Heart disease continues to be the leading cause of death globally. In 2022, heart disease was responsible for 702,880 (or one in every five) deaths in the United States. Despite these grave numbers, the survival rate for heart attacks has improved over the years.
Recognizing potential warning signs may improve outcomes and reduce the impact of heart-related complications.
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Understanding Heart Attack and Its Early Warning Signs
A heart attack, medically known as a myocardial infarction (MI), occurs when a blood clot blocks blood flow to a part of the heart. This blockage prevents oxygen-rich blood from reaching the heart muscle, leading to damage or death of heart tissue. The severity of a heart attack can be influenced by factors such as the size of the affected area and the duration of the blockage.
Heart attacks often result from the buildup of plaque – a combination of fat, cholesterol, and other substances – in the coronary arteries. This condition, known as atherosclerosis, narrows the arteries and restricts blood flow. When a plaque ruptures, it can form a blood clot.
Why Early Detection Matters
- Reduced Risk of Severe Damage: Early intervention may help restore blood flow and reduce potential heart muscle damage.
- Improved Survival Rates: Prompt medical treatment increases the chances of survival.
- Better Long-Term Health: Early detection and addressing risk factors can improve overall heart health and reduce the likelihood of future heart events and complications.
6 Signs of a Heart Attack a Month Before It Happens
While the symptoms of a heart attack may appear to come on suddenly, research suggests that more than 40% of patients experience early warning signs – called prodromal symptoms – beforehand.
Recognizing these six potential warning signs of a heart attack may offer an opportunity for timely intervention and better outcomes.
1. Chest Discomfort or Pain
According to one study, 52% of patients with acute MI reported experiencing chest pain (angina) before the event. Specifically, 31% had a history of chronic angina, with 18% experiencing worsening symptoms in the month before the infarction, and 21% had new onset angina in the month prior to the event.
The American Heart Association and American College of Cardiology (AHA/ACC) guidelines explain that chest pain is often associated with certain heart problems that may increase the risk of a heart attack.
This pain often occurs in the center of the chest and lasts more than 15 minutes. It can happen when resting or doing only light activities and may spread to your arms, neck, or jaw.
Other early heart attack symptoms can include chest heaviness, tightness, or pressure, often during physical activity, and heart palpitations.
However, not everyone who suffers a heart attack will experience chest pain. One study found that 33% of patients with confirmed MI did not present with chest pain at the time of hospital admission.
2. Unusual Fatigue
Unusual fatigue, often described as a notable change from baseline energy levels, tiredness, and lack of energy, is a recognized prodromal symptom of acute MI, particularly in women. It occurs in close to one-quarter of patients diagnosed with heart attack.
Studies have highlighted that fatigue is one of the most commonly reported symptoms among women who later experience a heart attack. For instance, one study found that 70.7% of women reported unusual fatigue as a prodromal symptom more than one month before their MI.
3. Shortness of Breath
Shortness of breath (dyspnea) can occur with or without chest discomfort. It may feel like you can't catch your breath, even while resting or performing minimal activities.
If the heart's function is reduced, fluid may accumulate in the lungs, potentially making it harder for oxygen to move from the lungs into the blood and contributing to breathlessness. Additionally, if your heart is struggling, your body may try to get more oxygen by making you breathe faster or harder.
A 2003 survey of over 500 women found that dyspnea was one of the three most common prodromal symptoms of myocardial infarction in women, affecting 42.1% of participants.
4. Sleep Disturbances
According to that same survey, 47.8% of women reported sleep disturbances as a heart attack prodromal symptom.
Heart disease is one of many underlying reasons for insomnia. It can interfere with falling or staying asleep easily because lying down can cause fluid to build up in the lungs, making it hard to breathe, causing orthopnea (shortness of breath when lying down) and paroxysmal nocturnal dyspnea (waking up feeling short of breath).
5. Digestive Problems and Nausea
Common gastrointestinal symptoms associated with MI include upper abdominal pain, heartburn unrelated to meals, nausea, and vomiting.
Women may be more likely than men to report these non-traditional symptoms. Some studies suggest that nearly 40% of women report heartburn or indigestion prior to a heart attack.
Distinguishing between heartburn and a heart attack can be challenging due to overlapping symptoms. However, these features can help distinguish the two:
6. Dizziness and Lightheadedness
Dizziness and lightheadedness are less frequently reported prodromal symptoms of heart attack compared to others, but they still occur in 10% of patients who suffer from a heart attack, especially those older than 40.
Heart attacks may result in hemodynamic instability. Damage to the heart muscle during a heart attack reduces cardiac output, leading to decreased blood flow to the brain and resultant dizziness.
What to Do If You Experience These Symptoms
If you or a person close to you experiences any combination of the symptoms above, take the following steps:
- Call 911: Don't ignore the symptoms.
- Stay Calm: Sit down, rest, and try to keep calm.
- Take Aspirin: If advised by a healthcare provider, chew and swallow a full dose (325 mg) of aspirin, provided you are not allergic to it.
- Take Nitroglycerin: If you have a prescription for this chest pain medication, take it while you're waiting for medical help to arrive.
- Start CPR: If the person is unconscious, not breathing, and does not have a pulse, begin CPR.
- Use an Automated External Defibrillator (AED): If an AED is available and the person is unconscious and doesn't have a pulse, use it per the device's instructions.
Preventing Heart Attacks: Lifestyle and Health Tips
Therapeutic interventions for both primary prevention – helping those at risk of developing heart disease – and secondary prevention – for individuals who have already experienced heart problems – reduce the likelihood of future heart attacks.
Healthy Diet
A heart-healthy diet, such as the Mediterranean diet, emphasizes high consumption of olive oil, vegetables, fruits, whole grains, legumes, fish, and nuts and reduces the risk of major cardiovascular events. The PREDIMED trial suggests that a Mediterranean diet supplemented with extra-virgin olive oil or nuts may help reduce the incidence of major cardiovascular events compared to a control diet.
Regular Exercise
The ACC and AHA recommend that adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity (or an equivalent combination of both) per week to reduce the risk of atherosclerotic cardiovascular disease (ASCVD). This recommendation is based on extensive data demonstrating the cardiovascular benefits of regular aerobic exercise.
For those unable to meet these minimum recommendations, engaging in some moderate- or vigorous-intensity physical activity, even if less than the recommended amount, can still be beneficial in reducing ASCVD risk.
Reducing sedentary behavior may support cardiovascular health and reduce ASCVD risk. According to one study, substituting one hour of sedentary time with light-intensity physical activity light intensity reduced the risk of cardiovascular events by one-fifth.
The AHA/ACC guidelines also highlight the importance of resistance exercise, which offers several health benefits such as improved physical functioning, glycemic control, and blood pressure reduction.
Improving Sleep Quality and Managing Stress
The AHA has incorporated sleep health as a new metric in their Life's Essential 8 (LE8)
framework. Insufficient or poor-quality sleep is associated with adverse cardiometabolic outcomes, including hypertension, obesity, type 2 diabetes, and cardiovascular disease. Studies have shown that both short (<7 hours) and long (>9 hours) sleep durations are linked to increased risks of stroke, heart failure, and other cardiovascular conditions in adults.
Psychosocial factors, including stress, are also recognized as significant contributors to cardiovascular health. Elevated stress levels are associated with an increased incidence of stroke and acute cardiovascular events in individuals with diabetes. Stress can compound cardiovascular risk by negatively impacting other factors, such as diet and sleep. Therefore, stress management should be incorporated into a comprehensive cardiovascular health management protocol.
Regular Health Screenings
Regular health screenings aid in the early detection and management of heart disease risk factors:
- Cholesterol Checks: Check your cholesterol levels regularly, especially if you have a family history of high cholesterol.
- Blood Pressure Monitoring: Keep track of your blood pressure and manage it through lifestyle changes or medication if necessary.
- Diabetes Screening: Regularly monitor blood sugar levels, particularly if you have risk factors for diabetes.
- Heart Health Assessments: Undergo routine heart health assessments, including ECGs or stress tests, as recommended by your healthcare provider.
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Key Takeaways
- The recognition of the six prodromal symptoms of a heart attack – chest pain, fatigue, shortness of breath, sleep disturbances, digestive problems, and dizziness — provides a unique opportunity for early intervention.
- Timely medical attention may improve outcomes during a heart attack. Don’t question your symptoms. Call 911 if you ever experience heart attack warning signs.
FAQs
1. Can a heart attack be prevented if early signs are recognized?
Recognizing early signs of a heart attack may allow for prompt medical intervention, potentially reducing the risk of progression to a more severe event. Early detection enables timely treatments that restore blood flow and minimize heart muscle damage.
2. How can I tell if my chest pain is serious?
Chest pain is considered serious if it:
- Lasts longer than a few minutes or recurs
- Spreads to other areas like the arms, neck, jaw, or back
- Is accompanied by other symptoms, such as shortness of breath, sweating, nausea, or dizziness
- Is triggered by minimal activity
- Does not improve with rest
3. Is unusual fatigue always a sign of heart issues?
Fatigue can result from various factors, including lack of sleep, stress, poor diet, or other medical conditions like thyroid disorders or anemia.
4. What risk factors increase my chances of a heart attack?
Heart attack risk factors include:
- Age: Men over 45 and women over 55 are at higher risk
- Family History: A family history of heart disease increases risk
- Tobacco Use: Including smoking and long-term exposure to secondhand smoke
- High Blood Pressure: Puts extra strain on the heart and arteries
- High Cholesterol: Contributes to plaque buildup in arteries
- Diabetes: Increases the risk of atherosclerosis
- Obesity: Strains the heart and is linked to other risk factors
- Sedentary Lifestyle: Lack of physical activity
- Unhealthy Diet: Diets high in saturated fats, trans fats, salt, and sugars
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