Am I Having a Heart Attack?
By Jon-Cecil Walkes, M.D.
Methodist DeBakey Heart Center, Houston, Texas
Clinical Assistant Professor, Baylor College of Medicine
Cardiovascular disease is the leading cause of death in our country and yet few people recognize the signs and symptoms associated with cardiovascular disease. Approximately one in four people discover that they have heart disease only after suffering a life-threatening heart attack. With this in mind, let’s talk about the symptoms of heart disease and some common medical problems that put you at an increased risk of cardiac disease.
To begin, plaque formation in the coronary arteries, the arteries that supply blood to the heart muscle, is a natural part of the aging process. By the age of 30 most people have some disease in their coronary arteries although the amount is not significant enough to cause symptoms. The most common symptom associated with heart disease is chest pain. Chest pain, also referred to as “angina” is caused by a decreased supply of blood to the heart. It may take the form of tightness or heaviness in the chest and may be associated with movement of the pain up into the neck area or down one’s arm. The pain is typically brought on by exercise and subsides with rest. An ongoing heart attack is often marked by constant chest pain. If you experience constant chest pain you should immediately seek medical attention.
There are several conditions that one can control and help decrease the likelihood of having a heart attack. One of the most important factors that we can control is our cholesterol. In general we should try to limit our total cholesterol consumption to <200mg per day. In addition we should try to keep our LDL or “bad” cholesterol to < 100mg/dl and our HDL or good cholesterol to <40mg/dl.
In addition to high blood cholesterol, high blood pressure and smoking also contribute to coronary heart disease. On average, each of these doubles your chance of developing heart disease. Therefore, a person who has all three risk factors is eight times more likely to develop heart disease than someone who has none. Obesity and physical inactivity are other factors that can lead to coronary heart disease. Being overweight increases the likelihood of developing high blood cholesterol and high blood pressure and physical inactivity increases the risk of heart attack.
Regular exercise, good nutrition and smoking cessation are keys to controlling the risk factors of coronary heart disease. They include a family history, diabetes, high cholesterol, hypertension and smoking. None of us can choose our family but the other risk factors can be controlled. If you suffer from one of the above conditions it is important that you work with your family physician to get them under control by adjusting your diet, exercising regularly and taking prescription medication as necessary. As part of your evaluation the family physician may order an EKG, chest X-ray, cholesterol level and some form of cardiac stress test. Based on the results of these tests you may need to be seen by a cardiologist.
A cardiologist will then evaluate you for coronary artery disease. The evaluation process will likely involve a screening test such as a stress test that, if positive, will be followed by a cardiac catherization. A cardiac catherization involves using dye to outline your coronary arteries and thereby allow your cardiologist to evaluate the extent of the coronary artery disease. Treatment of coronary disease usually either involves the use of stents or cardiac surgery. The choice which is appropriate for you will depend on the extent of disease, the function of your heart muscle and whether or not you have associated diabetes mellitus. The key to living with cardiovascular disease is to understand the basic symptoms and seeking medical help early.
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