Heart Attacks: Answers to Your Most-Asked Questions

12/29/2020 | 6 min. read

Dr. Stephen Sinatra

Dr. Stephen Sinatra

Nearly half of Americans have at least one risk factor for heart disease, and heart attacks are one of the most serious and dreaded consequences. So, it is not surprising that I get a lot of questions about heart attacks. In this article, I am going to answer some of the most common questions. 

What Does It Feel Like to Have a Heart Attack?

Perhaps the most important question—after how to prevent heart disease—is how to tell if you’re having a heart attack. Where is heart attack pain? Could it be somewhere other than the chest? 

Not all heart attacks are like the ones you see in the movies, where a guy clutches his chest, breaks out in a sweat, and falls to the ground. Symptoms are often less dramatic. They include: 

  • Constant or intermittent pain or uncomfortable pressure in the center of the chest, one or both arms, the neck or jaw, and/or the back
  • Sweating
  • Shortness of breath
  • Dizziness, lightheadedness, or fainting
  • Weakness or extreme fatigue 
  • Nausea or vomiting

Some people experience “silent heart attacks,” which have such vague symptoms that they are chalked up to other causes or shrugged off. Others, especially women, have subtle warning signs days or weeks in advance. The important thing is to get familiar with all the signs and symptoms so you can act quickly if a heart attack does occur.

How Can You Stop Heart Attacks? 

If you suspect that you or a loved one is having a heart attack, call 911 right away. Do not wait it out. Do not call your doctor’s office. Do not drive to the hospital. Next, chew a full-strength (325 mg) aspirin. Do not take Tylenol or ibuprofen or swallow the aspirin whole—chewing it helps it to get into your bloodstream more quickly.

If the person is unconscious, begin “just hands” CPR, a simple procedure that everybody should learn. Then wait for the ambulance to arrive. The only way to really stop a heart attack is to restore blood flow to the affected coronary artery. The faster you get treatment, the less damage to the heart and the greater the recovery. 

What Is the Average Age of Heart Attacks?

The average age for a first heart attack is 65 for men and 72 for women. However, heart attacks can occur at any age—and the proportion of patients younger than age 50 has been rising. This includes the “very young” (40 and under). In a 2020 study, Harvard researchers reported that heart attacks in this age group have increased every year over the past decade. 

Don’t make the mistake of thinking heart disease is an old people’s disease. No matter what your age, it is important to get cardiovascular risk factors under control.   

Can Children Have Heart Attacks?

Heart attacks are exceptionally rare in children. When you hear about a child or adolescent suddenly dying of a “heart attack,” it is more likely cardiac arrest due to an electrical malfunction that causes the heart to stop beating. Sudden cardiac arrest in children, which is also quite rare, is usually triggered by a structural abnormality or other underlying congenital problem. 

Can Alcohol Cause Heart Attacks?

There is a common belief that alcohol—red wine in particular—is good for your heart. An occasional glass of red wine is fine, perhaps even beneficial, for most people. However, excessive alcohol increases the risk of atrial fibrillation, heart failure, and other cardiovascular disorders that are linked with heart attacks. 

How much is excessive? Much less than you may think. An international group of researchers published a study in Lancet that analyzed the cardiovascular effects of alcohol on nearly 600,000 drinkers enrolled in 83 studies. They concluded that more than 100 g of alcohol (about six drinks) a week was associated with an increased risk of heart attack and death from all causes in both women and men.

Based on this and other recent research, the current guidelines are too high. My recommendation is to limit alcohol consumption to three to five drinks a week, at most.

What Is the Difference Between Heart Attacks & Strokes?

Although heart attacks occur in the coronary arteries that supply the heart muscle and strokes affect blood vessels in the brain, both are caused by interrupted blood flow.

Severely narrowed arteries, due to plaque buildup or vasospasms, restrict blood flow—and when a blood clot from inflamed arterial plaque lodges in a narrowed vessel, blood flow may be cut off completely. When either of these essential organs is deprived of oxygen- and nutrient-rich blood, cells begin to die within minutes. 

Should You Take Aspirin to Prevent Heart Attacks? 

It depends. If you have never had a heart problem, do not take aspirin. Although low-dose aspirin used to be widely recommended for prevention, it no longer is. Current research reveals that daily aspirin does more harm than good for people with no history of cardiovascular disease. A 2019 JAMA study found that it offered scant protection—but increased the risk of major bleeds by 43%.

Now, if you have had a heart attack, stroke, stent, or angioplasty, or been diagnosed with coronary artery disease, your doctor will probably recommend low-dose aspirin (81 mg per day). Aspirin’s blood-thinning effects discourage the formation of blood clots that could lodge in a blood vessel and cause a heart attack or stroke. This benefit easily outweighs the risk of bleeding.

Can Emotions Cause a Heart Attack?

I am convinced that emotional distress plays a significant and overlooked role in heart disease. I noticed early in my medical career the increase in heart attacks, arrhythmias, hypertension, and other cardiovascular problems following the loss of a loved one, trauma, divorce, economic hardship, and other emotional upheavals. 

Overwhelming emotion—whether it’s anger, anxiety, grief, or despair—can provoke irregular heartbeat, chest pain, shortness of breath, and other symptoms similar to heart attacks. There is even a medical condition, appropriately called broken heart syndrome, marked by these symptoms. This is why I believe it is essential to address the emotional risk factors for heart disease.

What Happens After a Heart Attack?

It takes a minimum of three months to recover from a heart attack—or much longer, depending on the extent of the damage. Take it easy and don’t jump back into the thick of things. If your doctor recommends a cardiac rehab program, take it seriously and stick with it. Above all, give yourself the time and TLC needed to heal your heart

Take this time to get serious about adopting a healthier lifestyle. A heart-healthy diet, a gradually increasing exercise regimen, smoking cessation, and stress management have been shown in clinical trials to stave off repeat heart attacks and improve overall health. I also suggest adding the following nutrients to help restore cardiac energy and facilitate recovery: 

  • CoQ10 100–300 mg daily
  • Magnesium 400–800 mg daily
  • L-carnitine 500 mg once or twice daily
  • D-ribose 5 g twice daily
Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

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