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Heart Attack (Myocardial Infarction)

What is a heart attack (myocardial infarction)?

A heart attack results when an artery to your heart becomes completely blocked usually by a blood clot and the heart muscle (myocardium) fed by that artery cannot receive oxygenated blood. This leads to some heart muscle injury and death (infarction).

How serious is a heart attack?

Many people survive a heart attack. However, a heart attack can be very serious and can lead to immediate death. Why? For one of two reasons: (1) so much of the heart dies that it no longer can function, or (2) because of a rhythm disturbance that causes the heart to cease beating or beating ineffectively (rendering it unable to pump blood to the body). Prompt, efficient treatment is the key. If you have any doubt about your symptoms, call 911. Do not drive or have someone drive you to the Emergency Department.

Generally speaking, the percent of the heart that is damaged and the location of the damage affects the short- and long-term outcomes. For example, a heart attack affecting the bottom of the heart and affecting less than 10 percent of the total muscle would be considered a mild heart attack. However, a heart attack in the front of the heart involving 25 percent of the muscle would be more serious and could cause heart failure. Shock or death may occur with a heart attack involving more than 40 percent of the heart muscle.

How is a heart attack diagnosed?

At all of Inova Health System's Emergency Departments, diagnosis for a heart attack begins early. Electrocardiograms (EKGs) are performed in the field by the Fairfax County Rescue Squads to shorten the time for prompt treatment using thrombolytic or fibrinolytic therapies (which dissolve the clot blocking the coronary artery). Time is of the essence to salvage heart muscle, and the Emergency Departments have taken great strides to decrease the "time to treatment."

Diagnosis is initially confirmed using two methods: (1) blood samples of cardiac enzymes, and (2) electrocardiograms.

How is a heart attack treated?

Diagnostic tests provide Inova's cardiologists with more information about the percent of the heart muscle damaged, the location of the heart attack, the potential for further damage and the complications of the heart attack. Based on the information provided by these tests, the Inova Heart Center cardiologist will recommend the appropriate treatment alternatives.

You can maximize the benefits from the treatment prescribed by your Inova cardiologist by minimizing your individual cardiac risk factors for heart disease. If you continue to live without modifying your risk factors, the odds of having a reoccurrence of a heart attack are significantly higher. For example, if you continue to smoke tobacco after a heart attack, you have double the chance of dying from the heart attack.

So I've had a heart attack, what now?

The hospital and your Inova physician will give you the information needed to maximize your recovery. You should receive specific information regarding activity, exercise, how to minimize risk factors, what medications to take and when to receive follow-up care from your physician.