Archive | April, 2010

The simple new tool that predicts how well you’ll do after discharge from hospital

29 Apr

After I was discharged from the Coronary Care Unit following my heart attack, I was puzzled because, other than a pile of reading material about heart-healthy eating, I was pretty well booted out the door with virtually no follow-up care plan once I got home.

When my friend Viv’s daughter Kate phoned me a few days later (Kate happens to be a cardiac nurse at CCU), I had an endless list of panicky questions for her about my surprisingly distressing ongoing chest pains along with dozens of other issues.  I was convinced that another heart attack was imminent – an extremely terrifying prospect for a freshly diagnosed heart patient.

Canadian researchers in Ottawa have now developed a simple tool for hospital staff to predict the probability that patients like me, discharged from hospital to the community, will die or be unexpectedly readmitted within 30 days.

The study, published in the Canadian Medical Association Journal, could help identify patients who may benefit from closer monitoring and care, so that serious health problems can be prevented. (more…)

How women can have heart attacks without having any blocked arteries

25 Apr

Turns out that the kind of heart attack that I had (caused by a 99% blockage in the big left anterior descending coronary artery) – the so-called widowmaker heart attack - may actually be relatively uncommon  in women. You might guess that fact by its nickname.  It’s not called the “widower-maker”.

While cardiologists warn that heart disease can’t be divided into male and female forms, there are some surprising differences. Cardiologist Dr. Amir Lerman at the world famous Mayo Clinic in Rochester, Minnesota, told the Los Angeles Times recently:

“When it comes to acute heart attacks and sudden death from cardiac arrest, women have these kinds of events much more often without any obstructions in their coronary arteries.”

Instead, it appears that a significant portion of women suffer from another form of heart disease altogether. It affects not the superhighway coronary arteries but rather the smaller arteries, called microvessels. These tiny arteries deliver blood directly to the heart muscle.

Ironically, I can now boast two diagnoses for the price of one - first, the widowmaker heart attack caused by a fully occluded coronary artery back in 2008, and now, after two years of puzzling, ongoing cardiac symptoms - like chest pain, shortness of breath, and crushing fatigue - a second diagnosis of inoperable coronary microvascular disease. (more…)

Women’s heart health advice: “Walk often, walk far!”

21 Apr

If you are one of those misguided sods who still believe in the exercise axiom: “No pain, no gain”  – you can stop reading right now.  The rest of you, rejoice!  According to the National Heart, Lung, and Blood Institute, taking a long, leisurely daily walk may be a better way to go to improve heart health, lose weight and feel better.

A randomized controlled clinical trial funded by the NHLBI compared two exercise programs for heart attack survivors:

  • 1.  Standard cardiac rehab exercise:  25-40 minutes of exercise three times per week at approximately 65-75% peak aerobic capacity. This included 25 minutes of treadmill walking and 8 minutes on 2 to 3 ergometers: cycle, rowing, or arm.
  • 2.  High-calorie expenditure exercise: longer duration but lower intensity,  more frequent exercise (45-60 minute sessions, but at just 50-60% peak aerobic capacity, 5-7 times per week).

Walking, rather than weight-supported exercises (such as cycling and rowing), was preferred to maximize calorie expenditure, which was targeted at 3,000-3,500 calories per week. The protocol was essentially to “walk often and walk far.”  All heart patients studied were considered overweight before starting the program. Each subject  also received 16 hours of group dietary counselling, and were given a target goal of consuming 500 calories per day less than their predicted maintenance calories.

What did their results show?  (more…)

Gender differences in heart attack treatment contribute to women’s higher death rates

17 Apr

An alarming study undertaken in France highlighted serious gender differences in cardiac treatment of men and women.  These shocking differences contributed to a higher death rate among women suffering a heart attack.

The French study looked at more than 3,000 patients, of whom 32% were women. These people had been treated for heart attacks over a two-year period between 2006 and 2007.

Lead author Dr. Francois Schiele, Cardiology Chief at the University Hospital in Besancon, France, presented the results of the research at the American College of Cardiology’s 59th Annual Scientific Session in Atlanta last month. By examining the raw data, Dr. Schiele’s team found that, on average, the women studied:

  • were nine years older than their male counterparts
  • were in poorer health
  • had been less effectively treated for heart attack
  • were almost twice as likely as men to die as a result, whether in the hospital or at home during the month following their heart attack.  (more…)

The emotions of the wounded heart

13 Apr

“We connect with each other through our wounds”

Rachel Naomi Remen

Right after his heart attack, Dr. Steve Parker began an impressive project as part of his healing journey. The result is a compelling series of images that the Alaska clinical psychologist created over a 40-day period of recuperation.  The 40 drawings came first, and then his accompanying commentary, which then became a blog, and the blog then became a travelling art exhibit titled “Healing after a Heart Attack: Images of the Psyche”.  

A year later, New York journalist Natalie Walsh interviewed Steve’s sister Anne Diggory about her initial reaction when finally alerted to the depth of her brother’s illness: 

“She told those who had gathered at the exhibit’s opening reception that when she was first notified that Steve was having heart trouble, she felt removed from the experience.

“He was far away. I didn’t really understand what he was going through. Then I read the blog and I really understood, and I realized that I wasn’t paying attention.”

Steve explains:  “A heart attack is a deeply wounding event. I have been struggling with this never-ending wound for more than a year, and still it haunts me by the hour. A heart attack is also a deeply isolating event. Others act as if their lives will go on forever, but can I participate in this charade, knowing deeply and irrevocably that any moment could be my last one?”   (more…)

Inside your heart – as captured by National Geographic

9 Apr

Here’s how your heart looks during a coronary angiography procedure. The white/yellow blood vessels are bringing oxygenated blood to the working muscles of the heart.  (See link below to the whole slide show).

Coronary angiography (also called cardiac catheterization) is sometimes referred to as the ‘gold standard’ of diagnostics for heart patients. The procedure involves threading a tiny catheter through an artery in the wrist or groin and pushing it up, up, up right into the beating heart. It’s considered to be an invasive procedure, but not surgical. Patients are sedated, but usually awake throughout.

The catheter is guided through the artery with the aid of a special x-ray machine. Contrast material (dye) is injected through the catheter and x-ray movies are created as the contrast material moves through the heart’s chambers, valves and major vessels.

The interventional cardiologists in the ‘cath lab’ then watch your beating heart up on the monitor, where they can spot any coronary arteries that are blocked or narrowed, and evaluate your heart function. If significant blockages are seen, further procedures like balloon angioplasty, stent implants or coronary artery bypass graft (CABG) - commonly known as bypass surgery – may be attempted to restore blood flow to the threatened heart muscle.

I’ve undergone two of these invasive cardiac procedures – the first an emergency catheterization and stent implant when I was hospitalized for a heart attack, the second 15 months later to investigate ongoing cardiac symptoms. And I can tell you that it is freakishly fascinating to lie on the cath lab table, sedated yet very awake, and watch your own beating heart on the overhead monitor.   (more…)

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