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Entries in Heart Attacks (20)

Wednesday
Dec052012

Coated Aspirin May Lose Heart Benefits

Amazon(NEW YORK) -- Coated aspirin may lose some of its cardiovascular benefits because it takes longer for the drug to dissolve into the bloodstream, a new study suggested.

The study of 400 healthy volunteers was designed to uncover whether certain people were resistant to aspirin's blood-thinning effects. Millions of men and women take aspirin daily to prevent blood clots that cause heart attacks and strokes.

Instead, the authors from the University of Pennsylvania pointed to the stomach-soothing coating sometimes applied to aspirin as a culprit.

The results were published Tuesday in the journal Circulation.

Brand-name aspirin maker Bayer, which partially funded the study, took issue with some of the conclusions.

"The authors' suggestion that use of enteric coated aspirin should be questioned, based on these study results, is of concern given the study population and methodology used, neither of which reflect real-world clinical use," spokeswoman Anne Coiley said in a statement to ABC News.

For people with a high risk of heart attack or stroke, studies suggest an aspirin a day can cut the risk.

If a person is experiencing a heart attack, it is believed chewing an aspirin can buy time by thinning the blood while help is on the way.

"Chew the aspirin, don't just swallow it," said ABC News senior health and medical editor Dr. Richard Besser. "You need that anti-clotting effect in your bloodstream as quickly as possible. If you have uncoated aspirin, that's best. If not, take a coated aspirin. But remember: Chew it, don't swallow it."

Whether you take aspirin to ease a headache or to help fend off heart disease, uncoated pills dissolve faster in your stomach.

While coated aspirin takes longer to dissipate, mostly in your lower digestive tract after it leaves your stomach, it does mean fewer stomach ulcers and less stomach upset -- good for people with sensitive stomachs.

"But for primary prevention of heart attack and strokes, I agree with the study findings, and it is very interesting to see this and be aware of this," said Dr. Martha Gulati, associate professor of medicine in at Ohio State University's Wexner Medical Center in Columbus.

Daily aspirin -- coated or not -- can help prevent heart disease, Besser said. He encouraged people at risk to carry the drug at all times.

"You can even get one of these key-ring gizmos so that you have an aspirin with you all the time," he said. "My dad carries one of these."

Copyright 2012 ABC News Radio

Monday
Nov052012

Study Reveals the Costs of a Heart Attack

Stockbyte/Thinkstock(NEW YORK) -- Heart disease is the leading cause of death in the United States. If you're lucky enough to survive a heart attack, then you know that your health is not the only thing that takes the hit. Heart attacks can hurt your finances and hinder your ability to work.
 
A study presented to the American Heart Association reveals more about the toll heart attacks and other coronary conditions take on our resources.

For the study, the researchers looked at 37,000 people from 2007 to 2010. Most were men, many younger than 65. They found that the cost of hospitalization and medication was $8,170 per person.
 
Patients lost an average of 60.2 workdays right after their heart attacks and -- over the longer term -- lost more than a year.
 
For employers, the disability costs were greater than the direct costs: $7,943 for short-term disability and $52,473 for long-term disability.
 
The study authors concluded that heart disease can impose devastating effects financially as well as in lost productivity -- arguing for more prevention in the form of no smoking, weight loss, a healthful diet and proper drugs to control high cholesterol and high blood pressure.
 
Copyright 2012 ABC News Radio

Tuesday
Oct022012

Beta Blockers May Not Prevent Heart Attacks and Strokes

iStockphoto/Thinkstock(NEW YORK) -- New research suggests that beta-blocker pills don't prevent heart attacks, strokes or cardiac deaths in patients with heart disease, but doctors are torn over whether there's enough in the study to make them want to stop prescribing the drugs. Beta blockers have been a standard heart medication for decades.

The study, published in the Journal of American Medical Association, looked at nearly 45,000 patients with prior heart attacks, coronary artery disease or risk factors for coronary artery disease, and found that those on beta blockers didn't show significantly lower rates of heart attack, stroke or cardiac death than those not on the medication.

"This is a very compelling study that has the potential to shake up the conventional wisdom that exists regarding the role of beta blockers in the management of patients with cardiovascular disease," said Dr. Randal Thomas, a cardiovascular specialist at the Mayo Clinic. "At a minimum, it will lead to new studies that address this issue once again."

Beta blockers work by blocking adrenalin receptors in the brain that become activated when the body is stressed. Beta blockers are used to treat heart disease, high blood pressure, anxiety and other conditions.

Some doctors say they are glad beta blockers are being questioned because their use had been "written in stone" for so many years, but others say using a non-randomized data sample is not as reliable as a randomized drug trial.

While the authors attempted to account for differences between the patient groups that might have had an impact on their health, they did not have access to information on why some patients were prescribed these drugs and some were not, said Dr. Richard Besser, the chief heath and medical editor at ABC News.

Dr. Melvin Rubenfire, who directs cardiovascular medicine at the University of Michigan, said he'd been hoping for a study like this, but it won't change his prescribing habits because he uses beta blockers only in specific cases. Rubenfire also weans patients off the pills 18 months after they have a heart attack if they experience adverse side effects, such as fatigue and erectile dysfunction.

Rubenfire said the existing data wasn't enough to determine which patients would benefit from beta blockers, and what kinds of beta blockers are better than others. Beta blockers include at least six brand names, including Sectral, Tenormin and Zebeta.

Even study coauthor Christopher Cannon, a professor at Harvard Medical School, said he will continue to prescribe beta blockers to his patients, adding, "I would not make too much of this" because the study is only observational.

"All it can do is raise up an idea for us researchers to consider for further study," he said.

Cannon said this research shows that it's unclear whether beta blockers add more benefit than the other therapies developed in the decades since beta blockers became a standard of practice for treating patients with heart disease. Since patients are often taking several drugs, it's hard to pinpoint how much one agent helps compared with another.

Dr. Steven Nissen, who chairs the department of cardiovascular medicine at the Cleveland Clinic Foundation, said the medicine might not be ideal for all of the patients it's prescribed to, but a new randomized, controlled trial will be necessary to change guidelines for prescribing beta blockers.

"Abandonment of this type of therapy for post-MI [post-heart attack] patients based upon an observational study is not warranted," he said.

For the time being, the study raises questions, said Dr. Harlan Kumhulz, a professor of medicine, epidemiology and public health at Yale University.

"The question it raises is about how long after having a heart attack should patients remain on beta blockers?" Kumhulz said, noting that beta-blocker patients didn't have better outcomes than the other patients did after the first year. "The study cannot definitively answer that question -- but raises doubts about the need to continue to take them for the rest of a patient's life."

Copyright 2012 ABC News Radio

Tuesday
Sep042012

Unrecognized Heart Attacks Common, Deadly

iStockphoto/Thinkstock(BETHESDA, Md.) -- For every heart attack that strikes with chest pain, shortness of breath and nausea, almost two more slide under the radar among older adults, a new study found.

The imaging study of 936 elderly men and women in Iceland found 17 percent had signs of an unrecognized heart attack: a blood vessel blockage that scarred the heart, according to MRI images, without sparking the symptoms that land patients in the hospital. Less than 10 percent of study participants had a heart attack with recognizable symptoms.

"The fact that there were more people with unrecognized heart attacks than recognized heart attacks suggests it's a big problem," said study author Dr. Andrew Arai of the Bethesda Md.-based National Blood, Heart and Lung Institute, a division of the National Institutes of Health.

But the problem gets bigger. Unrecognized heart attacks are almost as deadly as "full-blown" symptomatic ones, Arai said. Of the 157 people whose heart attacks went unnoticed, 44 died within eight years of follow-up.

"I think doctors need to be looking more carefully for this," said Arai, whose study was published Tuesday in the Journal of the American Medical Association. "And maybe we should be treating these people a little more aggressively. If someone we know had a heart attack, we work twice as hard to lower their cholesterol."

Arai said about half of patients who had evidence of an unrecognized heart attack recalled having symptoms they chalked up to the flu or indigestion at the time.

"But the other half had no idea," he said, adding that patients are often surprised to hear their hearts have been damaged. "Maybe it happened in their sleep. Or in people with diabetes, maybe they just didn't feel it."

Roughly 28 percent of the study participants had diabetes, which can cause nerve damage that blocks the warning signs of a heart attack, said Dr. Martha Grogan, a cardiologist at the Mayo Clinic in Rochester, Minn., who was not involved in the study.

"Diabetics often have atypical symptoms or none at all," Grogan said, stressing that the elderly and largely diabetic Icelandic study population -- 60 percent of whom smoked -- are not representative of the greater population.

But even in the greater population, Grogan added, "Heart attack symptoms are often vague and start out slowly."

"It's not like the Hollywood heart attack, where someone grabs their chest as they fall to the ground," she said. "Some people think they have a bad case of the flu, they feel achy and run-down. Some people think they have heartburn."

Because damage from unrecognized heart attacks can only be detected by pricy MRI scans and can't be undone, preventing the damage is key, according to Grogan.

"If you think you might be having a heart attack, err on the side of getting checked out," Grogan said, adding that blood tests can quickly detect the signs of a heart attack, and medications can restore blood blow and prevent irreversible harm.

"Don't feel silly or feel like you're imposing. If you go to the emergency room and it's not a heart attack, trust me, everyone will be happy."

Copyright 2012 ABC News Radio

Monday
Aug272012

Why Severe Heart Attacks Are Becoming Less Deadly

iStockphoto/Thinkstock(NEW YORK) -- Severe heart attacks may not be as deadly as they used to be, according to new research.

A new French study demonstrated that in patients who are hospitalized for severe heart attacks -- technically known as ST-elevation myocardial infarctions -- the chances of dying within 30 days dropped from 13.7 percent in 1995 to 4.4 percent in 2010, an improvement of 68 percent.

Researchers looked at data from nationwide registries in France in 1995, 2000, 2005 and 2010, which included more than 6,700 patients who had heart attacks and were admitted to intensive care units.  They analyzed the data and found that the improvement in survival was likely related to a number of factors, including changes in demographics, more timely presentation to hospitals, improvements in medications and treatments, and higher rates of stenting opening up blocked arteries.

The reduced chance of dying is “consistent with many other sources in the United States and Europe,” reported the lead author, Dr. Etienne Puymirat, in the article published Monday by the Journal of the American Medical Association (JAMA).  So even though the study was conducted in France, cardiologists in the U.S. report similar experiences.

The authors found that a number of improved preventive strategies and advances in treatment have helped heart attack victims’ survival.

On average, patients came to the hospitals much sooner after the onset of symptoms like chest pain -- perhaps because public health efforts have increased awareness that symptoms like chest pain or pressure, shortness of breath, or pain radiating down the arms, back, neck or jaw, can be symptoms of a heart attack.

Once patients arrived at the hospital, there was a 50 percent increase in therapy to fix coronary artery blockages, usually with a technique involving the insertion of a tiny metal sleeve known as a stent to prop the blood vessels open.  In addition, there was more efficient use of effective medications such as beta-blockers, ACE inhibitors, statins and blood-thinning medications.

Another finding was the change in demographics of who is having a heart attack.  The study found that the proportion of younger women having heart attacks more than doubled from 11.8 percent in 1995 to 25.5 percent in 2010.  The authors attributed this to the prevalence of smoking and obesity.

According to the study, “These observations suggest that future reductions in the incidence and mortality related to [heart attacks] will need specific targeting of preventive measures toward younger women and possibly younger men.”

Copyright 2012 ABC News Radio

Monday
Aug132012

Heart Attack or Not? New Test Might Tell

iStockphoto/Thinkstock(NEW YORK) -- For Martin Black, it feels exactly like a heart attack.

"A pressure, an uncomfortable feeling," says the 89-year-old Black, who lives in Sarasota, Fla.

The pain starts on his left side just below his heart. Sometimes it goes away, but sometimes it lasts for hours. While the pain first only came at night, it has also pestered him in the early evening or early morning.

Out of concern for his health, Black did what anyone else would do. "I would call my doctor's service," he says. "Sometimes they would say, 'Call 911 and go to the hospital.'"

So he would.

As a result, Black has gone to the emergency room about 10 times for chest pain in the past few years. Such unexpected visits have led to his missing family parties and graduations, not to mention the large medical bills.

Black has few complaints, of course. He knows what doctors do, that such visits are crucial when it comes to ruling out a life-threatening situation. But, he said, the long wait for test results is more than just simply inconvenient for him.

"I'm not interested in staying [in the hospital] overnight," Martin said. "It's expensive; I've seen some of the Medicare bills that come out after I spend a night. ... The emergency room beds are not very comfortable, and it's not very pleasant to have to spend the night there getting blood tests."

New research suggests, however, that unnecessary hospital admissions under these circumstances might soon be a thing of the past.

A study released Monday in the journal Archives of Internal Medicine suggests that a new, more sensitive test for substances known as troponins, which are released by heart tissue during a heart attack, could help doctors determine whether a patient is having a heart attack within one hour.

Doctors now use troponins to monitor how much damage is occurring in the heart. Troponin levels are checked in patients who might be having heart attacks, on admission and at subsequent time intervals in the next eight to twelve hours. Potentially, the patient's first troponin test could be negative, but a subsequent test could show it as positive. So many patients must stay in the hospital for long periods of time, placing both a strain on patients as well as over-crowed emergency department and hospitals.

The new method described by Swiss researchers appears to be able to distinguish between a heart attack and chest pain from other causes after only 60 minutes for 77 percent of patients. The method involves taking blood when a patient first gets to the hospital and then repeating the test one hour later. The initial value of the high-sensitivity troponin test, as well as the change, along with information doctors gather from the electrocardiogram, history and physical exam, can point to whether a heart attack is actually in progress.

More than five million people come to the emergency department every year with chest pain at a cost of more than $6 billion to the health care system but only about 1.6 million, or 32 percent, are actually having a heart attack. So such a test, if it became a clinical reality, could represent huge savings in costs and time if implemented.

Cardiologists, however, cautioned that the test is not yet ready for widespread use, at least until all of the potential problems can be ironed out.

Dr. Christopher Cannon of the Cardiovascular Division of Brigham and Women's Hospital in Boston says that the tool sounds promising, but adds that the methods for using the information provided by a more sensitive test for troponin need to be tested and proven before they become a standard approach.

"It would help on the efficiency," Cannon says. "But this rule needs to be validated and refined."

There are also several heart conditions that can be dangerous but are not a heart attack that should be looked for in the emergency department.

Dr. Clyde Yancy, chief of cardiology at Northwestern University in Chicago, says that while a new tool to distinguish one case of chest pain from another would be helpful: "We should maintain an approach that incorporates useful tools in our diagnostic armamentarium but not allow this or any other diagnostic tool to trump the needed clinical judgment in the patient that is acutely ill."

Copyright 2012 ABC News Radio

Wednesday
Jun202012

Heart Attacks and PTSD: A Vicious Cycle

iStockphoto/Thinkstock(NEW YORK) -- PTSD is a type of anxiety that occurs after a severely frightening experience. Sufferers experience nightmares, high blood pressure and an increased heart rate. Often, they live in fear of things that would remind them of the initial traumatic event.

PTSD is usually associated with war, assault, abuse and violence -- but new research suggests that heart patients also battle this disorder.

Donald Edmondson, a professor of behavioral medicine specializing in cardiovascular health at Columbia University Medical Center in New York, led a study examining the relationship between heart attack and PTSD. This review of 24 studies involved more than 2,000 patients, and revealed that one in eight heart patients develop significant symptoms of PTSD.

Considering the fact that 1.4 million Americans are hospitalized for cardiac events each year, the findings suggest a substantial portion of the population may be living with psychological trauma and not realize why.

"I became interested in the relationship between PTSD and heart attacks after watching my patients," Edmondson said. "Once the physical threat is over, the family is ready to move on. But for the patients themselves, it's not over with. It's with them every day. "

The new analysis also suggests that heart patients who suffer PTSD face twice the risk of having another cardiac event -- or even dying within one to three years -- compared to patients without psychological symptoms.

Doctors hope that knowing about the specific relationship between heart attack and PTSD will continue to improve treatment for better mental and physical health.

"We can't intervene on the battlefield to prevent soldiers from getting PTSD," Edmonson said. "But there may be things we can do to help protect our patients."

Copyright 2012 ABC News Radio

Tuesday
May152012

Beijing Olympics Show Air Pollution-Heart Attack Link

Top Photo Group/Thinkstock(NEW YORK) -- Eat healthy. Exercise. Don’t smoke. These are all tips we’ve heard on ways to reduce the risk of heart attacks and blood clots. But most people would never think air pollution can increase their risk.

A study, published Tuesday in the Journal of the American Medical Association, found that a drop in air pollution levels during the 2008 Beijing Olympics was linked to decreased risk factors for heart problems, stroke and blood clots there.

Authors of the research attributed the improved air in China’s capital to a decreased amount of traffic in normally congested areas during this time. Two weeks after the Olympics, the air pollution returned to its normally high levels -- and so did the risk factors in Beijing’s inhabitants.

While previous research has suggested such a link, “this study is different because it is the first study to show how air pollution affects young and healthy hearts,” said Junfeng Zhang, professor of environmental and global health at the University of Southern California and one of the authors. “It also shows how our body responds rapidly to changes in pollution.”

In separate research, Dr. Tim Nawrot, associate professor at Hasselt University in Belgium, led a 50-year review of the literature on the relationship between heart attacks and air pollution. His findings also supported the link between air pollution and heart disease -- and he believes the impact can even be quantified.

“On a population level, our study found that air pollution is comparable to other triggers for heart attacks such as using cocaine, stress, physical exertion, and excess coffee or alcohol,” Nawrot said. “Actually, we can say that at a population level, five percent of heart attacks are triggered by air pollution.”

In light of the growing body of research, major organizations such as the American Heart Association are taking notice.

“Previously we thought that air pollution affects only the lungs but there is a huge body of evidence that suggests air pollution synergizes with other risk factors such as diabetes, high cholesterol, smoking, obesity, and hypertension to increase the risk of having a heart attack,” said  Dr. Sanjay Rajagopalan, professor of cardiovascular medicine at Ohio State University and a member of the heart association’s  Scientific Statement Committee. “In and of itself, air pollution is a weak factor, but in conjunction with other risk factors, it can amplify the risk for heart attacks.”

So what can be done in light of Tuesday’s study? Zhang suggests greater use of public transportation and not going outdoors when levels of air pollution are high.

Rajagopalan said people should focus on the things they can control, such as blood pressure, cholesterol, diabetes, and smoking.  He also suggests avoiding nonessential travel to areas that are heavy in air pollution.

Internationally, this would include India, which was found to have the worst air pollution in the entire world, followed by Bangladesh, Pakistan and China. The figures come from the 2012 Yale and Columbia Universities Environmental Performance Index.

According to the American Lung Association, the top 10 polluted U.S. cities in 2012 include:

  1. Bakersfield-Delano, Calif.
  2. Hanford-Corcoran, Calif.
  3. Los Angeles-Long Beach-Riverside, Calif.
  4. Visalia-Porterville, Calif.
  5. Fresno-Madera, Calif.
  6. Pittsburgh-New Castle, Pa.
  7. Phoenix-Mesa-Glendale, Ariz.
  8. Cincinnati-Middletown-Wilmington, Ohio/Ky./Ind.
  9. Louisville-Jefferson County-Elizabethtown-Scottsburg, Ky./Ind.
  10. Philadelphia-Camden-Vineland, Pa./N.J./Del./Md.

Copyright 2012 ABC News Radio

Friday
Apr202012

What Dad Didn't Know Best: Heart Attack Signs

ABC News' Dr. Richard Besser and his father, Bill Besser (ABC News)By Dr. Richard Besser

(NEW YORK) -- It's the phone call you never want to receive.

"Hi, it's Mom. We're at the hospital. They are admitting Dad. Give us a call."

My dad is a doctor. He is one of the big reasons I went into medicine. Seeing the impact he had on people's lives every day was inspiring. My mind was racing through the possibilities. I'm fortunate in that I come from healthy stock. Neither of my parents has ever had a serious illness. Their parents all lived to old age with their minds and bodies in great shape.

I called her back immediately. Dad was being admitted to the hospital because they thought he may have had a heart attack. Sometimes, it's obvious. With a massive heart attack you may lose consciousness and your heart may stop. With a small heart attack, they need to do multiple blood tests over time to see if there has been damage to heart muscle; that defines a heart attack.

My dad having a heart attack? How could that be? My dad was more active than I am. My parents are in their 80s but play tennis several times a week, ride their bikes every day, and swim. He'd never mentioned that he had chest pain or heart troubles.

Turns out he did have a heart attack but he had ignored every symptom. When he finally thought it was his heart, he waited hours before getting help. He did everything wrong. He doesn't want you to make the same mistakes.

Here are some of his signs that you should not ignore.

  1. Heartburn -- My father had been having heartburn for the past couple of months. It wasn't relieved by an antacid. This was new for him. If you have new onset heartburn, get it checked out.
  2. Poor sleep -- sleep disturbance can be the presentation of a number of medical problems. If your heart isn't working well, lying down can make it harder to breath but sometimes, all you'll see is a problem sleeping. My father attributed his problem sleeping to a new bed. If you are having trouble sleeping for the first time, get it checked out.
  3. Trouble climbing steps -- This is a classic sign of heart trouble. My mom could go up two flights of stairs without a problem. My dad was short of breath after even one flight. He attributed it to aging. Don't do that!

And while my dad didn't have pain, remember that the pain with a heart attack can vary from crushing pain in the chest to simple discomfort in your neck and jaw.

When my dad finally thought that he might be having a heart attack, he proceeded to make even more mistakes. He had my mom drive him to the hospital! He didn't take the aspirin that was in the emergency pill case on his key chain. And rather than going to the nearest hospital, he went to a hospital further away that he liked more. Thankfully, despite his mistakes, the cardiologists were able to open up his blocked arteries (one was 95-percent blocked), and within days he was back to playing tennis.

I feel so lucky that my dad dodged a bullet here. He wants to make sure you do all you can to increase your chances of making it through a heart attack. If you think you or someone you are with is having a heart attack, time really matters.

Here's what you should do, according to MayoClinic.com:

  1. Call 911. Emergency responders will start treatment on the way to the hospital. For the best outcome, you should be at the hospital within one hour of a heart attack. Nearly half don't get there until four hours afterward because they ignore the signs.
  2. Chew and swallow an aspirin. Aspirin can cut down on clot formation. With a heart attack, the usual cause is a blood clot forming in one of the arteries supplying your heart muscle.
  3. Take nitroglycerin if it has been prescribed by your doctor. Don't take it if it wasn't prescribed for you.
  4. Begin CPR if the person having the heart attack is unconscious. New CPR guidelines call for skipping the mouth-to-mouth and just doing chest compressions. Remember to call 911 first so they can be on their way.

Copyright 2012 ABC News Radio

Wednesday
Mar282012

Alcohol May Benefit Heart Attack Patients

Monkey Business/Thinkstock(BOSTON) -- A daily alcoholic beverage or two may be good for men who have survived a heart attack, according to new research published in the European Heart Journal.

The study, carried out by researchers at Brigham and Women's Hospital in Boston, found that men who consumed two alcoholic drinks per day after their first heart attack were at lower risk of dying than non-drinking men. The type of drink did not have an effect on the results, but heavy drinkers had a risk of death that was similar to that of non-drinkers.

Researchers followed more than 1,800 men who survived a heart attack. The study participants filled out lifestyle questionnaires, and researchers found that men who drank about two alcoholic drinks per day had a 42 percent lower risk of dying from cardiovascular problems and a 12 percent reduced risk of dying from any cause, when compared with teetotalers.

"For many men after experiencing a heart attack, major diet and lifestyle changes are recommended by their physicians," said Dr. Jennifer Pai, lead author of the study and assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School. "Our study indicates that for men already consuming moderate amounts of alcohol, continuing to consume moderate amounts after a heart attack may be beneficial for long-term survival."

Pai noted that moderate alcohol consumption has long been associated with lower risk of coronary heart disease among healthy populations.

"More recently, some studies have suggested a beneficial effect of moderate alcohol consumption on reduced mortality among individuals with established heart disease, but the results were somewhat conflicting," continued Pai. "Our study is the first to examine moderate alcohol consumption both before the men experienced their heart attack, and also after they survived the event."

But because the data was based on self-reports, which can lead to measurement errors, Dr. Robert Bonow, professor of medicine at Northwestern Memorial Hospital, said the findings should be taken with caution. It is unclear whether women would have similar results, and the findings certainly should not encourage non-drinkers to suddenly start drinking after a heart attack, he said.

Copyright 2012 ABC News Radio







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