Heart Attack (Myocardial Infarction)

A heart attack happens when blood flow to part of your heart is blocked. Without oxygen, heart muscle is injured—sometimes within minutes. Quick action protects more heart muscle and can save your life. If you or a loved one has chest pressure, shortness of breath, sweating, nausea, or sudden fatigue, call 911 immediately. Do not drive yourself.

Knowing the signs—especially those more common in women, like back, jaw, or upper-stomach discomfort—helps you act fast. Many people wait, hoping symptoms pass. Waiting risks permanent damage and complications like heart rhythm problems or heart failure.

A heart attack often starts with chest discomfort—a pressure, tightness, or squeezing that may spread to your arm, neck, jaw, or back. Some people describe it as “an elephant on my chest.” It can build slowly or come on suddenly. You might also notice shortness of breath, a cold sweat, nausea or vomiting, or lightheadedness. These symptoms can occur together or one at a time. If they last more than a few minutes—or fade and return—treat it as an emergency.

How symptoms can look different in women

Women are more likely to have symptoms that don’t fit the “classic” picture. Instead of crushing chest pain, they may feel unusual fatigue, shortness of breath, or pressure in the back, jaw, neck, or upper stomach. Some women think it’s indigestion or a pulled muscle and wait it out. Don’t. If something feels “off,” especially if it’s new, severe, or unexplained, get help right away.

Subtle or “silent” symptoms

Not every heart attack is dramatic. In older adults and people with diabetes, symptoms may be mild or even painless. You might feel weaker than usual, winded with simple activity, or have a sense that “something isn’t right.” These quieter signals still mean the heart may be in trouble and need fast care.

Some heart attacks cause very mild or no chest pain. This is called a silent heart attack because symptoms can be easy to miss—like unusual fatigue, shortness of breath, or just not feeling right. If you notice these changes, especially with risk factors, get checked promptly.

Act Fast: When to Call 911

If chest discomfort lasts more than 5 minutes, or you notice shortness of breath, cold sweat, nausea, or unusual fatigue—call 911 now. Don’t drive yourself. Emergency teams can begin life-saving care on the way to the hospital.

Conditions that can feel similar

Several conditions can mimic heart symptoms. The safest move is to treat new or unexplained chest discomfort as a heart emergency until tests prove otherwise.

• GERD/acid reflux (heartburn): Burning behind the breastbone, often after meals or when lying down; may improve with antacids. It can feel like chest pressure.
• Muscle or chest wall strain (costochondritis): Pain that is tender to the touch or worsens with movement or deep breaths.
• Gallbladder or stomach issues: Upper‑abdominal pain (sometimes to the right), nausea, or pain after fatty meals.
• Anxiety or panic attacks: Chest tightness, rapid heartbeat, shortness of breath; symptoms may peak within minutes. (Anxiety and heart disease can also occur together.)
• Lung and aortic emergencies (look‑alikes we check for): Pulmonary embolism (blood clot in the lungs) and aortic dissection can cause severe chest pain and shortness of breath and also require immediate care.

Heart attack symptoms often occur with activity, may not fully go away with rest or antacids, and can include shortness of breath or a cold sweat. When in doubt, call 911—ER tests quickly tell the difference and protect heart muscle.

A heart attack happens when a coronary artery becomes blocked—most often after a fatty plaque in the artery wall ruptures and a blood clot forms. The clot limits or stops blood flow, and the heart muscle downstream is starved of oxygen. Less commonly, a heart attack can occur from coronary artery spasm—a temporary tightening of the artery that sharply reduces blood flow. Some heart attacks start with a small, partial blockage that worsens; others are sudden and severe. Understanding what raises your risk can help you act early.

What raises risk (you can’t change)

• Age: risk rises for everyone as we get older.
• Family history: a parent or sibling with early heart disease increases your risk.
• Biological sex: men tend to have earlier events; women’s risk rises after menopause.

What raises risk (you can change)

• High blood pressure and high LDL cholesterol
• Diabetes or prediabetes
• Smoking or vaping nicotine
• Excess weight and inactivity
• Unhealthy sleep and chronic stress

Other contributors

• Autoimmune or inflammatory conditions (e.g., lupus, rheumatoid arthritis)
• Pregnancy-related hypertension or diabetes (raises future risk)
• Substance use (e.g., cocaine)
• Air pollution exposure

How risks add up

Risks stack. For example, high blood pressure plus diabetes and smoking is far more dangerous than any one alone. The good news: improving even one factor—like quitting smoking or lowering LDL—cuts risk quickly and helps your arteries heal.

Including what to do at home or as a bystander

When you call 911 for possible heart symptoms, the response starts before you reach the hospital. Paramedics/EMTs can begin life-saving care on scene and on the way.

What EMTs do

• Record a 12-lead ECG in your home or workplace and send it ahead to the ER.
• Start oxygen if needed and give medications per protocol (for example, aspirin if appropriate).
• Place an IV, monitor vital signs, and take you to the right hospital for rapid treatment.
• Alert the cath lab so a cardiologist is ready if a blocked artery is likely.

Why 911 matters: Ambulances bring equipment and experts to you. Driving yourself delays care and is unsafe if your condition worsens.

If you’re the patient (at home, work, or anywhere)

1. Call 911 now. Don’t drive yourself.
2. Rest and stay calm. Sit or lie down; avoid walking around.
3. Follow the dispatcher’s instructions. They may advise chewing an aspirin (not if allergic or your clinician told you to avoid it).
4. Prepare for EMTs: Unlock the door, put pets away, have a medication list and ID ready, and keep your phone close.
5. If symptoms stop, still go. Pain that fades and returns can still be a heart attack.

If you’re a bystander

1. Call 911 and put the phone on speaker.
2. Keep them still and calm. Loosen tight clothing; reassure them help is coming.
3. Aspirin, only if advised by the dispatcher and the person is awake, able to chew/swallow, and not allergic.
4. If the person collapses and isn’t breathing normally: begin hands-only CPR—push hard and fast in the center of the chest until help arrives.
5. Use an AED if available. Turn it on and follow the voice prompts.
6. If they’re awake but feel faint or nauseated: place them in a comfortable position; if vomiting or very drowsy, use the recovery position (on their side).

What happens in the ER

Several tests happen in the first minutes to see if heart muscle is in danger and to guide treatment.

First tests

• ECG (electrocardiogram): painless stickers record heart signals; certain patterns suggest a blocked artery.
• Blood tests (troponin): check for heart-injury proteins; may be repeated because levels can rise over time.
• Vitals & exam: blood pressure, oxygen level, pulse, and focused exam.

If the ECG shows a full blockage (STEMI)

• A STEMI means a major coronary artery is fully blocked.
• You’re taken straight to the cardiac catheterization lab to open the artery—often with a balloon and stent.
• “Widowmaker” refers to a STEMI from a high LAD blockage, which threatens a large area of heart muscle and requires urgent treatment.

If the ECG is not classic but concern remains (NSTEMI/unstable angina)

• NSTEMI is a heart attack from a partial artery blockage; rising troponin levels show heart muscle injury.
• Unstable angina: similar symptoms but no troponin rise; still treated as high risk.
• You’ll undergo repeat (“serial”) blood tests for troponin to check for ongoing heart injury, along with continuous heart monitoring.
• Chest X-ray and/or echocardiogram are taken as needed.
• If tests point to a partial blockage or high risk, you’ll go to the cath lab, often within hours, for angiography and possible stent.

Look-alike conditions we rule out

• Severe heartburn/reflux, anxiety/panic, muscle strain, blood clots in the lungs, aortic problems, or gallbladder issues can mimic heart pain. ER testing helps tell them apart quickly.

What to expect: You’ll be connected to a heart monitor, given oxygen if needed, and may receive aspirin and other medicines right away. Our goal is to diagnose, treat, and protect your heart muscle as fast as possible.

Fast treatment limits heart damage. Your team will choose the safest, most effective option based on your symptoms, ECG/troponin results, and artery blockage pattern.

Medicines given early

• Aspirin + a second antiplatelet (e.g., clopidogrel/ticagrelor) to prevent new clots
• Anticoagulant (heparin) to keep the clot from growing
• Nitroglycerin for chest pain and blood flow (if safe for your blood pressure)
• Oxygen if levels are low; pain/nausea relief as needed
  These stabilize you and prepare you for a procedure if one is needed.

Opening the artery (first-line)

Cardiac catheterization with angioplasty/stent (PCI).
A cardiologist threads a tiny tube from your wrist or groin to the heart, inflates a small balloon to clear the blockage, and places a stent to hold the artery open. Most patients are awake with local numbing and light sedation.

What to expect

• You’ll feel pressure, not cutting; procedure time is often under an hour.
• Radial (wrist) access can mean faster mobility and fewer bleeding issues.
• After PCI, you’ll take dual antiplatelet therapy for months to keep the stent open.

Time matters: For a major blockage (STEMI), our goal is to open the artery quickly after arrival. That speed protects heart muscle.

If PCI isn’t immediately available

Clot-busting medication (thrombolysis).
In select cases—typically when rapid PCI isn’t possible—EMTs or ER clinicians may give a medicine that dissolves clots. You’ll still be transferred for a cath procedure soon after to confirm and secure the artery.

Bypass surgery (CABG)

If you have multiple severe blockages, left main disease, or diabetes with complex plaque, the heart team may recommend coronary artery bypass grafting. A surgeon uses vessels from your chest/leg to route blood around the blockages. CABG is planned once you’re stable, unless emergency surgery is needed.

Advanced support if you’re very sick

For cardiogenic shock or dangerous rhythms, specialists may use temporary heart pumps (e.g., impella/IABP) or ECMO to support circulation while the artery is opened and the heart recovers.

After the acute phase: protecting your heart

You’ll likely go home on a combination of:

• Antiplatelet(s) to prevent clots in stents/arteries
• High-intensity statin to stabilize plaque
• Beta-blocker and ACE inhibitor/ARB (or ARNI) to reduce heart strain
• Medicines for blood pressure, diabetes, or smoking cessation as needed

Next step: Enroll in cardiac rehabilitation—a medically supervised program that improves fitness, confidence, and long-term heart protection.

Healing starts in the hospital and continues at home. Your team will create a plan to help your heart recover, lower the chance of another event, and get you back to daily life.

In the hospital

• We monitor heart rhythm, blood pressure, and oxygen.
• You’ll start heart-protective medicines (antiplatelet, statin, beta-blocker, ACE inhibitor/ARB).
• A nurse or rehab specialist will help you sit up, walk short distances, and learn safe activity.

Before you go home

• You’ll receive a medication list, when to take each pill, and what side effects to watch for.
• We’ll schedule follow-up visits (usually within 1–2 weeks) and enroll you in cardiac rehabilitation.

Cardiac rehabilitation (your key to long-term recovery)
A 12-week, supervised program with exercise, nutrition, stress support, and coaching. It’s proven to cut the risk of another heart attack, improve stamina, and boost confidence. If transportation or schedule is a barrier, ask about flexible or home-based options.

At home: the first month

• Take medicines exactly as prescribed. Don’t skip or stop without calling us.
• Move a little, most days. Short walks are good—increase slowly as advised.
• Eat fiber-first. More plants, lean proteins, less salt and added sugar.
• Sleep and stress. Aim for regular sleep; try brief daily relaxation.
• No tobacco or vaping. We can help you quit.

Returning to life

• Work and driving: depends on your procedure and recovery; your clinician will clear you.
• Sexual activity: usually safe once you can climb 1–2 flights of stairs without symptoms; ask your clinician.
• Emotional health: Feeling anxious, down, or afraid is common after a heart attack. Tell us—counseling and rehab support help.

Call 911 if you have:

Chest pressure, shortness of breath, fainting, a fast/irregular heartbeat, or swelling that worsens—especially if symptoms are new or return after getting home.

Your UC Health team stays with you—adjusting medicines, tracking your numbers, and supporting the small steps that protect your heart for life.

• 24/7 Emergency & Interventional Care: Rapid ECG, on-site cath labs, and coordinated door-to-balloon pathways.
• Integrated Heart Team: Cardiologists, interventionalists, cardiothoracic surgeons, electrophysiologists, emergency medicine, nurses, and rehab specialists work as one.
• Cardiac Rehabilitation: Evidence-based programs that speed recovery and lower the chance of another event.
• Advanced Options: Complex PCI, bypass surgery, mechanical support, and access to clinical trials.
• Care that Fits Your Life: Multiple clinics, virtual visits, and support for medication management, nutrition, and smoking cessation.

Ready When Seconds Matter — Get Care at UC Health

Emergency: If you or a loved one has symptoms of a heart attack, call 911 now. Ask EMS to take you to an emergency department like UC Medical Center or West Chester hospital.

Non-urgent care: To understand your risk or get a second opinion, request an appointment with UC Health Cardiovascular Medicine. We’ll review your history, check your numbers, and create a plan that protects your heart. Schedule an appointment by calling 513-475-8521.

Recovery support: If you’ve had a heart attack or stent procedure, ask your clinician for a referral to UC Health Cardiac Rehabilitation or call 513-475-8521.