askthedoctor Heart Attack T
Know Three Facts The most important things to remember about a heart attack are 1) you can control most risk factors with a healthy lifestyle; 2) symptoms of a heart at- tack vary; and 3) imme- diate treatment is critical for the best outcome.
48 MILITARY OFFICER AUGUST 2016
Nearly 1 million people in the U.S. have a heart attack each year; about 15 percent die. Rear Adm. Joyce Johnson, D.O., explains how to help prevent heart attacks and reduce their consequences.
The heart is a muscle, about the size of a clenched fist, that works nonstop pumping blood, which contains oxygen, around the body. The heart requires a vibrant blood supply to get the oxygen it needs to keep working. When one of its blood vessels is blocked (often by a small piece of plaque and the resulting clot), the heart doesn’t get enough oxygen. Alter- natively, an artery in the heart can spasm, reducing blood fl ow. A heart attack — also called a myocardial infarction — can result. When the heart doesn’t get enough blood or oxygen, muscle cells start to die. The resulting scar tissue permanently damages the heart. Prompt treatment can interrupt this process and lead to a better patient outcome. The key is recognizing the signs of a heart attack. Though a heart attack often is depicted as a sudden onset of excruciating pain, not all heart attacks happen this way: About half of all heart at- tacks have no symptoms. The most common symptoms (for those
who experience them) are pain or discomfort in the chest or upper body (jaw, neck, back, arm, or shoulder); nausea or vomiting; feeling faint or light-headed or breaking into a cold sweat; or shortness of breath. Particularly in women, a period of feeling very tired also might signal a heart attack. The best way to recognize a heart attack
is to know the diff erences among symp- toms and know your personal risk factors.
The primary risk factors for a heart attack are high blood pressure, high low-density lipoprotein levels in the blood, and smok- ing. Additional risk factors include diabe- tes, being overweight or obese, poor diet, lack of regular exercise, and excessive alco- hol use. A healthy lifestyle can reduce these risk factors. For example, if you have high blood pressure, it is important to manage it, which might require lifelong medication. (Two other risk factors — family history and increasing age — can’t be controlled. ) If you think you are having a heart attack, call 911 immediately. You might be told to chew an aspirin and/or take nitroglycerin (if you have it). When an ambulance arrives, you will be carefully monitored on the way to the hospital. The main goal of treatment is to reestab- lish blood fl ow to the aff ected area of the heart as soon as possible. This usually is done with medications that dissolve a clot or through coronary angioplasty, a procedure that uses a balloon catheter to open up the clogged part of the artery and also might include inserting a stent (like a small straw) to keep the artery open. Upon discharge from the hospital, car-
diac rehabilitation — including an exercise program, education, and lifestyle changes — is critical.
MO
— Rear Adm. Joyce Johnson, USPHS (Ret), D.O., M.A., is a health care consultant in Chevy Chase, Md. Find more health and wellness resources at
www.moaa.org/wellness. For sub- mission information, see page 4.
PHOTO: STEVE BARRETT
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