by Karen Cheong

Created on: August 01, 2007

Most people fear they are having a heart attack when they experience chest pain. There's good news and bad news. The good news is, not all chest pain comes from the heart. The causes can range from merely being inconvenient , like a muscle ache , to the more serious like heart burn, as the oesophagus ( the "foodpipe") runs behind the heart. Some can even be life-threatening, like a blood clot in the lungs.

The chest pain from the heart is called angina. It tends to be worse with exercise, and better with rest. It can feel like an uncomfortable pressure, squeezing, fullness, or pain and can be mild or severe. Heart attack pain can sometimes feel like indigestion or heartburn. The bad news is, not all heart attacks begin with a sudden, crushing pain that is often shown on TV or in the movies. Some can start slowly as mild pain or discomfort. Some people don't have symptoms at all (this is called a silent heart attack). It is not the same for everyone.

So what is a heart attack ?

A heart attack occurs when blood flow to a part of the heart becomes blocked. If the flow of blood isn't restored quickly, the section of the heart becomes damaged from lack of oxygen and begins to die. Coronary artery disease is when a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.

How do I know if I'm at risk of having a heart attack ?

Unfortunately, some things cannot be changed. How old you are and your gender plays a part in your risk for a heart attack. The older your are, the higher the risk. And men are at higher risk of heart attacks than women, till after menopause. Then the risks for women increase.

Fortunately, there are some risk factors for heart attacks which can be changed or controlled. These include smoking, obesity, high cholesterol, high blood pressure, and diabetes.

So a 20 year old woman who is otherwise well, and suddenly experiences chest pains after fighting with her boyfriend is far less likely to be having a heart attack than a 60 year old male smoker who skipped his last doctor's appointment for his diabetes review, and now experiences chest pain.

So what can I do to prevent or lower my risk of heart attacks

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