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Heart attacks are the number one killer of Americans every year and are also a leading cause of major disability. Each year about 1.1 million Americans have heart attacks and almost half of those are fatal.

Fortunately, today there is much that can be done to prevent heart attacks and treat coronary artery disease once it occurs.

Marion Hogan, M.D., a cardiologist at Mount Auburn Hospital, a teaching hospital of Harvard Medical School, says, “In recent years, medicine has made significant advancements in the treatment of heart disease. There are highly effective interventional procedures that can prevent serious heart damage during a heart attack and there are also effective medications that can control many of the risk factors for heart attacks. But Americans also need to take steps in their own lives to prevent or control heart disease.”

A heart attack occurs when the blood supply to the heart muscle or to a certain area of the muscle is cut off, usually due to blockages from a build-up of plaque in the heart’s arteries. Other terms for heart attack include myocardial infarction, coronary occlusion, or coronary thrombosis, but, whatever the terminology, the end result is the same. The more heart muscle that is damaged during a heart attack, the greater the likelihood of death or disability.

Dr. Hogan emphasizes that the sooner you receive medical attention during a heart attack the more likely it is that heart muscle can be saved. Consequently, if you experience any symptoms of a heart attack you should immediately call 911. Calling for an ambulance is much wiser than trying to drive yourself or have someone drive you to the hospital because the EMS (emergency medical service) personnel can provide care on the way to the hospital or even in your home when they arrive. These paramedics can use a defibrillator if your heart stops, and, if necessary, can give you oxygen or appropriate medications.

Dr. Hogan also advises taking an aspirin at the first signs of a heart attack. Aspirin acts as a blood thinner and may help keep blood flowing through blockages.

While the classic heart attack symptom of severe chest pain does occur in some people, there are other important symptoms that you should know about—symptoms that are particularly common in women, the elderly, and those who have diseases such as diabetes. These symptoms include the following:

Heart attack symptoms:

Shortness of breath

Chest pressure or feeling of fullness or indigestion

Weakness, lightheadedness, or dizziness

Any abdominal, back, arm, neck, jaw or chest pain

Sweating

Nausea

Once you arrive at the hospital, there are a variety of paths your treatment may take, depending on your condition. Various non-invasive tests may be ordered, including an electrocardiogram (EKG), which will show where the heart is injured. You may be given medications, such as clot busters, which will dissolve clots in coronary arteries. However, according to Dr. Hogan, in most situations the optimal way to determine what is happening to your heart is to have an interventional cardiology procedure called a cardiac catheterization.

During this procedure, a catheter is inserted in the femoral artery (in the thigh) and pushed up to the heart. Images are produced which show the doctor if there are any blockages in the heart that could be producing your symptoms. If there are blockages, then they can usually be immediately treated with stents (tiny metal tubes) or balloons that open up the artery and allow the blood to flow again. Unfortunately, if you arrive at the hospital too late, then the muscle damage may be permanent and the heart muscle will not be able to be revitalized with this procedure.

Dr. Hogan says, “Ideally, you should arrive at the hospital within an hour or two of the onset of heart attack symptoms. In many cases, with today’s interventional procedures, we can restore a heart to normal or near normal functioning but only if we have the opportunity to provide treatment before the heart muscle has been irreversibly damaged.”

If you have had a heart attack and are treated with a non-surgical invasive procedure, you will have a quicker recovery with a minimal hospital stay.

While most heart attacks today can be treated with medications or catheterization, sometimes a person’s blood vessels are not appropriate for a stent. Perhaps there are too many vessels affected or they are too small or turn at difficult-to-reach angles. In those cases, coronary artery bypass surgery may be warranted; however, there are many fewer surgical procedures being performed today than ten or fifteen years ago because of the effectiveness and applicability of interventional procedures.

Dr. Hogan emphasizes that people who have had heart attacks or have been treated for coronary blockages need to realize that, despite effective treatment, coronary artery disease is a chronic condition, which needs close attention throughout a person’s life. Those affected usually need to make dramatic changes in their lifestyles to prevent further coronary incidents or complications.

Dr. Hogan says, “You need to stop smoking, control your blood pressure and cholesterol, eat well, exercise, and treat diseases like diabetes. You need to understand that coronary artery disease is a very serious ongoing condition that will not go away. Fortunately, leading a healthy life and taking medications to control conditions like high blood pressure and cholesterol can make a huge difference in your longevity and quality of life.”

Dr. Hogan is optimistic about many of her patients and others who have been able to make these significant changes in their lives. She says, “People do have the capacity to change, especially when they understand that their lives are at stake. Modern treatments for heart disease have helped us save many lives so there are many more people alive today with heart disease than was the case even ten years ago. Many of these people have been able to make the necessary changes in their lives and slow down the progression of their disease. It does take commitment and an understanding of how lifestyle choices affect the condition of the heart.”

Dr. Hogan also feels that it is important for anyone with heart disease to be under the care of a cardiologist. The cardiologist will monitor the patient’s condition through regular examinations and a variety of tests, will recommend necessary lifestyle changes, and prescribe appropriate medications and other treatments. The cardiologist and the patient can work together to achieve their common goal of avoiding heart attacks and other complications of heart disease.

If you do not have coronary artery disease, paying attention to these same healthy lifestyle guidelines can also reduce your chances of developing this disease or having a heart attack later in life. Dr. Hogan says, “Those people who focus on leading healthy lives while they’re in their 30s, 40s and 50s have a much better chance of avoiding a heart attack or other heart problems later in life. Prevention is always the best approach to heart disease.

For a free Mount Auburn Hospital healthy heart pocket slider, please call us at 617-499-5094.