Heart Attack: Warning Signs and Risk Factors

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What are the signs of a heart attack? Many people think a heart attack is sudden and intense, like a "movie" heart attack, 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. If you feel such a symptom, you may not be sure what's wrong. 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 ones.

The most common heart attack signs and symptoms are:

  • Chest discomfort or pain—uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.
  • Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath may occur with or before chest discomfort.
  • Nausea (feeling sick to your stomach) and/or vomiting
  • Lightheadedness or fainting
  • Breaking out in a cold sweat

A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn't restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you're with is having a heart attack, call 9–1–1 right away.

Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.

During a heart attack, if the blockage in the coronary artery isn't treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.

Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can't pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.


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Get Help Quickly

Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms.

If you think you or someone you know may be having a heart attack:

  • Call 9–1–1 within a few minutes—5 at the most—of the start of symptoms.
  • If your symptoms stop completely in less than 5 minutes, still call your doctor.
  • Take an ambulance to the hospital. Going in a private car can delay treatment.
  • Take a nitroglycerin pill if your doctor has prescribed this type of medicine.
  • Chew an aspirin. Aspirin reduces blood clotting and can help keep a heart attack from getting worse. But don't delay calling 9–1–1 to take an aspirin.

Outlook

Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States.

Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.

Source: The National Heart, Lung and Blood Institute (NHLBI), https://www.nhlbi.nih.gov/health-topics/heart-attack

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