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Medicine & Health Education
The Story of Heart Attack
Lifestyle Modifications for a Healthy Body, Mind and Spirit
Bala N. Aiyer, M.D.
Part - 1

How Common are Heart attacks?

Diseases of the heart and blood vessels are the major causes of death and disability among the adult population in United States and all developed countries. More than half of these are due to the disease of the blood vessels of the heart called "Coronary Artery Disease", which causes heart attacks. It is estimated that within the next one year, over 1.5 million people will suffer a heart attack in our country and about half a million of them will die of the heart disease. Many of them will not even get a chance to reach the hospital on time. Even though heart attacks may be sudden, in many instances, there are always some indications of the underlying problems like episodes of sudden tightness in the chest or a weakness that are often ignored or passed off as `gas' pains or indigestion. About one third of all people suffering a heart attack will feel no chest pain or discomfort except slight weakness, hence called 'silent heart attack.'

What is a Heart attack?

A blockage to a blood vessel of the heart [Coronary Artery] causes a heart attack. This leads to the damage [death] and destruction of the heart muscles that will be unable to function. It can cause severe chest pain, general weakness, heart failure or a rupture of the heart muscle wall or one of the valves, Depending on the area involved. Blockages also can cause abnormal heart beats or missed beats and irregular heart rhythm. Any one of these problems can lead to death in a matter of few minutes or hours. Many will survive a heart attack and may have no further problems. Those who survive the attack will be left with a scar due to damage to the heart muscle. They may continue to get chest pains [angina], weakness or breathing problems after any usual or strenuous activities. Even persons with silent heart attacks may later feel angina or general weakness or difficulty breathing as the first sign of their past heart attack.

What is Angina Pectoris?

If there is only a partial blockage of the blood vessels there will be no `heart attack'. The person will get only brief episodes of chest pains on and off, relieved by rest and medicines. This is called `Angina Pectoris'. This pain occurs mostly under stress, physical or mental, as sufficient blood flows during rest, but it does not increase while exercising or during any stress. Even though it is called "chest Pain" most people do not feel it as a "Pain" but more as a pressure or a tightness over the mid chest and sometimes over the shoulder, jaw or arm, often on the left side. Some times it is accompanied by a feeling of tiredness, a short winded feeling or profuse sweating. Some may also feel a heavy, irregular or fast pounding heart beats. Some times, a person may not feel any symptoms at all or may have such mild discomfort, that it is not noticed and is easily forgotten. This is called silent ischemia and silent heart attack. Some people, even if they feel it, due to a fear, do not accept it as heart problem and may not tell this to other family members.

How do we treat heart attacks?

The best method to treat heart attack is to prevent them. Next is early diagnosis and early treatment of aggravating and precipitating factors. There are many "risk factors" that cause a higher incidence of heart attacks in any group of population. We must make efforts to avoid these risk factors. Early treatment can prevent death and disability in a large number of people. Once the condition occurs, it leaves a damage of the heart muscle leaving a swelling or scar, causing weakness of heart and irregularity of pulse. Now we have new methods of treatments available to open up a blocking blood vessel and improve the blood supply of the heart. This can prevent complications of a severe heart attack and improve the quality of life.

Who need dieting and exercise program?

Though lots of people go on special diets, weight reduction and exercise program or restrict their life style for the sake of their health, it is important to know who are in real need for the proper diet and exercise programs. Some suddenly realize the need at a later age and start on a vigorous exercise and diet program inappropriately. If they have already developed blockages in the blood vessels, it can be dangerous in some instances. Persons at low risk need not restrict their life style too vigorously.

What is a risk factor?

In the past few years, medical research has developed a list of factors to identify persons who are likely to develop a heart condition, heart attack or a stroke, more than others. If we can identify these individuals with the high probability of coronary artery disease, it is possible to select such persons for early preventive measures and treatments to avoid a major heart attack and complications with disability. Many of these individuals will need planned diet and exercise program, a life style modification, some treatment for the underlying medical problems and investigation and early treatment for the heart disease. The various things that indicate a higher incidence or higher probability of a heart disease are called `Risk Factors'.

What are the "Risk Factors"?

The major coronary risk factors are :
[1] Family history of heart disease prior to the age of 50 years among close relatives;
[2] Diabetes mellitus, not well controlled;
[3] High blood pressure, not well controlled;
[4] High cholesterol and high triglyceride (fat) levels in blood;
[5] Cigarette smoking (heavy smoking for many years).

Many consider Diabetes Mellitus as equivalent to Coronary Artery Disease - [Subtle]


In addition certain definitive indicators of heart disease are [1] Abnormal EKG suggesting an old heart attack or a strain pattern, [2] Past history of heart attack or heart failure and [3] chest pains after exertion or at rest. Over eating, Obesity [over weight] and excessive alcohol intake habits by themselves are not definite primary risk factors but can contribute to other risk factors or could make a heart problem worse or difficult to treat.

-- This is called Behavior Modification --
Essential Changes -- for a healthy Heart and General Health0