Heart Health Resource Page

Heart Disease Signs and Symptoms	Heart Disease Facts
Heart Disease Fact Sheet	Other Conditions and Related Terms
Heart Disease FAQs

Heart Disease Signs and Symptoms

Heart Attack Signs

If the blood supply to the heart muscle is cut off, a heart attack can result. Cells in the heart muscle do not receive enough oxygen and begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. Having high blood pressure or high blood cholesterol, smoking, and having had a previous heart attack, stroke, or diabetes can increase a person’s chances of having a heart attack.

According to the American Heart Association, about 700,000 Americans have an initial heart attack and another 500,000 have a recurrent heart attack each year. According to a CDC report, almost half of the cardiac deaths in 1999 occurred before emergency services and hospital treatment could be administered.

It is important to recognize the signs of a heart attack and to act immediately by calling 9–1–1. A person’s chances of surviving a heart attack are increased if emergency treatment is given to the victim as soon as possible.

Symptoms of a Heart Attack

The National Heart Attack Alert Program notes these major symptoms of a heart attack:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath. This often comes along with chest discomfort. But it also can occur before chest discomfort.
Other symptoms. These may include breaking out in a cold sweat or feeling nausea or light–headedness.

Heart Disease Facts

Heart disease is the leading cause of death for both women and men in the United States.
In 2002, 696,947 people died of heart disease (51% of them women). This was 29% of all U.S. deaths. The age-adjusted death rate was 241 per 100,000 population.1
Heart disease is the leading cause of death for American Indians and Alaska Natives, blacks, Hispanics, and whites. For Asians and Pacific Islanders, cancer is the leading cause of death (accounting for 26.1% of all deaths), heart disease is a close second (26.0%).1
Heart disease crude death rates per 100,000 population for the five largest U.S. racial/ethnic groups are as follows: Hispanics, 72; Asians and Pacific Islanders, 78; American Indians, 80; blacks, 206; and whites, 259.1
In 2002, age-adjusted death rates for diseases of the heart were 30% higher among African Americans than among whites.2 Age-adjusted rates are used to compare populations with differing age distributions.
By state, age-adjusted death rates per 100,000 for diseases of the heart ranged from 165 (Minnesota) to 327 (Mississippi) in 2002.3
Coronary heart disease is the principal type of heart disease. There were 494,392 people that died from coronary heart disease in 2002. That is about 71% of all heart disease deaths.4
It is estimated that about 47% of cardiac deaths occur before emergency services or transport to a hospital.5
In 2006, heart disease is projected to cost more than $258 billion, including health care services, medications, and lost productivity.6
Worldwide, coronary heart disease kills more than 7 million people each year.7
Risk factors for heart disease among adults (for years 1999–2002 unless noted):2
Percentage of persons aged 20 years and older with hypertension or taking hypertension medications: 30.2%

Percentage of persons aged 20 years and older with high blood cholesterol: 17.3%

Percentage of persons aged 20 years and older with physician-diagnosed diabetes: 6.5%Percentage of persons aged 20 years and older who are obese: 30.5%

Percentage of adults aged 18 years and older who are current cigarette smokers (2003): 21.6%

Percentage of adults aged 18 years and older who engage in no leisure-time physical activity (2003): 37.6%
In 2003, approximately 37% of adults reported having two or more of six risk factors for heart disease and stroke (high blood pressure, high cholesterol, diabetes, current smoking, physical inactivity, and obesity).8
Timely access to emergency cardiac care and survival is partly dependent on early recognition of heart attack symptoms and immediate action by calling emergency services. In a 2001 survey, most persons (95%) recognized chest pain as a heart attack symptom, but only 11% correctly classified all symptoms and knew to call 9–1–1 when someone was having a heart attack.9
Studies among people with heart disease have shown that lowering high blood cholesterol and high blood pressure can reduce the risk of dying of heart disease, having a nonfatal heart attack, and needing heart bypass surgery or angioplasty.
Studies among people without heart disease have shown that lowering high blood cholesterol and high blood pressure can reduce the risk of developing heart disease.

Heart Disease Fact Sheet

http://www.cdc.gov/DHDSP/library/fs_heart_disease.htm

Other Conditions and Related Terms

Coronary Heart Disease (CHD)

CHD is the most common type of heart disease. CHD occurs when the coronary arteries, that supply blood to the heart muscle, become hardened and narrowed due to the plaque buildup. The plaque buildup and the narrowing and hardening of the arteries is called atherosclerosis. Plaques are a mixture of fatty substances including cholesterol and other lipids. Blood flow and oxygen supply to the heart can be reduced or even fully blocked with a growing plaque. Plaques may also rupture and cause blood clots that block arteries.

CHD can lead to a heart attack. Angina can also occur. Angina is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. Over time, CHD can weaken the heart muscle and lead to heart failure, a serious problem where the heart cannot pump blood the way that it should. Also, irregular heart beats, called arrhythmias, can develop.

The most common symptom of CHD is angina. In some people the first sign of CHD is a heart attack. Doctors can assess a patient’s risk status by checking several factors, including blood pressure, blood cholesterol and glucose, history of heart disease, and other factors. Doctors can perform several tests to assess CHD in patients who are at high risk or have symptoms. These may include one or more of these tests:

ECG or EKG (electrocardiogram), which measures the electrical function and the rate and regularity of your heartbeat.
Echocardiogram, which creates a picture of the heart.
Exercise stress test, to measure how well the heart pumps at greater than usual workloads when it needs more oxygen.
Chest x–ray, a picture of the organs and structures inside the chest.
Cardiac catheterization, a thin, flexible tube is passed through an artery in the groin or arm to reach the coronary arteries. The tube lets your doctor check the inside of your arteries to see if there is any blockage. Your doctor also can measure the pressure and blood flow in the heart’s chambers, collect blood samples from the heart, and examine the arteries of the heart by x–ray.
Coronary angiography, which is usually performed along with cardiac catheterization. A dye is injected through the catheter into the coronary arteries. The doctor can then take an x–ray to see the flow of blood through the heart and check for blockages.

For persons with CHD, treatment will involve addressing those factors that put them at risk for CHD and heart attack. The doctor may recommend lifestyle changes to help reduce risk. Medicines and medical treatments may be needed. Medicines are available to treat high blood cholesterol, high blood pressure, irregular heart beats, blood flow, and other potential problems. Some advanced treatments and surgical procedures may be used to help restore blood flow to the heart muscle.

In principle, all people can take steps to lower their personal risk of heart disease and heart attack by addressing their risk factors. People who already have heart disease especially need to control their risk factors.

Heart Attack

A heart attack is also called a myocardial infarction. If the blood supply to the heart is severely reduced or completely blocked, heart muscle cells may not receive enough oxygen and begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. This damage can cause irregular heart rhythms or even sudden cardiac arrest or stopping of the heart beat. Death can result. Coronary artery disease is the chief underlying cause of a heart attack. A less common cause of a heart attack is a severe spasm of a coronary artery that reduces the blood supply to the heart.

When a person is having a heart attack, emergency care is needed that may include cardiopulmonary resuscitation (CPR), electrical shock (called defibrillation), and other advanced emergency medical care. Emergency medical personnel and doctors can quickly perform emergency treatment and transport the person to the hospital. Bystanders might also be trained to perform CPR and to use an automated external defibrillator, if one is available, until emergency medical personnel arrive. Once at the hospital, doctors can perform several tests to quickly determine if the person is having or has had a heart attack and the best course of action to restore blood flow.

Because a heart attack is a medical emergency, it is important to recognize the signs and symptoms of a heart attack and to act immediately by calling 9–1–1. A person’s chance of surviving a heart attack is increased the sooner emergency treatment is administered.

A heart attack survivor may have a damaged heart that affects the heart rhythm, pumping action, and blood circulation. This puts heart attack victims at greater risk of having another heart attack or other events such as a stroke, kidney problems, and peripheral arterial problems. Cardiac rehabilitation is usually recommended for heart attack survivors after the emergency event has stabilized. Cardiac rehabilitation guides the patient to make changes that can help improve cardiovascular fitness and quality of life. These changes may include dietary changes, physical activity, smoking cessation, and other issues such as medication schedules and stress management. Heart attack survivors should seek their doctor’s advice about daily activities such as returning to work, driving, physical and sexual activity, and air travel.

Angina

Chest pain or discomfort that occurs when the heart muscle is not getting enough blood. Angina may feel like pressure or a squeezing pain in the chest. The pain may also occur in the shoulders, arms, neck, jaw, or back, and it may feel like indigestion. Angina is a symptom of coronary heart disease. Angina may be stable or unstable. Stable angina is chest pain that occurs on physical exertion or under mental or emotional stress. Unstable angina is chest pain that occurs even while at rest, without apparent reason.

Acute Coronary Syndrome

A term that is sometimes used to describe people who have either an acute myocardial infarction or unstable angina.

Aortic Aneurysm and Dissection

A condition where the aorta stretches or dilates (aneurysm) and ruptures (dissection). A ruptured aneurysm is an emergency situation.

Arrhythmias

Irregular, or abnormally fast or slow, beating of the heart. The heart beat is controlled by electrical impulses. When the timing or frequency of these electrical impulses are disrupted, arrhythmias develop. Some arrhythmias are quite serious. An example is ventricular fibrillation, a severely abnormal heart rhythm that causes death unless treated right away by providing an electrical shock to the heart (called defibrillation). Others are less severe but can develop into more serious conditions over time. A particular concern is atrial fibrillation. Atrial fibrillation is rapid, irregular beating of the upper chambers of the heart. The chambers can quiver instead of beating in a regular pattern. Blood is not fully pumped out of them and may pool and clot. For more information, see our atrial fibrillation fact sheet.

Cardiomyopathy

A weakening of the heart muscle or a change in heart muscle structure. It often results in inadequate heart pumping or other heart function abnormalities. These can result from various causes, including prior heart attacks, viral or bacterial infections, and others.

Congenital Heart Disease

Malformations of heart structures, present during pregnancy or at birth. These may be caused by genetic factors or by adverse exposures during pregnancy. Examples include holes in the walls that divide the heart chambers, abnormal heart valves, and others. Congenital heart defects can disrupt the normal flow of blood through the heart. Congenital heart defects are the most common type of major birth defect.

Heart Failure

This may also be called congestive heart failure or chronic heart failure. Heart failure is a condition where the heart cannot pump enough blood and oxygen to meet the needs of other body organs. Heart failure does not mean that the heart has stopped, but that it cannot pump blood the way that it should. Heart failure is a serious condition. There is no cure for heart failure at this time, except a heart transplant. Once diagnosed, medicines are needed for the rest of the person’s life. See our heart failure fact sheet.

Peripheral Arterial Disease (PAD)

Hardening of the arteries that supply blood to the arms and legs. PAD is usually the result of atherosclerosis, the buildup of plaque and narrowing of the arteries. Blood flow and oxygen to the muscles in the arms and legs can be reduced or even fully blocked. Painful leg muscles, numbness, swelling in the ankles and feet, and weak pulse in the feet are some of the signs and symptoms of PAD.

Rheumatic Heart Disease

This condition is damage to the heart valves and other heart structures due to inflammation and scarring caused by rheumatic fever, which occurs from streptococcal infection.

For More Information

Please see the following Web sites which have additional glossaries about medical conditions:

Heart Disease FAQs

What is Heart Disease?

Heart disease is a term that includes several more specific heart conditions. The most common heart disease in the US is coronary artery disease (CAD). CAD occurs when the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque. The narrowing and buildup of plaques is called atherosclerosis. Plaques are a mixture of fatty and other substances including cholesterol and other lipids. Blood flow to the heart is reduced, which reduces oxygen to the heart muscle. This can lead to heart attack. Other heart conditions include angina, heart failure, and arrhythmias. Find out more about heart diseases.

What are symptoms of heart attack?

The National Heart Attack Alert Program notes these major symptoms of a heart attack:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath. This often comes along with chest discomfort. But it also can occur before chest discomfort.
Other symptoms. These may include breaking out in a cold sweat or experiencing nausea or light–headedness.

What should a bystander do if they think someone is having a heart attack?

If you think that you or someone you know is having a heart attack, you should call 9–1–1 immediately.

Why is there a need to act fast?

Death or permanent disability can result from a heart attack. The risk of death or permanent damage can be reduced with timely treatment. Some newer treatments need to be given soon after the onset of a heart attack in order to be effective. It is important to know the symptoms of a heart attack and act right away.

What are the risk factors for heart disease?

Some conditions as well as some lifestyle factors can put people at a higher risk for heart disease. The most important risk factors for heart disease are high blood pressure, high blood cholesterol, cigarette smoking, diabetes, and obesity. In principle, all persons can take steps to lower their risk for heart disease. For more information about these risk factors, please see our section on risk factors.

What can you do to reduce your risk?

Persons can take steps to lower their risk of developing heart disease by preventing or treating and controlling high blood pressure, preventing or treating and controlling high blood cholesterol, by not using tobacco, by preventing or controlling diabetes, and by maintaining adequate physical activity, weight, and nutrition. Persons being treated for conditions or risk factors should follow the guidance of their health care providers. See our section on heart disease prevention.

What is the burden of heart disease in America?

Heart disease is the leading cause of death in the United States and is a major cause of disability. Almost 700,000 people die of heart diseases in the US each year. That is about 29% of all U.S. deaths. In addition, heart disease is a leading cause of disability in the US. See more statistical information.

What is the cost of heart disease for our nation?

According to the American Heart Association, all cardiovascular diseases together are projected to cost $403.1 billion in 2006, including health care services, medications, and lost productivity.

What is CDC doing to address heart disease?

CDC has several programs that address heart disease. These are mostly located in the Division for Heart Disease and Stroke Prevention. They include activities with other CDC components, other federal agencies, state health departments, and local and tribal organizations. For more information on these programs, please see our CDC Addresses Heart Disease section.