Surviving a heart attack can be a wake-up call; patients need to adopt new lifestyle patterns and get used to taking medications. All this change can be challenging, but with the right information and support, you can prevent another heart attack and live a healthier life. Cardiologist Helga Van Herle, MD, MS, FACC, explains what she tells her patients about living a heart-healthy life after a heart attack. 1. Q: What happens in the body during a heart attack? A: During a heart attack, an area of the heart muscle isn’t getting enough blood flow and is deprived of oxygen. That’s usually because there’s a blockage, or clot, inside the artery that provides blood to that part of the heart. Most of the time, people will feel chest pain and discomfort during a heart attack, although symptoms can vary. Women tend to have different symptoms than men; they might feel pain in the neck, jaw, back, and abdominal area, as well as nausea, vomiting, shortness of breath, and sometimes severe sweating. If you’re experiencing these symptoms, don’t hesitate—call 911 or get to an emergency clinic as soon as you can. Getting treatment in a timely fashion prevents heart muscle damage. The earlier patients are treated, the better outcomes they have. 2. Q: What are the risk factors for a second heart attack? A: Having one heart attack significantly raises your risk of having another one, which is why it’s so important for people to start living a heart-healthy life and really commit to it. You’re more likely to have a second heart attack if you have high cholesterol that’s not being treated, uncontrolled hypertension (high blood pressure), if you smoke or abuse drugs like methamphetamine and cocaine, or if you have diabetes. If you have a family history of first-degree relatives that had heart attacks at an early age, you’re also at a higher risk. Most of these risk factors can be managed with treatment, although aging is also a risk factor, and you can’t do much about that. Men over 55 years old and women over 65 years old are at a higher risk of a heart attack in general, and women are particularly affected once they go through menopause. 3. Q: What lifestyle changes must people make to prevent another heart attack? A: A healthy lifestyle is key for people to keep their hearts in shape. I instruct my patients to follow a heart-healthy diet, which means lowering your intake of saturated and trans fats, including full-fat dairy products and red meat. I recommend my patients get plenty of whole grain fibers and fresh fruits and vegetables in their diet, as well. It can be hard to eat out at restaurants when you’re following this kind of diet, and it’s so much easier to know what you’re eating if you prepare your own food at home. It can be a burden sometimes to take the time and effort, but when you make your own meals, you control what goes into them and what goes into your body. Exercise is also really important. I ask patients to get a pair of well-fitting athletic shoes and just go out and walk. If you can get in at least 30 minutes of walking each day, physical activity can be beneficial in so many ways. Sometimes, I’ll actually write patients a prescription for exercise, and it works! They feel better, they lose some extra weight, they’re more physically conditioned, and their stress levels even go down. Additionally, exercise can help lower cholesterol and improve blood pressure control. I tell patients to work activity into their everyday lives if possible—you can park far away from the store and walk across the parking lot, take the stairs instead of the elevator, and even just go for a 10-minute walk around your office to make a difference. There’s also a whole body of evidence out there that shows stress contributes to the development of heart disease. That’s why changing your lifestyle isn’t just about diet and exercise—it’s also about taking time to relax and manage your emotions. I tell my patients to take time out for themselves, to meditate, practice mindful breathing, and other calming activities like that. 4. Q: What medications can help patients prevent another heart attack? A: After a heart attack, patients will typically be given aspirin and a prescription blood thinner, a statin to lower cholesterol, and either a beta blocker or an ACE inhibitor, which are both drugs that protect the heart from damage. Patients will take these medications for a long time after their heart attack, and we like to see them back for follow-ups fairly regularly. If you had a stent placed after your heart attack, you’ll want to see your cardiologist within two weeks from your discharge from the hospital. And I think it’s important for patients to know that they need to check in with their cardiologist regularly, even if their heart attack was many years ago. Even if you’re doing great, touch base with your cardiologist once in a while to make sure there’s nothing new on the horizon that you should be aware of. It doesn’t mean you’re going to have to do a whole bunch of tests or get new medications, but we, as cardiologists, like to keep track of every patient and make sure they’re all doing well. If you commit to your medications, live a healthy lifestyle, and see your cardiologist regularly, you’re lowering your risk of another heart attack and increasing your chances of living healthier for longer.