Heart disease is the leading cause of death among men and women in the United States, accounting for about 600,000 fatalities a year.

It refers to several types of conditions, including heart failure, arrhythmia and heart valve abnormalities. But more than half of all heart disease is related to the accumulation of cholesterol-laden plaque in the arterial walls - a condition more specifically defined as coronary artery disease or coronary atherosclerosis (hardening of the arteries).

This is the type of heart disease over which we have the most control with some of our lifestyle choices.

In coronary artery disease, the build-up of plaque narrows the arteries and impedes blood flow. If plaque becomes unstable and ruptures, it further narrows the arteries and may cause a heart attack or stroke.

Most people survive their first heart attack, but may have significant heart damage. This can result in the development of heart failure, in which the heart's pumping function is impaired resulting in the accumulation of fluid in the lungs. In order to minimize heart damage, it is important to recognize the warning signs of a heart attack so intervention can begin as soon as possible. The sooner we intervene, the more lives - and heart muscle - we can save.

Heart attacks may start with mild pain or discomfort. A heart attack may not be a sudden, intense event. In some cases, there are no warning signs. If you think you are having a heart attack, call 9-1-1. The worst thing you can do is to ignore the symptoms. You should be especially on guard if you have risk factors such as family history of heart disease, high cholesterol levels, high blood pressure, diabetes and smoke tobacco.

More than 715,000 Americans have a heart attack every year, according to the Centers for Disease Control. Symptoms include the following:

  • Chest discomfort that often feels like pressure, squeezing, fullness and pain; it can last for  minutes and may worsen with walking and improve with resting;
  • Discomfort in other areas of the body - in one or both arms, back, neck, jaw or stomach;
  • Shortness of breath with or without chest discomfort, and;
  • A cold sweat, nausea or lightheadedness.

The heart disease risk factors are the same for men and women, but in recent years we've learned that women often present with symptoms differently than men. More women appear to experience blockages without the crushing chest pressure. Instead, they express other symptoms such as shortness of breath; pressure or pain in the lower back, chest or upper abdomen;  dizziness, lightheadedness or fainting; and upper back pressure or extreme fatigue.

In general, the signs are more subtle and confusing in women, but they should not be dismissed as the flu or indigestion. Heart disease is the No. 1 killer among women, even though many continue to view it primarily as a male disease.

Early detection of coronary artery disease in men and women can reduce its potentially fatal effects and enhance the long-term success of treatment.

We have a variety of treatments for coronary artery disease including lifestyle changes, medications and procedures to clear or bypass blockages. But the best treatment is prevention. It should focus on living a healthy lifestyle and managing conditions such as high blood pressure and diabetes that can place undue stress on the heart.

Prevention strategies include the following:

  • Don't smoke or use nicotine;
  • Get regular exercise, at least 30 minutes a day;
  • Eat a heart healthy diet, including less saturated fat and more fruits and vegetables;
  • Maintain a healthy weight; and;
  • Receive regular screenings for cholesterol levels, high blood pressure and other heart disease risk factors.

By: David Nicholson, DO, a cardiologist who practices at OhioHealth Grady Memorial Hospital