Heart Attack Archive

People who get migraines with aura have a slightly higher risk of heart attack, stroke, or death from cardiovascular disease than people who get migraines without aura or no migraines. But migraines are most common in younger women, whose baseline risk of cardiovascular problems is very low in the first place. Still, those who get migraine with aura should be sure to tell their primary care provider or gynecologist. Taking estrogen-containing birth control pills or hormone therapy may further raise stroke risk in these women.

Spontaneous coronary artery dissection is an underrecognized but important cause of heart attack, especially in younger women.

Most heart attacks happen when a blood clot blocks an artery feeding the heart. But a small percentage result from a tear in the inner wall of one of the heart's arteries. The resulting flap or swelling inside the artery wall obstructs normal blood flow. Known as a spontaneous coronary artery dissection, or SCAD, the condition strikes both sexes but is more common in women.

In women who are under 50, SCAD is the most common reason for acute coronary syndrome. This medical emergency refers to inadequate blood flow to the heart; it includes both heart attacks and unstable angina (sudden chest pain that occurs at rest).

Research we're watching

Google searches for "chest pain" spiked in March and April of 2020 during the initial sharp rise in COVID-19 infections, according to a new study. The findings suggest that people were attempting to self-diagnose heart attacks — and may explain why fewer people sought treatment for heart attacks in hospitals during the pandemic.

The study relied on Google Trends, a tool that monitors search term queries over time. The authors looked at searches for "chest pain" and five control terms — "toothache," "abdominal pain," "knee pain," "heart attack," and "stroke" — from January 2017 through May 2020. Searches for chest pain (a common symptom of heart attack but not COVID-19) spiked in states with high rates of COVID-19 infection (New York, New Jersey, and Illinois), while searches for other terms stayed steady.

If you've been diagnosed with heart disease, the FITT approach can reduce your risk for heart attack and stroke.

About half of all Americans have at least one of the key risk factors for heart disease, such as high cholesterol, high blood pressure, and excess weight.

You can address those risks with a heart-healthy diet and medications to lower blood pressure and cholesterol levels. But perhaps the biggest boost you can give your heart is regular aerobic exercise.

Research we're watching

Think you're doing your heart a favor by drinking diet instead of regular soda? That may be wishful thinking, according to a research letter published Nov. 3, 2020, in the Journal of the American College of Cardiology.

Researchers studied nearly 105,000 people who filled out three 24-hour dietary recall surveys every six months. During a 10-year follow-up, researchers tracked the participants' cardiovascular health.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

Research we're watching

Couples sometimes worry about restarting sexual activity after one partner has had a heart attack. But a new study has found that returning to usual levels of sexual activity within a few months of a heart attack is linked to improved survival.

The study, published online Sept. 23, 2020, by the European Journal of Preventive Cardiology, included 495 sexually active people who were hospitalized for a first heart attack in 1992 or 1993. All of them were 65 or younger (the average age was 53) and 90% were men.

Research we're watching

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart's arteries, according to a study published online Aug. 29, 2020, by the European Heart Journal. The findings may explain why the drug, icosapent ethyl (Vascepa), lowers the risk of heart attack and stroke by 26% in people at high risk for those serious problems.

The study included 80 people with fatty plaque in the arteries of the heart (coronary artery disease). Most of them had diabetes and were taking a statin. Their trigly­cerides were elevated, ranging from 135 to 499 milligrams per deciliter. Half were randomly assigned to take 4 grams of icosapent ethyl daily; the other half received a placebo.

Over-the-counter and prescription drugs known as NSAIDs pose a risk to the cardiovascular system. They include over-the-counter drugs such as ibuprofen (Motrin, Advil) and prescription drugs such as celecoxib (Celebrex). NSAIDs can cause the kidneys to hold on to salt and water, which tends to raise blood pressure. They also appear to affect the inner linings of blood vessels and alter other blood substances in a manner that promotes blood clots. People who need these pain-relieving medications should take the smallest dose for the shortest possible period of time.

ECG readings taken with a smart watch may be just as accurate as a traditional ECG done in a medical setting. But the notion of using a smart watch to diagnose a heart attack is still years away. One main reason: obtaining an ECG with a smart watch requires carefully holding the back of the watch on the wrist and at eight specific locations on the chest and abdomen. Quality control and regulatory issues are other important hurdles that need to be addressed. But experts believe improved smart watches with enhanced diagnostic ability may be on the market within a decade.