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Heart Attack Archive
Heart Beat: Rheumatoid arthritis should heighten heart awareness
Rheumatoid arthritis begins in the joints, but it doesn't end there. The inflammation that causes swelling and pain in fingers, wrists, knees, and other joints can also affect the heart. A large study from Sweden suggests that a new diagnosis of rheumatoid arthritis should get you thinking about your heart, too.
In a group of 7,500 men and women with new rheumatoid arthritis whose health was followed for up to 12 years, more people than expected had a heart attack, developed chest pain with activity or stress (angina), or needed a procedure to open or bypass a blocked heart artery within five years of their diagnosis (Journal of Internal Medicine, December 2010).
Understanding the ECG: Reading the waves
The electrocardiogram (ECG) is one of the most common, enduring, and important tests in all of medicine. It's easy to perform, noninvasive, produces results right away, and is useful in diagnosing dozens of heart conditions. The ECG has taken on even more importance lately because a particular ECG pattern, called ST elevation, is a strong indication that a serious heart attack has occurred, and there's more emphasis than ever on treating heart attacks as soon as possible. An ECG isn't necessarily going to be part of a routine physical, but if you need medical attention because you have chest pain, sudden unexplained shortness of breath, or other symptoms that suggest a possible heart attack, you will almost certainly get an ECG.
The ECG is a reading of the electrical impulses in the heart that activate the heart muscle and its blood-pumping action. Twelve electrodes affixed to the skin on the chest, arms, and legs sense those impulses from various vantage points. Part of the reason the ECG has had such staying power is that the output is visual: a line graph with peaks and valleys, not a stream of numbers. As a result, reading an ECG is a matter of pattern recognition, not computation. There are many permutations, but someone can be trained to recognize the most common patterns relatively quickly.
Cough and ACE inhibitors. About one in nine people (11.5%) who take an ACE inhibitor such as enalapril or ramipril develops a dry cough. That's about 10 times higher than listed in the fine print of the drug's prescribing information or in the Physicians' Desk Reference, a commonly used resource for drug information (American Journal of Medicine, November 2010). For some people, the cough is a mild nuisance. For others, it is so aggravating they stop taking the drug. If you take an ACE inhibitor and are bothered by a dry cough, ask your doctor about switching to an angiotensin-receptor blocker or another medication.
Waist circumference and longevity. A bigger waist isn't a good sign for living to a healthy old age. Among 105,000 middle-aged men and women taking part in the Cancer Prevention Study II, the larger the waist, the greater the chances of dying over the nine-year study. As expected, the connection was seen among individuals who were overweight or obese. But it was also seen in those with healthy weights (Archives of Internal Medicine, Aug. 9/23, 2010). The increased risk of dying was most pronounced in men with waists greater than 43 inches and women with waists greater than 37 inches.
Is the heart attack going out of style?
Hospitalization rates for heart attacks are going down, so maybe prevention efforts are paying off.
Two studies published in 2010 show that the American heart attack rate is continuing to decline. The first, published in Circulation, was based on Medicare data. The main finding was that hospitalization rates for heart attack dropped by about 23% between 2002 and 2007, which by the authors' calculations might have translated into 100,000 fewer hospitalizations a year for the 45 million Americans enrolled in the Medicare program.
Chest pain: A heart attack or something else?
What makes you worry that chest pain is serious, like a heart attack
When is chest pain serious? That dull burning feeling in your chest doesn't seem to be going away, and even feels like it is getting worse. Is it a heart attack, or something else?
It's a vexing question, one that millions of people — and their doctors — face each year. What's the problem? Chest pain can stem from dozens of conditions besides heart attack, from pancreatitis to pneumonia or panic attack.
High resting heart rate predicts heart risk in women at midlife
A study based on data from the Women's Health Initiative suggests that a high resting heart rate is an indicator of risk of heart attack in middle-aged women.
Ask the doctor: Does exercise help damaged heart muscle?
Q. After my heart attack, my doctor told me that damaged heart muscle cannot be replaced. If this is true, why am I walking on a treadmill five days a week? Is this helping repair the heart muscle damage or strengthen what's left of my heart muscle?
A. Your skeletal muscles can repair themselves after an injury — pull your calf muscle and, after a few days or so, it heals. Until recently, it was believed that the human heart didn't have this capacity. But the heart does have some ability to make new muscle and possibly repair itself. The rate of regeneration is so slow, though, that it can't fix the kind of damage caused by a heart attack. That's why the rapid healing that follows a heart attack creates scar tissue in place of working muscle tissue.
What tests do you recommend for detecting my risk of heart disease?
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