HealthONE - January 29, 2021

In early 2018, popular TV show “This is Us” revealed that the patriarch of the show's family—Jack Pearson—died as a result of a “widowmaker” heart attack. In the hours after the episode aired, the phrase's online searches increased by more than 5,000%. Viewers were curious about what makes this type of heart attack so deadly, and how can they make sure it won't happen to them?

“A widowmaker heart attack is not a technical term,” explains Brett Book, director of cardiovascular services at Swedish Medical Center in Englewood, CO. “But it usually describes what we call a STEMI—a ST-segment elevation myocardial infarction that involved the front main artery of the heart. A STEMI is a type of heart attack where the artery is blocked 100%. That means the heart muscle is deprived of critical oxygen and the chance of a patient surviving without emergency treatment is slim.”

Types of heart attacks

There are three types of heart attacks: ST-segment elevation infarction (STEMI), non-ST segment elevation myocardial infarction (NSTEMI) and coronary artery spasm (CAS). STEMI heart attacks are extremely serious, occurring when one of the heart's major arteries is completely blocked—often with a build-up of fatty deposits (plaque). These arteries are crucial because they supply the heart with oxygen and nutrient-rich blood. Without access to oxygen and blood, parts of the heart may suffer irreparable damage.

A NSTEMI is like a STEMI heart attack, except that the blockage is less than 100% – often 80-90%. In this case, some blood and oxygen can get through the blockage, but not enough. While there may be less damage to the heart muscle, it is still a serious condition and must receive proper, timely treatment.

A CAS, also called a silent heart attack, occurs when one of the heart's arteries tightens temporarily and restricts blood flow. There is no lasting damage from a CAS, but it increases the patient's risk for a future heart attack.

“Because a heart attack can be so deadly – as in the case of a STEMI— we want make sure that people understand the warning signs and where to go to get the appropriate treatment,” Book says. “Time is so critical in treating a heart attack—the faster the medical team is able to assess and treat a patient, the less damage and the more likely return to normal activity.”

Signs of a heart attack

Symptoms of a heart attack often include pain, pressure and/or tightening in the chest. Patients also experience shortness of breath, nausea, anxiety, lightheadedness. Other symptoms such as pain in the jaw, arm neck, back or stomach also may indicate a heart attack. If you or a loved one experience these symptoms, call 911 immediately for medical help.

“Some people are at a higher risk for these types of heart events: those who are ages 50 and older, have diabetes, have high blood pressure, are current or former smokers and/or have a family history of heart disease,” Book details. “For people with these types of risk factors, we encourage you to be proactive and have a relationship with a cardiologist who can monitor your heart for any warning signs that a blockage is forming.”

Every minute matters during a heart attack

Advancements in medicine have improved the survival and recovery of STEMI patients. Treatment for a STEMI heart attack is performed in the cardiac catheterization lab. There, a team of cardiac experts inserts a catheter (thin tube) into a blood vessel into the heart. Once in place, the team can see the location and severity of the blockage and insert a tiny balloon that is expanded to reopen the artery. Then, a stent is placed to prop open the artery and restore healthy blood flow.

When this type of procedure is within 90 minutes, data shows that patients have the best opportunity for a return to healthy living. Often, in these cases, patients can be released from the hospital the next day.

Cardiac Alert program at Swedish

While 90-minute treatment time is the gold standard, the team at Swedish has implemented procedures to best that time, typically less than 60 minutes. “We work very closely with our local emergency medical service (EMS) responders,” Book explains. “If they suspect a heart attack, they contact us immediately to activate a ‘Cardiac Alert.’ This signals our specialized team of emergency medicine doctors, cardiac cath lab team and expert cardiologists to assemble and prepare for the patient’s arrival. Then, the second the patient arrives, we take them directly into the cardiac cath lab with one goal: to open up blocked arteries as quickly as possible.”

Continued education, outreach, coordination of care and advanced treatments will continue to improve the ability for patients to not only survive these types of significant heart attacks, but also thrive. “We believe that if the fictional Jack Pearson could have been treated by our team, he would have not only survived his event, but also had a long, happy life,” Book says. “No doubt a happier ending, but probably not a storyline dramatic enough for ‘This is Us’!”

To learn more about emergency services and heart care at Swedish Medical Center, visit our ER page.