Heart Attack Archive

A stent can save your life during a heart attack, but can it help prevent one?

 Image: © jauhari1/Getty Images

An estimated two million people get coronary artery stents every year, and if you have coronary artery disease, there is a good chance your doctor will suggest you get one.

But do you really need it? In 2013, the American Medical Association issued a report that said stents were one of the most highly overused medical interventions.

Taking an aspirin can protect you from heart attack, blood clots and more

First marketed by the Bayer Company in 1897, aspirin (acetylsalicylic acid) is one of our oldest modern medications — and its parent compound is much older still, since Hippocrates and the ancient Egyptians used willow bark, which contains salicylates, to treat fever and pain. Over the past 100 years, aspirin has made its way into nearly every medicine chest in America. Indeed, this old drug is still widely recommended to control fever, headaches, arthritis, and pain.

Although aspirin remains an excellent medication for fever and pain, other drugs can fill these roles equally well. But aspirin has a unique role that was not even suspected by its early advocates. In patients with coronary artery disease, aspirin prevents heart attacks.

Atrial fibrillation can be dangerous from a fast heart rate and a higher stroke risk

Is atrial fibrillation serious? People who are old enough to remember the sound of wind-up clocks often refer to their hearts as their "tickers." It's an affectionate term that pays tribute to the regular, rhythmic beat of the healthy heart. In fact, though, the healthy heart is much more sophisticated than the most precise Swiss timepiece.

Instead of maintaining a single, monotonous beat, the heart can speed up in response to exercise, strong emotions, and fever. Common chemicals can also jack up the heart rate; examples include caffeine, nicotine, and decongestants. And the healthy heart can also slow down when you rest, relax, or sleep.

Discovered more than 150 years ago, this drug comes in a variety of formulations. Does one make sense for you?

If your heart's arteries are choked with cholesterol-filled plaque, a sudden increase in the heart's demand for oxygen-rich blood from physical exertion or emotional stress can trigger the chest pain known as angina. But a tiny tablet of nitroglycerin often relieves the pain within minutes.

Nitroglycerin is underused

Nitroglycerin and related drugs, known as nitrates, widen the arteries that nourish the heart and reduce the heart's workload. Under-the-tongue (sublingual) nitro- glycerin tablets are perhaps the best-known version of this common medication. But nitrates come in a variety of different formulations (see "Nitrates for angina: Many choices").

Plant chemicals known as flavonoids may explain why tea drinkers seem less likely to have cardiovascular disease.

Black or green, hot or iced, tea is gaining in popularity. Many cities and shopping malls feature specialty tea shops, and bottled teas vie for space on store shelves. The tea market continues to grow year after year.

Ask the doctor

Q. Should I take aspirin if I think I'm having a heart attack, and what kind of aspirin should I take?

A. First, what symptoms indicate you might be having a heart attack? The main symptom is a squeezing, tight sensation in the middle of the chest that can travel up into the jaw and shoulders, and even down the left arm. Along with the pain you may begin to sweat and to feel weak, like you might pass out, and be short of breath. While other conditions besides a heart at-tack can cause similar symptoms, you need to take such symptoms very seriously. First, call 911.

Research we're watching

Doing easy leg stretches may improve blood flow throughout the body by making the arteries more flexible and able to dilate, according to a small study in the July 1, 2020, Journal of Physiology.

The study included 39 young adults, 27 of whom did passive leg stretches five times a week for 12 weeks, while the other 12 did no stretching. (Passive stretching involves holding a stretch for a set period of time aided by an outside force, such as one's body weight or gravity). Volunteers held the thigh and calf stretches for 45 seconds, followed a 15-second rest. They repeated each set a total of five times.

Research we're watching

A team of scientists have created a tiny heart muscle "pump" using human cells and a three-dimensional bioprinter. The model heart — which was sized to fit inside a mouse's abdominal cavity — may one day prove useful for studying new heart medications and other therapies, they say.

The researchers first tried using heart muscle cells (cardiomyocytes) in the 3D printer, but the cells didn't grow to a sufficient size and volume. So they instead used so-called pluripotent stem cells, which have the ability to transform into different cell types. After printing a chambered structure, they were able to program the stem cells to become cardiomyocytes, which then began to organize and work together. Within about a month, the cells began beating together, similar to a human heart. The research is detailed in a study published July 3, 2020, in the journal Circulation Research.

Research we're watching

A recent study found that nearly one in 10 people who received opioid pain relievers following heart surgery continued to take them for three to six months — a time point when no one should still be experiencing pain from the operation.

The study included nearly 36,000 people with private health insurance who had a coronary artery bypass graft (known as CABG or bypass surgery) or a heart valve replacement between 2003 and 2016. People who were prescribed more than 40 5-mg tablets of oxycodone (Oxycontin, Roxicodone, others) or an equivalent amount of a similar drug were at a much higher risk of prolonged opioid use than people who were prescribed lower doses. Other factors that increased a person's odds of taking opioids long-term included having CABG, being female, or having a history of chronic pain or alcoholism.

Heart attack symptoms can differ between men and women, but not as much as you might think.

Thanks to national campaigns to boost awareness, more people now recognize that heart disease is the leading cause of death in women as well as in men. For both sexes, cardiovascular disease is to blame for one of every three deaths in the United States.

Throughout the country, someone has a heart attack — the most common manifestation of this prevalent disease — about every 40 seconds, on average. Maybe you've heard that women are more likely to have "atypical" heart attack symptoms than men. But what does that really mean? A review article in the May 2020 Journal of the American Heart Association offers some perspective.