People who are at risk for the development of coronary artery disease and myocardial infarction include those who fall into any of the categories listed below:

-People with a history of heart disease.

-Males.

-Smokers.

-People with high cholesterol.

-People with high blood pressure.

-Obese people.

-People with diabetes.

-People who suffer stress.

-People who live a sedentary life style.

-Heredity is a powerful factor that contributes to early heart disease.  Being male is a risk factor, but the incidence of heart disease in women increases dramatically after menopause.

-The risk factors to concentrate upon are those that can be modified.  These include cigarette smoking, high blood pressure, cholesterol, obesity, sedentary life style and stress.  Cigarette smoking causes many deaths from myocardial infarction and other heart diseases.  Smoking contributes to almost half of the heart attacks of women under age 55.

-Stopping smoking can greatly reduce your chances of having a heart attack.  Controlling blood pressure can reduce your risk of heart attack.  Lowering cholesterol to safe levels through diet and medications can reduce your risk and may even lead to some regression of the plaques already present.  Lean body weight and a regular exercise program are helpful.

-If you are diabetic, precise control of your diabetes will help reduce your risk of blood vessel damage due to diabetes.  Stress is a risk factor that is common, difficult to quantify and difficult to control effectively over time.  Methods of stress reduction include meditation, regular exercise, time management, and a supportive environment.

How is a heart attack diagnosed?

Chest pain is the most common symptom of a heart attack.  The chest pain is usually a burning or pressure sensation beneath the mid or upper breast bone.  The pain may radiate into the upper mid back, neck, jaw or arms.  The pain may be severe but often is only moderate in severity.

There may be associated shortness of breath or sweating.  If patients have had angina previously, the heart attack pain will feel the same as their usual angina only stronger and more prolonged.  If you have a pain like this that lasts longer than 15 minutes, it is best to be evaluated immediately.

Calling your medic unit is the fastest and safest way to ask for help.  If you have symptoms like this that wax and wane, this is often a warning sign that a heart attack is about to occur and prompt medical attention is needed.

Once you are in an emergency room or a doctor’s office an electrocardiogram (ECG or EKG) will be obtained.  This is often helpful in diagnosing a heart attack.  Sometimes, however, the test is normal even when the heart injury is present but usually a great diagnostic tool.

When heart cells die, certain enzymes present in heart cells are released into the bloodstream that serve as a marker of heart injury (troponin I and CPK or CK-MB).  These enzymes can be measured by blood tests.  The amount of enzyme released into the blood stream also helps assess how much heart damage has occurred.

TREATMENT:

The best way to limit the size of a heart attack is to restore the flow of blood to the heat muscle as fast as possible.  There are two basic methods to do this.

Because most heart attacks are caused by clots forming within the coronary artery, dissolving the clot quickly will restore blood flow.  Drugs called thrombolytics are quite effective.

The sooner these drugs are given, the quicker the blood flow will be restored.  An alternative method involves the use of balloon angioplasty.

This involves taking the heart attack victim promptly to the cardiac cath lab in the hospital.

An angiogram is performed to show the blocked blood vessel leading to the heart attack.  Then a balloon catheter is placed across the blockage and flow is restored.

Sometimes a stent (a device that assists in holding the blood vessel open) is placed to create a large channel.

Smaller heart attacks, often  those not producing significant abnormalities on the ECG are often treated with bedrest and blood thinners such as heparin as well as drugs to reduce the work the heart does.

These heart attacks are called non-transmural myocardial infarctions.  Before discharge, x-ray studies of the heart arteries are often carried out to see if angioplasty or surgery will be necessary.

Following thrombolytic (clot reducing) therapy, angiogram are often performed to outline the coronary anatomy to help determine if additional therapy such as angioplasty or bypass surgery is indicated.  This may be done during the initial hospitalization or later as an outpatient procedure

Angina is a medical term simply meaning lack of oxygen to the heart.  Lack of oxygen to any area of the body will cause pain in time since oxygen is the nutrients to our tissues in the human body.  Since the heart is in our upper chest angina will cause pressure or pain in the chest area and could radiate down the left arm.  Angina is reversible, no damage has occurred to the heart, but don’t get it treated and a heart attack will soon occur.

A Myocardial Infarction (MI) is just another name for a heart attack.  The coronary arteries supply the heart muscle which is called the myocardium in medical terms.  When one of these arteries are blocked and the blood supply is cut off partially to completely an MI can definitely occur.  The problem here is actual damage and scarring occurs at the area of where the MI took place in the heart.  Cell death does not occur immediately once the artery is blocked.  It takes several minutes to start the injury process and this continues for several hours unless the artery is opened up and blood flow is restored.

Cause:

The reason for the blockage is usually a buildup of plaque (deposits of fat-like substances) in the walls of the coronary arteries.

The plaque buildup narrows the walls of the artery and can cause blood clots to occur.  Plaque buildup is caused by a disease known as artherosclerosis (hardening of the arteries).  An artherosclerotic plaque is a made up of cells, cholesterol, and other fatty substances.  The plaque develops in the wall of the coronary artery and over time becomes large enough to start narrowing the channel through which the blood travels.

The pool of lipid (the fat) within the plaque is covered by a thin fibrous cap.  This cap may split or fracture, exposing the blood to elements within the plaque that cause blood clot formation.

This clotting process may be controlled by the body, which contains substances to dissolve clots, or may lead to complete blockage of the artery.  When the artery is  blocked acutely for more than a few minutes, cell death start to occur.

Coronary heart disease is a very common disease and is the leading cause of death in the United States.  More than 500,000 men and women suffer a heart attack each year.

Are all heart attacks the same?   NO, A small heart attack means only a small amount of the heart muscle tissue has died.  Recovery in such cases is typically fast, and complications are to a minimum.

Large heart attacks that involve a large portion of heart tissue can cause problems like:  low blood pressure, shock, or heart failure because the heart’s ability to pump blood is reduced.  Recovery is typically longer in such cases and complications are at a higher potential of happening or death can occur.

Until the are of damage heals, the dead heart muscle is soft/weak and rupture of the heart wall can occur.  This usually results in death.  The normal rhythm of your heartbeat can change during a heart attack.  These rhythm abnormalities can be very serious and cause death if not treated promptly.

With prompt and effective treatment of a myocardial infarction, most potential complications can be avoided, and the mortality rate can be reduced dramatically.

Recovery for a heart attack:

In years past, hospitalization was often prolonged, lasting 3 to 4 weeks.  Today, hospitalization following a heart attack is usually brief in the absence of complications.  Often patients are home within 4 to 5 days or sooner.  Activities will be restricted for a few weeks to allow the healing process to occur.  The damage to the heart tissue will usually heal in 4 to 8 weeks.  The heart forms a scar tissue that is permanent; just like what would happen if any other tissue of the body suffered damage. (ex. You cut yourself with a knife damaging your skin (which is tissue and a organ of the body, than get stitches by the doctor which heal on their own in time  and  a scar in that area remains for life).  The same thing occurs to the heart in a MI.

Many patients will participate in a formal cardiac rehabilitation program.  These pro- grams typically focus on exercise and other lifestyle changes in order to speed recovery, and to fight the coronary artery disease that originally caused the heart attack.  Cardiac rehabilitation is so vital, it helps people to resume normal activity to their optimal level as quickly as possible with whatever adjustments they needed to make in their life to prevent this from happening again whether it be diet, exercise balanced with rest, and medications to take (new or adjustments in doses) or all 3.

Come back tomorrow for Part 2 on What are risk factors for a Myocardial Infarction with how is a heart attack diagnosed, treatment with When you can return to work and further details on how to prevent further heart attacks from occurring.

Angina is a medical term simply meaning lack of oxygen to the heart.  Lack of oxygen to any area of the body will cause pain in time since oxygen is the nutrients to our tissues in the human body.  Since the heart is in our upper chest angina will cause pressure or pain in the chest area and could radiate down the left arm.  Angina is reversible, no damage has occurred to the heart, but don’t get it treated and a heart attack will soon occur.

A Myocardial Infarction (MI) is just another name for a heart attack.  The coronary arteries supply the heart muscle which is called the myocardium in medical terms.  When one of these arteries are blocked and the blood supply is cut off partially to completely an MI can definitely occur.  The problem here is actual damage and scarring occurs at the area of where the MI took place in the heart.  Cell death does not occur immediately once the artery is blocked.  It takes several minutes to start the injury process and this continues for several hours unless the artery is opened up and blood flow is restored.

Cause:

The reason for the blockage is usually a buildup of plaque (deposits of fat-like substances) in the walls of the coronary arteries.

The plaque buildup narrows the walls of the artery and can cause blood clots to occur.  Plaque buildup is caused by a disease known as artherosclerosis (hardening of the arteries).  An artherosclerotic plaque is a made up of cells, cholesterol, and other fatty substances.  The plaque develops in the wall of the coronary artery and over time becomes large enough to start narrowing the channel through which the blood travels.

The pool of lipid (the fat) within the plaque is covered by a thin fibrous cap.  This cap may split or fracture, exposing the blood to elements within the plaque that cause blood clot formation.

This clotting process may be controlled by the body, which contains substances to dissolve clots, or may lead to complete blockage of the artery.  When the artery is  blocked acutely for more than a few minutes, cell death start to occur.

Coronary heart disease is a very common disease and is the leading cause of death in the United States.  More than 500,000 men and women suffer a heart attack each year.

Are all heart attacks the same?   NO, A small heart attack means only a small amount of the heart muscle tissue has died.  Recovery in such cases is typically fast, and complications are to a minimum.

Large heart attacks that involve a large portion of heart tissue can cause problems like:  low blood pressure, shock, or heart failure because the heart’s ability to pump blood is reduced.  Recovery is typically longer in such cases and complications are at a higher potential of happening or death can occur.

Until the are of damage heals, the dead heart muscle is soft/weak and rupture of the heart wall can occur.  This usually results in death.  The normal rhythm of your heartbeat can change during a heart attack.  These rhythm abnormalities can be very serious and cause death if not treated promptly.

With prompt and effective treatment of a myocardial infarction, most potential complications can be avoided, and the mortality rate can be reduced dramatically.

Recovery for a heart attack:

In years past, hospitalization was often prolonged, lasting 3 to 4 weeks.  Today, hospitalization following a heart attack is usually brief in the absence of complications.  Often patients are home within 4 to 5 days or sooner.  Activities will be restricted for a few weeks to allow the healing process to occur.  The damage to the heart tissue will usually heal in 4 to 8 weeks.  The heart forms a scar tissue that is permanent; just like what would happen if any other tissue of the body suffered damage. (ex. You cut yourself with a knife damaging your skin (which is tissue and a organ of the body, than get stitches by the doctor which heal on their own in time  and  a scar in that area remains for life).  The same thing occurs to the heart in a MI.

Many patients will participate in a formal cardiac rehabilitation program.  These pro- grams typically focus on exercise and other lifestyle changes in order to speed recovery, and to fight the coronary artery disease that originally caused the heart attack.  Cardiac rehabilitation is so vital, it helps people to resume normal activity to their optimal level as quickly as possible with whatever adjustments they needed to make in their life to prevent this from happening again whether it be diet, exercise balanced with rest, and medications to take (new or adjustments in doses) or all 3.

Come back tomorrow for Part 2 on What are risk factors for a Myocardial Infarction with how is a heart attack diagnosed, treatment with When you can return to work and further details on how to prevent further heart attacks from occurring.

“Honey or Cola May Disrupt Heart”

“TUESDAY, June 25, 2013 (MedPage Today) — A detailed history of patients with arrhythmia or syncope might need to decrease their cola intake or the origin of the honey they consume, two case studies suggest.” 

Chris Kaiser, Cardiology Editor, MedPage Today www.everydayhealth.com

Syncope, also known as fainting, is a sudden, temporary loss of consciousness.

THE CAUSES:

Syncope is caused by a temporary decrease in the flow of blood to the brain.  A large number of situations or conditions can cause this decrease in blood flow.  They can include straining for a prolonged period of time, common mild illnesses like as simple as the cold or flu or sinusitis, standing up too quickly allowing the blood to drop from the brain in decreasing blood supply to that area, emotionally stressed, heart disease, standing rigidly for a long time, arrhythmias (abnormal heart beats = irregular heartbeats), pain, fright, drugs and alcohol.

Certain heart conditions can cause syncope.  They include heart attacks, certain arrhythmia (like atrial fibrillation), hypertropic cardiomyopathy (A disease that involves thickening of the heart muscle which is greatest in size on the L side of the heart since that side of the heart has to pump blood to the feet up to the head and back to the right side of the heart; the Rt. side of the heart only pumps blood from the Rt side of the heart to lungs and back to the L side of the heart with oxygenated blood.)  Other conditions causing syncope can be disorders of the heart valves, or heart blocks (a problem with the heart’s electrical system blocked due to the conduction system not going completely from the top to the bottom of the heart which can be slight (1^st degree heart block to moderate=2 types of 2^nd degree heart block to completely being 3^rd degree heart block).

DIAGNOSIS:

Like any other condition in determining the cause we have to use diagnostic tools through certain tests to figure out the actual etiology of the syncope or any symptoms you’re experiencing.

The doctor will start with a thorough physical exam and review of your medical history with significant changes from your last physical or visit with the doctor.  The doctor may recommend certain diagnostic tests to determine the cause of your fainting episodes.  These tests could include: X-rays, use of a Holter monitor (a device that you  wear during the day that records the electrical activity over a period of time), or other diagnostic or imaging testing procedures.

Our doctor might recommend a “tilt-table test”.  This test involves a special table that tilts upright. Sometimes, medications are given during the test to help with the diagnosis.  Your doctor may order a Stress Test where you walk to run on a treadmill with or without IV contrast to determine if this is possible cardiac situation and if it is than the doctor would further order other cardiac testing from Echocardiogram (soundwaves checking the heart) to microsurgery possibly like an angiogram (cardiac cath)=microsurgery if the situation was a blockage in an artery that needed to be declogged than a angioplasty would be performed if you were a candidate for this procedure, which a cardiologist would decide.

PREVENTION OF THIS PROBLEM:

If this was to prevent cardiac conditions from occurring to stop the syncope from occurring live a life with a healthy diet, balancing exercise and rest and if overweight start a program with both diet and exercise involved.  To do it right first go to a cardiologist, if obese or overweight, to do it safe and correctly.

Already with some type of cardiac problem than be compliant in what your cardiologist provides you in your individual plan of care in treating this condition to prevent it worsening or causing other problems as well.

TREATMENT:

Treatment depends on the cause of the fainting spells.  If the problems are related to medications the doctor may have to change the dosage or the type of medication.  Medications are generally not required to treat syncope, but they might be required to treat the cause of syncope.

Most fainting spells are not dangerous.  Individuals usually regain consciousness on their own in a few minutes.

Diabetes is linked to a 65 percent increased risk of developing Alzheimer’s, which may be due, in part, because insulin resistance and/or diabetes appear to accelerate the development of plaque in your brain, which is a hallmark of Alzheimer’s. Separate research has found that impaired insulin response was associated with a 30 percent higher risk of Alzheimer’s disease, and overall dementia and cognitive risks were associated with high fasting serum insulin, insulin resistance, impaired insulin secretion and glucose intolerance.

A drop in insulin production in your brain may contribute to the degeneration of your brain cells, mainly by depriving them of glucose, and studies have found that people with lower levels of insulin and insulin receptors in their brain often have Alzheimer’s disease (people with type 2 diabetes often wind up with low levels of insulin in their brains as well). As explained in New Scientist, which highlighted this latest research:

What’s more, it encourages the process through which neurons change shape, make new connections and strengthen others. And it is important for the function and growth of blood vessels, which supply the brain with oxygen and glucose.

As a result, reducing the level of insulin in the brain can immediately impair cognition. Spatial memory, in particular, seems to suffer when you block insulin uptake in the hippocampus… Conversely, a boost of insulin seems to improve its functioning.

When people frequently gorge on fatty, sugary food, their insulin spikes repeatedly until it sticks at a high level. Muscle, liver and fat cells then stop responding to the hormone, meaning they don’t mop up glucose and fat in the blood. As a result, the pancreas desperately works overtime to make more insulin to control the glucose – and levels of the two molecules skyrocket.

The pancreas can’t keep up with the demand indefinitely, however, and as time passes people with type 2 diabetes often end up with abnormally low levels of insulin.”

Alzheimer’s Might be “Brain Diabetes”

It’s becoming increasingly clear that the same pathological process that leads to insulin resistance and type 2 diabetes may also hold true for your brain. As you over-indulge on sugar and grains, your brain becomes overwhelmed by the consistently high levels of insulin and eventually shuts down its insulin signaling, leading to impairments in your thinking and memory abilities, and eventually causing permanent brain damage.

Regularly consuming more than 25 grams of fructose per day will dramatically increase your risk of dementia and Alzheimer’s disease. Consuming too much fructose will inevitably wreak havoc on your body’s ability to regulate proper insulin levels.

Although fructose is relatively “low glycemic” on the front end, it reduces the affinity for insulin for its receptor leading to chronic insulin resistance and elevated blood sugar on the back end. So, while you may not notice a steep increase in blood sugar immediately following fructose consumption, it is likely changing your entire endocrine system’s ability to function properly behind the scenes.

Additionally, fructose has other modes of neurotoxicity, including causing damage to the circulatory system upon which the health of your nervous system depends, as well as profoundly changing your brain’s craving mechanism, often resulting in excessive hunger and subsequent consumption of additional empty carbohydrate-based calories.

In one study from UCLA, researchers found that rats fed a fructose-rich and omega-3 fat deficient diet (similar to what is consumed by many Americans) developed both insulin resistance and impaired brain function in just six weeks.

Plus, when your liver is busy processing fructose (which your liver turns into fat), it severely hampers its ability to make CHOLESTEROL^{, an essential building block of your brain crucial to its health. This is yet another important facet that explains how and why excessive fructose consumption is so detrimental to your health.  Decreasing fructose intake is one of the most important moves you can take in decreasing the risk of Alzheimer’s disease in your lifetime.}