Septal Infarct

A septal infarct is an area of damaged or dead tissue in the wall that separates the two sides of your heart (septum). A heart attack causes it. During a heart attack, certain areas of your heart muscle can’t get enough blood. Those tissues start to die. It’s rare for your septum to be the only area that’s affected. Usually, there’s damage to other parts of your heart, too.

The term “infarct” refers to the dead tissue itself. You might also hear the terms “septal infarction” or “septal myocardial infarction.” These refer to the event that injures your heart’s septum — typically reduced blood flow from a coronary artery blockage.

If an EKG test shows you have a septal infarct, that usually means you’ve had a heart attack. But your provider may redo the test to make sure — especially if you have no other signs or symptoms of a heart attack. It’s possible to get misdiagnosed with a septal infarct due to an error in the test process. This can happen if the EKG leads (sticky patches on your chest) are in the wrong spots.

Symptoms of a septal infarct

Septal infarct symptoms are the same as those for a heart attack and typically include:

• Chest pain or discomfort
• Pain that spreads to your jaw, neck, shoulder, arm or back
• Shortness of breath
• Fatigue
• Upset stomach or vomiting
• Anxiety or feeling like something bad will happen
• Excessive sweating
• Dizziness or fainting

What causes a septal infarct?

A septal infarct happens when there’s a blockage in your left anterior descending (LAD) artery or one of its branches. Most often, the blockage is in the LAD artery. Your LAD is your heart’s biggest artery. A blockage keeps blood from reaching a large area of your heart muscle, including the front (anterior) wall and the septum. 

Your LAD has small branches called the septal arteries. These supply blood to your septum. Very rarely, a blockage in one of these arteries can cause a septal infarct. Healthcare providers call this an isolated septal myocardial infarction. That means your septum is the only area of your heart that’s losing blood flow. This can damage the electrical system of your heart, which passes through the septum.

Complications of this condition

A septal infarct keeps your heart from working as it should. Your heart may have trouble:

• Squeezing and relaxing to pump blood
• Sending electrical signals that control your heartbeat
• Keeping its two lower chambers (ventricles) beating in sync

These issues can lead to abnormal heartbeats, heart failure and other complications that often happen from heart attacks.

How doctors diagnose this condition

Healthcare providers diagnose a septal infarct with an EKG. This test shows how your heart beats. It’s a key part of emergency care for anyone who may be having a heart attack. An EKG can show if there’s damage to your heart muscle. Your provider may run further tests to learn the extent of damage and guide treatment.

Providers often diagnose septal infarcts in non-emergency situations. This might happen if you get an EKG done as part of a routine checkup. The results may say “septal infarct, age undetermined.” This may mean there’s damage to your septum from a past heart attack. You may have had a “silent heart attack” without knowing it. This can feel scary. But your provider will know what to do to care for your heart based on this new information.

How is a septal infarct treated?

There’s no way to reverse the damage that’s already occurred to your septum. But quick treatment for a heart attack can limit the damage and lower your risk of complications. During this emergency care, you may need:

• A procedure to open your coronary artery and restore blood flow to your heart, particularly if the LAD is affected, as well
• Medicines to help your heart recover from the injury
• Medicines to prevent dangerous heart rhythms and other complications

You’ll also need to take medicines to manage risk factors that could cause you to have another heart attack. For example, your provider may prescribe medicine to lower your cholesterol or keep your blood pressure in the healthy range. These treatments can help you protect your heart and live longer.

If you’re diagnosed with a septal infarct weeks or months after a heart attack, you still need treatment. Your healthcare provider will explain what’s best in your situation. You’ll likely need medicines to help your heart function and lower your risk of future heart attacks. You may also need a procedure or surgery to improve blood flow to your heart.

When should I see my healthcare provider?

Your provider will tell you how often to come in for follow-up appointments. These are a key part of your recovery. Once you’ve had a heart attack, your risk of having another goes up. Your provider will run tests and talk with you about how you’re feeling. This lets you catch any signs of trouble early.

Call your provider any time you have new or changing symptoms or questions about your treatment plan.