Heart Attack Archive

Articles

Sex differences in heart disease: A closer look

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.

Taking statins later in life still offers heart benefits

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.

Telemedicine: A good fit for cardiovascular care?

For monitoring conditions that contribute to heart attack and stroke, virtual doctor visits are much more convenient than in-person appointments. Where is this trend headed?

Virtual doctor visits — when you talk to a physician on a video call instead of during an in-person office exam — have been available in certain places for years. But they never really caught on until the pandemic hit earlier this year. Almost overnight, virtual care became an indispensable tool for managing coronavirus infections and other health conditions during the crisis.

In 2019, virtual visits accounted for fewer than 1% of the appointments at Mass General Brigham, a large health care system founded by Harvard-affiliated Brigham and Women's Hospital and Massachusetts General Hospital (MGH). "But during the peak of the coronavirus surge in Boston, 80% of all visits were done virtually," says Dr. Lee Schwamm, director of the Center for TeleHealth at MGH and vice president of virtual care at Mass General Brigham.

FDA approves broader use of clot-prevention drug

Research we're watching

Ticagrelor (Brilinta), a drug that helps prevent blood clots, was approved in 2011 for treating people who had experienced a heart attack or acute coronary syndrome (a sudden loss of blood flow to the heart). Now, the drug can be prescribed to a broader group of people. In June 2020, the FDA expanded ticagrelor's approval to reduce the likelihood of first heart attack or stroke among high-risk people with coronary artery disease.

The expansion is based on results from a multiyear study of more than 19,000 people with coronary artery disease and diabetes at high risk for a heart attack. Participants who took aspirin plus ticagrelor were less likely to experience a heart attack, stroke, or death from heart disease compared with those who took aspirin alone.

Chronic pain linked to higher risk of heart attack and stroke

Research we're watching

People with chronic pain may be more likely to have a heart attack or stroke than those without chronic pain, according to a study published online May 7, 2020, by the journal Pain Medicine.

From 2001 to 2005, researchers identified 17,614 Taiwanese people who had used pain relievers for at least three months. The most common causes of pain were spinal disorders, arthritis, and headaches; the pain relievers included both over-the-counter drugs and prescription opioids. For the comparison group, researchers used 35,228 people without chronic pain who were matched by age and sex to those in the first group.

The mental side of cardiac rehab

If you have experienced a heart attack or undergone a heart procedure, don't neglect your mental health during recovery.

Recovery from a heart attack, heart failure, angioplasty, or heart surgery — what doctors call heart events — can be stressful. Depending on your condition, it may also involve cardiac rehabilitation. This medically supervised program focuses on exercise, diet, and lifestyle changes. While the primary focus is to help you physically, you also need to address your mental and emotional health.

"It's normal to have some anxiety and stress after a heart attack or heart surgery," says Dr. Christopher Celano, assistant professor of psychiatry at Harvard-affiliated Massachusetts General Hospital. "But how long these feelings linger, and whether they are also associated with symptoms of depression, can affect your rehab recovery success and potentially increase your risk of future problems."

How does sleep apnea affect the heart?

 

Ask the doctor

Q. My husband is reluctant to get tested for sleep apnea. But I'm pretty sure that he has it, and I'm concerned because I've heard that it can contribute to heart disease. How are these two conditions connected?

A. As you likely know already, people with sleep apnea may snore loudly and may also periodically gasp for breath throughout the night. These explosive snorts often wake up bed partners or roommates — although not necessarily the person with apnea.

How serious is bundle branch block?

Ask the doctor

Q. A recent electrocardiogram showed that I have a right bundle branch block. My doctor says it's fairly common and nothing to worry about, but I'm a bit concerned. What is it, exactly? And what specifically can cause this problem?

A. Bundle branch block refers to a small glitch in the heart's electrical conduction system. The term "bundle" refers to a collection of nerve fibers that receive the "contract now" signal from the atrioventricular node and relay it to the ventricles, the heart's lower chambers (see illustration).

When heart attacks go unrecognized

A high pain tolerance may account for some "silent" heart attacks. But failing to recognize atypical symptoms is a more likely explanation.


 Image: © digitalskillet/Getty Images

Nearly half of people who have a heart attack don't realize it at the time. These so-called silent heart attacks are only diagnosed after the event, when a recording of the heart's electrical activity (an electrocardiogram, or ECG) or another test reveals evidence of damage to the heart.

What's behind this surprising phenomenon? One explanation may be a higher-than-average tolerance for pain, as a recent study suggests (see "Does a high pain tolerance mask heart attack symptoms?"). Other people mistake their symptoms as indigestion or muscle pain. Still others may feel pain, but in parts of their upper body other than the center of the chest.

What's that chest pain?

Sometimes it's hard to tell the difference between a heart attack, heartburn, and lung problems.


 Image: © PeopleImages/Getty Images

Many kinds of health problems can cause chest discomfort, with symptoms so intense that you rush to the hospital. "I see older adults with chest pain or something related to it every time I work in the emergency department," says Dr. Kei Ouchi, an emergency medicine physician at Harvard-affiliated Brigham and Women's Hospital.

The big fear

You may worry that chest pain is due to a heart attack, which occurs when blood flow to the heart is blocked, typically by a blood clot and narrowed arteries. Classic symptoms include pressure or squeezing in the chest, lightheadedness, and pain in the shoulder, arm, neck, jaw, or back.

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