PATIENT PAGE
The Journal of the American Medical Association
Know
your heart
our heart is like the engine that
runs your car. A muscular pump,
the heart expands and contracts
(“beats”) about 100,000 times each day and
circulates about 2,000 gallons of blood to
keep your body functioning properly.
Anything that interferes with the heart’s
function must be immediately recognized
and treated to prevent possible irreversible
damage. Heart disease is the number 1
killer in developed countries, and heart
attacks are recognized as the most obvious
sign of heart disease.
Each year, approximately 1.5 million
people suffer a heart attack in the United
States. About a third of the people who
suffer a heart attack die within 20 days, and
an additional 3% to 12% die within a year.
About 30% survive 10 years after a heart
attack.
According to two related articles in this
issue of JAMA (pages 1351
Y
and 1358), doctors and other health care
professionals are working with patients,
medical opinion leaders, and the health care
system as a whole to increase recognition of
the symptoms of heart attack and improve
the quality of care and treatment options.
How do you know if you are having a
heart attack? The actual diagnosis must be
made by a doctor, but if you or someone
you know experiences any of the typical
symptoms, call your emergency medical services (such as 911 in the United States and
Canada) for immediate transport to the
nearest hospital with 24-hour emergency
cardiac care. Your doctor will review your
complete medical history, including your
family’s history of heart disease, perform a
physical examination, and order an electrocardiogram (ECG) to detect heart damage.
Additional Sources: American Heart Association,
American Medical Association’s Encyclopedia of
Medicine
WHAT HAPPENS:
• A heart attack occurs when a blockage or obstruction in the coronary
arteries supplying blood to the heart severely reduces or stops the
blood supply to the heart muscle, resulting in damage or death to
part of the heart muscle (myocardial infarction).
• A heart attack can be caused by plaque buildup on the
inner lining of the coronary arteries (atherosclerosis)
or a blood clot (coronary thrombosis or coronary
occlusion). Recurrent chest pain may be caused by a
lack of oxygen to the heart (angina pectoris).
HEART ATTACK
Understanding symptoms and treatment ensures
the best quality of care for a heart attack
SYMPTOMS OF HEART ATTACK:
• Sudden pain in central chest, ranging from
a tight ache to crushing agony, lasting 30
minutes or more and not relieved by rest.
• Pain sometimes radiates out to the
shoulders, neck, or arms.
• Chest discomfort or pain with shortness of
breath, restlessness, cold clammy skin, nausea or vomiting, or loss of consciousness.
RISK FACTORS:
• Uncontrollable factors include family history of
heart disease, age over 65, and being male.
• Controllable factors include cigarette smoking,
high cholesterol, high blood pressure, diabetes,
obesity, high-fat diet, and physical inactivity.
TREATMENT OPTIONS:
• Initial treatment may include oxygen, nitroglycerin, low-dose aspirin, or strong pain medication. Antiarrhythmic drugs may be used to control abnormal heart rhythms, and ß-blocker
drugs may be given to help reduce the risk of
further heart muscle damage.
• Thrombolytic drugs that dissolve blood clots
may be given if the patient arrives at the hospital within a few hours. Other methods of treatment include angioplasty (widening of the
narrowed coronary arteries) or coronary
artery bypass surgery.
FOR MORE INFORMATION:
• American Heart Association
800/242-8721 or www.amhrt.org
• National Heart, Lung, and Blood
Institute (NHLBI Information Center)
301/251-1222 or
www.nhlbi.nih.gov/nhlbi/nhlbi.htm
Blocked coronary artery
Area of damaged heart muscle
Coronary artery
INFORM YOURSELF:
Plaque
buildup
Mi Young Hwang, Writer
COPY FOR YOUR PATIENTS!
1414
JAMA, May 6, 1998––Vol 279, No. 17
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Richard M. Glass, MD, Editor
Jeff Molter, Director of Science News
The JAMA Patient Page is a public service of JAMA and the AMA. The information and recommendations appearing on this page are appropriate
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JAMA Patient Page––Heart Attack