Heart Attack Archive

Lifestyle changes — along with other proven therapies — can help improve these often-overlapping conditions.

Everyone goes through periods of feeling gloomy, irritable, or listless at least once in a while. And these emotions are perfectly normal after a diagnosis of a serious health problem such as heart disease. But if those unpleasant feelings drag on for weeks and gradually erase your sense of well-being, you may have depression.

Over a lifetime, about one in five Americans is affected by depression. But the risk of depression in people who've had a heart attack is three times as high as the risk among the general population.

Ask the doctors

Q. I experienced a heart attack a few years ago. I'm worried about getting the COVID-19 vaccine. Is it safe for someone with my medical history?

A. Yes. The vaccine is safe and advised for people with a history of heart attack and cardiovascular disease. While you should always discuss the particulars of your situation with your doctor, the American Heart Association said in a statement issued on Jan. 15, 2021, that it's important for people who have had heart disease or stroke (or who are at high risk for these conditions) to get vaccinated as quickly as possible, because they are at higher risk for severe disease if infected. The benefits of the vaccine far outweigh the risks. Clinical trials of the first two approved vaccines found that both are safe and, after two injections, are about 95% effective at preventing illness from SARS-CoV-2, the virus that causes COVID-19. The vaccine often causes soreness at the injection site. Other common side effects, such as headache and diffuse muscle pain, are usually mild and last only one or two days. More severe reactions, including allergic reactions, have occurred but are very rare.

These drugs actually help stop dangerous blood clots from forming. Here's when you may need them.

Nearly everyone has heard of "blood thinners." Maybe you or someone you know takes one. But these drugs don't "thin" blood at all.

"They are actually anti-clotting drugs," says Dr. Gregory Piazza, a cardiologist with Harvard-affiliated Brigham and Women's Hospital. "They prevent potentially dangerous blood clots from developing in people at high risk, like those who have atrial fibrillation or a stent in a blood vessel, or who are immobile after surgery."

About one in five people has high levels of lipoprotein(a), a fatty particle linked to premature heart disease.

Most people probably haven't heard of lipoprotein(a), although that's not surprising. Cardiologists have known for years that having high levels of these fatty particles circulating in the bloodstream poses a risk to the cardiovascular system. But there wasn't much they could offer in terms of therapy, so widespread testing for lipoprotein(a) — also known as Lp(a) — didn't make sense.

Recent progress means the landscape may soon be shifting. Earlier research showed that injectable cholesterol-lowering drugs known as PCSK9 inhibitors, such as evolocumab (Repatha) or alirocumab (Praluent), may lower Lp(a) by up to 25%. Until last year, however, it wasn't clear whether that reduction actually helped people with high Lp(a).

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

Spontaneous coronary artery dissection is an underrecognized but important cause of heart attack, especially in younger women.

Most heart attacks happen when a blood clot blocks an artery feeding the heart. But a small percentage result from a tear in the inner wall of one of the heart's arteries. The resulting flap or swelling inside the artery wall obstructs normal blood flow. Known as a spontaneous coronary artery dissection, or SCAD, the condition strikes both sexes but is more common in women.

In women who are under 50, SCAD is the most common reason for acute coronary syndrome. This medical emergency refers to inadequate blood flow to the heart; it includes both heart attacks and unstable angina (sudden chest pain that occurs at rest).

Research we're watching

Google searches for "chest pain" spiked in March and April of 2020 during the initial sharp rise in COVID-19 infections, according to a new study. The findings suggest that people were attempting to self-diagnose heart attacks — and may explain why fewer people sought treatment for heart attacks in hospitals during the pandemic.

The study relied on Google Trends, a tool that monitors search term queries over time. The authors looked at searches for "chest pain" and five control terms — "toothache," "abdominal pain," "knee pain," "heart attack," and "stroke" — from January 2017 through May 2020. Searches for chest pain (a common symptom of heart attack but not COVID-19) spiked in states with high rates of COVID-19 infection (New York, New Jersey, and Illinois), while searches for other terms stayed steady.

If you've been diagnosed with heart disease, the FITT approach can reduce your risk for heart attack and stroke.

About half of all Americans have at least one of the key risk factors for heart disease, such as high cholesterol, high blood pressure, and excess weight.

You can address those risks with a heart-healthy diet and medications to lower blood pressure and cholesterol levels. But perhaps the biggest boost you can give your heart is regular aerobic exercise.

Research we're watching

Think you're doing your heart a favor by drinking diet instead of regular soda? That may be wishful thinking, according to a research letter published Nov. 3, 2020, in the Journal of the American College of Cardiology.

Researchers studied nearly 105,000 people who filled out three 24-hour dietary recall surveys every six months. During a 10-year follow-up, researchers tracked the participants' cardiovascular health.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.