Heart attacks remain the leading cause of death among American men and women. If you have a heart attack, your best hope is always immediate treatment.

Not all heart attacks are equal, though. There are three coronary arteries that supply the heart muscle with blood-rich oxygen. A heart attack happens when the blood flow is reduced, usually by a blockage in one of these three arteries.

The left anterior descending coronary artery, or LAD, is the largest artery supplying oxygen-rich blood to the heart. When it is blocked, the consequences are often fatal if not treated immediately, which is where the widowmaker heart attack gets its name.

Regardless of the artery, a blockage is serious business, and all heart attacks must be treated quickly to prevent the heart muscle from damage.

Dr. Nitesh Ainani, a cardiologist at Tidelands Health Cardiology, says these symptoms should trigger a call to 911, without delay:

• Severe chest pain or heaviness
• Shortness of breath
• Nausea
• Pain in the jaw or arm

“With an LAD heart attack, your symptoms may be more severe. These symptoms aren’t something you want to discredit,” Dr. Ainani says.

If your symptoms go away and they don’t come back, it’s still a good idea to call your doctor. Often people with cardiovascular disease may get warning signs and can be treated before they have an actual heart attack.

“Inflammation can develop in coronary arteries when people have certain risk factors, like smoking or diabetes, for example,” says Dr. Ainani. “Plaque forms and collects in those inflamed areas causing narrowing of the arteries and a reduction in the blood flow.”

Using imaging, doctors can see areas where there is a build-up of plaque and intervene using minimally invasive techniques like angioplasty – inserting a tiny balloon into the artery through a small incision in the wrist or groin and opening the narrowed spot. Sometimes, they also place a tiny metal stent in the artery to keep it open.

Doctors often prescribe statin drugs to patients with high cholesterol – a common risk factor for cardiovascular disease – or with early evidence of plaque identified with a heart calcium score.

“There are two kinds of plaque — calcified and non-calcified,” says Dr. Ainani. “Non-calcified or soft plaque can easily break off suddenly and collect in the artery, which will cause a heart attack. Calcified is more stable, less likely to break off. Statin drugs reduce the amount of plaque in the blood preventing further plaque build-up and also stabilize the plaque that is there, so it won’t break off.”

Dr. Ainani reminds patients the risk factors are the same for all heart attacks:

• Smoking
• Diabetes
• Obesity
• High blood pressure

All of these risk factors cause injury and inflammation in the blood vessels.

“There’s nothing we can do about other risk factors like age and family history, but making healthy choices to reduce controllable risks is key,” Dr. Ainani says. A few healthy choices:

• Don’t smoke
• Maintain a healthy weight
• Exercise regularly
• Take medications as prescribed

“There is no way to predict which patients will develop a blockage of the LAD and end up having a widowmaker heart attack,” says Dr. Ainani. “So, the smart path to protecting your heart is to reduce risks through healthy choices, comply with medical treatment recommendations and seek help quickly if you have heart attack symptoms.”