A heart attack results when a complete occlusion suddenly forms in the arteries that supply blood to your heart – the coronary arteries. Blockages are caused by a disease process throughout the arteries in your body called atherosclerosis, in which plaque – a fatty substance – builds up in the arteries. This plaque narrows the arteries, leaving less room for blood to flow. A plaque can be topped with a thin, fibrous cap that ruptures. With rupture, exposure of atherosclerotic debris to the bloodstream can cause platelets (a component of blood that assists with clotting) and red blood cells to collect at the site of the rupture, cutting off blood flow to the artery. Alternatively, part of the plaque may break off and flow downstream in the blood. This piece of plaque can then lodge in a narrowed portion of the artery and blood will begin to clot around it. This blood clot (thrombosis) can partially or completely cut off blood flow through the artery. When blood flow is cut off, this is called ischemia.
Your heart is a muscle. Blood carries vital oxygen and nutrients to the heart muscle, and without blood, the heart muscle begins to die. That is why every second counts when it comes to heart attack treatment. An extensive blockage, especially in a major blood vessel, such as the left anterior descending artery, can cause a large heart attack. Large heart attacks that are not treated early and aggressively can lead to heart failure. The risk of death within five years of being diagnosed with certain types of heart failure can be 50 percent or more, worse than many forms of cancer.
It is better to go to the hospital and learn that you are not having a heart attack than to stay home and have one. That’s because the consequences of an untreated heart attack are so great. If your symptoms persist for more than 15 minutes, you are at more risk that heart muscle cells will die. It is critical for you and your heart that you receive immediate medical attention. To receive the best care, you have about 90 minutes from the onset of the heart attack for an interventional cardiologist or surgeon to restore the flow of blood to the heart before critical heart tissue dies or is damaged.