Heart Attack Archive

Q. The other night I woke up at about 2 a.m., and my heart was pumping hard and my lower jaw ached. It lasted about an hour, even though I took aspirin. Then I fell asleep. In the morning everything was fine. Was that a heart attack?

A. If you were my patient and you called my office and told me this, I would tell you to come right in and let me check you out. Probably it was not a heart attack, but the chance that it might have been is high enough that you need to be examined and tested. I hope that's what you did. If you didn't then, you should check with your doctor now.

Q. I had a mild heart attack a few years ago but am now feeling fine. I'm planning a trip to Colorado. Is it safe for me to hike at high elevations?

A. If you're feeling well and don't have any cardiovascular symptoms, hiking in the Rocky Mountains should probably be fine, though you should check with your cardiologist first. Doctors used to advise people with cardiovascular conditions—even just high blood pressure—not to spend time at high altitudes. But there wasn't much evidence behind that recommendation. Now, there's a general consensus that ascending up to 12,000 feet should be fine for most people with heart disease. Exceptions include people with unstable cardiac disease, heart failure, or severe lung disease, such as pulmonary hypertension.

Many men consider taking a daily low-dose aspirin to reduce the chance of having a heart attack or stroke. You should do so only if the chance of being helped outweighs the chance of triggering unwanted bleeding, since aspirin interferes with normal clotting. But about one in 10 men who take protective aspirin may not really qualify, according to a national study in the Journal of the American College of Cardiology.

Experts recommend that aspirin might be considered in someone whose chance of experiencing a cardiovascular problem is at least 6% in the next 10 years. At that tipping point, the chance of being helped is great enough to justify the risk of unwanted bleeding.

Q. I had chest pains for a couple of days and thought I was having a heart attack. My doctor did an electrocardiogram and said I had pericarditis and that it was not serious. What exactly is pericarditis?

A. Pericarditis is inflammation of the pericardium, a protective, double-layered sac surrounding the heart. It has many different possible causes, including a virus or other infection, certain illnesses, an injury to the chest, radiation therapy for cancer, or a reaction to medications. Complications from bypass surgery or the insertion of a pacemaker are other possible triggers. But most of the time, the cause remains elusive.

If you're over 65, be sure to follow the latest pneumonia vaccine guidelines.

Each year, about a million people in the United States end up in the hospital with pneumonia, a serious lung infection that can be caused by an array of different viruses, bacteria, and even fungi. New research suggests that older people hospitalized with pneumonia face four times their usual risk of a having a heart attack or stroke or dying of heart disease in the month following the illness.

If you have high blood pressure, there may be better alternatives.

Known as non-obstructive coronary artery disease, this condition can trigger heart attacks down the road.

You just had a cardiac stress test and you passed with flying colors. Does that mean you are free of heart attack risk? Not necessarily, says Dr. Ron Blankstein, assistant professor of medicine at Harvard Medical School and preventive cardiologist at Brigham and Women's Hospital.

A week or so after having a heart attack, if you can take a brisk walk without any heart-related symptoms, it's fine to have sex. So say the guidelines from the American Heart Association. But most doctors don't share this advice with their patients, according to a study in the December 2014 Circulation.

The study included more than 2,300 women and 1,100 men between the ages of 18 and 55. Just 12% of women and 19% of the men reported receiving any counseling about sexual activity within a month of their heart attacks. Those who did get advice were often given restrictions (such as to limit sex or to take a more passive role) that are not supported by evidence or guidelines. Being female or older was linked to a lower likelihood of receiving counseling.