Heart attacks are linked to patients’ activity level, emotional state

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A large global study of more than 12,000 first-time heart-attack patients found a strong link between the attack and what the patients were doing and feeling in the hour preceding the event.

The study, published in the journal Circulation, found that being angry or emotionally upset more than doubled the risk of suffering a heart attack. Performing heavy physical activity in a highly emotional state more than tripled the risk. The researchers compared people’s behavior in the 60 minutes before the onset of heart-attack symptoms with the same one-hour period 24 hours earlier.

The results, based on an analysis of heart-attack patients in 52 countries, were consistent regardless of other, traditional cardiovascular risk factors, such as obesity, high blood pressure and diet.

Intense physical activity and negative emotions can increase heart rate and blood pressure, which reduces the supply of blood and oxygen to the heart, the researchers said. This can cause arterial plaque to rupture and trigger an acute myocardial infarction, or heart attack, they said.

Previous studies have found links between heart-attack risk and anger, stress, physical activity—even extreme happiness. But these mostly involved a small number of subjects from Western countries, the researchers said.

Researchers at the Population Health Research Institute at McMaster University in Hamilton, Ontario, analyzed data from patients who were examined and interviewed at 262 health centers around the world as part of a larger study. The patients, about three-quarters of whom were men, were 58 years old, on average.

In the hour before the first symptoms, 13.6 percent were engaged in heavy physical exertion, compared with 9.1 percent on the previous day. Feelings of anger or being emotionally upset were reported by 14.4 percent and 9.9 percent during the same periods, respectively. The majority of heart attacks occurred between 6 a.m. and 6 p.m.


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Heart Attack vs. Sudden Cardiac Arrest: Understanding the Difference

Mary M. Newman

Image result for heart spaceshipAwake or Not Awake. That Is the Question.

October is National Sudden Cardiac Arrest Awareness Month. Understanding the difference between heart attack and sudden cardiac arrest could help save lives. One way to understand the difference between the two conditions is this distinction: The heart attack victim is awake and the heart is beating. In contrast, the sudden cardiac arrest victim is not awake and the heart is not beating. To survive sudden cardiac arrest, the victim needs immediate CPR and treatment with a defibrillator. [1]

Sudden unexpected cardiac arrest is the third leading cause of death in the U.S. [2], affecting 326,200 people each year, including 6,000 youth [3]. On average, about 10 percent of victims survive, though nearly 40 percent survive when bystanders call 911, start CPR, and use automated external defibrillators, or AEDs, before emergency medical services (EMS) arrives at the scene. [4]

It’s a common misconception that heart attack and sudden cardiac arrest are the same thing. In reality, the two conditions are quite different.

Heart attack, or myocardial infarction, occurs when part of the heart’s blood supply is reduced or blocked, causing the heart muscle to become injured or die. Victims may complain of various symptoms including:

• Mild intermittent chest discomfort that lasts a few minutes and comes and goes over a period of days

• Pain or discomfort in one or both arms that spreads to the shoulders, upper back, neck or jaw

• Shortness of breath

• Nausea, sweating, lightheadedness

• A general sense of anxiety

• A tendency to deny that anything serious is happening.

Women sometimes experience additional symptoms including:

• Stomach or abdominal pain

• Weakness and overwhelming fatigue

• Swelling of the ankles and lower legs.

When someone has a heart attack, he or she is awake and the heart is beating. It’s important to act right away to maximize the odds of survival and minimize permanent damage to the heart. Bystanders should call 911 and have the person lie down and rest until EMS arrives.

While heart attack is often described as a “plumbing problem,” sudden cardiac arrest is more of an “electrical problem” that prevents the heart from functioning effectively. Heart attacks can lead to sudden cardiac arrest, but there are many other causes as well, including congenital and electrophysiological abnormalities, severe heart failure, electrocution, and drug overdose.

In contrast, when sudden cardiac arrest occurs, the heart stops beating altogether. As a result, blood is no longer pumped throughout the body, including the brain. The person suddenly passes out, loses consciousness, and appears lifeless — except for abnormal gasping, which may last several minutes. Sometimes victims experience seizure activity at the onset of the event.

The sudden cardiac arrest victim is not awake and the heart is not beating. If no one provides immediate help, the victim will die within minutes.

When sudden cardiac arrest occurs, it is critically important for bystanders to call 911, give CPR, and use the nearest AED.

This is lifesaving care that anyone can provide. While it is best to be trained in CPR and the use of AEDs, even without formal training, bystanders can call 911, follow dispatcher instructions, push hard and fast on the center of the victim’s chest, and follow the directions on the AED while waiting for EMS to arrive.

Sometimes people hesitate to help because they are afraid they might do something wrong and hurt the victim. But since the cardiac arrest victim is clinically dead and cannot get any worse, bystander actions can only help. In addition, state and federal Good Samaritan laws provide protection to bystanders who render aid to sudden cardiac arrest victims in good faith.

Risk factors for sudden cardiac arrest include:

• A previous heart attack

• A previous episode of cardiac arrest

• A low (<35 percent) ejection fraction (the heart’s ability to pump blood)

• Underlying heart conditions such as coronary artery disease, congenital heart disease (e.g., hypertrophic cardiomyopathy), electrophysiological abnormalities (e.g., long QT syndrome, Wolff-Parkinson-White disease, Brugada syndrome)

• Severe heart failure

• Marked changes in electrolytes in the blood

• A tendency to faint

• Hyperthyroidism

• Electrocution

• Drug abuse

• A family history of heart disease or stroke, especially having relatives who died suddenly before age 50.

If your loved ones have one or more of these risk factors, they may be at risk for sudden cardiac arrest. If this is the case, they should see a cardiologist or heart rhythm specialist (electrophysiolgist) for an evaluation. The physician may recommend implantable cardioverter defibrillator therapy, medications, or other measures to prevent sudden cardiac death.

In summary, heart attack victims are awake and typically experience discomfort or pain. While they do not need CPR or treatment with a defibrillator, it’s essential to call 911 so they can be transported immediately to the hospital. In contrast, sudden cardiac arrest victims are not awake and need immediate CPR and treatment with a defibrillator. You can save a life by learning to recognize these conditions and being prepared to take appropriate action.

 

Worlds Collide and Life Is Rearranged

SPACE PHOTOS THIS WEEK: Planets Collide, Crater, More
August 10, 2009–Planet SMASH! A celestial body about the size of our moon collides with a planet roughly the size of Mercury in a new artist’s conception. Scientists think a scene like this played out just a few thousand years ago around a young star called HD 172555.NASA’s Spitzer Space Telescope recently detected the signatures of vaporized and melted rock along with rubble around the star, about a hundred light-years from Earth. Debris from a similar giant impact between Earth and a Mars-size body is thought to have created our moon about 30 to 100 million years after the sun formed.
—Image courtesy NASA/JPL-Caltech
LIFE IS REARRANGED
Star date 05-15-2014   I had a massive heart attack . In medical terms the Doctors and the Nurses called it the Widow Maker.    Yes I was on my way to see Mama and Them.    I eventually survived with a pace maker place just below my Collier Bone . I was released during the Memorial Weekend .
On Memorial Day evening  I had swollen up to 40 lbs. more than my normal weight.  I had retained that much water and had shortness of breath again.  Oh well,back to the hospital.   At fist the doctors weren’t sure what was causing the shortness of breath and the swelling in my legs and feet.  Finally it was pneumonia  on my left lung.
Star Date 05-30-2014   I was released to my home and  glad to be here.  I have an army of doctors and doctor visits upcoming .
I am written you to tell you that I worked out for years 4 to 5 days a week and had no signs of danger aware of until it happen.  I was being treated for another condition that was it.    I had not had an EMG in over 4 years.  You probably think I am just rambling on but ,THE EMG WAS THE MOST IMPORTANT PART TO THIS STORY.   PLEASE LADIES AND GENTS TELL YOUR DOCTOR TO INCLUDE AN EMG TO YOUR BREIF OFFICE VISITS IT MAY SAVE YOUR LIFE.