Heart attacks on the big screen: Two thumbs down

A middle-aged white man dramatically clutches his chest as sweat pours down his face. He gasps and his eyes flutter. Then, he falls to the ground. Hollywood writers seem to rinse/repeat this scene when a script calls for a heart attack.

But art doesn’t always mimic heart attack reality and representation matters. 

A team with Allina Health Minneapolis Heart Institute took a deep dive into Hollywood’s depiction of heart attacks in the study, “Portrayal of Acute Myocardial Infarction in Popular Film: A Review of Gender, Race, and Ethnicity," published in the Journal of the American Heart Association.

Study finds diversity is underrepresented in on-screen heart attacks

To conduct its research, the team searched “heart attack” in the Internet Movie Database (IMDb). After sorting the films from most to least popular, they confirmed the movies showed someone experiencing an acute myocardial infarction (heart attack). Of the 100 scenes analyzed, 83 were U.S. films and 17 were international films. Their release dates ranged from 1932 to 2022.

Gender representation

Art: Movies mainly show men. When they evaluated 100 movies, researchers found only 10% of the films showed women experiencing a heart attack. 

Reality: Cardiovascular disease remains the leading cause of death in women in the United States. 

Racial representation

Art: Movies mainly show white people experiencing a heart attack. In 94% of the analyzed films, the person having the heart attack was white. There were no Black women represented. 

Reality: Cardiovascular disease disproportionately affects patients from racial and ethnic minority groups. 

Symptom representation

Art: Films tend to show the dramatic moments and for heart attacks that means more severe symptoms like falls and loss of consciousness. They also show a higher rate of more unusual presentations, such as screaming. 

Reality: Heart attacks often present with more subtle symptoms, especially in women. 

What are the signs of a heart attack?

• Chest pain or uncomfortable pressure in the center of the chest. It may last more than a few minutes, or it may come and go. 
• Pain or discomfort in one or both arms, the back, neck, jaw or stomach. 
• Shortness of breath. 
• Breaking out in a cold sweat, lightheadedness, nausea. 

Chest pain is the most common symptom for both women and men, but women are more likely to experience the symptoms listed above that are less associated with heart attack, such as shortness of breath, nausea and back or jaw pain. The symptoms may be subtler for women than traditionally expected.

Why representation matters

The more we understand heart attacks in the real world, the better we’ll be at knowing the symptoms in ourselves and others. And time is muscle. Survival rates and positive outcomes are higher when someone quickly receives medical attention.