Heart Attack Archive

Articles

A little-known factor that boosts heart attack risk

About one in five people has high levels of lipoprotein(a), a fatty particle linked to premature heart disease.

Most people probably haven't heard of lipoprotein(a), although that's not surprising. Cardiologists have known for years that having high levels of these fatty particles circulating in the bloodstream poses a risk to the cardiovascular system. But there wasn't much they could offer in terms of therapy, so widespread testing for lipoprotein(a) — also known as Lp(a) — didn't make sense.

Recent progress means the landscape may soon be shifting. Earlier research showed that injectable cholesterol-lowering drugs known as PCSK9 inhibitors, such as evolocumab (Repatha) or alirocumab (Praluent), may lower Lp(a) by up to 25%. Until last year, however, it wasn't clear whether that reduction actually helped people with high Lp(a).

Treating heart attacks: Changes from Eisenhower’s era to the present day

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

A different type of heart attack

Spontaneous coronary artery dissection is an underrecognized but important cause of heart attack, especially in younger women.

Most heart attacks happen when a blood clot blocks an artery feeding the heart. But a small percentage result from a tear in the inner wall of one of the heart's arteries. The resulting flap or swelling inside the artery wall obstructs normal blood flow. Known as a spontaneous coronary artery dissection, or SCAD, the condition strikes both sexes but is more common in women.

In women who are under 50, SCAD is the most common reason for acute coronary syndrome. This medical emergency refers to inadequate blood flow to the heart; it includes both heart attacks and unstable angina (sudden chest pain that occurs at rest).

Googling "chest pain" during the COVID-19 pandemic

Research we're watching

Google searches for "chest pain" spiked in March and April of 2020 during the initial sharp rise in COVID-19 infections, according to a new study. The findings suggest that people were attempting to self-diagnose heart attacks — and may explain why fewer people sought treatment for heart attacks in hospitals during the pandemic.

The study relied on Google Trends, a tool that monitors search term queries over time. The authors looked at searches for "chest pain" and five control terms — "toothache," "abdominal pain," "knee pain," "heart attack," and "stroke" — from January 2017 through May 2020. Searches for chest pain (a common symptom of heart attack but not COVID-19) spiked in states with high rates of COVID-19 infection (New York, New Jersey, and Illinois), while searches for other terms stayed steady.

Get FITT to better fight heart disease

If you've been diagnosed with heart disease, the FITT approach can reduce your risk for heart attack and stroke.

About half of all Americans have at least one of the key risk factors for heart disease, such as high cholesterol, high blood pressure, and excess weight.

You can address those risks with a heart-healthy diet and medications to lower blood pressure and cholesterol levels. But perhaps the biggest boost you can give your heart is regular aerobic exercise.

Artificially sweetened drinks: No heart health advantage?

Research we're watching

Think you're doing your heart a favor by drinking diet instead of regular soda? That may be wishful thinking, according to a research letter published Nov. 3, 2020, in the Journal of the American College of Cardiology.

Researchers studied nearly 105,000 people who filled out three 24-hour dietary recall surveys every six months. During a 10-year follow-up, researchers tracked the participants' cardiovascular health.

Telemonitoring tied to fewer heart attacks, lower medical costs

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

Resuming sex within months of a heart attack linked to longer survival

Research we're watching

Couples sometimes worry about restarting sexual activity after one partner has had a heart attack. But a new study has found that returning to usual levels of sexual activity within a few months of a heart attack is linked to improved survival.

The study, published online Sept. 23, 2020, by the European Journal of Preventive Cardiology, included 495 sexually active people who were hospitalized for a first heart attack in 1992 or 1993. All of them were 65 or younger (the average age was 53) and 90% were men.

Fish oil drug helps shrink plaque in heart arteries

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.

The danger of “silent” heart attacks

About half of all heart attacks are mistaken for less serious problems and can increase your risk of dying from coronary artery disease.


 Image: goir/Getty Images

You can have a heart attack and not even know it. A silent heart attack, known as a silent myocardial infarction (SMI), account for 45% of heart attacks and strike men more than women.

They are described as "silent" because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness.

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