It’s alarming to think that a heart attack can come out of the blue, even in younger, seemingly healthy people.
Thanks to lower rates of smoking, the number of Australians with heart disease is falling. Eastern Heart Clinic’s Medical Director Assoc Professor Nigel Jepson says having a heart attack is less likely in younger people, but heart disease is becoming an increasing problem for people aged 45 to 55.
More than 9,000 Australians aged under 55 experience a heart attack each year, according to the Australian Institute of Health and Welfare.
Coronary heart disease – which can lead to heart attack – is the leading cause of death in Australia. Heart attacks cause almost one in 20 deaths in Australia, and men are twice as likely to die from the disease than women.
Associate Professor Jepson explains the symptoms to look for and how to reduce your risk of heart disease.
What causes heart attacks in young people?
A heart attack occurs when a coronary artery (which supplies blood to the heart muscle) suddenly becomes blocked. Heart attacks (including in younger people) are most commonly caused by fatty deposits on the coronary arteries known as plaques. Those fatty deposits can slowly clog the arteries and reduce blood flow, but during a heart attack, the plaque lining breaks down resulting in clot formation which suddenly and completely blocks the artery.
The most common indication of a heart attack is chest pain which can spread to the jaw, neck, arms or back. A heart attack requires emergency treatment to restore blood flow to the heart muscle.
A heart attack is different to a cardiac arrest. A cardiac arrest occurs when the heart stops beating due to an electrical malfunction. Importantly however, a heart attack can cause a cardiac arrest which is another factor why urgent treatment is needed.
Who’s at risk of having a heart attack?
“Obviously the healthier you are, and the better your diet and weight, the lower your risk of having a heart attack,” Associate Professor Jepson says. “However, the risk isn’t zero, even if you look after your health.
“As cardiologists, we regularly talk to younger people who have survived a heart attack and their families. And the first thing they ask is ‘why me, I’m young’.”
There are some factors that put you at greater risk of having a heart attack. Some of these can’t be changed, such as being older or having an immediate family member with a history of heart disease. But some risk factors can be changed and improved. These include:
- high blood pressure
- high cholesterol
- diabetes
- smoking
- physical inactivity
- being overweight
- a diet high in fats and salts
Symptoms are the tip of the iceberg
Once a heart attack occurs, it’s like the tip of an iceberg and a sign that there’s likely to be underlying heart disease, Associate Professor Jepson says.
“Symptoms often start to occur later in the disease process. For example we often find that there has been a steady build-up of plaque in the coronary arteries over time – long before we see signs and symptoms.”
Even young, healthy people can have evidence of early plaque on their arteries, putting them at risk of having a heart attack in the next five to 10 years, Associate Professor Jepson says.
“If we can catch disease in the arteries earlier, we can prevent sudden heart attacks,” he said.
What are the warning signs and symptoms of a heart attack?
In the days and weeks before a heart attack, there may be warning signs such as pain or tightness in the chest, or breathlessness, Assoc Prof Jepson says.
“But unfortunately, sometimes the very first sign of underlying heart disease can be sudden death.”
Knowing the warning signs of a heart attack can save your life – or someone you love.
Common signs in the hours, days and weeks before a heart attack are:
- tightness, pressure or pain in the chest that may spread
- shortness of breath
- extreme fatigue
- feeling dizzy or lightheaded
- abdominal pain that feels like heartburn or indigestion
- cold sweats
- nausea
For women, symptoms of chest pain may not be as noticeable. Women commonly experience these symptoms:
- pressure in the upper back
- nausea or vomiting
- extreme fatigue
- fainting
- feeling light-headed or dizzy
- cold sweats
The more of these symptoms you have, the greater the chance you’re having a heart attack.
If you think you’re having a heart attack, act fast and call an ambulance straight away. If you have aspirin available, take 300mg – this can help prevent blood clots and reduce heart damage.
Every minute counts. The sooner you get medical help, the sooner blood flow will be restored, reducing the chance that the heart muscle is permanently damaged.
Getting medical help early will restore blood flow to the heart and reduce the chance of permanent heart muscle damage.
How to reduce the risk of heart attacks in young people
We can all keep our hearts healthy by making positive healthy lifestyle changes, such as:
- exercising regularly
- maintaining a healthy diet
- managing diabetes (if you have it)
- keeping high blood pressure and cholesterol under control
- maintaining a healthy weight
- not smoking
- drinking alcohol in moderation
- managing stress
- getting regular heart health checks
Prevention is important to reduce your risk of heart disease, but you may still be at risk even if you have a healthy lifestyle. That’s where an annual heart health check can help detect heart disease early.
Who should get a heart health check?
A heart health check is the best way of detecting heart disease early, even if you have no symptoms. “Whether you’re younger or older, get a check. Don’t wait for symptoms,” Associate Professor Jepson says.
Even if you live a healthy lifestyle and feel fine, you can have underlying heart disease, he says.
If you’re over 45, or over 35 if you’re of Aboriginal or Torres Strait Islander descent, book a heart health check with your GP. The check is free at clinics that bulk bill for this service.
It’s especially important to get your heart checked out if you have a family history of heart disease or high blood pressure.
A heart health check will help your GP determine your risk of having a heart attack or stroke in the next five years – and help you take action to reduce your risk.
What happens during a heart health check?
During the check-up, your GP will ask you about your lifestyle, medical history, and any family history of heart disease. They’ll also check your blood pressure.
You’ll then have blood tests to check your cholesterol, blood sugar, and kidney function.
If necessary, your GP will help you work out a plan to reduce your risk of having a heart attack and may refer you to a cardiologist.
If you have signs that need further investigation, your doctor may order an ECG, an ultrasound of your heart (an echocardiogram), or a CT scan of the arteries. These procedures will help to show how much plaque is inside the arteries.
Heart disease is preventable if detected early
Assoc Prof Jepson is reassuring that if heart disease is detected early, a heart attack can be avoidable. The key is awareness and prevention, he says.
“Having these tests early means heart disease will be flagged,” Associate Professor Jepson says.
“We can prevent coronary heart disease. It’s not an inevitable consequence of aging. We can lower the risk as long as we identify and act on the signals early enough.”
Calculate your risk of developing heart disease
The Australian Cardiovascular Disease (CVD) Risk Calculator helps healthcare professionals calculate a person’s risk of developing CVD in the next five years. It was developed in association with the 2012 Absolute CVD Risk Guidelines.
You can read more about the Absolute CVD Risk Guidelines on the Heart Foundation website here. You can also find additional tools and information on the website to help you identify if you are at risk of heart disease.
If you’re concerned about your heart (or general health), or you’re due for a heart health check, make an appointment to see your GP.
About Eastern Heart Clinic
Eastern Heart Clinic is a private interventional cardiology hospital co-located at the Prince of Wales Hospital at Randwick in Sydney’s eastern suburbs.
One of the largest interventional cardiology hospitals in New South Wales, Eastern Heart Clinic provides diagnostic and interventional cardiology services to public and private patients in metropolitan Sydney and New South Wales.
Learn more about our clinic, cardiology procedures, and what to expect if you’ll be visiting us for a procedure.
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