What’s a Widowmaker?

What's a Widowmaker Heart Attack?

A widowmaker heart attack is a complete blockage of the left anterior descending (LAD) artery.
A widowmaker heart attack is a complete blockage of the left anterior descending (LAD) artery.

Any heart attack is serious. And true to its name, a widowmaker is especially deadly.

A heart attack starts when a clot forms in one of the three arteries -- muscular tubes -- that supply blood to your heart. The clot blocks the oxygen-rich blood your heart needs to pump. Without enough blood, part of the heart muscle dies.

A widowmaker is even more serious because it's a total blockage of the artery that supplies blood to the front of your heart -- the largest part. That’s the left anterior descending (LAD) artery. When it’s blocked at the beginning or very top of the artery, your heart muscle doesn’t get any oxygen.

A widowmaker can damage a large part of your heart very quickly. Your heart may even stop beating if you don't get treatment right away. That's why it's critical to get medical help immediately if you have symptoms of a heart attack.

Widowmaker Symptoms and Signs

You may not know whether you're having a widowmaker or a regular heart attack. The symptoms look the same. The most common heart attack symptoms are:

Despite the name, widowmakers can affect anyone. When women have these heart attacks, they're more likely to have unusual symptoms like:

Because any type of heart attack is serious, go to an emergency room or call 911 right away if you have symptoms.

Causes and Risk Factors for Widowmaker Heart Attack

Coronary artery disease causes widowmakers and other heart attacks.

In people who have this condition, a buildup of cholesterol and fatty deposits called plaques narrow arteries and prevent enough blood from flowing through them. If a piece of plaque breaks off and flows with the bloodstream toward the heart, a blood clot can form in the artery and block blood flow.

A clot that totally blocks the LAD causes a widowmaker.

Your risk for coronary artery disease and a widowmaker increases if you:

Widowmaker Heart Attack Treatment

Two surgeries can treat a widowmaker: coronary artery bypass grafting (CABG) or angioplasty plus stenting. Both procedures restore blood flow to the front of your heart. CABG is usually best for a total blockage in the LAD.

CABG takes a piece of a healthy blood vessel called an artery graft from your leg, arm, or chest. The graft diverts blood around -- bypasses -- the blocked LAD artery.

You will be asleep and pain-free during surgery. Usually, the surgeon stops your heart to keep it still during the procedure. A heart-lung machine pumps blood through your body while the surgeon places the new blood vessel. The name for this procedure is "on-pump" surgery. Afterward, your heart goes back to pumping as usual.

Less often, doctors perform CABG while the heart is still beating without a heart-lung machine. The name for this is "off-pump" or "beating heart bypass" grafting.

Risks of bypass surgery include:

During angioplasty you're awake but relaxed and pain-free. Your doctor makes a small cut in your groin or arm and threads a thin tube called a catheter up a blood vessel to your heart. The surgeon then inserts a tiny balloon into the blocked blood vessel and inflates it to widen the vessel.

The surgeon may then insert a mesh tube called a stent into the artery to keep it open. Some stents have medicine on them to keep the artery open.

Risks of angioplasty and stenting include:

  • Bleeding
  • Blood clots inside the stent
  • Artery re-narrowing, called restenosis
  • Heart attack (rarely)
  • Damage to the coronary artery
  • Kidney problems
  • Stroke

Widowmaker Heart Attack Recovery

You'll stay in the intensive care unit (ICU) for a couple of days after CABG surgery. Then, you'll move to a regular hospital room for another 3 to 5 days. It may be three months before you fully recover from surgery.

The hospital stay and recovery period after angioplasty are much quicker. You should go home within a day or two.

What Are the Chances of Surviving a Widowmaker Heart Attack?

A widowmaker can permanently damage your heart and leave scar tissue behind. The damage can cause an abnormal heartbeat. It can also lead to heart failure in which your heart muscle can't pump enough blood to meet your body's needs.

The sooner you get treatment, the better your outlook. Thanks to bypass surgery and other procedures to open up blocked arteries, the odds of surviving a heart attack are higher today than ever before.

Can a Widowmaker Heart Attack Be Prevented?

To avoid a widowmaker, you need to manage the major risk factors for heart disease. Eat a heart-friendly diet with lots of fruits and vegetables, exercise daily, and stay at a healthy weight for your height. If you smoke, quit. Find a way, whether through behavioral therapy or medication, that will help you.

See your doctor for regular check-ups to detect heart disease early. And ask your doctor if you need medicine to control high blood pressure and high cholesterol.

References
(c)2019 WebMD, LLC. All rights reserved.

Cleveland Clinic: "Coronary Artery Disease," "Coronary Artery Bypass Surgery: Procedure Details," "Why a 'Widowmaker' Heart Attack Is So Dangerous," "Why Survival Rates After Heart Attacks Have Improved."

Harvard Medical School: "Bypass or angioplasty with stenting: How do you choose?"

Mayo Clinic: "Coronary Angioplasty and Stents," "Coronary Bypass Surgery," "Heart Attack: Symptoms & Causes."

Michigan Health: "A Doctor Explains What Makes a Heart Attack a 'Widowmaker.'"

Seconds Count: "After Your Angioplasty & Stenting Procedure," "What Is Arterial Plaque?"

UCSF: "Coronary Artery Bypass Grafting (CABG)."