What is a heart attack?

A heart attack, also known as myocardial infarction, is a form of acute coronary syndrome. It happens when the heart doesn’t receive enough blood.

There are three types of heart attacks:

  • ST-segment elevation myocardial infarction (STEMI)
  • non-ST segment elevation myocardial infarction (NSTEMI)
  • coronary spasm, or unstable angina

What is STEMI

STEMI stands for ST-Segment Elevation Myocardial Infarction.

ST-Segment refers to the pattern that is seen on the ECG.

It’s a severe and common heart attack in which the coronary artery becomes completely blocked because the muscles stop getting blood

How do we differentiate between STEMI and NSTEMI?

The main difference between STEMI and Non-STEMI is the ST-segment elevation, which indicates the cardiac muscle damage limit.
ST-segment elevation usually implies that the cardiac muscle is dying due to a total blockage.
Non-STEMI heart attacks typically feature a partially blocked artery, which generally results in less damage to the heart muscle.
If the ECG doesn’t show ST-segment elevation, it’s recommended to do a troponin test as troponin level in blood indicates heart muscle damage, and it means that there is an NSTEMI.

Risk factors

Various factors are increasing the risk of having a heart attack. Some of these factors are controllable and some are uncontrollable.

Factors you can control:

  • Smoking
  • Sedentary lifestyle
  • High sodium intake
  • High sugar intake
  • Consuming a lot of fat-containing food
  • Alcohol consumption
  • Abusing stimulant drugs

Factors you can not control:

  • Old age
  • Sex, as men are more likely to experience a heart attack than women. A man’s chance of having a heart attack increases at the age of 45. Meanwhile, women’s risk of having a heart attack starts at the age of 50, or right after menopause.
  • Family history, as the heart attack risk increases significantly if the patient had a parent or a sibling who had a heart attack at an early age.
  • Congenital conditions. Some genetic or congenital conditions increase the risk of a heart attack.

What are the symptoms?

The most common symptom of STEMI or heart attack generally are:

  • Chest pain
  • Breathing difficulties
  • Nausea and stomach discomfort
  • Indigestion feeling
  • Heart palpitation
  • Sweating
  • Anxiety
  • Dizziness
  • Fainting

Usually, women can experience more symptoms than the ones mentioned above. These symptoms include:

  • Fatigue, insomnia, and shortness of breath prior to the heart attack
  • Having back, shoulder, jaw, neck, arm, or stomach pain

Vomiting and nausea


Based on a combination of a physical examination of the symptoms and diagnostic testing, a doctor will determine whether a patient has STEMI. A physician can conduct a physical examination and patient history evaluation after patients are in a stable medical condition and able to respond to questions.


Electrocardiogram (ECG or EKG), to record the electrical signal and display activity of the heart as a wave pattern to check different heart conditions including STEMI diagnosis.

Imaging, the most common imaging test in those cases is echocardiography which uses ultra-high-frequency sound waves to create an image of your heart, including the internal structure.

There are more imaging tests that are recommended if the echocardiography is not enough. Those tests include:

Computer tomography (CT)

This test creates a very detailed, layer-by-layer image of the heart using X-rays and computer processing. Contrast or another type of chemical or dye that is administered to the blood is usually used for this test. By demonstrating where blood is flowing and where it isn’t, this color can assist identify any obstructions.

Magnetic resonance imaging (MRI)

In this test, photos are processed by a computer and high-resolution photographs of the heart are produced using an incredibly strong magnet.

Lab testing

When the heart muscle cells are damaged, they release a chemical substance called troponin. A troponin test is done to confirm the heart attack and to rule out the other conditions that cause ST-segement elevation.


Some conditions like hypertension and diabetes may mask the symptoms of heart attack, so, it’s recommended to have an annual checkup if you have one or more risk factors.

An individual can follow some steps to prevent himself from heart diseases, they should:

  • keep a healthy weight
  • Consume a healthy diet
  • Practice moderate-intensity exercise for at least 150 minutes each week.
  • Quit using tobacco products.
  • Maintain good health, especially if they suffer from illnesses like diabetes, high blood pressure, or high cholesterol
  • take their medication regularly


The chances of successful therapy are improved with speed.

Oxygen therapy can be used if needed. There are a variety of potential therapies for heart attacks, some of which may occur simultaneously or in succession.

●  PCI

Percutaneous coronary intervention is a procedure an interventionist does to  identify and clear a blockage

Hospitals set a “door-to-balloon time” target for heart attack cases since PCI is time-sensitive.

It is also possible to insert a stent (a scaffold-like device) at the site of the obstruction during PCI. The stent will assist in keeping the artery open and preventing the development of new blockages.


Several drugs are frequently used early on in the treatment of a heart attack. They include:

  • Beta-blockers, to slow down the heart and make it beat less forcefully. This impact prevents abnormal cardiac rhythms, lessens heart damage, and helps the heart muscle cope with a decrease in blood flow.
  • Statins, to block cholesterol production in the liver and reduce blood cholesterol levels.
  • Aspirin and antiplatelets, to aid in preventing blood clots from forming on arterial plaque and, if a stent is inserted during PCI, on the metal surface of the stent.
  • Anticoagulants, to prevent blood cl
  • this drug widens youotting in a different manner than Aspirin.r blood vessels and is particularly efficient at vasodilation.
  • Pain killers, strong painkillers like morphine or others may be helpful for severe chest discomfort.


Coronary artery bypass grafting, also known as open-heart surgery, is required for the coronary arteries if they are severely blocked. A blood vessel from another part of your body is used by the surgeon to create a new blood vessel that gets around the obstruction during this treatment.


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Fawaz Almutairi

Saudi Arabia

Fawaz Portrait GIS president


President, Gulf Intervention Society

Interventional Cardiologists

National Guard Hospital

Riyadh, Saudi Arabia

Abdullah Shehab

United Arab Emirates

shehab portrait vice president GIS


Vice President, Gulf Intervention Society

Professor of Cardiovascular Medicine

Chairman of Education, EMA 

Editor Chief New Emirates Medical Journal 

Alain, Abu Dhabi, UAE

Khalid Bin Thani



Treasurer, Gulf Intervention Society

Head of Scientific Committee, GIS Conference

Consultant Interventional Cardiologist

Bahrain Specialist Hospital Manama, Bahrain
Khalid Bin Thani GIS

Mousa Akbar



General Secretary, Gulf Intervention Society

Head of Cardiology Unit, Al Sabah Hospital

Kuwait City, Kuwait

mousa Akbar GIS