Mayuri Bhakta, FNP-BC
Did you know that every 40 seconds, someone in America will have a heart attack?1 Heart attacks can occur at any age. People at higher risk of heart attacks are men over the age of 45 and women over the age of 55, but people decades younger can have life-threatening heart attacks as well, so it is important to know the risk factors.2
What is a heart attack?
In order to better understand what a heart attack is, let’s review terms that you may hear when people talk about heart attacks.
Heart Disease is a broad term that describes many conditions that may affect your heart. These conditions can include arrhythmias (abnormal heart beats), coronary heart disease (blockage of the heart vessels), heart defects, and heart valve abnormalities to name a few. Heart disease may increase your risk of heart attack.
Many people confuse heart attacks and cardiac arrest. Cardiac arrest occurs when the heart stops suddenly and there is no activity of the heart muscle and no heartbeat. Cardiac arrest can be caused by things such as heart attacks, strokes, drowning, severe injuries, shock, etc.
A heart attack occurs when an artery around the heart, also known as a coronary artery, becomes blocked. Buildups of fatty deposits, called plaque, can stick to the inside walls of the coronary arteries. Most heart attacks occur when a plaque breaks off, leading to the formation of blood clots which can block off the blood flow in that artery. The lack of blood flow causes the heart muscle tissue to become permanently damaged. The more time the heart muscle goes without blood flow, the more damage heart muscle sustains.3 Cardiologists use the phrase “time is heart muscle” to emphasize that time is critical when it comes to seeking medical care for a heart attack.
Although it may not be possible to get any treatment to reverse damage, healthcare providers may be able to prevent any worsening of the damage that has already been done. The sooner treatment is received to help open blockages, the sooner blood supply can return to the heart and the more heart muscle can be preserved. Waiting too long to seek medical attention can lead to increased permanent damage of the heart and may result in heart failure, or even death.
If you think you or someone around you is experiencing any signs or symptoms of a heart attack, call 9-1-1 immediately.
What are the risk factors for a heart attack?
Risk factors for heart attacks include the following:4
- Family history of early heart disease (men less than 55 years old; women less than 65 years old)
- High cholesterol levels
- Known history of heart disease
- Metabolic syndrome
- Chronic kidney disease
- Autoimmune disorders (i.e. rheumatoid arthritis, lupus, HIV/AIDS, etc.)
- Early menopause (before the age of 40 years) and history of preeclampsia during pregnancy
- South Asian ancestry
- Previous history of heart attack
- Tobacco use
- Recreational drug use (e.g., cocaine)
- Physical inactivity
What are signs and symptoms of a heart attack?
Someone having a heart attack may experience symptoms of:5
- Pain, pressure, or discomfort in the chest
- Pain or discomfort in the upper body including the neck, chest, back, jaw, or upper abdomen
- Difficulty breathing or chest pain
- Nausea, vomiting, heartburn, or belching
- Cold, clammy skin
- Dizziness or lightheadedness
- Feeling of impending doom
- Racing or uneven heartbeat
- Feeling of fatigue or extreme tiredness
If you believe that you are experiencing signs of a heart attack, call 9-1-1 immediately.
What happens at the hospital?
First, hospital providers will need to determine if someone is having a heart attack. They may perform tests such as an EKG, chest x-ray, blood tests, an echocardiogram, or even a heart catheterization to determine if someone is having or has had a heart attack.
People having heart attacks are typically given oxygen, medications for pain, and medications to help stop clotting. Medications and procedures to break up clotting may help reduce or prevent damage, “clot-busting” medication, a stent (a small device that helps push the blockage aside to keep the artery open), or even heart surgery depending on the severity of the blockage(s). Treatment options usually depend on a person’s health conditions, medical problems, risk factors, and the type and location of blockages. Healthcare providers will discuss treatment options specific to each patient.
Since post-heart attack recovery can widely vary based on severity, it will be best discussed by a cardiology team.
How can I reduce my risk of having a heart attack?
Lifestyle modifications may help reduce your risk of heart disease, and therefore reduce your risk of heart attacks.
- A healthy, well-balanced diet has been shown to reduce the risk of development of certain types of heart disease and reduce the risk of heart attacks. Making healthy food choices by eating real food and by avoiding processed foods, artificially-sweetened or sugar-sweetened products, and processed meats such as bacon and hot dogs, can help reduce your risk.6
- Moderate physical activity can help reduce your risk of heart attacks. It is important to talk to your healthcare provider before you start any new exercise regimen. The goal is at least 150 minutes of moderate physical activity/week, but any increase in physical activity is a good starting point!1,4
- Do not use drugs and if you use tobacco, quit. Smoking and smokeless tobacco use increase your risk of heart disease and heart attacks.7 Talk to your healthcare provider for help.
- Managing your chronic medical conditions such as high cholesterol, diabetes, and high blood pressure can reduce your risk of heart attacks. Talk to your healthcare provider about how to get in better control of your health.8
1 Emelia J. Benjamin, Salim S. Virani, et al., “Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association,” Circulation 137, no. 12 (2018): e67-e492. doi: 10.1161/CIR.0000000000000558
2 Mayo Clinic, “Heart attack,” https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106
3 Filippo Crea, Frank Kolodgie, et al., “Mechanisms of acute coronary syndromes related to atherosclerosis,” UptoDate, updated July 11, 2018.
4 Donna K. Arnett, Roger S. Blumenthal, et al., “2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines,” Circulation (2019). doi: 10.1161/CIR.0000000000000678
6 Emelia J. Benjamin, Michael J. Blaha, et al., “Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association,” Circulation 135, no. 10 (2017): e146–e603. doi: 10.1161/CIR.0000000000000485. See also “Heart Disease and Stroke Statistics” and “2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease” above.