February is American Heart Month
Heart disease is the leading cause of death for men and women in the United States. Every year 610,000 or 1 in 4 deaths are caused by heart disease. (1) “Heart Disease” refers to several types of heart conditions with the most common being coronary artery disease, which can cause heart attacks. There are other types of heart disease that directly involve the function of the heart such as defective valves or pumping problems that could lead to heart failure.
Here we will explore the most common form of heart disease – coronary artery disease. This condition occurs when plaque, which is made of cholesterol, fatty substances, cellular waste products, calcium and fibrin (a clotting material in the blood), builds up on artery walls slowing or even blocking the flow of blood to the heart. If a blood clot forms on top of the plaque or from a ruptured arterial wall it will travel through your bloodstream to your heart, your head or one of your extremities. If the clot blocks and artery to the heart a heart, also called a myocardial infarction, attack occurs. If the clot blocks an artery to the brain a stroke occurs.
What are the Signs of a Heart Attack?
There are several symptoms that are the same between men and women. The five major symptoms of a heart attack are:
- Pain or discomfort in the jaw, neck, or back
- Feeling weak, light-headed, or faint
- Chest pain or discomfort
- Pain or discomfort in arms or shoulder
- Shortness of breath
Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting.
Women are more likely to describe chest pain that is sharp, burning and more frequently have pain in the neck, jaw, throat, abdomen or back.
Sometimes heart disease may be silent and not diagnosed until a woman experiences signs or symptoms of a heart attack, heart failure, an arrhythmia, or stroke. (2)
If you think that you or someone you know is having a heart attack, call 9-1-1 immediately.
What Risk Factors Contribute to Heart Disease?
The three key heart disease risk factors are:
- High blood pressure
- High LDL cholesterol
- Smoking
About half of Americans (49%) have at least one of these three risk factors.
Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:
- Diabetes
- Overweight and obesity
- Poor or unhealthy diet
- Physical inactivity
- Excessive alcohol use
Diagnosis and Treatment
Diagnosis is made by your primary care provider in conjunction with a cardiac specialist. It will probably start with a trip to the emergency room during the onset of heart attack symptoms. The best time to treat a heart attack is within one to two hours of the first onset of symptoms, so getting to the hospital as quickly as possible is necessary to minimize the damage and start the healing process. Waiting longer increases the damage to your heart and reduces your chance of survival.
Diagnosis
Doctors in the emergency room will begin by asking and evaluating your symptoms. Then they will order a standard set of tests to confirm a heart attack diagnosis and the level of damage.
ECG, also known as EKG or electrocardiogram, can tell how much damage has occurred to your heart muscle and where it has occurred. Your heart rate and rhythm will also be monitored.- Blood will be drawn to measure levels of cardiac enzymes that indicate heart muscle damage. These enzymes are normally found inside the cells of your heart and are needed for their function. When your heart muscle cells are injured, their contents — including the enzymes — are released into your bloodstream. By measuring the levels of these enzymes, the doctor can determine the size of the heart attack and approximately when the heart attack started. Troponin levels will also be measured. Troponins are proteins found inside of heart cells that are released when they are damaged by the lack of blood supply to the heart. Detecting troponin in the blood may indicate a heart attack.
- Echocardiography is an imaging test that can be used during and after a heart attack to learn how the heart is pumping and what areas are not pumping normally. The “echo” can also tell if any structures of the heart (valves, septum, etc.) have been injured during the heart attack.
- Cardiac catheterization. Cardiac catheterization, also called cardiac cath, may be used during the first hours of a heart attack if medications are not relieving the ischemia or symptoms. The cardiac cath can be used to directly visualize the blocked artery and help your doctor determine which procedure is needed to treat the blockage. (3)
Treatment
Once diagnosed, drugs and surgical procedures are used to treat a heart attack. Drug therapies are introduced as quickly as possible to help break up and prevent clots from forming, prevent further plaque from building up and prevent further damage to the heart. Drugs typically used following a heart attack include:
- Aspirin to prevent blood clotting that may worsen the heart attack
- Other antiplatelets, such as Brilinta, Effient, or Plavix, to prevent blood clotting
- Thrombolytic therapy (“clot busters”) to dissolve any blood clots in the heart’s arteries
- Any combination of the above (3)
During or shortly after a heart attack, you will be evaluated by a cardiac team of doctors to determine the status of your heart, arteries, and the amount of heart damage. In some cases, procedures, such as angioplasty or stents, are used to open up your narrowed or blocked arteries to improve or restore blood flow to the heart. If necessary, bypass surgery may be performed in the days following the heart attack to restore the heart muscle’s supply of blood.
While there is no “cure” for heart disease and no guarantees you won’t suffer another one there are several things you can do to help prevent another one. Among these are medications to help prevent future clots and reduce the production of plaque. You should also consider lifestyle changes that significantly reduce your risk of another heart attack. (See following section.)
Your heart will normally heal in about eight weeks. However, the amount of damage depends on the size and area affected by the loss of the blood supply and the time between injury and treatment. When your heart heals it leaves a scar, just like a skin wound. And just like a thick scar on your skin, your heart scar is not pliable enough to contract thus reducing the ability of your heart to pump maximum blood to the rest of your body. The degradation of pumping ability depends on the size and location of the scar. (3)
How Can I Reduce My Risks of Heart Disease?
To reduce your risks of getting heart disease it’s important to (2):
- Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High blood pressure has no symptoms so it’s important to have your blood pressure checked regularly.
- Talk to your healthcare provider about whether you should be tested for diabetes. Having uncontrolled diabetes raises your chances of heart disease.
- Quit smoking. (Good for you on many levels!)
- Discuss checking your cholesterol and triglycerides with your healthcare provider.
- Make healthy food choices. Being overweight and obese raises your risk of heart disease.
- Increase your physical activity. Try to get at least 20 minutes of activity per day or 150 minutes per week.
- Limit alcohol intake to one drink a day.
- Lower your stress level and find healthy ways to cope with stress.
Disturbing Trend
Younger adults are at risk. National trends show heart disease death rates are declining more slowly than they have in the past, especially among adults ages 35 to 64. In many communities across the U.S., death rates are actually increasing among adults in this age group. Not only are more younger adults dying of heart disease, but their rates of risk factors—such as physical inactivity, tobacco use, and hypertension—are also increasing. (4) We can help our younger adults reduce their risk of heart disease by following the guide above. Companies can also help implement programs in the workplace that raise awareness and promote increased wellness by enforcing many of the good health guidelines outlined above!
February is American Heart Month Conclusion
Know the signs of heart disease and a heart attack! Educate men and women of all races and age groups as heart disease does not discriminate! Celebrated each February since 1964, American Heart Month seeks to raise awareness on cardiovascular disease, particularly heart disease and stroke, as it remains the leading global cause of death with 17.9 million deaths each year. And that number is expected to rise to more than 23.6 million by 2030 unless we start making lifestyle changes that reduce the risk factors of heart disease and increase the health of our heart. Start increasing your knowledge on heart health today and making those positive changes in your life, your loved ones, your friends and all those around you so we can significantly reduce those treatment and death numbers now!
To your improved health…
Resources:
- CDC Heart Age Predictor Using BMI
- CDC Million Hearts Program
- American Heart Association Newsroom
- Know the Difference Between “Cardiac Arrest” and “Heart Attack” (Hint: they are not the same thing)
- US Department of Health and Human Services HealthFinder.gov
References:
- (1) Centers for Disease Control (CDC) – Heart Disease Facts
- (2) CDC – Women and Heart Disease Fact Sheet
- (3) WebMD – Heart Attacks and Heart Disease
- (3) Million Hearts – American Heart Month 2018: You’re in Control