A heart attack happens when blood flow to your heart muscle is blocked for long enough to damage the muscle. If blood flow isn’t restored quickly, the heart muscle begins to die from a lack of oxygen, and non-functioning scar tissue forms in its place. If enough muscle function is lost, “heart failure” can occur.

Most heart attacks occur secondary to atherosclerosis, a condition in which a hard substance called plaque builds up inside your arteries, making them narrow and eventually block up over time. Genetics, high blood sugar levels, and smoking all cause the disease process to progress quicker. Plaque may also break open, causing a blood clot to form on the plaque’s surface and causing heart muscle death without advanced warning.

While all myocardial infactions or heart attacks can be fatal, some are truly notorious. A heart attack from a blockage in the main artery that goes down the front of the heart, known as the widowmaker, is often the most fatal. According to the American Heart Association, the survival rate following a widowmaker heart attack is only 12% when it occurs outside of a hospital or advanced care center.

Despite its name, a widowmaker can occur in both men and women. A blockage of 80 to 100% in the left anterior descending (LAD) artery – the largest of the three arteries providing blood to the heart – doesn’t allow oxygen to 40% of the muscle. Without oxygen, the cells in your heart muscles start to die in minutes.
Symptoms of Heart Attack

Many people that experience a heart attack either have no symptoms or have symptoms they associate with other problems. You can’t always tell from looking at someone if they are having a heart attack, or which type of heart attack it is.

Heart attack symptoms can include:

Pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes or stops and recurs
Discomfort that extends to the shoulders, arms, back, abdomen, jaw, and teeth
Shortness of breath
Sweating
Lightheadedness or fainting

Heart attacks symptoms can vary for women and include:

Abdominal pain that may feel like heartburn or indigestion
Dizziness
Unusual fatigue
Clammy skin

Reducing Your Risk for a Heart Attack

The best way to avoid a heart attack is to understand and limit your risk factors and that starts by having a good relationship with your primary care doctor. Your doctor is familiar with your health, wellness, family history, and risks, and can help you develop a plan accordingly.

Tips for keeping your risk as low as possible, include:
Not smoking
Maintaining a healthy weight
Eating a heart-healthy diet
Having an active lifestyle
Managing chronic conditions such as high blood pressure, diabetes, and high cholesterol

Time is Muscle
A heart attack is a medical emergency that can be deadly without treatment. The key to surviving a heart attack is to get help as quickly as possible because time is muscle. If you think you or someone else is having a heart attack, call 911 right away. Emergency responders can provide the fastest, safest route to the hospital and are trained to treat you on the way.

Michael Lazar, MD, is the medical director of UPMC’s Heart & Vascular Institute in Williamsport. Specializing in heart bypass surgery including beating heart bypass surgery, aortic and mitral valve repair and replacement, lung resection, and advanced aortic surgery, Dr. Lazar is also highly skilled and trained in minimally invasive surgical approaches and robotic assisted surgery. For more information or to schedule an appointment with UPMC’s Heart & Vascular Institute, call 570-321-2800.

What is a Widowmaker Heart Attack?
By Michael Lazar, MD
Cardiothoracic Surgeon, UPMC Heart & Vascular Institute