Providing independent clinical excellence since 2005
Posted on Monday July 31, 2023 in Naked Heart
Written by Dr Edward Leatham, Consultant Cardiologist
A heart attack happens when blood flow to part of the heart muscle is suddenly reduced or blocked, causing damage to the heart.
Most people associate heart attacks with blocked arteries, and this is correct in many cases — but it is not the only explanation. Heart rhythm problems, heart muscle diseases, blood clots, and even severe stress can all lead to sudden heart injury.
Understanding the different causes can help people recognise risk earlier, seek medical advice sooner, and in many cases prevent serious problems.
Coronary heart disease develops when fatty deposits build up inside the heart’s arteries. Over time, these arteries narrow and blood flow is reduced.
A heart attack happens when a blood clot forms on top of this build-up and suddenly blocks the artery.
The challenge is that coronary heart disease can develop silently for many years. For some people, the first sign may unfortunately be a heart attack. The good news is that modern scanning, risk assessment, and lifestyle changes can help identify and reduce risk early.
Atrial fibrillation (AF) is a common condition that causes an irregular heartbeat. When the rhythm is irregular, blood can collect inside the heart and form clots.
Rarely, a clot can travel and block a heart artery, leading to a heart attack.
Many people with AF have no symptoms, which is why simple pulse checks or ECG monitoring — especially over the age of 50 — can be very helpful.
SCAD is a less common cause of heart attack but is being recognised more often, particularly in younger individuals and women who may otherwise be healthy.
It happens when a small tear develops in the wall of a coronary artery, reducing blood flow to the heart muscle.
Although uncommon, outcomes are often good when recognised and managed appropriately.
A pulmonary embolism is a blood clot that travels to the lungs, usually from the legs. While it is not a classic heart attack, it places sudden strain on the heart.
In severe cases, this strain can cause heart failure or significant heart damage.
People with a family history of blood clots should discuss risk assessment with their doctor, as preventative treatment can be very effective.
High blood pressure forces the heart to work harder over many years. This extra workload can gradually weaken the heart muscle and lead to heart failure.
When the heart is already under strain, it becomes more vulnerable to damage during other cardiac events.
Regular blood pressure checks are one of the simplest and most effective ways to reduce future risk.
Some viral infections can cause inflammation of the heart muscle, known as myocarditis.
This can temporarily weaken the heart and cause chest pain, breathlessness, or palpitations. Most people recover well, but early diagnosis is important and may involve ECGs, blood tests, heart ultrasound, and cardiac MRI.
Cardiomyopathy simply means disease of the heart muscle. These conditions can weaken the heart or increase the risk of dangerous heart rhythms.
This inherited condition causes the heart muscle to become abnormally thick. In some people it increases the risk of rhythm problems and sudden cardiac events.
Because it can run in families, screening may be recommended when there is a history of heart disease or sudden collapse.
In dilated cardiomyopathy, the heart becomes enlarged and weaker, making it harder to pump blood effectively.
It may be caused by genetics, previous viral infections, alcohol, or other factors. Treatment can significantly improve symptoms and long-term outlook.
Less common forms include restrictive or arrhythmogenic cardiomyopathy, where the heart becomes stiff or prone to abnormal rhythms.
Although these conditions are rarer, specialist assessment and monitoring can greatly reduce risk.
This condition is triggered by intense emotional or physical stress and causes temporary weakening of the heart muscle.
It feels very similar to a heart attack and always needs urgent assessment, but most people recover well over time.
These are inherited conditions affecting the heart’s electrical system. They can lead to dangerous heart rhythms and, rarely, sudden cardiac arrest.
Although uncommon, they are important because many people are otherwise healthy before diagnosis. Specialist cardiology assessment can identify and manage these conditions effectively.
You should seek emergency medical attention if you experience:
It is always safer to get checked early.
Heart attacks can happen for several different reasons, not just blocked arteries. The encouraging news is that many causes can be recognised early and treated successfully.
Regular health checks, awareness of symptoms, and early medical assessment can make a major difference — helping people stay healthy and active for longer.
In cardiometabolic medicine, muscle is not a cosmetic tissue but a metabolic organ. Evidence consistently shows that strength, not muscle mass, predicts insulin resistance, cardiovascular risk, and survival. Many older adults are not losing muscle tissue — they are losing muscle function, and that is the pathology that matters.
Continuous glucose monitors reveal how differently individuals respond to carbohydrates. We classify these responses using Glucotype, which reflects innate carbohydrate tolerance, and Current Glucose Profile (CGP), which shows a person’s present metabolic state. Combined with visceral fat grading, this system helps identify metabolic risk and guide personalised dietary or medical interventions.
Research indicates that approximately 20% of the global population has elevated Lp(a), making it a prevalent, yet under-recognised, CVD risk factor. Despite its clinical significance, the management of elevated Lp(a) remains challenging. Standard lipid-lowering therapies, including statins, have little to no effect on Lp(a) and may even slightly increase its levels. However, emerging therapies such as PCSK9 inhibitors and innovative supplements like curcumin are shedding light on potential strategies to mitigate this risk.
Lp(a) testing is advised for individuals at high risk for cardiovascular disease, including those with a prior stent or bypass operation, coronary syndrome or heart attack as well as anyone with a family history of coronary heart disease, high FAI (coronary inflammation) or high risk patterns on Cardiac CT angiograms. In our practice, Lp (a) is offered as part of our comprehensive Metabolic Health assessment (MHA1).