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Everything You Should Know About the Types of Heart Attacks

By Dr. Naveen Bhamri in Cardiac Sciences

Jun 01 , 2018 | 4 min read

Heart diseases are highly common throughout the world; however, the rising figures are a cause for concern. Every heart condition is critical and needs immediate medical intervention.

Heart attacks pose a serious health risk and are always life-threatening. They occur when there is a blockage in the coronary arteries which leads to disruption in blood flow to or from the heart. The blockage can cause permanent damage to the heart.

Medical Dictionary – A heart attack is also known as myocardial infarction.

Types of Heart Attacks

Heart attacks are a form of Acute Coronary Syndrome (ACS). In this syndrome, the arteries carrying the blood to the heart get blocked, leading to a heart attack. Since blood also carries oxygen and nutrients to the rest of the body, a heart attack can stop this supply causing permanent organ damage.

There are five types of heart attacks:

  1. STEMI (ST-segment elevation myocardial infarction)
  2. NSTEMI (non-ST segment myocardial infarction)
  3. Coronary Artery Spasm (also known as ‘Prinzmetal's angina)
  4. Stable Angina
  5. Unstable Angina

Medical Fact – ST segment is a flat section of ECG that represents the interval between ventricular depolarization and repolarization. Heart attack or Myocardial Infarction is the main cause of an abnormality in the ST section of the EKG (electrocardiogram) – elevation (STEMI) or depression (NSTEMI).

STEMI Heart Attack

An ST-segment elevation myocardial infarction is the most severe type of heart attack in which the coronary artery is completely blocked. The blocked artery prevents blood from reaching a large area of the heart muscle. A STEMI heart attack causes progressive heart damage and requires immediate medical intervention.

STEMI Symptoms

  • Sharp pain in the center of the chest
  • Shortness of breath
  • Nausea
  • Pain in jaw, neck, and arms
  • Anxiety
  • Light-headedness

STEMI Treatment

STEMI is a critical situation and requires emergency revascularization – the restoration of blood supply through the blocked artery. The process of revascularization is achieved by either first giving thrombolytics intravenously or conducting a primary angioplasty where a catheter with a balloon is placed inside the blocked artery. The balloon is pushed to open the blocked artery which restores the blood supply. Furthermore, a stent is placed at the site to prevent further blockage.

Medical Dictionary – Thrombolytics are medications that are also known as clot busters as they dissolve the clots in the arteries.

NSTEMI Heart Attack

NSTEMI or non-ST segment myocardial infarction is a type of heart attack that does not show any change in the ST segment elevation on the electrocardiogram. In this type, the coronary artery is only partially blocked, and blood flow is severely restricted. Even though these types of heart attacks are less severe than STEMI heart attacks, they can cause permanent damage.

Typically, a coronary angiography shows the degree of blockage in the artery in case of an NSTEMI heart attack. A blood test will confirm elevated levels of troponin – a protein that regulates muscle contraction.

NSTEMI Symptoms

The symptoms of an NSTEMI heart attack are similar to that of a STEMI heart attack. However, a person can experience dizziness, sweating, and pronounced discomfort in the chest.

NSTEMI Treatment

Cardiologists use a GRACE (Global Registry of Acute Coronary Events) score to determine the extent of risk in a patient. The score uses 8 parameters to calculate risk, including:

  • Heart rate
  • Age
  • Systolic blood pressure
  • ST segment deviation in ECG
  • Serum creatinine level
  • Elevated cardiac maker
  • Killip classification
  • Cardiac arrest at admission

After a thorough evaluation of the patient’s present condition, the cardiologist will suggest the right treatment options. The cardiologist will prescribe medications to low-risk patients where the blockage can be controlled and minimized through drugs.

Medical Fact – Killip classification is a system used for patients with acute myocardial infarction. It takes the development of heart failure and physical examination into account to predict and stratify the risk of mortality.

Coronary Artery Spasm

Also known as silent heart attacks, coronary artery spasm happens when the artery wall suddenly tightens, which restricts the blood flow to the heart. When the blood flow is restricted due to the tightening of muscles, it leads to chest pain. However, when the blood flow is cut altogether, it leads to a heart attack. The symptoms of coronary artery spasm do not cause permanent damage, and this condition may come and go. Furthermore, since there is no blood clot or build-up of plaque in this condition, an angiogram cannot be used to check the arteries for blockages.

Coronary Artery Spasm Symptoms

The symptoms include:

  • Occasional light chest pain that only occurs during rest and lasts from 5 to 30 minutes
  • A feeling of constriction
  • Chest tightness
  • Pain that spreads from chest to arms, neck, or jawbone

Coronary Artery Spasm Treatment

This type of heart attack can be treated using medications such as calcium channel blockers and nitrates.

Medical Dictionary – Coronary Artery Spasm is also known as prinzmetal angina. Angina is chest pain, tightness, or discomfort in the chest.

Stable Angina

Angina is a type of chest pain that occurs when blood flow to the heart is reduced. When there is a reduction in blood flow, the heart will not get enough oxygen which can lead to a heart attack.

Stable angina is also known as angina pectoris and is a predictable pattern of chest pain. It occurs gradually and is usually triggered by strenuous activity or emotional stress.

Unstable Angina

Another form of angina, unstable angina occurs suddenly and gets worse over time leading to a heart attack. Patients suffering from unstable angina are at a higher risk of getting a heart attack. The most common cause of unstable angina is coronary artery disease due to atherosclerosis – which is the buildup of plaque in the walls of the arteries.

A Word from Max Healthcare

Heart attacks can be life-threatening, and people must never overlook any symptoms involving cardiac diseases. If immediate medical attention is provided, most heart conditions are highly treatable. We at Max Healthcare have a dedicated team of cardiologists and cardiac surgeons who specialize in treating all ailments related to the heart like CVDs, congenital heart defects, coronary artery diseases, and pulmonary heart failure. Furthermore, our doctors also specialize in treating end-stage heart failure patients. Max Healthcare promotes a healthy and active lifestyle.


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