Heart attack warning signs and other information for Heart Health Month

MEREDITH — February is an important month, with Valentine's Day. It is also Heart Health Month.

The Meredith Altrusa Club would like to remind everyone of some important information about the heart from the American Heart Association, Consumer Report, as well as the Framingham Heart Study.

According to the American Heart Association, warning signs regarding heart attack and other cardiovascular diseases include:

• Chest discomfort. This symptom takes place in the center of the chest and lasts for a few minutes or goes away and comes back. It can feel like a squeezing, uncomfortable pressure, and a fullness of pain.  
• Discomfort in the upper body: pain or discomfort in one or both arms, back, neck, jaw or stomach.
• Shortness of breath with or without chest pain.
• Other signs can be: breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. Women are somewhat more likely to experience other common symptoms, particularly shortness of breath, nausea, vomiting, and back or jaw pain.

Consumer Report lists the following warnings of a stroke:

• Face drooping. Does one side of the face droop or is it numb?  Ask the person to smile.
• Arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• Speech difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like: “Is the sky blue?” Is it repeated correctly?
• Time to call 911. If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately by ambulance. 

Consumer Report lists the following about understanding the stages of heart disease:

• High Blood Pressure happens when arteries are flexible and elastic in younger years but harden with age. A problem worsened by too much body weight, not being active enough, smoking and various circumstances. Blood pressure starts to rise, straining the heart to push blood through vessels with force. In time that can damage the vessel walls allowing cholesterol into blood where it can lodge.
• Atherosclerosis is a mix of high cholesterol, high blood pressure, and risk factors that can contribute to a build-up of plaque deposits, thereby straining blood flow to the heart. This is referred to as clogged coronary arteritis.
• Angina is the narrowing of the coronary arteries that can cause chest pain when over-exerted. Angina is the pain that signals something is wrong before a heart attack. Most people do not have any warning.  Heart attacks usually happen when the plaque ruptures, causing a blood clot to form and block an artery feeding the heart. A clot that blocks blood to the brain is a stroke.
• Aortic Valve Disease is aging combined with high blood pressure, diabetes, and other risk factors, can also damage the heart’s valves.  This can prevent a valve from fully opening or closing thereby limiting the flow of blood out of the heart or allowing blood to leak back in.  Over time, this can cause chest pain or tightness, shortness of breath, fainting, dizziness, or fatigue.
• Heart Failure is the combination of all of the above which can eventually weaken the heart, making it harder to pump blood through the body.

Before the Framingham Heart Study, most physicians believed that atherosclerosis was an inevitable part of the aging process, and were taught that blood pressure was supposed to increase with age, enabling the heart to pump blood through an elderly person's narrowed arteries.    

With a mounting epidemic of cardiovascular disease beginning in the 1930s, the U.S. Public Health Service decided to undertake a large-scale study to investigate why heart disease had become the nation's number one killer by the late 1940s.

The notion that scientists could identify, and individuals could modify, "risk factors" (a term coined by the study) tied to heart disease, stroke and other diseases was not part of standard medical practice. The majority of physicians did not understand the relationship, for example, between high levels of serum cholesterol and heart attacks. Many did not believe that modifying certain behaviors could enable their patients to avoid or reverse the underlying causes of serious heart and vascular conditions.

Framingham was chosen for its proximity to Boston hospitals, and was considered a typical American town. It was selected by the U.S. Public Health Service, and 5,209 healthy residents between 30 and 60 years of age, both men and women, were enrolled as the first cohort of participants. It was the first major cardiovascular study to recruit women participants.

At that time, Framingham residents largely worked in manufacturing jobs and went to Cushing Hospital. At this time many residents stayed in the area so this made it easy to follow them throughout the observational study.

Scientists are now following the surviving children, their spouses, and grandchildren of the original subjects. More than 14,000 people have participated in the study. 

It was assumed, correctly, from the start of the Framingham Heart Study that cardiac health can be influenced by lifestyle and environmental factors, and by inheritance. Before the study, doctors had little sense of prevention.

To learn more, or to donate to heart disease research, visit www.heart.org.