What is a Heart Attack?
A heart attack (myocardial infarction) occurs when the blood supply to part of the heart muscle is blocked, usually by a blood clot forming in a narrowed coronary artery. Without blood flow, the heart muscle is starved of oxygen and begins to die. The longer the blockage remains, the greater the damage to the heart.
Coronary arteries can become narrowed over time due to a build-up of fatty deposits called atherosclerotic plaques. When a plaque ruptures, a blood clot forms at the site and can completely block the artery.
Why It Matters
Cardiovascular disease, including heart attacks, is the leading cause of death in Sri Lanka, accounting for a significant proportion of all deaths in the country. Sri Lankans are at particularly high risk due to a combination of genetic predisposition (South Asian ethnicity), changing dietary habits, increasing rates of diabetes, and sedentary lifestyles. Early recognition and prevention can save lives.
This is a Life-Threatening Emergency
A heart attack is a medical emergency. Every minute counts — the sooner blood flow is restored to the heart, the less damage occurs. If you suspect a heart attack, call 1990 (Sri Lanka ambulance service) immediately or go to the nearest hospital with a cardiac unit.
Risk Factors
Non-Modifiable
- Age (men over 45, women over 55)
- Family history of heart disease
- South Asian ethnicity (higher genetic risk)
- Male sex (though women's risk increases after menopause)
Modifiable
- Smoking and tobacco use
- Diabetes mellitus
- Hypertension (high blood pressure)
- High cholesterol
- Obesity and overweight
- Sedentary lifestyle
- Chronic stress
- Unhealthy diet (high in salt, fat, and processed food)
Symptoms of a Heart Attack
Classic Symptoms
- Chest pain or pressure — a heavy, crushing, or squeezing feeling (often described as "an elephant sitting on the chest")
- Pain radiating to the left arm, jaw, neck, back, or stomach
- Shortness of breath
- Cold sweating (breaking out in a cold sweat)
- Nausea or vomiting
- Dizziness or light-headedness
- A sense of impending doom
Symptoms in Women
Women may experience different or less typical symptoms:
- Unusual fatigue (lasting days)
- Back pain or upper back pressure
- Nausea, vomiting, or indigestion without chest pain
- Jaw pain
- Shortness of breath without chest discomfort
- Dizziness or light-headedness
Women are more likely to dismiss symptoms or delay seeking help. Do not ignore these warning signs.
"Time is Muscle" — Every Minute Counts
During a heart attack, heart muscle is dying with every passing minute. The phrase "Time is Muscle" is used by doctors to emphasize that rapid treatment dramatically improves outcomes. Treatment within the first 90 minutes can save a significant amount of heart muscle and reduce the risk of death.
| Time to Treatment | Impact |
|---|---|
| Within 1 hour | Best outcomes — most heart muscle can be saved |
| 1 - 3 hours | Good outcomes — significant benefit from treatment |
| 3 - 6 hours | Some benefit — but more muscle damage has occurred |
| Beyond 6 hours | Much of the heart muscle may be permanently damaged |
What to Do If You Suspect a Heart Attack
Emergency Action Plan
- Call 1990 immediately (Sri Lanka ambulance service) or get someone to take you to the nearest hospital with a cardiac unit.
- Chew one aspirin (300mg) if you are not allergic to it and have no history of bleeding disorders. Chewing helps it absorb faster.
- Sit down and rest in a comfortable position (semi-upright). Do not lie flat.
- Do NOT drive yourself to the hospital — you may lose consciousness.
- Loosen tight clothing and try to stay calm.
- If the person becomes unresponsive and stops breathing, begin CPR (chest compressions) and call for help.
Prevention
- Stop smoking: Smoking doubles the risk of heart attack. Even quitting late in life provides significant benefit.
- Eat a heart-healthy diet: Increase fruits, vegetables, whole grains, and fish. Reduce fried food, red meat, salt, and sugar. Traditional Sri Lankan meals with moderate rice, dhal, vegetables, and fish are heart-friendly.
- Exercise regularly: At least 30 minutes of moderate activity (brisk walking, cycling, swimming) at least 5 days a week.
- Control blood pressure: Keep BP below 130/80 mmHg. Take medications as prescribed.
- Manage diabetes: Keep blood sugar well controlled. Get regular HbA1c checks.
- Lower cholesterol: Get lipid profiles checked regularly. Take statins if prescribed by your doctor.
- Maintain a healthy weight: Aim for a BMI under 23 (lower threshold for South Asians).
- Manage stress: Practice relaxation, maintain social connections, and get adequate sleep.
- Limit alcohol: If you drink, keep it to a minimum.
Recovery and Cardiac Rehabilitation
After a heart attack, recovery involves both physical healing and lifestyle changes:
- Hospital stay: Typically 3-7 days depending on the severity and treatment (angioplasty/stenting or bypass surgery).
- Cardiac rehabilitation: A supervised program of gradual exercise, dietary guidance, and psychological support. Ask your cardiologist about cardiac rehab programs.
- Medications: You will likely be prescribed blood thinners (aspirin, clopidogrel), statins, beta-blockers, and ACE inhibitors. Never stop these medications without medical advice.
- Lifestyle changes: Quit smoking permanently, follow a heart-healthy diet, exercise as guided, manage stress, and attend all follow-up appointments.
- Emotional recovery: Anxiety and depression are common after a heart attack. Talk to your doctor if you feel persistently low or anxious.
- Return to normal activities: Most people can gradually return to work and daily activities within 4-12 weeks, guided by their doctor.
Important: This information is for educational purposes only. If you are unsure about your symptoms or they are severe, please consult a doctor. Our doctors are available for home visits and telemedicine consultations.