Myocardial infarction continues to be one of the leading causes of death worldwide, despite remarkable progress in diagnosis and treatment. Understanding the causes and symptoms is essential for preventing and managing the risk of a heart attack.

What symptoms may indicate a myocardial infarction?

• Chest pain or discomfort (which may radiate to the left shoulder, left arm, neck, jaw, and back)

• Shortness of breath

• Cold, excessive sweating without physical effort

• Nausea or vomiting, more common in women

• Dizziness or light-headedness, sometimes fainting

• Palpitations or irregular heartbeat sensations

• Anxiety similar to a panic attack

Symptoms can vary in intensity and presentation, and some individuals—especially diabetics, the elderly, or women—may experience atypical or minimal symptoms. In any case of suspicion, we recommend calling emergency services immediately (112).

What causes a heart attack?

Heart attacks are caused by factors that contribute to atherosclerosis and the blockage of coronary arteries. These can be influenced by modifiable risk factors (through intervention and treatment) or non-modifiable ones.

Modifiable risk factors (can be influenced):

• High LDL cholesterol or low HDL cholesterol

• High blood pressure, heart disease

• Smoking: increases heart attack risk by 2–4 times

• Diabetes mellitus, especially type 2: accelerates atherosclerosis and is often associated with other risk factors

• Physical inactivity

• Obesity, especially abdominal: associated with insulin resistance, hypertension, and systemic inflammation

• Unhealthy diet: rich in saturated fats, salt, refined sugars, and low in vegetables and fruits

• Chronic stress and lack of sleep

Non-modifiable risk factors:

• Age: risk increases significantly after 45 in men and after 55 in women

• Sex: men have higher risk at younger ages; women’s risk increases post-menopause

• Family history of early cardiovascular disease: if first-degree relatives had heart attacks or strokes

Other emerging or contributing factors:

• Metabolic syndrome (cluster of risk factors like impaired glucose tolerance, high triglycerides, excess weight, etc.)

• Chronic inflammation (elevated C-reactive protein)

• Sleep disorders (sleep apnea)

• Excessive alcohol consumption

• Air pollution

Most myocardial infarctions can be prevented through lifestyle changes, regular visits to a cardiologist, and adherence to recommended treatment.

What to do in case of a myocardial infarction?

If symptoms of a potential heart attack occur, quick action is critical—every minute counts in saving heart muscle and the patient’s life. Immediate measures for the patient:

• Call emergency services (112) without waiting for symptoms to pass

• Sit down in a comfortable position with the torso slightly elevated and avoid any physical effort

• Take aspirin: ½ tablet of 500 mg, chewed. Do NOT take aspirin if allergic, have active gastric ulcer or bleeding

• Take one sublingual nitroglycerin tablet (or spray), but only if prescribed

• Note the time symptoms began — this information will help the medical team

What not to do:

• Do not ignore the symptoms

• Do not drive yourself to the hospital — there’s a risk of cardiac arrest at the wheel

• Do not take painkillers, antacids, or unprescribed medication thinking they will help

These measures must be taken urgently, because every minute lost means lost heart muscle, and treatment is most effective within the first 1–2 hours after symptoms begin.

Innovations in myocardial infarction treatment

Treatment for myocardial infarction and coronary artery disease has significantly improved in recent years thanks to technological advancements, new classes of medication, and personalized approaches. Key innovations include:

Acute myocardial infarction treatment (STEMI/NSTEMI)

• Primary angioplasty (PCI): performed via radial access (through the wrist), with advanced stent deployment techniques, allowing for faster recovery and reduced complications

• Modern coronary disease treatment benefits from innovative assessment and imaging methods, such as:

• FFR (Fractional Flow Reserve) – to precisely assess the severity of coronary stenosis
• IVUS (Intravascular Ultrasound)
• OCT (Optical Coherence Tomography) – for highly detailed images of coronary arteries

Medication advancements

• Modern antiplatelet drugs like ticagrelor, prasugrel, and cangrelor (more effective than clopidogrel)

• In addition to statins, cholesterol-lowering therapy includes PCSK9 inhibitors (evolocumab, alirocumab), inclisiran, and bempedoic acid — all significantly reduce cardiovascular risk

• SGLT2 inhibitors and sacubitril/valsartan combination help in post-infarction heart failure

Digital health tools

• Telemedicine and remote monitoring

• Personalized and genetic approaches to assess individual risk

• Online platforms for prevention and rehabilitation, offering guided exercise and education through personal coaching

Thus, myocardial infarction treatment has become:

• Faster — through efficient emergency interventions

• More precise — with physiological and imaging-guided procedures

• More personalized — with therapies tailored to each patient

• More accessible — through digital technology and modern medication

What you can do to prevent a recurrence

Lifestyle change can reduce the risk of cardiovascular events by up to 50% or more — just as important as taking medication.

Our recommendations:

• Heart-protective nutrition: Mediterranean-style diet and reduced intake of saturated fats, refined sugar, salt, processed meat, and fast food

• Regular physical activity: at least 150 minutes/week of moderate aerobic activity (e.g., brisk walking, cycling, swimming) and strength training twice a week

• Complete smoking cessation

• Maintaining a healthy body weight

• Managing stress and caring for mental health

• Medication adherence and regular medical check-ups

A consultation with a cardiology specialist can bring peace of mind and clarity when it comes to your heart health. If you have questions or concerns, schedule a visit with one of our cardiologists.