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How Many Heart Attacks Can One Person Survive?

by — 2015-10-18 in Cardiovascular Disorders and Diseases
Reviewed by Medical Team — 2017-10-11
Can you survive more than one heart attack? Can you survive more than two? The surprising answer to the question of survival after myocardial infarction is answered here.

A heart attack used to be considered a catastrophic event that you just weren't likely to survive.

As recently as 1950, almost the only thing a doctor could do for you after you had a heart attack was to give you what was politely called a water pill — meaning a diuretic, such as furosemide (Lasix). Because the diuretic caused the kidneys to remove both fluid and essential electrolytes such as potassium, the inevitable result was fatigue, and often severe fatigue. Heart attack patients had to spend much of their time in bed. Simply not getting enough sun led to vitamin-D deficiency diseases such as rickets and osteoporosis. People who survived heart attacks (and about 75 percent didn't) usually had just a year or two left to live, falling victim to a second heart attack if they survived the first. [1]

On the other hand, treating a heart attack was not terribly expensive. Going through my grandmother's trunk after she died, my cousins and I found the bill for four days in the hospital after her heart attack in 1948. It was for $47.25. She lived far longer than most, dying of a second heart attack in 1971.

How Many People Survive Their First Heart Attack?

In the United States alone, around 805,000 people have a heart attack every single year. Of that number, in the year 2011, 335 thousand died, that is, their first heart attack was also their last. About 40 percent of people who have heart attacks die with the first attack in the United States. [2] Statistics from 2013 show that about 610,000 people die of heart disease in the United States every year – that’s 1 in every 4 deaths [3].
 
Different groups of Americans, however, have very different survival rates after heart attacks. 
 
Sometimes the difference is in the local emergency medical response system. If you have a heart attack in Austin, Round Rock, or Georgetown, Texas, for example, where ambulances are equipped to begin procedures that usually have to wait for the emergency room, you are 10 times more likely to survive a cardiac arrest than you are in rural Tennessee. Sometimes the problem is traffic. You are about twice as likely to die waiting for help after a heart attack in New York City than the national average.

Predictors Of Sudden Death If You Have A Heart Attack

Researchers at Wake Forest University in North Carolina analyzed data from two of the largest US cardiovascular studies, the ARIC (Atherosclerosis Risk in Communities) and the CHS (Cardiovascular Health Study). Together, these two studies included records for more than 18,000 participants. 
The data showed that in the United States [3]:
  • African-Americans are more likely to die of their first heart attacks than people of other races. However, 
    African-Americans are less likely to suffer from coronary artery disease.
  • People who are obese but not morbidly obese are more likely to die after their first heart attack, but so are people who are thin but not extremely thin.
  • High blood pressure is a better predictor of death than how "clogged" your arteries are on a scan.
  • A fast heart rate predicts death, especially when it is coupled with low blood pressure.
  • Certain abnormalities on an EKG are predictive of sudden death, but not of stable coronary artery disease.

Who Survives Multiple Heart Attacks?

On the other hand, some heart attack survivors "take a lickin' and keep on tickin'" like the Energizer Bunny. I myself have had eight heart attacks over a six-year period, so many that the doctors no longer offer intervention (there's just no place left to do a coronary bypass). My father, who probably had the same clotting disorder I have, had 13 heart attacks in 15-hour period in 1994. He died in 2005 at the age of 80. His doctors said that they had never witnessed anyone who survived so much for so long (which is also something my doctors say about me). Retired British steel worker Brian Harries, just 44 years old, also survived 13 heart attacks over a two-day period.
 
 
The common factor in all three of our cases is that we managed to be in the right place at the right time. You are far more likely to survive a heart attack if you are near a modern hospital, as Brian Harries was, or you live in an area with an extremely advanced EMS system, as my father and I did.[4] 
 
You are also more likely to survive if:
  • You have your heart attack on a weekday between 8 am and 5 pm, when senior staff are likely to be available at the emergency room and in the hospital. Death rates go up when patients arrive just before shift changes. [5]
  • You don't go to a teaching hospital in July, when new residents are just starting their training. [6]
  • You are younger rather than older. About age 60 is usually a dividing line for survival rates. [7]
  • You don't have diabetes (especially with an HbA1C over 10 percent), or if you have either type 1 or type 2 diabetes, you use insulin. Insulin helps the heart muscle use oxygen more effectively after a heart attack. [8]
  • You take at least a children's aspirin every day. On average, people who take Aspirin have about a 14 percent lower risk of a heart attack. [9]
  • You are a man. Women are less likely than men to have heart attacks, but more likely to die of them if they do, something that is in large part caused by the fact that their symptoms are often less specific, and more likely to falsely be attributed to anxiety. [10]
  • You eat a diet with more fiber. In one study reported in the British journal BMJ, first-time heart attack survivors who ate more fiber were up to 44 percent more likely not to have a second heart attack. "More" fiber is just six servings of fruit, whole grains, or legumes daily. Whole grain and legume fiber were slightly more beneficial than fruit fiber. [11]
  • You don't smoke. Non-smokers are more likely to survive first heart attacks. [12]
  • You have an ejection fraction of at least 40 percent after your first heart attack. The ejection fraction is measured during a stress test. [13]
  • You have fewer "clogs" (atherosclerotic lesions) rather than more, ideally two or fewer.
  • You don't have kidney disease, and your creatinine levels are under 2.5 mg/dl.
  • You have been stable for 60 days or more.

Seeking treatment as early as possible if you have symptoms of a heart attack — including shortness of breath, feelings of weakness or fainting, pain in the jaw, neck, or back, and unexplained nausea and fatigue, as well as the chest pain people immediately think of — will give you a better fighting chance of surviving as well, of course.

People who don't develop new symptoms for just 60 days are more likely to live after a heart attack than those who do. The longer you can stay healthy, the more likely you are not to become a cardiovascular fatality statistic.

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