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Can heart attacks "go away" on their own?
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by zmonster, Dec 12, 2010
People often think they're having a heart attack (it has happened to me once or twice).  Basically I'd like to know, can heart attacks "go away" and clear themselves on their own?  It is my assumption that a momentary (1-2 minute) pain, or shortness of breath, is very likely NOT to be a heart attack if the symptoms go away.  Is it safe to assume that one should start getting concerned only after 4-5 minutes of pain/symptoms that grow, instead of subsiding?

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by RadioAstronomyObserver, Dec 12, 2010
Did you have heart attacks or just angina?  I'll stop worrying when I'm dead
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by kenkeith, Dec 12, 2010
There can be a silent heart attack (heart attack has a medical meaning there has been necrosis (dead heart cells) and that can happen with or without symptoms.  I had a silent heart attack and my first symptom was congested heart failure.  

It is not reliable indicator to judge any heart issue on just symptoms.  I'm sure there are instances when a heart attack occured and that led to cardiac arrest and death within a matter of seconds. The heart attack sets off arrhythmia (irregualr heart beats).  

There is a window of oppurtunity to save heart cells if treated within a short time period. Symptoms can go away subsequent to a myocardio infarct (MI, heart attack), and the damage could/would be the heart unable to pump adequately because the heart wall with damaged heart cells would not contract very well.  

According to a reilable source, there are about 26% of the heart population that don't know they have impaired contractility of the left ventricle. They perform normally without any symptoms.  
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by ed34, Dec 12, 2010
Well let's think about this, it's an interesting topic and one I have thought about a few times.
What about vasospasm? we know if severe, this can kill. If a spasm occurred for a relatively short period of time, wouldn't this give a heart attack and then resolve itself?
Is it not possible for a clot to form and become dissolved in a few minutes? Maybe with just enough room for a small blood flow to get through? If a piece of plaque breaks in a proximal part of a vessel, and 'hinges' across the lumen like a flap, but pressure eventually breaks it free, is this possible?
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by cindy707, Dec 12, 2010
I think zmonster that that could be a very deadly way of thinking since atypically the symtoms of a heart attack can come and go over a period of time.  It is not just the issue of having all of the earmarks of having a heart attack and then those symtoms suddenly subside because that is basically what can kill.  It is recognizing the red flags and then rather then being safe then sorry making the call to EMS before it becomes critical to the point of no return.  Like kenkeith says a heart attack is known as a silent killer because of varietals that are involved.  Some people have no symtoms and suddenly go into full cardiac arrest, then some people get the persistant symtoms that get to the point that you call for help and the third is exactly what you have described where the symtoms will subside for minutes, hours or even days but the one thing that is for absolutely sure is that the first 12 hours are the earmark for survival once a the person has been confirmed of having a heart attack and treatment begins...the next base you hope they reach is the next 3 to six hours and atypically if that person has a second heart attack within either of those periods of time the odds are not with them and many  times within 45 minutes to an hour after the second occurance happens there is an extremely high risk factor that the third will become deadly and not survivable.  I think the bottom line is the bottom line tho zmonster....if someone even suspects they are having a heart attack why in the world would anyone wait and see how it shakes out?  This is the number one killer in the U.S, for both men and women and each and every day something new is learned from the stats.  Ed also has some excellent points as well it his questioning the what ifs....i think medically speaking if the plaque or clot were to break free and absorb back into the system  that kind of falls along the lines of clot busters that are used to just do that to help patients recover as well as the plaque busters....so many questions, so many answers, so little time to thing of all of the varietables that are possible....thats why i love this site so much....wow...........
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by Flycaster305, Dec 12, 2010
This is a very interesting topic to me.  I've had three heart attacks, one classic Hollywood, one very suble, and one that almost passed me by but caused the most damage because I delayed treatment, but each caused a trip by ambulance to the hospital.  I've had two trips to the hospital, both within the last year and was totally fooled by GERD problems (I am recovering from surgery now to correct that problem).  It isn't easy to sort out chest pain.  I carry nitro and use it as I have angina frequently.  If the pain abates, the situation is under control.  If it continues, then I get concerned.  The fact that it continued with the GERD issues led to my call.

I'm a volunteer in the CVCU of a local hospital and hear loads of stories about what lead to a heart attack, and most often heart attack victims are those with the biggest risk factors.  I'm the poster boy for bad heart behavior when I had my first one, I know about that.  

There are so many variables, I'd be like Cindy707 and check things out at the hospital, STAT.
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by kenkeith, Dec 13, 2010
QUOTE: "What about vasospasm? we know if severe, this can kill. If a spasm occurred for a relatively short period of time, wouldn't this give a heart attack and then resolve itself?"

>>>>>I beleive we have had this discussion before.  By definition a spasm is a short interval of vessel constriction.  We know oxygenated blood would be deprived in the location serviced by the spasmatic vessel.  I seems there may be a situation were that can happen as ed as postulated.  We know if one has a myocardia infarct the heart cells have died from lack of oxygen, but there is a window where the cells can be revitalized (time is heart muscle as they say).  We know dead heart cells cannot be revitalized but stunned heart cells can be revitalized if promptly treated.  Wouldn't it then be logical that for a very short time (spasm) the heart cells are only stunned and subsequent to the spasm there is good blood flow to revitalize stunned cells.  So stunned heart cells are not necrotic heart cells until a short time after a heart attack.  That is my understanding, does that make sense?.
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QUOTE: Is it not possible for a clot to form and become dissolved in a few minutes?

>>>>>>Yes, the body system dissolves many small clots naturally...I don't know the time frame. But if dissolved in a few minutes what is the relevance?

QUOTE: Maybe with just enough room for a small blood flow to get through? If a piece of plaque breaks in a proximal part of a vessel, and 'hinges' across the lumen like a flap, but pressure eventually breaks it free, is this possible?

>>>>>You have lost me on what you have in mind?  Soft plaque can crack the inner lining of a vessel and begin to clot and that will eventually (usually) begin to extend the clot into the lumen and blood flow pressure (velocity) will/can dislodge the clot causing a heart attack. Have I missed your point?

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by ed34, Dec 13, 2010
Point? the title of the thread says it all really, "can heart attacks go away on their own" ?

Maybe I'm missing the point? I am simply trying to establish ways this could possibly happen.
I'm sure there are many instances where people have a chronic chest pain where it goes away after a few minutes, never to return again. So there has to be a reason. There are also cases where previous MI have been seen in tests, yet there is no evidential cause for this and the patient doesn't remember it.
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by kenkeith, Dec 13, 2010
Well. the way you explained it does seem to indicate there can be no permanent damage. But that doesn't mean there are no necrotic heart cells as a result of spasms...not enough to cause hypokinesis with one or a few spasms or angina episodes... I'm having a problem with the expression "heart attack go away"!

If I remember correctly on the subject prior there was a discussion regarding angina pectoris, and the question was raised can angina oiver a period of time cause heart damage?  To be consistant, I stated there could be permanent heart damage because everytime there is a deficit of blood going to a specific area of the heart there can be some permanent damage to heart cells that are more vulnerable, and untreated  angina can cause permanent damage to some cells and eventually heart failure. I based that view on all heart cells are not uniformally conditioned and some cells are more vulnerable and every time there is a lack of blood flow to a deficit of oxygen area there are necrotic heart cells.  Same with the brain, TIA's equal some  brain cell loss.

Doesn't it make sense that angina is a micro heart attack whether it is from a spasm or occluded vessels?  
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by ed34, Dec 13, 2010
I'm also confused about terminology because most terms seem to be used in a very general way now by cardiologists. When I first had problems in 2007, I was told I had suffered several myocardial infarctions, which is another term (so I was told) used for heart attack. I have no necrotic tissue. It was explained to me that there is a whole range of heart attack severity, from mild heart attack to acute. So, I don't think they all cause heart tissue death. I think anyone feeling symptoms, this is just termed generally as angina, which doesn't seem to be reflective of the actual condition. It just seems an overall term used for chest pain, jaw ache, throat discomfort etc. I personally see angina in any form as myocardial infarction, somewhere in the range of mild to acute because they are simply discomforts produced by the heart in stress. I've not heard of micro heart attack, but I have heard the term mild many times describing a patient in hospital. I don't think heart attack has ever meant to mean the situation where a heart is being starved fully of oxygen in a specific area and then necrotic tissue as a result. I think it's a general term with quite a wide range.