It’s More than Just Heart Attacks

Heart attacks used to scare many people severely. They still probably do until today. But as the survival rate for people with a heart attack ranges between 97% and 98%, there’s a good chance that anyone can avoid its life-threatening complications. What better way to start your preventive measures than by expanding your knowledge of the different types of heart attacks?

By learning how each form is different, their triggers, and standard treatments, you can better understand your risk and create a plan to optimize your heart health. Read on to get into the details. 

1. Complete Blockage (STEMI Heart Attack)

STEMI stands for ST-segment elevation myocardial infarction. It is a type of heart attack caused by the complete blockage of a coronary artery and is considered the most life-threatening.

When a STEMI occurs, a major coronary artery, which acts as a blood channel to the heart, becomes blocked by fragments of atherosclerotic plaque. This plaque comprises cholesterol and other substances accumulating in the blood vessel walls. Blood clots may also cause blockage. 

Since the heart attack is triggered by the complete lack of blood flow to the heart, the damage can be irreversible. The mortality rate for individuals who survive a STEMI heart attack ranges between 30% and 38%⁽¹⁾ in the next five years. This is because the muscle of the heart gradually decreases in capacity as a result of the heart attack. 

How to Identify a STEMI Heart Attack

Symptoms of a STEMI heart attack include a building pain and pressure in the chest that extends to the jaw, shoulder, arm, and back. You may also experience cold sweats, shortness of breath, nausea and vomiting, and lightheadedness. Some people lose consciousness as well.

Given the gravity of a STEMI heart attack, time is of the essence as every minute you lose diminishes your chance of immediate treatment, where your survival is highly dependent. Seek emergency services as quickly as possible. 

Treating a STEMI Heart Attack

The type of treatment you’ll get when you have a STEMI heart attack depends on what’s causing the complete blockage, the complexity of the condition, and other factors your doctor will look into. In most cases, the following treatment options are considered.

• Percutaneous coronary intervention (PCI): Also known as angioplasty with stenting⁽²⁾, this procedure uses a catheter to inflate a small balloon, which will relieve the blocked artery. 
• Thrombolytic therapy: This clot-busting treatment involves certain medicines that could dissolve the blood clot that blocks the artery. Thrombolytic therapy⁽³⁾ is the typical go-to treatment when PCI is unavailable.   
• Coronary artery bypass graft (CABG): In severe cases, a bypass may be necessary to graft a new blood vessel⁽⁴⁾ where the blood flow can be redirected. This is an invasive procedure and is typically done in complex heart attacks. 

Also Read: Widow Maker Heart Attack: What Is It and How Does It Happen?

2. Partial Blockage (NSTEMI)

Non-ST-segment elevation myocardial infarction (NSTEMI) is a less severe form of heart attack (compared to STEMI heart attack) as it is due to a partial blockage in one of the coronary arteries. However, that is not to say that NSTEMI does not require the same urgency as STEMI. It is still, in fact, a critical health crisis. 

However, unlike STEMI heart attack, in an NSTEMI heart attack⁽⁵⁾, the blood flow towards the heart is not completely blocked. Hence, the damage to the heart muscle could be minimal with immediate treatment.  

How to Identify a NSTEMI Heart Attack

The symptoms of NSTEMI heart attack are similar to STEMI but less severe. You will also experience chest pain that radiates to nearby body parts, trouble breathing, lightheadedness, cold sweats, and nausea with vomiting.   

Treating an NSTEMI Heart Attack

Blood thinners or beta-blockers⁽⁶⁾ are commonly given to reduce the heart rate and blood flow, relieving constriction. In some cases, the medications suffice. However, if the NSTEMI heart attack is not addressed immediately and the condition becomes complicated, procedures like PCI and CABG may become necessary. 

3. Coronary Artery Spasm (Unstable Angina)

Coronary artery spasms⁽⁷⁾, or unstable angina, are a type of heart attack different from STEMI and NSTEMI in that the cause is not a physical blockage. Instead, the coronary artery experiences a sudden spasm that temporarily dilates the blood vessel, causing blood flow restriction. 

But don’t let the word “temporary” fool you. An unstable angina can become a full-blown heart attack if not immediately addressed. Hence, it’s crucial to seek immediate medical attention. 

Moreover, the exact cause of the spasm remains unknown. However, certain triggers were noted, such as emotional distress, cold weather, and cocaine use.

How to Identify a Coronary Artery Spasm

Like the other types of heart attacks, unstable angina or coronary artery spasm starts with chest pain, followed by breathing problems, possible fainting, cold sweats, and nausea. But unlike the other two, wherein the discomfort is gravely felt with exertion, the chest pressure, in particular, is noticeable even at rest.

Treating a Coronary Artery Spasm

Similar to an NSTEMI heart attack, blood thinners may be given to someone who has unstable angina. However, your doctor may decide to perform PCI if you have an increased risk of experiencing a full-blown heart attack. 

Learn More: We have a plethora of guides on heart health issues that could expand your knowledge and understanding of cardiovascular diseases. 

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Heart Health Terminologies

For some, heart attack equates to heart disease. However, in understanding heart health, terms sound alike, but they are not exactly interchangeable. 

To better protect yourself from any factors that endanger your heart health, it’s best to understand the key terms that healthcare providers often use to describe certain diseases and conditions, which primarily include the following: 

• Cardiovascular refers to the heart and blood vessels–the heart muscle and vascular system that keeps the blood flowing throughout our bodies.

• Cardiovascular diseases include heart disease, high blood pressure, high cholesterol, and stroke.

• Coronary artery disease (CAD) is the most common type of heart disease. It occurs when plaque (made up of fat, cholesterol, calcium and other substances) builds up inside the arteries that supply oxygen-rich blood to the heart muscle. (This is sometimes called hardening of the arteries.)

• Coronary heart disease is often used instead of CAD, meaning that the heart’s circulation system is not pumping enough blood to the heart muscle and surrounding tissue.

• Heart arrhythmia is an abnormal heart rhythm. The heart might beat too slowly, too fast, or irregularly. Cardiac arrhythmias and heart valve problems are types of heart disease.

• Heart attacks happen when a coronary artery becomes blocked, and enough blood and oxygen can’t get through. The heart muscle then becomes damaged. The location and severity of the blockage can result in a mild or severe heart attack.

• Heart disease is often used to mean the same thing as cardiovascular disease and can refer to CAD as well as other problems like infections and heart defects you’re born with.

• Heart failure happens when the heart is too weak to pump enough blood and oxygen to the rest of the body. The heart is still working, just not well enough. Damage from a heart attack may cause heart failure, but there are other causes.

• Stroke refers to when the blood flow to the brain is stopped or reduced. A blood clot most commonly causes it. As opposed to heart attacks, some people call strokes “brain attacks.”

• Sudden cardiac arrest is when the electrical signals in the heart suddenly stop it from beating. The heart can’t pump blood to the brain or the rest of the body. Sudden cardiac arrest is a medical emergency. Without immediate treatment, it usually leads to sudden cardiac death.

Although any terms associated with a heart attack can be terrifying, not all of them warrant a panic. Some cardiovascular health problems can be corrected with proper medicines and lifestyle modifications. Work closely with your doctor to understand your risk and see the best course of action to protect your heart health. 

Frequently Asked Questions

Are heart attacks genetic?

Yes, your risk for heart attacks increases if someone in your family has experienced it. It could be due to a hereditary disorder that triggers heart attacks, such as hypertrophic cardiomyopathy (heart muscle thickening) or high lipid levels. Plus, multiple genes are involved in the affinity of an individual to heart attacks, making it more likely for familiar connections to form. 

How long do heart attacks last?

Depending on the type, heart attacks can last from a few minutes (20-30 mins) to a few hours. You may experience chest pain or discomfort, tightness that could spread to your shoulders and arms, lightheadedness, nausea and vomiting, and other symptoms of a heart attack. 

Can kids have heart attacks?

It is extremely rare, but children could have heart attacks. The chances of a child experiencing a heart attack increase with disorders such as congenital heart disease, genetic conditions that lead to elevated cholesterol levels, Kawasaki disease, and physical damage to the heart and arteries. 

The Bottom Line

Knowing the different types of heart attacks helps you prevent them by limiting their potential triggers. Of the three types of heart attacks, high cholesterol is clearly a critical culprit. That said, it’s imperative to check your lipid levels through a lipid panel blood test to understand your risk of heart attacks better. 

Sources

¹ Pascual I, Hernandez-Vaquero D, Almendarez M, Lorca R, Escalera A, Díaz R, Alperi A, Carnero M, Silva J, Morís C, Avanzas P. Observed and Expected Survival in Men and Women After Suffering a STEMI. J Clin Med. 2020 Apr 19;9(4):1174. doi: 10.3390/jcm9041174. PMID: 32325887; PMCID: PMC7230566.

² Hoole SP, Bambrough P. Recent advances in percutaneous coronary intervention. Heart. 2020 Sep;106(18):1380-1386. doi: 10.1136/heartjnl-2019-315707. Epub 2020 Jun 10. PMID: 32522821.

³ Kocayigit I, Yaylaci S, Osken A, Aydın E, Sahinkus S, Can Y, Genc AB, Gunduz H. Comparison of effects of thrombolytic therapy and primary percutaneous coronary intervention in elderly patients with acute ST-segment elevation myocardial infarction on in-hospital, six-month, and one-year mortality. Arch Med Sci Atheroscler Dis. 2019 May 27;4:e82-e88. doi: 10.5114/amsad.2019.85378. PMID: 31211274; PMCID: PMC6554752.

⁴ Bagheri J, Jameie M, Saryazdi ZD, Jalali A, Rezaee M, Pashang M, Aein A, Hosseini K, Ahmadi Tafti SH, Bagheri A. Coronary Artery Bypass Graft Surgery After Primary Percutaneous Coronary Intervention in Patients With ST-Elevation Myocardial Infarction. Heart Lung Circ. 2023 Oct;32(10):1257-1268. doi: 10.1016/j.hlc.2023.08.005. Epub 2023 Sep 22. PMID: 37741752.

⁵ Basit H, Malik A, Huecker MR. Non–ST-Segment Elevation Myocardial Infarction. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513228/

⁶ Hölschermann H. Antithrombotische Therapie bei Nicht-ST-Hebungsinfarkt [Antithrombotic therapy for non-ST segment elevation myocardial infarction]. Hamostaseologie. 2006 May;26(2):106-13. German. PMID: 16676052.
⁷ Yasue H, Nakagawa H, Itoh T, Harada E, Mizuno Y. Coronary artery spasm–clinical features, diagnosis, pathogenesis, and treatment. J Cardiol. 2008 Feb;51(1):2-17. doi: 10.1016/j.jjcc.2008.01.001. Epub 2008 Feb 1. PMID: 18522770.