Second Heart Attacks: Risk, Causes & Prevention

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If you’ve had a heart attack, there’s no question you don’t want to have another one. Yet, repeat heart attacks are all too common. 

According to American Heart Association statistics, each year 935,000 Americans suffer a heart attack—of those, 30% are second heart attacks. In fact, if you’ve had a heart attack, you’re at a 20% greater risk of having another one within five years than someone who hasn’t.

What Causes a Second Heart Attack?

During a heart attack, the muscle around the blockage temporarily loses its blood supply. Scar tissue develops in the injured area, just like it would in any area of your body that’s injured.

But scar tissue does a much poorer job of pumping blood than healthy heart muscle does. So, not only is your heart recovering following a heart attack, it has to work twice as hard.

Plus, after a heart attack, you still have the same health issues that provoked it—such as high blood pressure, being overweight, a sedentary lifestyle, stress, and more. Unless you address those factors, a second heart attack is likely. 

How to Prevent a Second Heart Attack

Understand life will be different for a while. One of the hardest things for many of my patients to appreciate after a heart attack was there’s a scar area that’s healing in their hearts. So, simple activities that never used to tire them were exhausting. The heart needs a full three months to truly heal after a heart attack, filling in and strengthening scar tissue in the area where cells have died—and for some people, it can take a lot longer. So, be patient with yourself.

Take cardiac rehabilitation seriously. Cardiac rehab is extremely important, helping you regain your strength, energy, and stamina—and the success rate is extremely high. Research quoted by the American Heart Association shows cardiac rehab helps to reduce the chance of a subsequent heart attack by 47%. Yet, many people don’t take advantage of it. If your doctor prescribes cardiac rehab, do it! One of the side benefits is you will meet others going through recovery, and that support network is extremely important.

When I was Chief of Cardiology and Director of Cardiac Rehabilitation at my hospital in Connecticut, I felt the major benefit of cardiac rehab was enabling patients to reconnect with their bodies and determine if any symptoms, with or without exercise, were related to the heart. Cardiac rehab is a great way of regaining confidence in the real world following your hospital stay.

Get regular exercise. Once your doctor clears you for exercise, I recommend beginning a walking program. Start slowly, and gradually add more time and intensity to your walking program. Here’s how to exercise safely for heart health

Listen to your body. If you notice symptoms like tightness in your chest or twinges of pain, alert your doctor, even if the symptoms quickly subside. These can indicate there’s an issue with your heart, so you can address it and prevent a second heart attack.

If you smoke, quit! Few things alarm me more than seeing a cardiac patient smoking or vaping—it’s one of the most effective ways of preventing a second heart attack. According to the Heart Foundation, quitting smoking following a heart attack can lower your chances of having a repeat heart attack by 50%. If you smoke, here’s how to quit

Eat a heart-healthy diet. I recommend eating a Pan-Asian Modified Mediterranean Diet, which combines the Mediterranean diet with the diet common to those living on the Asian side of the pacific rim. I’ve been recommending it since the mid-1990’s when the Lyon Heart Diet Study revealed that a Mediterranean-style diet outperformed the American Heart Association diet—reducing repeat heart attacks by 50-70% over four years. 

Fortify your heart with the right nutrients. Following a heart attack, I recommend taking CoQ10 100–300 mg daily, magnesium 400–800 mg daily, broad-spectrum carnitine 1–2 g daily in divided doses, and D-ribose 5 g twice daily. These nutrients help the heart recover and regain its energy. 

Follow up with your doctor regularly. Regular medical care is very important for preventing a second heart attack. When you see your doctor, express any concerns you have, including fatigue. Also remember that fatigue can be a symptom of depression which is common after a heart attack, so be sure to mention it to your physician so he or she can evaluate the cause.

Finally, take heart—quite literally! With the right proactive steps, you can prevent a second heart attack. My most successful patients were those who viewed a heart attack as a “wakeup call” and achieved even better health than they had before their cardiac event.

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

A true pioneer, Dr. Sinatra spent more than 40 years in clinical practice, including serving as an attending physician and chief of cardiology at Manchester Memorial Hospital, then going on to formulate his advanced line of heart health supplements. His integrative approach to heart health has changed the lives of hundreds of thousands.

More About Dr. Stephen Sinatra