When it comes to heart health, we often think that we know the basics. But here are 5 myths that will prove this wrong.

#1: That They Will Know When They Are Having a Heart Attack

You might be surprised to find that most people don’t know they are having a heart attack at the time. We all know the Hollywood heart attack scene with the actor clutching her chest and falling to the ground, but it rarely goes that way.

Take, for example, retired cardiac care nurse Robin Oliveirawho did not recognize her own heart attack. Author and nurse Oliveira thought she was having heart burn and did not immediately go to the hospital. Instead, she drove home alone from her fitness class. Oliveira lived to tell her story.

Or take Rosie O’Donnell, comedian and talk show host. Rosie didn’t think she was having a heart attack. Rosie googled heart attack symptoms and thought, “Naah.” She took aspirin and went to bed. The next day Rosie went to the hospital and immediately got a stent, a wire mesh, inserted into her artery to keep it open. O’Donnell tells her story as a cautionary tale for women to get to the hospital and believe their own symptoms.

And, on a very personal level, my lifelong friend Leslie did the same things as Robin and Rosie. Leslie thought her heart attack was heart burn, downplayed her symptoms, and took aspirin. By the way, carrying aspirin and taking it for chest discomfort is a good idea because it temporarily eases blood clotting often present in a heart attack.

But my friend Leslie did not survive her heart attack followed by sudden cardiac arrest.

#2: That a Heart Attack and Sudden Cardiac Arrest Are the Same Thing

As a former coronary care unit nurse, I know one way to understand the difference between a heart attack and sudden cardiac arrest is to think of a heart attack as a plumbing problem and sudden cardiac arrest as an electrical problem. And the plumbing problem often leads to the electrical problem.

In a heart attack, the blood is still flowing, but it is having a hard time getting to the heart. When a person is having a heart attack, they are awake and alert.

The heart’s electrical system controls the rate and rhythm of your heartbeat. If something goes wrong, your heart can beat too quickly, too slowly, or irregularly. The usual cause of sudden cardiac arrest is an abnormal heart rhythm (arrhythmia), which happens when your heart’s electrical system isn’t working correctly.

An arrhythmia is in a lower chamber of your heart (ventricle). Rapid, erratic electrical impulses cause your ventricles to quiver uselessly instead of pumping blood (ventricle fibrillation or V-fib). In a sudden cardiac arrest, the person immediately loses consciousness.

Still, when my dear friend Leslie died suddenly at the age of 63, I could not accept or understand why. Leslie was fine before heading out on her 3-day road trip, but did not make it past day two. My investigation into what happened to Leslie’s heart in two days on the road away from green space is what my new book, Optimize Your Heart Rate: Balance Your Mind and Body with Green Spaceis all about.

#3: That They Are Not at Risk Because They Have No Heart Disease Diagnosis

If you go to see your health care team about your heart, the first thing that your doctor or nurse will do to see how your heart is doing is to do an EKG. This is when they put electrode pads and wires on your arms and legs. But the trouble is EKGs may not pick up heart malfunction, especially if you are a woman.

The largest study to date, in Northern Finland (2019), of women’s sudden cardiac arrests, showed that over one third of the 1000 women who died of sudden cardiac arrest had normal EKGs.

So that means that EKG heart snapshot at one point in time may not pick up any heart malfunction. My friend Leslie had had several EKGs and no diagnosis of heart disease when she left on her road trip from Fort Frances, Ontario to Texas.

#4: That Their Doctor Will Know and Tell Them If They Are at Risk

A 2020 study published in The European Society of Cardiology summarized the research of 30,000 sudden cardiac death victims over a 14-year period in Denmark. It showed that the percentage of patients in contact with their GP was 26% year-round, but in the weeks before their sudden cardiac death that contact spiked up to 54%.

The study did not ask why the victims of sudden cardiac death went to see their doctor almost two times more often before they died, but it seems the patients knew that something was wrong. For those 54% seeing their doctor did not save their lives.

In spite of seeing their doctor weeks before, they died of sudden cardiac arrest. My friend Leslie had the same experience. She saw her nurse practitioner days before she left and her doctor the day she left Northern Ontario.

#5: Only Poor Diet and Lack of Exercise Put Your Heart in Danger

Your heart is under attack every day not from the obvious dangers of poor diet and lack of exercise, but from hidden assailants in your environment. For example, in 2020 the top medical journal The Lancet published Dr. Bing Zhao’s nation wide study in Japan of 250 thousand sudden cardiac arrest victims over two years in all of Japan (rural and urban).

Her work found that each increase in fine traffic emission pollution (called PM 2.5) was associated with an increase of out of hospital cardiac arrest on the same day. So this means that mere hours in traffic can cause sudden cardiac arrest.

Dr. Bing Zhao’s work also showed that those of us over 65 years are more susceptible to these invisible tiny traffic emission particles that make their way directly into our lungs and heart to alter how our hearts function.

On my podcast, Your Outside Mindset, in episode # 33, I talk to Dr. Bing Zhao about her work on the short-term effect of air pollution and sudden cardiac arrest.

My friend Leslie had a healthy diet, got outside for walks, and was not overweight. Still, she had no idea that her life was in danger on her short road trip. Some of the hidden villains I investigate by using heart rate measures include: internal emotions, access to green space and direct sunlight, air, noise, light pollution, sitting and sleep.

So What Can You Do?

By now I hope you are thinking that we are all at risk of a heart attack and sudden cardiac arrest. Bravo and congratulations: you are ahead of the game!

You also know that even if you see your health care team regularly, eat well, and exercise – do everything right – there is more you can do. Discovering your own resting heart rate and paying attention to and understanding what environments are helpful and what environments can harm your heart is the key to protecting your heart.

Can you see some of these heart attack and sudden cardiac arrest myths in your own life? Do you think our hearts are vulnerable to the different environments that we move through during the day? Do you think diet and exercise are enough to protect your heart? How important is it for you to know what affects your heart since you cannot see what is happening at the subconscious level?