A heart attack (also known as a ‘coronary’ or ‘myocardial infarction’) occurs when heart muscle cells die, nearly always from the sudden blockage of a coronary artery due to a blood clot (coronary thrombosis). This can range from a very small event after which a patient treated appropriately might be completely well and free from any restriction to a large event involving much of the muscle of the heart.
The key difference between stable angina and a heart attack is usually that the pain is persistent or comes on at rest. The pain is usually similar to angina pain in character (tight, heavy or squeezing chest or upper abdominal pain which may radiate to the neck and or arms) but usually worse, sometimes associated with nausea of vomiting and often doesn’t respond well to angina tablets or GTN spray
Anyone who thinks they may be having a heart attack or who is having an angina attack which is not settling promptly with rest and or GTN spray should seek urgent medical attention from the emergency services (by dialling 999 in the UK).
National Heart Lung and Blood Institute
The modern treatment of heart attack is complex and requires a dedicated pre-hospital , in hospital and post discharge team working closely together.
The emergency treatment of heart attack involves opening the blocked coronary artery using a technique called primary angioplasty. This requires an emergency coronary stent procedure both to open the blocked artery and to treat any underlying narrowing.
Following a heart attack it is essential that secondary prevention is undertaken to reduce as much as possible the risk of further events.
Dr Dalby will discuss these tests, their implications and any subsequent tests, treatment or follow up with you so that you may reach a mutually agreeable management plan.