According to the CDC, heart disease is the leading cause of death for men, women and people of most racial and ethnic groups in the United States. That’s why it’s important to know the signs of a heart attack, when to be extra careful and how to avoid heart-related illnesses.

“Talking about heart health is very important, and in some instances, it can be lifesaving,” said Dr. Thomas Kurian, a cardiologist at Cardiovascular Specialists of Lawrence. “When you are doing strenuous activity or just anything in general, symptoms of a heart attack could be anything like chest pains or discomfort that extends to the arms, neck, back (or) between the shoulder blades. If these symptoms last longer than five to 10 minutes, this could be the signs of a heart attack.”

It’s also important to note the signs of angina. Kurian said angina happens when a narrowed coronary artery restricts blood flow to the heart. It can be a precursor to a heart attack.

Kurian said angina can sometimes happen during physical exertion, but that it can also happen in people who aren’t doing any strenuous physical activity. He said the symptoms can include severe pain, discomfort or pressure in the chest, neck, back, arm or jaw.

Angina will sometimes disappear spontaneously in a few minutes, but Kurian said it’s important to seek help regardless because it could be the first sign of a heart attack.

“A heart attack is essentially a case where angina persists and does not seem to go away,” he said. “It can increase and decrease, but it never fully goes away, and this can be the sign of a heart attack in progress.”

Cold weather raises risk

When temperatures get colder, the risk of heart-related problems gets greater, for a number of reasons.

Kurian said cold weather causes blood vessels to constrict. That can raise blood pressure, which then increases the risk of heart attacks and strokes.

He said the heart also tends to work harder during the winter to maintain a stable body temperature, and that this is especially true during outdoor activities in cold weather. 

“This increased work of the heart means the heart needs more blood supply for performing a more intense workload,” Kurian said. “This, too, can cause episodes of angina, which is essentially a cry for help that your heart needs more blood supply.”

Cold weather isn’t the only thing that can increase risk of heart problems in the winter. Kurian said that winter can be a stressful time for many people, and that stress can be taxing on your heart. He also urged caution when doing strenuous activities during winter weather, such as shoveling snow.

“Shoveling, changing tires in the cold or pushing a vehicle that was stuck in a snowdrift are not only taxing activities but also correlate with high levels of stress,” Kurian said. “Add that onto the already present stress of the holidays, and you may experience an increased overall level of stress hormones. All of this in conjunction can lead to the rupture of preexisting atherosclerotic plaques. Plaques such as these are a build-up of cholesterol and inflammation in the wall of a blood vessel. The rupture could form a clot and cause stoppage of blood flow to a coronary blood vessel, thus marking the beginning of a heart attack.”

Don’t wait

Angina is more of a warning sign, but a heart attack can leave permanent heart damage. 

“Full damage to the heart can take six to 12 hours,” Kurian said. “If a patient seeks early medical attention, the damage can be greatly limited. In some cases, when people have sought help early, the damage can be very small — so small that it can be as though the heart attack did not even happen.

“When symptoms last five to 10 minutes or longer, it is time to seek medical attention,” Kurian said. “The people who seek treatment fast can have significantly better results. The quicker, the better.”

Kurian said it is imperative to call 911 immediately if you think you’re having a heart attack. 

“Do not wait, do not drive yourself and do not have someone else drive you,” he said. “Call 911 immediately and get the help you need. Heart attacks can bring the dreaded irregular heartbeat, which can cause sudden death. I cannot stress enough the importance of not being hesitant.”

It’s especially important to call an ambulance, Kurian said, because then your treatment can get started before you even get to the hospital.

“When you call 911 and are transported in an ambulance, they can often care for you while on the way to the hospital,” Kurian said. “Often the EKG is taken in the ambulance. The paramedics can assess your situation then and there and will contact the hospital to warn them you are coming. The team in the emergency department can prepare and equip their team to handle your care right away.”

Once a patient arrives at the hospital, Kurian said treatment often involves clot-busting medicines and heart catheterization to get the blocked artery open.

“Timeliness can be lifesaving, and the heart muscle can be saved,” he said.

Reduce your risk

Kurian shared a few suggestions to reduce your risk of heart problems:

• Maintain a healthy diet and exercise regularly.

• Manage your stress levels.

• Know your levels of cholesterol and sugars and your family history.

• In the winter, dress in warm clothes and pace yourself during strenuous outdoor work such as shoveling.

• Avoid excessive alcohol consumption.

• Take precautions against COVID-19.

• Take vitamin D if it’s suggested by your primary care provider.

• Get help immediately if you think you’re having a heart attack.

“Take care of yourself during these winter months, and remember, do not wait,” Kurian said. “Watch for symptoms and warning signs and listen to your body. Call 911 and get the care you need.”

— Jessica Thomas is the social media and digital communications specialist for LMH Health, which is a major sponsor of the Journal-World’s Health section.