Stages of Heart Attack

Heart attack is an emergency. Call 112 or 102 at the first symptoms.

A heart attack unfolds over hours, and the outcome depends on how fast blood flow is restored. Doctors also describe the stages of heart muscle injury and recovery.

Stage 1: Artery disease builds silently

Plaque grows for years, often with no symptoms, or with angina on effort.

Stage 2: Blockage and ischaemia (minutes)

A clot blocks the artery. The heart muscle is starved of oxygen, causing chest pain and other symptoms.

Stage 3: Muscle injury (first hours)

Without treatment, muscle begins to die within about 20 to 30 minutes, and damage spreads over the next hours. This is why the first hours are called the golden period. Opening the artery early saves muscle.

Stage 4: Acute care in hospital (hours to days)

Treatment includes opening the artery, medicines, and monitoring for rhythm problems, heart failure and shock.

Stage 5: Healing (days to weeks)

A scar forms where muscle died. The size of the scar affects how well the heart pumps.

Stage 6: Recovery and rehabilitation (weeks to months)

Cardiac rehab, medicines and lifestyle change reduce the risk of another attack.

Possible complications at each stage

Dangerous rhythms, heart failure, cardiogenic shock and rupture are most likely in the first days.

Key point

Early arrival at a hospital with a cath lab is the biggest factor you can influence.

Before your appointment

Bring all your reports, ECGs and medicine strips, and a list of every medicine and supplement you take, including herbal products. Note when symptoms occurred, what brought them on and how long they lasted. Share your family history of heart disease, and your smoking, alcohol, diabetes and blood pressure history. Ask about cardiac rehabilitation and the warning signs that mean you should call 112 or 102.