Heart Attack Archive

Ask the doctor

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Q. A friend of mine shared a Facebook post about how to survive a heart attack when you're alone. It says that you should cough very forcefully every few seconds until help arrives. Can that actually help?

A. This "advice" has been circulating around the Internet for nearly 20 years. I was reluctant to even address this question out of concern for perpetuating the idea of "cough CPR" or causing undue worry. However, I think it's important to clear up the confusion around this topic.

Not all heart attacks result from a blocked artery — and even small ones can have serious outcomes.

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Perhaps you've heard heart attacks described in various ways, from "mild" to "massive," or even the ominous-sounding "widow maker." But these terms may sow confusion and anxiety.

The good news: Most people who have a heart attack survive. The bad news? "Any heart attack can be fatal, no matter how big, how small, or where it occurs in the heart," says Dr. James Januzzi, a cardiologist at Harvard-affiliated -Massachusetts -General Hospital. There's a lot of mis-understanding among the general public about what a heart attack actually is, he adds.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

Q. There has been a lot of talk about the severity of this flu season, and I recently heard that influenza also can trigger a heart attack. Should I worry?

A. Influenza is responsible for about 10,000 to 20,000 annual deaths, mostly from pneumonia or internal organ failure. In other situations, influenza infection strains a person's health, which can worsen underlying conditions, such as heart disease.

In the journals

Taking a daily omega-3 fatty acid supplement might not reduce your chance of heart attacks or strokes if you already have heart disease or are at high risk for it, suggests a meta-analysis published online Jan. 31, 2018, by JAMA Cardiology.

The researchers compared 10 trials that included almost 78,000 people, approximately 47,000 of whom were men, with an average age of 64. Each trial involved at least 500 people who took daily doses of either an omega-3 fatty acid supplement or a placebo for at least a year. All participants had heart disease, had experienced a stroke, or were at high risk for these conditions.

Research we're watching

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Adding a little extra spice to your food may help you eat less salt, according to a study in the December 2017 issue of Hypertension. A salty diet may raise your risk of high blood pressure, leaving you more prone to heart attack and stroke.

For the study, Chinese researchers recruited 606 people and determined their preferences for salty and spicy foods, in part by asking how often they ate foods such as salted fried pork and pickled Chinese cabbage.

It may help prevent a heart attack or stroke, but it comes with the risk of bleeding.

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Maybe you've heard about people who take a low-dose aspirin each day to ward off heart problems. Since aspirin is a medicine you've probably used now and then without a problem, and since it is available without a prescription, you might consider trying a daily low-dose aspirin yourself. Don't do it. Unlike deciding to take a multivitamin, taking a daily aspirin isn't something you should decide to do on your own.

Aspirin therapy is typically prescribed to people who have atherosclerosis of the arteries of the heart or brain, or risk factors for such disease. Just who should take a daily aspirin, how much aspirin, and what type of aspirin are hotly debated issues, with clinical trials under way in search of answers. "Until those results are in, you should talk to your doctor before starting aspirin," says Dr. Deepak Bhatt, a cardiologist and the editor in chief of the Harvard Heart Letter.

Research we're watching

A research letter published in the July 3 issue of the Journal of the American College of Cardiology says that shingles, a painful rash caused by the varicella-zoster virus (the same virus that causes chickenpox) may be linked to an increased risk of stroke and heart attack.

South Korean researchers used a national medical database to identify diagnoses of shingles, stroke, and heart attack and followed them from 2003 to 2013. They compared 23,213 individuals who had developed shingles during this period and compared their subsequent rates of heart attack and stroke to approximately 23,213 shingles-free individuals. They found that people who had shingles had a 35% higher risk of heart attack and a 59% higher risk of stroke.

Research we're watching

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People who develop the painful, blistering rash known as shingles may be more susceptible to a heart attack, according to a study in the July 11, 2017, Journal of the American College of Cardiology. Also known as herpes zoster, shingles results from a reactivation of the virus that causes chickenpox, which most adults had during childhood.

Researchers relied on a Korean health database to identify people newly diagnosed with shingles, stroke, or heart attack over 10 years. Among the nearly 520,000 people they followed for that period, just over 23,000 were diagnosed with shingles, whom they compared with a similar number of people without shingles. People who'd had shingles had a 59% higher risk of later having a heart attack and a 35% higher risk of having a stroke compared with people who did not have shingles. The risk was highest during the first year after the onset of shingles and then diminished over time.

After calling 911, do you know what to do if a person is unresponsive and not breathing?

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Each year, an estimated 600,000 Americans suffer a cardiac arrest, during which the heart suddenly and unexpectedly stops beating. If someone nearby immediately begins cardiopulmonary resuscitation (CPR), the chest compressions can keep blood flowing to the person's brain and other vital organs — and more than double the odds of survival.

"About 70% of cardiac arrests happen at home. If this happened to your spouse or loved one, wouldn't it be awful if you didn't know what to do?" says Dr. Charles Pozner, associate professor of emergency medicine at Harvard-affiliated Brigham and Women's Hospital. But only 18% of adults in the United States have been trained in CPR within the past two years, according to a recent nationwide survey of 9,022 people, published in the May 24, 2017, Journal of the American Heart Association.