Heart attacks: What you should know

Every 40 seconds, a person in the United States suffers a heart attack. Heart disease is the leading cause of death in both men and women.

In my clinical practice, I treat a wide range of heart attack patients, ranging in age from their 30s to 90s. While most of my patients have multiple risk factors for heart disease, others lack traditional risk factors. In fact, I have treated marathon runners and Navy SEALs for heart attacks.

No one is “safe” from a heart attack. That’s why it is critical to be aware of warning signs and to seek treatment to minimize damage to heart muscle.

What is coronary artery disease, or CAD?

The heart is a muscular pump that transports blood to the body, and the coronary arteries deliver oxygenated blood to the heart. Fatty plaque deposits can develop within the arteries and block delivery of blood to the heart. During a heart attack, a plaque ruptures, causing a life-threatening narrowing that damages the heart from lack of blood flow.

What are heart attack symptoms?

When your heart lacks oxygen, you can develop chest pain that sometimes radiates to the arms, neck or back. If your chest pain becomes more frequent, intense, longer, and/or occurs at rest, you should seek medical attention. Notably, women, diabetic, and elderly individuals sometimes experience “atypical” symptoms. These can include shortness of breath, fatigue or weakness, back pain, jaw pain, nausea and indigestion. When in doubt, get checked out. Opening up narrowed arteries quickly can minimize heart injury. The best and safest way to get to the hospital is by calling 911 and taking an ambulance.

How is a heart attack diagnosed?

When you arrive at the hospital, doctors will check an electrocardiogram and your blood work to screen for a heart attack. If doctors are concerned that you’re having a heart attack, they may recommend a heart catheterization. This is where a small tube is placed in an artery. The doctor then takes pictures of the coronary arteries to look for blockages.

What are the treatment options?

If the doctor finds a severe blockage or several blockages, they may recommend stents, which prop open an artery where it narrows. If there are multiple severe blockages, doctors may recommend heart surgery. In addition to these procedures, medications also play a crucial role in improving blood flow to arteries and preventing plaque buildup.

What are CAD risk factors?

There are certain risk factors you cannot change, such as age and genetics. But there are other risk factors you can control with aggressive therapy and lifestyle modification. These include diabetes, high blood pressure, high cholesterol, obesity, and tobacco use. Exercise, a heart-healthy diet, avoiding tobacco, and taking prescribed medications are the cornerstones for a heart healthy lifestyle. If you have a heart attack, controlling cardiac risk factors is essential for preventing another heart attack.

Recognizing CAD symptoms early and getting timely treatment minimizes heart damage. Controlling reversible risk factors for coronary disease also helps prevent heart attacks.

Author

 Elizabeth Reineck, MD, is an interventional cardiologist at AAMC.