HOW DO MILD HEART ATTACKS AFFECT THE HEART?

A heart attack occurs when a blockage impedes the circulation of blood to the heart. If the blockage is not removed, heart tissue begins to die from lack of oxygen.

Heart attacks can vary in severity from mild to massive. A mild heart attack often doesn’t cause much permanent heart damage or only affects a relatively small portion of the heart muscle. It could be the result of a blockage that occurs in a small coronary artery, or the blockage does not completely block blood flow to the heart, or it only lasts a brief time.

A massive heart attack is the opposite. It affects a large portion of the heart muscle or causes a large amount of damage. In this case the blockage affects a large coronary artery, completely blocks blood flow, or lasts for a long period of time.

Whatever its size or effects, a heart attack should always be taken seriously. Even a mild heart attack that leaves no permanent damage can still be an indication that you are at risk for future heart attacks.

WHAT CAUSES A HEART ATTACK?

A common cause of heart attacks is coronary artery disease (CAD) – a buildup of plaque in the inner lining of an artery causing it to narrow or become blocked. When blood flow to the heart is reduced it can cause chest pain. Often medical imaging is ordered to investigate for CAD.

When looking for the cause of chest pain, medical imaging can assess the heart function, electrical changes, or blood flow (exercise stress testing, myocardial perfusion imaging). Coronary computed tomography angiography (CCTA) may also be appropriate.

CCTA can non-invasively examine the coronary arteries using a combination of X-rays and computer technology to produce comprehensive, detailed images. It’s designed to look for plaque buildup in the arteries supplying the heart muscle (a risk factor for heart disease). Patients with family histories of heart disease may be at risk for developing atherosclerotic plaque buildup, blocking or narrowing these arteries. On CT, these can be identified even before symptoms of chest pain develop.

WHAT ARE THE RISK FACTORS FOR HEART DISEASE?

Heart disease affects women differently from men. Part of that is anatomical; women generally have higher heart rates and smaller hearts and arteries than men. This makes women’s arteries more prone to blood clots or blockages and more difficult to repair.

For both women and men, the more risk factors you have the more you should be concerned about anything heart related. For example, if you’re 50 or older, overweight, diabetic, or have high cholesterol or high blood pressure, these are risk factors for a heart condition, and you should pay particular attention to changes in your health.

For women, risk factors like smoking, diabetes, high blood pressure, and a family history of heart disease pose an even greater threat compared to men. When estrogen levels drop during menopause, this also leads to an increased risk of heart disease for women.

WHAT ARE THE SIGNS OF A HEART ATTACK?

In both men and women, the most common sign of a heart attack is chest pain or discomfort, but you can experience a heart attack without chest pressure. Here are some important warning signs to be aware of:

1. Chest discomfort – is the most common sign and can be described as pain, tightness, or pressure in your chest. It may be a sign of a blocked artery or heart attack.
2. Nausea, indigestion, heartburn, or stomach pain – the nerves in your gastrointestinal tract are closely intertwined with the nerves from the heart, so heart pain can feel like stomach pain. Usually, nausea caused by an impeding heart attack gets worse with physical exertion and eases with rest.
3. Radiating pain – this is also a common symptom. Pain may spread down the left side of the body or upwards to your throat or jaw, or be solely centered in the arm. Women may also experience upper back pressure.
4. Dizziness or lightheadedness – this can be caused by many factors, but if it’s combined with chest discomfort or shortness of breath, call a doctor. It could mean your blood pressure has dropped because your heart isn’t pumping properly.
5. Shortness of breath – panting or difficulty drawing deep breaths could be a sign of a heart attack.
6. Sweating – if you break out in a cold sweat for no obvious reason, this could be a sign of a heart attack.
7. Irregular heartbeat – it’s normal for the heart to race during periods of tension or excitement, but, if you feel this happening for more than just a few seconds or regularly, it could signal atrial fibrillation and require treatment.
8. Extreme fatigue – you should pay attention if your usual routine seems unusually hard, or you wake up still feeling tired. It can signal weakness of the left ventricle, the main muscle responsible for pumping blood from the heart to the rest of the body. (Women more often report experiencing this symptom than men, but men may also experience it in the days leading up to an attack.)

If you experience any of the above emergency signs, it’s important to call 9-1-1 for the fastest medical help. For more information, please visit the heart and stroke website.

REFERENCES

Cleveland Clinic (2020) “What Is a ‘Mild Heart Attack’ (and Is It a Big Deal, or Not)?” health.clevelandclinic.org. Accessed February 8, 2021.

Heart and Stroke Foundation of Canada. (2019) “Are you at risk for heart disease or stroke?” www.heartandstroke.ca. Accessed February 8, 2021.

Heart and Stroke Foundation of Canada. (2021) “Emergency signs: When to call 9-1-1.” www.heartandstroke.ca. Accessed February 8, 2021.

Mayo Clinic Staff (2022) “Heart attack symptoms: Know what’s a medical emergency.” www.mayoclinic.org. Accessed February 8, 2021.

Newby, D. E., et al. (2018) “Coronary CT Angiography and 5-Year Risk of Myocardial Infarction.” The New England Journal of Medicine, 2018; 379: 924-33.

Spader, C. (2021) “Mild and Massive Heart Attacks: What’s the Difference?” www.healthgrades.com. Accessed February 8, 2021.

Williams, M.C., et al. (2016) “Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease.” Journal of the American College of Cardiology, 2016; 67 (15): 1759-68.