Your body relies on the oxygen-rich blood your heart pumps out to your brain, toes and everything in between. The heart muscle also needs replenished blood to do its job. When the flow of blood to fuel the muscle is interrupted, it’s a heart attack.

Clinically, it’s called a myocardial infarction to describe a loss of blood flow (infarction) to the heart muscle (myocardium).

If you’ve ever had a cramp in your calf or other muscle, you’ve gotten a taste of the pain that decreased blood flow to a muscle can cause. Now, imagine that your heart isn’t getting enough blood, and you get a better idea of why a heart attack causes chest pain.

Massaging a leg cramp can help restore blood flow and get you back up and around. Treating a heart attack is all about restoring blood flow to the heart muscle.

Treating a heart attack can range from medication designed to break up blood clots, thin blood, widen the blood vessels, lower blood pressure and slow the heartbeat. Medications can include beta blockers, thrombolytics or fibrinolytics, nitroglycerin and others.

Depending on the severity of the heart attack, minimally invasive techniques may be used to reopen a clogged artery. In these cases, a thin catheter is inserted into a blood vessel in the groin and threaded up to the site of the clogged artery. The procedure, percutaneous coronary intervention (PCI), allows the interventional cardiologist to directly address the blockage without major surgery.

An interventional cardiologist can employ a number of methods to restore blood flow. A tiny balloon can be deployed to widen the artery. A stent or wire tubular mesh may be placed to help keep the artery open.

In some cases, open heart surgery is needed, such as coronary artery bypass surgery (CABG). The surgeon uses a healthy blood vessel from another part of the body and creates a new blood vessel to the heart, bypassing the blocked or narrowed arteries.

Heart Attack Symptoms

Heart attack symptoms can start days or weeks ahead of the actual heart attack. These “pre-heart-attack symptoms” can appear days or weeks ahead of the actual heart attack. While there are common signs regardless of gender, there may be some unique symptoms that tend to affect women more than men.

Early signs and symptoms of a heart attack may occur in 50% of patients. Recognizing the beginning of a heart attack means treatment can begin before any damage.

Someone may show one or more of these common heart attack signs. When they start, they can be mild or come and go. Over time, the symptoms and pain become more intense. Stay alert and always pay attention to chest pressure.

A mild heart attack can last a few minutes, with symptoms easing with rest. Severe heart attacks can go on for 20 minutes or more.

Heart Attack Causes and Risk Factors

The most common cause of heart attacks is coronary artery disease, which is typically caused by the buildup of cholesterol. In the right amount, cholesterol helps the body function. Too much of it, however, causes waxy plaque that can cling to the walls of your arteries. Narrower arteries limit the amount of blood that can reach your heart muscle.

Lowering the levels of low-density lipoprotein (LDL) cholesterol in your blood helps prevent future plaque buildup, but won’t remove existing plaque. Diagnostic tools used at Norton Heart & Vascular Institute allow cardiologists to see where arteries have narrowed and by how much. This test, known as a CT-FFR, is noninvasive, using data collected from a CT scan to build a 3D image of your heart — revealing blockages that don’t always show up on conventional tests.

Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (Minoca)

Heart attacks can happen without significant obstructions in your arteries. Some of these rarer causes are more common in those assigned female at birth, especially those who are or have been pregnant.

• Small plaques that aren’t blocking your blood vessels can nonetheless break open and form blood clots that can block coronary artery blood flow. The condition is more common in women, smokers and those with other blood vessel conditions.
• Extreme cold or high levels of stress can trigger a coronary spasm. Smoking and drug use such as cocaine can increase your chances of a coronary spasm.
• A blood clot from elsewhere in your bloodstream can break free and get stuck in your coronary artery. Pregnancy, atrial fibrillation and thrombocytopenia can increase your risk.
• Pregnancy also can be a cause of spontaneous coronary artery dissection (SCAD). This condition develops as the wall of a coronary artery tears a bit. Blood can build up under and around the tear, forming a clot. In addition to pregnancy, SCAD can be caused by stress and extreme physical activity.

Heart Attack Risk Factors You Can’t Change

• Age: Those 65 or older are most likely to die of coronary artery disease, and women are at greater risk of dying.
• Gender: Men are more likely to have a heart attack and more likely to have it earlier in life. Women’s death rate from heart disease increases after menopause, but risk is still less than men. Women’s heart attack symptoms can be more subtle than men’s and are sometimes overlooked.
• Race and heredity: If your parents had heart disease, you are more likely to have it as well. Severe high blood pressure, developing earlier in life, is more common among Black people. Mexican American, American Indian, native Hawaiian and some Asian American people are also at higher risk. In addition to inherited risk, lack of access to health care and healthy foods, and other societal issues also explain the disparities.

Heart Disease Risk Factors You Can Improve

Identifying underlying causes of heart disease and putting you on a path to address them starts with annual check ups with your primary care provider.

Noninvasive Test Reveals Potentially Deadly Heart Issue

Tests in the emergency department didn’t reveal the source of Dan English’s chest pain. A noninvasive way to measure blood flow around the heart later showed Dan was at risk of a “widow-maker” heart attack.

Read Dan’s story

High blood pressure, if left uncontrolled, can affect your heart, kidneys, brain and other major organs. High blood pressure usually has no symptoms and can be detected only by blood pressure checks. Medication and lifestyle changes can reduce your blood pressure.

Cholesterol is made by your liver, but your diet can create more cholesterol than your body needs. The excess builds up as waxy plaques on the walls of your arteries, limiting blood flow. LDL cholesterol can cause plaque buildup in your arteries. High-density lipoprotein (HDL) cholesterol, on the other hand, can provide some protection against heart disease.

A lipid blood test measures your cholesterol levels.

Type 2 diabetes carries a higher risk of death from heart disease in adults.

Obesity typically comes with higher LDL cholesterol and triglyceride levels and lower levels of HDL cholesterol. Obesity also can trigger high blood pressure and diabetes.

What to Do if Someone Is Having a Heart Attack

When someone is having a heart attack, seconds count. It is critical to connect with quality heart attack care.

• If you are having heart attack symptoms or you are with someone who is, the first step is to call 911. If emergency medical services aren’t available, get a neighbor’s or friend’s help to drive you. Don’t put yourself and others at risk by attempting to drive yourself unless there is no other option.
• Chew and swallow an aspirin while you wait for emergency medical services, unless you are allergic or have been told by a medical professional never to take it. Aspirin thins your blood, reducing clotting and possibly reducing damage from interrupted blood flow to the heart muscle.
• If you’ve been prescribed nitroglycerin, take it.
• If the person is unconscious, start Hands-Only CPR by pushing hard and fast on the center of the chest to the beat of a song such as “Stayin’ Alive,” “Crazy in Love” or “Walk the Line” — about 100 to 120 compressions per minute.
• If an automated external defibrillator (AED) is available and the person is unconscious, use it following its instructions.

Norton Heart & Vascular Institute has been recognized by the American Heart Association, the American College of Cardiologists and others for providing quality heart attack care that stays at the forefront of lifesaving methods and procedures.

Many heart attack patients can be treated quickly with minimally invasive percutaneous cardiology intervention that reopens blocked blood vessels and can help prevent future heart attacks.

The care delivered by the Norton Heart & Vascular Institute doesn’t stop once you’ve started your post-heart attack life.

We’ll be there to provide support through Connecting Hearts for Support and other resources.

Heart and Vascular Care for the Whole Person

Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who are seeking to improve cardiovascular health or living with a heart condition.

Cardiac Rehabilitation Program

Our cardiac rehabilitation providers are leaders in developing and applying innovative techniques that can help you recover and resume your life.

Connecting Hearts Support Group

The group provides education and support to individuals who have had a heart attack, are living with a heart condition or are at risk for cardiovascular disease.

Heart Health Screenings

Prevention is the best way to manage heart disease, and screenings are available to detect early signs of cardiac and vascular disease and identify risk factors.

About Norton Heart & Vascular Institute

Every year, more than 137,000 people in Louisville and Southern Indiana choose Norton Heart & Vascular Institute specialists for their heart and vascular care. That’s more than any other health care provider.

• Norton Healthcare’s adult-service hospitals in Louisville all have received Chest Pain Center accreditation from the American College of Cardiology (ACC). This is the seventh consecutive accreditation for all four hospitals, which ensures quality for the treatment of heart attack.
• Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
• Norton Healthcare has the most facilities across the city of Louisville with the ability treat a life-threatening heart attack.

• You have access to more than 100 physicians and advanced practice providers with specialized training and experience in a comprehensive range of conditions and treatments.
• Patients can make appointments at 28 locations in Louisville and Southern Indiana. Telecardiology is offered at more than 30 sites in the region.
• Norton Audubon Hospital, a key location for Norton Heart & Vascular Institute services, has been recognized with a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
• U.S. News & World Report 2023-24 Best Hospitals ranked Norton Healthcare’s adult-service hospitals in Louisville as high performing in heart attack, heart failure, aortic valve surgery and heart bypass surgery.
• Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV – Healthcare and the Centers for Medicare & Medicaid Services.
• Communicate with your health care provider, renew prescriptions, get lab results and more through your free Norton MyChart account.