Heart disease is the leading cause of death for both men and women, responsible for about 1 in every 4 people who pass away in the United States (1).
Heart attacks are a feared complication of many chronic diseases including diabetes, hypertension, and high cholesterol. Because most of these diseases can be avoided with the right lifestyle approach, heart attacks and their devastating complications can usually be prevented too.
What is a Heart Attack?
The main blood vessels in the heart are called coronary arteries. Coronary artery disease is a condition in which these arteries start to build up plaque and get clogged. This is more likely to happen in people with an unhealthy diet who have low activity levels and are overweight.
Coronary artery disease is the most common form of heart disease (1).
If these arteries become too blocked with this plaque, not enough nutrient rich blood can reach the heart tissue the artery is supplying. Because all tissue needs blood to survive, this blockage can lead to tissue death - and this is called a heart attack.
A heart attack occurs when part of the heart tissue dies.
The medical term for a heart attack is ‘myocardial infarction’ and may also be referred to as ‘acute coronary syndrome' (ACS).
Heart Attack Symptoms
Heart attacks can feel differently in different people.
What Does a Heart Attack Feel Like?
Most classically, signs and symptoms of a heart attack can include:
- Chest pain that feels like pressure (‘elephant sitting on my chest’).
- Radiation of the pain to the neck, jaw, shoulder or back
- Pain is worse with walking or other exertion.
- Shortness of breath worse with walking or other exertion.
- Sweating (‘diaphoresis’).
Emergency room evaluation is recommended in anyone who experiences these classic symptoms. If it is determined in the hospital that these symptoms are not because of a heart attack (true heart tissue death), they could still represent warning signs for future heart problems.
To make sure that this isn’t the case, additional testing may be recommended in people who are very high risk.
Heart Attack Symptoms in Women
Women can often experience different symptoms than the classic textbook presentation described above.
These are often called ‘atypical symptoms’ and are also more common in people who are older and in people with diabetes.
Atypical Heart Attack Symptoms:
- Nausea & Vomiting
- Abdominal Pain
- Generalized Weakness
- Increased Fatigue
To make things just a little bit more confusing, 1 out of every 5 heart attacks can be ‘silent’. This means that heart damage can happen without feeling any symptoms at all (2).
Heart Attack Symptoms in Men
While men more commonly have the classic symptoms of exertional chest discomfort and shortness of breath, it’s not uncommon for them to experience atypical symptoms listed above. This is especially true in older men and in men with diabetes or other chronic diseases.
Heart Attack Complications
Heart attacks can cause many problems including:
- Abnormal Heart Rhythms (ie: atrial fibrillation)
- Heart Failure
- Aneurysm (abnormal bulging of heart wall)
- Cardiac Arrest
Signs of a Heart Attack
Diagnosing a heart attack happens at the hospital. Your doctor will often use an electrocardiogram (EKG), blood tests and a chest xray to evaluate your heart. Sometimes an ultrasound of the heart (echocardiogram) is also used.
Heart Attack Causes
While some of the risks for heart disease (ie: age and family history) can’t be influenced, most of the other contributing factors can be modified by our lifestyle choices.
Forty-nine percent (49%) of all American’s have high blood pressure, high cholesterol and/or smoke cigarettes, and these are all main contributors to heart disease (1).
Heart Disease Risk Factors (3):
- Overweight & Obesity
- High Blood Pressure
- High Cholesterol
- Unhealthy Diet
- Illicit Drug Use (ie: cocaine, methamphetamines)
- Excessive Alcohol
Heart Attack Treatment
Approaches on how to treat a heart attack may vary based on the person and how advanced their heart disease is.
Medications for Heart Disease
Blood thinners (anticoagulants ie: heparin) and antiplatelet treatments (ie: aspirin) are often used to help treat the blood clot. It’s also usually recommended that people be on medications to treat their cholesterol (ie: statin) and blood pressure as these can both be such large contributing factors to heart disease.
Surgery for Heart Disease
Another approach is to go into the heart and surgically remove the plaque that’s blocking the artery.
This can be done through open heart surgery and can include a cardiac bypass. This process a doctor rearranging the heart vessels in order to allow blood to flow through the healthier arteries and bypass the blocked vessels.
More commonly used is coronary angioplasty in a procedure called percutaneous coronary intervention (PCI). Doctors use a small tube to enter the heart through vessels in the groin and are able to help open the blockage, usually with an apparatus that appears similar to a balloon to stretch open the vessel. Straw-like tools called stents can then be placed in the artery to allow blood flow past the blockage.
Long Term Heart Disease Treatment
While medications and procedures may be used at first, lifestyle changes are at the core to real lasting changes.
Diet, exercise and weight loss are key treatments for long term success in developing a healthier heart.
How to Prevent a Heart Attack
Preventing and treating heart disease comes down to making consistent healthy lifestyle choices.
1. Heart Healthy Diet
So much of the prevention and treatment of heart disease is rooted in what you eat. Not only is diet critical for calorie control and weight loss, but it is also paramount in eliminating the other risk factors of heart disease including diabetes, high cholesterol, and high blood pressure.
2. Weight Loss
Losing weight and maintaining a healthy weight is a major factor in preventing and treating heart disease.
3. Increased Physical Activity
Not surprisingly, regular ‘cardiovascular exercise’ helps our hearts. While exercise can of course help with weight loss, it also independently helps the heart to be healthier.
The American Heart Association recommends at least 150 minutes of moderate intensity exercise each week. Consistency is key and even 30 minutes each day can reap tremendous results (4).
4. Smoking Cessation
Not only is smoking a strong risk factor for developing coronary heart disease, it independently contributes to a higher risk of sudden cardiac death. That means among all of the people that have coronary heart disease, people who smoke are more likely to die from it (5).
5. Blood Pressure Control
High blood pressure is hard on the heart in numerous ways. Controlling blood pressure through weight loss and eating a low salt heart healthy DASH diet is key in helping to treat and prevent heart disease.
6. Diabetes Control
Consistently controlling blood glucose levels is the main goal in diabetes treatment. The lifestyle modifications for the prevention and treatment of heart disease including a heart healthy diet, calorie control, weight loss and exercise are the same treatment approaches recommended for people with diabetes.
7. Cholesterol Control
High cholesterol is a strong independent risk factor for heart disease. This makes sense as cholesterol is part of what is clogging these arteries! Luckily the amount of cholesterol in your body can almost always be controlled by eating the right low cholesterol diet, regular exercise and weight loss.
8. Avoid Excessive Alcohol & Illicit Drugs
While small amounts of alcohol may positively contribute to your health, excessive alcohol use has been shown to be damaging to the heart. Illicit drug use, especially cocaine and methamphetamines can also have significantly negative effects on your heart and have been known to cause heart attacks.
9. Stress Management
While it’s not yet crystal clear if stress in of itself contributes directly to heart disease, it is well established that people who are more stressed on a regular basis have a much higher likelihood of engaging in unhealthy lifestyle choices such as increased eating and weight gain, smoking, unhealthy diet and unhealthy substance use (5).
Even if stress isn’t directly linked to a higher risk of heart disease, the consequences of stress can have a tremendously negative affect on your heart.
Choosing healthy habits to help you effectively manage stress including regular exercise, meditation, talk therapy, a healthy diet and healthy social interactions can all contribute to a happier life and healthier heart.