Studies have found that survival rates for people hospitalized for heart attacks are approximately 90% to 97%. This varies based on the type of heart attack, which arteries are involved, and additional factors such as age and gender.
A heart attack, also called a myocardial infarction (MI), occurs when there is a blockage or severe reduction in blood flow to a portion of the heart. It is a life-threatening medical emergency and more damage to the heart can happen the longer the blockage goes without treatment.
About Heart Attacks
A heart attack is the most severe form of acute coronary syndrome (ACS). This is a term for a medical emergency involving the heart's arteries.
Like all forms of ACS, a heart attack is usually triggered by the rupture of an atherosclerotic plaque within a coronary artery (the arteries that supply oxygen to the heart muscle). This plaque rupture causes a blood clot to form, leading to blockage of the artery. The heart muscle that is supplied by the blocked artery then begins to die.
A heart attack is diagnosed when there is death of a portion of the heart muscle.
Heart Attack Survival Rates
There are several factors that affect whether someone will survive a heart attack.
Type of Heart Attack
Most heart attacks are caused by a blockage in a coronary artery, but, in rare cases, they can be caused by a sudden spasm or tearing of an artery.
The two main types of heart attacks are:
- ST-elevation myocardial infarction (STEMI) is when there is a complete blockage in a coronary artery. It is the most severe type of heart attack.
- Non-ST-elevation myocardial infarction (NSTEMI) is when an artery is partially blocked and severely reduces blood flow to the heart. NSTEMI is slightly more common than STEMI.
Other types of heart attacks, which are less common than STEMI or NSTEMI, are:
- Coronary artery spasm is when the artery contracts or spasms severely. This narrows the artery and decreases blood flow to part of the heart muscle.
- Coronary artery dissection is a rare type of heart attack in which there's a spontaneous tearing of the coronary artery wall.
The likelihood of survival depends on which arteries are affected. A blockage in the left anterior descending (LAD) artery, a branch of the left coronary artery, has the highest risk of death.
The LAD artery supplies a large part of the heart and a STEMI of the LAD artery is sometimes referred to as the "the widowmaker" because of the increased risk of complications and death.
A widowmaker heart attack is also associated with an increased risk of heart failure and stroke, but it is less common than a blockage to the right coronary artery (RCA).
One study found that the unadjusted death rate for STEMI of the LAD was 7.1%, compared to 5.4% for the other branch of the left coronary artery (left circumflex artery, LCx) and 4.8% for the right coronary artery.
Sex Differences
There can be a significant difference in heart attack outcomes between men (assigned male at birth) and women (assigned female at birth).
Women usually have heart attacks at an older age and are more likely than men to die within the first few weeks after a heart attack. Compared to men, women have smaller arteries and may experience different symptoms of heart disease compared to men, which can sometimes delay a diagnosis.
One in four women (23%) will die within one year after a heart attack and 47% of women will die within five years after a heart attack.
Research has found that among people hospitalized for a first-time heart attack, women had a higher death rate than men for both STEMI (9.4% vs. 4.5%) and NSTEMI (4.7% vs. 2.9%). However, the gap wasn't as pronounced for NSTEMI when additional factors were taken into account.
The study also found that women who had a severe heart attack (STEMI) had a 20% increased risk of dying or developing heart failure within five years compared to men.
Location of Blockage
To a large degree, the outcome of a heart attack depends on how much heart muscle dies. This is largely determined by which coronary artery is blocked, the location in the artery where the blockage occurs, and how much time passes before the artery can be re-opened.
A blockage near the origin of an artery will affect more of the heart muscle than a blockage farther down the artery.
Length of Time Until Treatment
For anyone having a heart attack, getting rapid medical attention is absolutely critical. Both the short-term and the long-term consequences of a heart attack are largely determined by how much of the heart muscle dies. With rapid and aggressive medical treatment, the blocked artery can usually be opened quickly, thus preserving most of the heart muscle.
If treatment is delivered within three or four hours, much of the permanent muscle damage can be avoided. But if treatment is delayed beyond five or six hours, the amount of heart muscle that can be saved drops off significantly. After about 12 hours, the damage is often irreversible.
If the extent of heart damage is severe, acute heart failure can occur in tandem with a heart attack, a dangerous combination. Even if the extent of the damage is minimal to moderate, heart failure is more likely to occur later on due to the underlying injury sustained by the heart muscle.
A heart attack can also produce dangerous heart rhythm problems known as arrhythmias, including tachycardia (rapid heartbeat) and fibrillation (irregular rapid heartbeat). After the heart attack, scarred cardiac tissue can lead to permanent electrical instability and recurrent arrhythmia.
Cardiac arrest and sudden death are risks that are present both during an acute heart attack and to a lesser extent after the recovery.
Cardiac arrests can occur within the first few hours of a heart attack or during recovery. If a cardiac arrest occurs in the hospital, there is an excellent chance it can be treated. Unfortunately, the risk of sudden cardiac arrest is heightened after a heart attack, especially within the first year.
Age
The average age for a first heart attack in the United States is 65.6 years for males and 72.0 years for females. However, heart attacks can happen to anyone. A 2019 study showed heart attacks occurring in young people have been increasing. The study concluded the proportion of heart attacks among younger adults increased from 27% to 32% from 1995–2014.
In terms of surviving a heart attack, a 2017 study found that people 65 years and older were three times more likely to die from a heart attack compared to younger patients (aged 18 to 64 years). The rate of dying within 30 days of a heart attack was 9.4% for older patients and 3.0% for younger patients.
Number of Heart Attacks
After a first heart attack, around 20% of people age 45 and older will have another heart attack within five years of their first. Preventing a second heart attack is the priority and studies have shown cardiac rehabilitation can reduce the chance of a second heart attack by 42% to 47% within eight years.
Cardiac rehab is a medically supervised program that encourages lifestyle changes to reduce your heart disease risk, such as exercise training, heart-healthy eating, maintaining a healthy weight, and quitting smoking.
According to the Centers for Disease Control and Prevention, around 805,000 Americans have a heart attack each year. Of these, 605,000 are a first heart attack.
Heart Attack Symptoms
Getting rapid and appropriate medical care requires you to recognize the signs of a heart attack and seek medical help the moment you think you might be having one.
While chest pain, especially in the center or left side of the chest, is the classic symptom of a heart attack, other kinds of symptoms can occur in addition to (or instead of) chest discomfort.
Symptoms of a heart attack include:
- Chest pain or discomfort
- Pain or discomfort in the arms (one or both), shoulders, back, neck, jaw, or stomach
- Feeling weak, light-headed, or faint
- Breaking out in a cold sweat
- Shortness of breath
- Nausea or vomiting
- Unusual or explained tiredness
Chest pain or discomfort is the most common symptom in both men and women. It can feel like uncomfortable pressure, squeezing, fullness, or pain that lasts more than a few minutes or can go away and come back.
However, women are more likely than men to experience some of the other symptoms. The first symptoms in women may be shortness of breath, nausea or vomiting, and back or jaw pain.
Anyone who has risk factors for coronary artery disease ought to be alert to these symptoms. Even so, there are times when the symptoms may be uncertain or less overt, and people will not act immediately because the signs aren't "as severe" as they assume.
Silent Heart Attacks
According to the Centers for Disease Control and Prevention, one in five heart attacks is "silent" and will have few, if any, symptoms. Even if the underlying obstruction is less profound, the risk of death may be higher simply because treatment is delayed.
Silent heart attacks may cause subtle symptoms such as:
- Unexplained fatigue
- Shortness of breath
- Discomfort in the throat, neck, jaw, or arm
- Chest pain that may be mistaken as heartburn
Heart Attack Treatment
If you think there’s any chance you or someone else may be having a heart attack, you need to get medical help as quickly as possible. Even if it turns out to be something else, it is better to act quickly than risk putting your life on the line.
If you recognize the signs of a heart attack, call 9-1-1 immediately. The sooner treatment begins, the greater likelihood that you can minimize damage to the heart. Once a medical team is involved, medications and surgical procedures help restore blood flow to the heart.
The person having the symptoms should not drive. Always have someone else drive you to the hospital if you are not being transported by ambulance.
If the person goes unconscious, you can start cardiopulmonary resuscitation (CPR) while you wait for emergency medical services (EMS). If you are in a public place, ask if there is an AED (automated external defibrillator) on site. An AED is a portable device that can check someone's heart rhythm and, if necessary, deliver an electric shock to help someone who is in cardiac arrest.
Find trainings in CPR and AED use through the American Red Cross, so you are prepared if you are ever in an emergency situation.
Heart Attack Prevention
There are lifestyle changes that you can make to reduce your risk of a heart attack and increase your odds of surviving one.
According to the CDC, 47% of Americans have at least one of the three main risk factors for heart disease: high blood pressure, high cholesterol, and smoking.
Get your blood pressure and cholesterol checked regularly. If readings are high, you may be able to lower them with diet and physical activity, or your healthcare provider may recommend medications to help reduce your risk of heart attack and stroke.
In addition, these lifestyle changes can help:
- Quit smoking
- Eat a diet that is full of vegetables, fruits, and whole grains
- Limit sweets, sugar-sweetened beverages, and red meats
- Get physical activity every day
- Limit alcohol