Heart attack

A heart attack is caused by a coronary artery that is completely blocked. This means that part of the heart muscle no longer gets enough oxygen and can die off. Fast action is needed due to the risk of the person dying.

At a glance

  • A heart attack is caused by a coronary artery that is completely blocked.
  • Rapid assistance is required, otherwise part of the heart muscle can die off. This means a risk of death.
  • In Germany, about three out of four people now survive a heart attack.
  • Since women often only have mild symptoms, attacks are more frequently missed with them.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Heart attack: older woman holding both hands to her chest.

What is a heart attack?

A heart attack occurs when a coronary artery becomes completely blocked. This means that part of the heart muscle no longer gets enough oxygen. If this state lasts too long, part of the heart muscle dies off. This means that there is a risk of the person dying and they need medical attention as soon as possible.

What happens during a heart attack?

The video below reports on the possible causes, risk factors, and symptoms of a heart attack.

This and other videos can also be found on YouTube.

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What are the signs of a heart attack?

Indications of a heart attack are chest pain, nausea and shortness of breath.

The main symptoms of a heart attack are:

  • chest pain
  • shortage of breath
  • nausea

A heart attack often begins with sudden or gradually intensifying pain in the chest. It can be mild or very severe and doesn't go away when the person rests. It lasts more than five minutes and can radiate from the chest to an arm, the back, the neck or the upper abdomen.

During a heart attack, pain can affect the chest, arms, neck, nape of neck, shoulder blades, back, jaws and upper abdominal areas.

Fear of dying, a pale to sallow face and sweating are also typical. Difficulty breathing, nausea and vomiting can also occur. The latter symptoms can also be the only signs of a heart attack in women. This is why it fails to be identified in women more often than in men.

Other signs of a heart attack include:

  • a feeling of tightness and pressure in the chest
  • pain or numbness in the upper body that spreads to the shoulder blades, the neck and the jaw
  • sweating
  • paleness and cold sweats
  • lightheadedness or fainting
  • dizziness

Important: If someone has a heart attack they need urgent medical attention. If the person affected has pain in their chest, they should always call the emergency services on 112 and request an ambulance with an emergency doctor (NOT the on-call or stand-by GP service called “Ärztlicher Notdienst” oder “Ärztlicher Bereitschaftsdienst”). If signs of a heart attack occur at night, the person affected should NOT wait until the next morning to do something about it.

Further information, for instance on indications of a heart attack can be found at gesundheitsinformation.de

What causes a heart attack?

People who have heart attacks often have already had coronary heart disease (also called coronary artery disease) for years. This causes recurring chest pain (angina) or shortness of breath during exercise. Others have heart attacks who had no symptoms beforehand – they only find out about their heart problem when they have a heart attack.

Coronary heart disease occurs as a result of calcified coronary arteries (arteriosclerosis). The calcification begins with small areas of inflammation on the wall of a vein where cells, fats and other substances accumulate and gradually constrict the vein.

The danger of a heart attack exists when these plaques suddenly break open. A blood clot may form there. If it is so big that it blocks the blood vessel entirely, a heart attack occurs.

What affects the risk of a heart attack?

As with coronary heart disease, the risk factors for a heart attack are smoking, being very overweight, high cholesterol, high blood pressure and diabetes. The risk increases with age.

Why is high blood pressure dangerous?

The video below explains what happens in the body in the event of high blood pressure. What consequences can high blood pressure have and how can it be lowered?

This and other videos can also be found on YouTube.

Watch now

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It affects both men and women. But, on average, women have heart attacks at a more advanced age than men do. Overall, more women die of a heart attack than of breast cancer, for example.

What can I do to prevent it?

The same measures are recommended for prevention as for a healthy cardiovascular system:

  • Stop smoking.
  • Do regular physical exercise.
  • Maintain a normal weight.
  • Have a balanced diet.

How is a heart attack diagnosed?

The main test is an electrocardiogram (ECG). There are two types of heart attack based on the pattern shown on the recorded echocardiogram:

  • ST-segment elevation myocardial infarction (STEMI)
  • Non-ST-segment elevation myocardial infarction (NSTEMI)

With a STEMI, the ECG shows that a certain part of the curve is elevated – known as the ST segment. This indicates a more serious heart attack affecting larger parts of the heart muscle.

With a NSTEMI, no ST-segment elevation can be seen in the ECG. This is usually because a smaller area of the heart is damaged.

How is a heart attack treated?

The most important thing to do first is to call the emergency number 112 as soon as possible and request an ambulance with an emergency doctor. This is because the blocked coronary artery has to be opened again as quickly as possible.

  • Treatment of a STEMI (ST-segment elevation myocardial infarction): those affected usually have a cardiac catheter to widen the artery (angioplasty), providing the entire heart muscle with oxygen again.
  • Treatment of a NSTEMI (non-ST-segment elevation myocardial infarction): the type of treatment depends on various factors: How are symptoms progressing? Are there other medical conditions? Age is also a factor in assessing the risk of complication with surgery. But, most of the time, a NSTEMI is also treated with a cardiac catheter.

After the acute phase, there are other treatments intended to reduce the risk of a further heart attack.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG). As at:

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