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Entries in Heart Attack (58)

Sunday
Mar102013

New Drug to Help Stop Heart Attacks

iStockphoto/Thinkstock(STANFORD, Calif.) – A new experimental drug may help reduce the risk of blood clots, heart attacks, and strokes by 22 percent, according to a new study conducted by Stanford and Harvard researchers.

Some 600,000 people a year undergo a stenting procedure, in which surgeons insert a small mesh tube that props open blocked vessels in the heart following a heart attack or chest pain. A blood thinning agent is used during this common procedure to prevent further heart attacks, but the current drug is not ideal for a number of reasons.

Enter cangrelor, a new blood thinner shown to be a significant improvement in decreasing blood clots when compared to the older drug, clopidogrel.

Researchers studied 11,000 patients across the U.S. and found that while 5.9 percent of patients using the older drug reported blood clots, only 4.7 percent of patients on the newer canrelor did. This could mean that the new drug could prevent 7,000 people from experiencing blood clots, heart attacks, and strokes every year.

Cangrelor is an improvement over the clopidogrel, the older drug more commonly known by its brand name of Plavix, in several ways. Clopidogrel is taken orally, which can be a problem if a patient is very sick, and the drug is slow to act, and stays in the patient’s system for days after it is needed. The new drug is fast acting, reversible, and taken intravenously.

The study found that there were there were no serious side effects found when using cangrelor aside from some increased bleeding, which is to be expected with any blood thinner.

Copyright 2013 ABC News Radio

Friday
Feb222013

Texas Mother's Heart Attack at 40 Saves Her Son's Life

Courtesy of Wenter Blair(NEW YORK) -- No one believed Wenter Blair was having a heart attack -- the 40-year-old ranch photographer from Frisco, Texas, was just too healthy.

Blair had been referred for a nuclear stress test after she had an incident of chest pressure and sweated profusely.  But as she ran on the treadmill, a bit short of breath but in no pain, the doctor dismissed the results as a "false positive."

"When you see a 128-pound, 5-foot 4-inch woman in stilettos, doctors think it's a hormone issue," said Wenter, now 44.  "I was riding horses, chasing children, swimming -- I live a very active life.  I ran a 10K the week of my heart attack."

But a nurse who was monitoring the results recognized it was, indeed, a heart attack and pushed Blair to get herself to another doctor, saving her life -- and, surprisingly, the life of her then 9-year-old son.

Blair was diagnosed with familial hypercholesterolemia -- a lipid disorder that starts at birth, causing an elevation of fat in the blood and leading to heart disease, stroke and other medical problems.  And when genetic tests were done, they discovered her son Christian also had the condition.

With, FH, heart disease and heart attacks can occur at a young age.  People with a severe form of this condition can die in their 20s.

"The tragedy of it was it was only diagnosed because of a wonderful, crazy, God-like intervention and series of events," said Blair.  "Doctors watched my heart attack and didn't think it was real."

Now, she wants others to know about the disease so that their children can be tested and treated early, before damage sets in.

The American Academy of Pediatrics now recommends cholesterol testing for all children once between the ages of 9 and 11, in large part to detect familial hypercholesterolemia, according to ABC's Dr. Richard Besser.

"While this is somewhat controversial, if your child hasn't been screened, ask about this," he said.

For many people, abnormal cholesterol levels are partly due to an unhealthy lifestyle, such as eating a diet that is high in fat.  But in Blair and her son's case, high levels of LDL -- the so-called "bad cholesterol -- were genetic.

About one in 500 Americans has familial hypercholesterolemia or FH, but many more go undiagnosed, according to Dr. James Underwood, a clinical lipidologist at the NYU Center for Cardiovascular Disease Prevention.  There is also a higher risk among Ashkenazi Jews, French Canadians, Christian Lebanese and South African Afrikaners.

Blair finally got a proper diagnosis and, after quadruple bypass surgery and 10 stents around her heart, she is on medication.  Her son Christian, too, is being treated.

Copyright 2013 ABC News Radio

Thursday
Feb072013

Unusually Tired? It Could Be a Symptom of a Heart Attack

iStockphoto/Thinkstock(NEW YORK) -- If someone experiences symptoms that include a racing heart, sweating, shortness of breath and a crushing chest pain that shoots down one's arm, what do you think that means?

If you guessed a heart attack, you're correct.

A lot of work has gone into publicizing these symptoms.  They are the classic signs of a heart attack -- in men.  That’s right, in men.

Unfortunately, the more subtle signals that a heart attack is happening, particularly in women, are less well-known.  That is part of the reason why women frequently experience a delay in getting diagnosed and treated, which can have deadly consequences.

Although many people think of heart disease as a man’s disease, it is the leading cause of death in women as well.  It just tends to occur at an older age.  

During heart health month, it’s a great time to learn the subtler symptoms of a heart attack and what to do if you are experiencing them.  Just like in men, the number one symptom is still chest pain, but look for the new onset of these symptoms as well:

  • Unusual fatigue
  • Trouble sleeping
  • Shortness of breath
  • Indigestion
  • Pain in the neck, back, or jaw

If you, or someone you know is experiencing some of these symptoms, don’t ignore them.  Call 911 and say, “I think I may be having a heart attack.”  Then crush up an aspirin and swallow it, sit down and wait.

When you get to the hospital, demand a thorough evaluation.  Women often experience delays in getting evaluated once they get to the hospital, and time really matters.

Copyright 2013 ABC News Radio

Wednesday
Feb062013

Heart Disease: Women Can Miss the Warning Signs

iStockphoto/Thinkstock(NEW YORK) -- As the number one killer of women, heart disease is a bullet all women must dodge.  But despite the fact that many women have heard this statistic, only one in three of them thinks it applies to us.

Knowing the signs and symptoms of a heart attack can save your life.  But they can be subtle and sometimes indicate something other than a heart attack.

In medicine, it is always smart to put the worst case scenario at the top of the list.  So with that understanding, here they are:

Chest Pain, Pressure or Tightness

This is the most common symptom of a heart attack in women, as it is in men.  But the description of this pain can differ slightly in women.  It can be described as dull or uncomfortable pain, whereas men often feel the classic pressure of an "elephant sitting on their chest" or squeezing behind the sternum or breastbone.

Women experiencing chest pain or discomfort are likely to take an aspirin but not to call 911, according to the American Heart Association.  But chest pain bad enough to lead a woman to take an aspirin should be followed by a call to 911.

Flu-Like Symptoms

Heart attacks in women tend to produce symptoms that are vague in nature and even resemble that of a virus like the flu, such as fatigue, shortness of breath, nausea, dizziness and difficulty sleeping.

These symptoms in women often go unreported because women tend to be accustomed to functioning with a variety of aches, pains and physical complaints and also tend to put others first.

Take This to Heart

While doctors don't understand why men and women seem to experience heart attacks in slightly different ways, they do have some medical theories.  Differences in heart attacks between the sexes may be due to hormonal factors or to the size of the blood vessels that supply the heart muscle, for example.

More research between gender differences in heart disease is always ongoing, but for now, doctors know that recognizing the signs and symptoms of a heart attack is something that every woman needs to know.

Copyright 2013 ABC News Radio

Thursday
Sep132012

Job Stress Linked to Increased Heart Attack Risk

Goodshoot/Thinkstock(NEW YORK) -- "It's true, hard work never killed anybody, but I figure, why take the chance?" former President Ronald Reagan quipped at the Gridiron Dinner in 1987.

Reagan may have been onto something. A new review of research, published Thursday in the journal Lancet, shows that job strain can increase the risk of a heart attack and death.

The findings may be particularly relevant today. As the country struggles with an unemployment rate of 8.1 percent, many people are facing tremendous pressure to perform well on the job.

A team of researchers from across Europe examined a total of 13 previous studies conducted between 1986 and 2006 that looked at job strain as a risk factor for heart attack and death. In total, the researchers evaluated data from about 200,000 patients for an average of 7.5 years, more than two times the number of patients studied in a previous review.

The researchers found that people who have highly demanding jobs and little freedom to make decisions are 23 percent more likely to have a heart attack. This was true regardless of gender, age and socioeconomic status.

Additionally, if we assume that job strain causes heart attacks, the risk of having a heart attack from your job is 3.4 percent, relatively low compared to that of smoking (36 percent) and not exercising (12 percent). This study, though, cannot definitively demonstrate a cause-effect relationship.

Scientists think that the increase in job stress triggers your brain to go into a defensive "fight-or-flight" mode that can take its toll on the body, and your heart.

"The [theory] that work stress influences heart health is more than 30 years old," said lead study author Mika Kivimaki of University College London. "[But] the pooling of published and unpublished studies allowed us to investigate [this] with greater precision than has been previously possible."

Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University Medical Center, said the new research could leave many wondering what they can do in light of its findings.

"I think this is an area where changing the job situation may not be something that we have that much control over," said Williams, who was not involved with the study. "It may be in the long run that [we need] an alternative approach, rather than changing the work environment, that might focus on workers, try to train them in coping skills."

Williams said he has seen beneficial outcomes in highly stressed patients in his anger and stress management workshop LifeSkills, which provides training in coping skills and building supportive relationships.

He also stresses the importance of other psychosocial factors involved such as depression or stress at home that may play a role in risk of heart disease. Depression and anxiety are among the 10 most common diagnoses in primary care.

Moreover, many studies show that depression occurs more often in patients after a heart attack, creating a perpetual cycle of worsening severe heart disease and major depression.

Still, the American Heart Association considers stress a contributing risk factor to heart disease, but not a major risk factor. According to the AHA, healthy measures like quitting smoking, controlling cholesterol, exercising and maintaining a healthy weight are better ways of reducing your risk of coronary heart disease.

There are also major heart disease risk factors you cannot control, such as getting older, being male and your genes.

If there is one thing that is clear, it is that heart disease is a significant problem in the United States.

An American will have a coronary event about every 25 seconds, and someone will die of one about every minute, according to the updated 2012 AHA report on heart disease.

More than 16 million Americans have heart disease. It caused one of every six deaths in 2008, accounting for more than 400,000 deaths. Almost 800,000 Americans have a new heart attack each year, and 470,000 will have a repeat attack.

Study author Kivimaki agreed that people experiencing job strain would do well to address other more significant contributors to heart disease.

"High strain is associated with an elevated risk of developing heart disease, but this excess risk is probably smaller than previously thought," Kivimaki says. "For those with job strain, adopting a healthy lifestyle seems particularly important."

Copyright 2012 ABC News Radio

Tuesday
Sep112012

Painkillers May Pose Risks to Heart Attack Survivors

iStockphoto/Thinkstock(NEW YORK) -- A group of commonly used painkillers may increase the risk that first-time heart attack survivors will die sooner or have another heart attack, a new study released Monday suggests.

The study does not represent the first time doctors have warned that certain pain medicines may hold risks for heart attack survivors.  In 2007, the American Heart Association released recommendations for these patients and their doctors to balance risk factors and benefits when choosing a painkiller.

When it comes to these drugs, there is a wide variety on the market.  Among the choices is a group of very popular and widely used drugs called non-steroidal anti-inflammatory drugs, or NSAIDs for short.  Some of them are easily available over the counter, like ibuprofen.  Others, such as celecoxib -- commonly known by the brand name Celebrex -- require prescriptions.

The new Danish study, published in the journal Circulation, looked at the consequences of painkillers in almost 100,000 patients.  Of this number, nearly 44,000 filled at least one prescription for painkillers.

Those who took painkillers had a 59 percent higher risk of dying after one year and a 63 percent higher risk of dying after five years.  Moreover, these patients’ risk of experiencing another heart attack or dying from coronary artery disease was 30 percent higher after one year and 41 percent higher after five years.

“It is important to get the message out to clinicians taking care of patients with cardiovascular disease that NSAIDs are harmful, even several years after a heart attack,” said Dr. Anne-Marie Olsen, lead author of the study and a fellow in the cardiology department at Copenhagen University Hospital Gentofte in Denmark.

Still, patients have to manage pain -- and doctors say this study suggests that heart attack survivors and their doctors should be picky when choosing a painkiller.  

Alternatively, treatment of pain may also include no medications at all; some other pain relief options include physical therapy or heat and cold.  But if these non-medical options don’t cut it, physicians say, the risk profiles of some painkillers should be taken into consideration.

Copyright 2012 ABC News Radio

Tuesday
Aug282012

Study: More Heart Patients Should Get Stents 

Hemera/Thinkstock(NEW YORK) -- The latest salvo in the battle over stents -- the tiny mesh sleeves designed to keep clogged coronary arteries open -- came in the form of a study suggesting that the devices are better for some patients than medicines alone.

In a new multi-center study called FAME II, which examined outcomes of 888 patients with a significant blockage of least one coronary artery, researchers used a new measure -- known as fractional flow reserve, or FFR -- to decide if a patient should get a stent or not.

The study authors suggest that FFR could help doctors figure out whether a patient's coronary artery blockage is going to put them at risk for a heart-related emergency, such as a heart attack or severe chest pain.

The trial was stopped early because it quickly became clear that those who had not received stents required more hospitalizations and emergency procedures and experienced more heart attack symptoms than their stented counterparts. By the time the study was halted, 12.7 percent of patients without stents had experienced one of these cardiac events, while only 4.3 percent of people who received stents had.

The study was published Tuesday in the New England Journal of Medicine to coincide with its presentation at the annual meeting of the European Society of Cardiology in Munich, Germany. The research was supported by St. Jude Medical, a company that manufactures FFR assessment products and other heart-related devices.

"Stable coronary disease is a very common problem, and there is certainly room for improvement, and using FFR appears help guide stent placement," said lead study author Dr. William Fearon, an associate professor of medicine at Stanford University Hospital.

However, the new study is unlikely to end the debate over the use of stents, which has raged since a landmark study in 2007 known as the COURAGE trial. This study looked at all patients who required a coronary artery catheterization for symptoms of heart trouble. What it found was that less-invasive medical therapy -- in other words, using drugs to control heart risk factors -- was better than the more-invasive stent approach.

In 2009, a new trial -- known as FAME I -- reignited the stent debate. Previous trials, such as COURAGE, relied on a long-used diagnostic procedure known as angiography to assess the severity of coronary artery blockages. The researchers behind FAME I said that their findings showed that FFR painted a more accurate picture of who needed stents and who did not. Many criticized this trial, however, because it included patients who were actually having heart attacks -- patients who had been excluded in COURAGE. Additionally, it did not compare stenting to the standard practice of medical therapy.

Fast forward to FAME II -- a study that attempted to exorcise these demons by offering a comparison of FFR to medical therapy.

"I think that, based on COURAGE, many physicians are treating these patients with medical therapy alone," lead author Fearon said. "While it may be appropriate in some, others would benefit from intervention. This study shows that we can best identify those patients by FFR and will enable more appropriate care."

Some doctors not involved with the research agreed that FFR could be a very useful tool in determining the severity of a patient's heart disease.

"Fractional flow reserve (FFR) is a powerful, invasive tool that can pick out blockages that, at least at the time at which they are being studied, are sufficiently severe as to be able to prevent a safe and healthy increase of blood flow to the heart and can distinguish them from blockages that are not," said Dr. Brian O'Murchu, associate professor of medicine and associate director of the cardiac catheterization laboratory at Temple University in Philadelphia. "In this way, it gives much the same information as is provided by stress tests that include imaging of the heart."

"Recent pressure based on the COURAGE trial to reduce overall stent usage has made an early revascularization strategy less clear," said Dr. George W. Vetrovec, a professor of medicine in cardiology at Virginia Commonwealth University. "FAME II provides, I believe, an important counter argument in patient management for stable but symptomatic coronary disease."

Yet, some doctors remain cautious about these results.

One of these physicians is Dr. Harlan Krumholz, professor of medicine and investigative medicine at Yale University. Krumholz said that the new study falls short of proving that stents prevent heart attack and death.

"[T]he rates of death and the rates of [heart attack] were similar in the two groups," Krumholz said.

Others agreed. "I do not think that this trial should change practice," said Dr. Raymond Gibbons, professor of medicine at the Mayo Clinic. "Try medical therapy first. If your symptoms don't improve, then discuss the risk and benefits of stents with your physicians. Realize that stents do not reduce the rate of heart attack and death."

Copyright 2012 ABC News Radio

Wednesday
Aug222012

CT Scan for Heart Risk Splits Doctors

Hemera Technologies/Thinkstock(NEW YORK) -- For hundreds of thousands of Americans, the first sign of heart disease is when their heart stops.  It's a situation that has cardiologists constantly searching for better ways to detect heart problems sooner.

On Tuesday, a study published in the Journal of the American Medical Association suggested that a test using a CT scan could lead to answers for many of the 33.5 million Americans deemed to be at intermediate risk of heart problems.

Yet, the scan is not without its drawbacks -- a fact that has some doctors skeptical as to whether this test should be offered more widely.

The test -- known as a coronary artery calcium score, or CAC -- is found by evaluating the amount of calcium in blood vessels around the heart.  Doctors accomplish this through a CT scan of the chest.

In the new study, a team led by Dr. Joseph Yeboah, assistant professor of internal medicine-cardiology at Wake Forest Baptist Medical Center, found that this test was the most effective of the six different methods to determine someone's risk of future heart problems if they happened to be classified as having an "intermediate" risk of heart disease.

Doctors can tell patients whether they are at high, low or intermediate risk of developing heart disease by using what is known as the Framingham score -- a tool that looks at age, cholesterol, blood pressure, smoking history and gender.  A high-risk patient will likely be treated more aggressively with blood pressure and cholesterol medications than their low-risk counterparts.

But while this approach works well when it comes to high or low risk patients, for the 16 percent of Americans in the intermediate risk category the lines are fuzzier as to when they should start taking these medications.

While the CAC is not currently in wide use, the study authors argue that expanding its use could help guide treatment for these millions of patients.

"The present study provides additional support for the use of CAC as a tool for refining cardiovascular risk prediction in individuals classified as intermediate risk by the [Framingham risk score]," the study authors write.

Specifically, the coronary artery calcium score would have accurately "reclassified" 25 percent of individuals from intermediate to high risk, and another 40 percent to low risk.  This means more than half of the people previously labeled ambiguously as having intermediate risk would now be considered to be at either high or low risk, which would ideally lead to more appropriate care.

The implications of such an adjustment would be considerable.  Heart disease remains the leading cause of deaths worldwide.  Blockage of the arteries of the heart, or coronary heart disease, leads to heart attacks -- a condition that accounted for one out of six American deaths in 2008, according to the American Heart Association.

On the other side of the coin are the out-of-pocket expenses and the increased radiation exposure that this test entails.  Previous studies show that radiation from CT scans has been linked to cancers.

Some doctors say the downsides of this test outweigh these benefits.

"I strongly disagree with the authors' conclusions," said Dr. Steven Nissen, chairman of cardiology at the Cleveland Clinic Foundation.  "CAC scoring is a poor bargain with high costs and real harms."

"The test is potentially worth the cost and small radiation risk only if it is going to change a clinical decision regarding the use of aspirin, blood pressure medications or cholesterol treatment," said Raymond Gibbons, professor of medicine at the Mayo Clinic.  

So for an intermediate risk patient who has additional risk factors, such as a strong family history of heart disease, he argues that this added test would be pointless, as these patients would be treated aggressively anyway.

Still, some doctors agreed with the idea that CAC could be used more widely to evaluate patients.

"With these new data, we have a much better understanding of the best utility for this tool and can understand much better how to apply this technology," Clyde W. Yancy, chief of cardiology at Northwestern University, wrote in an email.  "That coronary artery calcium scoring prevails against these and other candidate risk markers is the news of the day."

Copyright 2012 ABC News Radio

Wednesday
Aug222012

Heart Attacks Lead to Depression, Anxiety for Partner

Photodisc/Thinkstock(NEW YORK) -- Spouses of those who experience a sudden heart attack -- what doctors call an acute myocardial infarction, or AMI -- have an increased risk of depression, anxiety and suicide afterward, even if their partner survives, a new European Heart Journal report suggests.  And they tend to suffer more psychologically than the partners of people who have other serious medical conditions.

In an investigation of more than 200,000 people, American and Danish researchers found that more than three times the number of people whose significant other died from a sudden cardiac attack were using antidepressants in the year afterward, compared to the year before.  Additionally, nearly 50 times as many of the spouses were taking a benzodiazepine, a class of drug used to treat anxiety.

Men were more susceptible to depression and suicide than women, and partners experienced the same level of mental anguish, whether or not they were married.

"Those whose spouse survived an AMI had a 17 percent higher use of antidepressants after the event, whereas spouses of patients surviving some other non-AMI related condition had an unchanged use of antidepressants compared to before," says Dr. Emil Fosbøl, the study's lead author.

Dr. Neica Goldberg, a national spokeswoman for the American Heart Association notes that her experience treating patients mirrors what the study has found.

"For a long time, we've known that there are issues with the psychological health of both the patient who suffers a heart attack and their spouse," she says.  "I've noticed it and patients report it."

Goldberg says it's common for doctors to overlook how a caregiver is holding up because the caregiver is focused on prolonging the life of the patient.

"We don't always take the time to focus on quality of life or what the family is going through," she points out.

Caregivers are often reluctant to talk about their own feelings because it's their partner who is sick and in need of immediate attention.  Personal problems tend to come up in the context of their spouse's illness.  For example, Goldberg says, a partner will take her aside to ask whether the patient can climb stairs, walk up hills or return to sexual activity.

"That gives me the opportunity to ask about how they're doing and whether or not they need anything," she says.

Goldberg also makes sure that close family members are present when she speaks to patients about their condition to ensure everyone has an opportunity to ask questions and talk about all the issues, including their own.

Even if they are aware the significant other of a patient is depressed or anxious, cardiologists can't prescribe medication for them.  But, Goldberg says, the doctor can and should recommend therapy.

Copyright 2012 ABC News Radio

Tuesday
Aug212012

Rosie O'Donnell Lucky to Be Alive, Heart Doctor Says

Michael Tullberg/Getty Images(WASHINGTON) -- A heart attack-surviving cardiologist says that comedian Rosie O'Donnell is lucky to be alive today, after she delayed seeking help for an impending heart attack, ignoring flu-like symptoms before seeing a doctor.

O'Donnell reported that she had suffered what her doctors called the "widow maker," a 99-percent blockage of the left descending artery that feeds the heart.

"The first thing we women do is become stupid," said Dr. Kathleen McNicholas, a former heart surgeon and medical director of performance improvement at Christiana Care Health System in Newark, Del. "She could have died. Sudden death in women is a reasonable presentation."

The former talk show host, 50, wrote on "Rosie Blog" that last week she had helped an "enormous" woman out of a car: "A few hours later my body hurt, I had an ache in my chest both my arms were sore, everything felt bruised."

Two-thirds of women and one-third of doctors don't recognize the symptoms of heart attack in females, McNicholas said.

"These symptoms are often more subtle than the classic 'elephant sitting on your chest,'" she said. "The universal sign of a heart attack, clutching your chest, often doesn't apply to women."

O'Donnell likely had ischemia, or a "heart cramp," McNicholas said. "We can get through heart cramps, but she could have gone on to total occlusion," or obstruction.

But she gives the comedian a pat on the back for taking aspirin, a move that might have saved her life.

McNicholas, 64, knows all too well how hesitant women are to believe they are having a heart attack. She had one herself 10 years ago, undergoing quadruple-bypass surgery to repair blockages in her arteries.

Like O'Donnell, she delayed getting help for weeks, continuing to perform heart surgery, but feeling exhausted and carrying a "sense of dread."

"It's very typical of women," she said. "The symptoms are not quite as classic and we really don't want to believe it. We are queens of denial.

"And when you don't have a good story [the piercing elephant on the chest pain], you really don't want to go to the cardiologist and waste his time....You are just so tired and dragging yourself around and think you have the flu."

McNicholas said her doctor was just as bad. "I couldn't convince my cardiologist, who could have turned around and convinced me," she said.

"We just suck it up."

An estimated 400,000 women die every year of heart disease, 10 times more than die of breast cancer annually, according to the American Heart Association. Symptoms can include pressure, a tightening or heaviness, not necessarily pain. Flu-like symptoms, nausea, shortness of breath and excessive fatigue are also common. Some women just stay at home because it is not painful enough to seek help. Others even say their earlobes hurt, McNicholas said. And the risk increases as women reach menopause, "catching up" with men's risk.

McNicholas was in her "prime" when she had a heart attack at 54, working 100 hours a week as a surgeon and going to law school at night. "I had every reason to feel fatigued," she said.

"My back and shoulders ached," she said. "I looked gray, but we don't ask other people how we look or say how terrible we feel. We lay on the couch and figure it's going to pass.

"The point is we don't want to go to the emergency room and make a fool out of ourselves if we don't have a good story."

She didn't seek help for a month, but came to her senses while on holiday at the Jersey Shore when her sister reminded her that both her parents had died of heart disease.

"My sister slept on the same floor as me, and the next morning she said, 'You coughed all night....Mom coughed like that when she died.'...That's what pushed me. You have to have someone else notice."

McNicholas began a program at Christiana Care called "No Heart Left Behind," encouraging teens to educate their middle-aged mothers about heart disease.

One of her students saved her mother-in-law's life on a ski vacation, insisting she go to the emergency room, even when everyone else around her said it was altitude sickness. The woman was perfectly fit, walking five miles a day.

As for O'Donnell, McNicholas said the comedian likely "sure looked like hell and should have said to her partner, 'How do I look?' and gone to the hospital."

O'Donnell is recovering. She is "resting at home and doing fine," according to her publicist. She also tweeted her support for the American Heart Association campaign "Go Red for Women": "Sign me up," she wrote. "Let's get the word out there -- count me in."

"I am lucky to be here," O'Donnell wrote on her blog. "Know the symptoms ladies, listen to the voice inside. The one we all so easily ignore. CALL 911."

Copyright 2012 ABC News Radio







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