Heart attacks: What you should know

Three coronary artery bypass grafts, a LIMA to...

Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery (RCA) system and one to the obtuse marginal (OM) system. (Photo credit: Wikipedia)

Editor’s note: Dr. John P. Reilly is editor-in-chief ofsecondscount.org, the patient education website of the Society of Cardiovascular Angiography and Interventions, which is focused on raising awareness of heart attacks and other cardiovascular diseases. Reilly is the program director for the Cardiology Fellowship Program at Ochsner Medical Center in New Orleans.

(CNN) — If you are one of the nearly 785,000 Americans who suffer a first heart attack this year, what you do in the first few minutes can determine an entire lifetime.

Unfortunately, many people do not know what symptoms to look for or what life-saving steps to take. To help make sense of it all, the following can help you or someone you know survive a heart attack:

Q: What are the top three things I should know about heart attacks?

A: When a heart attack strikes, seconds count.

Seek medical attention immediately. The longer your symptoms persist, the greater the amount of heart muscle damage you may suffer. The start of your symptoms is a signal that blood flow to your heart muscle has been blocked. The emergency department and interventional cardiologist or surgeon will move quickly to restore blood flow to your heart to prevent further damage.

Call 911 for an ambulance. Don’t drive yourself or have someone else drive you. During a heart attack, your heart rhythm can become abnormal or even stop.

Emergency medical providers can perform an electrocardiogram, or EKG, on the way to the hospital and confirm whether you are having a heart attack and treat your heart rhythm abnormalities if needed. They can also call the hospital in advance to prepare a medical team for your arrival so treatment can start immediately.

If available, chew one uncoated aspirin while waiting for the ambulance. This may help slow the formation of blood clots that can cause heart attacks.

Q: What are the common symptoms of heart attacks, and how do they differ between men and women?

A: We’ve all seen the scenario where the actor grabs his or her chest in agonizing pain and falls to the ground. A heart attack seems obvious, but in real life, it’s not always that clear.

Heart attack symptoms can vary and don’t always involve debilitating chest pain. Many patients say their symptoms were not painful but more like an ache or discomfort. Symptoms may start with a dull pain in the chest or disguise themselves as indigestion, nausea, shortness of breath or heartburn. Other common symptoms include arm, neck, jaw, back or upper stomach discomfort, dizziness, change in heart rhythm and sudden cold sweats.

But these symptoms may differ for your wife, mother or sister because women do not always experience the same heart attack symptoms as men. Symptoms may be subtle and difficult to identify and may not even include chest pain.

While this does not mean women cannot have chest pain, other symptoms that may signal a heart attack for women include sudden weakness and fatigue, body aches or flu-like symptoms. Heart disease is the leading cause of death for women, so it’s important that you don’t ignore these symptoms, regardless of how subtle they are.

Q: What are my heart attack treatment options?

A: There are various treatment options available when you’re having a heart attack. The most effective treatment is angioplasty and stenting. In some cases, clot-busting medication is administered intravenously. In rare and severe cases, emergency coronary artery bypass grafting is needed.

Angioplasty is a minimally invasive, nonsurgical procedure that opens the blocked artery. During the procedure, a small mesh tube called a stent may be placed in the artery to restore blood flow and scaffold the vessel open.

Clot-busting medications melt away the blood clot that is blocking the artery. Coronary artery bypass grafting is open-heart surgery where a healthy artery or vein from elsewhere in the body is connected upstream and downstream from the heart artery blockage, bypassing the blockage and creating a new path for blood flow.

Fortunately, medical technology has advanced tremendously in recent years, and many patients can return home and back to their normal — if not better — quality of life within days of treatment.

Q: What should I do following my heart attack?

A: Experiencing a heart attack is a life-changing event and an important time to reflect upon your current lifestyle.

Cardiac rehabilitation benefits many patients by helping them resume a healthy lifestyle following their heart attack. You’ll also be taking medication regularly. Adhering to your medical therapy and scheduling consistent follow-up visits with your cardiologist and primary care doctor are both beneficial habits to adopt.

In addition, it’s important to become your heart’s No. 1 health advocate. Assess your current lifestyle and see where you can make improvements. Can you eat healthier and exercise more, reduce your stress levels or quit smoking? These changes will greatly increase your odds of fighting off future heart attacks.

From CNN.com

Cardiac Rehabilitation Starts Today!

cardiac-rehab

DH finally starts his cardiac rehab today, just over 8 weeks after his triple bypass.

Cardiac rehabilitation (rehab) teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. Cardiac rehab can help you feel better and reduce your risk of future heart problems.

In cardiac rehab, you work with a team of health professionals. Often the team includes a doctor, a nurse specialist, a dietitian, an exercise therapist, and a physical therapist. The team designs a program just for you, based on your health and goals. Then they give you support to help you succeed.

If you have had a heart attack, you may be afraid to exercise. Or if you have never exercised, you may not know how to get started. Your cardiac rehab team will help you start slowly and work up to a level that is good for your heart.

Many hospitals and rehab centers offer cardiac rehab programs. You may be part of a cardiac rehab group, but each person will follow his or her own plan.

Who should take part in cardiac rehab?

Doctors often prescribe cardiac rehab for people who have had a heart attack or bypass surgery. But people with many types of heart or blood vessel disease can benefit from cardiac rehab. Rehab might help you if you have:

  • Heart failure.
  • Peripheral artery disease (PAD).
  • Had or plan to have a heart transplant.
  • Had angioplasty to open a coronary artery.
  • Had another type of heart surgery, such as valve replacement.

Often people are not given the chance to try cardiac rehab. Or they may start a program but drop out. This is especially true of women and older adults. And that’s not good news, because they can get the same benefits as younger people. If your doctor suggests cardiac rehab, stay with it so you can get the best results.

Medicare will pay for cardiac rehab for people with certain heart problems. Many insurance companies also provide coverage. Check with your insurance company or your hospital to see if you will be covered.

What happens in cardiac rehab?

In cardiac rehab, you will learn how to:

  • Manage your heart disease and problems such as high blood pressure and high cholesterol.
  • Exercise safely.
  • Eat a heart-healthy diet.
  • Quit smoking.
  • Reduce stress and depression.
  • Get back to work sooner and safely.

Exercise is a big part of cardiac rehab. So before you get started, you will have a full checkup, which may include tests such as an electrocardiogram (EKG or ECG) and a “stress test” (exercise electrocardiogram). These tests show how well your heart is working. They will help your team design an exercise program that is safe for you.

At first your rehab team will keep a close watch on how exercise affects your heart. As you get stronger, you will learn how to check your own heart rate when you exercise. By the end of rehab, you will be ready to continue an exercise program on your own.

What are the benefits of cardiac rehab?

Starting cardiac rehab after a heart attack can lower your chance of dying from heart disease and can help you stay out of the hospital. It may reduce your need for medicine.

Cardiac rehab may also help you to:

  • Have better overall health.
  • Lose weight or keep weight off.
  • Feel less depressed and more hopeful.
  • Have more energy and feel better about yourself.

Changing old habits is hard. But in cardiac rehab, you get the support of experts who can help you make new healthy habits. And meeting other people who are in cardiac rehab can help you know that you’re not alone.

Adapted from CardioSmart.org

Coronary Bypass Surgery

From MedStar Union Memorial Hospital.  They say “Last year alone, our doctors performed more than 880 open-heart surgeries and 6,100 catheter-based procedures, including nearly 2,000 angioplasties. No hospital in Maryland or nationally performs a higher percentage (94 percent) of beating-heart bypass surgeries.”

Warning – graphic video!