Why should I care about heart attacks and cardiac arrest?
You might assume that a heart attack or cardiac arrest is something you only need to worry about when you're older. But sad to say, heart problems are all too common in younger men. After accidents (such as car crashes), heart disease is the most common killer of men between the ages of 35 and 44. In men 45 to 54 years old, it's No. 1.
In the long run, the odds are almost one in three that you will die of cardiovascular disease. So why not try to put it off as long as possible -- or prevent it altogether?
What are heart attacks and cardiac arrest?
You've heard the terms a million times. But do you know the difference between a heart attack and cardiac arrest?
The cause of a heart attack (or myocardial infarction) is pretty easy to understand. It's essentially a plumbing problem. The heart is a pump that circulates the blood throughout your body. But like all pumps, it needs an energy supply to work -- in this case, a flow of blood with oxygen and nutrients.
Sometimes the arteries that feed the heart muscle -- called the coronary arteries -- get clogged with a combination of fats, clotted blood, and other nasty stuff. If a blood clot suddenly blocks a clogged artery, the heart stops getting the fuel it needs, the cells start starving and dying, and the pump can stop working.
Cardiac arrest is different. While a heart attack is a plumbing problem, cardiac arrest is electrical. Your heart is triggered to beat with regular electrical impulses. But if these electrical impulses become erratic -- causing an irregular heartbeat called an arrhythmia -- the pump may not work. When you see heroic TV doctors shouting "Clear!" and shocking a flat-lining patient with paddles, they're dealing with cardiac arrest. They're trying to electrically jolt the heart back into the correct rhythm. When it's fatal, cardiac arrest is known as "sudden cardiac death."
While they're different problems, a heart attack can sometimes lead to cardiac arrest.
How can I prevent a heart attack or cardiac arrest?
The goal of heart attack and cardiac arrest prevention is to avoid clots and the build-up of plaque in your arteries called atherosclerosis. If you can keep blood flowing smoothly through your body, your risks of having problems are much lower.
Plaque builds up gradually. The good news is that you don't have to worry that a single order of fettuccine Alfredo will suddenly plug up your arteries. The bad news is that decades later, your arteries may still show some ill effects of all that junk you ate in high school and college. Almost no one has significant coronary artery disease at the end of college, although the process starts in childhood. It accelerates markedly around age 50 to 60.
So how do you reduce the build-up of plaque? You probably already know the answer. It's all the stuff you should be doing (but maybe aren't). You can reduce the build-up if you do the following:
- Exercise for at least half an hour most days of the week.
- Eat right -- preferably a diet low in unhealthy fats and high in fruits and vegetables.
- Lose weight (if you're overweight).
- Don't smoke -- smokers are 2 to 4 times as likely to develop plaque in the coronary arteries.
- Reduce emotional stress.
It's so easy to put off making these changes. You keep meaning to eat better and exercise, but somehow it doesn't happen. You stall, you make excuses, and the years slide by. Eventually, some men assume that they're too old for any changes to make a difference, that the die is cast. But that's not true. Studies show that even people who have full-fledged heart disease live longer if they make positive changes in their way of life.
There are other medical conditions that increase your risk of clots - such as high blood pressure, diabetes, and high cholesterol. So if you have any of these, you need to control them with lifestyle changes or medication. Some men benefit from taking daily low doses of aspirin, but you should always check with your doctor first.
Your doctor may recommend other medicines such as statins to help reduce your risk of heart attack or stroke depending on your general health and risk factors. Also, in those who have been diagnosed with cardiovascular disease, the PCSK9 inhibitor evolocumab (Repatha) has been found to help prevent the buildup and significantly reduce the risk of heart attack or stroke.
Sure, some risk factors are beyond your control -- such as increasing age, family history, and the misfortune of being born a man. But even then, making changes to your way of life can still have a positive effect. Your genes are not your destiny! You have the power to create positive life-saving changes.
How are heart attacks and cardiac arrest treated?
Obviously, anyone who's having a heart attack or cardiac arrest needs emergency treatment. You need emergency help if you have symptoms such as any of the following:
- Pain, squeezing, or discomfort in the chest
- Pain that radiates into the arms, shoulders, neck, or jaw
- Shortness of breath, sweating, and nausea
- Racing heartbeat accompanied by dizziness or nausea
But what happens after emergency treatment? Unfortunately, if you have a heart attack, you're at higher risk of having more of them -- as well as having a stroke. If you have had one clot in your body, that almost certainly means that arteries elsewhere have blockages that could trigger clots. So you'll probably need ongoing treatment.
There are a lot of options. Depending on your case, your doctor might recommend blood thinners -- drugs that reduce your blood's tendency to clot. Other drugs can open up your blood vessels, easing your heart's workload. Stents can be implanted to open up a clogged artery. More involved surgery, such as a bypass, can re-channel blood flow away from clogged arteries to new ones. Pacemakers can keep your heart rhythm steady, and ICDs (implantable cardiac defibrillators) can shock an abnormal rhythm back to normal.
What else do I need to know about heart attacks and cardiac arrest?
Being healthy doesn't mean you have to give up everything. You can still have a burger once in a while – just not all the time. Experiment with other tasty options too.
But not taking care of yourself may make your life not only shorter but a heck of a lot worse. A heart attack can start you down a bad path. It injures the tissue, which reduces the heart's ability to pump and can lead to further problems -- strokes, cardiac arrest, and more heart attacks. You could face many years of suffering and disability before you finally die. While we have good treatments for even the gravest heart conditions, it's so much better if you prevent things from getting to that point.