Heart Attack Archive

Research we're watching

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People who develop the painful, blistering rash known as shingles may be more susceptible to a heart attack, according to a study in the July 11, 2017, Journal of the American College of Cardiology. Also known as herpes zoster, shingles results from a reactivation of the virus that causes chickenpox, which most adults had during childhood.

Researchers relied on a Korean health database to identify people newly diagnosed with shingles, stroke, or heart attack over 10 years. Among the nearly 520,000 people they followed for that period, just over 23,000 were diagnosed with shingles, whom they compared with a similar number of people without shingles. People who'd had shingles had a 59% higher risk of later having a heart attack and a 35% higher risk of having a stroke compared with people who did not have shingles. The risk was highest during the first year after the onset of shingles and then diminished over time.

After calling 911, do you know what to do if a person is unresponsive and not breathing?

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Each year, an estimated 600,000 Americans suffer a cardiac arrest, during which the heart suddenly and unexpectedly stops beating. If someone nearby immediately begins cardiopulmonary resuscitation (CPR), the chest compressions can keep blood flowing to the person's brain and other vital organs — and more than double the odds of survival.

"About 70% of cardiac arrests happen at home. If this happened to your spouse or loved one, wouldn't it be awful if you didn't know what to do?" says Dr. Charles Pozner, associate professor of emergency medicine at Harvard-affiliated Brigham and Women's Hospital. But only 18% of adults in the United States have been trained in CPR within the past two years, according to a recent nationwide survey of 9,022 people, published in the May 24, 2017, Journal of the American Heart Association.

Research we're watching

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Heart attack risk may rise within a week of taking daily high doses of certain over-the-counter pain relievers, according to a new study.

Previous research has linked the use of pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) to a heightened risk of heart attack. The new report, published in the May 9, 2017, issue of The BMJ, analyzed data from nearly half a million people, of whom about 61,000 had heart attacks.

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New research may help explain why diets rich in animal-based foods are linked to a higher risk of heart attack.

The average American diet contains about 300 milligrams per day of choline, a nutrient found in meat, eggs, and milk. Earlier research found that when gut bacteria feed on choline, they make a compound called TMA. In the liver, TMA is converted to TMAO — a compound closely tied to heart disease risk.

If so, be extra vigilant about measuring and managing your blood pressure and cholesterol.

Filling out those family history forms at the doctor's office can be tedious. But sometimes, the devil is in those details. Because heart disease is so common, many people check "yes" to the question about whether their father or mother had heart disease. But if your father had a heart attack at age 77, that's likely different than if his heart attack happened when he was only 44.

"If you have any family history of heart disease, that should serve as a keen reminder to pay attention to factors that can raise your risk of a heart attack, such as high cholesterol, high blood pressure, and diabetes," says Dr. Howard Sesso, an epidemiologist with the division of preventive medicine at Harvard-affiliated Brigham and Women's Hospital. But if a parent or sibling had a premature heart attack, that's an even stronger signal to be more proactive in monitoring and lowering your risk, he adds. A premature or early heart attack is one that occurs before age 55 in a man or before age 65 in a woman.

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

Research we're watching

Implantable cardioverter-defibrillators (ICDs) are miniature electronic devices placed under the skin below the collarbone to sense and stop abnormal heart rhythms. A study in the Jan. 24, 2017, Journal of the American College of Cardiology provides new information about outcomes in older people who receive these lifesaving devices.

The study included 12,420 people with an average age of 75. All had survived a sudden cardiac arrest and received an ICD. Nearly four in five of the participants survived at least two years. During the two-year period, nearly 65% were hospitalized at some point. Many were admitted to skilled nursing facilities during the study, including about 32% of those ages 80 and older.

After a Heart Attack

Questions to Discuss with Your Doctor:

• Have you had chest pain or pressure since you were discharged from the hospital?
• How severe is it?
• How long does it last?
• Does it stay in your chest or radiate to other parts of your body?
• Did you have this pain before your heart attack? What brings it on? How frequently do you get it?
• What were you doing just prior to the chest pain?
• Do you ever get chest pain or pressure at rest?
• What relieves the chest pain?
• If you take nitroglycerin, how many doses do you usually need to take before the pain goes away?
• How often do you take nitroglycerin?
• Do you get short of breath when you lie down or exert yourself?
• Do you awaken in the middle of the night short of breath?
• Do your ankles swell?
• Do you ever feel lightheaded?
• Have you fainted?
• Do you get rapid or pounding heartbeat for no reason?
• Do you know what each of the medications you are taking does?
• Do you know the side effects of each medication?
• Are you having any side effects?
• Are you taking an aspirin every day?
• Are you doing everything you can to modify the risk factors that can worsen your coronary artery disease (cigarette smoking, high blood pressure, high cholesterol, and diabetes are the most important risk factors)?
• Are you participating in a supervised exercise program?
• Are you resuming your normal activities?
• Are you sexually active?
• Have you returned to work?
• Have you been feeling depressed since your heart attack?
• Have you been able to reduce the stress in your life?
• Have you been fatigued?

Your Doctor Might Examine the Following Body Structures or Functions:

• Heart rate, blood pressure, and weight
• Pulses in your wrist, groin, and feet
• Listen over the major arteries in the neck, groin, and feet (for abnormal noises)
• Look at the veins in the neck to see if there is extra fluid in your body
• Heart and lungs
• Ankles and legs (for swelling)

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for glucose, lipid panel (cholesterol levels) and C-reactive protein (CRP)
• Electrocardiogram
• Echocardiogram
• Exercise stress test

Cardiovascular disease in women isn't identical to that in men. Understanding the differences can help you prevent or minimize the effects of a heart attack.

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Cardiovascular disease is the leading killer of women, but women's heart disease hasn't captured the popular imagination the way men's has. Although you can probably recall a movie in which a man collapsed with a heart attack, you're unlikely to remember a similar scene starring a woman. That may be because women develop heart disease about 10 years later than men do. While men are most likely to have a first heart attack around age 65, a woman's first heart attack occurs at an average age of 71. Moreover, heart disease doesn't become the leading cause of death for women until age 85.

If heart disease comes to women so late in life, why should we be concerned about it when we're younger?

In a large United Kingdom study, regularly practicing racket sports, swimming, or aerobics significantly reduced the risk of dying over eight to 13 years.