5 Things You Need to Know About Heart Attacks

February is American Heart Month, and this year we are spotlighting one of the oldest and most prevalent public health issues: the heart attack.^1,2 A heart attack occurs when blood flow to the heart is reduced or blocked altogether.³ This is often caused by atherosclerosis of the heart, or coronary artery disease, a condition that develops when cholesterol builds up in the coronary arteries.⁴ About half of Americans between ages 45 and 84 have atherosclerosis and don't know it.⁴

Check out five important facts you may not know about heart attacks:

1. They're pervasive.

   Every year in the United States, about 805,000 people have a heart attack. That's about one every 40 seconds. Of these, 605,000 are a first heart attack, and 200,000 are in people who have already had at least one heart attack.²

2. They're often caused by high LDL-C.

   LDL-C (low-density lipoprotein cholesterol) is often referred to as "bad" cholesterol. When your body contains high levels of LDL-C, LDL builds up in the walls of your blood vessels which can lead to atherosclerosis. This increases your risk for health problems, such as a heart attack.⁵ A low LDL-C level is optimal for your health, and it's even more important if you've had one or more heart attacks.⁶

3. Their symptoms might not be what you expect.

   In addition to the tell-tale signs of a heart attack (e.g., chest pain, shortness of breath, and pain or discomfort in one or both arms), there are other symptoms that you may not associate with heart attacks.⁷

   • Waking up in a cold sweat and experiencing nausea and/or vomiting may be symptoms of another ailment, but they can also be signs of a heart attack.^7,8
   • In movies we see people clutching their arms or chest in pain, but did you know pain is also common in the jaw, neck, and back?⁷
   • Fatigue and exhaustion often come into play during a heart attack because of the stress of your heart pumping an area where blood flow is blocked. This symptom is generally more common in women than men.⁹

4. They can be silent.

   One in five people have a silent heart attack, which is a heart attack with few, if any, symptoms, and sometimes the symptoms aren't recognized as a heart attack at all.² Those who have experienced this might think in the moment that they had heartburn, the flu, or strained a chest muscle.¹⁰ Research shows that having one silent heart attack increases an individual's risk of having another heart attack and increases the risk of complications like heart failure.¹⁰

5. They may be preventable, so act now and talk to your doctor.

   LDL-C is the main culprit for blockages in the coronary arteries, but an LDL-C test can help determine if you're at risk for a heart attack.¹¹

   There are ways to help lower your LDL-C, including:

   • Maintaining a healthy diet. A healthy diet is another way to help lower your LDL-C. Eating nutrient-dense foods that have vitamins, minerals, and fiber is a better choice than eating processed foods that may be high in saturated and trans fats.¹²
   • Staying active. Being active every day is a great way to help lower your LDL-C. Studies have shown that at least 150 minutes per week of physical activity can help lower LDL-C.¹²
   • Talking to your doctor about the right medication if you have high LDL-C. If you're on medication post-heart attack and your LDL-C remains higher than 55 mg/dL, your current treatment may not be enough.¹³

If you or someone you know is having a heart attack, call emergency services (911 in the United States).

References:

1. The American College of Cardiology. Earliest Case Of Coronary Artery Disease Found In Egyptian Princess. Accessed January 2023. https://www.acc.org/about-acc/press-releases/2011/04/05/16/22/mummies
2. Centers for Disease Control and Prevention. Heart Disease Facts. Accessed January 2023. https://www.cdc.gov/heartdisease/facts.htm
3. Mayo Clinic. Heart Attack: Symptoms & Causes. Accessed January 2023. https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106
4. National Heart, Lung, and Blood Institute. What is Atherosclerosis? Accessed January 2023. https://www.nhlbi.nih.gov/health/atherosclerosis
5. Centers for Disease Control and Prevention. LDL and HDL Cholesterol: "Bad" and "Good" Cholesterol. Accessed January 2023. https://www.cdc.gov/cholesterol/ldl_hdl.htm
6. Lloyd-Jones D, Morris P, et al. 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk. J Am Coll Cardiol. 2022 Oct, 80 (14) 1366–1418. https://doi.org/10.1016/j.jacc.2022.07.006
7. Centers for Disease Control and Prevention. Heart Attack: What are the symptoms of heart attack? Accessed January 2023. https://www.cdc.gov/heartdisease/heart_attack.htm
8. Penn Medicine. 4 Silent Heart Attack Signs. Accessed January 2023. https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2022/april/4-silent-heart-attack-signs
9. Healthline. Warning Signs of a Heart Attack. Accessed January 2023. https://www.healthline.com/health/heart-disease/warning-signs-heart-attack#fatigue
10. Mayo Clinic. Silent heart attack: What are the risks? https://www.mayoclinic.org/diseases-conditions/heart-attack/expert-answers/silent-heart-attack/faq-20057777
11. Medline Plus. Cholesterol Levels. Accessed January 2023. https://medlineplus.gov/lab-tests/cholesterol-levels/
12. American Heart Association. Lifestyle Changes for Heart Attack Prevention. Accessed January 2023. https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack/lifestyle-changes-for-heart-attack-prevention
13. Gencer B, Giugliano RP. Management of LDL-cholesterol after an acute coronary syndrome: Key comparisons of the American and European clinical guidelines to the attention of the healthcare providers. Clin Cardiol. 2020 Jul;43(7):684-690. doi: 10.1002/clc.23410. Epub 2020 Jun 29. PMID: 32596859; PMCID: PMC7368309.