Cardiac Arrest Interview
Ten people died today. Five of them died from heart attack. The other five died as a result cancer, Hiv/Aids, dengue and car accidents. Last week I told you after interviewing Dr Lana Boodhoo, a highly trained UK cardiologist and electro physiologist, that heart attack kills us more than anything else—that no one, not even the young, especially not women are immune. I wrote that deaths due to heart attacks make up 37 per cent of all deaths in this country. Shockingly most of the dead will be women. They seldom get a second chance. The response was unbelievable. At least a dozen women wrote in, telling me about the sudden and shocking deaths of their sisters and mothers, even daughters. Men wrote too. If it’s a lifestyle disease they are ready to make the change. Everyone wanted to know more. It’s encouraging. No one is immune. And if you take charge, a life can be saved. I promised you last week that I will bring you the answers for young female secretaries with high cholesterol. I asked her what women and men could do to protect themselves from this number one killer. Today, Dr Boodhoo answers all our questions. To begin, Dr Boodhoo differentiates between heart attacks and sudden cardiac arrest (SCA).
Heart attacks
A circulation problem causes a heart attack when one or more of the arteries delivering blood to the heart is blocked. Oxygen in the blood cannot reach the heart muscle, and the muscle becomes damaged. You can think of a heart attack as a “plumbing problem.” If someone has symptoms of a heart attack, an ambulance should be called and it may be useful to chew an aspirin.
Sudden cardiac arrest
SCA is the usual cause of death in people who die within an hour of a heart attack and refers to a heart rhythm abnormality. If someone collapses without a pulse (sudden cardiac arrest) then resuscitation and time is key to survival, with chances of survival decreasing about 10 per cent every minute without defibrillation. The American Heart Association recommends defibrillation within five minutes of collapse or sooner.
Signs of heart attack
So, how do you know you are having a heart attack? Dr Boodhoo tells us that the most common sign of a heart attack is pain or discomfort in the chest. It may feel like fullness, squeezing or pressure and may be mild or severe, she added. A heart attack may occur without any chest pain. Women are somewhat more likely than men to experience some of the other common symptoms which include: shortness of breath; pain in the arms, neck, jaw, or back; nausea, vomiting or indigestion; unexplained sweating; sudden or overwhelming fatigue; dizziness.
Response time
Fast action can save lives but bafflingly, Dr Boodhoo says “women take longer than men to respond to symptoms of heart attack, limiting the benefits of treatments like clot busters that work best within the first few hours after onset of pain. “Ideally, one shouldn’t wait more than five minutes to call an ambulance. Chewing an uncoated aspirin (325 mg) right away, at the first sign of chest discomfort or distress, can reduce the amount of damage to the heart muscle during a heart attack.”
Dr Boodhoo revealed some statistics that are scary particularly for us women. She said:
Sudden death is more common among women with heart attack than men
Women do worse than men after having a heart attack.
About 50 per cent of deaths occur within one hour of the heart attack outside hospital
Contributing factors
We all know that factors which contribute to heart disease are smoking, high blood pressure, high cholesterol, family history of heart disease, obesity and age. Some of these things we can’t help, like age, or family history. But we can use this knowledge to assess our risk. We can give God and fate a little nudge and live longer. It is in our hands. So if you want to dance at your great-granddaughter’s wedding, or to see every major city in the world before you die, or learn two languages, or sip cocktails on terraces in Turkey and Nice, or lie in a tent at night while animals roar around you on safari in Kenya, here’s what you should do:
Reduce risk
Stop smoking
Smoking is a major risk factor for heart disease; this includes second hand smoke. Women who smoke and use birth control pills increase their risk. Nicotine skin patches, nicotine gum or prescription medicines can help you to stop smoking.
Control blood pressure
Blood pressure is considered high if it’s greater than 140/90. In diabetics, blood pressure should never exceed 130/80. Limiting the amount of salt consumed in the diet, losing weight and exercising regularly will help to control high blood pressure. If these steps don’t lower blood pressure, then medicines should be prescribed.
Control cholesterol level
All adults aged 20 or older should have a fasting lipid profile once every five years. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. You may need to have your cholesterol checked more often if:
Your total cholesterol is 200 mg/dL or more.
You are a man over age 45 or a woman over age 50.
Your HDL (good) cholesterol is less than 40 mg/dL.
For high-risk patients the LDL cholesterol should be lowered to below 100 mg/dL. Recent evidence, however, supports lowering it to below 70 mg/dL.
A healthy diet is key to lowering high cholesterol levels. Keep fat calories to 30 per cent or less of the total calories eaten during a day and avoid saturated fat (like the fat in meats and dairy products).
However, some people may need to take medicine in addition to improving their diet and exercise.
Take care of diabetes
In diabetics’ regular exercise, weight control, a low-fat diet and regular doctor visits are important. Medicine for diabetes should be taken exactly as prescribed. That’s Dr Boohoo’s advice.
The last two points of maintaining a healthy weight and exercising regularly are close to my heart. I’ve been struggling with it, like all the women I’ve known all my life and I would like to share my experiences with you in next week’s column. In the meantime please keep sending me your stories on your own struggles to quit smoking and resist that extra creamy slice of chocolate mousse.