Millions of Europeans are affected by heart attacks each year — yet many people do not fully understand what happens, how to recognise one, or how to recover. Here we explain what a heart attack is, who is at risk, how to spot it, how it is treated, and how you can live well afterward.
A heart attack, also known as myocardial infarction (MI) occurs when blood flow to a portion of the heart muscle is severely restricted or blocked, causing injury or death (necrosis) of heart tissue. The blockage is usually due to a buildup over time of fats, cholesterol and other substances in the heart (coronary) arteries.
The fatty, cholesterol-containing deposits are called plaques. The process of plaque buildup is called atherosclerosis. When plaque buildup narrows a coronary artery, this leads to ischemia (inadequate oxygen-rich blood flowing to the heart mucle). Sometimes, a plaque can rupture. This triggers a blood clot to form in the artery that blocks blood flow. A blockage of blood flow leads to heart muscle damage or death.
The longer the blockage lasts, the more heart muscle is lost. Quick action can save your life and limit long-term damage.
High levels of "bad"cholesterol (LDL-C) and triglycerides are both considered risk factors for atherosclerosis, the buildup of substances in artery walls called plaque.
LDL-C is the primary substance in plaque. Triglycerides are not part of the plaque, but they can cause inflammation of artery walls, which can initiate or accelerate the plaque process.
Plaques limit the blood flow through the affected artery, or they can rupture, and block blood flow altogether, causing a heart attack or stroke.
A heart attack is part of a broader group of conditions known as acute coronary syndrome (ACS) — a medical emergency that occurs when blood flow to the heart muscle is suddenly severely reduced or blocked.
ACS covers three main situations, depending on the degree of blockage and heart damage:
A complete blockage of a major coronary artery, which causes significant damage to the heart muscle.
A STEMI heart attack is life-threatening if not promptly treated.
It is diagnosed by specific changes on an EKG called ST-segment elevation.
This is the most severe type of heart attack.
A partial or intermittent blockage reduces blood flow, leading to some degree of heart muscle injury.
A NSTEMI heart attack does not show specific changes on an EKG but rather is detected by blood tests.
Urgent hospital care and invasive assessment are needed.
A sudden worsening of chest pain or discomfort due to reduced blood flow, but without measurable heart damage.
It is a warning sign that a heart attack may soon occur if untreated.
Understanding your risk is key to heart attack prevention. There are two types of risk factors: modifiable (those you can manage, treat, or improve) and non-modifiable — those beyond your control.
high in salt, sugar, and saturated or trans fats
such as sleep apnea
although women’s risk rises after menopause
Recognising a heart attack early can save lives. Symptoms may vary between individuals (and between men and women), and some people may present without “classic” symptoms.
Common warning signs include:
pressure, squeezing, fullness, or pain in the centre of the chest
with or without chest discomfort
often cold sweat
especially in women
occasionally
Diagnosis is made quickly, often in the emergency / acute care setting, and typically includes:
Rapid diagnosis is critical, as many treatments are time-sensitive (e.g. opening blocked arteries within hours).
Treatment for a heart attack has four main goals: restore blood flow to the heart, limit heart muscle damage, stabilise the patient and prevent future events.
Approaches differ depending on whether the care is acute (hospital phase) or long-term (after discharge).
Rapid treatment is critical — every minute counts.
According to European Society of Cardiology (ESC) guidelines, patients should be managed in specialised cardiac units whenever possible, following structured pathways for acute coronary syndrome (ACS).
Key steps include:
ESC guidelines recommend a rapid invasive strategy for STEMI and for selected high-risk patients with non-ST-elevation ACS.
Once the acute phase is over, ongoing care focuses on preventing recurrence and supporting recovery.
Long-term management includes:
Recovery after a heart attack focuses on helping your heart heal, regaining confidence, and reducing the risk of another event. With appropriate treatment, cardiac rehabilitation, and heart-healthy lifestyle changes, many people return to their usual activities and continue living well. Protecting your heart moving forward requires ongoing attention to the areas below.
Key areas to focus on include:
Follow your treatment plan exactly as you were told. Taking medications as instructed is vital for feeling better and enhancing your longevity. If you have any uncertainties, don’t hesitate to reach out to your doctor.
Making changes to what you eat, how active you are, and whether you smoke can make a big difference in your recovery. Aim for a balanced diet, regular movement, and — if you smoke — seek support to stop. Small, consistent steps can have a powerful impact on your heart health.
If your care team recommends it, cardiac rehab can help you safely rebuild strength, gain confidence, and understand your condition better. These programmes offer exercise guidance, education, and emotional support — all tailored to your needs.
Regular check-ins allow your healthcare team to track your progress, adjust treatments if needed, and identify any issues early. Keeping these appointments is an important part of staying well and preventing future heart problems.
It is normal to feel anxious, low, or uncertain after a heart attack. Stress can also affect your heart. Speaking with a psychologist, counsellor, or joining a support group can help you process what happened and feel more in control.
Work with your healthcare team to keep your cholesterol, blood pressure, diabetes, and other risk factors well managed. These steps are key to protecting your heart and reducing the chance of another event.
Maintain connections with supportive individuals in your life and seek out peers who share similar experiences. Building an emotional support network is crucial for staying motivated and focused on your health goals. Share your journey, seek advice, and offer support to others in your community.
