Widowmaker Heart Attack: What Makes it so Dangerous?

Every minute, heart muscles contract several times, pumping blood carrying oxygen and vital nutrients to the rest of the body. Some people are predisposed to heart conditions due to lifestyle like lack of physical activity, diet, family history or the presence of certain risk factors leading to the formation of blockages in arteries which can lead to heart attacks.

According to Zeeshan Khan, M.D., “The odds of surviving a widowmaker heart attack are low because this type of heart attack affects the left anterior descending artery, which accounts for about half of the heart’s total blood supply. A complete blockage can cause heart cells to die, potentially leading to cardiogenic shock, cardiac arrest or even death.”

Any heart attack can prove fatal but heart attacks resulting from blockages in the left anterior descending artery can cause what is called a widowmaker heart attack. This is because the left anterior descending artery is a major pipeline to the heart and a blockage in this location creates a life-threatening situation. We will explore why it’s so dangerous and if there are ways to treat it.

What is a widowmaker heart attack?

Heart attacks, also called myocardial infarctions, cause damage to the heart muscle due to the interruption of oxygen and nutrients to areas of the heart. The longer a heart attack goes untreated, the more damage it causes and the more function is lost. Heart muscle cells begin to die within minutes of lost blood supply.

A widowmaker heart attack is a type of massive heart attack that occurs when 70 to 100 percent of the left anterior descending artery becomes blocked. Most cases involve full blockages (100 percent) leading to abrupt cessation of blood flow to a major portion of the heart.

The increased risk of fatality associated with a left anterior descending artery is why this type of heart attack is called a widowmaker. Contrary to the name this condition can affect both men and women. Conditions like diabetes, high blood pressure, high cholesterol, smoking or family history of heart disease put a person at a higher risk of heart attacks.

The heart relies on two main coronary arteries (left and right) to supply blood to the heart. The left main coronary artery branches off into two arteries: the left anterior descending artery and the circumflex artery. 

The left anterior descending artery (LAD) supplies blood to the front left side of the heart, as the heart contracts continuing to pump the blood to the aorta and out to the rest of the body. The LAD can account for about 50 percent of the heart’s blood supply.

Whenever a blockage develops – usually from a blood clot that forms on plaque buildup in the artery – it causes cells to die in the ventricles. This can lead to sudden weakening of the heart which is unable to maintain effective blood flow to the rest of the body and the body can go into cardiogenic shock as not enough blood is pumped to the brain and other organs.

Damage to the ventricles can also cause a fast dangerous heartbeat due to faulty electrical signals, a development known as ventricular tachycardia. If the increased heartbeat continues for more than a few seconds, it can lead to cardiac arrest and sudden death.

What does a sudden heart attack feel like?

Thanks to soap operas and television dramas, most people visually associate heart attacks with a person who clutches their chest and falls to the floor. Usually, that type of dramatization is far from the truth, as signs and symptoms of a heart attack tend to be subtle and more vague.

In general, though, here are the most common signs you’re having a heart attack:

Chest pain or pressure: Discomfort tends to occur in the center or on the left side of the chest. It can last continuously for more than several minutes to hours, or go away and come back.

Discomfort in upper extremities/torso: Some people feel discomfort in their shoulders, arms, back, face or abdomen due to referral pain from nerves. The same nerves that send messages from the heart to the brain also act as messengers for the arms, shoulders, face and torso. When activated, the brain gets confused and misinterprets a heart attack as pain elsewhere in the body.

Shortness of breath: The body receives less oxygen during a heart attack, so it responds by taking shorter and quicker breaths to receive more oxygen.

Lightheadedness: This may present itself as feeling like you’re going to faint or pass out.

Sweating: During a heart attack, it takes more effort to pump blood, which increases body temperature.

Women can experience “atypical symptoms” such as heartburn or indigestions, fatigue, dizziness or clammy skin.

How is a widowmaker heart attack treated?

While some heart attacks may respond to conservative drug treatments such as blood thinners like aspirin (to reduce blood clotting) or clot-busting drugs, thrombolytics or fibrinolytics to improve blood flow, widowmaker heart attacks are usually more severe and require more in-depth interventions. The two most common types include angioplasty or coronary artery bypass surgery.

Percutaneous coronary intervention

Percutaneous coronary intervention (PCI) is a minimally invasive procedure that opens coronary arteries to restore blood flow to the heart. The procedure is performed in a catheterization laboratory (cath lab) by inserting a small tube called a sheath into a blood vessel (usually in the wrist or groin). An interventional cardiologist then locates the blockage using IV contrast, which lights up on X-ray imaging.

From there, one of two types of PCI occur: a balloon angioplasty or angioplasty with a stent.

• Balloon angioplasty: Once the doctor locates the blockages, they use a second catheter to deliver a tiny balloon to the impacted artery. The balloon is carefully inflated to open or widen the artery and restore blood flow. 
• Angioplasty with stent: An angioplasty often includes the use of a stent to hold open the artery. The doctor inserts a mesh wire stent into the opened artery to reduce the risk of a future blockage. Nowadays, drug-eluting stents are the most common type used. The stents are coated with drugs to prevent the risk of these arteries clogging back up.
  PCI is the most common treatment for heart attacks because it carries a lower risk and a shorter recovery time compared to heart surgery.

Coronary artery bypass surgery

As the name suggests, bypass surgery involves inserting an artery or vein from another part of the body (arm or leg) to reroute blood flow around the blockage. This type of surgery is more invasive, as a large incision is needed to insert the new blood vessel. A bypass machine is also used to temporarily pump blood to your body while the surgery takes place.

In the event of a heart attack, time is of the essence – the longer the heart goes without blood flow, the more likely serious damage, including death, can occur. If you think you’re having a heart attack, call 911 for immediate assistance. 

For those who fall under the risk category of a widowmaker heart attack, visit the INTEGRIS Health Heart Hospital for an evaluation. Later this year, INTEGRIS Health will debut a new state-of-the-art heart hospital with 64 ICU beds, cardiac catheterization labs, cardiovascular operating rooms, hybrid operating rooms, electrophysiology heart labs and cardiac diagnostic testing areas. This facility is expected to open in June.