Listen To Your Heart
What to know about your risks of an attack and what to do when having one
By Mary Lorenz
Last October, Jeff Espina was playing volleyball when he started to feel symptoms of what he thought was heartburn. Then, on his way home, he noticed his arms and limbs were starting to feel weak.
“For a second, I thought, ‘Something’s going on,’” Espina says. “However, being the stubborn person I am, I didn’t think anything of it. I just thought maybe I was really tired.” So when his family suggested he go to the emergency room, he shrugged it off, telling them, “Let’s wait for the heartburn medicine to kick in, and figure out what’s going on.” So he took some Zantac and sat on the couch and waited for the symptoms to go away.
The pain had yet to subside four hours later, and that’s when Espina knew it was time to go to the ER. It was there, at NorthShore University HealthSystem in Evanston, where a number of tests confirmed his new worries; that his heartburn was actually a heart attack.
While in the cath lab to treat the heart attack, cardiologist Ted Feldman, MD, told Espina his left anterior descending artery—eerily nicknamed the widow maker—was 100 percent blocked. “If you ever want to avoid having an artery clogged, that’s the one,” Espina says.
Looking back now, Espina realizes he waited too long to seek help. But why should he have sought help any sooner? After all, at 42 years old, Espina is relatively young, doesn’t smoke, and doesn’t have a history of high blood pressure or high cholesterol. What he didn’t know, however, was that he was genetically predisposed to heart attacks on his father’s side; something he only discovered once he was discharged from the hospital.
Unfortunately, Espina’s case is all too common, say experts. Many people assume that because they are young and appear healthy, a heart attack is the last thing they have to worry about. And yet, these are just a few of the many misconceptions surrounding heart attacks, says Nauman Mushtaq, MD, cardiologist with Central DuPage Hospital, who names the most common misconceptions he encounters:
• Women can’t have heart attacks.
• Vitamin supplements can prevent heart attacks.
• A normal stress test puts you in the clear.
• An angioplasty or a stent placement (used to restore blood flow to the heart) prevents future heart attacks in patients with stable angina.
“People need to know their numbers,” says David Najman, MD, cardiologist with NorthShore, in reference to cholesterol, blood pressure and glucose levels. A person can appear and feel healthy, but in reality, they may have hidden risk factors such as high cholesterol. Najman urges adults to get checked as soon as possible for factors such as high cholesterol and high blood pressure so they can adjust their lifestyles accordingly.
“The first time you have an event like a heart attack, you’ve already had plaque buildup in your heart arteries for 10 to 20 years,” Mushtaq says. “Don’t wait until you’re in your 50s to start talking to your doctors about prevention.”
Preventing a heart attack may be easier said than done, particularly if it requires a dramatic lifestyle change, such as quitting smoking. Ultimately, however, such changes could mean the difference between life and death. Each drag on a cigarette increases a person’s risk of heart attack. “Smoking remains the most important reversible risk factor for heart attacks,” Najman says.
Regular exercise is also key to prevention. Because heart attack symptoms often appear during periods of physical exertion, exercise acts as the body’s own stress test, says Najman.
“Exercise-induced chest pain gives you a warning mechanism that something is wrong.” Not to mention that exercise also helps you lose weight or maintain a healthy one, which can minimize heart-related problems overall. Exercise is one of the best means to prevent the development of diabetes and heart disease, he adds.
One must avoid too much exercise too soon because it can put sudden strain on the heart. “The emphasis is on regular exercise,” Mushtaq says. “If one is at higher risk of heart disease or heart attacks, one should avoid sudden strenuous activity.” Start slowly with light to moderate activity, and build gradually from there.
Stress also plays a significant, but commonly overlooked, role in heart health, says Mushtaq. Try to identify the stress factors in your life (such as a job or a relationship), and look for ways to manage them and lower your stress levels. Set reasonable expectations of how to do this. For most, quitting a job and moving to a tropical island is not a possibility; however, setting aside 20 to 30 minutes a day for exercise, meditation or another soothing activity is doable.
While prevention is key, it’s not a guarantee against a heart attack. Therefore, knowing what to do in the event of a heart attack and how to identify the signs are equally as important. Unfortunately, there isn’t one universally recognizable heart attack symptom. Symptoms can range from recurring chest pain or pressure to far more subtle signs such as a toothache. Another red flag is pain that lasts more than a few minutes.
“That’s something that should be a concern and at least [warrant] a phone call to a physician, if not a trip to the emergency room,” Najman says.
Espina’s experience demonstrates the importance of knowing your family’s health history, which can factor into one’s risk. This way, a heart attack won’t be brushed off as heartburn.
If you’re experiencing symptoms and think you are having a heart attack, get yourself to a hospital immediately; however, don’t try to drive yourself there or ask someone to take you.
“Call 911 – that’s what it’s there for,” says Mushtaq. “Then tell your family, take an aspirin, and wait for the ambulance to [arrive]. Also, make it easy for the emergency medical services people to get to you—unlock the front door and rest in an easily accessible, easily visible, location.”
You may think that your odds of having a heart attack are on par with winning the Powerball, but think about this: Every year, 715,000 Americans have a heart attack. It’s time to put the odds of not having a heart attack in your favor: Pay attention to your body, know your history and start practicing prevention—stat.
Originally published in the Summer/Fall 2014 print edition
Area hospitals move to noninvasive tests for cardiac disease Amit Patel, MD, seen through a CT
Source: University of Michigan Day in and day out, for years on end, millions of people
Private patient advocates act as personal assistants, navigating care By Rhonda Alexander “Healthcare is complicated,” says Dan
Photo above: Mark Dunnenberger, PharmD. Courtesy of Jonathan Hillenbrand, Media Production and Photography, NorthShore University
By Laura Drucker A few years ago, I suffered from a herniated disc. The pain in