Post Heart Attack Symptoms

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Understanding heart attack

A heart attack, also known as a myocardial infarction, is one of the most serious yet common health problems that occur within the population. By definition, a heart attack occurs when there is an obstruction to the flow of blood to the heart. Therefore the heart muscle does not receive sufficient oxygenated blood, which means the heart cannot work at full capacity and the muscle can begin to die. If a large part of the heart muscle dies, the heart can stop beating. This is called cardiac arrest and leads to death. Heart attack symptoms vary greatly between people. If someone has a heart attack they can experience very severe symptoms, but they can also experience no symptoms. Symptoms include chest pain or pressure in the chest, fatigue, heartburn, nausea, or dizziness. 

Common causes

The main cause of heart attacks is coronary heart disease.1 In this disease, the coronary arteries, which are the arteries that supply blood to the heart, are obstructed by cholesterol deposits called plaques. These plaques block the flow of blood to the heart, meaning the heart receives less oxygenated blood and d cannot function at full capacity. The lack of oxygenated blood to the heart can cause a heart attack, without the artery being fully blocked. The other time of heart attack occurs when the plaque in the artery ruptures. This rupture leads to the formation of a blood clot within the artery, which blocks the blood supply to the heart, causing a heart attack. 

Other causes of heart attacks do not include plaque formation. Coronary artery spasm leads to constriction of arteries that supply the heart with blood. The constriction leads to a reduction of blood supply to the heart, which can lead to a heart attack.2 Some viral infections, including COVID-19, can cause damage to the heart muscle, which in turn can lead to a heart attack if a large proportion of the heart muscle is damaged. 

Warning signs of heart attack

The most common warning sign for a heart attack is chest pain. As well as chest pain, women are more likely to experience other symptoms such as nausea and/or vomiting, back or jaw pain, or shortness of breath.3 Discomfort in the arms or shoulders can also be a warning sign for a heart attack. 

Who is at risk

There are some people within the population that are more at risk of a heart attack than others. There are risk factors that increase one's chance of having a heart attack, such as;

  • High blood pressure 
  • High cholesterol 
  • Obesity 
  • High-fat diet 
  • Diabetes 
  • Smoking 
  • Lack of exercise 
  • High alcohol consumption4 

People with sleep apnea are also at greater risk of having a heart attack. The older a person is, the more at risk they are of having a heart attack. The use of stimulant drugs also increases one's risk of a heart attack. A loss of lung function or carbon monoxide poisoning can also lead to a heart attack as these both lead to hypoxia. Hypoxia is a lack of oxygen in the blood. Oxygen is essential for the function of the heart and to keep the heart muscle alive, therefore hypoxia leads to damage to the heart and consequently a heart attack. 

Prevention

The main way to prevent having a heart attack, or further heart attacks, is through lifestyle changes. There are three main lifestyle changes that will give one the best protection against heart attacks. These include;

  • A healthy, balanced diet
  • No smoking or alcohol 
  • Normal blood pressure5 

A healthy, balanced diet with a low saturated fat intake will help to prevent cholesterol deposits and hence plaque formation. Foods high in saturated fat should be avoided. This includes food such as fatty and processed meats, whole milk and butter. Whole milk can be replaced with milk lower in fat, or plant-based milk such as oat or almond milk. Butter should be replaced with vegetable-based products such as olive oil. A healthy, balanced diet includes eating lots of fruit, vegetables, fibre and fish, focusing less on meat. The best advice is to consult one's GP about diet relating to heart attack prevention, and before taking any food supplements. 

Smoking increases blood pressure, a large risk factor for heart attacks. Smoking also increases the risk of the arteries narrowing and becoming blocked, as the chemicals inside cigarettes can cause blood clots to form. With narrowing arteries and blood clots, a heart attack is very likely to occur. 

Normal blood pressure is incredibly important. If too high, the heart is put under constant strain, which increases the risk of a heart attack. There are many ways in which one can keep their blood pressure at a normal and healthy level. For example, following a healthy, balanced diet, regular exercise, and low alcohol intake can all help to reduce one's blood pressure. In terms of diet, the most effective way to reduce one's blood pressure is to reduce one's salt intake. Blood pressure is directly increased by a high salt intake. The NHS suggests that one should aim to eat less than 6g of salt a day. A high fibre intake has also been shown to reduce blood pressure. Food products high in fibre include wholegrain rice, pulses, broccoli, berries, granary bread, and oats. 

What are the post heart attack symptoms

The main post-heart attack symptoms are arrhythmias. An arrhythmia is where the heart beats irregularly. The heart may beat too fast, known as tachycardia, or too slow, known as bradycardia. They arise due to electrical disturbances to the heart. The damage that the heart suffers during a heart attack means the electrical control of the heart is not at 100% functional capacity, causing this irregular heartbeat. There are also life-threatening arrhythmias, called heart block and ventricular arrhythmia. In a heart block, the electrical signals of the heart completely fail, so blood cannot be pumped from the heart properly. In ventricular arrhythmia, the heart goes into a spasm and can lead to a stop informational failure can also occur after a heart attack, depending on the extent of the damage to the heart. 6 It is characterised by damage to the heart muscle, meaning the heart is less effective at pumping blood around the body. Symptoms include being short of breath, fatigue, and swelling in the extremities such as in the lower legs. Another uncommon post-heart attack symptom is heart rupture. In this case, the heart muscle walls can split apart, which causes symptoms such as mental confusion, breathing difficulties, and mental confusion. This is a very rare condition but is very serious as it requires open heart surgery to treat it. 

How long does it last? 

The life-threatening arrhythmias, known as heart block and ventricular arrhythmia, are a major concern for death in the 48 hours that follow a heart attack. However, the use of defibrillators has helped to increase survival rates greatly. The milder arrhythmias such as tachycardia and bradycardia usually come with milder symptoms. If severe symptoms such as strong palpitations and great chest pain occur, then medication such as beta blockers can be used to control this. Heart failure cannot be cured. It is something that an individual has to live with. Medication and a healthy lifestyle help an individual to control the symptoms and maintain one's quality of life whilst living with heart failure. The risk of heart rupture occurring is within 1-5 days following the heart attack. Heart rupture leads to death in 50% of cases within 5 days of it occurring. In the case of survival, surgery is required for a positive prognosis, but patients may suffer from negative symptoms after the surgery. There are even cases where patients are doing well 5 years after the surgery, hence the symptoms very much depend on the severity of the rupture and how well the surgery goes.

How to deal with post-heart attack symptoms

Arrhythmia symptoms vary greatly from person to person. Symptoms can range from very mild to very severe. Symptoms can be controlled with drugs called beta-blockers. In some cases, these drugs may not help with the symptoms, and further measures may need to be taken. The most common further measure is the implantation of a pacemaker into one’s chest. A pacemaker helps to regulate one's heartbeat, thus preventing arrhythmias from happening again. To help with heart failure, one can make lifestyle changes, like those to reduce one's blood pressure. A healthy diet, regular exercise, and limited alcohol and smoking will help to control and reduce the symptoms of heart failure. 

Tips for fast recovery after a heart attack

After a heart attack, it is important to recover fully as well as to increase one's physical fitness to return to normal daily activities, and prevent another heart attack from happening. Every person will recover at different rates, so the tips below are a very general guide. For more personal advice, one should consult with the nurses and doctors who helped the recovery process in the hospital following the heart attack. 7 

Initially, it is recommended to rest and limit one's physical activity. Unnecessary trips and activities should be avoided. Showers are recommended over baths, to have greater control of the water temperature and flow. Afternoon naps are recommended, as well as leisurely activities such as reading, watching TV, and listening to the radio. Physical activity should be kept to a minimum, and should only include walking up and down the stairs when necessary and a short stroll in the street or one's garden if feeling up for it. It is recommended to avoid driving a car, playing sports, or carrying out tasks that make you feel short of breath. 

After one week of being back at home and starting the recovery process, one should hopefully start to feel better. Daily exercise can be incremented to a 5-10 minute gentle stroll. One can begin doing tasks and activities that they think they can complete safely, but caution should be taken. After two weeks, the frequency of walks can increase up to two 15-minute walks if feeling up for it. One should not rush their recovery and should 

After a month, for some people the recovery period may be ending, and for some, it may only be halfway through. If feeling up for it, one would now be able to take up sports such as swimming or cycling. If any chest pain is experienced, then one should stop and consult with their GP. The recovery is not linear and should be a very gradual process. 

Summary

It is important to be well informed about heart attacks, including the causes, symptoms, and how to prevent them as well as the post-heart attack symptoms that one may suffer from. The key takeaway from this article should be the lifestyle changes that one can make to prevent heart attacks from occurring. It is incredibly important to maintain a healthy lifestyle, including a balanced diet, exercise, and minimal alcohol and smoking for every aspect of one's health -but specifically for heart health. As heart attacks and heart-related diseases, in general, are one of the biggest killers in the world, and one that can be prevented by lifestyle changes, prevention strategies should be taken very seriously and encouraged in every aspect of life.

References

  1. Heart attack: symptoms, causes, diagnosis, prevention, more [Internet]. Healthline. 2022 [cited 2022 Nov 4]. Available from: https://www.healthline.com/health/heart-attack 
  2. Heart attack - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106 
  3. Warning signs of a heart attack [Internet]. www.heart.org. [cited 2022 Nov 4]. Available from: https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack 
  4. Causes of heart attack [Internet]. nhs.uk. 2018 [cited 2022 Nov 4]. Available from: https://www.nhs.uk/conditions/heart-attack/causes/ 
  5. Lifestyle changes for heart attack prevention [Internet]. www.heart.org. [cited 2022 Nov 4]. Available from: https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack/lifestyle-changes-for-heart-attack-prevention 
  6. Complications of a heart attack [Internet]. nhs.uk. 2018 [cited 2022 Nov 4]. Available from: https://www.nhs.uk/conditions/heart-attack/complications/ 

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Paula Messa

BSc, Biomedical Sciences, University of Bristol, England

I am a recent graduate with a passion for healthcare. I am taking a year out to go travelling and get some experience in medical writing. I am hoping to do a Masters in Global Health next year, to allow me to work in humanitarian settings or in policy in the future.

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