 Hi, good morning. I am Dr. M N Butt, Senior Interventional Cardiologist, KMC, Mangalore. Today I will talk about heart attack. Heart attack is caused by blockages of coronary arteries which are supplying blood to the heart. There are three main coronary arteries which supply blood to the heart and a blockage of any one of them can lead to heart attack. This leads to the damage to the heart's pumping capacity and leads to the reduction in the BP and other complications. Let us see what are the common causes of heart attack. Heart attack commonly occurs above the age of 40 years. It is seen more commonly in males as compared to females. It is more common in patients who are having diabetes, high blood pressure, obesity, lack of exercise, smoking or use of tobacco in any other form and also those who are having a family history of heart attack. What are the common symptoms and how to identify heart attack by a common man? Usually the person who is having heart attack starts developing severe central type of chest pain exactly at the center of the heart. It is not at the side of left or the right. It begins at the center of the heart. It radiates to the back and when it is severe it also causes nausea, sweating and radiation even towards the upper part of the abdomen and both the upper limbs. More towards the left side as compared to right. The type of pain it is usually not a pricking type of pain where the patient can pinpoint to a particular small area. It occurs diffusely all around the heart and it is very constricting or burning type of pain rather than a pricking type of pain and usually it lasts quite some time. The initial episode lasts at least 5 to 10 minutes or more and if it is not relieved by any treatment it again recurs after 5 to 10 minutes and this time it becomes even more intense type of pain and may last continuously for half an hour or even continuous unless until a treatment is given to the patient. So the most important feature of this is that it is a diffuse type of pain cannot be pinpointed to any particular location. It is occurring all around the center of the heart with associated sweating and vomiting. This is the characteristic. However in some of the patients such as the elderly or diabetes these patients may not have typical central chest pain. Some of them may have only weakness or a giddiness or just sweating also. This is the atypical presentation occurring in some of these patients. Nevertheless in these patients also one should suspect heart attack especially if these are having associated diabetes blood pressure or use of tobacco. So what to do when you are having chest pain and you don't know whether it is heart attack or something else. If you are having a central type of chest pain and it is not relieved within 5 to 10 minutes it is better to consult a doctor and see. Basically they will do an ECG simple ECG can be done in a clinic to see whether there is any heart attack. If there is a doubt exists still they may do repeat ECGs or they may ask for certain blood tests or echocardiography or what is called as a treadmill test to confirm whether it is a heart attack or just a plain gastritis or some other disease.