How do I know if I am at risk for a heart attack?

There are a variety of conditions and “risk factors” that are related to the development of heart disease. Some are things that are not in your control, such as your family history, age or gender. Others, such as high blood pressure, poor diet, and smoking are things that can be controlled to lower your risk of a heart attack.

What can I do to lower my risk of getting a heart attack?

There are certain risks for heart disease that are outside of your control, such as inheriting your family history of heart disease, or getting older. However, there are many things that you can do to lower your risk of developing heart disease.

Stop Smoking!

Smoking cigarettes, or even cigars, places you at significantly higher risk of having a heart attack, and prematurely developing blocked arteries in the heart, to the brain or to your arms and legs.


Walking 30 minutes 3-4 times a week can strengthen your heart and lungs, lower you blood pressure and cholesterol levels, and help you lose weight. Exercise has been shown to be a powerful prevention tool in combating heart disease.


Eat a diet filled with whole grains, fresh fruits and vegetables, lean cuts of meat, and with fresh fish. Avoid heavy sauces, fried foods, fatty foods or salty foods. We have healthy and delicious menu guides available in the office to help you in choosing healthy foods.

If I get chest pain, does that mean I am having a heart attack?

Maybe. I can’t tell you if it is your heart without examining you. Sometimes chest pain is a heart attack, or “angina” – which is chest pain from a blocked artery leading to the heart. Sometimes chest pain is from indigestion, rib pain, or many other causes. Your doctor should be contacted immediately if you are having chest pain. However, if you are at risk for heart disease, or think you are having angina, you should be evaluated by a cardiologist.

What are other signs of heart disease?

There are other symptoms besides “angina”, or chest pain, that can come from heart disease. Palpitations, or a racing or skipping heart beat, may be signs or a serious arrhythmia. Shortness of breath may be a sign of a weakened heart muscle or a heart valve problems. Passing out, or “syncope”, may be a sign of an arrhythmia, valve problem or weakened heart muscle. Any of these symptoms should be evaluated by your doctor, or by a cardiologist, to determine why you are experiencing these symptoms.

I get a lot of palpitations. I’ve had 24 hours heart monitors but my symptoms occur every day, and they never happen when I have the Holster on. How can my problem be diagnosed?

The traditional 24-hour monitor is a good place to start in diagnosing arrhythmias. But like the toothache that disappears when you visit the dentist, the problem might not appear when you want it to, on the day you’re wearing the monitor. Fortunately, there are other devices, called “event monitors” that can be helpful. There’s one wrist watch device for example, that can be worn for up to 2 weeks. And can be activated by the wearer whenever the symptoms occur. In more extreme cases, there’s even an implantable monitor that can be placed under the skin and left there for several months.

I recently had a heart attack, even though I’ve always been told my cholesterol was okay. How is that possible?

Cholesterol is very important, but it’s one of many “risk factors” that can lead to a heart attack. Smoking, diabetes, high blood pressure, obesity, lack of exercise, as well as age, gender and genetics are some of the other risk factors. The more risk factors you have, the greater your chance of having a heart attacks.

What about Echocardiograms? Don’t they show everything?

An echocardiogram is a test for showing heart valves the heart muscle function. Heart arteries are too small to be seen with ultrasound.

I get an EKG done every year, and it is always been normal. So I guess I don’t have blockages?

That’s not necessarily so. An EKG is very helpful for many things, but because it only shows the heart activity at rest, a normal ECG cannot completely rule out all coronary problems. Like a single frame from a movie, it can tell a part of the story, but not necessarily the complete picture.

Do women need to worry about heart attacks as much as men do?

Yes. Heart disease is the leading cause of death among both men and woman. Women tend to have heart disease at an older age than men do. But have higher mortality rates than men. Too often symptoms are minimized by woman who don’t recognize their risk of heart disease.

After my heart attack my doctor put me on a cholesterol lowering medication, even though he always told me that my cholesterol levels were normal. Why?

Once you’ve had a heart attack, a “pretty good” cholesterol isn’t good enough anymore. At that point, your cholesterol really needs to be aggressively lowered, usually to less than 180, or an LDL (bad cholesterol) under 100. Studies have also demonstrated additional benefits from certain cholesterol lowering medications, the “statins”, beyond simply lowering cholesterol values, that can help lower the risk of a future heart attack.

Learn More About Specific Heart Diseases

Dear Patients and Friends,

Due to circumstances beyond our control, CompleteCare Cardiology, the office of Dr. Randy Kiewe, is closing. Dr. Michael L. Friedman of Long Island Heart Associates has been assigned to be the Custodian of Medical Records. If you need an appointment or if you need to pick up a copy of your records, please call his office at (516) 869-3100. His office is located at 2110 Northern Blvd Suite 207 Manhasset NY 11030.

We apologize for any inconvenience this may have caused. The staff of CompleteCare Cardiology wish you all good health and we thank you for your kindness, patience, support and understanding.

CompleteCare Cardiology Staff