Everything You Need To Know About Heart Attacks – Prevention.com

When someone has a heart attack (also called a myocardial infarction), the heart temporarily doesnt get oxygen-rich blood because an artery supplying blood to the heart is blocked or partially blocked. This can cause chest pain or discomfort, shortness of breath, lightheadedness, or pain in the upper body. [1]

Anyone, at any age, can have a heart attack. However, men 45 and older and women 55 and older are at greater risk than younger people. [2] This is due to many factors, including changes in the heart and heart vessels as well as greater prevalence of conditions such as high blood pressure and atherosclerosis, which increases the risk of a heart attack. (Atherosclerosis is the build-up of fats and cholesterols in the artery walls.) As we get older, especially with a Western diet and lifestyle, typically we will all accumulate some degree of cholesterol plaque in the arteries, says Christine Jellis, MD, PhD, a cardiologist at the Cleveland Clinic. [3]

About 805,000 Americans have a heart attack every yearthats one every 40 seconds. Most are first-time heart attacks, but about a quarter happen to people whove previously had one. Also, about 20 percent of people experience a silent heart attack. That means theyre not aware theyre having the attack. [5] Someone may dismiss their chest pain as indigestion and later see a cardiologist who finds damage to the heart vessel indicating they previously had a heart attack, Dr. Jellis says. Or, diabetics, for example, often dont demonstrate the same chest pain as people without diabetes and may not realize theyre having a silent heart attack because their symptoms may be things like heartburn, a feeling of fullness in the chest, or shortness of breath. [19]

A heart attack occurs when blood flow to the heart stops. This can happen due to the buildup of fatty deposits called plaque in the arteries. If the plaque breaks open, it can form a blood clot. This clot can then block the blood flow to the heart. [8]

Your family history, health, and lifestyle all play a role in your heart attack risk.

Family history: If any male grandparents, parents, or siblings had a heart attack before age 55 you may be at greater risk. The same holds true for immediate female relatives who had a heart attack before age 65. [2]

Age: The risk of heart attack rises after age 45 for men and 55 for women. [2]

Sex: Men are at greater risk than women. [4] Premenopausal women have higher estrogen levels, which are somewhat protective against heart attack, Dr. Jellis explains. Postmenopausal women tend to lose that protective effect [as their estrogen levels fall] and they develop a more similar risk of heart attack as men.

High blood pressure: Chronic high blood pressure can damage the arteries, increasing heart attack risk. [2]

High cholesterol: High bad LDL cholesterol or triglycerides can build up in the arteries, reducing blood flow to the heart. [9]

Diabetes: Elevated blood sugar levels increase the risk of a heart attack. [2] Diabetics often have an acceleration of the risk of atherosclerosis and cholesterol plaque, as well as chronic inflammation and narrowing arteries, Dr. Jellis says.

Obesity: Having a higher body mass index (BMI) increases the risk of other risk factors including high blood pressure, high LDL, high triglycerides, and diabetes. [9]

Being inactive: Not being physically active increases the risk of high blood pressure, high LDL, diabetes, and obesity. These conditions can all up the risk of having a heart attack. [9]

Smoking: Tobacco smoke damages the blood vessels and heart. [9] Smoking also accelerates cholesterol buildup in all arteries in the body, Dr. Jellis says. This, plus chronic inflammation leads to the acceleration of progressive artery disease, or narrowing of the arteries.

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Despite what the movies show, a heart attack does not always cause a person to clutch their chest. Symptoms vary from person to person and differ between the sexes. For example, nausea, fatigue, and lightheadedness are more common among women. However, generally speaking, common symptoms include:

Chest pain, pressure, or discomfort

Pain in your neck, jaw, back, shoulder, or one or both arms

If you think youre having a heart attack, immediately call 911 or go to the emergency roomdont hesitate or stay home because youre unsure. Err on the side of caution, Dr. Jellis says. If we can intervene early in a heart attack, we can decrease the damage to the heart muscle, and hopefully you can live longer.

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In order to diagnose a heart attack, the doctor will first want to know your symptoms. Come prepared to discuss any chest pains youre experiencing in detail. Tell your care team where the pains occur, if they are sharp or heavy, if they come during rest or exertion, how long they last, and if anything helps to relieve the pain, Dr. Jellis says. Based on this, your healthcare provider will decide which tests to run.

The first test is usually an electrocardiogram (EKG). An EKG records the hearts electrical activity. It can detect changes in your heart rhythm and determine if a heart attack happened or may develop. [11]

Depending on the results of the EKG, your healthcare provider may also do blood work. They may check the level of different enzymes and proteins in the blood that indicate there was a heart attack and how much damage it caused. [12]

Not every heart attack is the same. The two types of heart attack are:

This is the more common type of heart attack. It occurs when at least one coronary arteryan artery supplying blood to the heartbecomes blocked. [6] Typically, a cholesterol plaque in one of the arteries that supply blood to the heart has ruptured. This causes a collection of platelets to develop into a blood clot that blocks the artery, Dr. Jellis explains. Doctors use an electrocardiogram (EKG) to diagnose a STEMI, because this type of heart attack causes specific changes in heart activity that the EKG picks up. [7]

In an NSTEMI heart attack, the artery is only partially blocked, which means less heart damage occurs. The person typically already has narrowing in their artery caused by the progression of artery plaque over time, Dr. Jellis says. Often they will have preceeding warning signs of angina, or chest pain. Although this type of heart attack doesnt always cause changes on an EKG, a blood test will show elevated levels of certain markers that indicate an NSTEMI. [7]

Treatment for a heart attack typically begins with medication, followed by surgery and other procedures depending on the type and severity of the attack.

In the immediate aftermath of a heart attack, the following medications may help dissolve or break up blood clots so the blood flows better:

Following a heart attack, your doctor may also recommend other medications to help your heart function better:

[13, 14]

If the results of the EKG indicate a STEMI heart attack, very often, the next immediate step is to insert a stent (a tiny tube that opens an artery) to restore blood flow to the artery, Dr. Jellis says. In more complicated heart attacks, bypass surgery may be performed either immediately or a few days later so the heart can recover some from the attack. [14]

The damage from a heart attack can have lasting impacts. This can lead to:

This is why its so critical to be diagnosed and treated quickly when you suspect a heart attack. Its much better to try to prevent the damage than to see someone after the attack occurs and see theyve sustained long-term damage to the heart, Dr. Jellis says.

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Although you cannot change your family history or age, you can decrease the risk of heart attack by following some healthy lifestyle habits. We have no control over our genetics, so we need to concentrate on other modifiable risk factors, Dr. Jellis says. The more healthy changes you can make, the better. Its an investment. Thinking about prevention can set us up for long, healthy, happy lives without any complications from heart attacks, she adds.

Dont smoke or stop smoking. The nicotine in tobacco smoke can increase blood pressure and cause the walls of the arteries to harden. Meanwhile, carbon monoxide can increase how much cholesterol builds up in the arteries. Both increase the risk of a heart attack. [16] Its never too late to stop smoking, Dr. Jellis says. Ask your doctor what smoking cessation program would be best for you.

Be active. Regular exercise can help with many risk factors for heart attack, including managing blood pressure, cholesterol, and body weight. The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity (such as walking, dancing, or double tennis) or 75 minutes of vigorous aerobic activity (such as running, biking at least 10 miles per hour, and aerobic dancing) each week. [17] If you are currently inactive, start small, such as walking for 10 minutes a day, and build up from there with the help of your doctor.

Eat more plants. A diet high in trans fats, cholesterol, and saturated fats can impair heart health. Try to center your diet around vegetables, fruit, whole grains, healthy fats (such as olive oil, nuts, seeds, and avocado), and lean proteins (like fish, poultry, and beans). [14] Limit your intake of red meat, alcohol, and foods with added sugars such as sweets and soda. [4]

Manage your cholesterol and blood pressure. Have your doctor check these regularly so you can be aware of any changes. You can also manage your cholesterol and blood pressure by being physically active and eating a diet rich in plants and low in red meat and sodium.

Work to reduce stress. When were stressed, we often turn to less-healthy habits such as overeating, smoking, drinking, and being inactive. This can also increase the risk of high blood pressure and cholesterol. [18] Additionally, a heart attack can occur after a very stressful event, such as the death of a child or spouse. The stress-heart attack link is still unclear, but its likely related to increased circulating chemicals the body makes during stress, such as adrenaline, says Dr. Jellis. These chemicals are thought to constrict or cause spasm in the arteries, which restricts blood flow and oxygen to the heart muscle, resulting in chest pain, she explains. Bottom line: Find what works for you to reduce stress, whether that's exercise, meditation, getting out in nature, journaling, or working with a therapist.

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References

[1] https://www.cdc.gov/heartdisease/heart_attack.htm

[2] https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106

[3] https://my.clevelandclinic.org/staff/19994-christine-jellis

[4] https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack

[5] https://www.cdc.gov/heartdisease/facts.htm

[6] https://www.ncbi.nlm.nih.gov/books/NBK532281/

[7] https://my.clevelandclinic.org/health/diseases/16713-cad-acute-coronary-syndrome

[8] https://my.clevelandclinic.org/health/diseases/16818-heart-attack-myocardial-infarction

[9] https://www.cdc.gov/heartdisease/risk_factors.htm

[10] https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women