9 Things to Know About Heart Attacks Before You Have One

Recognize these common heart attack signs and symptoms so you know what to expect before a heart attack strikes.

adapted by Alyssa Jung

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How will I know if I’m having a heart attack?
The number one rule: don’t diagnose yourself. Call 911 if you have the slightest suspicion that you may be having a heart attack. Since most heart attack deaths happen in the first hour after an attack, waiting several hours before calling for help could be deadly! If you have any of the following symptoms, dial 911. Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and then comes back. It may feel like an uncomfortable level of pressure, squeezing, fullness, or pain. Upper body discomfort: Pain in one or both arms, the back, neck, jaw, or stomach could signal a problem. Shortness of breath: This symptom may occur with or without chest discomfort. Other signals: Pay attention to body symptoms you don’t normally experience, such as breaking out in a cold sweat, nausea, lightheadedness, overwhelming fatigue, or a feeling of impending doom. (These signs are especially common in women.)

Will I get that “elephant on the chest” feeling I’ve heard about?
Maybe, maybe not. In a heart attack, blood supply to the heart muscle is interrupted and heart muscle cells start to die, which may cause chest pain—but sometimes it doesn’t, especially in women. Most heart attacks build up slowly, with milder pain or discomfort.

Can I have a heart attack and not know it?
Yes, and while it can happen to anyone, it’s people with diabetes are more likely to have what’s called a “silent heart attack.” You may not experience any of the “expected” heart attack symptoms, like chest pain. However, you may feel nauseous, short of breath, or even faint.

Is there any time of day when I’m more likely to have a heart attack?
A heart attack can strike at any time, but it occurs most frequently in the early hours of the morning. Heart attacks are 40 percent more common between 6 a.m. and noon than at other times of the day. Similarly, sudden cardiac deaths are 29 percent more common in the morning.

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What should I do if I think I’m having a heart attack?
Call for an ambulance immediately, and stay calm. Then, sit or lie still and slowly chew one 300 mg aspirin tablet—aspirin helps minimize heart damage or development of a dangerous blood clot by reducing the “stickiness” of the platelets that play an important part in blood clotting. Also, make sure your door is unlocked so emergency responders can get into your house. Don’t eat or drink anything, and phone a relative, neighbor, or friend to come wait with you.

What can I expect once I get to the hospital?
First, you’ll be hooked up to a cardiac monitor and intravenous drip. You’ll be given oxygen and pain medication while an electrocardiogram (ECG) test is performed to measure the heart’s electrical impulses and to detect any irregular rhythm or other abnormalities that indicate a heart attack. They’ll take a blood sample to see if the heart muscle is damaged and may repeat this up to 12 hours after a suspected attack. These blood tests measure levels of an enzyme called troponin, which is released into the bloodstream if the heart muscle is damaged or dying. Depending on your condition or the severity of your attack, doctors may keep you in the hospital until the best treatment is determined.

Will I have to have surgery?
If you reach the hospital quickly, doctors may try to open up your coronary arteries mechanically in a procedure known as coronary angioplasty. A thin tube with a balloon at the tip is threaded up from your groin to your coronary artery, and a small amount of dye is injected so that the site of the blockage can be seen using an x-ray video. The balloon is inflated to widen the artery, and when the tube is withdrawn, a small metal coil known as a stent is usually left in place to keep the artery open and prevent further blockages. Some stents can also release medication to keep the artery clear.

Can I exercise after a heart attack?
Exercise actually lowers your risk of suffering a second heart attack, but talk to your doctor to find an exercise routine that is safe for you. Doctors may recommend cardio like walking, jogging, cycling, or swimming to help strengthen the heart muscle. Never start training until the doctor gives you the all-clear.

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Will I be able to have sex after a heart attack?
Once your doctor gives you the green light to engage in moderate exercise, it’s safe to be intimate. Most people are able to start having sex again within two or three weeks of having a heart attack, but always check with your doctor first and be sure to tell them if you’re experiencing any chest pain or heart palpitations.

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