Knowing the
Signs of a Heart Attack Could Save a Life
Mention the words "heart attack" and most
of us recoil at the image of someone clutching at their chest in sudden,
obvious agony before collapsing to the ground.
While that scenario happens in some cases,
you should know that mild chest pain, discomfort in the jaw, and lightheadedness
are among other, less-dramatic signs that can signal a heart attack.
Further, by not responding quickly to those
warning signals and delaying treatment, you could be putting yourself
at risk for heart damage and even death.
This is why the National Heart,
Lung, and Blood Institute (NHLBI), part of the National
Institutes of Health (NIH), the National Council on
the Aging, the American Heart Association,
and other groups have launched a new public education campaign called
"Act in Time to Heart Attack Signs."
Too few Americans get to a hospital fast
enough when they have a heart attack; anyone with symptoms should call
911 immediately. Yet studies show that many people wait two hours or
more before they seek emergency care, according to the NHLBI.
Each year, about 1.1 million Americans
suffer a heart attack and about 460,000 of them die. Nearly half of
those deaths occur within one hour of the start of symptoms, the NHLBI
says.
"We are certainly aware that the number
one cause of death and disability in older Americans is due to premature
heart attack and stroke," says Roba Whiteley, the National Council
on the Aging's vice president of marketing and communications.
"But people don't know what the signs and
symptoms are and it can be quite confusing," she says.
Heart attacks happen when blood flow to
the heart is nearly or completely blocked. And it is during the crucial
first hour after symptoms appear that "clot-busting" drugs and other
treatments, such as angioplasty, are most effective in opening clogged
arteries and restoring blood flow, says Mary Hand, coordinator of the
NHLBI's National Heart Attack Alert Program.
"The sooner the artery is opened and the
blood flow in the blocked artery is reestablished, the much better outcome
the patients have, both in terms of surviving and in terms of saving
their heart muscle," Hand says.
Yet only one-in-five heart attack patients
gets to a hospital emergency room fast enough to benefit from these
treatments.
Some of the less-familiar signs of a heart
attack include:
- chest discomfort or pain
- discomfort in the arm or arms, as well
as the back, neck, jaw, or stomach
- shortness of breath
- a cold sweat
- nausea
- lightheadedness
Many people are unaware that these milder
symptoms may indicate a heart attack; they dismiss them as signs of
indigestion, the flu, or even a pulled muscle. Always consult your physician
for a diagnosis.
One reason people are unaware of these
subtle signs is that too few physicians take the time to discuss them
with their patients, Hand says. One focus of the "Act in Time" campaign
is to get physicians to talk to their patients about heart attack symptoms
and how to respond to them.
Lack of knowledge is not limited to a heart
attack's warning signs. Many women are slow to seek help when having
a heart attack simply because they believe they are not at risk.
"Women, still, as a rule, don't think that
they're going to get heart disease or a heart attack. They're more concerned
about breast cancer. And yet one-in-three women are going to die from
heart disease and approximately one-in-seven will die from breast cancer,"
Hand says.
And sadly, some people delay calling for
help because they worry about being embarrassed if their symptoms turn
out to be a false alarm.
The "Act in Time" campaign is not aimed
just at people who may be at risk for a heart attack, either—everyone
needs to know the signs of a heart attack so they can be ready to help
family members, friends, and co-workers.
Hand also encourages everyone to have a
"heart attack action plan," much the same way you make an emergency
plan for a house fire.
"We actually want people to think through
and talk with their family members about what they should do if they
get these symptoms and to make sure everybody is on board with what
we're asking them to do. That is, call 9-1-1, get to the hospital right
away," Hand says.
Older Americans should be sure to discuss
their action plans not just with family members, but neighbors, friends,
caretakers, or housekeepers, the National Council on the Aging's
Whiteley says.
Always consult your physician for more
information.
In Other News That May Affect Your Cardiovascular
Health:
Chronic
Heart Failure Medication May Not Be Working as Intended
A drug that relaxes blood vessels does
not appear to help people with flare-ups of chronic heart failure and
may even worsen the problem, a new study has found.
The study, published in the Journal
of the American Medical Association (JAMA), showed that heart
patients were better off without the drug, called milrinone, which increased
the risk of seriously low blood pressure and abnormal heartbeats.
"Milrinone isn't working," said Dr. Mihai
Gheorghiade, a Northwestern University cardiologist who led the study.
Dr. Philip Poole-Wilson, a cardiologist
at Imperial College in London and author of an editorial accompanying
the journal articles, said milrinone "has probably been used too much
and the indications for its use are getting very much more narrow."
An earlier study showed that the drug was not effective—and potentially
dangerous—for people with chronic heart failure.
However, Poole-Wilson said, the drug may
be appropriate for people with other forms of congestive heart failure.
Who these patients are is not yet known, he added, because of the paucity
of good clinical evidence for treatments of this disease.
Improved Blood Flow
Seen in Second Study
A second study, also appearing JAMA,
found that a newer medication markedly improved blood flow in a similar
group of patients.
Experts said the two studies are important
because they represent the first large-scale, placebo-controlled trials
of drugs to treat worsening heart failure.
Almost five million Americans suffer from
heart failure, and 200,000 a year die from the disease, which involves
a fluid build-up in the lungs that forces patients to strain for breath.
Fluid can also pool in the legs. Heart failure can lead to liver congestion,
abnormal heart rhythms, and, ultimately, death.
Beta-blockers, ACE-inhibitors, and a variety
of other medications can improve heart function in patients with chronically
weak pumps. But physicians have hit on nothing so far that prolongs
life in those hospitalized with acute failure.
The problem, heart experts said, is that
patients, their families, and their physicians are frustrated by the
lack of a successful remedy for severe exacerbations of heart failure.
Everyone wants to do something, but nothing seems to work. So drugs
that might ordinarily be avoided are tried, in the hope that patients
might have a glimmer of improvement.
Always consult your physician for more
information.
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