Heart Attack Archive

Research we're watching

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart's arteries, according to a study published online Aug. 29, 2020, by the European Heart Journal. The findings may explain why the drug, icosapent ethyl (Vascepa), lowers the risk of heart attack and stroke by 26% in people at high risk for those serious problems.

The study included 80 people with fatty plaque in the arteries of the heart (coronary artery disease). Most of them had diabetes and were taking a statin. Their trigly­cerides were elevated, ranging from 135 to 499 milligrams per deciliter. Half were randomly assigned to take 4 grams of icosapent ethyl daily; the other half received a placebo.

Over-the-counter and prescription drugs known as NSAIDs pose a risk to the cardiovascular system. They include over-the-counter drugs such as ibuprofen (Motrin, Advil) and prescription drugs such as celecoxib (Celebrex). NSAIDs can cause the kidneys to hold on to salt and water, which tends to raise blood pressure. They also appear to affect the inner linings of blood vessels and alter other blood substances in a manner that promotes blood clots. People who need these pain-relieving medications should take the smallest dose for the shortest possible period of time.

ECG readings taken with a smart watch may be just as accurate as a traditional ECG done in a medical setting. But the notion of using a smart watch to diagnose a heart attack is still years away. One main reason: obtaining an ECG with a smart watch requires carefully holding the back of the watch on the wrist and at eight specific locations on the chest and abdomen. Quality control and regulatory issues are other important hurdles that need to be addressed. But experts believe improved smart watches with enhanced diagnostic ability may be on the market within a decade.

New imaging techniques that use light or sound waves to create images of the inside of coronary arteries have helped researchers better understand the fat-laden plaque that builds up inside artery walls (atherosclerosis). Most heart attacks happen when small, inflamed areas of fatty plaque rupture suddenly, causing a clot that blocks blood flow. This may explain why treating large, obstructive plaques with stents or bypass surgery does not seem to prevent heart attacks or help people live longer.

Ask the doctor

Q. My doctor says I'm at risk for a heart attack because a test shows inflammation. I know about high cholesterol and blood pressure, but how does inflammation increase the risk for heart attacks?

A. I can understand why you're puzzled. In medical school I learned that there is a simple road to a heart attack. First, cholesterol starts building up in the wall of a coronary artery carrying blood to the heart muscle. Over many years, the plaque of cholesterol slowly grows bigger. When it grows large enough that the heart can't get the blood it needs to work hard, the heart cries out in pain — chest pain, a condition called angina. Finally, when the plaque grows large enough, it blocks the flow of blood completely, causing a heart attack. It was a beautifully simple explanation.

Exposure to microscopic particles called PM_2.5 in air pollution may increase a person’s risk of heart attack, stroke, and heart rhythm disorders. The tiny particles pass from the lungs into the bloodstream, triggering inflammation and other cell-damaging processes. Air pollution comes mainly from coal-fired power plants, industrial factories, and motor vehicles. To limit exposure, people should try to avoid exercising outdoors near busy roads or industrial areas.

People who’ve never experienced wooziness should call 911 if the symptom comes on suddenly or severely, especially if it’s accompanied by other symptoms. However, a person who has experienced wooziness before or been unwell recently should sit down, have a drink of water or juice, and rest for 10 to 15 minutes. If the feeling of wooziness persists, if other symptoms develop, or if it’s hard to get up without feeling faint, one should call 911.

Peripheral artery disease (PAD), which occurs when fatty deposits clog arteries outside the heart, is underrecognized and potentially dangerous. The hallmark symptom is leg pain that occurs with exercise, called intermittent claudication. PAD is more common among people who are older, who smoke, and who have diabetes. The recommended treatment involves short periods of walking interspersed with rest periods when pain occurs. Walking increases blood flow in the leg's smaller arteries and helps create new channels to move blood around the blockages; it also helps discourage new blockages.

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.

In the journals

Age may not be a factor when it comes to who can benefit from statins. A study published online July 7, 2020, by JAMA found that people who started taking the cholesterol-lowering medication in their mid-70s or later had fewer heart-related problems and lived longer than non-users.

Researchers looked at 326,981 mostly male veterans, ages 75 and older, who were free of cardiovascular disease and did not take statins. Over the next 10 years, more than 57,000 began statin therapy.