Myths and Facts About Heart Disease: What You Should Know

Every year more than 800,000 Americans have a heart attack. That’s a scary statistic, but there’s good news: Over the past decade we’ve learned a lot about what causes heart attacks, how to prevent them, and how to treat them. 

Even so, confusion remains. And misunderstandings about what does and doesn’t put you at risk for heart disease can be harmful. 

Let’s look at four common myths so you can keep your ticker in tip-top shape.

Myth 1: Being thin saves you from heart disease

Fact: your weight doesn't predict your heart health.

“I’m thin, so there’s no way I have heart disease.” Maintaining a healthy weight— with a body mass index (BMI) between 20 and 25—is recommended for everyone, but your weight doesn’t predict your heart health. 

Being slim doesn’t mean you can’t have heart disease. In fact, you can have high cholesterol even if you’re at a healthy weight, due to risk factors such as age, lifestyle, and family history. Behaviors that increase your risk for heart disease include smoking and inactivity. 

Recent research finds that a sedentary lifestyle, especially in middle age and beyond, can increase the risk of a heart attack in a person that is a healthy weight to that of someone who is overweight. 

For women, one risk factor is being postmenopausal. “Premenopausal women may have normal cholesterol levels, but then postmenopause cholesterol can rise significantly because of hormonal changes,” explains Sophia Chang, MD, MPH, internist, and Chief Clinical Informatics Officer at Clover Health. 

Dr. Chang recommends that both men and women get regular cholesterol screenings to track any changes in their low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels, as well as their triglycerides. 

If your doctor spots any red flags in your results, lifestyle changes and medication can improve your cholesterol counts. 

Myth 2: Heart attack symptoms are the same for everyone

Fact: Not everyone who has a heart attack will have the same symptoms at the same intensity. 

“Heart attack symptoms are the same for everyone.” The classic signs of a heart attack are pain in the arm, neck, or jaw, as well as shortness of breath. But not everyone who has a heart attack will have the same symptoms at the same intensity. 

Some heart attacks strike suddenly, while others cause symptoms across hours or days. 

“For many people, they don’t actually feel any pain, but they might feel a pressured sensation in their chest, or they might feel something in their neck but not in their arm,” explains Kumar Dharmarajan, MD, MBA, cardiologist, geriatrician, and Associate Chief Medical Officer at Clover Health. 

“For some older adults, women in particular, there may be more atypical symptoms of a heart attack, like weakness, fatigue, or nausea,” he adds. 

Dr. Chang says she’s had patients who are regular exercisers and suddenly notice significant fatigue during a typical workout. “They might chalk it up to age or having an off day, when it turns out it could be their left anterior descending artery,” she says. 

While you shouldn’t be alarmed anytime you feel tired or nauseous, it’s probably better to err on the side of caution if you’re older or have known risk factors for heart disease—especially if you’ve had a previous heart attack. 

“Sometimes people know that their symptoms are not normal, but they think, ‘Oh, I’ll see if it goes away or maybe I need a nap,’ when instead they should call their doctor. If we can catch it early, we can save your heart function,” explains Dr. Chang. 

Heart Health Tip: Have a cholesterol screening every five years. If you have heart disease risk factors, talk with your doctor about getting tested more often. 

Myth 3: My parents had heart attacks, so there’s no way I can avoid heart disease

Fact: Even people with a family history of heart attacks or heart disease can lower their risk significantly by working on things in their control.

“My parents had heart attacks, so there’s no way I can avoid heart disease.” The understanding of what causes heart disease and how it can be prevented has come a long way since our parents’ generation. Even people with a family history of heart attacks or heart disease can lower their risk significantly by working on things in their control.

While we can’t change our family history or age, we can work on eating more whole grains, fruits, and leafy green vegetables. We can add more healthy fats like those in olive oil, avocado, and salmon. Staying active and quitting smoking are other important ways to improve your cardiovascular health. 

Also, don’t forget that your parents had their own lifestyle choices to consider. “Our parents may have had a heart attack or heart disease, but it could have been because of their behaviors, like smoking cigarettes or eating a high-fat diet or having high blood pressure that wasn’t managed well,” adds Dr. Dharmarajan. 

Furthermore, there have been major advances in preventing and treating heart disease that may not have been available to older family members. Today there are medications and procedures that help to prevent heart attacks.

Myth 4: I’ve had a heart attack, so I can’t exercise

Fact: Exercising immediately after a heart attack is not recommended, but once your doctor gives you the all-clear, being active is not only safe but actually helps people feel better and get healthier. 

“That’s the whole reason cardiac rehab exists,” explains Dr. Dharmarajan. “It’s a well- studied intervention that is used after someone has a heart attack, and it’s also been shown to reduce the risk of future heart attacks and improve quality of life.” 

A recent study in the Journal of the American Medical Association found that among participants with diabetes, bicycling regularly lowered the risk of cardiovascular disease. And if cycling isn’t your thing, remember that any physical activity counts. 

Dr. Dharmarajan recommends doing any activity that makes you

happy. “It could be yoga, it could be walking, it could be swimming, it could be playing ping-pong. Whatever you’re comfortable with and enjoy is the thing you’re most likely to stick with.” 

Vicki’s Story

Vicki Soll, a technology consultant in San Jose, California, was a healthy and fit 53-year-old when she was surprised by an unexpected cardiac emergency. Now in her 60s, she enjoys a full and active life. Here’s her story: 

“I’ll never forget that Thursday evening when I suddenly felt this intense burning in my upper chest, neck, and jaw, accompanied by pain radiating down my left arm.”

“At the ER I had the usual workup, but because my blood work was normal, I was sent home. When I saw my cardiologist a few days later, though, I failed my stress test after three minutes. I was sent back to the ER, where I was diagnosed as having had a heart attack. I was diagnosed with SCAD (spontaneous coronary artery dissection).”

“I had five stents placed in one of my arteries and attended cardiac rehab sessions twice a week for three months. Today I exercise six days a week for roughly 45 to 55 minutes. I’ve also modified my diet somewhat to reduce the amount of dairy and animal fat I consume.” 

“I was lucky. I made a full recovery and have gone on to live a full and active life, but my story could have ended very differently.” 

While it can happen to anybody, SCAD is most common in women who are in their 40s and 50s. Symptoms are caused by slowed blood flow to your heart and include chest pain, shortness of breath, nausea, pain in your arms, and extreme fatigue. Seek medical care if you experience these signs of heart trouble. 

This article was originally published in the winter 2022 issue of Clover Living magazine. Want to see more articles like this? Subscribe to Clover Living magazine for free (if you aren’t already subscribed) here.

 

This article was medically reviewed by Dr. Kumar Dharmarajan and Dr. Sophia Chang.

Published 2/16/22

Illustration by Sébastien Thibault