HEART ATTACK & STROKE - Symptoms & Response

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One chapter from the book Love to Live and Live to
Love: Making Longevity Worthwhile
(click here), copyright 2002 by Ken Wear.
This web page is excluded from copyright; copy it freely.

I am not medically trained so anything you read here should be interpreted as the product of my years and study and experience rather than advice from a trained physician.


Perhaps the most prevalent debilitating illness is heart attack, but most of us, if we survive it initially, can with time and effort return to an essentially normal life.

Warning signs are:
1) uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back
2) pain that spreads to the shoulders, neck or arms
3) chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath
4) unaccustomed fatigue (especially in women) can be an early warning.
Not all these warning signs occur in every heart attack, but we novices are ill-prepared to distinguish between real heart attacks and these discomforts.

Traditional advice is that, if you feel the onset of some signs, give heed; the sensation may build or it may pass quickly. If you suspect a heart attack, don’t wait; heart attack is a medical emergency. Taking an aspirin, if your body allows it, may improve your chances of survival and recovery.

And conventional advice is this: Do not drive yourself to the hospital. Seek another since you don’t want to lose consciousness while driving. If you live alone, secure the promise of assistance and then unlock your door and sit or lie down awaiting your ride to the hospital. Your fellow man will likely be sympathetic and helpful since they know that it is only by the grace of God they aren’t lying there in your place.

Discussion of Heart Attack is continued below.

In a


a portion of the brain is damaged by restricted blood flow or leakage of blood into brain tissue; it leaves us with weakened mental faculties and possibly a resultant loss of portions of our brain function and therefore a part of our bodily function.

Warning signs are:
1) sudden numbness or weakness of the face, arm or leg, especially on one side of the body
2) sudden confusion, trouble speaking or understanding
3) sudden trouble seeing in one or both eyes
4) sudden trouble walking, dizziness, loss of balance or coordination
5) sudden, severe headache with no known cause
Note the word “sudden” in all of the warning signs. And not all these warning signs occur in every stroke; different parts of the body are often affected in differing degrees. Of course, if you were asleep when it happened, 'sudden' is 'when you awaken you will recognize.'

Traditional advice is that, if you experience any of these signs, don’t wait; stroke is a medical emergency. Time is of the essence.

Conventional advice is this: Do not drive yourself to the hospital. Seek assistance since your senses may be impaired; moreover, you don’t want to lose consciousness while driving since that would put others at risk and leave you without assistance.

Discussion of Stroke is continued below.

Continuing HEART ATTACK (includingANGINA).

Aspirin is touted as beneficial in general, including conditions other than headache or other pain; it reduces stickiness of platelets as well as relaxing the muscles in the walls of your arteries and thereby allows blood to pass more freely. In cases of pronounced build-up of plaque, aspirin has the obvious effect of promoting blood flow, and the use of aspirin has been advertised as part of a heart-healthy regimen.

Symptoms versus time: To me advice from the medical community is confusing here. I suggest that, if you suspect you may be susceptible to angina or heart attack, you should develop a history with a doctor (or possibly also with a cardiologist). Should you experience symptoms that may be either angina or heart attack, you may not know which it is. If it is at all possible, cease physical activity, rest, and contemplate your need for medical attention. By all means, discuss it with your doctor when next you have an opportunity.

If you have discussed it with your doctor, you likely carry a vial of nitroglycerin tablets. Upon recognition of symptoms use your nitroglycerin; if symptoms persist as much as five minutes use your nitroglycerin again; again, if symptoms persist as much as five minutes use your nitroglycerin a third time. If symptoms persist in spite of rest and the nitroglycerin, consider that it is a heart attack rather than angina.

Angina is of lesser severity but is also due to a heart muscle not receiving enough blood and oxygen. If symptoms are brief and resolved in a few minutes by rest or nitroglycerin plus rest, it is considered to be angina, which is not treated by the medical community as a heart attack. I suppose it is because the body responds to an insufficiency of blood by -- with time measured in weeks or months -- increasing the capacity of auxiliary blood vessels, so a partial blockage of blood is not considered of medical noteworthiness unless that blockage exceeds some 70%(?) or more. But, if your angina is becoming worse, then likely you should discuss this with your doctor.
By 'becoming worse' I mean:
(1)developing new symptoms or
(2)a change in your usual pattern of symptoms, such as
(a) having symptoms after not having any for a long time,
(b) symptoms coming on more often or during rest or sleep, or
(c) symptoms lasting longer at a time or requiring additional nitroglycerin for relief

Traditional medical advice is that, if angina symptoms are not relieved within 15 minutes by nitroglycerin and/or rest, you have a medical emergency and should seek medical care at once.

From my own experience I would suggest this:
1) Do what you can in the way of immediate self-help (aspirin, nitroglycerin, cease activity, protection from weather, . . .)
2) Seek assistance -- 911 if available. You must decide if your chances for survival are improved by waiting for the ambulance, by riding as a passenger or by driving yourself; but you should also consider that other people may be put at risk (or, if by yourself, that you would be without assistance) should you lose consciousness.
3) Do what other steps you know of self-help while waiting for your assistance.

Because time is of the essence in treating heart attack, and a clot is so often the cause of ischemic pain (pain caused by lack of oxygen) a thrombolytic drug (“clot-buster”) may be used. I was advised there may be serious side effects but that the probability of clot is so prevalent that this is generally a wise first treatment. Time permitting, the heart arteries may be examined, by a process known as catheterization wherein a catheter (tube) is inserted into an artery some distance from the heart, guided into the heart artery, and then dye injected so X-ray pictures of blood flow can reveal restrictions.

If the blood supply to your heart muscles is near that critical level, then these activities may encourage angina or heart attack:
Exercise or exertion
A heavy meal
Walking up a hill or upstairs
Walking in very cold or in very hot and humid weather, or against a strong wind
Stress, fright, anger, or other strong emotions
Higher altitude than normal for you

I have read this claim dealing with a suspected heart attack: Without help, the person whose heart begins to beat improperly or erratically, so that he begins to feel faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let up until help arrives, or until you feel the critical danger is adequately reduced. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating. The squeezing pressure on the heart also helps it regain normal rhythm. I understand the American Heart Association recommends that the public not use this method in a situation where there is no medical supervision. My personal opinion is that it is better to spend effort rather than meekly allow yourself to slip into unconsciousness, especially if you are caught alone with little hope of expeditiously reaching a medical facility. But you assuredly would not rely on that alone or take it as an adequate substitute for medical attention.

Continuing STROKE

While the brain itself may be unlikely to recover, with today’s medical technology, we can often regain the compromised bodily functions with therapy since the body may respond by reallocating regions of the brain so there is no permanent loss in apparent mental function. And new therapies are being researched.

That word “sudden” in all of the warning signs: Stroke is not something that slips up on you gradually week by week, or even day by day, but overtakes you within minutes (or even seconds). The conditions leading to stroke -- well, that is another subject and part of the purpose of the book, Love to Live and Live to Love, from which this is taken.

Other warning signs may include dim or blurred or double vision, drowsiness, nausea, vomiting, numbness or tingling in the mouth or cheeks, weakness in the legs and arms, headache in the back of the head. Sometimes the warning signs (notably the 5 listed above) may last only a few moments and disappear -- Transient Ischemic Attack (TIA) -- ‘mini-stroke.’ Although brief, they may identify an underlying condition that should not be ignored. While I would not advocate dashing to the hospital every time you feel drowsy or nauseated, it is true that vigilance is one of the keys to longevity, and incidents that are not otherwise explained should be part of your running mental record that you will wish to share with your doctor when next you see him.

If you see someone in apparent difficulty, you can quickly assess the likelihood he is experiencing a stroke.
1) Ask him to smile; if facial muscles are affected the smile will be crooked, one side only.
2) Ask him to raise both arms; only one will work well and the other may be weak or limp.
3) Ask him to voice a simple sentence; speech is likely to be difficult and may be difficult to understand.
This information was presented to the American Stroke Association at their annual meeting in February 2004.

Problems of blood flow are at the root of stroke, as they are of heart attack, although brain tissue is much more sensitive to loss of oxygen than heart muscle tissue. Some 80% of strokes result from blockage of a blood vessel in the brain or neck; that is an ischemic stroke. Bleeding into the brain or spaces surrounding the brain cause the hemorrhagic stroke.

Early research suggests that the combination of caffeine and alcohol can considerably reduce stroke damage. One ounce of whiskey in a cup of strong, black (not decaffeinated) coffee -- the thicker the better -- qualify. Alcohol opens up blood vessels and caffeine is known to increase blood flow. Should it turn out to be a false alarm, an occasional Irish coffee (if you are not allergic) offers a pretty small risk.

CONTRIBUTING FACTORS for both stroke and heart attack. There are several:
1. Genetics -- if your family has a history of cardiovascular problems. This you cannot change but must work around.
2. Build-up of plaque in the arteries, and that is influenced by:
3. Stress -- especially emotional -- or should I say distress?;
4. Exercise, or lack of it;
5. Diet, including consumption of saturated fats, trans-fatty acids, and cholesterol (in meats, eggs and dairy products);
6. Smoking tobacco;
7. Inflammation of arteries, which may trigger plaque deposits or their disruption. (This is a current research topic.)

You will note in the Table of Contents of my book, Love to Live and Live to Love, (to go there, click here) that there are chapters devoted to each of the voluntary or life style contributing factors. For instance the chapters on love, communication, disagreements and conflicts deal with factors underlying your emotional state. Substance abuse is entirely voluntary, so much in the public dialogue that I need say little. There are extensive suggestions on dealing with stress; inclusion of massage offers one means of reducing stress. The chapters on pleasuring and sexual delights are intended to offer specific information on improving these facets of life with a committed partner and hence help decrease stress from this perilous background. Chapters on diet and exercise offer specific information on foods and an exercise regimen. And Physical Bases discusses cholesterol and provides pertinent information on cholesterol, your heart, blood pressure, stroke, weight management and sex. All of these have as their one motivating factor reducing your risk of heart attack or stroke.

The above is extracted from the book Love to Live and Live to Love, by Ken Wear, copyright 2002. This is only a portion of the life style and health information contained in the book; it is presented here for its vital educational value. More colmplete descriptions of my cardiovascular problems are described in the full chapter from which this is extracted. The presentation in this web page is specifically excluded from copyright of the book as a whole so you may copy it and/or distribute it freely.

Another chapter than has been condensed for your perusal, dealing with the whys and whats of bodily response, can be read by clicking here.

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I have included at this web site excerpts from the chapter on physical bases for heart health, heart attack, stroke and diabetes in order to give you further vital information. You may access that by clicking here.

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By clicking here you may access a series of observations (including my first heart attack) I have made over a period of time on body and mind. They may be of little value to you, but, again, . . . (There are also threads on my heart attack, stroke and prostate problems.) How I quit smoking may be of interest to you; to view that click here.

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