Can You Survive a Heart Attack?

Are you able to recognise the signs of a heart attack if it happens to someone right in front of you? And if so, will you know what to do?

We tend to think of heart attacks as sudden, intense events culminating in a chest-clutching fall to the floor. However, in reality, most heart attacks, also known as a myocardial infarction, start slowly and are often overlooked. In fact, 7 out of 10 people in Singapore can't recognise the symptoms of a heart attack when it is happening to them, or to someone they're with.

Identifying the symptoms of a heart attack

A heart attack usually starts slowly with mild pain and discomfort. Ignoring these signs can be fatal, so it is important that you can recognise them when they occur, and react quickly.

Call 995, or get someone around you to do so, if you experience:

• Discomfort in your chest.
  You may feel pain, pressure, or a squeezing sensation in the centre of your chest. This can last several minutes before subsiding. However, the pain will likely return again.
• Discomfort in the upper body.
  You may experience pain that radiates to your neck, jaw, arm(s), back, or the upper part of your stomach.
• Shortness of breath.
  You may not experience chest pains at all. Women especially, may experience shortness of breath instead of chest pains. This symptom is often overlooked or ignored.
• Cold sweat, light-headedness or nausea.
  These are all possible symptoms accompanying a heart attack.

Are the symptoms different in women?

The symptoms are similar between man and women. However, women are more likely to feel other symptoms besides chest discomfort, and they sometimes dismiss their chest pains. Women often attribute the symptoms to acid reflux, the flu or discomfort that is a natural part of growing older.

Minutes matter. Call 995.

Swift action can make the difference between life and death. If you are unsure if you have having a heart attack, call 995 and describe your symptoms to the operator. If the symptoms point to a heart attack, the paramedics on call will be able to start treatment immediately upon arrival, and this is the fastest way to get potentially life-saving treatment.

Dos and don'ts while waiting for the ambulance

Do take an aspirin: Unless you are allergic to it, take some aspirin. This helps thin the blood and prevents any blood clot(s) in the heart's major artery from getting bigger, improving your chances of surviving the heart attack.

Do take nitroglycerin: This medication helps widen blood vessels to improve blood supply to the heart to provide temporary pain relief. If you have been prescribed nitroglycerin in the past, take it while waiting for emergency help to arrive. However, nitroglycerin does not stop the heart attack and you will still need to be evaluated at the emergency department as soon as possible.

Do not cough repeatedly: It is an urban myth that coughing helps during a heart attack. It may help restore heart rhythm, but that won't help you during a heart attack, which is caused by blockage.

Do not apply pressure to the chest: If the person is still talking and breathing, CPR is not required. Unless the person's heart has stopped, which is also known as a cardiac arrest, do not attempt CPR.

Who is at risk of a heart attack?

Cardiovascular diseases affect both men and women, and especially women after menopause. It isn't a disease that only afflicts the elderly. Many of the risk factors for cardiovascular disease are lifestyle related, and there are measures that you can take to lower your risk.

What can I do to lower my heart attack risk?

Making changes towards a healthier lifestyle can reduce your risk of having a heart attack.

Here are some recommended lifestyle changes:

Give up smoking

Smoking puts you at higher risk of having a heart attack. While it may be hard to kick any long-practised habit, it is possible to do so with professional support. If you're having difficulty quitting the habit, consider calling QuitLine at 1800-438-2000, a toll-free helpline that offers counselling for those who want to quit smoking. Second-hand smoke can also be harmful, so if there are people around you who smoke, avoid being around them when they light up a cigarette.

Keep a healthy diet

A healthy diet can help you fight against cardiovascular diseases, controlling risk factors such as high cholesterol, diabetes and obesity. Opt for natural foods that are rich in vitamins and minerals, high in fibre, and low in calories. Eat more vegetables and whole grains, dairy, poultry, fish, vegetable oils and nuts. Avoid processed foods as well as food and drinks with a high sugar content. Control your meal portions to avoid overeating and putting on excess weight.

Control your cholesterol levels

Having a high level of bad cholesterol or a low level of good cholesterol can lead to atherosclerosis – the build-up of fatty deposits in artery walls that increase the risk of a heart attack. To reduce bad cholesterol levels, cut down intake of food with high levels of saturated fat, trans fat and cholesterol. Increase your HDL cholesterol levels (good cholesterol) with regular exercise.

Get 150 minutes of exercise per week

Research has shown that getting at least 150 minutes of moderate-intensity physical activity per week can help lower blood pressure, lower cholesterol and maintain a healthy weight. These all go towards lowering your risk of a heart attack.

If you haven't exercised in a long time, start off slowly with light exercises such as a morning walk before gradually working up to more intense physical activities such as running. Studies show that those who engage in a moderate amount of exercise have a higher life expectancy and are much less likely to suffer from premature death, as compared to those who lead a sedentary lifestyle with little exercise.

Maintain a healthy weight

If you are overweight, consult your doctor on dietary and lifestyle recommendations for weight loss. You may also consider engaging a dietitian to help you plan a nutritious low-calorie diet. Try to avoid jumping into fad diets as most of these diets are unsustainable, and may even be detrimental to your health in the long run. The safe and effective way to lose weight is to do so gradually, by maintaining a healthy diet along with regular exercise.

Reduce stress

Often referred to as a silent killer, stress can contribute to heart diseases as it may trigger overeating, adopting bad lifestyle habits as a coping mechanism, and result in poor quality of sleep. Some ways to help manage stress levels include mindful meditation, deep breathing and yoga.

Limit alcohol intake

While moderate alcohol consumption is not harmful to heart health, drinking too much can increase your risk of cardiomyopathy, contribute to high triglycerides, and cause an irregular heartbeat. Limit your alcohol consumption to no more than two drinks per day.

Prevention is better than cure. Regular heart screening can help to identify potential problems and hidden heart disease risks, allowing you to take action before you're in danger of having a heart attack. Consult a cardiologist to find out what tests are appropriate for you based on your health profile.