Heart Attack Archive

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.

Image: SomkiatTakmee /Thinkstock

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. 

A large international study of people around the world suggests that extreme physical exertion or emotional upset may be triggers for a heart attack. 

Anger or emotional upset may double the risk of having a heart attack. Heavy physical exertion appears to have the same effect. And people who do intense exercise while they’re upset or mad may face three times the risk of heart attack. 

Medications such as aspirin, statins, ACE inhibitors, and beta blockers are prescribed to certain patients to lower the chance of a first or repeat heart attack. New research shows that they also may reduce the severity of attacks that do occur.

A majority of men do not talk about resuming their sex life after a heart attack, which may lead to sexual problems like lack of interest and erectile difficulties. Researchers say that before being discharged from the hospital, men should expect to have a conversation with their physician about when it’s okay to resume all regular activities, including sex. If the topic does not come up, men should take the initiative.

Millions of older adults aren’t taking their blood pressure drugs as directed. Ways to combat adherence problems include asking a doctor for less expensive drugs, understanding what a medication is for, and reporting side effects. 

Frank discussions with a doctor can help heart attack survivors return to sexual activity.

Image: UrosPoteko/Thinkstock

Few things shake your sense of well-being more than a sudden heart attack. When the initial shock wears off, an over-whelming need to get life back to normal as quickly as possible usually takes hold. "Patients always ask me when can they drive again, when can they start exercising, and when can they return to work," says Dr. Donna Polk, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. A key issue that seldom gets mentioned, though, is the struggle many heart attack survivors encounter when trying to resume their sex lives.

The same physical changes involved in a heart attack can conspire to diminish sexual enjoyment. Faulty circulation throughout the body, a hallmark of cardiovascular disease, reduces the amount of blood that reaches the sex organs. Men may develop erectile difficulties, and women may not have the blood flow needed for vaginal arousal and lubrication.