She was jolted awake in the middle of the night by what she describes as “crushing” chest pain, as well as pain down her left side from her jaw to her arm. “Things that you hear about on TV but that you don’t really think are going to happen to you,” she says. After she realized that she was likely having a heart attack, she alerted her husband, and he called 911. In the ambulance, her worst fears were confirmed when the emergency medical technician told her she was having a right-sided heart attack. “I remember looking at the ceiling of the ambulance praying to God, begging my dad in heaven and all my guardian angels to let me live,” Murphy wrote in a blog post about the experience. Her prayers were answered and she survived. But she knew she needed to make some changes in her life — and she’s certainly not alone. Heart problems remain the No. 1 health threat to American adults. Heart disease is the leading cause of death in both men and women in the United States, killing about 659,000 people each year, according to the Centers for Disease Control and Prevention (CDC). That’s 1 in 4 deaths. The most common type of heart disease in the United States is coronary artery disease, which can lead to a heart attack. Coronary artery disease occurs when plaque builds up in the walls of the arteries that supply blood to the heart and other parts of the body. The plaque causes the insides of the arteries to narrow over time, partially or even completely blocking blood flow. A heart attack occurs when the heart muscle doesn’t receive enough blood flow. In the United States, someone has a heart attack every 40 seconds, with about 805,000 Americans affected every year, according to the CDC.
A Heart Attack as a Wake-up Call
For most patients, having a heart attack is a wake-up call that they need to make certain changes in their lives. In 2015, Jeff Breece had a heart attack at age 46. Just a few days earlier, he had been at the gym bench-pressing his own weight. After the heart attack, his doctors said he wouldn’t be able to lift a 10-pound dumbbell. He went to cardiac rehab for 12 weeks and began seeing a therapist to deal with the anxiety and depression that came with his new reality. He changed his eating habits and became a vegetarian. When he received the all clear from his doctors, he also started running races, including half-marathons. Now, several years later, Breece says that the whole process has been a “journey” that continues to change him.
The Biggest Challenges of Life After a Heart Attack
Surviving a heart attack, for many, requires some major adjustments. Most of the time, they aren’t easy. “No longer can we go out and eat and not really think about the cholesterol or fat content or how bad it is for our arteries,” Murphy says. “We really have to start looking at lean choices.” That was particularly challenging for her because she has children, and “they like to eat the things we probably shouldn’t eat,” she says. “Before, I did not understand how somebody could not let go of a drug addiction, or any type of addiction,” she says. “But now I do. It is very difficult to change habits.” Her motto in overcoming these challenges: “One step at a time.” Robinson has since founded a nonprofit organization called Black Heart Association to promote heart healthy living and advocacy for underserved communities and people of color. Like Robinson, Murphy also found exercising challenging, but for different reasons. Before her heart attack, Murphy ran a lot, including half-marathons. After the heart attack, she wasn’t able to resume running at the pace she was used to. Instead, she has had to take up different kinds of exercise, such as the elliptical machine or walking the dog. Disappointed at first, she has embraced these changes and learned to turn them into positives. “It really has made me take a step back and not always be in such a rush to get out there and run a few miles and then move on to the next thing — but instead to really enjoy and take every day and really be grateful that I did have a day to just take a walk with the dog,” she says. For Breece, the biggest challenge was absorbing all the information he needed to know to maintain his new lifestyle, which quickly became overwhelming. After the initial influx of information, it became important for him to “treat it like a marathon, not a sprint.” “You don’t go directly straight up a mountain,” he says. “You take zigzags and you get to the top eventually.” Additionally, the depression and anxiety he experienced as a result of his heart attack were difficult to process. The isolation of the COVID-19 pandemic further exacerbated his mental health struggles. Therapy and meditation have helped him learn to cope. “It’s been a lot of work personally and emotionally, but it’s life,” he says. “I’m here seven years later and still breathing.”
Know the Symptoms of a Heart Attack
Getting treatment as soon as possible for a heart attack greatly increases the chance of survival, so it’s important to know the symptoms. Heart attacks can occur suddenly, or symptoms can start slowly and progress over time. The major symptoms of a heart attack are:
Pain or discomfort in the jaw, neck, or backWeakness or light-headednessChest pain or discomfort (also known as angina)Pain or discomfort in the arms or shouldersShortness of breath
Andrew Freeman, MD, a cardiologist at National Jewish Health in Denver, says that certain symptoms can be easily overlooked or mistaken for something else. “The main one I would say is angina, which happens when the heart wants more than it’s getting in terms of nutrients or oxygen,” he says. “In short, any symptom that occurs above the waist that comes on with activity or stress and resolves with rest really needs to be considered as potentially being angina.” Other symptoms can include:
NauseaVomitingUnusual or unexplained tiredness
Women are more likely to experience a heart attack without chest pressure. “The presentation is definitely different in women,” says John Osborne, MD, director of cardiology at State of the Heart Cardiology in Southlake, Texas. “Typical heart attack symptoms in women can be pretty nonspecific. Some women even think they have the flu.” Robinson says that before her heart attacks, her left arm went numb and her neck felt like she had slept poorly, “like I had a crook in my neck. Those were the two main symptoms before I actually had the heart attack itself.” On the days when she had her heart attacks, she felt those same symptoms in addition to chest pain, upper back pain, nausea, and feeling “hot and clammy.” Experts say that everyone, especially women, should be aware of the many different ways heart attacks can present, so that they can seek medical attention as soon as possible.
Which Heart Attack Risk Factors Can You Control?
Certain factors make someone more likely to have a heart attack. Some of them are modifiable and some are not. Those that can be changed include high cholesterol, high blood pressure, physical inactivity, being overweight or obese, smoking tobacco, and diabetes. Risk factors that are not modifiable include older age, sex (men have a greater risk of heart attack than women), and family history. The last one, Dr. Osborne says, is particularly important to be aware of. “You may eat right, exercise, not smoke, and do the right things, but if you’ve got a bad family history, be aware that doing those things certainly may reduce your risk of heart disease but not eliminate it,” he says. It’s important for people who have a greater risk of a heart attack to be extra vigilant when it comes to noticing the signs of one — and to get to a doctor right away if symptoms occur.
Treatment Options for a Heart Attack
There are a number of different treatment options following a heart attack, depending on how much blockage there was in the coronary arteries. Treatments include:
Percutaneous coronary intervention (formerly called coronary angioplasty with stenting)Clot-dissolving drugsBalloon angioplasty (special tubing with an attached deflated balloon threaded up to the coronary arteries)Coronary artery bypass surgeryA combination of these treatments
Of course, long-term treatment for a heart attack involves making lifestyle changes, including adopting a healthy diet, increasing physical activity, and changing modifiable risk factors — such as reducing blood pressure, losing weight, reducing cholesterol, and quitting smoking. “We most certainly cannot underestimate the value of diet and exercise and changing other modifiable lifestyle factors when it comes to the treatment of a heart attack,” Dr. Freeman says.
Staying Motivated After a Heart Attack
Adhering to the many lifestyle changes that come after a heart attack can be difficult, but for many heart attack survivors, family members and a strong support system help push them forward. Murphy explains the importance of “having a great support system and caretakers to let you know that you’re not alone on this journey.” She also found it helpful to talk to other people who have survived heart attacks or strokes or have had some kind of illness for which they needed to rely on their family. For Robinson, her children provide the biggest motivator to push forward. “I think about not being here to see my children have children or get married or any success they’re going to have that I wouldn’t be here to share,” she says. Breece suffered from depression and anxiety after his heart attack and says that therapy was extremely beneficial in helping him stay on track with his recovery. “One of the tricks I use is to personify the anxiety; the therapist taught me how to do this,” he says. “Treat the anxiety as if it’s your mom and you’re 17 and she’s there to check in on you. You thank her and then get back to what you’re doing so she can go do what she needs to do somewhere else. It’s not an adversarial relationship anymore — it’s more of a familial relationship.” In this way, he’s learned to “make friends” with the anxiety. Breece says that meditating and periodically getting out of his comfort zone by leaving the city to go solo camping has also helped him stay motivated.
Heart Disease Deaths by the Numbers
Over the past several decades, heart disease–related deaths in the United States have declined, although more Americans still die from heart disease than any other cause. According to the American Heart Association, research shows that age-adjusted death rates for heart disease fell from about 520 deaths per 100,000 Americans in 1969 to 169 per 100,000 in 2013. “The big-picture, 30,000-foot-view is that we’ve made huge advances in the prevention of cardiovascular death,” Osborne says. That success is due to less smoking among the U.S. population overall, improved medications, and better control of risk factors such as high blood pressure and cholesterol. But a research analysis published in JAMA Cardiology in January 2022 concluded that progress is stagnating, and there have not been any further significant declines in coronary heart disease deaths in the past decade. Furthermore, heart disease remains the No. 1 killer of both men and women in the United States. “Not only is that statistic frightening, but in fact cardiovascular disease kills more people than the next seven leading causes of death combined,” Osborne says. “So we still have a really long way to go.”
What to Do if You Think You Are Experiencing a Heart Attack
A heart attack is a medical emergency. If you think you or a loved one is experiencing a heart attack, call 911 or your local emergency number immediately. Prompt medical attention is necessary. The sooner the person gets to the hospital, the higher their chance of survival.
