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Heart Attacks: Identification and Prevention

February 24, 2020 11:00 AM with Dr. Philip Krause

What is a heart attack and how do you identify one.  It's not always easy to tell, as not every heart attack involves clutching your chest and falling to the floor. Learn identification and prevention tips from Dr. Philip Krause, of the NorthShore Cardiovascular Institute. We welcome you to add your questions now, and then come back on the day of the chat to see them answered live.

woman clutching her chest

Ben (Moderator) - 10:51 AM:
Welcome to NorthShore University HealthSystem's latest chat: Heart Attacks: Identification and Prevention with Dr. Philip Krause, Cardiology. The chat will not begin for another 10 minutes, but please start submitting any questions you may have now.

  Georgia (Glenview, IL) - 11:10 AM:
What are possible signs of heart attack in females that are not the textbook signs of a heart attack such as chest pain or arm pain? Can you have neck pain or spasms? Does it have to be constant pain or can it come and go?
Dr. Philip Krause
Excellent question, Georgia. Women can present with heart attack symptoms that are what we call "atypical" Chest fullness or tightness, shortness of breath, indigestion or heartburn, nausea and even neck or jaw pain or aching. Also, we can see women with upper back pain, dizziness and sweating. Other findings may include change in exercise tolerance. They may not be constant and can come and go. you should seek medical care immediately if symptoms like this occur.

  Jim (Wilmette, IL) - 11:16 AM:
A few years ago, I was awakened at night by a very strong burning sensation in my sternum. The burn lasted a few minutes before fully subsiding. I figured it was acid reflux. When I told my doctor, she said to call 9-1-1 if that were to ever happen again. Did I miss a warning sign prompting me to receive immediate medical attention? Can acid reflux be misidentified as something more serious?
Dr. Philip Krause
Jim- Glad you asked. Certainly, acid reflux or GERD can cause burning after meals and at night. However, chest pain due to a heart problem such as angina when an artery is blocked can cause very similar symptoms as well as chest pressure, heaviness, nausea, difficulty breathing or sweating. Based on other risk factors such as high blood pressure, smoking, family history of coronary disease, diabetes and high cholesterol, you may be in line for a stress test or other imaging. It is imperative for people to know the warning signs and seek medical attention immediately to address the issue and prevent heart attack, heart damage and potential heart failure or worse. prevention is key.

  Willis (Skokie, IL) - 11:21 AM:
After suffering a heart attack, what treatments will I need or should I expect?
Dr. Philip Krause
Willis: After suffering a heart attack or MI (myocardial infarction) the treatment depends on whether a coronary angiogram and PTCA and stent were placed to treat a blocked artery. If so, then daily aspirin 81 mg along with another antiplatelet agent such as clopidogrel or ticagrelor is used to prevent the stent from forming a blood clot. These patients also benefit from cholesterol-lowering medications such as statins. Strict control of blood pressure and diabetes is also imperative. Those who smoke should quit immediately to prevent another heart attack. Cardiac rehabilitation should be considered for a smooth recovery. Most importantly, these recommendations should be discussed with you prior to discharge from the hospital with your physicians and healthcare team members.

  Angelina (Skokie, IL) - 11:27 AM:
What are the first steps that should take place as soon as symptoms are felt?
Dr. Philip Krause
If you are referring to the heart attack symptoms I just mentioned, the first step is to take 4 chewable aspirins (81 mg each). If the symptoms last more than 10 minutes and persist, the patient should call 911 to get to the nearest hospital and get treated quickly. This is especially important if symptoms of chest pressure come on suddenly and accompanied by shortness of breath or sweating. If a patient loses consciousness, this is an ominous sign and 911 should be called immediately. People with risk factors such as tobacco use, High blood pressure, high cholesterol, diabetes, and family history of heart attack should see their physician and go over these risk factors and choose an appropriate treatment strategy.

  Carol (Skokie) - 11:33 AM:
Are sudden bursts of headache, nausea and vomiting symptoms of a heart attack?
Dr. Philip Krause
The symptoms of headache nausea and vomiting are more consistent with migraine headache or stroke. This should be addressed immediately especially if it is the first episode. The symptoms of nausea and vomiting may occur with heart attack as well. Either way, getting to the nearest Emergency Department is key to preventing damage.

  Tad (Skokie, IL) - 11:38 AM:
I sometimes get a quick, repeated, twitching in my heart area...but it feels like its just the skin on top of the heart, and not internal. It lasts 1-2 seconds and then I might not feel it again for months. Have you ever encountered something like this? Was it dangerous or benign?
Dr. Philip Krause
The symptoms of a few seconds of twitching do not sound like a heart-related problem. You should discuss them with your physician to try and identify a cause. It does not sound dangerous based on your description but you need to discuss with your healthcare provider.

  Nancy (Chicago, IL) - 11:42 AM:
What are some simple things one can do in their everyday lives to prevent a heart attack?
Dr. Philip Krause
Great Question, Nancy. Modify the modifiable risk factors: Stop smoking. Adhere to a low cholesterol low-fat diet like the Mediterranean diet. Weight loss with smaller portion sizes. Stop eating when no longer hungry. Do not eat until full. Take blood pressure medications as prescribed and do not skip pills. Get BP checks regularly. Keep cholesterol low with diet as well as cholesterol medications if needed. Keep blood sugar in check and adhere to a strict diabetic diet and medical care to keep sugar levels in check Regular exercise when deemed safe by your doctor. 30 minutes of daily dedicated walking or aerobic activity at least 5 days per week. Manage stress in healthy ways. Limit alcohol intake - moderation is the key

  Janice (Skokie, Illinois) - 11:48 AM:
Is there such a thing as a heart muscle pull? Sometimes I get what feels like a strong grasp in my chest that makes me think it's my heart, but it doesn't happen enough to make me run to the doctor. Many months can pass even a year without me feeling this hurt. I'm 60 and paying attention!
Dr. Philip Krause
No such thing as " heart muscle pull" but can be related to the chest muscle (pectoralis) during an upper-body activity like tennis or weight training. If symptoms of a grasping of the chest occurs and CONTINUES OR GETS WORSE, this can be due to a heart attack or an aortic tear/dissection and requires emergent attention in the ER. If symptoms are fleeting and last a second or 2, and do not recur, this is not typically associated with a heart or vascular problem. Still, it should be discussed with a physician.

  Kate (Glenview) - 11:52 AM:
I had a heart CT calcium scoring scan that was advertised not because I had symptoms but because I thought it was an easy way to get a heart check. It came out clear - a 0 score - but my cholesterol is high, just over 200. What does this test actually check for and how much stock should I put in it for evaluating my heart health?
Dr. Philip Krause
Good question, Kate. A cardiac calcium CT score is a screening test to look for calcium buildup in and around the arteries of the heart. A score of 0 is excellent and the likelihood of a heart attack within the next few years is very low, but not 0. The other risk factors need to be reviewed. We use this test to decide if cholesterol medicine is needed for a score > 100 or if a patient may benefit from a stress test for a higher score.

  Angelina (Skokie, IL) - 11:55 AM:
Are some of the risk factors in women different from men?
Dr. Philip Krause
Risk factors differ in women in that the family history of premature coronary disease is age less than or equal to 65 vs. men which is family history of a relative at age less than or equal to 55. Women who are premenopausal are protected with estrogen until mid to late 50' s but it is not a guarantee; just lower risk at this age then men. However, once menopause occurs, the women catch up quickly and their risk for heart attack rises quickly. The other risk factors include: Smoking Diabetes High blood pressure High cholesterol

Ben (Moderator) - 12:00 PM:
Thank you, Dr. Krause, for your time and expertise. A complete transcript of the chat will be available on northshore.org shortly.
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