Question on risks : Hi, since I learnt... - British Heart Fou...

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Question on risks

Healing_Heart profile image
22 Replies

Hi, since I learnt that I had a HA, I’m totally obsessed with the idea of it reoccurring.

What I don’t know is whether having had a heart issue increases the risk of having another just by itself. Or whether now that we know we are at risk we can reduce the risk factors.

Sorry if im not making myself clear. I mean: are we LESS at risk after a first problem with adequate meds and lifestyle, or MORE than before we started having problems, even with meds?

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Healing_Heart profile image
Healing_Heart
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22 Replies
Happyrosie profile image
Happyrosie

my view is: You’ve had a warning. You can make changes to your lifestyle and diet, and medication and thus reduce the risk factors.

Sb1171 profile image
Sb1171

I would suggest that a heart attack often causes damage which might, in some cases, increase the risk of another directly, but not in others. Also some people are more disposed to heart issues than others. Someone who has already had one, is more likely to be one of those who are pre-disposed and therefore statistically more likely to have another. Some people seem to be able to smoke, drink and eat lard into their nineties with no problem. If you have had a HA you probably are not one of those people. While that is probably not the answer you wanted, I find it helpful to think of it another way. Now that you are carefully managing your risk factors and taking appropriate medication your personal risk of a heart attack is probably lower than it was before you had your first one.

DWizza profile image
DWizza

What sort of heart attack did you have ? I had an Nstemi, ( thought it was trapped wind) been told no damage to my heart . I had quadruple bypass surgery. Consultant said that as I was strong and fit I should make a full recovery and that I should look after my new pipes , keep them clear and they will be good for at least 20-25 years or longer. If it hadn’t been for the ambulance crew insisting ( although they said they couldn’t make me ) I went in for a trop blood test to confirm if a cardiac event had happened, the outcome would have no doubt been much worse , possible fatal. I am in a much better position now and feel very confident about the future . I was fit and strong prior to my heart attack , I’ve now embraced a better lifestyle and attitude (to stress) now I have been given this opportunity/re birth . 👍

Lowerfield_no_more profile image
Lowerfield_no_more

For whatever reason there was always the possibility you might have a heart attack. Then the possibility turned into a reality. From that time onwards assuming you have changed lifestyle where appropriate, body mass, diet, alcohol, smoking, exercise, etc, and been prescribed medication, together with any physical interventions such as stenting, the chances/possibility/risk of a further heart attack will have been reduced. However there may be some underlying physical characteristics concerning your heart that cannot be changed, such as damage to your heart arising from the HA . But what all this means is overall it is highly likely your heart health risk has improved and not worsened. So my suggestion is to get on and enjoy life, and don't get concerned about something that may never happen.

Healing_Heart profile image
Healing_Heart in reply to Lowerfield_no_more

Thank you so much 🙏 . I know I need to quit this state of doom and gloom, hopefully as time goes by I’ll manage to spend longer moments without thinking of it.

tannery profile image
tannery in reply to Healing_Heart

Hi - I had a HA 22 years ago and can still remember the doom and gloom of the weeks and months which followed but as time went on this reduced as I got back into life. Take care of yourself and try and think positive from what was a tramatic experience, what you are feeling is natural. I wish you well in recovery and developing a positive outlook to life.

Chappychap profile image
Chappychap

"What I don’t know is whether having had a heart issue increases the risk of having another just by itself. Or whether now that we know we are at risk we can reduce the risk factors."

I don't think it's an "either/or" type question. Yes, having had a heart attack we're at a higher risk of another heart attack. But it's also yes, we can mitigate that risk with both medication and with life style changes.

The main tool that a British doctor uses for quantifying heart attack and stroke risk is the QRisk3 process. It's all public domain so you can check your risk factors for yourself. According to QRisk3 the average 48 year old woman, who is a non smoker and without any other obvious risk factors, has less than a 2% chance of a heart attack or stroke in the next ten years. But this is for someone who has never had a heart attack. QRisk3 is not normally used for someone who has had a heart attack. However, I heard during my Cardio Rehab course (but have never found independent validation for this) that having had one heart attack increases the QRisk by at least 20 points.

The really important take out from all this is that there are plenty of things we can all do to significantly reduce our future risk of heart attacks. From the obvious things like weight loss, smoking, diet, exercise, drinking, and stress, to the less obvious things like preventing gum disease and fixing sleep apnea. No matter what our medical history there's always a benefit to be gained by reducing risk factors.

Good luck!

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Chappychap

I looked up QRisk3. The banner headline at the top states (as you indicated).....

This calculator is only valid if you do not already have a diagnosis of coronary heart disease (including angina or heart attack) or stroke/transient ischaemic attack.

So for the layman, and perhaps the medical professional too, any assessment of risk post heart attack using this method is questionable and is therefore largely irrelevant to the thrust of the question originally asked by the OP, easily demonstrated by someone who had a massive heart attack which resulted in serious heart soft tissue damage, compared to someone like me who is also post heart attack but who has not apparently suffered any after effects, and which this analysis does not take into account.

Therefore the key issues post heart attack, as I stated above and you have recognised, are if you make lifestyle improvements post heart attack, and likely take up new medication, and where appropriate have interventions such as stents, your heart health risk is reduced. That is not eliminated just reduced and that will vary from individual to individual according to circumstances.

Alternatively if you don't take up lifestyle changes, don't accept medication or interventions when recommended, the risk is likely equal to or worse than before.

Healing_Heart profile image
Healing_Heart in reply to Lowerfield_no_more

Hopefully I didn’t have a “massive heart attack”, as I don’t think doctors would have misdiagnosed as myocarditis. When you say you had no after effects, do you mean nothing showed on the MRI? How can that be possible? From what I understood the diagnosis of HA depends on damage being visible on the heart muscle.

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Healing_Heart

Nearly six years ago I had an NSTEMI. I didn't even know I was having or had had a heart attack. I thought I had a mild chest infection with chest discomfort but decided to get it checked out and ended up in hospital for four days. My troponin was low but just enough to confirm I had had my heart attack. My understanding is that tropinin can be used as a measure of the stress the heart was put under during the cardiac event and perhaps a measure of any damage caused. I have since had two angiograms and many ECGs but never an MRI and I assume that is because one is not required.I don't get angina and for my age I manage to do most things and am as active as the rest of my body allows.

So if I am wrong and my cardiac event did do some damage I certainly don't notice it.

Healing_Heart profile image
Healing_Heart in reply to Lowerfield_no_more

An inflammation can also increase troponins. I’m surprised that you didn’t get an mri done. Maybe your troponins weren’t very high.

Sibwd profile image
Sibwd in reply to Lowerfield_no_more

Hi can I ask what your trop levels were please?

Healing_Heart profile image
Healing_Heart in reply to Sibwd

They were very high, up to 1200 🤦‍♀️

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Sibwd

38 at about 10 -12 hours on

Smitty1956 profile image
Smitty1956

Hi, Healing_Heart,

Since my HA in 2022, I have read a great deal about HAs, heart diseases, and health-related topics. I’m no expert, but I have learned a thing or two from my readings. I also have learned things from the good people on this forum. I still have my fears of having another HA, but I also have anxiety disorder so I am more inclined to worry about dying.

The statistics from the research that I have read suggests that people who have had one HA are much more likely to have a second, or even a third, HA. The statistical evidence suggests that.

On the other hand, I do believe that lifestyle changes can improve one’s overall health, and perhaps change one’s trajectory toward a second HA.

I have tried, since 2022, to eat more vegetables, cooked and raw—to eat more fruits—-I try to always have fresh bananas and blueberries every morning as part of my breakfast—I have not had even one drink of any alcohol since 2022—I have never smoked, etc. Of course, I still need to improve in this diet area. I also try to walk more, but I definitely need improvement in this area too.

Taking a statin medication has improved my cholesterol levels (except for “good” cholesterol). My doctor advocates more exercise to raise that level. This medication is important because I do have CAD, and the doctor believes that a piece of plaque broke off, formed a blood clot, and caused my HA.

The last month, I have been trying extra hard to give up sugary treats. I am pre-diabetic, and I love donuts, cake, ice cream, even fruitcake, but I am trying to give up as much sugar as possible.

Anyway, I am hoping that lifestyle changes do make a difference, but so many things come into play—such as genetics. My father died of a massive HA at the age of 70. My paternal grandfather died of a stroke in his 70s.

It is definitely worth making lifestyle changes and taking your medications in order to try to live a long and healthier life. You are young and likely to have many good years ahead of you!❤️

Healing_Heart profile image
Healing_Heart in reply to Smitty1956

Hello Smitty, I do believe and hope that medicine has improved and many people who died in the past would have been saved today,

baly_2023 profile image
baly_2023

I had a HA a few weeks ago (Stemin lad).

I've been thinking about life, mortality, my wife, my young daughter, what if it happens again, will it happen again, will I die earlier, so many thoughts, which is to be expected when any person goes through such a traumatic experience.

This forum has been invaluable as you learn there is a long healthy life ahead provided we take the medication and lifestyle changes that the doctors advise us to.

I asked the BHF helpline via email a rather morbid question ie will I die sooner now? yes I did ask the question.

There response was medicine , the understanding of the heart and techniques to help have advanced massively and provided I take the medicines, make lifestyle changes I should expect to have a long healthy life like any other person.

It gave me comfort and I've decided to stop googling , stop thinking about tomorrow ( because you never know what tomorrow will bring) and appreciate the now and make sure that I'm doing all I can do to become a upgraded, enhanced, better version of me.

Healing_Heart profile image
Healing_Heart in reply to baly_2023

Thank you so much for this Baly. I’ve been having the sane thoughts, especially that I live alone with my kids aged only 10 and 19. I think I’ll start thinking differently once I start feeling better (I still can’t go for a walk) and I’ve started rehab. How are you feeling now?

baly_2023 profile image
baly_2023 in reply to Healing_Heart

I'm feeling positive and looking forwards. I have those moments when I'm sitting alone, when thoughts pop into my head but I get up and do something to manage them.

I'm going to cardio rehabilitation in 2 weeks time, which will get my confidence back up so I can slowly but surely get back to my pre HA exercise routine and feel normal and good again.

All our journeys are different but we all are aiming for the same thing.

Be kind to yourself, be patient and I would definitely give cardio rehabilitation a chance to do its good as I've heard positive things about it.

weechaz63 profile image
weechaz63

Hi first let me say I am wishing you a speedy recovery 💪💯 what your going through in your thought processes is natural for a great percentage of heart attack recovery patients and it's the fear of the unknown, Been there myself over my 18 yr heart attack journey for which I am in recovery from my 4th heart attack at the moment from which I am doing very well, I could write a book about my journey good and bad, but really it's all about your own perspective and educating yourself on your condition, I don't mean that in a negative way at all but the more knowledge you fill yourself with the better understanding you will have and begin to get a better prospective which in turn makes you feel better 👍 meds, lifestyle changes, exercise all these things help to reduce some of the risk of another heart attack but never eradicates it completely, But let me finish with this and I know it's not easy? You got to eradicate the doom and gloom from your thoughts as believe it or not you are much better than you think you are right now💯💪You've got this, keep well and stay safe❤️

trafar profile image
trafar

I too had HA and I am going with the view it has happened and it could happen again but I have been given a warning and it’s up to me to reduce that risk as much as possible. I survived and will treat each day as a bonus, I can’t let it overshadow the rest of my life be that today tomorrow or 20 years time.

Highnoon profile image
Highnoon

Hi just back on here been a couple of yrs sadly I had a heart attack 4 yrs ago got 3 stents in took me a while till get used till that but I think a change of life style walking good diet medication reduces your chances of having another one I've starting smoking again after been of 10 months feel very guilty about that do everything by the book diet walking etc so the fags will have till go for sure

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