Sometimes, the danger signal from the heart is more dramatic. Atherosclerosis causes plaques to accumulate in the coronary arteries. These plaques are lumps and bumps within the coronary arteries that can contain cholesterol, white blood cells, and other substances. Sometimes they grow to block the arteries and sometimes they are small and do not effect the blood flow. A cap forms on top of the plaque to keep the contents from seeping into the bloodstream. These plaques can be quiet and not cause a problem. Occasionally, however, the cap on a plaque can rupture exposing its contents to the bloodstream. When this happens, the content of the plaque are mixed with the blood and can cause formation of a blood clot. If the blood clot blocks an important artery supplying blood to the heart, heart muscle can be suddenly deprived of vital oxygen and nutrients. At this point, every minute counts because heart muscle cannot survive long without receiving fresh blood. Within a relatively short period the damage to the
heart can be severe and permanent. This event is what doctors call myocardial infarction. Everyone else calls it a heart attack.

The symptoms of a heart attack are often similar to those of angina, but much worse and more persistant. The classic description of a heart attack is a crushing chest pain that does not go away, even after resting or taking angina medication. Other symptoms, which sometimes can even occur without chest pain, can include sweating, nausea, light headedness, and breathlessness. These symptoms are often confused with those caused by other much less serious conditions.

Here is the important thing to keep in mind: Don’t take chances. If you experience symptoms that may represent a heart attack, you should call an ambulance immediately and be brought to an emergency hospital; your survival may depend on it. It is natural to feel reluctant  to ask for help, and for many people it is embarrassing to call an ambulance. Also, heart attacks often do not start like they do in the movies, with crushing pain that causes you to clutch your chest. Uncertainty is quite common. but you should not wait to see whether your condition gets worse. This is the time to call 911.

As a general rule, doctors recommend that angina like discomfort that occurs without exertion or persists for more than ten minutes should be treated as a sign of a possible heart attack, even if more dramatic symptoms do not develop. The national heart, lung, and blood institute of the national institutes of health recommends that people should not wait more than five minutes before calling 911. Why the rush? Treatment, particularly in the first hour, can make an enormous difference in improving a person’s chance od survival. Unfortunatly, most people experiencing a heart attack wait much longer to seek help. According to experts, most people wait two or more hours before obtaining medical attention.

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