Reducing the risk for a second heart attack

Many patients come through their heart procedures and feel they are cured. Unfortunately for most, heart disease is a chronic progressive disorder of the arteries in which deposits of cholesterol, calcium, and abnormal cells (that is, plaques) build up on the inner lining of the arteries.  Heart disease usually progressively deteriorates over time, whether due to normal bodily wear or lifestyle choices such as exercise or eating habits. This is a hard concept to grasp, and it doesn’t mean it is a death sentence either.

You can do everything right and still have further heart issues.

When patients struggle with this, I point out doing everything right may be why they survived, as approximately 50% of people do not survive their first heart attack.   It is so important for each person to know their body’s signs and symptoms and not ignore them. We don’t really know what makes coronary artery disease aggressive, there seems to be several factors. These factors include inflammation, c- reactive proteins, genetics, lifestyle to name a few.

Some patients will have multiple issues for years requiring frequent interventions and then be fine for many years before having another issue. On average coronary artery bypass  grafts  10 years out will be 50% blocked. Some patients will go 20-30 years before needing another intervention, yet others may not even go a week or month before having symptoms. Thirty percent of open heart surgery patients will continue to have angina symptoms after surgery. The drug eluding stents have  much lower rates of re-stenosis than the bare metal stents which average 25-30% re-stenosis rates, but in both cases the vessels often continue to develop blockages in other locations in the artery. If the bare metal stents are going to re-stenos the usually do so in the first 3-6 months.  It is vital to stay on the platelet inhibitors – Plavix (clopidogrel) as prescribed to prevent complications. Frequently second heart attack occur when patients stop taking their platelet inhibitor medication.

 

Try to adhere to lifestyle changes that will reduce your long-term risk after another heart attack. These  are known  risk factor reduction measures and they include achieving and maintaining an optimal weight, beginning a heart-friendly diet, ending tobacco use, achieving excellent control of diabetes and high blood pressure, and adhering to regular exercise. Lifestyle changes are much more challenging to start and adhere to.  If it were only as easy taking a pill. Keep your risk factors in the best control possible. Try to get blood pressure, blood sugar, cholesterol numbers to national guidelines. Exercise regularly. Eat a rainbow of color in fresh fruits and vegetables each day. Don’t let stress effect your health, manage your stress as best as possible, consider counseling.  

Listen to your body are symptoms creeping up on you?

Be on the lookout for new symptoms, for changes in energy patterns, note if you are becoming less active due to fatigue. I believe many can stave off a second heart attack if they are very tuned in to their bodies signals. Keep a diary or log of your symptoms, look or patterns especially increasing fatigue, increasing shortness of breath, increased use of nitroglycerin,  episodes of sudden weakness or profuse sweating. If you note a pattern don’t wait, contact your healthcare practitioner to discuss. They key is to prevent any further loss of heart tissue by preventing another heart attack. If you think you may be having another heart attack follow the emergency steps listed below:

• Call 911 and describe what symptoms you’re feeling and where you are located.

• Chew an aspirin (325 mg) at the first sign of an attack. Aspirin makes blood platelets less likely to stick to each other, assisting blood flow and reducing clots. Chewing the aspirin gets it into your blood stream much faster than if you drink it down with water.