Call 911 if you want to live
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Image source: Clotbuster Archives.

A heart attack means a sudden, severe blockage in one of the coronary arteries that nourishes the heart. If the artery is completely blocked, you have a STEMI,  or ST elevation myocardial infarction. Put more simply, you have The Big One.

A full-blown heart attack can develop in a matter of seconds. A spontaneous rupture of a lipid plaque (blockage) inside the artery causes a thrombus (blood clot), which restricts or completely shuts off blood flow and can quickly result in heart damage. Frequently, the first sign of a heart attack is sudden death.

From the time the clot forms, it takes only between eight to twelve hours for permanent damage to the heart to occur. Half of all deaths from a heart attack occur within the first hour. About 30 percent of the people who die from a heart attack never reach a hospital.

If the thrombus only partially blocks the artery and some blood is still getting through,  you experience a mini-heart attack, or non-STEMI, or The Little One. The symptoms may not be as severe and the damage to the heart muscle may be small, at least at first. 

The third possibility is frequent chest pain even while resting, but without measurable heart damage—unstable angina. If untreated, mini-heart attacks and unstable angina progress on to death in about 5 to 10 percent of patients. They progress to a full-blown heart attack in about 10 to 20 percent of patients. A heart attack or death is extremely likely within a few days to a few weeks of the start of the first symptoms.

The Big One, The Little One, and unstable angina are all classified as acute coronary syndromes. While The Big One is the one most likely to kill you suddenly, all three types of acute coronary syndrome are life-threatening.

Image source: Clotbuster Archives.