The fact that heart attacks are the number one killer of American men and women, may not be an alarming fact. It may not even come as a shock that 1.1 million Americans will suffer a heart attack this year. What will come as a shock to many, is the fact that 435,000 of these heart attacks will be suffered by women and 42 percent will die within a year. Twenty four percent of the men will die within a year.
Death and disaility may be reduced by prompt intervention, ideally, within the first hour after symptom onset. Unfortunately, most people take a "wait and see" attitude, which is absolutely the wrong approach. Patient delay is the largest barrier to receiving therapy quickly. Most patients wait two or more hours after symptoms begin before they seek medical attention. Surprisingly, women wait longer than men, according to Respiratory Therapist Phil Pooley, RCP of Biggs-Gridley Memorial Hospital.
Many consider the cost of an ambulance, hope to "wait out the symptoms" or make it to the nearest hospital by car. If ambulance cost is the consideration then the question is, "How much is your life worth?" asks Pooley.
Another barrier to patients receiving timely care is that they don't recognize the warning signs of a heart attack, such as, chest discomfort (pressure, squeezing, fullness, pain in center of chest); discomfort radiating from the chest to one or both arms, back, neck, jaw or stomach; shortness of breath, often with or before chest discomfort; breaking into a cold sweat, nausea or light-headedness and many women experience extreme weakness.
As many can attest, minutes do matter and the quicker you call 911 and get to your nearest hospital, the less chance of permanent damage or death. The American Heart Association feels anyone with heart attack symptoms should not wait more than a few minutes, five at the most, to call 911. Obviously, there are instances when immediate entry into the emergency medical system is needed.
"Our Gridley paramedics have the capabilities in the home, to determine if the patient needs to go to the local emergency room or on to a larger hospital. Every second counts. We want the patient to get to the right hospital within one hour or less of symptoms first onset. Most patients too often delay with undesirable consequences.. We are here for those individuals who come here either by ambulance or brought by a family member, which we don't recommend," Pooley stated.
There are documented instances of well meaning, but panicked family members hhabing been known to cause an accident while attempting to get their loved one to the nearest emergency room. Pooley of course recommends that people call for an ambulance because it is not just a mode of transportation. "The ambulance can be on the scene in most areas within six minutes or less. Call 911," Pooley emphasized.
The paramedics are trained to stat IV's, administer medications and can begin immediate care while transporting and these early crucial minutes could mean the difference between life and death. "Most times people wait two hours before coming in, waiting to feel better. Women wait longer for some reason. Women are different. Interestingly, seventy percent of women present with a heart attack with symptoms they think are the flu. They experience a weakness that is similiar to the flu illness."
Pooley asked, "Why wait to become a statistic when you can prevent a heart attack? To avoid a heart attack, sit back and see what you can change about your lifestyle. Is it the way you eat? Are you getting enough exercise? Most importantly, if you smoke - stop. Smoking contributes significantly to heartdisease and stroke and of course to pulmonary disease. Choosing good nutrition is of course paramount. One of the best weapons to fight cardiovascular disease and control other risk factors is to watch cholesterol, blood pressure, diabetes and obesity. Coordinate your diet with physical activity, such as walking.
Keep total cholesterol less than 200. The LDL is bad cholesterol level and a level of less than 100 is high risk for heart disease. HDL is the good cholesterol and level above 40 for men and 50 for women is good. Triclycerides of less than 150 are recommended. Of interest, is the fact that men's cholesterol tends to be more clumpy when it adheres to the coronary vessel wall, whereas, a woman's tends to be much smoother and uniform, lining the vessel wall. Many physicians feel this may be part of the reason womens diagnosis of coronary arery disease is overlooked or missed. There isn't the classic obvious narrowing of the coronary vessel.
Cook with heart-healthy foods, cook with less fat, choose leaner cuts of meat, poultry and pork, choose low-fat dairy foods and substitute lower-fat ingredients in recipes. You can cut down on total fat by broiling, microwaving, baking, roasting, steaming, or grilling foods. Non-stick pans and cooking sprays also work well. Boost the flavor with seasonings and sauces instead of fats. Look for recipes that use herbs and spices for flavor instead of fat. Squeeze fresh lemon juice on steamed vegetables, broiled fish, rice or pasta.Try lemon pepper or mesquite seasoning on chicken. Use onion and garlic to liven up meats and vegetables. Try baking chicken or pork with barbecue sauce or low-fat Italian dressing. Trim the fat when possible. Cut away visible fat from meat and poultry. Roast food on a rack to let the fat drip off. Make soups a day ahead, so you can chill them and remove the fat when it has risen to the top.
Lower high blood pressure (single largest risk factor for stroke, number three killer in the U.S.) Shake the salt habit. Take medication as prescribed. Target is 120/80.
Research indicates exercise of 30 minutes at least five days per week, can reduce blood pressure, lower cholesterol and keep weight at a heathier level. Do consult your physician before beginning an exercise program.
Aim for a healthy weight. Obesity is epidemic in the United States. Too many calories and not enough exercise can lead to obesity, along with heredity. Obesity places people at a risk for high cholesterol, high blood pressure and often is a precursor to diabetes.
If you are diabetic you need to manage your diet. Diabetics are two to four times more likely to develop cardiovascular disease.
Find ways to reduce stress. Scientists have noted the relationship between coronary heart disease and stress. People who are stressed out are often over eating, started smoking or increase their smoking.
Alcohol should be limited because too much alcohol can increase the blood pressure, lead to heart failure or stroke, contribute to increased triglycerides, produce irregular heart beats and affect other disease processes, such as obesity, alcoholism, suicide and accidents.
Pooley stated the stroke risk factors as: age - risk doubles for each decade over 55; heredity - family members who have had a stroke increases your chances of stroke; gender - more common in men than women, but half of all death strokes occur in women; a prior stroke - or TIA. A person who has had a Transient Ischemic Attack (TIA) is ten times more likely to have a stroke than someone of the same age and sex who has not. Reduce the risk factors! Stop smoking, control diabetes, reduce high blood pressure, watch your diet, get more physical activity and watch your blood cholesterol.
Pooley suggests if you are feeling any discomfort, such as crushing chest pain, especially any of the signs mentioned above, call 911. Have your cholesterol checked periodically. Frequent and recurring headaches may be a sign of high blood pressure. See your physician.
Pooley has worked at BGMH for eight years. He and Jon Smedberg, RCP and four respiratory therapists, work in CardioPulmonology Services at BGMH.
