The principal function of the heart is to pump blood around the body, so that oxygen and nutrients can be delivered where they are needed, and waste products can be removed.

A healthy heart is therefore key to a healthy body. It’s certainly a well used organ, beating approximately three billion times over the course of a lifetime. Unfortunately our hearts are fallible and heart disease remains the leading cause of death in both men and women in Australia. All the more reason to look after our hearts as well as we can!

Like other tissues in the body, heart muscle depends on its own blood supply. This arrives into the heart muscle via the coronary arteries, and it is blockages of these arteries that can lead to a variety of clinical syndromes such as ‘angina’, ‘acute coronary syndrome’, and ‘myocardial infarction’ (also known as a heart attack). These disease processes are sometimes collectively referred to as ‘ischaemic heart disease’ (IHD).

The good news is that much can be done to manage our individual risk of IHD. Many risk factors have been identified, some of which are ‘modifiable’, meaning we can change them or reduce them, which in turn will reduce our chances of developing IHD.

So, it follows from the table above that if an individual were to stop smoking, control their blood pressure, manage any diabetes well, get physically active, eat a healthy balanced diet, manage any elevated cholesterol readings and keep to a healthy weight - all of this would have a significant impact on that individual’s IHD risk.

In fact, risk assessment tools are widely available and doctors routinely use these tools to assess their patients’ risk of IHD and other cardiovascular diseases. The risk assessment helps guide recommendations for treatment or prevention strategies. It is recommended that all adults without existing cardiovascular disease over the age of 45 years (or over 35 years for Aboriginal and Torres Strait Islander peoples) undergo a cardiovascular risk assessment.

Most people agree that ‘prevention is better than cure’, but if someone is unfortunate enough to develop IHD, it’s extremely important to recognise the symptoms, so that any necessary medical treatment can be provided in good time.

Blockages of the coronary arteries can be partial or complete.

A partial blockage often leads to a syndrome called ‘angina’, which is characterised by chest pain that occurs on exertion (when the partially blocked coronary artery cannot supply enough blood to keep up with the demands of the pumping heart muscle). Any exertional chest pains should be assessed by a medical professional - this should not be ignored.

A complete blockage is usually a medical emergency, as the heart muscle supplied by the blocked artery quickly ‘dies off’ when it loses its blood supply. This process is called ‘myocardial infarction’, more commonly referred to as a heart attack. There are treatments (either medications or procedures) that can often open a blocked coronary artery, if the individual presents to the hospital or emergency services quickly, and this can often prevent or reduce the permanent damage to the heart muscle that would occur without treatment. It is therefore vitally important that anyone experiencing the symptoms of a heart attack presents for emergency assessment straight away by calling ‘000’ for an ambulance.

So, how would someone know if they are having heart attack symptoms? Some people may experience the typical symptoms which include:

• central heavy chest pain, possibly radiating to the arm and/ or jaw
• associated nausea, sweating, shortness of breath, cold sweat, dizziness

Importantly, the symptoms are not always as sudden and dramatic as we might expect. Some people don’t even get much chest pain; perhaps just some discomfort in the upper body. The onset can be gradual as well as sudden. Studies have shown that 40% of women can have no chest pain at all with their heart attack, and people with diabetes can also commonly suffer a heart attack without much chest pain to speak of.

Sounds confusing? The Heart Foundation has produced a helpful guide to making sense of potential heart attack symptoms and how to act upon these; it can be found here:

http://www.heartattackfacts.org.au/action_plans/HeartAttackActionPlan-english.pdf

So, in summary, to minimise your risk of heart disease:

1. Avoid or stop smoking tobacco products (see http://www.quit.org.au/)
2. Follow guidelines for a healthy balanced diet see http://www.eatforhealth.gov.au/)
3. Keep physically active (see http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines)
4. Keep to a healthy weight (see http://www.healthyactive.gov.au/internet/healthyactive/Publishing.nsf/Content/healthy-weight)
5. Consider a formal risk assessment with the guidance of your doctor.