v Share Your Health: Arrhythmia
Showing posts with label Arrhythmia. Show all posts
Showing posts with label Arrhythmia. Show all posts

Too Few People Know Symptoms of Heart Trouble

SATURDAY, Sept. 13 (HealthDay News) — If that nagging pain in your chest just won’t go away, and suddenly you feel like you’re having trouble catching your breath, it’s time to call 9-1-1.

Those symptoms could indicate either a heart attack or impending cardiac arrest. And waiting to see if the symptoms subside could cost you your life.


“The unfortunate fact is that we have become very good at treating heart disease once you have reached medical care. But, the majority of people who die, die before they reach medical care,” said Dr. Joon Sup Lee, clinical director of the Cardiovascular Institute at the University of Pittsburgh Medical Center.

In fact, about 330,000 Americans die each year from heart problems and heart disease before they get to the hospital, according to the American Heart Association.

In cardiac arrest, the heart actually stops beating, usually after a period of fast or irregular heartbeats. In a heart attack, blood flow is blocked to part of the heart, damaging heart muscle, but the heart usually continues to beat.

Cardiac arrest is usually caused by existing heart disease or a heart attack, but can also be caused by electrocution, drowning, respiratory failure and choking. Sometimes, no known cause for cardiac arrest is found, according to the heart association.

Symptoms that precede both conditions are similar and include:

    Chest pain or pressure or a feeling of tightness in the chest.
    Shortness of breath.
    Extreme fatigue.
    Pain that radiates down the left arm.
    Jaw pain or neck pain.
    Upper abdominal pain or a feeling of indigestion.
    Nausea or vomiting.
    Breaking out in a sweat.
    Dizziness or lightheadedness, possibly fainting.

“If any of these symptoms are new to you, you should go get it checked out,” advised Dr. Nieca Goldberg, director of the New York University Langone Medical Center’s Women’s Heart Program in New York City. She said that many people, especially women, wait to get medical help, because they don’t want to look silly or waste doctors’ time.

“Don’t worry about what others will think — just go,” she said.

Lee agreed. “If you’re having symptoms, and they persist for more than a few minutes, seek medical care. If you wait, you may never make it to the hospital,” he said, adding, “If you look at people who died suddenly, they often had symptoms but ignored them.”

A recent study in the journal Circulation looked at the events leading up 406 cardiac arrests and found that many of these people had symptoms prior to the cardiac arrest, sometimes for as long as two hours beforehand.

Two-thirds of these cardiac arrests were witnessed by someone. And 25 percent of those people whose cardiac arrest was witnessed by someone else experienced chest pain, and 17 percent had breathlessness.

The survival rate for people in the study who received CPR was around 23 percent, compared to just 4 percent for those who didn’t receive CPR. People who went into cardiac arrest in a public place were more likely to get CPR than people whose hearts stopped at home.

“What this study suggests is that most people do have a warning, many of them had more than one hour, which is more than enough time for EMS to get there. Most people who die suddenly, die of an irregular rhythm,” said Lee, and that’s the type of problem that defibrillators were designed to correct.

The bottom line, said Lee, is don’t wait. “There’s a fear that you’ll feel stupid if you go to the hospital, and you’re OK. But, if you want to be 100 percent sure, you’re risking your life.”

More information

To learn more about cardiac arrest, visit the American Heart Association.

SOURCES: Joon Sup Lee, M.D., clinical director, Cardiovascular Institute, University of Pittsburgh Medical Center; Nieca Goldberg, M.D., director, New York University Langone Medical Center’s Women’s Heart Program, New York City; Sept. 5, 2006, Circulation

By Serena Gordon
HealthDay Reporter

Last Updated: Sept. 13, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Most Patients With Irregular Heartbeat Take Inadequate Blood Thinner Dose

THURSDAY, Aug. 28 (HealthDay News) — Only 40 percent of patients with atrial fibrillation, a known risk factor for stroke, who did suffer a stroke were taking the anti-clotting drug warfarin, a new study found.

Among those taking warfarin, 75 percent weren’t getting the dose needed to prevent a stroke. And an additional 25 percent were taking medications that were less effective at preventing clots or no medication at all, according to the report by Canadian researchers.


“These are missed opportunities for stroke prevention,” lead researcher Dr. David J. Gladstone, a stroke neurologist at the University of Toronto, said in a prepared statement. “Sadly, we frequently see patients admitted to a hospital with a devastating stroke who are known to have atrial fibrillation, yet were either not taking warfarin or were taking a dose that is not therapeutic. We consider these to be potentially preventable strokes.”

The findings are published online Aug. 29 in the journal Stroke.

Gladstone’s team collected data on 2,135 stroke patients listed in the Registry of the Canadian Stroke Network. Among these patients, 597 were diagnosed with atrial fibrillation, an irregular heartbeat, before their stroke. For these patients, 60 percent of the strokes were disabling, and 20 percent were fatal.

Warfarin, by thinning the blood, helps prevent clots from developing and reduces the risk of stroke by about 67 percent in people with atrial fibrillation (AF). Strokes caused by AF can be more severe than other strokes, and studies have shown that warfarin can reduce the severity of strokes in patients with atrial fibrillation, the researchers said.

It’s not clear why the rates of warfarin use were so low, the researchers said. “On one hand, we have an extremely effective and cheap medication for stroke prevention — warfarin — yet, on the other hand, it remains under-used in people who would benefit most from it,” Gladstone said.

The study authors believe that efforts are needed to educate physicians and patients about the benefits of warfarin therapy for those with atrial fibrillation. “This is a public health priority, because atrial fibrillation is one of the most common causes of stroke,” Gladstone said. “Many more strokes could be prevented if anti-coagulation therapy were optimized in the population at large.”

Dr. Byron Lee, an assistant professor of cardiology at the University of California, San Francisco, thinks part of the problem may owe to the fact that many patients have problems taking warfarin, because it requires blood tests to monitor its effectiveness. Too low a dose is ineffective, while too high a dose can cause internal bleeding. So, patients need to have their warfarin levels measured at least once a month, he said.

“Patients hate taking warfarin, and doctors hate prescribing it,” Lee said. “This is mainly because it’s a hassle. However, this study confirms that many strokes can be avoided if patients are adequately anti-coagulated. Therefore, both patients and doctors need to do a better job of overcoming the inconvenience of warfarin.”

Dr. John Worthington is a stroke physician at Liverpool and Northern Beaches Hospitals at the University of New South Wales in Sydney, Australia, who wrote an accompanying editorial in the journal. He said it’s essential for patients with atrial fibrillation to receive warfarin to prevent a stroke.

“Warfarin is usually the best and safest available treatment to prevent stroke in people with atrial fibrillation. Increasing the uptake of warfarin would reduce the risk of death and disability of stroke,” he said.

Worthington said patients with AF should ask their doctor why they aren’t being prescribed warfarin.

More information

To learn more about atrial fibrillation visit the American Heart Association.

SOURCES: John Worthington, MB, Stroke Physician, Liverpool and Northern Beaches Hospitals, University of New South Wales, Sydney, Australia; Byron Lee, M.D., assistant professor of medicine, University of California, San Francisco; Aug. 28, 2008, online edition, Stroke

By Steven Reinberg
HealthDay Reporter

Last Updated: Aug. 28, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.