Heart-healthy nutrition, daily physical activity, eliminating tobacco, controlling diabetes and a commitment to follow your healthcare professional's recommendations (including for cholesterol and high blood pressure) are all part of reducing your risk for heart disease, heart attack and stroke.

Every year, tens of thousands of Americans survive heart attack, go back to work and enjoy a normal life. You have every reason to be confident of a full recovery. Your heart is healing and with each passing day you’ll get stronger and more active. The following questions and answers will help you better understand what has happened to you and how you get started on the road to recovery.

Why did I have a heart attack?
Why didn’t I have any warning?
Is my heart permanently damaged?
Will I recover from my heart attack?
Is all chest pain a heart attack?
What are the different medical terms for a heart attack?
Are there any other causes of heart attack?
Is heart attack the same as cardiac arrest?

The American Heart Association has identified several risk factors. Some of them can be modified, treated or controlled, and some can't. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the level of each risk factor, the greater the risk. For example, a person with a total cholesterol of 300 mg/dL has a greater risk than someone with a total cholesterol of 245 mg/dL, even though everyone with a total cholesterol greater than 240 is considered high-risk.

What are the major risk factors that can't be changed?
Increasing Age
Male Sex (Gender)
Heredity (Including Race)

What are the major risk factors you can modify, treat or control by changing your lifestyle or taking medicine?
Tobacco Smoke
High Blood Cholesterol
High Blood Pressure
Physical Inactivity
Obesity and Overweight
Diabetes Mellitus

What other factors contribute to heart disease risk?
Stress
Alcohol
Diet and Nutrition

Heart Attack, Stroke and Cardiac Arrest Warning Signs

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Heart Attack Warning Signs
Stroke Warning Signs
Cardiac Arrest Warning Signs

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.   
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. 
• Shortness of breath with or without chest discomfort.  
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness    

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.

If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself, unless you have absolutely no other option. 

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Stroke Warning Signs
If you or someone with you has one or more of these signs, don't delay!

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

A TIA or transient ischemic attack is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke. The usual TIA symptoms are the same as those of stroke, only temporary. The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA and stroke.

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Cardiac arrest strikes immediately and without warning. Here are the signs:

• Sudden loss of responsiveness (no response to tapping on shoulders).
• No normal breathing (the victim does not take a normal breath when you tilt the head up and check for at least five seconds). 

If these signs of cardiac arrest are present, tell someone to call 9-1-1 and get an AED (if one is available) and you begin CPR immediately.  

If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR. 

Use an AED as soon as it arrives.

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Act in Time
The American Heart Association and the National Heart, Lung, and Blood Institute have launched a new "Act in Time" campaign to increase people's awareness of heart attack and the importance of calling 9-1-1 immediately at the onset of heart attack symptoms. Find the links here.

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ABCs of Preventing Heart Disease, Stroke and Heart Attack

Sounds simple doesn’t it? So why is coronary heart disease the single major cause of death and stroke the No. 3 killer in the U.S.? One reason is undeniably a lack of commitment to a heart-healthy lifestyle. Your lifestyle is not only your best defense against heart disease and stroke, it’s also your responsibility. A heart-healthy lifestyle includes the ideas listed in the heart below. By following these three simple steps you can reduce all of the modifiable risk factors for heart disease, heart attack and stroke including:

Stop smoking. If you smoke, quit. If someone in your household smokes, encourage them to quit. We know it’s tough. But it’s tougher to recover from a heart attack or stroke or to live with chronic heart disease. Commit to quit. We’re here to help if you need it.

Learn more about smoking and cardiovascular disease

Visit our Quitting Smoking area for plans, tips and tools to help you quit

Choose good nutrition.  A healthy diet is one of the best weapons you have to fight cardiovascular disease. The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. A diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fat-free or low-fat dairy products is the key. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in.

Visit our Diet and Nutrition Web site

Select American Heart Association cookbooks

Reduce blood cholesterol. Fat lodged in your arteries is a disaster waiting to happen. Sooner or later it could trigger a heart attack or stroke. You’ve got to reduce your intake of saturated fat, trans fat and cholesterol and get moving. If diet and physical activity alone don’t get those numbers down, then medication may be the key. Take it just like the doctor orders.  Here’s the lowdown on where those numbers need to be: 

Total Cholesterol: should be less than 200 mg/dL
LDL (bad) Cholesterol:

• If you're at low risk for heart disease: LDL should be less than 160 mg/dL
• If you're at intermediate risk for heart disease: LDL should be less than 130 mg/dL
• If you're at high risk for heart disease (including those with heart disease or diabetes): LDL should be less than 100mg/dL

HDL (good) Cholesterol: should be 40 mg/dL or higher for men or 50 mg/dL or higher for women
Triglycerides: should be less than 150 mg/dL

Visit our Cholesterol Web site

Get your free personalized cholesterol treatment options report from the Heart Profilers

Lower high blood pressure. It’s the single largest risk factor for stroke. Stroke is the No. 3 killer and one of the leading causes of disability in the United States. Stroke recovery is difficult at best and you could be disabled for life. Shake that salt habit, take your medications as recommended by your doctor and get moving. Those numbers need to get down and stay down. Your goal is less than 120/80 mmHg.

Visit our High Blood Pressure Web site

Take our Blood Pressure Risk Assessment

Get your free personalized high blood pressure treatment options report from the Heart Profilers

Be physically active every day. Research has shown that getting at least 30 minutes of physical activity on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep your weight at a healthy level. But something IS better than nothing. If you’re doing nothing now, start out slow. Even 10 minutes at a time may offer some health benefits. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level.

Visit our Physical Activity and Fitness Web site

Start! a walking program

Choose To Move: our free 12-week physical activity program for women

Aim for a healthy weight. Obesity is an epidemic in America, not only for adults but also for children. An epidemic is when a health problem is out of control and many people are affected by it. Fad diets and supplements are not the answer. Good nutrition, controlling calorie intake and physical activity are the only way to maintain a healthy weight. Obesity places you at risk for high cholesterol, high blood pressure and insulin resistance, a precursor of type 2 diabetes — the very factors that heighten your risk of cardiovascular disease. Your Body Mass Index (BMI) can help tell you if your weight is healthy.

Visit our Weight Management Web site

Calculate your Body Mass Index

Manage diabetes. Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors, including high blood pressure, high cholesterol, smoking, obesity and lack of physical activity.

Visit our Heart of Diabetes Web site

Reduce stress. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life that may affect the risk factors for heart disease and stroke. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Research has even shown that stress reaction in young adults predicts middle-age blood pressure risk.

Get stress management tips and tools

Limit alcohol. Drinking too much alcohol can raise blood pressure and lead toheart failure or stroke. It can contribute to high triglycerides, produce irregular heartbeats and affect cancer and other diseases. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. However, it’s not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.

Read our recommendation on alcohol, wine and cardiovascular disease

Learn about major risk factors that can't be changed.

Cardiac Procedures and Surgeries At-A-Glance

	Name of Procedure		What the Procedure Does		Reason for the Procedure
	Angioplasty (Also known as Percutaneous Coronary Interventions [PCI], Balloon Angioplasty and Coronary Artery Balloon Dilation)		Special tubing with an attached deflated balloon is threaded up to the coronary arteries. The balloon Is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or cutoff. Often combined with implantation of a stent to help prop the artery open and decrease the chance of another blockage. Considered less invasive because the body is not cut open. Lasts from 30 minutes to several hours. Often requires an overnight hospital stay.		Greatly increases blood flow through the blocked artery. Decreases chest pain (angina). Increases ability for physical activity. Reduces risk of a heart attack. Can also be used to open neck and brain arteries to help prevent stroke.

	Laser Angioplasty		Similar to angioplasty except that the catheter has a laser tip that opens the blocked artery. Pulsating beams of light vaporize the plaque buildup.		Increases blood flow through blocked arteries.

	Atherectomy		Similar to angioplasty except that the catheter has a rotating shaver on its tip to cut away plaque from the artery.		Increases blood flow through the blocked artery by removing plaque buildup. May also be used in carotid arteries (major arteries of the neck leading to the brain) to remove plaque and reduce risk for stroke.

	Stent Procedure		A stent is a wire mesh tube used to prop open an artery during angioplasty. The stent stays in the artery permanently.		Holds the artery open. Improves blood flow to the heart muscle. Relieves chest pain (angina).

	Transmyocardial Revascularization (TMR)		An incision is made on the left breast to expose the heart. Then, a laser is used to drill a series of holes from the outside of the heart into the heart's pumping chamber. In some patients TMR is combined with bypass surgery. In those cases an incision through the breastbone is used for the bypass. Usually requires a hospital stay.		Used to relieve severe chest pain (angina) in very ill patients who aren’t candidates for bypass surgery or angioplasty.

	Bypass Surgery (Also known as CABG or “cabbage," Coronary Artery Bypass Graft and Open-Heart Surgery )		Treats blocked heart arteries by creating new passages for blood to flow to your heart muscle. It works by taking arteries or veins from other parts of your body — called grafts — and using them to reroute the blood around the clogged artery. A patient may undergo one, two, three or more bypass grafts, depending on how many coronary arteries are blocked. Requires several days in the hospital.		One of the most common and effective procedures to manage blockage of blood to the heart muscle. Improves the supply of blood and oxygen to the heart. Relieves chest pain (angina). Reduces risk of heart attack. Improves ability for physical activity.

	Minimally Invasive Heart Surgery (Also known as Limited Access Coronary Artery Surgery and includes Port-Access Coronary Artery Bypass (PACAB or PortCAB) and Minimally Invasive Coronary Artery Bypass Graft (MIDCAB)		An alternative to standard bypass surgery (CABG). Small incisions ("ports") are made in the chest. Chest arteries or veins from your leg are attached to the heart to "bypass" the clogged coronary artery or arteries. The instruments are passed through the ports to perform the bypasses. The surgeon views these operations on video monitors rather than directly. In PACAB, the heart is stopped and blood is pumped through an oxygenator or "heart-lung" machine. MIDCAB is used to avoid the heart-lung machine. It's done while the heart is still beating. Requires several days in the hospital.		Manages blockage of blood flow to the heart and improves the supply of blood and oxygen to the heart. Relieves chest pain (angina). Reduces risk of heart attack. Improves ability for physical activity.

	Radiofrequency Ablation (Also known as Catheter Ablation)		A catheter with an electrode at its tip is guided through the veins to the heart muscle with real-time, moving X-rays (fluoroscopy) displayed on a video screen. The catheter is placed at the exact site inside the heart where cells give off the electrical signals that stimulate the abnormal heart rhythm. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the pathway. This destroys carefully selected heart muscle cells in a very small area (about 1/5 of an inch).		Preferred treatment for many types of rapid heartbeats (arrhythmias) especially supraventricular tachyarrhythmias .

	Artificial Heart Valve Surgery (Also known as Heart Valve Replacement Surgery)		Replaces an abnormal or diseased heart valve with a healthy one.		Restores function of the heart valves.

	Heart Transplant		Removes a diseased heart and replaces it with a healthy human heart when a heart is irreversibly damaged. Uses hearts from organ donation .		Recognized as a proven procedure to restore heart health in appropriately selected patients.

	Cardiomyoplasty		An experimental procedure in which skeletal muscles are taken from a patient's back or abdomen. Then they're wrapped around an ailing heart. This added muscle, aided by ongoing stimulation from a device similar to a pacemaker, may boost the heart's pumping motion.		Increases the pumping motion of the heart.

Implantable Medical Devices At-A-Glance
Cardiac Medications At-A-Glance

Implantable Medical Devices

In certain cases, your doctor may prescribe an implantable device to assist your heart.

Pacemakers and Implantable Cardioverter Defibrillators (ICDs) are used to treat  arrhythmias  — a condition of heart rhythm problems that occurs when the electrical impulses that coordinate your heartbeats don’t function properly, causing your heart to beat too fast, too slow or irregularly. The Left Ventricular Assist Device (LVAD) helps maintain the pumping ability of your heart.





Click on the name of the medical device in the chart to learn more.

Click on this picture  in the chart to see an illustration of a medical device.

	Name of Device		What the Device Does		Reason for Device
	Left Ventricular Assist Device (Also known as LVAD)		The left ventricle is the large, muscular chamber of the heart that pumps blood out to the body. A left ventricular assist device (LVAD) is a battery-operated, mechanical pump-type device that's surgically implanted.		Helps maintain the pumping ability of a heart that can't effectively work on its own. Sometimes used as a “bridge to transplant” for patients waiting for a heart transplant.

	Pacemaker (Also known as Artificial Pacemaker)		A small device that has wires which are implanted in the heart tissue to send electrical impulses that help the heart beat in a regular rhythm. The device is powered by a battery.		When the heart’s “ natural pacemaker ”  is defective and causes the heart to beat too fast, too slow or irregularly, a pacemaker helps the heart beat in a regular rhythm.

	Implantable Cardioverter Defibrillator (Also known as ICD)		A device that has wires which are implanted into the heart tissue and can deliver electrical shocks, detect the rhythm of the heart and sometimes “pace” the heart’s rhythms, as needed.		Used in patients at risk for recurrent, sustained  ventricular tachycardia or fibrillation. Restores the heart to normal rhythm. Helps prevent sudden cardiac death .

Cardiac Procedures and Surgeries At-A-Glance 
Cardiac Medications At-A-Glance