A Guide to a Heart Attack

 

Over time, cholesterol and a fatty material called plaque can build up on the walls inside blood vessels that take blood to your heart, called arteries. This makes it harder for blood to flow freely. Most heart attacks happen when a piece of this plaque breaks off. A blood clot forms around the broken-off plaque, and it blocks the artery.

If this happens, you may feel pain, pressure, or discomfort in your chest. You could be short of breath, sweat, faint, or feel sick to your stomach. Your neck, jaw, or shoulders might hurt.

Actually, men and women can have different symptoms. Men are more likely to break out in a cold sweat and to feel pain move down their left arm.

Women are more likely than men to have back or neck pain, heartburn, and shortness of breath. They tend to have stomach trouble, including feeling queasy and throwing up. They may also feel very tired, lightheaded, or dizzy. A couple of weeks before a heart attack, a woman might have flu-like symptoms and sleep problems.

If it is a heart attack, the blood cannot get to your heart, your heart muscle does not get the oxygen it needs. Without oxygen, its cells can be damaged or die. Thus the key to recovery is to get your blood flow restored quickly. You are more likely to survive if you get treated within 90 minutes.

When this happens, you can chew and swallow an aspirin (unless you are allergic) to lower the risk of a blood clot. Hands-only CPR (Cardiopulmonary resuscitation) can double the chances of survival.

Doctors will then try to restore the flow of blood to your heart. You may get drugs that dissolve blood clots in your arteries. You will likely get a procedure called a coronary angiogram. Doctors put a thin tube with a balloon on the end through your artery. It opens up the blockage by flattening the plaque in your arteries. Most times, doctors place a small mesh tube called a stent in your artery to make sure it stays open.

An EKG (electrocardiogram), which checks your heart's electrical activity, can help doctors see if you are having a heart attack. It can also show which artery is clogged or blocked.

Doctors can also diagnose a heart attack with blood tests that look for proteins that heart cells release when they die.

Your odds of having a heart attack go up with age, and men are more likely to have one than women. A family history of heart disease also makes one more likely. Smoking raises your chances of a heart attack. So does having high blood pressure, high cholesterol, diabetes, and being obese. Stress, a lack of exercise, and depression can, too.

If you smoke, stop. It will immediately cut your chances of a heart attack by a third. And you need to get exercise, eat right and find positive ways to manage your stress. The American Heart Association recommends 30 minutes of moderate exercise a day, 5 days a week. Eat plenty of fruits, veggies, and whole grains to keep your arteries healthy.

For some people, taking a daily aspirin might help.

Exercise Gains Traction as a Way to Fight Cancer

Exercise is a potent weapon against cancer.

Research in the fast-growing field of exercise oncology has left little doubt that staying physically active improves symptoms and side effects during cancer treatment. And there is now solid evidence that exercise reduces the risk for some cancers and lowers the odds of dying if you are diagnosed with certain forms of the disease. Previous finding shows that breast cancer patients having chemotherapy who exercised regularly had less fatigue, nausea, and disability from the treatments.

In 2019, Kathryn Schmitz, director of the Oncology, Nutrition, and Exercise Group at the Penn State Cancer Institute, found that exercising during and after treatment for cancer eases fatigue, anxiety and depression, while improving quality of life and physical function, i.e. the ability to go about a normal day.

Meanwhile, studies strongly suggest that exercise lowers the risk for seven forms of cancer: bladder, breast, colon, endometrial, esophageal, kidney and stomach.

There are also intriguing clues that exercise helps prevent lung, blood, head and neck, ovarian, pancreatic, and prostate cancers, too. And exercising appears to reduce the risk of dying in people diagnosed with breast, colorectal and prostate cancers, in the range of 40% to 50%.

Schmitz points out that exercise reduces levels of inflammation and insulin, which are linked to some cancers.

Also, exercise induces angiogenesis, or the creation of new blood vessel, which could mean that more blood-driven anti-cancer medicine can be delivered to malignant tumors.

“Exercise may actually change the potency of chemotherapy,” says Schmitz.

Immune function also plays a role. While cancer weakens the immune system, a single bout of exercise produces a flood of defender immune cells, says Michael Gustafson, scientific director of the Nyberg Human Cellular Therapy Laboratory at the Mayo Clinic’s Arizona campus.

Gustafson found that pedaling full-speed on a stationary bike for 10 minutes can boost tumor fighters called natural killer cells by 10 times; protective T and B cells rise in the blood, too.

By using exercise to help cancer patients build up bigger armies of defender cells, Gustafson believes that it may be possible to make powerful immunotherapy treatments work better. Those treatments “teach” a patient’s own immune cells to attack tumors.

It is also well-known that body fat makes the hormone estrogen, which can cause some forms of breast cancer, says Betsy O’Donnell, director of the Lifestyle Medicine Clinic at Massachusetts General Hospital in Boston. Luckily, exercise, along with cutting calories, helps reduce body fat, a concern for many breast cancer patients, who often gain weight during treatment.

Research shows that aerobic exercise (such as walking, jogging, or cycling) and strength training (such as lifting weights or using resistance bands) can benefit cancer patients.

A 2007 study involving 242 women with breast cancer who were about to begin chemotherapy found that aerobic exercise improved patients’ self-esteem and reduced body fat, while resistance training helped build muscle and made them more likely to finish their treatment.

Not all cancer survivors are eager to hit the gym during or soon after the rigors of treatment, so tailoring the intensity of an exercise prescription to each patient is essential, says O’Donnell.

Walking is perhaps the most popular option many of her patients choose, particularly since many people have been avoiding gyms due to the COVID-19 pandemic. She recommends building up to at least 150 minutes of walking per week, maintaining a pace that allows you to talk, but not sing.

2021 The American Heart Association Dietary Guidance

 

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality.

Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following:

(1) Adjust energy intake and expenditure to achieve and maintain a healthy body weight;

(2) Eat plenty and a variety of fruits and vegetables;

(3) Choose whole grain foods and products;

(4) Choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms);

(5) Use liquid plant oils rather than tropical oils and partially hydrogenated fats;

(6) Choose minimally processed foods instead of ultra-processed foods;

(7) Minimize the intake of beverages and foods with added sugars;

(8) Choose and prepare foods with little or no salt;

(9) If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake.

Adhere to this guidance regardless of where food is prepared or consumed.

Global Climate Change

Climate change is impacting human lives and health in a variety of ways. It threatens the essential ingredients of good health - clean air, safe drinking water, nutritious food supply and safe shelter - and has the potential to undermine decades of progress in global health. 

Between 2030 and 2050, climate change is expected to cause approximately 250 000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress alone. The direct damage costs to health is estimated to be between USD 2-4 billion per year by 2030. 

Areas with weak health infrastructure (mostly in developing countries) will be the least able to cope without assistance to prepare and respond.

The 26th UN Climate Change Conference of the Parties (COP26) in Glasgow in November this year brought parties together to accelerate action towards the goals of reducing emissions of greenhouse gases through better transport, food and energy-use choices resulting in transformational change to protect the health of people and the planet. 

Initiatives under the COP26 Health Programme include: 

• ·        Building climate resilient health systems.
• ·        Developing low carbon sustainable health systems.
• ·        Adaptation Research for Health.
• ·        The inclusion of health priorities in Nationally Determined Contributions.
• ·        Raising the voice of health professionals as advocates for stronger ambition on climate change. 

Commitments are anticipated to be implemented in the coming years and will allow countries to develop a roadmap for future investments in climate resilient and low carbon sustainable health systems and facilities.

All countries are committed to deliver a baseline assessment of greenhouse gas emissions of the health system (including supply chains) and to develop an action plan or roadmap by a set date to develop a sustainable low carbon health system (including supply chains) which also considers human exposure to air pollution and the role the health sector can play in reducing exposure to air pollution through its activities and its actions. 

The Healthy Climate Prescription, a letter from the health community worldwide to COP26 national climate negotiators, calls for effective action to limit global warming to 1.5 °C, increased financing from high-income countries to support low-income countries’ transitions, and for strengthened investment in adaptation and resilience.