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What Everyone Should Know About Heart Attacks


February is American Heart Month and to support heart health, LIVESTRONG.COM is featuring a series of heart-focused articles this month on how to protect your health.

Man who is concerned about his heart health
Did you know that heart disease is a leading cause of death and disability in the United States? Typical symptoms of coronary artery disease include pain in the middle of the chest while walking, lifting something heavy or climbing stairs. If it's a warning sign of an impending heart attack, this pain will eventually go away with rest.

But if it's a life-threatening heart attack, the chest pain will persist. The classic scenario of a heart-attack case is a slightly overweight, sedentary, middle-age man who smokes and ventures out to shovel snow on a cold winter day. "Classic," however, does not mean "always," and there are a few things everyone should know about heart-attack symptoms:

[Read More: Foods That Will Take Care of Your Heart]

1. Chest pain does not have to be "pain," and it doesn’t have to be in the chest. The pain can feel more like a pressure, tightness or squeezing sensation. This pain, pressure or tightness can also be in the left shoulder, left arm, throat, jaw or back.
Heart attack warning signs
2. You don't have to have chest pain or pressure to be suffering from a heart attack. Although pain or pressure in the left-side shoulder, arm or jaw is most common, some people may experience nausea, vomiting, weakness, dizziness, hiccups, sweating and/or sudden trouble breathing. Overall, there's a sudden sense of not feeling well, and the time frame is usually anywhere from 15 minutes to several hours. People with diabetes (high blood sugar) and of older age may have milder symptoms.

3. Heart disease does not discriminate and can strike even in people at low risk. You don't have to be overweight, sedentary or a smoker to have a heart attack.

A recent report from one of the American Heart Association's national registries evaluated 100,884 people without known cardiovascular disease presenting with their first heart attack [2]:

* About three-fourths of this group did not have a known history of diabetes.

* A little more than one-third did not have known high blood pressure.

* More than half did not have high cholesterol or smoke tobacco.

* Almost half of the group had either none or one known modifiable risk factor.

* It's possible that part of this group may have had a risk factor such as diabetes, high blood pressure or high cholesterol, but they were not aware of it.

 [Read More: 6 Ways to Reduce Your Heart Attack Risk]

Non-modifiable risk factors, such as age (45 and older for men, 55 and older for women) as well as male gender, were also added to the risk profile:

* About one-fifth of the group was younger than 45 years old (men) or 55 years old (women).

* About one-third of the group was women.

* About eight percent of the group had none or one traditional risk factor.

So, while diabetes, high blood pressure, high cholesterol, kidney disease and tobacco use elevates your risk of heart disease, everyone needs to be aware of the signs and symptoms of a heart attack.
Woman at table with head resting on hand
4. Heart disease doesn't just affect men. Heart disease is also the number one cause of death in women across all races. In fact, death from heart disease is more than 10 times more likely than death from breast cancer.

Like men, women may present with vague symptoms like nausea, vomiting, weakness, dizziness, hiccups, sweating and/or sudden trouble breathing. However, more often than not, women present with the classic chest pressure and, unlike men, symptoms are missed simply because of lack of awareness.

Education and altering the stereotypical image of a man clutching his chest is key, but it's only one part of the solution. Women must start advocating for their own health.

Heart disease kills more women than men every year, and women are more likely to die within a year of their heart attacks than men. However, compared to men, women have underlying differences in the structure and function of the arteries of their heart and the sequence of events in the body that lead to their heart attacks. [4]

Although the prognosis after a heart attack has improved over time, this improvement is much lower in women than men. [5] Despite these differences, women remain underrepresented in clinical trials that evaluate the optimal treatment strategies for heart attacks. [6] There's a call to increase the number of women who enroll in research studies that evaluate heart disease so that the best possible treatment strategy for women are implemented in women.

5. There's an art to exercise. Anyone over the age of 40 should be cautious when exercising — even relatively healthy people shouldn’t suddenly exert themselves more than usual. All exercise should start slowly and gradually increase in pace, duration and resistance. And it's always a good idea to talk to your physician before starting a new exercise regimen.

--Dr. Shah

Readers -- Have you or anyone you know suffered a heart attack? Did you realize at the time what was happening? Did some of the facts mentioned above surprise you? Leave a comment below and let us know.

Dr. Binita Shah, M.S., M.D., is an instructor of medicine in the Division of Cardiology at NYU Langone Medical Center. She earned her M.D. and M.S. in Clinical Investigation at NYU School of Medicine. Dr. Shah is board-certified in both cardiovascular disease and interventional cardiology.

Dr. Shah has an interest in improvement of outcomes after a cardiovascular event. She has an active research program in the study of glucose, metabolic syndrome and inflammation in heart disease, melding well with her clinical focus on treatment of patients with coronary artery disease. Dr. Shah is also a member of the American Heart Association's Harlem Go Red Education Committee to increase awareness of heart disease in women and the New York State chapter liaison for the American College of Cardiology Women in Cardiology section to advocate for women physicians in the field of cardiology.




2. Shah B, Bangalore S, Gianos E, Liang L, Peacock WF, Fonarow GC, Laskey WK, Hernandez AF, Bhatt DL. Temporal trends in clinical characteristics of patients without known cardiovascular disease with a first episode of myocardial infarction. Am Heart J. 2014;167:480-488.


4. Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GB, Feit F, Pena-Sing I, Axel L, Attubato MJ, Yatskar L, Kalhorn RT, Wood DA, Lobach IV, Hochman JS. Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011;124:1414-1425.

5. Dougherty AH. Gender balance in cardiovascular research: importance to women’s health. Tex Heart Inst J. 2011;38:148-150

6. Melloni C, Berger JS, Wang TY, Gunes F, Stebbins A, Pieper KS, Dolor RJ, Douglas PS, Mark DB, Newby LK. Representation of women in randomized clinical trials of cardiovascular disease prevention. Circ Cardiovasc Qual Outcomes 2010;3:135-142





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