A heart attack is the most common cause of death in the United States. Every minute of the day, someone dies from a heart attack, and early treatment is crucial for these patients. Prompt cardiopulmonary resuscitation, or CPR, can save a life.

Chest pain or heart attack? What's the difference?
Chest pain occurs when the arteries that carry blood to the heart muscle are blocked by disease, thereby preventing the heart from getting the oxygen it needs to work. Exertion (or stress) compounds this problem by making the heart work harder. This creates chest pain called angina. People with this kind of chest pain are more likely to die from a heart attack.

A heart attack occurs when the heart muscle does not get the blood it needs for nourishment. The heart depends on special blood vessels, called coronary arteries, to provide nutrition and oxygen. If these arteries become blocked, the part of the heart that depends on them can become injured. Permanent injuries to the heart muscle can Ðresult in a heart attack.

Because chest pain can indicate potential heart problems, people worry when they or their loved ones develop chest pain. It is important to know that most chest pain is not caused by heart problems. There are many people who have chest pain even though they have normal hearts, just as there are people with heart disease who have unusual symptoms or no pain. Sometimes the symptom is similar to nausea, or breathlessness. Sometimes it is only felt in the back, arm, or jaw, and not in the chest. While it is impossible to know without doing specific tests if chest pain is heart-related, we know the following about angina:

• The pain of angina usually feels like a squeezing or pressure sensation in the chest. It usually occurs with exercise and goes away with rest, but can begin when lying down.
• Angina is usually felt in the center of the chest, but can also go down the arm or elbow, up into the jaw, into the back, or into the neck.
• People who have angina usually know what activities bring on the pain and what stops it.
• Pain that comes on when a person is not exercising or is sleeping is probably not angina, but might be.

The only way to know for sure if chest pain is caused by heart disease is to be evaluated by a doctor and undergo certain tests. Keeping track of your pain is helpful in the evaluation process. Write down everything you experience when you have a bout with pain, including:

• when it occurred
• what the pain feels like (such as stabbing or dull)
• how long it lasts and how often it occurs
• where it hurts
• what makes it better or worse

When to call 9-1-1
Although heart attack symptoms vary from individual to individual, in general they include:

• an uncomfortable squeezing heaviness or pressure sensation in the chest that lasts more than a few minutes or goes away and comes back
• chest pain that also goes to the arms, shoulders, back, neck, jaw, or elbows
• chest pain with sweating, nausea, shortness of breath, lightheadedness, or fainting
• new chest pain in a person who has already had a heart attack
• sudden beginning of confusion, dizziness, or extreme weakness
• pain or shortness of breath with indigestion or after a large meal or
• chest pain with use of cocaine, methamphetamines, or other drugs

Not all these warning signs will occur. If any of these signs last more than a few minutes, take immediate action, by calling 9-1-1.

People with angina have a higher chance of having a heart attack. Should a heart attack occur, early treatment can reduce the damage to the heart muscle and, possibly, save a life. Signs of a heart attack include angina pain that is worse than usual or pain that does not go away with medicine or rest. If the pain changes and becomes more frequent or comes on with less exertion, a health care provider should be contacted immediately.

What is a Chest Pain Center?
A chest pain center is an area within an emergency treatment center that is specifically designed to diagnose chest pain. At a chest pain center, patients are evaluated for a heart attack and observed for an eight to twelve hour period to better determine if they need a hospitalization or if they can be safely discharged. Studies have shown that making the diagnosis of a heart attack upon initial arrival at an emergency room can be very difficult. Chest pain centers adequately allow physicians to properly diagnose and treat chest pain patients.

At University of Iowa Hospitals and Clinics, patients will also receive a cardiac risk assessment, healthy heart education, and counseling by a cardiac rehabilitation specialist. The goal is to provide custom strategies for reducing their risks of coronary artery disease.

Decrease your risk for a heart attack
Although some risk factors such as having a family history cannot be changed, there is plenty that you can do now to make your heart healthier. The American Heart Association recommends several steps that can be taken to prevent heart attacks:

1. Quit smoking. If you smoke, STOP NOW. A smoker's chance of heart attack is greatly increased over that of a nonsmoker. Smoking is the biggest risk factor for sudden death. One in five deaths from heart disease is credited to smoking.
2. Lower your blood cholesterol level if it is high. Have your blood cholesterol checked. The risk of a heart attack rises as blood cholesterol increases. The risk is even greater when other risks, such as high blood pressure and smoking, are also present. A diet high in saturated fat and cholesterol raises blood cholesterol. A diet low in saturated fat and cholesterol usually lowers it.
3. Exercise regularly. Lack of exercise is a risk factor for heart disease. The heart is a muscle and if it is out of shape, it does not work as well as it should.