Jul 15, 2003 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Heart Attack: Warning Signs and Tips on Prevention

Am Fam Physician. 2003 Jul 15;68(2):345-346.

What is a heart attack?

Heart attack (also called myocardial infarction) is the name we use when part of the heart muscle is damaged or dies because it is not getting enough oxygen. Oxygen is carried to the heart by the arteries (also called blood vessels). Most heart attacks are caused by a blockage in these arteries. Usually the blockage is caused by atherosclerosis, which is the buildup of fatty deposits called plaque inside the artery. This build-up is like the gunk inside a drainpipe that slows the flow of water.

Heart attacks also can be caused by a blood clot that gets stuck in a narrow part of an artery to the heart. Clots are more likely to form where atherosclerosis has made the artery more narrow.

How do I know if I am having a heart attack?

The pain of a heart attack can feel like bad heartburn. You also may be having a heart attack if you notice these symptoms:

  • A feeling of pressure or a crushing pain in your chest, sometimes with sweating, nausea, or vomiting.

  • Pain that extends from your chest into your jaw, left arm, or left shoulder.

  • Tightness in your chest.

  • Shortness of breath for more than a couple of seconds.

Do not ignore this pain or discomfort. If you think you are having heart problems or a heart attack, get help right away. The sooner you get treatment, the greater the chance that the doctors can prevent further damage to your heart.

What should I do If I think I am having a heart attack?

Right away, call for an ambulance to take you to the hospital. While you wait for the ambulance to come, chew one regular tablet of aspirin. Do not take the aspirin if you are allergic to aspirin.

If you can, go to a hospital with advanced care facilities for people with heart attacks. In these medical centers, the latest heart attack technology is available 24 hours a day. This technology includes rapid thrombolysis (using medicines called clot busters), cardiac catheterization, and angioplasty. If you have any of the risk factors listed in the box below, you should know which hospital you want to go to, know who you want to contact in an emergency, and keep aspirin handy at all times.

Risk factors for a heart attack

  • Smoking

  • Diabetes

  • High cholesterol level

  • High blood pressure

  • Family history of heart attack

  • Atherosclerosis (hardening of the arteries)

  • Lack of exercise

  • Obesity

  • Male gender

In the hospital, you might be given clot busters that reopen the arteries to your heart very fast. Nurses and technicians will place an IV line (intravenous line) in your arm to give you medicines. They also will do an electrocardiogram (ECG or EKG), give you oxygen to breathe, and watch your heart rate and rhythm on a monitor.

How can I avoid having a heart attack?

Talk to your family doctor about your specific risk factors (see box on previous page) for a heart attack and how to reduce your risk. Your doctor may tell you to do the following:

  • Quit smoking. Your doctor can help you. (If you do not smoke, do not start!)

  • Eat a healthy diet. Cut back on foods high in saturated fat and salt to lower your cholesterol and blood pressure. Ask your doctor about how to start eating a healthy diet.

  • If you have diabetes, control your blood sugar level.

  • Exercise. This is hard if you have not exercised for a while, but try to work up to at least 30 minutes of aerobic exercise (that raises your heart rate) at least four times a week.

  • If you are overweight, lose weight. Your doctor can advise you about the best ways to lose weight.

  • If you have hypertension, control your blood pressure.

Talk to your doctor about whether aspirin would help reduce your risk of a heart attack. Aspirin can help keep your blood from forming clots that can eventually block the arteries.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2003 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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