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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 disease increases.

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 cardiology.

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 attacks.

Symptoms

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.

Risk factors

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 attacks:

• Smoking and long term exposure to second hand smoke
• High blood pressure (hypertension)
• High cholesterol
• Sedentary lifestyle
• Obesity
• Diabetes
• Stress
• Alcohol
• 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

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.

Prevention

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 come.