Am I having a heart attack?

What is a heart attack

A heart attack is when the blood suddenly stops flowing to a part of your heart muscle. You must get treatment as soon as possible to limit the amount of damage caused to your heart.

What are the symptoms of a heart attack in women?

According to the World Health Organization, coronary heart disease (CHD) - the main cause of heart attacks – is the single biggest cause of death in women worldwide. In the UK it kills more than twice as many women as breast cancer - yet it’s often thought of as a man’s disease.

The British Heart Foundation (BHF) estimates there are more than 800,000 women in the UK living with CHD – around one half of them have survived a heart attack.

Men and women have the same heart attack symptoms – but to greater or lesser extents. This table shows the percentage of men and women who feel the key symptoms of a heart attack.

Comparison of heart attack symptoms felt by men and women

Source: BHF

Whilst men and women generally have the same heart attack symptoms, BHF research shows that women are 50% more likely to be mis-diagnosed than men. An initial misdiagnosis means a 70% higher risk of death after 30 days compared to receiving the correct diagnosis straightaway. Women are also more likely to delay receiving treatment than men. Once they do receive treatment women are less likely to be prescribed medicines to help prevent a second heart attack.

The changes following menopause that may happen to your body - such as weight gain, lower oestrogen levels, or higher cholesterol - also increase your chances of developing CHD. The lack of awareness about this is another possible reason that heart attack survival rates are lower for women than for men. If more women who are living with menopause knew their chances of heart attack were increased they would be more likely to spot the symptoms.

Causes of heart attacks

The most common cause of heart attacks is when a blood clot (thrombosis) stops your blood getting to your heart. Blood clots are caused by a build-up of fatty material called atheroma (or plaque) which builds up in your artery walls – these carry the blood from your heart to the rest of the body.

Lifestyle, health conditions and family history all affect your chances of you having a heart attack.

Lifestyle factors that will increase your risk of heart attack include:

• Smoking.

• Being overweight

• Being inactive.

• Unhealthy diet.

Having diabetes type 2, high cholesterol and blood pressure levels will also increase your risk.

Factors that are outside your control which can raise the chance of you having a heart attack include:

• Diabetes type 1.

• Having a family history of heart disease or stroke that happened to your father or brother aged below 55, or in your mother or sister aged below 65.

• Being from certain ethnic groups - for example, South Asian.

Treatment and recovery from heart attacks

Emergency treatment

As soon as possible after a heart attack is suspected you will be given treatment. This may include aspirin - if you have not already had one - GTN spray (glyceryl trinitrate), oxygen, and morphine. The medical care team will try and restore the blood flow as quickly as possible by clearing your blocked artery.

The main methods used to get your blood flowing again are:

• Thrombolysis – an injection of clot-busting medicine to clear the blocked artery. You may be given this in the ambulance on the way to hospital.

• Coronary angioplasty – small wire mesh tubes (stents) are put into the blocked artery to keep it open and let your blood flow to your heart.

• Coronary bypass surgery – uses a healthy blood vessel from your chest or leg area to create a new route for blood to flow around the blocked artery.

You may be given other medicines to treat your heart attack, these include.

• Beta-blockers - to protect your heart muscle, prevent abnormal heart rhythms, and help to prevent another heart attack.

• Injections to help prevent further blood clots from forming – such as heparin.

• Insulin - to control your blood sugar levels if they are raised.

• Oxygen - to reduce the chance of damage to your heart muscle.

• Pain relief - such as morphine.

Recovering from a heart attack in the hospital

How long you stay in hospital will depend on the treatment you have had, the severity of your heart attack, and general fitness levels. If you have had stents or coronary angioplasty, you’ll probably go home after two or three days. If you’ve had by-pass surgery you may stay in for one week or more.

Your doctor will not send you home until you are well enough and it is safe for you.

Treatment after you have had a heart attack

Your treatment after a heart attack will help reduce your chance of having another one – and stop your heart disease from getting worse.

It's likely you will need to take certain medicines for the rest of your life. The actual medicines prescribed for you will depend on factors such as the type of heart attack you had and other health conditions you may have.

Common medicines you may prescribed include:

• Antiplatelets – such as clopidogrel or ticagrelor to help prevent blood clots.

• Angiotensin-converting enzyme (ACE) inhibitors to help protect the heart.

• Beta-blockers to help protect the heart.

• Statins to lower the cholesterol level.

How to minimise the risk of a second heart attack

If you've already had a heart attack, you're at an increased risk of having another. As well as medicines there are several lifestyle changes you can make to reduce the risk though, these include:

• Eating healthily.

• Keeping your weight at healthy levels.

• Exercising regularly.

• Looking after your mental wellbeing.

• Taking your medicines when you should.

• Drinking within safer alcohol limits.

• Not smoking.

• Managing your blood sugars.

• Managing high blood pressure.