As of Today…

Cardiac rehab is finished!

WOOHOO

 

The heart attack was January 27, 2013 and it took until today to finish the rehab but it got done.  We’ve both learned quite a bit and I doubt that we’ll ever go back to our earlier way of eating.

What a journey this has been – and I hope it’s done now.

I know that there’s always something else right around the corner but I hope it doesn’t hit us too soon.

Prevent heart attack and stroke

Generic regular strength enteric coated 325mg ...

Generic regular strength enteric coated 325mg aspirin tablets. The orange tablets are imprinted in black with “L429”. (Photo credit: Wikipedia)

This brief article will provide information and links to where additional information can be found to help you recognize and hopefully prevent a heart attack or stroke.

According to cardiologists, most heart attacks occur in the day, generally between 6 a.m. and noon. If you take an aspirin or a baby aspirin once a day, take it at night. Aspirin has a 24-hour “half-life” therefore, the aspirin would be strongest in your system when most heart attacks happen, in the wee hours of the morning.

A 2012 RetiredBrains survey of cardiologists provides the following information on the symptoms, warning signs and treatment for heart attack and stroke.

How to recognize heart attack symptoms

Chest discomfort that feels like pressure, or seems like a squeezing pain in the center of your chest. This pain generally lasts for more than a few minutes, but sometimes goes away and returns.

Pain and/or discomfort that extends beyond your chest to other parts of your upper body, such as one or both arms, back, neck, stomach, teeth, and even your jaw; shortness of breath, with or without chest discomfort. Other symptoms include: cold sweats, nausea or vomiting, lightheadedness, indigestion, and fatigue.

What should I do when heart attack symptoms occur

If you or someone you are with experiences chest discomfort or other heart attack symptoms the first thing you should do is call 9-1-1.

Don’t wait to make the call. Don’t drive yourself to the hospital. Don’t drive the person having a heart attack to the hospital. Immediate treatment lessens heart damage and can save your life. Emergency medical services personnel can begin treatment in the ambulance on the way to the hospital and are trained to revive a person if his/her heart stops. Some people delay treatment because they are not sure they are really having a heart attack. Remember call 911 immediately as treatment given within an hour of the first heart attack symptoms saves lives and damage to the heart and substantially increases the chances of survival.

What should I do before paramedics arrive

If 911 has been called:

1. Try to keep the person calm, and have them sit or lie down.

2. If the person isn’t allergic to aspirin, have them chew and swallow an aspirin (It works faster when chewed than swallowed whole.)

3. If the person stops breathing, you or someone else who is qualified should perform CPR immediately. If you don’t know CPR, the 9-1-1 operator can assist you until the EMS personnel arrive.

For more information, check out the heart disease section on Mayo Clinic’s site and the warning signs of heart attack, stroke and cardiac arrest, compiled by the American Heart Association.

The information contained in this article should not be substituted for the advice of your physician. If you experience any symptoms or are concerned about your health in any way, you should immediately seek the advice of your physician.

From MarketWatch

The Difference Between Sudden Cardiac Arrest and Heart Attacks

Cardiac Arrest Survival

Cardiac Arrest Survival (Photo credit: GEEKSTATS)

, director of cardiology at Johns Hopkins Hospital, talks about the difference between sudden cardiac arrest and a heart attack and what those at risk can do.

Question: What is sudden cardiac arrest?

Answer: Sudden cardiac arrest refers to collapse and loss of consciousness due to a dramatic fall in blood pressure. This is often but not always the result of a life-threatening arrhythmia or an abnormality of the normal rhythmic activity of the heart. An excessively fast or slow heart rate can cause a profound drop in the blood pressure and sudden cardiac arrest. [It] is not a heart attack or myocardial infarction, which refers to a critical blockage in a blood vessel that supplies blood, oxygen and nutrients to the heart muscle. A blockage in a blood vessel can cause part of the heart muscle to die and be replaced by scar.

Q: How common is it, and who is at risk?

A: The risk factors for sudden cardiac arrest include the presence of heart disease, a family history and many of the factors that increase the risk for a heart attack, such as smoking, obesity, physical inactivity, high blood pressure, high cholesterol, high blood sugar or diabetes, and a poor diet. If someone has heart disease, particularly with weakness of the heart muscle, they may be at particularly high risk for sudden cardiac arrest and may benefit from implantation of an Implantable Cardioverter Defibrillator. [The defibrillators] may also benefit patients with a family history of sudden cardiac arrest and/or a genetic tendency to arrhythmias.

Q: How can you prevent sudden cardiac arrest?

A: In some cases, sudden cardiac arrest can be brought on by exertion, but this is not always the case, as sudden cardiac arrest often occurs when one is at rest. Physical activity is generally good for all of us. Those with known heart disease should consult their health care provider about the details of their own physical activity, but generally, even patients with heart disease should try to remain active. It’s wise to avoid extreme activity, particularly in harsh environmental conditions, such as heat or cold. For anyone who exercises, symptoms such as profound dizziness or lightheadedness, chest pain, shortness of breath, extreme fatigue and/or palpitations should prompt cessation of exercise and depending upon the severity of the symptoms and get prompt medical attention.

Q: How is sudden cardiac arrest different from a heart attack?

A: Heart attacks are caused by blockage of the arteries, which supply oxygen and nutrients. These most often are accompanied by chest pain and/or shortness of breath. Sudden cardiac arrest can be a complication of a heart attack, but it can occur without a heart attack. The treatment of a heart attack is to limit the damage to the heart by promptly opening up the involved blood vessel by a procedure known as angioplasty and by placing a stent to keep that vessel open. The treatment of sudden cardiac arrest is restoration of the heart’s normal rate of contraction and rhythm, and this typically involves a shock to the chest that’s known as cardioversion or defibrillation.

Q: How quickly do you need to be treated to survive?

A: The most common arrhythmias or irregularities of the heart that cause sudden cardiac arrest are rapid heart rhythms from the heart’s lower chamber. These are called ventricular tachycardia and ventricular fibrillation. If these arrhythmias are not promptly corrected by a shock to the chest, the individual will die. In the case of ventricular fibrillation, this may take only minutes. One can buy time by performing effective CPR. Just chest compressions, or so-called “hands-only” CPR, can be lifesaving.

Adapted from The Baltimore Sun

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

Patient Outcomes Significantly Improved By L-Carnitine Following Heart Attack

myocardial infarction - Myokardinfarkt - scheme

myocardial infarction – scheme (Photo credit: Wikipedia)

L-carnitine significantly improves cardiac health in patients after a heart attack, say a multicenter team of investigators in a study published in Mayo Clinic Proceedings. Their findings, based on analysis of key controlled trials, associate L-carnitine with significant reduction in death from all causes and a highly significant reduction in ventricular arrhythmias and anginal attacks following a heart attack, compared with placebo or control.

Heart disease is the leading cause of death in the United States. Although many of the therapies developed in recent decades have markedly improved life expectancy, adverse cardiovascular events such as ventricular arrhythmias and angina attacks still occur frequently after an acute myocardial infarction (heart attack).

It is known that during ischemic events L-carnitine levels are depleted. Investigators sought to determine the effects of targeting cardiac metabolic pathways using L-carnitine to improve free fatty acid levels and glucose oxidation in these patients. By performing a systematic review and meta-analysis of the available studies published over several decades, they looked at the role of L-carnitine compared with placebo or control in patients experiencing an acute myocardial infarction.

L-carnitine is a trimethylamine which occurs in high amounts in red meat and is found in certain other foods, and is also widely available as an over-the-counter nutritional supplement which is claimed to improve energy, weight loss, and athletic performance. Its potential role in treating heart disease was first reported in the late 1970s.

A comprehensive literature search yielded 153 studies, 13, published from 1989-2007, were deemed eligible. All the trials were comparison trials of L-carnitine compared with placebo or control in the setting of acute myocardial infarction.

This systematic review of the 13 controlled trials in 3,629 patients, involving 250 deaths, 220 cases of new heart failure, and 38 recurrent heart attacks, found that L-carnitine was associated with:

  • Significant 27% reduction in all-cause mortality (number needed to treat 38)
  • Highly significant 65% reduction in ventricular arrhythmias (number needed to treat 4)
  • Significant 40% reduction in the development of angina (number needed to treat 3)
  • Reduction in infarct size

There were numerically fewer myocardial reinfarctions and heart failure cases associated with L-carnitine, but this did not reach statistical significance.

First author James J. DiNicolantonio, PharmD, Wegmans Pharmacy, Ithaca, NY, observes, “Although therapies for acute coronary syndrome (ACS), including percutaneous coronary intervention, dual antiplatelet therapy, b-blockers (BBs), statins, angiotensin-converting enzyme inhibitors (ACEIs), omega-3 fatty acids, and cardiac rehabilitation, have markedly improved clinical outcomes, adverse cardiovascular (CV) events still occur too frequently after ACS. One promising therapy for improving cardiac health involves using L-carnitine to improve free fatty acid levels and glucose oxidation.”

“The potential mechanisms responsible for the observed beneficial impact of L-carnitine in acute myocardial infarction are likely multifactorial and may, in part, be conferred through the ability of L-carnitine to improve mitochondrial energy metabolism in the heart by facilitating the transport of long-chain fatty acids from the cytosol to the mitochondrial matrix, where b-oxidation occurs, removing toxic fatty acid intermediates, reducing ischemia induced by long-chain fatty acid concentrations, and replenishing depleted carnitine concentrations seen in ischemic, infarcted, and failing myocardium,” says DiNicolantonio.

L-carnitine is proven to be safe and is readily available over the counter. The investigators agree that the overall results of this meta-analysis support the potential use of L-carnitine in acute myocardial infarction and possibly in secondary coronary prevention and treatment, including angina. They advocate for a larger randomized, multicenter trial to be performed to confirm these results in the modern era of routine revascularization and other intensive medical therapies following acute myocardial infarction. But, says DiNicolantonio, “L-carnitine therapy can already be considered in selected patients with high-risk or persistent angina after acute myocardial infarction who cannot tolerate treatment with ACE inhibitors or beta blockers, considering its low cost and excellent safety profile.”

These findings may seem to contradict those reported in a study published earlier this month in Nature Medicine by Robert A. Koeth and others (Koeth, R. A. et al. Nature Med.*), which demonstrated that metabolism by intestinal microbiota of dietary L-carnitine produced trimethylamine N-oxide (TMAO) and accelerated atherosclerosis in mice. They also noted that omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of L-carnitine, and suggested a possible direct link between L-carnitine, gut bacteria, TMAO, and atherosclerosis and risk of ischemic heart disease.

“The Nature Medicine paper is of interest,” agrees senior investigator Carl J. Lavie, M.D.,FACC,FACP,FCCP, Medical Director of the Cardiac Rehabilitation and Prevention Center at the John Ochsner Heart and Vascular Institute at the University of Queensland School of Medicine in New Orleans, “but the main study reported there was in animals, and unlike our study, lacks hard outcomes.” He also notes that “there are various forms of ‘carnitine’ and our relatively large meta-analysis specifically tested L-carnitine on hard outcomes in humans who had already experienced acute myocardial infarction.”

from Sciences, E. (2013, April 16). “Patient Outcomes Significantly Improved By L-Carnitine Following Heart Attack.” Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/259096.php.

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

Warning Signs of Heart Disease & Heart Attack

An example of a heart attack, which can occur ...

An example of a heart attack, which can occur after the use of a performance-enhancing drug. (Photo credit: Wikipedia)

 

Preventing Heart Disease and Heart Attack Educational Video. U.S. Department of Health and Human Services
National Institutes of Health; National Heart, Lung, and Blood Institute; Act in Time to Heart Attack Signs; Item #56-042N, September 2001;

 

The dramatic, moving stories of three heart attack survivors and their families illustrate the importance of heeding heart attack warning signs and seeking medical care quickly. They vividly convey how a real heart attack may differ from the stereotypical “movie heart attack” and how getting immediate treatment can save lives. The warm and sympathetic narration by an emergency department physician explains what a heart attack is, the treatments that can save lives if given quickly, why many heart attack victims delay seeking care, and how to make a heart attack survival plan. Useful for health fairs, medical waiting rooms, community groups, and home viewing.

 

Producer: National Institutes of Health; Keywords: hhs.gov; public_safety; Creative Commons license: Public Domain.

 

Heart Attack Warning Signs. A heart attack is a frightening event, and you probably don’t want to think about it. But, if you learn the signs of a heart attack and what steps to take, you can save a life–maybe your own. What are the signs of a heart attack? Many people think a heart attack is sudden and intense, like a “movie” heart attack, where a person clutches his or her chest and falls over. The truth is that many heart attacks start slowly, as a mild pain or discomfort. If you feel such a symptom, you may not be sure what’s wrong. Your symptoms may even come and go. Even those who have had a heart attack may not recognize their symptoms, because the next attack can have entirely different ones. Women may not think they’re at risk of having a heart attack–but they are.

 

Learn more about women and heart attack. It’s vital that everyone learn the warning signs of a heart attack. These are: Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach. Shortness of breath. Often comes along with chest discomfort. But it also can occur before chest discomfort. Other symptoms. May include breaking out in a cold sweat, nausea, or light-headedness. Learn the signs–but also remember: Even if you’re not sure it’s a heart attack, you should still have it checked out. Fast action can save lives-maybe your own.

 

After you learn more about heart attack, try a brief quiz to see if you know what to do if you or someone else has warning signs. How do you survive a heart attack? Fast action is your best weapon against a heart attack. Why? Because clot-busting drugs and other artery-opening treatments can stop a heart attack in its tracks. They can prevent or limit damage to the heart–but they need to be given immediately after symptoms begin. The sooner they are started, the more good they will do–and the greater the chances are for survival and a full recovery. To be most effective, they need to be given ideally within 1 hour of the start of heart attack symptoms. You can reduce your risk of having a heart attack—even if you already have coronary heart disease (CHD) or have had a previous heart attack. The key is to take steps to prevent or control your heart disease risk factors.

 

Six Key Steps To Reduce Heart Attack Risk; Taking these steps will reduce your risk of having a heart attack: Stop smoking; Lower high blood pressure; Reduce high blood cholesterol; Aim for a healthy weight; Be physically active each day. Manage diabetes.