A myocardial infarction—commonly called heart attack—occurs when a coronary artery becomes blocked and prevents blood from reaching a portion of the heart muscle. Without oxygen and nutrients, the heart muscle begins to be damaged. Prompt treatment is essential: the sooner blood flow is restored, the better the chances of limiting damage and saving heart muscle.

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Why does a heart attack happen?

Most heart attacks occur because of atherosclerosis, a process in which cholesterol and fatty deposits (plaques) build up inside the coronary arteries.
If one of these plaques ruptures, a blood clot can form and suddenly block the artery.

Other, less common causes include:

• Spasm of a coronary artery (coronary vasospasm)

• Spontaneous tearing of the artery wall (SCAD)

• Embolism (a clot coming from another area of the body)

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Recognizing a Heart Attack: Main Symptoms

Typical symptoms include:

• Pressure, tightness, or pain in the chest, often spreading to the left arm, shoulder, neck, jaw, or back

• Shortness of breath

• Cold sweats

• Nausea or vomiting

• Sudden fatigue, weakness, or light-headedness

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⚠️ A heart attack is a medical emergency. Call emergency services immediately if symptoms appear.

Not everyone experiences “classic” chest pain. Women, older adults, and people with diabetes may have milder or atypical symptoms, such as:

• Indigestion-like discomfort

• Sudden fatigue

• Breathlessness without chest pain

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Types of Myocardial Infarction

Heart attacks are not all the same. The diagnosis is based on symptoms, ECG changes, and blood tests (troponin).

1. STEMI (ST-Elevation Myocardial Infarction)

• The coronary artery is completely blocked.

• Requires immediate reopening of the artery, ideally within 90 minutes from first medical contact.

• Urgency is critical: “Time is muscle.”

2. NSTEMI (Non-ST-Elevation Myocardial Infarction)

• The artery is partially blocked.

• Damage occurs but usually to a smaller portion of the heart.

• Treatment is urgent, but timing is guided by risk assessment.

3. MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)

• Heart attack caused by conditions other than classic plaque rupture, such as spasm or microcirculation dysfunction.

• More common in younger patients and women.

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How is a Heart Attack Treated?

The main goal is to restore blood flow to the heart as quickly as possible.

 

Emergency Treatments

Depending on the type of infarction:

• Primary angioplasty (PCI):
  A small balloon is inserted to open the blocked artery, followed by the placement of a stent.

• Thrombolytic therapy (fibrinolysis):
  Medication is given intravenously to dissolve the clot (used if angioplasty is not immediately available).

Medications

 

After the acute phase, patients typically receive medications to:

• Prevent new clots (antiplatelet therapy)

• Reduce cardiac workload (beta-blockers)

• Lower cholesterol and stabilize plaques (statins)

• Help heart function and protect arteries (ACE inhibitors / ARBs)

Cardiac Rehabilitation

A structured program of exercise, lifestyle support, and risk factor management. It improves quality of life and reduces the risk of future events.

 

Prevention: What You Can Do

You can significantly reduce the risk of recurrence by managing the main risk factors:

• Control blood pressure, cholesterol, and blood sugar

• Quit smoking

• Maintain a healthy weight

• Follow a Mediterranean-style diet

• Exercise regularly, as advised by your cardiologist

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A heart attack is a serious but treatable condition. Recognizing symptoms early and getting immediate medical care can save heart muscle—and save lives. After treatment, ongoing follow-up and rehabilitation are essential to reduce the risk of recurrence and support long-term heart health.