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Can heart attacks "go away" on their own?
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Can heart attacks "go away" on their own?

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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907968_tn?1292625804
Did you have heart attacks or just angina?  I'll stop worrying when I'm dead
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367994_tn?1304957193
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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976897_tn?1379171202
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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1137980_tn?1281289046
I think zmonster that that could be a very deadly way of thinking since atypically the symtoms (symptoms) 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 (symptoms) 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 (symptoms) and suddenly go into full cardiac arrest, then some people get the persistant symtoms (symptoms) that get to the point that you call for help and the third is exactly what you have described where the symtoms (symptoms) 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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63984_tn?1385441539
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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367994_tn?1304957193
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?.
________________

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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976897_tn?1379171202
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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367994_tn?1304957193
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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976897_tn?1379171202
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.
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187666_tn?1331176945
This is an excellent discussion but I'm not sure the poster is around any more. No responses.

Heart attack to the general population can mean almost any severe chest pain. But doctors know differently. A medical dictionary defines myocardial infarction (aka heart attack) as:  "death of a part of the myocardium from deprivation of blood.The deprived tissue becomes necrotic and requires time for healing."
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1137980_tn?1281289046
Actually Ed angina is a sympton not a disease and is a manifestation from a variety of issues not all ending or even beginning with a heart attack.  And you are also right that not all events end up with dead tissue because so many things come into play here and how fast treatment is administered, what treatment is administered, etc.I also have never been privy to the term of a micro heart attack and am assuming what is meant is that it falls below the scale of measurement which at the point would make it a non....to have a heart attack does not mean that there has to be a full blockage of either clot or plaque...it simply means that 02 or blood is impeded and it doesn't have to be completely blocked.   I agree with your comment about it being a general term with a wide range and depends on an event by event situ.....your heart attack for instance would be very different  then the person laying on the gurney in trauma next to you...even if you are the exact same sex, age and race so much depends on personal lifestyle, condition of the heart muscle, velocity of the blood flow and EF and this list goes on and on and on.....
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367994_tn?1304957193
QUOTE: 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.

>>>>>>>Myocardial infarctions literally means heart cell (myocyte) necrosis, and all scholars and the medical community agree on that meaning.  As you state heart attack has been used in a general to mean anything from chest pain to cardiac arrest. QUOTE: 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.

>>>>Acute indicates real-time event.  Chronic is a history of condition.  An MI does have a range of necrosis.  

QUOTE:  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 agree with that statement, but probably for a different reason, and MI is death of heart cells (myocytes). The Micro MI is a phrase that I coined and meant to describe mini, small, etc. heart cell death (MI) from angina, spasm.  We know that an acute complete occlusion of a coronary artery there is simultaneous myocyte death in the area supplied by the vessel.

"There can be areas of infarction of differing ages probably caused by repeated episodes of transcient occlusion, platelet emboli or both. Also, vulnerable myocytes can be caused by the geographic variation in the incidence of myocardial calcification". All myocyte cells within geographic group have a variation of vulnerability and a spasm or angina will effect some vulnerable myocytes and other myocytes will recover with a good supply of blood oxygen...but slowly die off to some degree with each angina and/or spasm episode.  
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976897_tn?1379171202
I suppose what I had, and anyone who survives without tissue damage should really be classed as acute angina then? Strange how my records state "several episodes of MI over a 3 day period" ?
Perhaps it's due to the fact that my heart was in a MI state, but not long enough for actual tissue death? each episode lasted 20 mins on average and was caused by eating, there was no discomfort the rest of the time.
I remember a cardiologist 2 years ago who said "I can give you a treatment which will destroy the cells responsible for causing the angina symptoms, giving you a more comfortable quality of life". This sounded great, but of course I questioned how I would know if I am pushing my heart too hard and damaging it. He said "Angina isn't damaging your heart". Confused even more I questioned how a lack of oxygen wouldn't damage a heart and he suddenly said "actually, I don't think this would be ideal" ??????

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187666_tn?1331176945
It would be interesting to know what type of "treatment" the doctor had in mind to stop the angina symptoms. Destroying the tissue sounds like catheter ablation. I've had that done 3 times (for arrhythmias) with a total of 38 burns to the heart. And yet they say it does no long term harm to the heart. Funny how an MI can kill off heart muscle and it's bad; an ablation burns heart muscle and that's good. Glad I'm not a cardiologist.
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976897_tn?1379171202
I know what you're saying. Maybe the ablation is to such a tiny area that it wouldn't really affect anything. That's what I'm guessing anyway. What confused me is how they know which cells cause angina discomfort. Where on the heart are they, how do they produce things such as throat discomfort.
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1137980_tn?1281289046
Hey Ireneo great to see you here too!!! And that is why like we've spoken before that "burning" has basically become antiquated in ablations and why they are using cryo and RF's to deal w. it.    The only end result of the burns that is of issue is the scar tissue that builds up from the burning just like on the outside of the body when someone unfortunately has some sort of accident that their skins burns...it become tightened, hard and has little hills and vails that the electrical pathway now has to take time to find its way around...i am totally w. you Ireneo on that one...glad i am not a heart doc either....
and Ed
As far as the throat discomfort goes from my understanding it is considered more of a referred pain or discomfort sort of like when we have a tooth ache on the lower teeth and the top teeth hurt...it is referred and where that term comes from i haven't a clue but do know its been used forever from anything from an appendicitis when the pain starts on the left side of your body...moves to center and finally directly to the appendix....thats my take on that part of it...that kind of is an interesting question tho about which actual cells cause angina pain and my question is ...is it the actual cells on the heart or is it the heart talking to the brain telling us it is a result of a blockage or partial blockage....wow this is one intense site.......i am loving it...
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