Every 40 seconds someone in the U.S. will have a heart attack. Although the symptoms of a heart attack can vary from person to person, knowing how and when to act can save your or a loved one’s life. Tufts Medical Center Cardiologist, Arsalan Rafiq, MD, shares what you need to know about this all too common medical emergency.
What Is a Heart Attack?
A heart attack, or myocardial infarction (MI), occurs when one or both of the main coronary arteries that supply oxygen-rich blood to the heart are clogged by fat and cholesterol deposits called plaque.
Over time, the plaque builds up and narrows the artery, reducing blood flow and weakening heart muscles. Sometimes plaque ruptures causing a clot that partially or completely blocks blood flow and damages heart muscle. Without blood and oxygen, heart muscle dies, and your heart can’t pump.
There are some telltale signs of a heart attack. Many people have chest pain or discomfort, or a tightness and pressure that feels like their chest is being squeezed. Others are lightheaded, tired, nauseous and experience shortness of breath, heartburn and indigestion.
Warning signs of a heart attack
The most common heart attack symptom is chest pain or chest discomfort often described as a feeling of tightness, fullness or as if something is sitting on your chest. Other warning signs include:
- Shortness of breath
- Nausea/vomiting
- Lightheadedness/dizziness
- Cold sweat
- Fatigue
- Heartburn/indigestion
A heart attack sufferer may also experience symptoms like pain throughout other parts of the body including the neck, jaw, back and upper abdomen or unexplained, extreme fatigue.
If you or someone else is having heart attack symptoms, it’s crucial to act immediately and call 911 to increase the chance of survival and minimize irreversible heart muscle damage.
Heart attack symptoms: Men + women
Women and people assigned female at birth (AFAB) tend to have smaller hearts and narrower blood vessels than men or individuals assigned male at birth (AMAB). Women/AFABS are also more likely to dismiss symptoms of a heart attack and fail to get help on time.
Common heart attack symptoms in Men/AMABs may include:
- Intense chest pain or discomfort
- Shortness of breath
- Cold sweat
- Heartburn/indigestion
Common heart attack symptoms in Women/AFABs may include:
- Tightness or dull ache in the chest
- Shortness of breath
- Pain in jaw, neck, shoulder, throat and upper back
- Nausea/vomiting
- Sweating
- Fatigue/insomnia
- Lightheadedness/dizziness
What to do if you think you’re having a heart attack
If you suspect you or someone you know is having a heart attack, call 911. Heart muscle is damaged and starts to die within 30 minutes of having a heart attack. The faster you get emergency medical care, the better your chances of survival and avoiding permanent damage to your heart.
Call 911
As soon as you notice heart attack symptoms, call 911 immediately, give the operator your location and closely follow their instructions. Every minute counts. Don’t delay or ignore heart attack symptoms. Call 911 before following any of the steps below.
Chew aspirin
The 911 operator may suggest you chew an aspirin (if you’re not allergic and don’t have a condition that makes taking aspirin dangerous). Aspirin helps reduce blood clotting and improves blood flow to the heart. It can potentially save a life during a heart attack.
Sit or lay down
Sitting or lying down is the best way to reduce strain on the heart during a heart attack. It’s safest to rest in a comfortable position in case the person having a heart attack becomes dizzy or lightheaded.
Remain calm
Heart attacks are frightening, but it’s important to remain calm to reduce stress on the heart, especially if you’re alone. Slow, deep breathing can help reduce anxiety while you rest and wait for 911.
Avoid driving yourself to the hospital
Do not drive yourself to the hospital unless you have no other option. The best chance of survival is to call 911 or emergency medical services. If an ambulance can’t arrive quickly, have someone drive you to the nearest emergency room.
Causes of heart attacks
Most heart attacks are caused by atherosclerosis or when plaque clogs the inner lining of the arteries and can lead to thrombosis, or blood clot formation. Artery-blocking plaque can be caused by high cholesterol, high blood pressure, smoking, diabetes, obesity, lack of physical activity and eating a diet high in saturated fats.
Not all heart attacks are caused by clogged arteries. Viral infections like COVID-19, coronary artery spasms and tears inside a heart artery (spontaneous coronary artery dissection) can trigger a heart attack.
In some people, heart attacks can come on without warning. In others, symptoms can appear gradually. Plaque can take years or decades to build up enough to partially block an artery.
There are also heart conditions that interfere with heart function and increase heart attack risk including irregular heartbeats or arrhythmias, valve disorders and myocardial diseases. If not treated, these conditions can cause a heart attack and death.
Risk factors for heart attacks
You can’t change your age, family history or health conditions that put you at risk for a heart attack. However, there are three main factors for heart attacks—high blood pressure, high cholesterol and smoking—which can be improved with lifestyle changes. Heart attack risk factors include the following:
High blood pressure
High blood pressure (hypertension) is a major risk factor for heart attacks and is often called a “silent killer” because the only way to detect high blood pressure is by getting it checked. High blood pressure, if not treated properly, can damage the arteries that carry blood to your heart.
High cholesterol
High cholesterol is a risk factor for atherosclerosis, a common condition that leads to heart attacks. Atherosclerosis is when plaque deposits harden the arteries and restrict blood supply to the heart. Plaque is made up of fats, cholesterol and other substances.
Smoking
Smoking damages the heart and blood vessels, increasing your risk for atherosclerosis and heart attack. Small amounts of second-hand smoke can cause blood to clot, increasing the chance of a blockage and heart attack.
Diabetes
People with diabetes (type 1 and type 2) are twice as likely to have a heart attack as non-diabetics. Diabetics also have other heart attack risk factors like high blood pressure or high cholesterol.
Obesity
People who are obese are likely to develop conditions like high blood pressure and diabetes that can lead to a heart attack. Obesity causes stress on your heart, making it work harder to supply blood to your body.
Family history of heart disease
People with a family history of heart disease may inherit the condition. Having a parent or sibling with a history of heart disease increases your risk because you share similar genes.
Inactive lifestyle
Getting plenty of intense daily exercise is essential to keeping your heart pumping. Spending too much time sitting or being inactive increases your risk for diabetes and high blood pressure and can lead to coronary artery disease.
Poor diet
Diet is a big factor in heart health. Eating a poor diet, high in saturated fats and low in fruits and vegetables, can cause cholesterol to build up in your arteries, increasing your risk for atherosclerosis and heart attack.
Age
Heart attacks can happen at any age, but your risk goes up as you get older. For Men/AMABs the chance of having a heart attack increases after 45 and for Women/AFABs it rises after 50 or when menopause starts.
Tips for heart attack prevention
You can make simple lifestyle changes that are good for your heart, body and mind. Start putting your heart health first by following the tips below.
Maintain a healthy diet
Eat a heart-healthy diet with a variety of fruits, vegetables, whole grains and lean proteins and reduce the amount of high-fat, sugary and processed foods that are high in salt and added sugars. Avoid saturated and trans fats found in fatty beef, butter and fried foods. Don’t forget about controlling your portions and eating mindfully, which will help you control your weight and lessen the strain on your heart.
Stay active
Physical activity is one of the best ways to avoid weight gain and prevent heart attacks. It’s important to move your body every day either by walking, jogging, biking, swimming, group exercise or playing sports. Aim to exercise for at least 150 minutes (moderate intensity) or 75 minutes (vigorous intensity) per week.
Manage your stress levels
Stress plays a big role in your overall physical health and your heart health. Reducing stress is key to keeping your heart happy. There are ways to manage physical stress such as deep breathing exercises, yoga and mindfulness techniques, but it’s also important to manage mental stress. Spending time with supportive friends and family, finding new hobbies and activities and talking to a mental health professional can help lower stress levels.
Quit smoking
Smoking is harmful to your health and is bad for your heart and blood vessels. If you smoke, make it a priority to quit. If you don’t, avoid second-hand smoke. There are options to help you quit smoking and resist cravings including nicotine replacement, free smoking cessation programs and support groups.
The following resources can help you quit today:
- Mass.gov – 1-800-QUIT-NOW
- Centers for Disease Control – Free Help to Quit Smoking
- American Lung Association – Freedom From Smoking Program
- American Heart Association – Help! I Want to Quit Smoking American Cancer Society – Empowered to Quit
- Substance Abuse and Mental Health Services Administration – National Helpline
Manage cholesterol
When you have high cholesterol, fat can accumulate in your blood vessels, damaging them and causing atherosclerosis, a common cause of heart attacks.
One of the best ways to lower your cholesterol is by eating a diet low in saturated fats, trans fats and sugars. Increasing fiber and adding plant-based food like nuts, seeds and vegetable oil to your diet can help lower cholesterol levels.
If you have high cholesterol, heart disease or have had a heart attack, your doctor may prescribe a medication called a statin. Statins reduce the amount of cholesterol your liver produces and help remove cholesterol from your blood. Your doctor will likely want you to remain on statins long-term to keep your blood pressure low.
Maintain a healthy weight
If you’re obese (defined as having a body mass index of 30 or higher) you are more likely to develop high blood pressure, high cholesterol and diabetes which are linked to a higher risk of heart attack.
Maintaining a healthy weight will lower your risk of developing heart disease. Setting realistic weight loss goals and developing healthy exercise and eating habits will help you stay on track.
Limit alcohol
Drinking too much alcohol can lead to high blood pressure and increase your risk for heart disease. Heavy, excessive drinking or long-term alcohol use weakens your heart muscle and damages your heart. To keep your heart healthy, limit your daily alcohol intake.
Get regulars screenings
Getting regular blood pressure and cholesterol screenings is one of the most important ways to manage your heart health. If your blood pressure or cholesterol is elevated, you have a greater chance of having a heart attack. High blood glucose can cause serious health issues like type 2 diabetes and can lead to heart disease and stroke. A blood glucose test measures your “blood sugar” levels and screen for diabetes.
Heart attack prevention + treatments at Tufts Medicine
At Tufts Medicine, we are focused on preventing heart attacks by keeping your heart healthy. We offer education on lifestyle changes, regular screenings and risk factor management for hypertension, high cholesterol and diabetes. We also provide state-of-the-art treatments, minimally invasive procedures, innovative surgical techniques and customized treatment plans.
