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Heart attacks and heart diseases can be prevented

By B.L. Azure

ST. IGNATIUS — Whenever I think about people having a heart attack, I flashback to the 1970s television sitcom “Sanford and Son.” A reoccurring theme on the show was Redd Foxx as Fred Sanford faking a heart attack. Fred would clasp his chest while looking to the heavens, and say, “It’s the big one Elizabeth, I’m coming to join you honey.” It was always good for a chuckle because you knew it was just another way that old Fred would use to dodge work. However, in real life heart attacks are no laughing matter — they are serious life-altering or life-ending events.

Heart disease is the number one cause death in America: one in four deaths are caused by it — more than all types of cancer combined.

In a study by Trinity College in Ireland, researchers found that 65 percent of the 900 heart attack patients interviewed experienced a slow onset of symptoms that included chest and left arm discomfort, shortness of breath and fatigue. The rest — 35 percent — experienced gasping for air/oxygen, and pain so severe that they immediately collapsed to the floor.

Heart attacks are usually due to an abrupt closure of an artery that could kill the heart muscle and as a result the person instantly or within a matter of hours. Time is off the essence and the sooner a blocked artery is opened via angioplasty or clot-busting medication the better the chances of survival and recovery.

However, it is best to take measures to prevent heart attacks or disease.

The American Heart Association and American College of Cardiology have issued the first new guidelines in a decade for preventing heart attacks and strokes. Among other things, they call for twice as many Americans — one-third of all adults — to consider taking cholesterol-lowering statin drugs.

The new guidelines include strokes, not just heart attacks. They estimate a person’s risk in a novel way and change the goal of treating high cholesterol.

A new formula includes age, sex, race, blood pressure, cholesterol, diabetes and smoking. People ages 40 to 79 should get an estimate every four to six years. If risk is still unclear, family history or three other tests can be considered. The best one is a coronary artery calcium test, an X-ray to measure calcium in heart arteries.

High cholesterol leads to hardened arteries, which can cause a heart attack or stroke. Most cholesterol is made by the liver, so diet changes have a limited effect, and many people need medicines to lower their risk.

The guidelines don’t change the definition of high cholesterol, but they say doctors should no longer aim for a specific number with whatever drugs can get a patient there. The new advice stresses statins such as Lipitor and Zocor; most are generic and cost as little as a dime a day.

The guidelines also recommend 40 minutes of moderate to vigorous exercise three to four times a week. They call for a “dietary pattern” that is focused on vegetables, fruits and whole grains and includes low-fat dairy products, poultry, fish, beans and healthy oils and nuts. Limit sweets, sweet drinks, red meat, saturated fat and salt

To fight obesity, doctors should develop individualized weight-loss plans including a moderately reduced-calorie diet, exercise and behavior strategies. The best plans offer two to three in-person meetings a month for at least six months. Web or phone-based programs are a less-ideal option.

Four groups are targeted in the new guidelines:
   • People who already have heart disease (clogged arteries).
   • Those whose LDL, or “bad cholesterol,” is 190 or higher, usually because of genetic risk.
   • People ages 40 to 75 with Type 2 diabetes.
   • People ages 40 to 75 who have an estimated 10-year risk of heart attack or stroke of 7.5 percent or higher, based on the new formula. This means that for every 100 people with a similar risk profile, seven to eight would have a heart attack or a stroke within 10 years.

Recommended measures to prevent heart disease:
   • Quit smoking and stay away from secondhand smoke.
   • Control your cholesterol and blood pressure.
   • Drink alcohol only in moderation. This means no more than one drink a day for women and no more than two drinks a day for men.
   • Eat healthy and get active. Aim for two hours and 30 minutes of moderate aerobic activity every week.
   • Aim for a healthy weight. If you are overweight or obese, losing just 10 pounds can lower your risk of heart disease.

Heart Attack Warning Signs

It may seem as if a heart attack comes out of the blue, but there are numerous symptoms that can sound the alert — if you know what to watch for. According to a recent Harvard study, only 25 percent of heart attack victims had no prior symptoms. The trouble is, these danger signs aren’t necessarily the symptoms you’ve been warned about.

Here are seven early warning signs that could save a life — yours or that of someone you love

Rapid, pounding, or irregular heartbeat
Sudden, unexplained episodes of rapid, irregular heartbeat and pulse can predate a heart attack by weeks or months.

Skipped beats or arrhythmias that aren’t accompanied by an increase in heart rate are less serious, though they still need medical attention.

However, an irregular heartbeat accompanied by an increase in the number of beats per minute — what’s known as supraventricular and ventricular tachycardia — can indicate a serious problem.

Scary Stat: Ventricular tachycardia, particularly after exercise, is closely associated with sudden death, so it’s important to get help fast.

Top Clues: The symptoms are easy to confuse with a panic attack. Your heart may feel like it’s pounding, as if you’d just run for the bus or had a terrible fright. And the episodes are likely to come on suddenly. Typically, there’s no obvious trigger for the sudden heartbeat acceleration and arrhythmia, but there is a type of ventricular tachycardia that’s triggered by vigorous exercise in someone with heart disease. When these episodes last longer than a minute or two, dizziness and weakness may follow.

What To Do: Call the doctor right away.

Nausea, stomachache, and indigestion
If you’ve been battling stomachache, nausea, or indigestion without any obvious cause, you might be mistakenly attributing cardiovascular symptoms to a gastrointestinal problem. Blockages of fatty deposits in an artery can reduce or cut off the blood supply to the heart, causing angina, which feels like squeezing, cramping, or pain. Although most people associate angina with chest pain, in many cases the body sends those pain signals down into the abdomen. Poor circulation and lack of oxygen circulating in the blood, caused by a weak heart or blocked arteries, can lead to ongoing nausea, indigestion, or vomiting, particularly in women or those over 60.

Scary Stat: This symptom is particularly common in women, who are more likely to avoid going to the emergency room. This is one reason that 42 percent of women who have heart attacks die within one year, compared to 24 percent of men. And under age 50, women’s heart attacks are twice as likely as men’s to be fatal.

Top Clues: The pain worsens with exertion and gets better with rest. You’ve been relying on antacids, anti-nausea medication, or other indigestion remedies for more than a few days. The symptoms are episodic, easing and then returning, rather than feeling like one long bout of indigestion.

What To Do: Watch your symptoms for a few days to rule out a stomach virus or food poisoning. If symptoms persist, get a checkup for gastrointestinal illness, but make sure to ask your doctor to consider heart health as well.

Extreme fatigue
A sense of crushing fatigue that lasts for days, weeks, or even months can signal heart trouble months before a heart attack occurs. This isn’t run-of-the-mill fatigue but the debilitating kind you’d typically associate with having the flu.

Scary Stat: More than 70 percent of women in a National Institute of Health study reported extreme fatigue in the weeks or months before having a heart attack.

Top Clues: Fatigue comes on suddenly, without any clear explanation such as extreme exertion, lack of sleep, or illness. Typically you’ll start the day with close to normal energy but become increasingly tired, feeling exhausted by afternoon. A heavy feeling in the legs is another sign. Women should be particularly alert for unexplained, long-lasting fatigue.

What To Do: Call your doctor and schedule a checkup.

Anxiety attacks and insomnia
A decrease in oxygen levels — caused by changes in the heart due to heart disease — may trigger subtle changes that lead to anxiety, insomnia, and agitation that can’t be explained by normal circumstances. Looking back, people who’ve had a heart attack often realize they began to experience anxiety and insomnia in the months before the attack. This may be the body’s way of trying to let you know that something’s not right.

Scary Stat: Two landmark studies, one published in “Circulation” and a follow-up study in the “Annals of Behavioral Medicine,” found a strong association between self-reported symptoms of serious anxiety and a risk of fatal coronary heart disease.

Top Clues: Sudden onset of insomnia when you haven’t experienced this problem before is a signal to watch out for. It can take the form of trouble falling asleep or unexplained middle-of-the-night waking. Racing thoughts or unexplained feelings of dread or impending doom are also clues.

What To Do: Ask yourself whether the anxiety is related to recent events or triggers, or whether it seems abnormal in proportion to life events. Sudden, unexplained anxiety or insomnia should be discussed with your doctor.

Pain in the shoulder, neck, jaw, or arm
While chest pain is a well-known sign of heart attack, it’s much easier to miss this sign if the pain mimics typical shoulder, neck, or jaw pain. Damaged heart tissue or angina — pain from a blocked artery — sends pain signals up and down the spinal cord to junctures with nerves that radiate out from the cervical vertebrae. The pain may travel up the neck to the jaw and even to the ear, or radiate down the shoulder to the arm and hand, or it may center between the shoulder blades. The pain may feel sharp, or it may be a dull ache such as you’d feel with a pulled muscle. This is a symptom doctors have only recently begun to focus on, due to patient reports post-heart attack that this was one of the only symptoms they noticed in the days and weeks leading up to the attack.

Scary Stat: For 50 percent of the men who die from heart attacks, the attack itself is their first noticed symptom. Recognizing the pain of heart attack is key to fast treatment, yet it’s often missed if it’s not felt in the chest.

Top Clues: The pain comes and goes, rather than persisting unrelieved, as with a pulled muscle. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then later it moves to your ear and jaw. Numbness, tightness, or tingling may accompany the pain.

What To Do: Pain that doesn’t go away after several days merits a medical checkup. If the pain seems to move or radiate upward and out, this is important to tell to your doctor.

Breathlessness, dizziness, or a feeling of being unable to draw a deep breath
When you can’t draw a deep breath, you probably assume it’s your lungs, but it could be the result of too little oxygen circulating in your blood from a weakened heart. Officially known as dyspnea, shortness of breath is often the first sign of serious heart disease.

Scary Stat: In a landmark study in “Circulation,” 40 percent of women heart patients reported shortness of breath for up to six months prior to having a heart attack.

Top Clues: You feel like you’re not getting enough oxygen, just as you would at high altitude. You might also feel light-headed and dizzy. An ongoing concern or suspicion that you’re developing asthma or lung disease can also be a sign your heart’s acting up.

What To Do: Shortness of breath can indicate a problem with the lungs, the heart, or both, so this symptom is always a reason to call the doctor.

Unusual, excessive sweating
Unusual sweatiness when you haven’t been exerting yourself more than usual has only recently been recognized as a sign that frequently precedes heart attacks. In women, it may feel similar to the hot flashes or night sweats typical of menopause.

Scary Stat: According to a University of Chicago study, excessive perspiration in many areas of the body, such as the chest, back, scalp, palms, or soles of the feet, in addition to the underarms, is often the first indicator that something’s wrong — before a heart attack begins. Excessive sweating also occurs with a condition called endocarditis, an infection of the lining of the heart and heart valves, which can trigger a heart attack or stroke.

Top Clues: Flu-like symptoms, like clammy skin or sweatiness, that aren’t accompanied by a fever, that last longer than a week, or that come and go over a long period of time, are signs that there’s some other underlying cause, which may be heart disease.

What To Do: If symptoms persist and seem unusual, call your doctor to talk through your concerns.

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