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Heart Attack

Coronary heart disease (CHD) is the leading cause of death for both men and women in the United States. CHD is caused by a narrowing of the coronary arteries that supply blood to the heart and often results in a heart attack.

Each year, about 1.1 million Americans suffer a heart attack. About 460,000 of those heart attacks are fatal. Approximately half of those deaths occur within one hour of the start of symptoms and before the person reaches the hospital.

Fortunately, everyone can take steps to protect his/her heart and life or the life of someone else. The key is seeking medical care as soon as possible.

What is a heart attack?

The heart works 24 hours a day, pumping oxygen and nutrient-rich blood to the body. Blood is supplied to the heart through its coronary arteries. Coronary heart disease causes plaque or fatty substances to build up inside the walls of the arteries. The plaque also attracts blood components that stick to the artery wall lining. Called atherosclerosis, the process develops gradually over many years. It often begins early in life, even in childhood.

The fatty buildup or plaque can break open and lead to the formation of a blood clot that seals the break and reduces blood flow. The cycle of fatty buildup, plaque rupture and blood clot formation causes the coronary arteries to narrow, reducing blood flow.

When too little blood reaches the heart, the condition is called ischemia. Chest pain (angina) may occur. The pain may be mild and intermittent or more pronounced and steady. It can be severe enough to make normal everyday activities difficult. However, the same inadequate blood supply may cause no symptoms. This condition is called silent ischemia.

If a blood clot suddenly cuts off most or all blood supply to the heart, a heart attack results. Cells in the heart muscle that do not receive enough oxygen-carrying blood begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart.

Who's at risk?

Heart attacks strike both men and women. However, some persons are more likely than others to have a heart attack because of their "risk factors." Risk factors are behaviors or conditions that increase the chance of a disease. Some of the risk factors for heart attack cannot be controlled, but most can be modified to help lower the risk of having a first or repeat heart attack.

Factors you cannot control

  • Pre-existing coronary heart diseases. These would include a previous heart attack, a prior angioplasty or bypass surgery, or angina.
  • Age. In men, the risk increases after age 45; in women, the risk increases after age 55.
  • Family history of early heart disease. Of particular concern are those whose father or brother was diagnosed before age 55 or whose mother or sister was diagnosed before age 65.

Factors you can control

  • Smoking
  • High blood pressure
  • High blood cholesterol
  • Overweight and obesity
  • Lack of physical activity
  • Diabetes

Having more than one risk factor increases your chance of having a heart attack. Therefore, it is very important to prevent or control risk factors that can be modified. If you have one or more of these factors, see your health care provider to find out how to reduce your risk of having a first or repeat heart attack.

Heart attack warning signs

A heart attack is a frightening event, and you probably don't want to think about it. But, if you learn the signs of a heart attack and what steps to take, you can save a life -- maybe your own.

What are the signs of a heart attack? Many people think a heart attack is a sudden and intense episode where a person clutches his or her chest and falls over. The truth is that many heart attacks start slowly, as a mild pain or discomfort. Your symptoms may even come and go. Even those who have had a heart attack may not recognize their symptoms because the next attack can have entirely different symptoms.

It's vital that everyone learn the warning signs of a heart attack:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Pain or discomfort in one or both arms, the back, neck, jaw or stomach can occur.
  • Shortness of breath. This can occur before or along with chest discomfort.
  • Other symptoms. Symptoms may include breaking out in a cold sweat, nausea or light-headedness.

Learn the signs, but also remember, even if you're not sure it's a heart attack, you should still seek professional medical advice. Fast action can save lives – maybe your own.

Reducing heart attack risk

You can reduce your risk of having a heart attack even if you already have coronary heart disease or have had a previous heart attack. The key is to take steps to prevent or control your heart disease risk factors.

Key steps to reduce heart attack risk

  • Stop cigarettes. Help is available to assist you.
  • Lower High blood pressure. Eat a balanced diet, maintain a healthy weight and exercise to reduce blood pressure. Your physician may also prescribe medication.
  • Reduce high blood cholesterol. The best way to lower cholesterol is to reduce your intake of saturated fats and to increase physical activity. Your physician may also prescribe medication.
  • Aim for a healthy weight. Control your caloric intake and lose excess weight.
  • Be physically active each day. 30 minutes or more on most, preferably all, days each week of moderately intense physical activity is recommended for adults.
  • Manage Diabetes. Treatment and better blood sugar control can delay complications that increase the risk of a heart attack.