How To Know If You’re Having A Heart Attack

February is Heart Disease Awareness Month which makes all us more aware of the importance of recognizing the signs of a heart attack. Would you know what to do if you or someone you love is having a heart attack?

What is a heart attack?

Dr Catanese

James W. Catanese, MD, FACC

When blood cannot get to the heart, the heart muscle does not get the oxygen it needs. Without oxygen, the cells of the heart can be damaged or even die. The key to recovery is to get the blood flow restored to the heart quickly. That’s why it is absolutely critical to get medical help right away if you think you’re having a heart attack.


Over time, cholesterol and plaque (fatty material) can build up on the inside walls of arteries, which are the blood vessels that take blood to the heart. This makes it harder for blood to flow freely. Most heart attacks occur when a piece of this plaque breaks off. A blood clot forms around the broken-off plaque and blocks the artery, preventing oxygen-carrying blood from reaching the heart.

Symptoms of a heart attack

  • Pain, pressure, or squeezing in your chest (It does not have to be severe)
  • Pain or pressure in your upper body, especially your neck, jawline, back, stomach or in one or both of your arms
  • Shortness of breath
  • Sweating
  • Fainting
  • Feeling sick to your stomach (nauseous)
  • Pain in the neck, jaw or shoulders

The pain often lasts for a few minutes. It can get worse with physical activity or emotional stress, and it doesn’t go away with rest. Almost 15% of patients have no symptoms, so they never know they’re having a heart attack. This is more common in the elderly and people with diabetes.

Men and women can have different symptoms

Men are more likely to break out in a cold sweat and feel pain moving down their left arm.

Women are more likely to have back or neck pain, heartburn and shortness of breath. They tend to have stomach trouble, including an upset stomach, queasiness and nausea. Women may also feel very tired, light-headed or dizzy. A couple of weeks before a heart attack, women might have flu-like symptoms and sleep problems.

What to do if you or someone around you is having a heart attack

If you or someone you are with has symptoms that you think might be a heart attack, call 911 right away. If it is a heart attack, you’re more likely to survive if you get treated within 90 minutes. If possible, and as soon as possible, chew and swallow an aspirin (unless you’re allergic) to lower the risk of a blood clot. If you are unconscious, CPR can double your chance of survival.


An EKG (electrocardiogram test) which checks your heart’s electrical activity can help doctors determine whether you’re having a heart attack. An EKG can also reveal which artery is clogged or blocked. In addition, doctors can diagnose a heart attack by performing blood tests that identify proteins released by heart cells when they die.


If you’re having a heart attack, doctors or emergency personnel will quickly act to get blood flowing to your heart again, and may administer drugs to dissolve blood clots. You will likely have a procedure called a coronary angiogram which involves a thin tube with a tiny balloon on the end being threaded through your artery. This opens up the blockage by flattening the plaque against the artery walls. Typically, doctors place a small mesh tube called a stent in your artery to make sure it stays open.

Risk factors for a heart attack

Several factors increase your chances of a heart attack, particularly in combination:

  • The odds of having a heart attack increase with age
  • Men are more likely to have a heart attack than women
  • Family history of heart disease
  • Smoking
  • High blood pressure
  • High cholesterol levels
  • Diabetes
  • Obese
  • Stress
  • Lack of exercise
  • Depression

Preventing heart attacks

1) If you smoke, stop. This will immediately cut your chances of a heart attack by a third.

2) Get exercise and eat healthy. The American Heart Association recommends 30 minutes of moderate exercise a day, 5 days a week. It also recommends a diet containing plenty of fruits, vegetables and whole grains to keep your arteries healthy.

3) For some people, taking a daily aspirin helps in prevention. Consult with your doctor to see if this is right for you.

4) Find positive ways to manage your stress. Yoga, biking, swimming, volunteering or even taking up a craft or hobby are just a few suggestions of healthy ways to relieve stress and avoid a heart attack.

5) Control your blood pressure. Check your BP every day and contact your doctor if you notice a change.

6) Take your medicine. Certain medications can lower your cholesterol and blood pressure, prevent blood clots, and even lower your chances of a heart attack. They can also ease your symptoms and take stress off your heart. If you have been prescribed medicines for your heart, be sure to take them.

7) Watch your cholesterol. High LDL (bad) cholesterol can lead to heart problems. Aim to keep your level at 100 mg/dL or lower. If you have already had a heart attack or are at high risk for one, shoot for 70 or below. Sometimes diet and exercise aren’t enough to control cholesterol, and your doctor may want to put you on medication to keep yours in check.

8) If you drink alcohol, do so in moderation.  Alcohol can weaken your heart and make it work harder. Research has shown that a small amount can raise your HDL (good) cholesterol level, but too much can make you gain weight or raise your blood pressure. Ask your doctor what’s best for you.

9) See your doctor regularly. Keep up with your appointments, and tell your physician about any heart-related symptoms you may have noticed symptoms. Remember, your doctor is your partner in your healthcare.

Good news: Heart disease is mostly preventable.

Research shows that up to 90% of heart disease can be prevented by changing your diet, exercising more, maintaining a healthy weight and not smoking. While some heart disease risk factors, such as family history, are out of your control, a healthy diet and lifestyle can really make a difference. Now in February, Heart Disease Awareness Month, and every month, take care of your heart and it will take care of you!

For more information, advice and tips, come in and see us

If you’re concerned about any aspect of your healthcare, please call (914) 232-1919 to make an appointment with one of our Westchester Health cardiologists to come in and talk about it. Whenever, wherever you need us, we’re here for you.

By James W. Catanese, MD, FACC, a Cardiologist with Westchester Health, member of Westchester Health Physician Partners

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