When the blood supply that sustains the heart is cut off, the heart muscle begins to die. This is known as a heart attack, and it is a medical emergency that needs to be treated right away.

If you have coronary artery disease, the arteries that supply oxygen-rich blood to your heart become narrow. A build-up of cholesterol or fatty matter, calcium and protein forms plaque in the arteries. The plaque may then rupture, creating blood clots which block the artery and starve the heart of the oxygen it needs to survive. More rarely, an artery may spasm or narrow and restrict blood flow.

Contrary to what you see in the movies, not all heart attacks are sudden and intense. The symptoms may actually seem insignificant, or build gradually over time. They may also present themselves differently in men and women.

Common symptoms for both genders include:

Pain, pressure or a heavy feeling in the chest, arm or upper stomach area
Pain that radiates to the arm, back, jaw or throat
Choking sensation
Sweating
Nausea or vomiting
Shortness of breath
Rapid or irregular heartbeat

• Feeling of indigestion 
• Dizziness
• Nausea
• Fatigue
• Pain between the shoulder blades
• Sense of impending doom

More rarely, a heart attack does not cause any obvious symptoms. In fact, approximately 15% of patients have no idea they are having a heart attack. This is more common in the elderly and people with diabetes. Rather than causing traditional symptoms, the heart attack may simply feel like a long bout of the flu, a chest strain or extreme tiredness. 

If you are concerned about ongoing or unexplained symptoms, consult a doctor. 

There are several factors that may increase your risk of a heart attack. Some of them – like age, sex, family history and race – are beyond your control. But there are several steps you can take to reduce your risk of having a heart attack:

• Stop smoking
• Exercise regularly
• Eat a healthy, well-balanced diet to lower cholesterol, with plenty of fruits, vegetables and wholegrains 
• Reduce stress

Your doctor can assess your cholesterol level using a simple test.

Bear in mind that your risk of having a heart attack may be higher if you:

• Are over 65 years old
• Are male
• Have a family history of heart disease, high blood pressure, obesity or diabetes
• Are of African descent

While prevention is better than cure, it is essential to know the signs of a heart attack so that if it happens to you or a loved one, you can seek treatment immediately.

With the right medical attention, your heart muscle will heal on its own after a heart attack. But you may be left with scar tissue around the heart that impacts the heart’s pumping ability. Your heart’s electrical system may also be damaged. In some cases, this can lead to irregular heart rhythms, or even heart failure. Quick treatment will help to lessen this damage. 

At the first sign of a heart attack, call an ambulance immediately.

Article reviewed by Dr Leslie Tay, cardiologist at Mount Elizabeth Hospital.