Heart Attack Quiz – The Nebraska Medical Center

Heart Attack Quiz – The Nebraska Medical Center


Somebody who’s having chest pain should
call 9-1-1. I often tell my patients that I would rather you would come to the emergency
room be evaluated for what isn’t a heart attack, than to stay home, have a heart attack
and then end up in severe problems. I think if you have any concern that this is a heart
attack or a heart attack developing, call 9-1-1. Make sure you take care of yourself.
And then we all learn from that. Not always do many patients understand that
a third of people don’t have any symptoms of the heart attack itself. They sometimes
just have symptoms of the heart not functioning normally. So at a time when you have artery
inclusion, many people may feel the chest pain or the shoulder pain or the jaw pain
(which is classic), we think about. They might feel short-of-breath, they might be short-of-breath
with activity. They may even actually have some stomach indigestion type symptoms. Not always, women often don’t have the severity
of the symptoms; they don’t have the classic warnings that we think about (the chest pain,
the elephant sitting on my chest, the arm pain). They’re more like to have atypical
symptoms, such as short-of-breath, dysemia. And again, some people don’t have any symptoms
at all. As you get older, there’s a heart attack
risk. One of the number one predictors for developing a heart disease and a stroke is
being old enough. We know that people in their 20s and 30s have narrowing of their arteries
that gradually develop and progresses to the point where they have their heart attack at
the age of 55 or 60. Even though you might be healthy and thin, you still might have
the genetic previous position or the risk for developing coronary disease and heart
attack or stroke. So making sure you’re thinking about those things when you’re
twenty, when you’re thirty or when you’re forty could often prevent disease progression
to the point where you would prevent having a heart attack when you’re 55 or 65. I always
think of the patient I took care of who was 35 years old and had a heart attack; very
athletic, vegetarian, but he was still having a heart attack. And as I told him, if he hadn’t
done those things, he maybe have had that heart attack earlier. There’s an increased
risk for him and his family for having early heart disease. So taking care of yourself
and doing the right things is clearly an important step, but also know what your individual risk
is is the right thing. Generally true, but what we really need to
understand is that a total cholesterol can be elevated for a couple different reasons.
It can be elevated with disproportionately high bad cholesterol. It can also be elevated
with good cholesterol. So what we really need to do is look at the different components
of the total cholesterol and say, “is that an adverse risk, is this a profile that’s
going to limb me towards a heart attack?” I think yes, but we still need to be smarter
about it and know more information. That’s a common misperception. To develop
a heart attack, is years and years of accumulation of lipids in the artery, developing that plaque.
So the issue of having your heart attack today only reflects those years of accumulation
and I think you were healthy yesterday in that you weren’t bothered, but you truly
had the disease that was progressing (it was what we call subclinical). It was present,
but you weren’t bothered by it. Today you were bothered with your heart attack. It’s
a reflection of a long-time accumulation.