5 Early Warning Signs of a Heart Attack (and 5 Other Things You Need to Know)
The difference between a strong, healthy ticker and a ticking time bomb could come down to having the right info. Check your cardiac quotient with this quiz.
Illustration: Boyoun Kim
1. For each pair of breakfast foods, circle the option with less sodium per serving.
A. Cornflakes or shredded wheat
B. Greek yogurt or cottage cheese
C. Whole wheat toast or a bagel
Answer: Shredded wheat, Greek yogurt and whole wheat toast all contain significantly less sodium per serving than the other options. Why should you care? Americans consume more than 3,400 milligrams of sodium a day on average—far above the American Heart Association's recommended daily limit of 2,300 milligrams and nearly double its ideal limit of 1,500. "All that sodium can raise blood pressure, a major contributor to heart disease," explains Cheryl Anderson, PhD, an associate professor at the University of California, San Diego School of Medicine. Try to eat mostly fresh food, and always check labels. Choosing foods that contain only one milligram of sodium per calorie or less— no more than 100 milligrams in a 100-calorie food, for example—can help you stay within healthy limits, says Anderson.
2. Which of these is not a risk factor for heart disease?
A. High blood pressure
B. Obesity
C. Migraines
D. Smoking
E. Diabetes
Answer: Trick question—they all might be. You can probably rattle off most risk factors by...well, heart, with the possible exception of migraines. But a Harvard study of more than 100,000 women recently found that migraine sufferers were 50 percent likelier to have a heart attack, a stroke or fatal heart disease, regardless of other risk factors. Genetics, hormones and inflammation all are possible culprits, but "the short answer is that we do not yet know what precise mechanism causes this," says lead researcher Tobias Kurth, MD, adjunct professor at the Harvard T.H. Chan School of Public Health.
3. True or false: Women need to start worrying about heart disease after they hit menopause.
Answer: False. It's believed that the drop in estrogen that accompanies menopause may make your blood vessels less elastic, increasing the strain on your heart. However, when researchers followed nearly 1,500 women over nine years, they found that in the years leading up to menopause, there was an increase in the severity of metabolic syndrome—a group of risk factors, including high fasting blood sugar and high blood pressure, associated with heart disease. This effect was even more pronounced in black women.
4. Your friend just betrayed you big-time! What's the heart-healthiest way to manage your anger?
A. Tell her off
B. Run it off
C. Walk it off
D. Find consolation in Ben & Jerry's
Answer: C. Taking a walk calms the fight-or-flight response, as do cooldown activities like stretching and deep breathing. Intense physical activity, on the other hand, can push your heart into the danger zone. "Anger triggers an adrenaline response that reduces blood flow to the arteries," says Donna Arnett, PhD, dean of the University of Kentucky College of Public Health. "Strenuous exercise in this state is incredibly taxing on the heart." An Australian study found that the risk of a heart attack was more than eight times higher when patients had been very angry in the two hours before the onset of symptoms, while another recent study showed that the risk tripled in those who experienced anger and heavy exertion in the hour before.
5. Attention, workaholics: How many hours can you clock each week before your heart pays a price?
A. 45
B. 50
C. 55
D. 60
Answer: A. When researchers at the University of Texas Health Science Centers and the University of St. Thomas in Houston analyzed data on more than 1,900 people, they found that among people who worked over 45 hours per week for a decade or more, each additional hour meant greater risk of heart disease. Risk climbed 16 percent when people put in 55 hours and 35 percent for 60 hours.
6. Which of the following could be an early warning sign of a heart attack?
A. Anxiety
B. Nausea
C. Jaw pain
D. Fatigue
E. Sweat
Answer: All of them, again (are you onto us?). "It's hard to parse some of these symptoms because women tend to be juggling so much as a matter of course," says Arnett. Three questions to ask: Is this a new symptom? Did it appear suddenly? Does it resolve if I rest for a few minutes? "When in doubt, call an ambulance," she says. "If the worst-case scenario is wasting time at the hospital, that's far better than the alternative."
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A. Cornflakes or shredded wheat
B. Greek yogurt or cottage cheese
C. Whole wheat toast or a bagel
Answer: Shredded wheat, Greek yogurt and whole wheat toast all contain significantly less sodium per serving than the other options. Why should you care? Americans consume more than 3,400 milligrams of sodium a day on average—far above the American Heart Association's recommended daily limit of 2,300 milligrams and nearly double its ideal limit of 1,500. "All that sodium can raise blood pressure, a major contributor to heart disease," explains Cheryl Anderson, PhD, an associate professor at the University of California, San Diego School of Medicine. Try to eat mostly fresh food, and always check labels. Choosing foods that contain only one milligram of sodium per calorie or less— no more than 100 milligrams in a 100-calorie food, for example—can help you stay within healthy limits, says Anderson.
2. Which of these is not a risk factor for heart disease?
A. High blood pressure
B. Obesity
C. Migraines
D. Smoking
E. Diabetes
Answer: Trick question—they all might be. You can probably rattle off most risk factors by...well, heart, with the possible exception of migraines. But a Harvard study of more than 100,000 women recently found that migraine sufferers were 50 percent likelier to have a heart attack, a stroke or fatal heart disease, regardless of other risk factors. Genetics, hormones and inflammation all are possible culprits, but "the short answer is that we do not yet know what precise mechanism causes this," says lead researcher Tobias Kurth, MD, adjunct professor at the Harvard T.H. Chan School of Public Health.
3. True or false: Women need to start worrying about heart disease after they hit menopause.
Answer: False. It's believed that the drop in estrogen that accompanies menopause may make your blood vessels less elastic, increasing the strain on your heart. However, when researchers followed nearly 1,500 women over nine years, they found that in the years leading up to menopause, there was an increase in the severity of metabolic syndrome—a group of risk factors, including high fasting blood sugar and high blood pressure, associated with heart disease. This effect was even more pronounced in black women.
4. Your friend just betrayed you big-time! What's the heart-healthiest way to manage your anger?
A. Tell her off
B. Run it off
C. Walk it off
D. Find consolation in Ben & Jerry's
Answer: C. Taking a walk calms the fight-or-flight response, as do cooldown activities like stretching and deep breathing. Intense physical activity, on the other hand, can push your heart into the danger zone. "Anger triggers an adrenaline response that reduces blood flow to the arteries," says Donna Arnett, PhD, dean of the University of Kentucky College of Public Health. "Strenuous exercise in this state is incredibly taxing on the heart." An Australian study found that the risk of a heart attack was more than eight times higher when patients had been very angry in the two hours before the onset of symptoms, while another recent study showed that the risk tripled in those who experienced anger and heavy exertion in the hour before.
5. Attention, workaholics: How many hours can you clock each week before your heart pays a price?
A. 45
B. 50
C. 55
D. 60
Answer: A. When researchers at the University of Texas Health Science Centers and the University of St. Thomas in Houston analyzed data on more than 1,900 people, they found that among people who worked over 45 hours per week for a decade or more, each additional hour meant greater risk of heart disease. Risk climbed 16 percent when people put in 55 hours and 35 percent for 60 hours.
6. Which of the following could be an early warning sign of a heart attack?
A. Anxiety
B. Nausea
C. Jaw pain
D. Fatigue
E. Sweat
Answer: All of them, again (are you onto us?). "It's hard to parse some of these symptoms because women tend to be juggling so much as a matter of course," says Arnett. Three questions to ask: Is this a new symptom? Did it appear suddenly? Does it resolve if I rest for a few minutes? "When in doubt, call an ambulance," she says. "If the worst-case scenario is wasting time at the hospital, that's far better than the alternative."
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