Okay, I've got a silly question: Can you have a heart attack without your arteries being clogged?

Heart attack also can occur due to problems with the very small, microscopic blood vessels of the heart. This condition is called microvascular disease.

Another less common cause of heart attack is a severe spasm (tightening) of a coronary artery that cuts off blood flow through the artery. These spasms can occur in coronary arteries that don’t have CAD. It’s not always clear what causes a coronary artery spasm.

Actually, that is not a silly question.

Yes, but. Probably 99 out of 100 'heart attacks' with resulting damage(death) of heart muscle is caused by clogged arteries. Primarily, the larger coronary arteries. The smaller arterial branches are typically clogged most frequently in Diabetes Mellitus. The larger arteries are also clogged in Diabetes Mellitus but also from hi BP, hi cholesterol, smoking, etc.

This clogging appears to respond to cholesterol lowering meds, and other tactics to lower cholesterol.

Most heart attacks occur as a result of coronary artery disease (CAD). CAD is the buildup over time of a material called plaque on the inner walls of the coronary arteries. Eventually, a section of plaque can break open, causing a blood clot to form at the site. A heart attack occurs if the clot becomes large enough to cut off most or all of the blood flow through the artery.

The blocked blood flow prevents oxygen-rich blood from reaching the part of the heart muscle fed by the artery. The lack of oxygen damages the heart muscle. If the blockage isn’t treated quickly, the damaged heart muscle begins to die.

Heart attack also can occur due to problems with the very small, microscopic blood vessels of the heart. This condition is called microvascular disease. It’s believed to be more common in women than in men.

Another less common cause of heart attack is a severe spasm (tightening) of a coronary artery that cuts off blood flow through the artery. These spasms can occur in coronary arteries that don’t have CAD. It’s not always clear what causes a coronary artery spasm, but sometimes it can be related to:

Taking certain drugs, such as cocaine

Emotional stress or pain

Exposure to extreme cold

Cigarette smoking

This depends largely on what you mean by "heart attack." If by "heart attack" you mean the deprivation of oxygen to an area of heart tissue resulting in damage or death of that tissue, then you need a mechanism for interrupting the oxygen-carrying blood supply to that area of the heart. That interruption is frequently caused by a thrombus or embolism (different kinds of clots), but like others have said, it could also be due to vasospasm of the coronary arteries secondary to something else (like ingesting a drug such as cocaine).

However, if by "heart attack" you mean the sudden stopping of the heart resulting in clinical death, then no, you don't need clogged arteries at all. For example, an electrolyte imbalance could cause your heart to "fire off" an electrical impulse at the wrong time and throw your heart into ventricular fibrillation (a lethal rhythm). Potassium is an example of one such electrolyte that has the potential to cause cardiac arrest when blood serum levels are off. So, if you somehow became hyperkalemic (high potassium levels) you could go into cardiac arrest despite otherwise being perfectly healthy.

Additionally, there is a condition called "R on T phenomenon" where a premature ventricular contraction occurs right on the T-wave in an EKG reading, which could possibly cause your heart to fibrillate and arrest. However, for this to occur your heart must be experiencing premature ventricular contractions and normally that requires some level of irritation or hyper-excitability.

Yes.........Having high blood pressure and living with a lot of stress, plays a big part in your chances of having a heart attack......But most heart attacks do occur from clogged arteries.......

Yes, Stress is a leading cause of a heart attack.

Yes. Great fear or great strain can cause a heart attack.