Is Chest Pain A Definite Sign for Heart Attack?

When someone is having a serious pain in the chest, the first thing that comes to our mind is: is he or she having a heart attack (or myocardial infarction)?

Serious pain in the chest seems to be an obvious sign of a heart attack. Researchers from the Hospital of the University of Pennsylvania, however, did not appear to agree.

In their paper published in August 2011 in the ‘Annals of Emergency Medicine’, they pointed out that a high degree of pain does not indicate that someone entering the emergency room with chest pains is having a heart attack.

After examining and following for 30 days more than 3,000 patients who arrived at the UPenn hospital emergency department complaining of chest pain, the researchers found that most severe chest pain was not a good predictor for identifying patients who were having heart attack or who were more prone to having one over the next month. Meanwhile, they also stressed that a patient who does not have severe chest pain does not mean that he or she is not having a heart attack.

The results of their study showed that pain that lasted more than an hour was not a useful sign of heart attack versus other conditions, and the pain of a heart attack also does not always settle in the chest area but might be in the chest, arm, jaw back or abdomen.

According to the researchers, failure to diagnose acute myocardial infarction accounted for 30 percent of malpractice claims paid out, with 2 to 5 percent of patients who were having heart attack being inappropriately discharged from emergency departments.

Though pain severity was not a good predictor, it could correctly identify people who had such symptom and arrived at the emergency department in an ambulance. This might be due to the fact that people tend to ignore chest pain until it is serious enough to call for emergency services.

While the cause of chest pain might or might not be a heart attack, people who have such experience should not ignore it because something serious must have emerged.

Lose Weight Can Help You Stay Away From Hypertension!

When a person’s systemic arterial blood pressure is elevated, this person is said to have hypertension, or more commonly known as high blood pressure. Having hypertension over a long period of time can place a person at higher risk of stroke, myocardial infarction, heart failure, arterial aneurysm, and even kidney failure.

Blood pressure measurements consist of 2 readings: systolic (higher) and diastolic (lower). A systolic blood pressure of more than 140 is high, and a diastolic blood pressure of over 90 is also high.

For most patients, dietary and lifestyle changes could improve blood pressure control thus reducing the risk of the likely health complications. However, medication treatment might still be required for other patients, especially those who cannot effectively or sufficiently change their lifestyle.

Researchers from the University of Texas Southwestern Medical Center found that overweight or obese people were more likely to have a high systolic blood pressure, and for those with a high body mass index (BMI), how in shape they were only had a small impact on their blood pressure. Their findings were published in the American Heart Journal, July 2010.

BMI stands for body mass index, which is a measure commonly used to determine whether a person is overweight or obese. BMI is calculated by dividing the weight (in kilos) by the square of height (in meters). Overweight or obesity is a known risk factor of hypertension.

Data of approximately 35,000 patients consisting mostly white males was collected over the last 20 years at the Cooper Clinic in Dallas, Texas and analyzed. Measurements recorded when patients came into the clinic included body composition, blood pressure and fitness levels.

Results of analysis showed that having a higher BMI was associated with having a higher systolic blood pressure for all participants. Such correlation has already been found many times in the past. For people of the same age and gender, fitness did not seem to have any effect on blood pressure at all.

While fitness plays an important role in the overall health and mortality, the results suggested that people trying to reduce their risk for hypertension should set losing their weight as first priority and increasing physical fitness as a secondary goal. In other words, achieving a normal body weight is the key to lower one’s blood pressure.

A New Way To Curb Heart Failure!

You might have heard a lot about heart failure, either from newspapers or from friends and relatives. For instance, someone had collapsed or dropped death because of heart failure. But, how much do you know about heart failure?

More often than not, heart failure is incorrectly used to describe other heart-related disease including myocardial infarction (heart attack) and cardiac arrest. According to Merriam-Webster's Dictionary, heart failure is a condition in which the heart is unable to pump blood at an adequate rate or in adequate volume, or cessation of heartbeat (death).

Victims of heart failure might not die instantly but heart failure is a potentially deadly condition. About 2 percent of adults in developed countries suffer from heart failure. For those aged 65 and above, the number increases to between 6 and 10 percent.

Heart failure can be triggered by heart events such as myocardial infarction (heart attacks) and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. A number of symptoms, including shortness of breath (typically worse when lying flat), coughing, ankle swelling, and exercise intolerance, can be seen in people with heart failure.

Frequently, doctors treat their heart failure patients by changing lifestyle such as smoking cessation, light exercise, reduced salt intake and changes in diets; medications; implantation of devices or in serious case by surgery.

Recently, researchers from Nova Southeastern University (NSU) revealed a breakthrough method to curb heart failure. In a paper appeared in the Journal of the American College of Cardiology, they reported that they had found a way, using gene therapy, to block the actions of a gene-encoded protein that can contribute to heart failure.

The protein, known as beta-arrestin 1, can raise the production of aldosterone, which is a hormone, from the body's adrenal glands into the blood. It also increases the re-absorption of sodium and water into kidneys, causing high blood volume and blood pressure. Moreover, it has several direct damaging effects on the heart, such as fibrosis, hypertrophy, and inflammation.

An increase in blood volume means higher blood pressure. This in turn decreases the pumping action of the heart, and is one of the causes of heart failure. By blocking beta-arrestin 1 through the gene therapy approach, it is hoped that reduction of the severity of heart failure could be achieved.

Would Vitamin Help Diabetics?

For people who are unable to get adequate amount of vitamins and minerals from their diet, taking vitamin supplements could be a feasible alternative to help them meet their nutrition requirements. The elderly, strict vegetarians, people on low-calorie diets and those that are malnourished are some good examples of this type of people.

How about diabetics? Would vitamin help control their condition? Most health organizations associated with diabetes do not advocate using vitamins. In fact, they usually warn against using large doses of vitamins or supplements, which could possibly cause adverse side effects.

In April 28, 2010 edition of the Journal of the American Medical Association (JAMA), researchers from the University of Western Ontario and the Robarts Research Institute in London, Ontario reported that patients with diabetic nephropathy would suffer rapid deterioration of the kidneys if treated with high doses of Vitamin B. Moreover, these patients are likely to face a higher risk of heart attack and stroke than patients who took a placebo.

Diabetic nephropathy is a progressive kidney disease because of longstanding diabetes mellitus, and it is a prime indication for dialysis in many Western countries. Even with the many treatments available right now, about 40 percent of the 21 million Americans who have diabetes still develop diabetic nephropathy.

Prior observational studies have shown that there is an association between high concentrations of plasma total homocysteine and the risk of developing diabetic nephropathy, retinopathy, and vascular diseases, including myocardial infarction and stroke. B-Vitamin therapy using folic acid, Vitamin-B6 and Vitamin-B12 is known to be capable of lowering the plasma concentration of homocysteine.

With an aim to developing a new approach to treatment, the researchers conducted a study to see if B-Vitamin therapy would actually slow progression of diabetic nephropathy and prevent vascular events in 238 patients with Type-1 or Type-2 diabetes. Meanwhile, the placebo-controlled trial was carried out at 5 university medical centers in Canada between May 2001 and July 2007.

Patients were prescribed with single tablet of B-Vitamins with folic acid (2.5 mg/d), Vitamin-B6 (25 mg/d), and Vitamin-B12 (1 mg/d), or matching placebo. After an average period of 31.9 months, patients with Vitamin-B were found to have a faster rate of reduction of kidney filtering and so the kidney function, as compared with those on a placebo course. For patients with the diabetic nephropathy, the risk of heart attack and stroke were also higher than those who took placebo.

What Can Plavix and Aspirin Do For Heart Disease Patients With AF?

A blood thinner, a common name for an anticoagulant agent, is a drug used to prevent formation of blood clots by hindering coagula. Blood thinner does not really thin the blood; it just prevents the blood from clotting. Doctors usually prescribe blood thinners to heart disease patients who are at risk for heart attack and stroke.

So far, anticoagulants such as warfarin and aspirin have been the only effective therapies in treating heart disease patients suffering from atrial fibrillation (AF). AF is a condition in which the heart's 2 upper chambers, the atria, quiver instead of beating effectively. This will raise the risk of blood clotting or pooling in the chambers that could eventually trigger a heart attack or stroke.

According to the American Heart Association (AHA), there are some 2.2 million Americans suffer from AF. These patients often need to be fitted with a pacemaker. Yet many of them cannot be treated with warfarin to stop blood clotting because warfarin increases the risk of an internal hemorrhage by up to 70 percent.

At the annual conference of the American College of Cardiology in Orlando on March 31, 2009, researchers from Ontario's McMaster University revealed that they managed to help AF patients cut the risk of heart attack and stroke by combining Plavix with aspirin.

Plavix is known under the generic name of clopidogrel. It is used to prevent the platelets in blood from coagulating and forming clots.

ACTIVE-A, a clinical trials involving 7,554 patients, aimed to determine whether the addition of clopidogrel to aspirin could reduce major vascular events and stroke in AF patients at an acceptable risk of increased hemorrhage. In the trials, the researchers showed that combination of Plavix and aspirin could help AF patients who are unable to take other blood thinners like warfarin.

The combination of clopidogrel and aspirin reduced major vascular events by 11 percent, including a 28 percent reduction in stroke and a 23 percent reduction in myocardial infarction (also known as heart attack), as found in the study.

It is believed that this is a new treatment for AF for the first time in 20 years.

How Effective Is Crestor In Preventing Heart Disease?

Being manufactured by AstraZeneca, Crestor is a cholesterol-lowering medicine that aims to reduce levels of bad cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, and in the meantime increase levels of good cholesterol (high-density lipoprotein, or HDL). It has been approved for use in over 95 countries with nearly 15 million patients being prescribed presently worldwide.

By lowering the bad cholesterol, it is possible to help prevent heart disease and hardening of arteries. These two conditions can develop heart attack, stroke, as well as vascular disease. Nevertheless, how effective is this medicine?

Presented during November 2008 at an annual meeting of the American Heart Association in New Orleans and published online by the New England Journal of Medicine, the study known as “JUPITER” revealed that Crestor could actually reduce by 44 percent the risk of heart problems among patients who currently do not face a high risk of getting a heart disease.

The study involved 17,802 men and women, of the age of 50 and more, who took 20 milligrams of Crestor on a daily basis. It was found that the combined risk of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes was reduced by 44 percent as compared with placebo among men and women with elevated hs-CRP but low to normal cholesterol levels.

By the way, CRP is a protein that is produced by the liver. It plays an important role in inflammatory processes and serves as a biological marker to measure the risk of artery blockage.

Also shown in the study, patients who took Crestor also had the combined risk of heart attack, stroke or death from heart disease reduced by 47 percent. Meanwhile, their risk of heart attack was cut by more than half, the risk of stroke was reduced by nearly half and the total mortality of the participants was lowered by 20 percent.

It was also recorded in the study that a daily dose of 20 milligrams of Crestor was well tolerated in nearly 9,000 patients during the course of the trial, and there was no difference between treatment groups for major adverse events, including cancer or myopathy.