Every year, about 1.2 million Americans have a heart attack. Although a heart attack, or myocardial infarction, may come without warning, it is usually the end result of a long-term disease process. When one of the coronary arteries, the arteries that branch off the aorta and supply blood directly to the heart muscle, becomes blocked, a heart attack results. A heart attack caused by a clot is called a coronary thrombosis. During a heart attack, part of the heart muscle (myocardium) may die from lack of oxygen. If myocardial infarction is not fatal, the heart muscle may sometimes partially repair itself.
Symptoms of a heart attack may include chest pain or pressure; arm, neck, or jaw pain; difficulty breathing; excessive sweating; nausea and vomiting; and loss of consciousness. Although chest pain occurs in the majority of heart attack victims, yet about 30% of people having a heart attack do not experience chest pain.
Are there any warning signs for a heart attack?
Some heart attacks are sudden but most heart attacks start slowly with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are some of the warning signs:
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath may occur with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea, or lightheadedness.
Most people who die from a heart attack do so within 2 hours from the time they experience the first symptoms. If you or someone you are with has any of the warning signs of heart attack, take immediate action. Get help even if the person denies there is something wrong. One additional step recommended by many experts is for the affected individual to chew and swallow one adult aspirin tablet (325 mg); aspirin has an immediate clot busting effect. If you or someone you’re with has chest discomfort, especially with one or more of the other signs, don’t wait longer than a few minutes (no more than 5) before calling for help. Calling 911 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive–up to an hour sooner than if someone gets to the hospital by car. The staff is also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away. If you’re the one having symptoms, don’t drive yourself, unless you have absolutely no other option.
If the person loses consciousness, emergency cardiopulmonary resuscitation (CPR) should be initiated by a qualified person. If the victim receives emergency care quickly enough, a clot dissolving agent can be injected to break up a clot in the coronary artery. Patients who arrive to the hospital early will also benefit from emergency Percutaneous Transluminal Coronary Angioplasty (PTCA).
How can you protect yourself from coronary heart disease and eventually a heart attack? There are several important steps you can take now to lower your risk of developing coronary artery disease and heart attack in the future:
1. Stop Smoking:
The number one risk factor for coronary heart disease that you can control is smoking. If you smoke, quit. If you don’t, don’t start. If you live or work with people who smoke, encourage them to quit–for their sake and yours. If you find yourself breathing in smoke, take steps to prevent or stop this exposure. Quitting smoking significantly reduces heart attack risk. Quitting smoking is highly beneficial, but abstaining from cigarette smoking throughout your entire life is even better.
2. Exercise Regularly
You can significantly reduce your risk of coronary heart disease and heart attack with a moderate amount of physical activity. Begin by accumulating at least 30 minutes of moderate intensity physical activity each day. Activities like brisk walking, gardening, and stair climbing are appropriate. Increasing the duration or intensity of exercise can provide even greater health benefits. The American Heart Association recently recommended strength training in addition to aerobic exercise for building and maintaining cardiovascular health.
3. Check your blood pressure regularly and seek treatment if it is high
If you have no coronary heart disease risk factors, check your blood pressure by a trained professional at least once every 2 years. Yearly tests are recommended if you have other risk factors. If your blood pressure is high, follow your physician’s advice on how to lower it.
4. Check your Cholesterol Levels
All people age 20 and over should have their cholesterol checked at least once every 5 years. Your Low Density Lipoprotein cholesterol (LDL) goal depends in part on how many of the following major risk factors you have; cigarette smoking, high blood pressure, low High Density Lipoprotein (HDL) cholesterol (less than 40 mg/dl), a family history of heart disease, and age (45 years and older for men, 55 years and older for women). An HDL level of 60 mg/dl or higher is protective and counts as a “negative” risk factor, meaning it removes one risk factor from your total countof risk factors.
Depending on your LDL level and other risk factors, your physician may recommend changes in lifestyle alone or lifestyle changes in combination with drug therapy. For example, if you have one or no risk factors, your LDL goal is less than 160 mg/dl. If your LDL is below that, diet, getting regular exercise, maintaining a healthy body weight, and not smoking will be sufficient. If your LDL is 160 mg/dl or Higher, you may need medication to bring your LDL into the healthy range.
4. Eat a Healthy Diet for Your heart
For most people, changing to a heart healthy diet involves substituting unsaturated fats for saturated and transfats and increasing intake of whole grains and fiber. The National Cholesterol Education Program (NCEP) recommends that all Americans over the age of 20 adopt a diet in which total fat consumption is no more than 30% of total daily calories, with no more than one–third of those fat calories (10% of total daily calories) coming from saturated fat. For people with heart disease or high LDL levels, the National Cholesterol Education Program recommends a total fat intake of 25-35% of total daily calories and a saturated fat intake of less than 7% of total calories.
Saturated fats are found in animal products; palm and coconut oil; and hydrogenated vegetables oils, which are also high in transfats. Choose unsaturated fats, especially omega 3 polyunsaturated fats, over saturated and transfats. Animal products contain
cholesterol as well as saturated fat; vegetable products do not contain cholesterol.
Increasing Fiber Intake is very beneficial since fiber traps the bile acids that the liver needs to manufacture cholesterol and carries them to the large intestine, where they are excreted. Fibers also slow the production of proteins that promote blood clotting which lowers the incidence of a heart attack. Fiber may also interfere with the absorption of dietary fat and may help you cut total food intake because foods rich in fiber tend to be filling. To obtain the recommended 25-38 grams of dietary fiber per day choose a diet rich in whole grains, fruits, and vegetables. Good sources of fiber include oatmeal, some breakfast cereals, barley legumes, and most fruits and vegetables.
Limit sodium intake by reading food labels carefully and avoid foods particularly high in sodium. Limiting sodium intake helps in controlling your blood pressure which in turn lowers your risk of coronary heart disease and heart attack. Foods that are fresh, less processed, and less sodium dense are good choices. Adequate potassium intake is also important in control of blood pressure. Good food sources include leafy green vegetables like spinach and beet greens, root vegetables like white and sweet potatoes, vine fruits like cantaloupe and honeydew melon, winter squash, bananas, many dried fruits, and tomato sauce.
Omega 3 fatty acids found in fish, shellfish, and some plant foods (nuts and canola, soybean, and flaxseed oils) may reduce clotting, abnormal heart rhythms, and inflammation and have other heart healthy effects.
5. Manage stress and anger
To reduce the psychological and social risk factors for coronary heart disease and heart attack, you should develop effective strategies for handling the stress in your life. Shore up your social support network, exercise regularly, have a healthy diet, have adequate sleep, manage your time effectively, maintain positivity, think and act constructively, modify your expectations, and develop a sense of humor.
6. Moderate Alcohol Consumption
The Dietary Guidelines for Americans state that moderate alcohol consumption may lower the risk of coronary heart disease among middle aged and older adults. (Moderate means no more than one drink per day for women and two drinks per day for men.) For most people under age 45, however, the risks of alcohol use probably outweigh any health benefit. If you do drink, do so moderately with food, and at times when drinking will not put you or others at risk.
To summarize, heart disease is the leading cause of death in the United States, accounting for nearly half of all deaths. Although age, genetics, and the physical environment play roles in the development of heart disease, yet heart disease is primarily lifestyle disease, linked to many controllable lifestyle risk factors.