A heart attack can happen to anyone.
If you’re thinking, “I exercise, eat well, maintain a healthy weight … I’m definitely not at risk,” then you’d be on the same page as celebrity personal trainer Bob Harper, before he suffered a heart attack last year at 52 years old.
NBC News BETTER caught up with Harper as he shared his story to promote a project with AstraZeneca called Survivors Have Heart, an essay contest where heart attack survivors can share personal stories of their journey.
"On February 12 of last year I was in the gym, the next thing I knew I woke up in a hospital two days later being told that I had a heart attack and that I immediately went into cardiac arrest. Talk about a life-changing experience," says Harper.
Harper's not alone. According to the CDC, 735,000 Americans have a heart attack each year and of these, 525,000 are a first-time heart attacks.
And believing that you are aren’t at risk is the number one biggest misconception, says Dr. Warren Wexelman, a cardiologist with NYU Langone School of Medicine and Medical Center and President of the American Heart Association in Brooklyn. “It’s not the question of who is at risk, but who isn’t? The answer is everybody is at risk,” he says. “There is no one who is immune from heart disease. Heart disease is one of the most equal opportunity killers there is. It is the largest killer of human beings in the United States.”
A 2005 survey found that only 27 percent of respondents were aware of all the major symptoms of a heart attack and knew to call 911 when someone was having a heart attack.
“The reason why so many heart attacks are still fatal before a patient ever gets to the hospital is because they want to deny the symptoms. They don’t want to give in to the fact that they may be sick and they put their lives in danger for it,” says Dr. Wexelman.
The most common symptoms of heart disease are chest heaviness and tightness that gets worse when you exert yourself, shortness of breath (sometimes that’s the only symptom), palpitations and some people get very sweaty along with the chest pain, which is a major red flag, says Wexelman. But, he adds, “heart diseases are interesting, it’s different in everybody, no blockage is the same, nobody experiences it the same, so when people complain of any discomfort in the chest, back, neck or arm, especially when it comes on with exertion, it needs to be evaluated right away.”
For Harper, dizziness was the main symptom that presented itself. “Bob had dizziness for several episodes that got him down on to the floor, and that’s a very bad sign of the disease that he had,” says Wexelman. “And that’s what nearly killed him: he got dizzy while he was exercising at the gym, he dropped to the floor and two days later he woke up. The only reason he was really able to wake up was because of his amazing physical condition. The average individual would’ve never gotten through that.”
Being a Woman is Major Risk Factor
For many years, heart disease was seen as a man’s problem. Women got a free pass, says Wexelman, but the tides have changed. Today, 90 percent of women have one or more risk factors for heart disease or stroke, and fewer women than men survive their first heart attack, according to the American Heart Association.
“It’s interesting because in my work with the American Heart Association, you can’t get people emotional about heart disease. If you talk to women about breast cancer, it’s an emotional thing. You can cut the emotion with a knife. When you talk about heart disease it’s ‘Oh, you know, my uncle had a heart attack, my neighbor had a heart attack, they are back to work, they’re fine, it’s all good.’ There’s no emotion. But the reality here is that 1 out of every 8 women could perhaps get breast cancer, 1 out of every 3 women will die of a heart attack or stroke in the US. That is huge."
1 out of every 8 women will get breast cancer; 1 out of every 3 women will die of a heart attack or stroke in the US.
What has prompted this change? "Women are running the world. They are running for president, they are running corporations, they are out in the workplace and doing what they used to do before, taking care of families and keeping up their home," says Wexelman. "Stress levels are high, their diets aren’t so great, and men and women are dying of heart diseases now equally, whereas before it was anywhere from 4 to 6 times the amount of men than women. Being a female now is an actual risk factor for strokes in people with [irregular heartbeat]. We need to develop the emotion: Heart disease is still the number one killer of human beings in the United States and that’s just a damn shame because there’s so much we can do about it.”
Heart attack prevention tips
The statistics are scary, but there are also some promising stats that show taking actionable steps to keep your ticker healthy — and nip problems in the bud if they arise — does make a difference. In fact, 80 percent of heart disease and stroke events may be prevented by lifestyle changes and education.
- Listen to your body. "My symptoms were different than the traditional chest pain, numbing in the arm, the headaches ... I didn't experience any of those. But what I did experience were dizzy spells. Six weeks prior to my heart attack I was in Los Angeles in the gym and I fainted and that was the start of this whole roller coaster ride. I wasn't listening to my body like I always tell every person I've ever worked with that they needed to do. Dr. Wexelman said something that I found really profound but so simple: 'If something is going on, it's not going to go away you need to get it checked out.'" The reason why so many people end up in more trouble than they should be and with more damage, is because they have symptoms for a long time and ignore them, says Wexelman. "There are many diverse symptoms; if you're not feeling right, that's the time to go to the doctor," he says.
- Know your family history. “The most important way to deal with that risk is by going to the doctor, getting checked, making sure that your family history is known," says Dr. Wexelman. “Bob had a family history of his mother dying from a heart attack at 70, his grandfather dying of it, and his cholesterol was quite high despite all the exercise.”
- Get a good yearly history and physical examination. “The most important thing is to first get to the doctor, establish the relationship, get a full history physical and blood work, and then determine what your real risk of heart disease is,” says Wexelman.
- Ask the right questions. “There are three important questions to ask when you go to the doctor that usually determine what the doctor and you will do as partners. And these three questions are just never asked,” says Wexelman. “They are: What’s wrong with me and why am I feeling this way? What do we do about it? And what does this mean to me in the long run? So if patients are feeling chest pain or shortness of breath or even fatigue – you can’t ignore it, and you have to ask the doctor to pursue it."
- Get a fitness Rx. “Doctors tell patients to go get exercise, but they don’t tell them how much, what’s right for them, etc.” says Wexelman. “Everyone has an exercise prescription and it’s just like a medication prescription: how often, for how long, what type of exercise and how to get your training heart rate up appropriately.”
Survivor basics: moving forward after a heart attack
Suffering a heart attack is a significant event – one that inevitably changes your outlook on life and your daily routine.
"I was told information incrementally. So I wasn't told that I actually on my file a 'cause of death.' When I found that out, it was a lot of information to take in," says Harper. "I've always been a person that was so driven and type A and I have my routine, which I love, and when all of that was taken away from me and my whole identity of fitness was taken away, I went through an identity crisis. I didn't know who I was and it became a journey for me. I was going through this new life of mine and having to rediscover different sides of me. It was really hard. It was really emotional; I went through a lot of depression because of it."
I've always been a person that was so driven and I have my routine, which I love. When all of that was taken away from me, I went through an identity crisis.
But as jarring of an experience as it can be, Wexelman stresses that it isn’t a death sentence, it’s actually quite the opposite. “The first misconception is that if you’ve had a heart attack, it’s the end of your life,” he says. “It’s actually the beginning of a better, healthier life. There’s nothing to say that you can’t do the same things after a heart attack as before.”
But you do have to do it appropriately, he says. Here are some of Harper and Wexelman’s expert tips for living your best life post-heart attack.
- Ask about cardiac rehab. "I was afraid to go to the gym. It took time and confidence. I was afraid to get my heart rate up," says Harper. "Cardiac rehab really saved my life, the care that I got, the attention and confidence that I got again from the help of my cardiac rehab team was so beneficial." Wexelman agrees: "You find so many heart patients that have never been at a cardiac rehab. If you have heart disease, or have had a heart attack, ask a doctor to get you in cardiac rehab. What it does is it allows you to exercise under a monitored circumstance so that you can build yourself back up safely. And that's the way to get back to normal life."
- Change your exercise and diet. "I still do Crossfit, I love it, but I do it at a lower intensity. I incorporate a lot more yoga. One thing I did in my rehab was I walked my dog a lot, and I still do that. It's very cathartic, therapeutic, it makes me feel good. In terms of eating, I had to struggle because I thought I knew how I should be eating. I was a big carnivore before. I worked with my cardiologist and what we came up with for me was to be more plant-based, leaning towards a Mediterranean lifestyle. I am really aware of the fats that I consume, even the good fats. Since my heart attack I haven't had any red meat at all. I'll have fish ... Greek yogurt ...egg whites." Wexelman echoes this sentiment: “Eating correctly is crucial; keeping your weight down and making sure you eat a balanced diet. I personally like plant-based diets, more of a Mediterranean kind of diet for everybody,” he says. “Exercise is also important; follow the exercise prescription of your cardiologist, [which should be] 5-7 days a week of 30 to 60 minutes of exercise.”
- Listen to your healthcare team. “Out of the 790,000 heart attacks in the US every year, 210,000 of them are second heart attacks. There’s much more of a chance of getting a second heart attack within a year of your first. So that’s why you need to be under care,” says Wexelman. And Harper agrees: “I used to be afraid of doctors. I avoided them. I had something called 'white-coat syndrome;' every time I'd go into get my annual they'd have to sit me down for awhile to calm my nerves. Now, I am so comforted by doctors; I love them. I really do wish that people could have that kind of relationship with their doctor. It's important to have a doctor with a rally good bedside manner who is there for you and cares."
- It’s not all physical — be aware of your mental health, too. "One of my tips is something that is so simple: Breathe," says Harper. "And what I mean by that is to find ways that you can manage your stress. I do meditation; maybe it's yoga, taking your dogs for a walk, or playing with your kids in the park. Whatever you can do to manage that stress. You're going to be doing so much more good for your body than you even know."
- Let it change you. "I don't want to say it woke me up, because I was already 'woke,'" says Harper. "But I became so much more aware of how precious this life is and that life can turn on a dime and lights can go out before you know it. I found that I'm much more appreciative and much more passionate. Once you've had a heart attack, and survive it, you're part of the club — the heart attack survivors club — you want to be able to get the message out to help people as much as you can."
- Live your life. “It’s very simple to be treated after a heart attack: You’re given medicine and exercise prescriptions, you keep in touch with your doctor and you live your life,” says Wexelman. “The most common thing that people do after a heart attack is go back to living their lives.”