to widen the artery and restore blood flow.
Typically, a stent (a small metal mesh tube) is then placed to keep the artery open. Some stents are drug-eluting, meaning they release medication to help prevent future blockages.
After stent placement, blood can flow normally through the artery again.