After Heart Attack, a Second Chance

Every day clinicians and patients at Rush face moments of great challenge and great inspiration. During this time of giving thanks, they’re sharing what they are thankful for and how their experiences at Rush have inspired them. 

Gary Schaer, MD

By Gary Schaer, MD

Heart disease is not a death sentence. Even if you’ve survived a heart attack, proper medical therapy and lifestyle modifications can allow you to have an excellent quality of life — and a long life. Surviving a heart attack can be a second chance.

Recently, I cared for a previously healthy, 42-year-old firefighter who came in after having a cardiac arrest in the field. His fellow firefighters brought him to Rush University Medical Center, and he arrested again upon his arrival. He was having a heart attack and we took him directly to the cardiac catheterization lab to fix a severely blocked artery.

When I came out of the cath lab to tell his wife that he was going to be fine, there were at least 20 firefighters and police officers waiting outside. I’d never seen anything like it. I walked through the parting huddle of police officers and firefighters all looking very grim, and they pointed me to his wife, who was stricken and expecting the worst. When I said he would be fine, she hugged me and the firefighters introduced me to his young son. It was wonderful to be able to deliver good news about a young guy with so much potential, so much life ahead of him and so many people caring and depending on him. I was pretty choked up by the whole thing.

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Patient Takes Heart in Supporting Rush

By Tami McQuown

My first personal encounter with Rush University Medical Center was about 11 years ago. I was having chest pains, my heart was fluttering strangely, and though I had been diagnosed with mitral valve in college, I assumed it was only panic attacks. After several of these occasions, I was referred to cardiology at Rush and was given an immediate appointment.

Following blood and stress tests and a series of other diagnostic procedures, I was told by a cardiology intern that while my current condition was stress-related, there was a bigger issue: sometime in the past I had suffered a mild heart attack or cardiac event that had, in fact, caused damage to my heart. I was so unprepared for the news that I really didn’t know what questions to ask. I felt very confused, unsure about what to do and what my condition would mean. My father had died at 39 of a heart attack, and upon learning that I, too, had sustained damage to my heart, I was suddenly terribly scared and alone.

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Avoiding Winter Heart Attacks

By Philip R. Liebson, MD

The snow is falling. The winter winds are raging, you are over 50 years of age and you have to shovel the driveway. You may be aware that heart attacks are increased in winter, almost twice the rate as at other seasons. Why and how can you protect yourself?

The reason for the increase in heart attacks involves the cold weather primarily, although snow shoveling helps. Cold weather causes the arteries to constrict, increasing the work of the heart by raising the blood pressure. When the arteries have arteriosclerotic plaque, this decreases blood flow even more. Also, cold causes the heart rate to increase, making the work of the heart even greater. Finally, lifting snow with your shovel is an isometric exercise adding to the work of the heart by an increase in blood pressure.

If you want to shovel snow early in the morning, beware! This is the time of day when heart attacks are greatest, because of the surge of adrenaline that occurs around the time of awakening. With the decreased daylight hours there is also a tendency for depressed mood which can also affect the function of the heart.

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African Americans More Vulnerable to Heart Problems

By Richard Olstein, MD

Despite all the advances the medical community has made in the treatment of coronary heart disease, preventing the occurrence of heart attacks, strokes and other forms of vascular disease remains essential to our fight against this No. 1 killer in America. In this fight, a portion of our community remains particularly susceptible — African Americans.

African Americans have a higher chance of death if they suffer a heart attack compared to Caucasians. According to the U.S. Department of Health and Human Services, in 2007, African American men were 30 percent more likely to die from heart disease compared to Caucasians. The explanations for this disparity have not been discovered. What’s clear is that preventing heart disease is one’s best chance of living a longer and healthier life. The only way to prevent heart disease is to control or prevent the classic risk factors.  These controllable risk factors include high blood pressure, diabetes, high cholesterol and smoking.

High blood pressure, or hypertension, is nearly 1.5 times more common in the African American population. In addition to leading to heart attacks and strokes, hypertension increases your chance of developing heart failure, kidney failure and vision loss. The goal is to reduce your blood pressure to less than 140/90 mmHg. This can sometimes be accomplished with a low salt/sodium diet and exercise, but often requires medications. Medications that are often particularly effective in African Americans include diuretics, or “water pills,” and calcium channel blockers. Continue reading

Can Stress Cause a Heart Attack?

Can stress cause a heart attack?By Jill Waite Goldberg

Stress can trigger insomnia, exacerbate digestive problems and cause muscle tension that leads to body aches. But can stress cause a heart attack? Or is it just a dire, unsubstantiated warning offered by concerned family and friends along the lines of “You’ll catch pneumonia if you go outside with your hair wet”?

When faced with a stressful situation (known as acute stress) — such as rush-hour traffic or babysitting an ornery grandchild — our bodies release hormones, including cortisol and adrenaline, which help us react to the situation. These hormones increase heart rate and blood pressure, supplying the body with a burst of energy and strength. This creates a “fight or flight” reaction that, when you’re in actual danger, helps you defend yourself or flee. When the “danger” or stressful scenario passes, the body’s relaxation response kicks in and hormone levels return to normal.

Stress and Heart Health

“In a person with a healthy cardiovascular system, this surge shouldn’t be a problem,” says Rami Doukky, MD, a cardiologist at Rush. However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack. The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat.

“There is no solid evidence that stress can directly cause a heart attack,” says Doukky. “However, chronic stress — the kind of stress that’s due to ongoing situations like a bad relationship or difficult job — can lead to risk factors that affect heart health.”

Chronic stress has been linked to overeating (which can result in obesity), poor sleep habits and tobacco and alcohol use — practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes. For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says. Continue reading