Heart Attack Archive

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Squeezing chest pain isn't always from a blocked artery.

Classic heart attack symptoms—severe pressure, heaviness, or pain in the chest—most often arise from a blockage in a coronary artery that prevents blood from reaching the heart muscle. But a lesser-known condition, called takotsubo cardiomyopathy, can produce the same sudden heart symptoms even when the coronary arteries are clear.

Research we're watchting

Many people with heart disease worry if sexual activity is safe for their hearts. But sex is rarely the cause of a heart attack, and sex after a heart attack is safe for most people, according to a research letter in the September Journal of the American College of Cardiology.

Researchers asked 536 people ages 30 to 70 who were undergoing cardiac rehabilitation after a heart attack to fill out questionnaires about their sexual activity in the 12 months before their heart attack. Over the 10-year follow-up, there were 100 adverse heart-related events among the participants, including heart attacks, strokes, and deaths from cardio-vascular disease.

Ask the doctor

Q. I've read news reports that the heartburn drug I take may cause heart attacks. Should I worry about this?

A. Several studies have reported an association between proton-pump inhibitors (PPIs) and heart attacks. PPIs are medications for heartburn, such as omeprazole (Prilosec) and pantoprazole (Protonix). Overall, however, the evidence suggests these medications are not risky for your heart.

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In the journals

The influential U.S. Preventive Services Task Force (USPSTF) has endorsed low-dose daily aspirin to prevent cardiovascular disease in people ages 50 to 59 who have a 10% or greater chance of heart attack or stroke in the next 10 years. Unless a person already has cardiovascular disease, the actual number of heart attacks and strokes prevented with daily aspirin is relatively small. This draft recommendation did not recommend aspirin for those younger than 50 or 60 or older, citing insufficient evidence to make a recommendation.

The USPSTF statement is at odds with a statement in 2014 by the FDA that evidence does not support general use of aspirin to prevent a first heart attack or stroke in otherwise healthy adults. However, daily aspirin is often recommended for those with a history of cardiovascular disease, since the potential benefit (preventing heart attacks and strokes) outweighs the risk of bleeding that comes with regular aspirin use.

Participation in a cardiac rehabilitation program following a heart attack helps people live longer and better.

In emergency departments, doctors routinely test blood levels of a protein called troponin to diagnose people with suspected heart attacks. That's because damaged heart muscle releases troponin into the bloodstream. Now, new research suggests that a high-sensitivity troponin test may help identify people with heart disease who face a high risk of fatal heart events.

For the study, published in the August 13 issue of The New England Journal of Medicine, researchers measured troponin levels with the high-sensitivity test in nearly 2,300 people with type 2 diabetes and stable heart disease (meaning they had narrowed heart arteries and chest pain but not a heart attack). Within five years, nearly one in three people with elevated troponin levels had a heart-related problem or died from one.

If you have heart disease, national guidelines recommend that you take a low-dose (81-mg) aspirin every day. It's an inexpensive and effective way to lower your risk of a heart attack or stroke. According to a report in the July 17 Morbidity and Mortality Weekly Report, about seven in 10 adults with heart disease follow this advice.

The study relied on telephone surveys done by the CDC about health behaviors. It included data from more than 17,900 adults from 20 states and the District of Columbia.

Q. My cardiologist told me to take clopidogrel for a year after I received a stent. Now the year is up. I haven't had any bleeding problems. Should I keep taking it?

A. In addition to aspirin, doctors routinely prescribe clopidogrel (Plavix) for people who receive stents, the tiny metal mesh tubes placed in clogged blood vessels to improve blood flow. This medication stops blood components called platelets from clumping together and forming clots. The current guidelines generally recommend that people take the drug for a year. This advice assumes they don't have any side effects such as unusual bleeding, which can show up as severe nosebleeds or blood in the urine or stools. However, these guidelines are still evolving. Experts are currently reviewing new findings from large studies on the benefits and risks of taking clopidogrel and similar drugs for extended periods of time.

New findings may help allay fears about sports-related heart death.

Summer's heat, humidity, and smog may be tough for people at risk of heart disease.