Heart Attack and Diabetes
Common Health Issues

Heart Attack and Diabetes

A heart attack occurs when the flow of blood to the heart is interrupted abruptly. This can happen when a coronary artery is blocked suddenly. This can come after a long period in which cholesterol plaque gradually builds up in an artery, as occur in stable coronary artery disease. But then something happens. 


There may be a crack in a cholesterol plaque that causes a tear in the blood vessel. The vessel hemorrhages and the resulting blood clot now entirely blocks the artery. Or the vessel may become progressively narrower until a small clot or clump of cholesterol plaque completely blocks the narrow opening and the blood supply is cut off. 


Sometimes something, such as a rapid surge of blood, shears the lining of the blood vessel. This can cause a hemorrhage and clot in the artery. Or a portion of a cholesterol plaque may shear and form a flap that blocks a coronary artery. Whatever the cause, when a coronary artery is suddenly blocked, a heart attack can ensue.



Severe, crushing chest pain under the breast bone that spreads to the left armpit, shoulder, neck or jaw can signal a heart attack. In the initial stages, the pain may be less severe and may come and go over several hours. You may only experience abdominal discomfort or back pain. But severe pain, often accompanied by nausea, vomiting, sweating, palpitations, feelings of light-headedness, fainting, and shortness of breath, is not unusual. In fact, the pain from a heart attack may be just about the worst pain you have ever experienced.

Unfortunately, people with diabetes sometimes have no symptoms of a heart attack. This is especially true if you have any kind of neuropathy. If you have diabetes and any risk factors for heart disease—obesity, high triglyceride and cholesterol levels or high blood pressure, for example—talk to your doctor about how to be alert to an impending heart attack. You may experience nausea and abdominal pain with no chest pain. Even a sudden swing in your blood glucose level could be a sign that a heart attack is occurring. If you feel anything out of the ordinary—dizziness, palpitations, sweating or stomach pain—with or without chest pain, you could be having a heart attack.

What You Should Do

Any time a heart attack is suspected, you or those around you should call for emergency help at once. If you are having a heart attack, time is of the essence. Don’t dismiss the symptoms and wait to see if they get worse, or assume it’s just indigestion. 50% of all people who die of a heart attack do so within the first hour. Many of these deaths could be prevented with prompt treatment. Get emergency help right away, if you are even the least bit suspicious.



If you are having a heart attack, emergency treatment will be aimed at getting the blood flowing to your heart. To do this, your medical team will try to open up whatever is blocking the artery. If blood flow is restored quickly, you will have a better chance of avoiding permanent damage to the heart and a better chance of survival with fewer long-term complications.


There are two options at the onset of a heart attack: medical treatment with clot-dissolving drugs or surgical intervention such as angioplasty to remove the blockage. The decision will be based on your individual circumstances and by logistical factors in the particular treatment setting. For example, if your hospital does not have the means to insert a catheter, angioplasty may be out of the question. On the other hand, medical factors may dictate the course of treatment


If you have a condition that would be made worse by a clot-dissolver—a recent stroke or surgery, for example—then angioplasty may be favored. Your medical team will take into account many factors to determine the treatment that is best for you. If you are unable to communicate, it is important that someone close to you be able to provide your medical team with any critical information. Make sure to tell the hospital or medics that you have diabetes.


If you are given a clot-dissolving medication such as tissue plasminogen activator or streptokinase within 1 hour of the onset of symptoms, your chances of survival will double. This medication works well in people with and without diabetes. You may also be given a blood-thinner such as aspirin. This will not be dissolving existing clots, but it will prevent additional clotting from occurring. 


You may also be given a beta-blocker as part of your initial treatment to slow the heart rate and reduce your blood pressure. Many heart patients will be treated with angioplasty following the administration of a clot-busting drug. However, if you have diabetes, this approach will triple your risk of complications, including death, and is not recommended. If you are able, make sure to discuss the treatment options with your medical team.



Whether you are at risk for a heart attack or have already survived one, it is important to take steps to prevent one from occurring or recurring. The key is to keep your arteries clear and the blood flowing and to keep the arteries from clogging up. If you are a smoker, quitting smoking is the single greatest step you can take to reduce the risk of a heart attack.

Reducing fat and cholesterol intake, beginning a modest program of physical activity (if appropriate), losing weight if you are overweight and eating a balanced diet rich in fruits and vegetable, will all help reduce the risk of a heart attack. In addition, your doctor may recommend taking a low dose of aspirin on a daily basis to prevent stroke and heart attack.


If you have already experience a heart attack, your doctor may also recommend one of several long-term therapies to prevent any recurrence of a heart attack. Beta-blockers have been shown to prolong life following a heart attack in people with and without diabetes. Drugs such as angiotensin-converting enzyme (ACE) inhibitors, which prevent the heart from enlarging and also lower blood pressure, lower the risk of death for 3 to 5 years following a heart attack in people with and without diabetes. If you are at risk for a heart attack, and especially if you have already had a heart attack, talk to your doctor about what steps you can take to reduce your risk.


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Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette


Diabetes and the Heart by T Hyde and A D Timmis 


Myocardial Infarction: Symptoms and Treatments by Lei Lu, Min Liu et al


Rich Health Editorial Team

Health Research

Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner