Cardiovascular disease remains one of the leading causes of death worldwide, and heart attack statistics identify a heart attack as being one of the major contributors. While this is a sobering statistic, most heart attacks are preventable through science-based nutrition and lifestyle changes.
Whether you are at risk for a heart attack or want to prevent a future one, addressing the underlying root causes such as inflammation and oxidative stress is one of the most important steps.
As a heart health dietitian and nutritionist working as part of a cardiology team, I help determine and address the underlying root causes to develop the best holistic heart attack prevention and treatment approach for you. Let’s dive into how you can take charge of your heart health.
What is a Heart Attack?
A heart attack, also known as a myocardial infarction (MI), is when part of the blood flow to the heart muscle becomes partially or completely blocked. When this happens, the heart becomes starved of essential oxygen and nutrients, resulting in damage or death to the affected heart muscle cells.
This blockage is typically caused by the buildup of fatty deposits called plaque, otherwise known as atherosclerosis. This plaque accumulates over time in the coronary arteries, leading to an eventual blockage and a full-blown heart attack if not addressed early on.
There are a few different types of heart attacks such as a widowmaker heart attack, STEMI, and NSTEMI heart attacks, depending on the severity or location of the blockage.
Heart Attack Statistics
As of 2023, the latest heart attack statistics put out by the Centers for Disease Control (CDC) reveal the following:
- Heart disease remains the leading cause of death globally.
- Heart attacks are a significant contributor to heart disease-related deaths, but 80-90% of them are preventable.
- In the United States, someone experiences a heart attack every 40 seconds.
- Every year, about 805,000 people in the U.S. have a heart attack. Of these, 605,000 are first heart attacks, and 200,000 are recurrent heart attacks.
- About 1 in 5 heart attacks are completely silent – where a heart attack occurs, but the person was unaware of it because they didn’t have symptoms.
- Lifestyle choices profoundly impact the risk of heart attacks. This includes but is not limited to smoking, stress, excess weight around the midsection, unbalanced diet, and lack of exercise.
When it comes to heart attacks, early detection, action, and modifying your lifestyle choices like diet are key to prevention.
Heart Attack Symptoms
While 1 in 5 heart attacks do not cause any symptoms, there are several common symptoms to look out for. These heart attack symptoms are different from those of heartburn, so it’s important to differentiate them.
Here are the most common symptoms of a heart attack:
- Chest pain, tightness, or pressure: This is one of the most telltale heart attack symptoms.
- Shortness of breath
- Upper body pain
- Lightheadedness or dizziness
- Nausea, vomiting, or indigestion
- Cold sweats
- Flu-like symptoms
It’s important to keep in mind that heart attack symptoms can differ significantly between men and women. While both men and women may experience chest pain as one of the most common symptoms, women are more likely to experience nausea, shortness of breath, and back or jaw pain.
Heart Attack Diagnosis
In addition to the initial symptoms that may suggest a heart attack, there are a few specific tests that may be ordered to confirm a heart attack diagnosis.
Blood tests are one of the first diagnostic tools to assess whether a heart attack occurred.
Examples of these blood tests include:
- Troponin test: Troponin is a protein found in heart muscle cells that is released into the blood when the heart is damaged. These tests are highly sensitive and specific for detecting heart injury and thus are typically one of the most common blood tests done.
- Creatinine kinase (CK) test: CK is an enzyme in the heart that is released into the blood upon heart damage. A specific type of CK called CK-MB is primarily found in the heart muscle, so elevated levels of CK-MB can suggest a heart attack.
- Myoglobin test: Myoglobin is a protein found in the heart and skeletal muscle that may be released into the bloodstream during a heart attack. However, myoglobin can also be elevated for different reasons such as in other muscle injuries, so taking this test alone would not be enough to give a definitive heart attack diagnosis.
Also known as an electrocardiogram, this medical test records the electrical activity of your heart. Small adhesive electrodes are placed on your chest, arms, and legs that are connected to a machine to assess different aspects of your heart’s activity. It can also determine how much oxygen is flowing into your heart.
This test can diagnose a heart attack by detecting changes in the heart’s electrical patterns, which may indicate damage to the heart muscle. During a heart attack, the blood supply to the heart muscle is blocked. This lack of blood supply can cause damage to the affected heart muscle cells, leading to abnormal electrical activity in the heart that is visible during the EKG.
An EKG can also detect an enlarged heart or abnormal heart rhythms that may increase the risk of future heart failure.
A chest X-ray may also be performed for the doctor to visualize the size and condition of your heart and lungs. A few warning signs that may indicate a heart attack diagnosis include an enlarged heart, pulmonary edema (excess fluid in the lungs), or a pleural effusion (fluid accumulation in the space between the lungs).
This is an X-ray of the blood vessels of your heart. During this procedure, a type of dye that’s visible on an X-ray machine is injected into your heart’s blood vessels and a series of images are taken.
With this, a scoring tool called CAC scoring or coronary artery calcium scoring is used to determine the extent of plaque buildup present by measuring calcium levels. The CAC score can range from 0 to over 400. A score at or above 400 indicates the highest likelihood of a heart attack or risk of a heart attack in the near future.
If a blockage is found in the blood vessels or a high CAC score is detected, a procedure called angioplasty may be done to open up the clogged arteries.
In most cases, an angioplasty is performed immediately as an emergency procedure to open the clogged arteries. However, it may also be used as a preventative measure in some situations if you are considered high risk, have a positive stress test, or have heart disease and are at risk for future cardiovascular events.
Cardiac CT or MRI
Cardiac CT (computed tomography X-ray) or MRI (magnetic resonance imaging) are two more advanced tests to obtain valuable information about your heart’s structure, blood vessel health, and function.
A cardiac CT scan is a non-invasive imaging test that can detect heart damage in a few ways. It can identify calcium deposits in coronary arteries, which can indicate plaque build-up. It can also detect the heart’s structure and function, identifying any areas that may have been damaged or at risk of damage to a reduced blood supply.
An MRI uses a magnetic field to take detailed pictures of your heart and surrounding arteries. Through this, it can detect tissue damage, reduced blood flow, swelling, and inflammation around the heart – all likely indicators of a heart attack.
These tests are usually done when other first-line tests like blood tests or EKG are inconclusive and more information is needed.
Heart Attack Causes and Risk Factors
There are several possible risk factors and causes of a heart attack to be aware of. As your cardiology dietitian, I conduct a full heart attack risk assessment from a nutrition and lifestyle perspective and work as part of your cardiology care team to help determine and mitigate your level of risk and address any underlying root causes.
If you have heart disease in your family, you may be especially concerned about your own risk. You may then have inherited certain genes that influence your cholesterol levels, blood pressure, and your response to inflammation.
If you have a family history (or even if you don’t), get your Lipoprotein (a) blood levels checked. If this is high and you have heart disease in your family, this combination further increases your chances of a heart attack.
However, even if you don’t have a known genetic risk, or are adopted and don’t know your risk, you should consider getting these levels checked as well, as heart disease risk can skip generations.
But while family history and genetics certainly play a role, this does not mean having a heart attack is inevitable in your future. Early detection and consultation with a cardiac dietitian and medical team are key.
There are certain medical conditions associated with a higher risk of a heart attack.
- High blood pressure
- High cholesterol
- High blood sugar
- High triglycerides
- Excess fat distributed in the waist
- Rheumatoid arthritis
- Gestational diabetes
All of these conditions are associated with inflammation in the body, which is associated with heart damage.
In addition, impaired gut health is also possibly connected to heart disease risk, as the gut and heart are connected in what is known as the gut-heart axis.
Decreased estrogen levels are one of the biggest hallmarks of menopause. As the primary female reproductive hormone, estrogen has a protective effect on your heart. As estrogen levels decline during menopause, this protective effect starts to diminish, increasing the risk of heart problems.
Your lifestyle plays a huge role in your heart attack risk, regardless of your family history. The good news about this risk factor is you can control it.
I always tell my clients to focus on what they can control – and you can do this too. Even if you cannot control your genetics, you can control the daily diet and lifestyle habits you make. These are the things we work on together in my 1:1 nutrition counseling program.
Heart Attack Treatment and Prevention
There are several ways to prevent a heart attack in the first place if you have a family history or other risk factors (known as primary prevention) or prevent and treat a recurrent heart attack (known as secondary prevention).
Medical research shows you are at a higher risk of another heart attack after your first one, and this is where addressing the underlying root cause of your first heart attack is incredibly valuable.
There are three classes of medications commonly prescribed if you’ve had a heart attack, intended to reduce your future risk.
- Beta-blockers – a class of cardiac medications that slow down your heart rate and reduce blood pressure
- Statins – medications that block the production of cholesterol, thereby helping to lower cholesterol levels, a risk factor for a heart attack
- Anticoagulants – blood thinners that reduce the risk of blood clots
While these meds can be life-saving, they aren’t necessarily meant to be taken for life or to be a single-line treatment. Many of my clients come to me after being on statins and/or various medications for years, yet they still had a heart attack.
Implementing a whole-person lifestyle approach that addresses the root cause of your heart attack through science based nutrition is also essential. I help my clients incorporate a heart-healthy nutrition and lifestyle plan with the goal of lowering their medication dose(s) as much as possible.
If medical interventions are not enough to treat and prevent a future heart attack, there are a few common surgical procedures that may be needed.
- Coronary angioplasty – a minimally invasive procedure that opens clogged arteries
- Stenting – a small metal or plastic tube is inserted into the blocked artery to dilate and open it up
- Coronary artery bypass graft (CABG) – This is one of the most invasive surgical procedures to treat heart disease. During this surgery, you will be given general anesthesia to ensure you are fully asleep and free of pain.
The surgeon makes an 8-10 inch cut to the chest to expose the heart. Once your heart is visible, you may be hooked up to a heart-lung bypass machine to direct blood flow away from the heart. This helps the surgeon perform the procedure more easily.
A healthy blood vessel is used from another part of the body and is attached to the blocked area. This creates a “graft” vessel where the blood can then flow more freely, reducing the risk of future blockages.
While surgery may seem permanent, it is not a true “cure” for a heart attack. Without healthy lifestyle changes such as following a cardiac diet, exercising, and reducing stress, your arteries will eventually become hardened and narrowed again.
Working on improving your lifestyle habits will be your biggest opportunity to reduce your risk of a future heart attack.
In addition to genetics, your lifestyle choices are one of the most common causes of heart attack risk in the first place.
Here are the top factors you can work on to reduce your risk:
- Transition to a heart-healthy diet – your diet can make or break your heart health. I see this every day with my heart health clients and see a vast difference between those who practice heart-healthy eating and those who don’t. Several studies show the connection between heart attacks and the presence of oxidative stress, insulin resistance, inflammation, and high blood pressure – all of which are affected by your diet.
To start, you can move more towards plant-based eating and increasing your fiber intake while lowering your intake of saturated fat and sodium. When it comes to heart-healthy eating, I help you focus on what to eat more first and foremost versus restriction.
This way of eating is a more sustainable, long-term approach to longevity. And when it comes down to it, your diet habits need to be feasible and realistic for you in the long term for it to truly protect your heart.
- Achieve a healthy weight – Losing weight if you are considered overweight may also help lower your risk. However, what is more important here is your waist circumference. If you have excess weight distributed around your waist rather than your hips, this is more associated with an increased heart attack risk. Even a modest weight loss of 5-10% of your weight can make a difference.
The recommendation for waist circumference to reduce risk is less than 35 inches for women and less than 40 inches for men. It is important when measuring your waist to measure at the height of your belly button (it is not based on your pants size).
While weight is a factor, even athletes experience heart attacks with a healthy waist circumference and have to learn how to reduce their future risks by addressing other root causes.
- Physical activity – Your heart is a muscle, and it needs exercise to stay strong and healthy. If you have a favorite form of exercise, start with this as it will likely keep you coming back for more.
If you suffered a heart attack, you’ll want to get back into exercise gradually. Consult with your doctor for the safest way to start. It’s also essential to couple your exercise routine with good nutrition, to not only fuel your exercise but to balance out the oxidative stress created during exercise.
- Stress management – Chronic, unresolved stress can increase the risk of heart attacks in several direct and indirect ways. It can increase blood pressure, trigger inflammation, and increase the risk of blood clots.
It can also increase the stress hormones cortisol and adrenaline, which increase blood pressure and heart rate if chronically elevated. Stress can also affect your habits. When you’re in a constant state of stress, you’re more likely to smoke, drink alcohol, or overeat as a coping mechanism – all risk factors for a heart attack.
If you have underlying stress, it’s essential to find ways to manage it such as daily meditation, deep breathing practice, nature walks, and/or working with a therapist.
- Quitting smoking – Even if you’ve been smoking for years, it’s never too late to quit. Speak to your doctor for guidance on how to start the process and get support.
All of these prevention techniques matter, no matter your age, weight, or fitness level.
Prevent a Heart Attack and Protect Your Heart With a Healthy Lifestyle
No matter where you are in your health journey, there are many heart attack risk factors you can control such as transitioning to a heart-healthy diet, exercising regularly, managing stress, and quitting smoking.
And if you’re ready to optimize your heart health now, I’m here to help! Learn more about my 6-week heart optimization group program, where you’ll learn how to implement scientifically proven nutrition to optimize your heart health and reduce your risk of heart attack and stroke.
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