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HEART ATTACK: ARE YOU AT RISK? Heart attacks can be prevented, yet millions of people in the western world increase their risk of having a heart attack by some things they do every day. Lifestyle can contribute to, or prevent, a heart attack. The first step you can take to reduce your chance for having a heart attack is to stop unhealthy habits that contribute to the development of cardiovascular disease. To do this, you must know the risk factors that are promoting your risk of getting it. Unchangeable major risk factors include inherited traits, being male, and increasing age. Heart disease tends to run in families with a history of it. Even though the death rate for women is increasing, men have a greater risk for heart attack earlier in life. As we get older, the risk increases. Four out of five people who die of heart attack are age 65 or older. Major risk factors you can change include cigarette and tobacco smoking, high blood cholesterol, high blood pressure, and physical inactivity. Smokers have twice the risk for heart attack as nonsmokers. Smokers who have a heart attack are more likely than nonsmokers to die and to die suddenly. Constant exposure to second-hand smoke increases the risk for heart attack. On the other hand, blood cholesterol levels below 200 milligrams in middle-aged adults seem to indicate a low risk of disease. The risk of a heart attack rises as cholesterol levels rise. This risk is even higher when other risks are present, such as high blood pressure and smoking. A diet high in saturated fat and cholesterol raises blood cholesterol. High blood pressure increases the heart's workload. It causes the heart to enlarge and weaken over time. It also raises the risk of stroke, heart attack, kidney failure, and heart failure. The risk of heart attack triples when high blood pressure is combined with obesity, smoking, high blood cholesterol level, or diabetes. Lack of exercise is a major risk factor for heart attack. The heart is a muscle and if it is out of shape, it does not work as well as it should. Routine exercise plays a crucial role in preventing heart and blood vessel disease. Exercise at least 30 to 60 minutes four to six times a week. Seek medical advice before starting any exercise program. Contributing risk factors for heart attack are diabetes, obesity, and stress. More than 80 percent of people with diabetes die of some form of heart or blood vessel disease. People who have too much body fat are more likely to develop heart disease even if they have no other risk factors. Being overweight, and more specifically overfat, increases the strain on the heart. It raises blood pressure and blood cholesterol and can lead to diabetes. Prolonged, excessive stress can impact the health of the heart. If your lifestyle habits include one or more of these risk factors, then you are at risk for a heart attack. . The heart normally beats about 60 to 80 times each minute. The pattern is regular, and increases or decreases in response to activity levels. Special heart cells send electrical signals throughout the heart. These signals cause the heart muscle to contract. This squeezes blood from the heart to the body and the lungs. If a heart attack, infection, medication, or a disease damages the heart, those special cells may not work properly. If the signals are not sent often enough, other parts of the heart will react, causing a slower, irregular, or faster heart rate. A slower heart rate may not pump enough blood for the body's needs. This may result in feeling lightheaded, tired, or faint. With an irregular or rapid heart rate, a person may feel that his heart is racing or skipping beats. When the heart beats too fast, it can fail to pump enough blood. Some abnormal heartbeats are little more than an annoyance, while others can be life-threatening. If the part of the heart that pumps the blood beats too rapidly, too irregularly, or stops beating, the person could faint or even die. The diagnosis of abnormal heartbeats is usually made with an electrocardiogram, also called an EKG. If the irregular heart rate happens frequently, it may be seen on a routine EKG in the doctor's office. Sometimes a device called a Holter monitor will be worn for 24 to 48 hours to record a longer EKG so that the abnormal beats can be seen. There are many causes for an abnormal heartbeat. Besides heart attacks, infections, and diseases, some drugs can also cause abnormal heartbeats. So can stimulants, such as caffeine and nicotine. A person may also be born with an abnormal heartbeat. The treatment of abnormal heartbeats depends on the cause. Stopping
stimulants, such as tea, coffee, and cigarettes, may help. Medications
may be needed to stabilize the heart rate. If the heart is too slow,
a pacemaker, a device to control the heart rate, can be used. If the
heart beats too irregularly or too fast, surgery or a special device
to shock the heart may be needed. HIGH BLOOD PRESSURE AND HEART DISEASE All of us, when we are excited or afraid, have an increase in our pulse and a rise in the pressure inside our blood vessels. Many people have this kind of increase in pressure even when they are not excited or afraid. This condition is called "high blood pressure." High blood pressure is considered a silent killer, because most people with this disease have no symptoms. Over time, this increase in blood pressure can damage the blood vessels or vital organs. This can lead to strokes, heart disease, or kidney disease. High blood pressure is one of the most common risk factors for heart disease. When your blood pressure goes up, the heart has to work harder than normal. This puts the heart and the blood vessels under a strain. If high blood pressure is not treated, the heart will have to work even harder to pump enough blood and oxygen to meet the body's needs. The heart enlarges when it is forced to work harder than normal for a long time. An enlarged heart may have a hard time meeting the demands put on it. Blood vessels also suffer the effects of high blood pressure. Over time, they become hardened. This often occurs as people age. High blood pressure also speeds this process. Blood vessel damage is bad because hardened or narrowed arteries may be unable to supply the amount of blood the body's organs need. If the body's organs, especially the heart, do not get enough blood, they cannot function properly. Treating high blood pressure early can decrease the chances of having heart problems in later life. A healthy diet and healthy lifestyle habits, such as regular exercise and managing stress, help control high blood pressure. Healthcare providers often recommend these methods to control blood pressure before prescribing medications. There are many drugs that can lower high blood pressure. Some rid the body of excess fluids and salt. Others reduce the heart rate and blood pressure by allowing the walls of the blood vessels to widen.
.HIGH BLOOD PRESSURE TREATMENTS All of us, when we are excited or afraid, have an increase in our pulse and a rise in the pressure inside our blood vessels. Many people have this kind of increase in pressure even when they are not excited or afraid. This condition is called "High Blood Pressure." High blood pressure is considered a silent killer, because most people with this disease have no symptoms. Over time, this increase in blood pressure can damage the blood vessels or vital organs. This can lead to strokes, heart disease, or kidney disease. High blood pressure is one of the most common risk factors for heart disease. Treating high blood pressure early can decrease the chances of having heart problems in later life. A healthy diet and healthy lifestyle habits, such as regular exercise and managing stress, help control high blood pressure. Some people with mild hypertension can lower their blood pressure by using less salt. Alcohol intake of more than two ounces daily should be avoided because it raises blood pressure in some people. Blood pressure also returns to normal in many obese people when they lose weight. Healthcare providers often recommend these methods to control blood pressure before turning to medications. There are many drugs available to lower high blood pressure. Some rid the body of excess fluids and salt. Others reduce the heart rate and blood pressure by allowing the walls of the blood vessels to widen. Not all people respond to a specific blood pressure medication. Therefore, many patients must go through a trial period to find out which drugs are most effective while causing the fewest side effects. If you have high blood pressure, remember:
The most common heart problems in childhood are congenital. That is, the problems are present at birth. Babies with severe congenital heart problems may need surgery at an early age to survive. These babies will have symptoms at birth. More often the heart can have a small abnormality that may or may not be noticeable at birth. If there is a hole in the heart wall that lets blood go from one side to another, the baby or child may have blue lips or fingers. Sometimes these holes heal up and at other times they need to be closed with surgery. Other problems, such as an abnormal heart valve, may allow blood to flow the wrong way, or prevent it from flowing easily. These problems will also need surgery when the child is older. Children can sometimes have abnormal heartbeats. Most of these are not serious and will not affect the child's life span. More serious problems, however, may require immediate treatment. Some heart diseases in children are not congenital. Strep throat infections can lead to rheumatic fever in children and young adults. Rheumatic fever can damage the heart muscle or heart valves. With antibiotic treatment of strep infections, however, it is much less common. Other diseases, such as muscular dystrophy and Kawasaki Disease, can also affect the heart muscle or the arteries of the heart. These diseases are rare and should be treated by a specialist in children's heart diseases. Heart disease can be prevented. Our everyday choices determine our risk for developing or preventing heart disease. When unhealthy lifestyle habits are practiced, our risk increases greatly. Healthy lifestyle habits are crucial factors to preventing heart disease. The American Heart Association recommends the following:
Develop healthy habits that incorporate these lifestyle goals. If you do, you will greatly decrease your chances for developing heart disease. . There are many kinds of heart disease. Sometimes damage to the heart can be reversed with treatment. Sometimes the problems that led to the damage cannot be reversed. The most common type of heart disease is blockage of the coronary arteries. These blood vessels provide nourishment to the heart muscle. If they are blocked, the heart muscle may be injured or die. If the heart muscle dies, this is called a heart attack. When heart muscle dies, it will form a scar. Scars cannot be reversed. Even if scars of the heart muscle cannot be changed, blockage of the coronary arteries can be changed. Persons who have had a heart attack can decrease their chances of a second heart attack by:
There is also evidence that a vegetarian diet, with very low levels of cholesterol and fat, can actually reverse disease in the coronary arteries. This type of diet is sometimes recommended to persons who have had a heart attack. There are other treatments for coronary artery disease. These include surgery to bypass or open blockages. These treatments reverse the immediate heart problem, but they do not change the causes of the problem. To change the causes of coronary artery disease, you need to lower the amount of fats and cholesterol in the blood. Heart disease can also be caused by infection, damage to the heart valves, drugs, and birth problems. If the heart muscle has not died, some of the damage caused by these problems can be reversed. For example, a damaged heart valve can put a great deal of strain on the heart muscle. If the valve is repaired by surgery, the heart muscle can return to almost normal. If medications damage the heart, sometimes the damage will be reversed if the medication is stopped. Coronary artery disease is a condition in which the coronary arteries are narrowed and blood flow to the heart muscle is reduced. The heart gets its nourishment from the coronary arteries. These arteries branch off from the main artery (the aorta) right into the heart muscle itself. They carry nutrients and oxygen to the heart muscle. If the coronary arteries become damaged or diseased, the heart muscle does not get the nutrition and oxygen it needs to do its job. The heart's job is to pump blood to the rest of the body. When this is impaired, a heart problem becomes serious. The most common coronary artery disease is that which blocks arteries with cholesterol and fat. The blockage seems to start with a small injury on the inside of the coronary artery. The injury attracts blood clotting elements and cholesterol. In time, the cholesterol builds up, just like a blockage in a pipe. If the artery is part way blocked, then the heart may not get enough blood when it needs to beat quickly. This can cause chest pain or angina. If a narrow part of the artery is blocked with a small blood clot, then no blood passes through. When a coronary artery is completely blocked, the heart muscle that depends on it may die. This causes a heart attack. Factors that increase the risk for coronary artery disease and make it worse include:
If coronary artery disease is very severe, surgery may be necessary. The surgery may clear the blockage or bypass the blockage with vein grafts that will carry the blood. The surgery does not cure the disease. It's very important that people who have coronary artery surgery control their risk factors. They can improve their health and decrease their risk by:
.NON-SURGICAL TREATMENTS FOR CAD Coronary artery disease is any condition that narrows the coronary arteries and reduces blood flow to the heart muscle. The coronary arteries supply blood and nourishment to the heart muscle. When these blood vessels are diseased, the heart muscle can become injured. The most common type of coronary artery disease is the blockage of an artery with cholesterol and fat. Temporary injuries to the heart muscle can cause heart pain, or angina. Permanent injuries to the heart muscle can cause a heart attack. One way to treat a blocked coronary artery is with surgery. During surgery a healthy blood vessel is used to bypass the blocked blood vessel. There are other ways of dealing with a blocked coronary artery that do not involve bypass surgery. Some of these ways are:
Diet and exercise can improve survival after a heart attack. In many people, a low-cholesterol, low-fat diet can slow the development of coronary artery disease. A change in diet works best if combined with regular aerobic exercise. In some cases, these steps may even decrease the amount of disease that is already present. Many medications are used to treat coronary artery disease. Certain
drugs, combined with diet and exercise, will lower cholesterol. These
drugs can help slow the progress of coronary artery disease. Other drugs,
such as nitroglycerin, help treat angina by widening blood vessels and
decreasing the work the heart has to do. Still, other drugs can thin
the blood and lower blood pressure. The type of treatment you may need for coronary artery disease depends on the kind of disease you have. Be sure you and your healthcare provider discuss the benefits and risks involved with the treatments that are available to you. There are many risk factors that increase your risk of stroke. Five of these can be treated:
Seven risk factors for stroke cannot be changed. These are:
High blood pressure is the most important risk factor for stroke. Since this affects one in every four American adults, it is a very common problem. Because the risk of stroke from high blood pressure does not decrease as a person gets older, everyone should have their blood pressure checked regularly. Control of high blood pressure reduces the risk of stroke. Often blood pressure can be controlled simply by eating a healthier diet and maintaining proper weight. Drugs to control blood pressure are also available. Many people think the reason the death rate from stroke has declined over the past decade is due to better control of high blood pressure. Heart disease increases the risk of stroke. Persons with abnormal heart rhythms or a heart attack have a higher chance of stroke. These people should carefully follow the advice of their healthcare provider. Smoking increases the risk of stroke. Smoking also increases the effects of other risks, such as high blood pressure. Persons who smoke should stop. To learn more, contact your American Heart Association office or call (800) 242-8721. Valvular heart disease affects the valves of the heart. Only four valves service the heart. Their job is to allow the blood to flow through the heart in only one direction. To work properly, each valve must open and close completely at the right time. The heart valves can develop problems or disease for many reasons.
Sometimes the valves are not normal at birth. Rheumatic fever can cause
valve disease. Bacteria can infect the heart valves. Injured valves
makes a sound as the blood passes through them. The sound is called
a murmur and is best heard through a stethoscope. Not all murmurs mean
that there is a valve problem. A valve that does not close completely, so that blood goes backwards, is referred to as "insufficient" or "incompetent." This makes the heart work harder by causing it to pump some of the same blood twice. When this happens the heart, and one or more of its four chambers get bigger. Not all valve problems cause problems for the patient. Many people live a normal life with a small amount of valve disease. Tests to diagnose valve problems include ultrasound testing, where sound waves are bounced off the heart valves to show how they move during the heart's beating. Another test involves injecting a dye into the bloodstream while x-rays are taken of the heart. By determining the cause of valvular heart disease, treatment can be targeted. Antibiotics may need to be given before certain procedures, such as dental work or surgery. This is done to prevent infections from starting on damaged heart valves. People who have had rheumatic fever may need to take antibiotics whenever they get a sore throat. Heart medicines may be required if valvular heart disease creates a strain on the heart. When the problem is serious, surgeons can replace the damaged valve. For more information, contact your healthcare provider, or your local chapter of the American Heart Association.
The American Heart Association recommends several steps that can be taken to prevent heart attacks:
If you smoke, STOP NOW. A smoker's chance of heart attack is more than twice that of a nonsmoker. Smoking is the biggest risk factor for sudden death. Smokers have two to four times the risk of those who do not smoke. Have your blood cholesterol checked. The risk of a heart attack rises as blood cholesterol increases. The risk is even greater when other risks, such as high blood pressure and smoking, are also present. A diet high in saturated fat and cholesterol raises blood cholesterol. A diet low in saturated fat and cholesterol usually lowers it. Lack of exercise is a risk factor for heart attack. The heart is a muscle and if it is out of shape, it does not work as well as it should. Routine exercise plays a crucial role in preventing heart and blood vessel disease. Exercise at least 30 to 60 minutes four to six times a week. Seek medical advice before starting any exercise program. People who have too much body fat are more likely to develop heart disease and stroke even if they have no other risk factors. Being overweight increases the strain on the heart. It raises blood pressure and blood cholesterol and can lead to diabetes. High blood pressure increases the heart's workload. This causes the heart to enlarge and weaken over time. It also raises the risk of stroke, heart attack, kidney failure, and heart failure. The risk of heart attack is greatly increased when high blood pressure is combined with obesity, smoking, high blood cholesterol levels, or diabetes. .EARLY WARNING OF HEART ATTACK A heart attack occurs when the heart muscle does not get the blood it needs for its nourishment. The heart depends on special blood vessels, called coronary arteries, to supply it with nutrition and oxygen. If these arteries become blocked, then the part of the heart that depends on them can become injured. Permanent injuries to the heart muscle can cause a heart attack. A heart attack is the most common cause of death in the United States. Every minute of the day someone dies from a heart attack. Early treatment is crucial for heart attack victims. Prompt cardiopulmonary resuscitation, or CPR, can save a life. Quick treatment with drugs that break up blood clots can greatly improve a person's chance of surviving a heart attack. Since early treatment makes a difference, it's important to know the early signs of a heart attack. The most common sign is chest pain or chest discomfort. Other signs to watch for are:
Not all these warning signs will occur. If any of these signs last more than a few minutes, take immediate action, by calling an ambulance or emergency services. Sometimes a person having a heart attack, even if they have had one
before, may not want to call for help. Since early treatment is so important,
do not let this keep you from calling for medical help. Someone should
stay with the heart attack victim until help arrives. This person should
be ready to perform CPR if breathing and the heart stop. Healthy eating is very important for a healthy heart. Eating more calories than your body burns will cause the extra calories to be stored as body fat. People who have too much body fat have a higher risk of developing heart disease and stroke. Excess weight puts strain on the heart. It raises blood pressure and blood cholesterol and can lead to diabetes. Fat has more calories than other types of food, eating less fat can
help reduce the day's total caloric intake. A diet that makes small
but permanent healthy changes in eating habits works best.
Your ideal weight depends on your age, sex, and height. Your healthcare provider can tell you what your ideal weight should be. Combining a healthy diet with a regular exercise program is the best approach to losing weight and helping your heart. People who weigh too much should try to lose only about 1 to 2 pounds per week. Routine exercise helps use up stored body fat. It also plays a role in reducing the risk of heart disease. Be sure to check with your healthcare provider before starting a new exercise program. .EXERCISE MAKES YOUR HEART STRONGER Lack of exercise increases the risk of heart disease. Lack of exercise
is also related to other diseases such as obesity, diabetes, and high
blood pressure. Even limited amounts of physical activity can be good
for your heart if done regularly and over the long term.
Exercise should include aerobic activities, resistive exercises, and other active recreational-leisure sports. Shoes and clothing should be worn that are appropriate for extremes of heat, cold, and humidity. The best kind of exercise for your heart is regular aerobic exercise. Aerobic exercise, such as swimming, bicycling, jogging, or walking, helps build up endurance. It should be done for at least 30 to 60 minutes four to six times a week or 30 minutes on most days of the week. The frequency, duration, and intensity of the activity should be personalized, as should the kind of activity and progression. Resistive exercises should be done 2 to 3 times a week. Free weights or standard equipment can be used. Resistive exercise develops muscle tone and strengthens muscles. These are very important for aging adults. Compliance influences the long-term effect of any physical activity program. Even if exercise is not vigorous, if it is regular, it can help the heart. A lifestyle that includes activities like walking, gardening, housework, dancing, and home exercise are all beneficial for yielding long-term health benefits. A lifestyle that includes physical activity from childhood throughout the adult years fosters good health and longevity. Before beginning any exercise program, see a healthcare provider if:
Begin a new exercise program gradually. Do not overdo it! Learn how
to exercise safely and correctly. If possible, seek help from a certified
exercise instructor who can develop a custom program to meet your health
and fitness goals. If you develop chest pain, breathlessness, or other
unusual symptoms during exercise, stop and rest. If these problems are
new, or concern you, see your healthcare provider. We shall shortly be adding this section.
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