Heart Attack Archive

In addition to a prompt assessment and potentially lifesaving treatment, expect a COVID-19 test and extra safety precautions.

Even before the pandemic, people with heart attack symptoms sometimes hesitated to seek emergency care. But during the first wave of COVID-19 infections in early 2020, many more people than usual stayed away. From mid-March to late May 2020, emergency room visits for heart attacks fell by 23% compared with the preceding 10 weeks. And 20% fewer people showed up with strokes, according to the CDC.

Fear of leaving home and risking exposure to the coronavirus likely explains this trend, which has abated over time. "The overall volume at emergency rooms is still somewhat below normal, and we're seeing people who come in many hours or even a day after their heart attack symptoms began," says Dr. Joshua Kosowsky, assistant professor of emergency medicine at Harvard Medical School. These people sometimes have signs of heart damage that might have been easier to reverse or treat if they had come in right away, he adds.

It takes a one-two punch to lower these risks for heart disease, heart attack, and stroke.

High cholesterol has long been known as a bad actor in heart health. Too much LDL (bad) cholesterol in your blood can lead to fatty deposits in your arteries and the formation of artery-narrowing plaque (atherosclerosis), heart attacks, and strokes.

But LDL doesn't act alone. Chronic inflammation — a persistent activation of the immune system — also fuels heart attack and stroke risks. That means you must address both high LDL levels and chronic inflammation to protect your health.

After receiving a stent, people normally take aspirin and another anti-clotting drug for up to a year afterward and sometimes longer. Doctors adjust the timeline depending on an individual's situation.

Whether you've had a stent placed or may need one in the future, here's what you should know about these tiny devices

Close to a million heart stents to open blocked or narrowing arteries are implanted each year in the United States, and as you age, the odds rise that you'll end up on the list of recipients.

"Getting a stent can save your life during a heart attack, but what you do after the procedure can dictate your future heart health," says Dr. C. Michael Gibson, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center.

News briefs

Fried foods carry heart risks in part because they spur inflammation. But how many servings of crispy French fries does it take to raise your risk for cardiovascular disease? Not many, suggests a large analysis published online Jan. 18, 2021, by the journal Heart. Scientists pooled the findings of 17 studies on fried foods and problems like heart attacks, clogged coronary arteries, heart failure, and stroke. The studies included more than half a million people. Researchers also looked at the data from another six studies assessing the association of eating fried food and dying prematurely. Those studies involved more than 750,000 people. People who ate the most fried foods each week were 28% more likely to have heart problems, compared with people who ate the least. Each additional 114-gram (4-ounce) serving of fried foods per week bumped up overall risk by 3%. But the analysis failed to show that people who ate lots of fried foods were more likely to die prematurely. Besides provoking inflammation, fried foods are often also high in sodium as well as harmful saturated fats. If you choose to indulge in them, do it sparingly. And avoid foods fried in animal fats; instead, choose foods fried in vegetable oils.

Image: © Amarita/Getty Images

In the journals

Regular exercise is good medicine, but more may be better, suggests a study published online Jan. 12, 2021, by PLOS Medicine. Scientists asked more than 90,000 people without heart disease to wear a fitness tracker for a week to measure the duration and intensity of their physical activity. Five years later, they found that the most active people were less likely to have had a heart attack or stroke or be diagnosed with heart disease.

That's no surprise, but the researchers also discovered that risk continued to shrink as weekly minutes of activity and intensity rose. People who exercised the most and at the highest intensity had the best odds of maintaining good cardiovascular health. Guidelines recommend people get 150 to 300 minutes of moderate-intensity exercise per week, but these findings suggest that trying to do a little extra — whether in time, intensity, or both — offers more reward.

In the journals

Blood pressure readings are usually done on only one arm, but a new analysis makes the case for checking both arms, as the difference between them may suggest an elevated risk for heart disease. The findings were published in the February 2021 issue of Hypertension.

Researchers examined 24 studies that measured blood pressure in both arms in 53,827 adults without high blood pressure. They found that a difference of more than five points between the left and right arm systolic readings (the top number) was linked with a 9% higher risk for a first-time heart attack or stroke and a 6% increase in cardiovascular death within 10 years. The greater the difference between the two readings, the higher the risk.

Lifestyle changes — along with other proven therapies — can help improve these often-overlapping conditions.

Everyone goes through periods of feeling gloomy, irritable, or listless at least once in a while. And these emotions are perfectly normal after a diagnosis of a serious health problem such as heart disease. But if those unpleasant feelings drag on for weeks and gradually erase your sense of well-being, you may have depression.

Over a lifetime, about one in five Americans is affected by depression. But the risk of depression in people who've had a heart attack is three times as high as the risk among the general population.

Ask the doctors

Q. I experienced a heart attack a few years ago. I'm worried about getting the COVID-19 vaccine. Is it safe for someone with my medical history?

A. Yes. The vaccine is safe and advised for people with a history of heart attack and cardiovascular disease. While you should always discuss the particulars of your situation with your doctor, the American Heart Association said in a statement issued on Jan. 15, 2021, that it's important for people who have had heart disease or stroke (or who are at high risk for these conditions) to get vaccinated as quickly as possible, because they are at higher risk for severe disease if infected. The benefits of the vaccine far outweigh the risks. Clinical trials of the first two approved vaccines found that both are safe and, after two injections, are about 95% effective at preventing illness from SARS-CoV-2, the virus that causes COVID-19. The vaccine often causes soreness at the injection site. Other common side effects, such as headache and diffuse muscle pain, are usually mild and last only one or two days. More severe reactions, including allergic reactions, have occurred but are very rare.

These drugs actually help stop dangerous blood clots from forming. Here's when you may need them.

Nearly everyone has heard of "blood thinners." Maybe you or someone you know takes one. But these drugs don't "thin" blood at all.

"They are actually anti-clotting drugs," says Dr. Gregory Piazza, a cardiologist with Harvard-affiliated Brigham and Women's Hospital. "They prevent potentially dangerous blood clots from developing in people at high risk, like those who have atrial fibrillation or a stent in a blood vessel, or who are immobile after surgery."