Sarcopenia and Cardiovascular Diseases | Circulation
Heart Attack Warning Signs Not To Ignore
Typical signs of heart attack can include tightness and pain in the chest. But other signs can also include lightheadedness and pain in the neck or jaw.
Every year, an estimated 805,000 people in the United States have a heart attack, according to the Centers for Disease Control and Prevention (CDC).
Chest pain is the most common heart attack warning sign, but there can be other symptoms, too, such as shortness of breath or lightheadedness. Symptoms may be severe or mild, and can vary from one person to the next.
Sometimes, a heart attack can be mistaken for heartburn or an anxiety attack. In addition, heart attack symptoms can vary between men and women.
This article will take a closer look at the warning signs of a heart attack, what it typically feels like, and how the symptoms can vary between men and women.
A heart attack (also known as a myocardial infarction) happens when blood flow to the heart is blocked. If there's not enough blood flowing to your heart muscle, it can damage the affected part of your heart and cause the muscle to die. This can be life threatening.
Heart attacks are usually caused by waxy plaque that's built up inside the blood vessels that lead to your heart. This plaque is made up of low-density lipoprotein (LDL) cholesterol, fats, and other inflammatory products.
When a hard plaque bursts, a blood clot forms quickly. If the clot is big enough, it will disrupt blood flow to your heart.
If the flow of oxygenated blood is completely blocked, the heart tissue supplied by that artery becomes damaged and may die, placing you at higher risk of heart failure and other serious complications.
If you suspect you or someone close to you is having a heart attack, call 911 or local emergency services. Don't try to drive yourself to the hospital if you have heart attack symptoms. Immediate medical treatment that restores normal blood flow quickly can result in less damage to your heart tissue.
A heart attack usually involves pain in the center or left side of the chest that lingers for several minutes or comes and goes. The pain can feel different from one person to the next. It's often described as:
However, sometimes there are other symptoms in addition to chest pain. And, in some cases, these symptoms may be present without chest pain.
Symptoms that often accompany — or are present without chest pain — include:
Chest pain or pressure is a common heart attack symptom among both men and women.
However, the feeling of chest discomfort can be somewhat different for men and women. There are also some non-classic heart attack warning signs that are more common among women.
Heart attack warning signs for menThe classic symptom of chest pain may not be present in every heart attack, but it remains the most common warning sign, especially among men.
The pain is often described as a heavy weight on the chest. It tends to be located in the center of the chest, but it can be felt from armpit to armpit.
Other heart attack symptoms that are common among men include:
While chest pain is often a symptom of a heart attack among women, the pain is often described as pressure or tightness instead of the "heavy weight on the chest" pain that men describe.
In some cases, there may only be other symptoms and very little or no chest pain.
Women are also more likely than men to experience nontraditional heart attack symptoms, such as:
Women are often reluctant to seek medical attention for heart attack symptoms, partly because of delays in recognizing heart attack symptoms since they're not commonly talked about.
While women are slightly less likely than men to have heart attacks before menopause, the odds essentially are equal after menopause.
Because certain symptoms, such as nausea or fatigue, can signal any number of health concerns, it's important to be aware of other possible heart attack symptoms.
If you suddenly become nauseated and are having trouble catching your breath or you have serious jaw pain, call 911. Tell the 911 dispatcher you may be having a heart attack.
You may be reluctant to call 911 if you're not sure whether you or a loved one is having a heart attack, but it's better to err on the side of caution.
A heart attack is often a life threatening emergency. The faster you get medical attention, the better chance you have of a good recovery.
When to call 911
Any time you have pain or pressure in your chest that lasts more than a few minutes and is different to pain you've felt before, it's important to get medical attention as soon as possible. This is especially important if you have other symptoms, too, such as:
While you're waiting for an ambulance to arrive, make sure to stay on the phone with the 911 dispatcher, and unlock the front door for emergency personnel to come in.
The 911 dispatcher may tell you to chew on an aspirin while you wait for them. This may not be safe to do if you take blood-thinning medications.
Try to remember how and when your symptoms began so you can provide this information to the emergency personnel.
To make matters even more complicated, some heart attacks occur without any traditional symptoms, or even any noticeable symptoms at all.
These so-called silent heart attacks could represent nearly a quarter of all heart attacks in the United States, according to the American Heart Association.
A silent heart attack may resolve on its own if, for example, the clot blocking blood flow dissolves or becomes dislodged and is absorbed into the body. But a silent heart attack can still cause damage.
If a doctor discovers that you had a silent heart attack, you may want to consider cardiac rehabilitation and the type of care that any other person who's had a heart attack receives.
A silent heart attack may be discovered months or years after the fact if you have an electrocardiogram (EKG) to check your heart's electrical system. Evidence of a heart attack can often be seen in the electrical patterns picked up by the EKG.
Even though a heart attack is a sudden event, some symptoms can come on mildly and slowly.
You may feel unusually tired for a few days leading up to the onset of more serious symptoms. Some people who've experienced a heart attack report feelings of anxiety and dread for a few days before the onset of other symptoms. This tends to be more common among women, but can happen with men, too.
Mild to moderate pain in one or both arms, along with shortness of breath and nausea, may also occur in the lead-up to a major heart attack.
Some people are at a higher risk of a heart attack than others. If you have any of the following risk factors, it's especially important to pay attention to any warning signs of a heart attack:
Chest pain is the most common heart attack warning sign. What it feels like, though, can be somewhat different for men versus women. With men, the pain is often described as a heavy weight on the chest, and tends to be located in the center of the chest.
With women, chest pain that's associated with a heart attack is often described as pressure or tightness. In some cases, there may only be other symptoms and very little or no chest pain.
Other heart attack symptoms that are more common among women include abdominal discomfort, dizziness, extreme fatigue, and jaw pain.
It's very important not to ignore any symptoms that feel like a heart attack. Even if you're not having a heart attack, it's better to be evaluated than to risk serious, life threatening complications.
Trust your instincts and pay attention to what your body is telling you. If your chest pain or symptoms last more than a few minutes, don't hesitate to call 911 immediately.
AI-powered Solution For Personalized Treatment Of Heart Failure Patients
Heart failure is the leading cause of hospitalisation in those over 65 and research predicts that the condition will increase in global prevalence by almost 50% by 2030. Currently heart failure affects more 64 million people worldwide. In order to reduce the burden of disease on both health systems and patients, Amsterdam UMC is launching, thanks to a Horizon Europe grant of almost 6 million euros, a consortium to look for an AI-powered solution.
Consortium leader and Professor of Precision Medicine at Amsterdam UMC, Folkert Asselbergs explains that the consortium "has the ambitious objective of developing a model that can predict the likely outcome for each, individual patient based on available data. Which will allow for timely and highly personalized care."
In order to achieve this "ambitious" goal, the consortium, which consists of partners from across the world, will develop an algorithm, that will facilitate the personalized risk assessment, by combing data from cardiac imaging, cardiac biomarkers, ECG data as well as information from patient records. In order to build this AI-model, the consortium will combine the data of around 900,000 patients from Europe, South America and Africa.
Our patient data set provides us a great opportunity to really understand all of the factors that determine the progress of the condition and, thus, assess an individual patient's risk. Moreover, by involving patients and clinical experts through co-creation workshops from the start we ensure that all relevant patient and clinical requirements are taken into account when developing the AI- model to maximize inclusion, accountability, transparency and fairness, well beyond the quality of technical performance required by the current regulatory frameworks".
Folkert Asselbergs, Professor of Precision Medicine at Amsterdam UMC
Once the AI model has been built, it will also be translated into an easy-to-use tool for clinicians in their appointment rooms for shared decision-making. With the goal of widespread role out once the project has been completed and appropriate certification has been obtained.
A key aspect of this project is also ensuring that AI models are implemented in a responsible way. For Asselbergs, this is "crucial" in ensuring that AI is adopted appropriately. "In order to for our model to be usable, it requires continuous engagement from patients, clinicians and data experts. This will only open happen if there is trust in the way the data is used," adds Asselbergs.
To promote this trust, the consortium will also develop mechanisms that will monitor how AI performs after being introduced in a real-world setting. The five clinical sites involved in this study are in the Netherlands, Spain, Czechia, Peru and Tanzania and the diversity of location will allow thorough testing of the model as well as facilitating the collection of diverse patient data.
This will also include the study of social and ethical issues that may arise from the implementation of AI to assess patient risk. "We want to show with this project just how powerful AI can be as a tool in clinical practice, but we also want to do it a way that is responsible and considers all of the factors that will affect its use," concludes Asselbergs.
Heart Disease Hitting Malaysians At Younger Age As Cholesterol Issues Go Undiagnosed: Paper
KUALA LUMPUR – Cardiovascular disease is on the rise in Malaysia.
A paper released by a panel of medical experts in June revealed that Malaysians are getting heart disease eight years younger than the global average.
The average age of Malaysians who suffer a heart attack is 58, compared with 63 in Thailand and 68 in Singapore.
One of the main causes is high cholesterol going undiagnosed among many Malaysians.
Despite high cholesterol being the second most prevalent risk factor for heart disease, it had the lowest diagnosis rate of 35 per cent among the risk factors, according to the study.
About a quarter, or 24.6 per cent, of Malaysians were unaware they had high cholesterol.
"The relative age of cardiovascular disease (CVD) patients in Malaysia is lower compared with other countries," said the paper titled Heart Matters: The Rising Burden Of Cardiovascular Disease In Malaysia And Potential Touchpoints For Interventions.
"In 2019, the mean age of these patients was 56 to 59 years, which is approximately 10 years younger than those in advanced countries, and as at 2019, almost one in four CVD patients was aged below 50."
Dr Alan Fong, consultant cardiologist and author of the position paper, said high cholesterol is often overlooked.
"High cholesterol typically presents no noticeable symptoms – that's why people often perceive it as being less dangerous," he added.
A separate survey conducted in December 2022 on behalf of the Malaysian Medical Association and pharmaceutical company Novartis found that 75 per cent of Malaysians believe that high cholesterol comes with symptoms, which is untrue.
A blood test is the only way to detect it.
High cholesterol, particularly LDL cholesterol, increases the likelihood of developing atherosclerotic cardiovascular disease, the most common type of heart disease.
Atherosclerosis is a condition where LDL cholesterol and other substances accumulate inside the walls of blood vessels, forming atherosclerotic plaque. Over time, this can grow, especially when cholesterol levels are high, and cause severe narrowing of the blood vessels, which can lead to heart attack or stroke.
The paper's co-author and consultant family medicine specialist Sri Wahyu Taher told The Straits Times that screening for the public at outreach events in places such as malls involves a simple finger prick test for total cholesterol levels. But this does not reveal LDL-cholesterol levels, whose tracking requires drawing blood from the arm in a healthcare set-up.
While she cautioned that the data compiled may not be representative of the entire population of the countries, she noted that Malaysia has the highest prevalence of obesity among South-east Asian countries, which could be one of the factors leading to Malaysians getting heart attacks at a younger age.
In 2019, the National Health and Morbidity Survey reported that one in two Malaysians was overweight or obese and four in 10 had high cholesterol.
Dr Sri Wahyu's advice is for people to get a health screening at least once a year to check their blood pressure, blood glucose and cholesterol, and monitor their body mass index at home.
"People need to be active, undergo regular screening and pay attention to their health. Everybody needs to have that awareness," she said.
Beyond the necessary lifestyle changes, the paper's co-author and senior consultant cardiologist at Universiti Malaya Medical Centre, Datuk Wan Azman Wan Ahmad, said patients need to adjust their perception and beliefs towards cholesterol-lowering medication.
"Statins are generally the first-line medications prescribed to patients. There are also innovative treatments in the form of injectables available," he added.
A cardiologist who declined to be named said the Malaysian patient demography differs from Singapore's, and that different races have different prevalence rates for cardiovascular diseases.
Countries that are more affluent also tend to have patients experiencing heart attacks at an older age.
"Singapore is a small nation with a good public health system, good screening, and patients are compliant," he added.
In comparison, he noted, Malaysia has a wide spectrum of patients, with people in urban areas who have greater health awareness and easier access to healthcare facilities, while those in rural areas may not know where to go for screening, or may not take medication even if they have healthcare access.
"In countries with a high economic status, you have access to a better and balanced diet," he said, adding that their populations are unlikely to eat at hawker stalls every day.
In 2019, CVD was the leading cause of mortality and ranked fourth as a cause of hospitalisations in Malaysia's public hospitals.
Treating CVD costs RM3.9 billion (S$1.1 billion) annually – more than 40 per cent of the total healthcare costs for non-communicable diseases in Malaysia, according to a report by its Health Ministry and the World Health Organisation.
A 2017 study estimated that CVD results in annual productivity losses of about RM4 billion.
Engineer and start-up founder Ammar Zolkipli, 44, had a sudden heart attack in 2022.
He initially experienced what felt like gastric pain. He felt pale, was short of breath and had numbness in his left arm.
A doctor at a clinic carried out an electrocardiogram (ECG) to check if there were any problems with his heart rate or heart rhythm.
The results were normal, and he was diagnosed with gastritis and told to go home.
That night, he had gastric pain again. His wife drove him to the emergency department at a private hospital, but the medical officer there was also convinced it was gastritis.
"By midnight, the pain had become worse and he was admitted to an isolation ward while waiting for his Covid-19 test results to be ready. By morning, he said he could hear a gurgling sound when he breathed, and the ECG finally picked up something. He was wheeled to the operating theatre immediately and an angioplasty was done," his wife Bibi Misbah told ST.
Angioplasty is a procedure used to open blocked coronary arteries.
Mr Ammar is now on eight types of medication for heart failure, blood thinning and blood pressure.
He was previously diagnosed with elevated cholesterol in 2011 but had gone on a strict diet then and got it under control. However, his last health check was in 2018.
"The heart attack took us by surprise," Mrs Bibi said. "I was very worried at the time, as he had a 100 per cent blockage of the left anterior descending artery and, because treatment was delayed, his heart was damaged. As a result, he now has heart failure."
Mr Ammar has changed his diet to include foods that have more fibre, a low glycaemic index and are plant-based. He has cut out sugary items. He exercises daily and tries to get enough sleep and reduce stress.
His advice is for people to get a regular check-up, especially those aged 35 and above, and who have a strong genetic disposition to high cholesterol, high blood pressure and diabetes.
Comments
Post a Comment