Types of Heart Attack

Any suspected heart attack needs emergency care. Call 112 or 102.

Doctors classify heart attacks by what the ECG and blood tests show, and by cause. The type decides how urgent and which treatment is used.

By ECG pattern

• STEMI (ST-elevation myocardial infarction): a main artery is fully blocked. The ECG shows a typical ST rise. Treatment is urgent opening of the artery, by clot-dissolving medicine or angioplasty.
• NSTEMI (non-ST-elevation myocardial infarction): the artery is partly blocked or the blockage is smaller. Blood tests show heart injury. Treatment includes medicines and angiography, often within a day or two.
• Unstable angina: chest pain at rest or with minimal effort, without clear heart muscle damage on tests. It is part of the same emergency group and can lead to a heart attack.

By cause (universal classification)

• Type 1: plaque rupture with a clot, the most common.
• Type 2: oxygen supply does not meet demand, for example in severe anaemia, fast heart rhythm or very low blood pressure.
• Other types: related to procedures such as angioplasty or bypass surgery.

Other forms

• Spontaneous coronary artery dissection: a tear in the artery wall, more often in younger women.
• Coronary spasm: temporary tightening of an artery.
• Silent heart attack: minimal or no symptoms, found later on an ECG.

Key point

The label matters to the doctors, but the first step is the same for all: call for emergency help.

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.