Most people fear they are having a heart attack when they experience chest pain. There's good news and bad news. The good news is, not all chest pain comes from the heart. The causes can range from merely being inconvenient , like a muscle ache , to the more serious like heart burn, as the oesophagus ( the "foodpipe") runs behind the heart. Some can even be life-threatening, like a blood clot in the lungs.

The chest pain from the heart is called angina. It tends to be worse with exercise, and better with rest. It can feel like an uncomfortable pressure, squeezing, fullness, or pain and can be mild or severe. Heart attack pain can sometimes feel like indigestion or heartburn.

The bad news is, not all heart attacks begin with a sudden, crushing pain that is often shown on TV or in the movies. Some can start slowly as mild pain or discomfort. Some people don't have symptoms at all (this is called a silent heart attack). It is not the same for everyone.

So what is a heart attack ? A heart attack occurs when blood flow to a part of the heart becomes blocked. If the flow of blood isn't restored quickly, the section of the heart becomes damaged from lack of oxygen and begins to die.

Coronary artery disease is when a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.

How do I know if I'm at risk of having a heart attack ? Unfortunately, some things cannot be changed. How old you are and your gender plays a part in your risk for a heart attack. The older your are, the higher the risk. And men are at higher risk of heart attacks than women, till after menopause. Then the risks for women increase.

Fortunately, there are some risk factors for heart attacks which can be changed or controlled. These include smoking, obesity, high cholesterol, high blood pressure, and diabetes.

So a 20 year old woman who is otherwise well, and suddenly experiences chest pains after fighting with her boyfriend is far less likely to be having a heart attack than a 60 year old male smoker who skipped his last doctor's appointment for his diabetes review, and now experiences chest pain.

So what can I do to prevent or lower my risk of heart attacks ? Stop smoking. Maintain an ideal weight. Eat sensibly. Exercise regularly. Get screened for any of the treatable medical conditions, especially if you have a strong family history of heart disease, are a smoker, already have one of the diseases, or are above 40 years old.

And if you have any of the medical conditions like high blood pressure, high cholesterol or diabetes, see your doctor regularly and get them under control.

Are there any tests that a doctor can do to check if I am at risk for a heart attack ? There are a whole range of tests, including blood tests to check for the above risk factors, like your sugar levels and cholesterol levels.

The electrical activity of the heart can also be measured by an ECG. The doctors can also stress the heart by making you run on the treadmill, called an exercise ECG. Think of the first test as checking the traffic flow on a major a highway on Sunday morning, with 2 out of the 4 lanes blocked, and revisiting the same highway the next day during peak rush hour, with the same 2 lanes blocked.

If the doctors have a high suspicion, they may do an invasive test called a cardiac catheterisation, where a catheter is introduced into your blood vessel to check the extent of blockage. A stent can be put in at the same time, if necessary. There's also a non-invasive method now using a CT scan, called a CT coronary angiogram.

Treatment of a heart attack is targeted at reducing the chance of having another heart attack, and helping the damaged heart to function optimally. Treatment depends on how severe the symptoms are. There's a range of treatment available, from medical treatment, to angioplasty with stenting, to surgery. A combination can also be used. The doctor will assess each patient and decide what the best options are.