The One Thing You Should Never, Ever Say to Someone Who Recently Had a Heart Attack
Doctor speaking to patient about her recent heart attack
Heart disease can take various forms, and it's widespread in the United States. A 2019 American Heart Association report indicated that nearly half (48 percent) of U.S. adults have some form of cardiovascular disease. Chances are, you or someone you know will receive a diagnosis at some point—and you may even know someone who's had a heart attack, since approximately 805,000 Americans have one every year.
Experts share that it's essential to know what to say when someone has a heart attack. "Most people know that heart health is essential to survival and quality of life," says Dr. Gary Small, MD, the chair of psychiatry with Hackensack University Medical Center and the behavioral health physician-in-chief with Hackensack Meridian Health. "So, saying the wrong thing to someone, especially soon after [having a heart attack], can stir up feelings of anxiety and depression. Even a well-intentioned comment can backfire and lead to a downward spiral of worry and concern."
Olivia Dreizen Howell, the co-founder and CEO at Fresh Starts Registry, was diagnosed with a heart condition at birth that required open surgery when she was eight months old. While she was too young to know which phrases were and weren't helpful in the immediate aftermath of her diagnosis, she can speak to what has and hasn't helped when people first learned of her condition.
"I've had some people say very limiting things to me, like, 'You can't run fast' or 'Can't do that,' when they don't know anything about my condition, other than that I have one," Howell says. "It's a huge assumption to know something about someone's health simply because they have a scar across their chest."
Experts emphasized that one comment in particular is beyond offensive and invalidating. Providers shared the top phrase to avoid saying to someone diagnosed with a heart condition, plus other no-nos.
Why It Matters What You Say to Someone Who Just Had a Heart Attack
Actions may speak louder than words (and we'll get to actions). However, experts share words still matter to a person in the wake of a heart attack.
"As a chronic mental health clinician, I cannot begin to count the number of times I have helped someone to process not only the gravity of their diagnosis but also the reactions of those around them," says Dr. Erisa M. Preston, PsyD, a licensed clinical psychologist and the regional psychotherapy director in California for Mindpath Health. "Saying the right thing—and there are many of these—can significantly impact that person."
The first rule is to lead with empathy. “It’s important that if you are speaking with someone who [recently had a heart attack] that we communicate with them from a place of empathy,” says Dr. Howard Pratt, D.O., a psychiatrist and the medical director at Community Health of South Florida, Inc. (CHI). “[This event] can define a person, define their future, their goals, their dreams, all within a brief moment.”
Heart attacks vary in severity. Some are minor, while others are more severe. But word choice is important, regardless of the situation.
"Whether the health condition is mild or severe, what you say matters," Dr. Preston stresses.
The No. 1 Thing To Avoid Saying to Someone Who Recently Had a Heart Attack
The worst thing you can say to someone who recently had a heart attack "This is your wake-up call," Dr. Preston says.
The phrase sounds exceptionally harsh, and variations of it seem milder but they're not. “It’s always best to avoid giving a lecture on how they should change their lifestyle to support their heart health," Dr. Small says.
Dr. Pratt agrees. "Don’t tell them that they need to start living better or that this heart condition was preventable,” he says.
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You may be trying to help when discussing the lifestyle tweaks you think a person needs to make to reduce the risks of hospitalization or death from a heart condition. But that's probably not how that person is taking it.
"Telling a person who [had a heart attack] that their condition was preventable is cruel and ends up shaming the person, suggesting that if they were a better person, they wouldn’t have the condition," Dr. Pratt says. "By doing so, when they are most vulnerable, we are kicking a person while they’re down."
Heart conditions and heart attacks can also be genetic or brought on by other issues. Even healthcare providers can fall into the trap of insisting lifestyle tweaks will solve everything. Dr. Preston recalls navigating healthcare with her husband, who also has a heart condition and kept getting met with advice that he should "just lose some weight."
"Much of what happened during those scary months in the hospital is somewhat fuzzy memories, just a series of bad news and unending fears about various surgeries and whether my husband would live to the next day or week," Dr. Preston says. "Despite that, I have a crystal-clear recollection of every person who said this to either of us because it was intensely hurtful. So, take it from me, as a person and clinical psychologist; don’t say it."
Other Phrases To Avoid Using When Speaking to a Person With a Heart Condition
1. "Don't stress. Just be calm."
Stress may not be helpful to a person who has had a heart attack or has a more general heart condition, but this phrase isn't, either. "Such statements imply that they caused their heart disease, and they reaped what they sowed," Dr. Small says.
2. “I know someone who had a heart condition."
Because heart conditions are so common, it's easy to utter this phrase. Experts share that it can be harmful.
"Making this statement directs the conversation away from the person who is sharing and brings unintended comparison or competition," says Abbey Sangmeister, MS.Ed, LPC, ACS of Evolving Whole. "It also dismisses their feelings or invalidates them."
Sangmeister adds that people should avoid telling scary stories, like that they know someone who died from a specific condition.
3. "It could be worse."
OK, and? "Any time someone is diagnosed with a chronic health condition, they will need time to process the information and understand what it means," Dr. Preston says. "Saying, 'It could be worse,' implies that the person is not allowed to feel the gravity of their situation or that they should be grateful that their condition is not more severe."
4. "I know how you feel. I was diagnosed with X."
Even if you were diagnosed with the same condition or even had a heart attack yourself, Sangmeister suggests avoiding this phrase. "This takes away from the person's experience and away from what they are sharing. Instead of listening and supporting the person who is sharing about themselves, you are turning the focus onto yourself, which is hurtful and harmful," Sangmeister says.
5. "But you look the same."
Heart disease does not have a specific "look."
"Such a statement arises from one’s expectations of how someone should appear after having a heart condition, which does nothing helpful for the person, but rather communicates that you look at them differently now because of the condition," Dr. Pratt says.
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Better Ways To Respond to Someone's Heart Disease Diagnosis
1. Ask inviting questions
Dr. Preston suggests asking questions like, "How are you handling the news?" or "What do you think about it?"
"This emphasizes their experience, not yours, invites them to discuss the situation with you, and allows space for them to discuss their thoughts or feelings," Dr. Preston says. "Some people may need an invitation or encouragement to open up."
2. Clarify needs
Before going into fix-it-mode, ask a person if they want you to. Sangmeister suggests posing the question, "Would you like me to listen, or do you want my advice?"
"For each conversation, you may want to ask this," she says. "Most times, people want to be heard and either don’t want advice or have already received so much."
3. Show you care through your actions
Sometimes, the best statements are actions (or at least specific offers for help).
"I have had special people in my life offer to go to the doctor with me, which is super kind," Howell says, who adds that friends had attended annual appointments as stress-reducers.
Some friends have offered to pick up medications for her, and other loved ones keep information that could save her life. "My very close family members carry around a copy of my EKG in their car or wallet in case of an emergency because my heart looks 'different' than others," Howell says. "In case of an emergency, the EMTs need to be aware that my 'normal' heartbeat looks different."
Next up: The #1 Way to Unclog Your Arteries Naturally, According to Cardiologists
Sources
Dr. Gary Small, MD, the chair of psychiatry with Hackensack University Medical Center and the behavioral health physician-in-chief with Hackensack Meridian Health
Olivia Dreizen Howell, the co-founder and CEO of Fresh Starts Registry
Dr. Erisa M. Preston, PsyD, a licensed clinical psychologist and the regional psychotherapy director in California for Mindpath Health
Dr. Howard Pratt, D.O., a psychiatrist and the medical director at Community Health of South Florida, Inc. (CHI)
Abbey Sangmeister, MS.Ed, LPC, ACS of Evolving Whole
