Dr. Stephen L. Kopecky on How to Survive a Heart Attack

"There have been studies that look at whole populations, and about half of heart attacks were unknown. You can find an episode when a patient, in retrospect, thought it was the flu."
Stephen L. Kopecky, MD, specializes in cardiology and internal medicine in the cardiovascular diseases department at the Mayo Clinic in Rochester, Minn.

Q: Several of my family members have had heart attacks. What are the chances that I will too?

A: If there is an incidence of early-in-life heart attacks in your family, it should be a red-flag warning. If your uncle had a heart attack at age 48, you need to pay attention to your health. Go get your cholesterol checked and dont ignore health issues. If the genes are there and family members have had early heart attacks, you need to assume that you have the same genes. Dont assume youre any different, even if youre not obese or don't have high cholesterol.

Q: If I have high cholesterol, what are my risks of a heart attack?

A: Cholesterol is a big factor. What we used to call normal is now high, and high cholesterol is a huge problem in our country. We see metabolic syndrome, high triglycerides, low HDL, and high LDL—all causing heart disease in many of our patients. Then there are plenty of people with high cholesterol who dont have heart attacks. About 80% of people who have heart attacks have at least one of the main risk factors, such as cholesterol, high BMI, or diabetes. If you dont have any of these risk factors—high cholesterol, high blood pressure, current smoking, or diabetes—by age 50, there is only a 5% chance youll have a heart attack by age 90.

Q: I know the classic symptoms of a heart attack, such as chest pain. What are some less common symptoms?

A: About half of all heart attacks occur without significant symptoms. The attacks are only identified after or during the electrocardiogram. Most of the time, the first symptom of heart disease is the heart attack.

Chest pain doesnt happen in more than half the patients. For patients older than 65, there is increased shortness of breath when doing things that dont normally cause shortness of breath. Nausea is also associated with problems with the underside of the heart. Pain in the left arm is not uncommon. Sometimes patients feel it in the jaw or teeth, especially with problems in the left front artery of the heart. Pain between the shoulder blades tends to confuse us more than anything, but it is usually associated with a tear in the aorta.

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Last Updated: September 09, 2008

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