Myocardial infarction (MI), commonly known as a heart attack, is a life-threatening condition that occurs when blood flow to a part of the heart muscle is suddenly reduced or blocked. Without adequate oxygen, the affected heart muscle becomes damaged and may begin to die if blood flow is not restored quickly.[1]
Most heart attacks occur as a result of coronary artery disease, in which fatty deposits or plaques accumulate within the coronary arteries. Rupture of a plaque can lead to formation of a blood clot that partially or completely blocks blood flow to the heart.[1]
Global Impact
Heart attacks are a major contributor to the global burden of cardiovascular disease. Cardiovascular diseases are the leading cause of death worldwide, and approximately 85% of cardiovascular deaths are due to heart attacks and strokes.[2]
The burden is particularly high in low- and middle-income countries, where more than three-quarters of cardiovascular disease deaths occur.[2]
Impact in India
Myocardial infarction is an important cause of cardiovascular morbidity and mortality in India. The high burden of coronary heart disease and major cardiovascular risk factors such as hypertension, diabetes, tobacco use, unhealthy diet, physical inactivity and abnormal blood lipids contributes to the occurrence of heart attacks in the Indian population.[2]
Early recognition and rapid access to emergency cardiovascular care are particularly important because treatment of acute myocardial infarction is time-sensitive, and delays can increase heart muscle damage and the risk of death.[3]
During July 2018–December 2021, the Chandigarh NCD Registry recorded 1,835 acute cardiac events. Among cases with information on event type, 29.6% were STEMI and 28.7% were NSTEMI. Most acute cardiac events (59.5%) occurred among people aged 45–69 years.[4]
Risk Factors
Major risk factors for myocardial infarction include tobacco use, high blood pressure, high blood cholesterol, diabetes, overweight and obesity, physical inactivity, unhealthy diet, harmful use of alcohol, increasing age and family history of cardiovascular disease.[1,2]
Signs and Symptoms
Symptoms of myocardial infarction can develop suddenly or begin gradually and may vary between individuals.[5]
Common symptoms include:
- Pain, pressure, heaviness or discomfort in the chest
- Pain or discomfort spreading to the arms, shoulders, neck, jaw or back
- Shortness of breath
- Cold sweating
- Nausea or vomiting
- Dizziness or light-headedness
- Unusual fatigue
- Rapid or irregular heartbeat.[5]
Some heart attacks may cause only mild symptoms or no noticeable symptoms, particularly among older adults and people with diabetes.[5]
Treatment and Management
A myocardial infarction is a medical emergency requiring immediate treatment. Rapid restoration of blood flow can limit damage to the heart muscle and improve survival.[1,3]
- Medications: Medicines may include antiplatelet medicines such as aspirin, anticoagulants, nitrates and, in selected situations, thrombolytic medicines that dissolve blood clots.[6]
- Percutaneous Coronary Intervention (PCI): PCI or coronary angioplasty is used to open a blocked coronary artery. A stent is commonly inserted to help maintain blood flow.[6]
- Coronary Artery Bypass Grafting (CABG): In selected patients with severe or multiple coronary artery blockages, bypass surgery may be required to restore adequate blood flow to the heart.[6]
Following a heart attack, long-term management may include medications, lifestyle modification, management of cardiovascular risk factors and cardiac rehabilitation to reduce the risk of another cardiovascular event.[7]
Prevention
The risk of myocardial infarction can be substantially reduced by avoiding tobacco, following a healthy diet, engaging in regular physical activity, maintaining a healthy weight and controlling blood pressure, cholesterol and blood glucose.[2]
Early identification and treatment of people at high cardiovascular risk can help prevent heart attacks and other cardiovascular complications.[2]
References
- National Heart, Lung, and Blood Institute. Heart attack: what is a heart attack?. Bethesda (MD): National Heart, Lung, and Blood Institute; 2022 Mar 24. Available from: https://www.nhlbi.nih.gov/health/heart-attack
- World Health Organization. Cardiovascular diseases (CVDs). Geneva: World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-%28cvds%29
- World Health Organization. Framework for the care of acute coronary syndrome and stroke. Geneva: World Health Organization; 2024 Dec 13. Available from: https://www.who.int/publications/i/item/9789240103665
- Thakur JS, Malhotra P, Bhadada SK, Kapoor R, Vijayvergiya R, Khurana D, Arora P. Chandigarh Noncommunicable Diseases (NCD) Registry, July 2018 to December 2021. Chandigarh: World NCD Federation; 2025.
- National Heart, Lung, and Blood Institute. Heart attack symptoms. Bethesda (MD): National Heart, Lung, and Blood Institute; 2022 Mar 24. Available from: https://www.nhlbi.nih.gov/health/heart-attack/symptoms
- National Heart, Lung, and Blood Institute. Heart attack treatment. Bethesda (MD): National Heart, Lung, and Blood Institute. Available from: https://www.nhlbi.nih.gov/health/heart-attack/treatment
- National Heart, Lung, and Blood Institute. Heart attack recovery. Bethesda (MD): National Heart, Lung, and Blood Institute. Available from: https://www.nhlbi.nih.gov/health/heart-attack/recovery