Heart Attack Archive

Women are at higher risk for heart attacks that don't involve blocked arteries — and they should receive the same follow-up treatment as conventional heart attack patients.

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For years, people who suffered heart attacks but didn't have major blockages in their arteries — a condition called myocardial infarction with nonobstructive coronary arteries (MINOCA) — were thought to have a less serious form of heart disease. As a result, doctors often opted against aggressive follow-up treatments. But a study published June 15 in the International Journal of Cardiology contributes to the growing body of evidence that MINOCAs merit follow-up treatment.

The study, which looked at data from an online Swedish cardiac registry, found that a quarter of people who were diagnosed with MINOCAs went on to have another major cardiovascular event, such as another heart attack, a stroke, or heart failure. Of the original group of 9,092 people who were diagnosed with MINOCAs (62% of them women), some 2,147 went on to have another cardiovascular event during a follow-up period averaging about 4.5 years.

Research we're watching

It seems the old adage "everything in moderation" might have an exception — smoking. A study in the January 24 issue of The BMJ found that smoking even one cigarette a day carries significant health consequences, namely a higher risk of heart attack and stroke.

Using data from 141 different studies, involving millions of participants, researchers compared people who smoked either one, five, or 20 cigarettes each day. They found, counter to what many people assume, that rates of heart disease and stroke were not reduced as much as expected in casual smokers compared with pack-a-day smokers.

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Doctors may be more likely to dismiss heart attack symptoms as not heart-related in women younger than age 55, according to a study published online Feb. 20, 2018, by Circulation. This may be the case because women often report other symptoms in addition to chest pain, said the study's authors.

The researchers interviewed more than 2,000 women and 976 men ages 18 to 55 who were hospitalized for a heart attack — what doctors call acute myocardial infarction (AMI) — at 100 hospitals that are participating in a study. They found that both men and women reported chest pain and pressure, but women were more likely to have other symptoms as well, such as pain in the jaw, neck, and arms; indigestion; or shortness of breath. In addition, women were more likely than men to tell their doctors that they thought the symptoms might be stress-related.

Not all heart attacks result from a blocked artery — and even small ones can have serious outcomes.

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Perhaps you've heard heart attacks described in various ways, from "mild" to "massive," or even the ominous-sounding "widow maker." But these terms may sow confusion and anxiety.

The good news: Most people who have a heart attack survive. The bad news? "Any heart attack can be fatal, no matter how big, how small, or where it occurs in the heart," says Dr. James Januzzi, a cardiologist at Harvard-affiliated -Massachusetts -General Hospital. There's a lot of mis-understanding among the general public about what a heart attack actually is, he adds.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

Q. There has been a lot of talk about the severity of this flu season, and I recently heard that influenza also can trigger a heart attack. Should I worry?

A. Influenza is responsible for about 10,000 to 20,000 annual deaths, mostly from pneumonia or internal organ failure. In other situations, influenza infection strains a person's health, which can worsen underlying conditions, such as heart disease.

In the journals

Taking a daily omega-3 fatty acid supplement might not reduce your chance of heart attacks or strokes if you already have heart disease or are at high risk for it, suggests a meta-analysis published online Jan. 31, 2018, by JAMA Cardiology.

The researchers compared 10 trials that included almost 78,000 people, approximately 47,000 of whom were men, with an average age of 64. Each trial involved at least 500 people who took daily doses of either an omega-3 fatty acid supplement or a placebo for at least a year. All participants had heart disease, had experienced a stroke, or were at high risk for these conditions.

Research we're watching

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Adding a little extra spice to your food may help you eat less salt, according to a study in the December 2017 issue of Hypertension. A salty diet may raise your risk of high blood pressure, leaving you more prone to heart attack and stroke.

For the study, Chinese researchers recruited 606 people and determined their preferences for salty and spicy foods, in part by asking how often they ate foods such as salted fried pork and pickled Chinese cabbage.

It may help prevent a heart attack or stroke, but it comes with the risk of bleeding.

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Maybe you've heard about people who take a low-dose aspirin each day to ward off heart problems. Since aspirin is a medicine you've probably used now and then without a problem, and since it is available without a prescription, you might consider trying a daily low-dose aspirin yourself. Don't do it. Unlike deciding to take a multivitamin, taking a daily aspirin isn't something you should decide to do on your own.

Aspirin therapy is typically prescribed to people who have atherosclerosis of the arteries of the heart or brain, or risk factors for such disease. Just who should take a daily aspirin, how much aspirin, and what type of aspirin are hotly debated issues, with clinical trials under way in search of answers. "Until those results are in, you should talk to your doctor before starting aspirin," says Dr. Deepak Bhatt, a cardiologist and the editor in chief of the Harvard Heart Letter.

Research we're watching

A research letter published in the July 3 issue of the Journal of the American College of Cardiology says that shingles, a painful rash caused by the varicella-zoster virus (the same virus that causes chickenpox) may be linked to an increased risk of stroke and heart attack.

South Korean researchers used a national medical database to identify diagnoses of shingles, stroke, and heart attack and followed them from 2003 to 2013. They compared 23,213 individuals who had developed shingles during this period and compared their subsequent rates of heart attack and stroke to approximately 23,213 shingles-free individuals. They found that people who had shingles had a 35% higher risk of heart attack and a 59% higher risk of stroke.