This is a story of a gynecologist as he related in MedScape:
“When I began experiencing chest pain that was different from my usual heartburn symptoms, I denied I could possibly be having a heart attack, but chewed four baby aspirins just in case. Of the more than 350,000 individuals who experienced an out-of-hospital cardiac arrest in 2016, only 12 percent survived. Bystander recognition of cardiac arrest and prompt intervention with cardiopulmonary resuscitation (CPR) and rapid defibrillation is essential for out-of-hospital survival.
“While exiting the expressway on my way to perform scheduled surgeries that morning, I came to a complete stop in the left-hand lane of the exit ramp with three cars ahead of me. The indigestion I had been experiencing overnight was different from the heartburn symptoms I’d had in the past. I declined my wife’s suggestion to go to the emergency department, but compromised by taking four baby aspirins, and planned to follow-up with a previously scheduled appointment that afternoon with my internist. At the age of 53, on August 29, 2016 at approximately 7:40 a.m., I died waiting for the traffic light to change.”
Luckily, a school bus driver who witnessed the accident called 911. This physician was successfully resuscitated.
This is not an isolated story and it illustrates some fundamental principles we could learn from.
Medical Facts And Lessons
1. After age 40, chest discomfort should be suspected to be an impending heart attack, till proven otherwise, and must be attended to ASAP. Denial could be fatal. It could well be indigestion or stomach acid reflux, but erring on the safer side is the wiser choice. Heart attack is treacherous. It could happen among persons with pain in the jaw area and arm, with no actual chest pains. Hence, routine annual medical check-up is essential.
2. A history of chest pain should be investigated, even among younger individuals. I have done heart bypass on a 25-year-old woman, who was a diabetic and hypertensive, with high cholesterol level, who smoked heavily. Heart attack victims are getting younger and younger.
3. A visit to a family physician, if not a cardiologist, even before any medical problem arises for those beyond 40 will establish a baseline, upon which one could measure his/her own health status and progress. Any deviation from the parameters shown by all the tests done could alert the person accordingly.
4. The tests, depending on the complaints, signs, and symptoms, could include a complete blood count, blood chemistries (comprehensive metabolic panel, electrolytes, lipid profile, liver and renal panels, and thyroid functions), urinalysis, chest x-ray, EKG; and other more specific tests the physician might determine necessary after the interview and physical examination.
5. For those with chest or upper abdominal discomfort where the physician suspects gastroesophageal reflux diseases (GERD), upper GI endoscopy (telescopic visualization of the throat, food pipe and the stomach) might be recommended. If the findings point to a non-cardiac condition, it is managed accordingly.
6. If the family physician thinks the chest discomfort or other symptoms could be due to coronary heart artery disease, the patient would be referred to a cardiologist, who might perform any of the following: Thallium Stress EKG, an ECHO, or Cardiac Catheterization to view the heart function and the integrity of the heart valves, and Coronary Angiogram to see if any heart arteries are blocked by cholesterol deposits, which is the main cause of heart attacks.
7. When Coronary Angiogram shows significant blockages (more than 50 percent obstruction) in any major coronary arteries, an angioplasty with stent may be done. If more than two blockages are found, coronary bypass surgery would be recommended. The usual 1 to 2 percent risk for this procedure worldwide is clearly outweighed by the 50 percent risk of heart attacks and potential death of those refused surgery.
8. Obviously, prevention is the key. The vital factors include lifestyle and behavior: a low carbohydrate diet of fish, vegetables, nuts, some fruits, occasional or no red meat, with as little or no rice, bread, sweets, as possible, more of protein; abstinence from smoking and substance abuse, severe moderation in alcohol intake, doing daily physical exercises, and stress management with weekly R&R, mini or full vacation with family and/or friends.
9. Since dental problems cause inflammation which adversely affects our immune system and contributes to heart diseases, a visit to the dentist every six months would be very beneficial to overall health.
10. When one feels irregularity or rapid heart beat or thumping in the chest and dizziness anywhere, or while driving, taking a very deep breath and coughing as hard and as often as you can every two seconds or so could being your heart beat back to normal. Without delay, drive to the nearest emergency room. A false alarm might be embarrassing, but at least, you are alive.
11. When alone at home and chest pains develop, dial 911 for emergency help and notify a family member or neighbor, and take four baby aspirins (81 mg each) if previously recommended by your physician for such an event. As a home remedy for headache and pains, the usual dose is two tablets of regular aspirin (325 mg each, or a total of 650 mg) every 4 to 6 hours, so taking 4 baby aspirin tablets is like taking only one regular tablet. Aspirin is a mild blood thinner. This will prevent a severely blocked coronary artery from being totally obstructed by a blood clot and cause cardiac arrest. Those with a history of stomach ulcer/bleeding should not take aspirin, unless instructed by their physician.
12. In addition to the above, do not eat anything. Unlock your front door to allow paramedics to get in, and sit up by the front door (do not lie down as this would flood your heart and lungs with more blood, while your heart is having a hard time beating from the insult of the heart attack).
Scary statistics
In the United States alone, a person suffers a heart attack every 20 seconds and one dies from heart disease every 34 seconds, one every 5 minutes (close to 300 every 24 hours) in the Philippines. Each day, more than 2,700 Americans die from heart disease. About quarter of a million Americans die of a heart attack annually before they reach the hospital. Those who are under-educated have a higher risk of suffering a heart attack. Countries with the highest death rates from heart diseases include Russia, Poland, Hungary, Romania, and Czechoslovakia, and the lowest are Japan, France, Canada, Spain and Switzerland.
Notwithstanding our genes, our health and longevity, to a greater extent, are intricately linked to our lifestyle and behavior.
