5. Excess body weight and abdominal fat
Excess body fat, particularly around the abdomen, is associated with a higher risk of high blood pressure, insulin resistance, abnormal cholesterol, and type 2 diabetes.
These conditions can combine to increase the likelihood of coronary artery disease.
Weight management should not be approached through extreme diets or unrealistic targets. Gradual, sustainable changes in eating habits and physical activity are generally more beneficial.
For some people, medical treatment may also be appropriate, depending on their health history and overall risk.
6. Physical inactivity
Regular movement helps maintain healthy blood pressure, improve insulin sensitivity, support weight management, and improve cardiovascular fitness.
A sedentary lifestyle, on the other hand, is associated with a greater risk of cardiovascular disease.
People who spend most of the day sitting may benefit from introducing short periods of movement throughout the day, even if they cannot immediately begin a formal exercise program.
Walking, cycling, swimming, dancing, and other activities can all contribute to better heart health.
7. Family history and age
A family history of premature cardiovascular disease can increase a person's risk.
For example, having a close relative who experienced a heart attack at a relatively young age may suggest inherited susceptibility to high cholesterol or other cardiovascular conditions.
Age also matters. The risk of coronary artery disease generally increases as people get older.
Although these factors cannot be changed, knowing about them can help individuals and healthcare professionals make better decisions about screening and prevention.
8. Chronic stress and poor sleep
Long-term stress can influence cardiovascular health through several pathways. It may contribute to elevated blood pressure, poor sleep, unhealthy eating habits, smoking, and reduced physical activity.
Sleep disorders, particularly obstructive sleep apnea, are also associated with increased cardiovascular risk.
Stress alone does not mean that someone will have a heart attack. However, persistent stress and poor sleep can make other risk factors more difficult to manage.
Establishing a consistent sleep schedule, seeking support, and addressing underlying sleep disorders can be valuable parts of a heart-health plan.
Can a Heart Attack Be Predicted Through Medical Tests?
Although no single test can predict every future heart attack, several medical assessments can help identify cardiovascular risk and detect existing disease.
Blood pressure measurement
Blood pressure testing is one of the simplest ways to identify an important cardiovascular risk factor.
A healthcare professional may recommend repeated measurements, home monitoring, or ambulatory monitoring over a 24-hour period to obtain a more accurate picture.
Cholesterol testing
A lipid profile commonly measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
The results help clinicians evaluate cardiovascular risk and determine whether lifestyle changes or cholesterol-lowering medication may be needed.
Blood glucose and HbA1c testing
Blood glucose testing can identify diabetes or prediabetes.
HbA1c reflects average blood glucose over approximately the previous two to three months. It can help assess long-term glucose control and identify people who may need further evaluation.
Electrocardiogram
An electrocardiogram, or ECG, records the electrical activity of the heart.
It can help identify certain heart rhythm abnormalities and signs of a current or previous heart attack. However, a normal ECG does not rule out every heart attack or coronary artery problem.
Cardiac troponin testing
Troponin is a protein released into the bloodstream when heart muscle cells are injured.
Elevated cardiac troponin levels can indicate damage to the heart muscle. Doctors often use repeated blood tests to examine whether troponin levels are rising or falling.
Troponin results must be interpreted alongside symptoms, ECG findings, medical history, and other clinical information. An elevated result does not automatically mean that a person has had a heart attack, because other conditions can also injure the heart.
Imaging and additional investigations
Depending on the situation, doctors may recommend an echocardiogram, coronary CT angiography, stress testing, or invasive coronary angiography.
An echocardiogram uses ultrasound to examine the heart's structure and pumping function.
Coronary CT angiography can provide images of the coronary arteries and help identify plaque or narrowing in selected patients.
Invasive coronary angiography involves introducing a thin catheter into the blood vessels and injecting contrast material to visualize the coronary arteries. It is commonly used when doctors need to identify a blockage and may be followed by treatment during the same procedure.
Not everyone needs all these tests. The appropriate investigation depends on symptoms, risk factors, and clinical findings.
What Should You Do If You Suspect a Heart Attack?
Knowing how to respond can make a critical difference.
If you or someone nearby develops symptoms that may indicate a heart attack, do not wait for the symptoms to become severe.
1. Call emergency medical services immediately
In Vietnam, call 115 for emergency medical assistance.
Explain that a heart attack is suspected and describe the person's symptoms. Give the location clearly and follow the dispatcher's instructions.
Do not delay the call while searching online, contacting multiple relatives, or waiting to see whether the symptoms disappear.
2. Stop physical activity
The person should stop what they are doing and rest in a comfortable position, usually sitting or semi-reclining if that makes breathing easier.
Avoid walking around, climbing stairs, or attempting to drive.
3. Do not drive yourself to the hospital
An individual experiencing a possible heart attack should not drive themselves.
Symptoms can worsen suddenly, and dangerous heart rhythm disturbances may develop. Emergency medical teams can begin assessment and treatment during transport and arrange appropriate care at the hospital.
4. Follow professional advice about medication
Aspirin may be recommended in certain suspected heart attacks because it reduces the ability of platelets to form clots. However, it is not appropriate for everyone.
Follow the instructions of the emergency dispatcher or a healthcare professional. Aspirin may be unsafe for people with certain allergies, active bleeding, or other medical conditions.
Do not take someone else's prescription medication. If nitroglycerin has previously been prescribed for the person, it should only be used according to their medical instructions.
5. Stay with the person
If someone else is experiencing symptoms, remain nearby and monitor their condition.
If they become unconscious and are not breathing normally, call emergency services if this has not already been done, begin CPR, and use an automated external defibrillator (AED) if one is available. Follow the dispatcher's instructions.
If you are not trained in CPR, the emergency dispatcher can guide you through chest compressions.
These actions are important because a heart attack can lead to a life-threatening cardiac arrest.
Why Early Hospital Treatment Matters
A common expression used in cardiovascular medicine is that time is muscle.
It refers to the fact that heart muscle can be permanently damaged when blood flow remains blocked.
However, there is no single universal time limit after which treatment becomes pointless. Even when symptoms have been present for several hours, emergency assessment and treatment may still be beneficial.
In hospital, doctors first assess the patient's condition, obtain an ECG, and perform blood tests. If a heart attack is confirmed or strongly suspected, treatment depends on the type of heart attack and the available medical resources.
One common treatment for certain types of heart attack is percutaneous coronary intervention, often called PCI.
During this procedure, a cardiologist guides a thin catheter through a blood vessel toward the affected coronary artery. A small balloon may be inflated to open the narrowed area, and a metal mesh tube called a stent is often placed to help keep the artery open.
For certain heart attacks, particularly ST-elevation myocardial infarction (STEMI), rapid restoration of blood flow is especially important. Primary PCI is generally preferred when it can be delivered within the recommended timeframe.
In some situations, clot-dissolving medication may be considered when timely PCI is unavailable and the patient is eligible.
Other treatments may include antiplatelet medicines, anticoagulants, cholesterol-lowering drugs, and medications that reduce the heart's workload.
The exact treatment plan depends on the patient's condition, the location and severity of the blockage, and the presence of complications.
Recovery After a Heart Attack: What Happens Next?
Surviving a heart attack is only the beginning of the recovery process.