Heart Attack in Seniors
Last Updated: April 2, 2013
"The heart is a very resilient muscle," says Woody Allen in his
film Hannah and Her Sisters. And indeed it is. Charged with pumping
blood throughout the entire circulatory system, the heart is also a
muscle that reflects the treatment by its host more than any other
muscle in the human body. Treat the heart well with frequent
exercise, a good diet, and no smoking, and its potential to remain
healthy improves dramatically. Treat the heart poorly with a
cholesterol-laden, sedentary lifestyle and the chance of heart
A heart attack, often caused by a combination of the above, is
often confused with
sudden cardiac arrest. "It is important to clarify the
differences between these two conditions because people frequently
lump them together," says Dr. Michael Chen, assistant professor of
medicine at the University of Washington in the division of
The heart attack is medical shorthand for myocardial infarction
and is the more common of the two conditions. Heart attacks occur
when one or more of the arteries supplying blood to the heart
become blocked from a buildup of cholesterol or other substances.
Once often fatal, today victims in the U.S. usually survive heart
Early symptoms of a heart attack often occur days or even weeks
before the victim notices that something is wrong. The earliest
predictor of a potential heart attack is recurrent chest pain
triggered by exertion that is then relieved by rest. Abnormal fluid
retention and fatigue are also factors.
The actual heart attack itself may often occur over several
hours as the heart tissue is deprived of blood and begins to
deteriorate or die.
"Heart attack victims often deny that the sensations they are
experiencing are actually a heart attack," Chen says. "They worry
that sounding a false alarm will be embarrassing. However, every
minute of treatment during a heart attack is important. The sooner
blood flow is restored the greater chance that damage to the heart
can be reduced or averted."
If the early symptoms go undetected, breathing difficulty
increases, the victim may feel a tingling or numbing in the left
arm and shoulder and will also often clutch his left chest as the
sensation of pressure builds in the chest's center. Woman often
identify pain in the back of the jaw as well. The victim may also
become sweaty, nauseous, and light-headed and feel an impending
sense of doom.
While congenital heart disease may occur, doctors today agree
that a healthy lifestyle, a balanced diet, and reduced stress are
three key factors to successfully combating heart attacks.
Conversely, these risk factors increase the likelihood of heart
- Smoking and long term exposure to second hand smoke
High blood pressure (hypertension)
- Sedentary lifestyle
- Family history of heart attacks and heart disease
- Higher levels of homocysteine (a sulfur-containing amino acid),
C-reactive protein (a protein involved in acute inflammation), and
fibrinogen (a blood clotting protein that helps stop bleeding)
Treatment of the heart attack begins with the first symptoms. If
your loved one experiences the symptoms of a heart attack, you
should call 9-1-1 immediately. If your loved one has
doctor-prescribed nitroglycerin she should take it as instructed
while awaiting the EMT. Another reason that immediate treatment is
essential is because heart attacks can trigger ventricular
fibrillation (sudden cardiac arrest). Once your loved one arrives
at the hospital she will likely receive medication, undergo a
surgical procedure, or both. Restoring blood flow is the key to
keeping heart tissue alive and healthy.
Doctors will prescribe medications based on the patient's
personal health history and the cause and severity of his heart
attack. Some of the common drugs given to treat and prevent heart
attack include: aspirin to prevent clotting, thrombolytics or
clot-busters to keep blood flowing; superaspirins, more potent
aspirin given in tandem with thrombolytics to prevent clotting;
pain relievers; nitroglycerin, designed to open arterial blood
vessels; beta blockers to relax the heart muscle, slow heartbeat,
and decrease blood pressure; and cholesterol-lowering medications
to lower cholesterol and improve survival rates.
In some cases surgery may be warranted, which usually take one
of two forms:
- Coronary angioplasty: This procedure involves the insertion of
a catheter with a balloon tip that inflates to open a blocked
artery, increasing blood flow. A mesh stent may then be inserted as
a permanent solution.
- Coronary artery bypass surgery: This procedure involves
bypassing blocked coronary arteries with a segment of healthy blood
vessel taken from another part of the patient's body. Unlike
angioplasty, which is most successful when completed immediately
after a heart attack, bypass surgery usually occurs after the heart
has had time to strengthen.
Doctors will often recommend rehabilitation begin while the
patient is completing hospital recovery. Rehabilitation includes
new medications, changes in lifestyle, and reductions in stress,
often through counseling.
Some of the medications used to treat the aftermath of a heart
attack are also the same ones used in the prevention of heart
attacks, such as blood thinners, beta blockers, and cholesterol
lowering medications. In addition, there are also
angiotensin-converting enzyme (ACE) inhibitors that ease blood flow
to the heart. Doctors may also recommend changes in lifestyle that
include: regular exercise and healthy diet; stopping smoking if the
patient is a smoker; maintaining a healthy weight; regular checkups
and monitoring of cholesterol and blood pressure; reducing or
managing stress; and moderating alcohol consumption.
Heart attacks and sudden cardiac arrest starkly remind us of our
physical vulnerabilities, often a consequence of unhealthy
lifestyle choices. They are the heart's way of telling us in no
uncertain terms that we need to change our routines, if not our
entire way of life, if we want to continue living.
Over 25 percent of the deaths in 2003 were the result of heart
disease, by far the leading cause of death in the United States.
Someone dies from heart disease every forty-six seconds. The onset
of heart disease forces people to confront death, an experience
that makes most of us feel frightened and helpless. Yet we can make
daily decisions to fight heart disease when we choose to exercise,
to avoid smoking, and to eat a healthier diet high in fruits and
vegetables and low in saturated fats, and encourage those we love
to do the same. Modern medical advances, together with our
determination to change, can now give us and our loved ones a
second chance to fully live our lives for years, even decades, to
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