People are having heart attacks or myocardial infarctions at younger and younger ages these days. Reasons are numerous including being middle aged, overweight, smoking, having high cholesterol, hypertension and a family history of coronary artery disease. Our high stress lifestyles also contribute to an increased risk of having a heart attack. Touched by An Angel actor, John Dye, was only 47 when he died of a heart attack on January 10, 2011. His death made me wonder why people are dying from heart attacks when we’ve had so many advances in cardiac care.
First, what is a heart attack?
A heart attack or myocardial infarct is caused by decreased blood flow through the arteries supplying your heart muscle with oxygen. When the heart muscle stops receiving oxygen it dies, decreasing its ability to function properly. This decreased blood flow could be caused by blood clots, atherosclerosis, thrombosis or coronary artery hardening or spasms. The resulting blockage causes ischemia and necrosis of the heart muscle and is felt as pain by the body.
- Ischemia: Local deficiency of blood supply produced by vasoconstriction or local obstacles to the arterial flow.
- Necrosis: the death of one or more cells in the body, usually within a localized area, as from an interruption of the blood supply to that part. (Dictionary.com)
How are heart attacks treated?
Many hospitals participate in the D2B program, or door-to-balloon initiative, which goals include having an electrocardiogram within ten minutes of arrival in the emergency room and to have the patient in the cath lab for stent placement or ballooning within ninety minutes by a cardiac interventalist. The D2B program was initiated by the American College of Cardiology in 2006 to save heart muscle by providing rapid reperfusion of clogged vessels that supply blood to the heart. Less than 50% of people having ST elevated myocardial infarction (STEMI) receive the suggested percutaneous coronary intervention within the allotted time.
Note: Not all heart attacks are treated the same way. It depends on how the patient presents upon arrival to the emergency room, if they are having an active heart attack (which will be revealed on the EKG) and the treatment plan developed by the cardiologist and emergency room physicians. Many people are treated medically, (i.e. with medication such as Plavix or Aspirin therapy.)
Recently a family friend had a heart attack that required cardiac catheterization with stent placement to reopen his clogged arteries. Our friend is a 33 year old African American male. He is overweight and a smoker, two factors that put him at risk for having a heart attack. He started having chest pain at midnight but waited until morning to seek medical attention. This unnecessary delay could have cost him his life.
In my clinical practice I see many patients with similar stories. They often arrive at the emergency room clutching their chest, breathing heavily their faces dripping in sweat having waited too long to see if the pain would just go away. Is it the recklessness of youth that leads us to ignore the signs and symptoms of a heart attack or a lack of education about the warning signs?
Assuming the latter, I have listed below the signs many but not all people experience when they are having a heart attack.
- Crushing chest pain/pressure that may radiate to the left arm, jaw, neck or back.
- Fatigue
- Nausea/Vomiting
- Shortness of Breath
- Anxiety (feelings of impending doom)
- Indigestion or Epigastric Abdominal Pain
- Sudden Cardiac Arrest
- Sweating
- Tachycardia (rapid heartbeat)
- Bradycardia (slow heart beat)
- Hypertension (High Blood Pressure)
- Hypotension (Low Blood Pressure)
What should you do if you experience any of these symptoms?
Seek medical treatment right away. Call 9-1-1. Prompt medical attention is important in the treatment of myocardial infarcts. Time = heart muscle lost. Do not wait to see if the chest pain goes away. Remember women, the elderly, and diabetics may experience more subtle symptoms. If something doesn’t feel right don’t be afraid to check it out.
What can you do to decrease your risk of having a heart attack?
If you smoke cigarettes quit. If you are overweight, talk with your doctor about starting a diet and exercise program. Take medications as prescribed to treat pre-existing conditions such as high cholesterol, hypertension and diabetes. For more information talk with your family doctor and visit one of the websites listed below.
American Heart Association
D2B Door–to-Balloon Initiative
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Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Lexi Flint - Lexi Flint
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