Experiencing chest pain can be alarming, but it’s often easy to dismiss or downplay discomfort, especially when it comes to heart health. Many people underestimate the urgency of heart-related symptoms. But understanding what happens during a heart attack, and crucially, how long a heart attack lasts before irreversible damage occurs, is vital for ensuring timely medical intervention. Dr. Joseph Cookman, DO, FACC, a specialist at UnityPoint Health, breaks down the stages of a heart attack, the warning signs to be aware of, and why acting fast can be life-saving.
What is a Heart Attack and What are the Stages?
Simply put, a heart attack occurs when a part of your heart muscle is deprived of sufficient blood flow. This lack of blood supply is most often caused by a blockage in a blood vessel, hindering the delivery of oxygen and essential nutrients to the heart.
Dr. Cookman outlines four distinct stages that precede a full-blown heart attack:
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Stable Angina: In this initial stage, the blood vessels are narrowed but not completely blocked. Symptoms are typically triggered by periods of increased physical exertion. For instance, you might experience chest pain or discomfort when climbing stairs, as the heart struggles to receive enough blood to meet the demands of the activity.
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Unstable Angina: This stage signifies a worsening condition. The plaque and blockage within the blood vessels are growing, leading to more frequent symptoms even with less physical activity. While there might be periods without chest pain, it’s important to note that at this stage, no permanent heart damage has yet occurred.
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Heart Attack with Partial Blockage: Here, the situation becomes critical. Although the blockage isn’t complete, it’s severe enough to cause damage to the heart muscle. This is a significant event and requires immediate medical attention to prevent further harm.
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Full Heart Attack or Complete Blockage: This is the most severe stage. A complete, 100% blockage prevents any blood from reaching a part of the heart. The pain is intense and persistent, accompanied by classic heart attack symptoms. At this point, the duration of the heart attack becomes crucial. Immediate medical intervention is absolutely necessary to minimize heart damage, prevent life-threatening complications, or even death.
Dr. Cookman emphasizes the alarming statistic: “Forty to 50 percent of heart attacks present with a fatal event.” He explains that this often happens because “people ignore symptoms, which are usually taking place for weeks or months before finally having a heart attack with complete blockage. At that point, the heart isn’t getting blood and it can go into a life-threatening rhythm, which presents as cardiac arrest.” This highlights that recognizing early symptoms and understanding the progressive nature of heart disease is vital to prevent a catastrophic event.
What Triggers a Heart Attack?
Numerous factors can contribute to the development of a heart attack. Some risk factors, like family history, are beyond our control. However, many others are modifiable through lifestyle changes and medical management. Dr. Cookman points out factors we can influence, such as:
Managing these controllable risk factors is paramount in preventing heart attacks.
Recognizing the Signs: Heart Attack Symptoms in Men and Women
Heart disease, including heart attacks, is a significant threat to both men and women. While men tend to develop heart disease at younger ages, women are equally at risk, often experiencing heart events later in life. Dr. Cookman details how heart attack symptoms progress in both genders, using the mnemonic “OPQRST” to describe key characteristics:
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Onset: Heart attack symptoms typically don’t appear suddenly like a switch being flipped. They usually begin gradually, with the intensity of symptoms fluctuating – coming and going. This subtle onset can lead to delayed recognition and action.
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Provocation: The pain or discomfort associated with heart attack symptoms is often “provoked” or worsened by physical activity or exercise. Conversely, rest usually provides relief, lessening the symptoms. This relationship to exertion is a crucial clue.
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Quality: The sensation is often described as discomfort, tightness, pressure, or squeezing, rather than a sharp, stabbing pain. This quality of pain can be misleading, causing individuals to underestimate the seriousness of their symptoms and delay seeking help.
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Radiation: Heart attack symptoms are not always confined to the chest. The pain or discomfort can radiate to other areas of the body, such as the stomach, shoulders, arms (often the left arm), and jaw. This radiating pain can sometimes be mistaken for other conditions.
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Site: Symptoms are generally not localized to a single, pinpointed spot. Instead, people often experience a generalized ache or pressure across a broader area of the chest, rather than pain directly over the heart.
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Time (Duration): This is where the question of “How Long Does A Heart Attack Last?” becomes incredibly important in symptom recognition. Mild heart attack symptoms, such as those experienced during unstable angina, might only last for a brief period, perhaps two to five minutes, and then subside with rest. However, a full heart attack with complete blockage is characterized by symptoms that persist for a much longer duration, sometimes lasting for 20 minutes or more. Pain that lasts for more than a few minutes, especially if accompanied by other symptoms, should be treated as a medical emergency.
Understanding the “Widow-maker” Heart Attack
The term “widow-maker” refers to a particularly severe and often sudden heart attack that carries a high risk of fatality. In medical terms, it’s known as an anterior descending artery (LAD) occlusion. This occurs when the LAD, a major artery responsible for supplying blood to a significant portion of the heart muscle, becomes severely blocked.
When the LAD is obstructed, it drastically reduces blood flow to a large area of the heart, leading to a massive heart attack. The “widow-maker” is notorious for its potential to cause sudden cardiac arrest and death due to the extensive damage it inflicts on the heart. Experiencing chest pain, shortness of breath, or pain in the arm or jaw demands immediate medical attention, as it could be a “widow-maker” situation where rapid intervention is critical to survival.
What Steps to Take If You Suspect a Heart Attack
“If you experience anything that seems like heart attack symptoms, call 911 immediately,” urges Dr. Cookman. “You can’t ignore something as serious as a heart attack, or it might be the last time you ever brush anything off. It’s better to be seen by a medical professional than to assume it’s not a heart attack.” Time is muscle when it comes to heart attacks, and every minute counts in minimizing damage.
If you are with someone who you believe is having a heart attack, calling 911 remains the absolute priority.
“Getting medical support for that person as soon as you can is always your first action. While waiting for an ambulance to arrive, taking aspirin is a reasonable step. If this isn’t the first heart problem for the individual, taking nitroglycerin is also a good measure, along with an aspirin,” Dr. Cookman advises.
Crucially, even if the symptoms seem mild or you are unsure, do not drive yourself to the hospital during a suspected heart attack. Calling emergency services ensures that you receive immediate medical attention and transport, increasing your chances of a positive outcome.
Life After a Heart Attack: Treatment and Prevention
Treatment following a heart attack typically involves a coronary intervention. This procedure, performed by a cardiologist, involves accessing the heart through an artery, usually in the wrist or leg, to locate and address the blockage. A stent is often placed to open the blocked artery and restore blood flow. Medications are prescribed to prevent future blockages and manage risk factors. In cases where multiple blockages are present, open-heart surgery may be necessary.
To prevent future heart attacks, Dr. Cookman stresses the importance of lifestyle modifications. “If you’ve experienced a heart attack, you’re definitely at risk to have another. Doing things like quitting smoking, maintaining a healthy weight, eating a balanced diet, exercising regularly, and lowering your cholesterol help reduce that risk. If you’re someone with diabetes, you’re already at higher risk,” he explains.
He also highlights the increased risk during colder months, particularly in regions with harsh winters. Cold weather constricts blood vessels, and combined with activities like shoveling snow, increased physical exertion, and holiday stress, heart attacks become more prevalent during this time.
Regardless of the season, Dr. Cookman advises proactive communication with your doctor about any health changes you experience. “If something’s changed in the last two weeks and you are wondering about heart attack symptoms, it’s better to get help earlier and prevent long-term consequences of heart damage,” he concludes. Recognizing symptoms, understanding how long a heart attack can last before causing irreversible damage, and acting swiftly are crucial steps in protecting your heart health.
