Heart Recommendations and Considerations

Hearth Recommendations

If you experience any of the following warning signs of heart attack, seek emergency medical care immediately:

• Chest discomfort in the center of the chest that lasts more than a few minutes or that goes away and then comes back. Discomfort can be defined as pressure, squeezing, fullness, or pain. heart recommendations here.
• Pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
• Shortness of breath.
• Sweating (possibly profuse).
• Nausea and/or vomiting.
• Light-headedness.

If you think you may be having a heart attack, follow the steps outlined below:

• Stop what you are doing and sit down.

• Assess the situation. Try to remain calm. If there is someone else around you, let him or her know what is happening. If there is no one else there and you are still feeling pain or discomfort after a few minutes. Or if you are sweating and weak without any other obvious symptoms. Call for emergency help and tell the person on the other end of the line that you may be having a heart attack. Do not drive yourself to the hospital. Do not delay getting treatment. Heart recommendations.

• After calling for medical help, if you are unable to leave your telephone number and address. You may want to leave the telephone off the hook so that your number and address can be traced. 1- If you have given your address and telephone number successfully, hang up and call a friend or relative who may be of assistance.

• 2- If you have nitroglycerin tablets, take one every five minutes, up to three tablets in total. 3- If you have aspirin in the house, take one and chew it. Heart recommendations. This may prevent a blood clot.

• Perform a technique called cough CPR, which involves vigorous coughing. This may help you to remain conscious long enough to call for help. Obviously, it is something that must be learned before it is needed; 1- if you are considered at increased risk of a heart attack, discuss this with your health care professional

• 2- If a friend or relative is with you, have him or her check your pulse and respiration (breathing) at regular intervals. 3- If your pulse or breathing stops, this person should start cardiopulmonary resuscitation (CPR) immediately. He or she should then call the emergency number again, so that when the ambulance arrives, emergency personnel know that this is indeed a heart attack. Heart recommendations.

• If it is later established that the episode was not a heart attack, consider having your potential for a heart attack assessed by a doctor to relieve any doubts and concerns you may have.

❑ If you have suffered a heart attack, or if you are considered at risk for a heart attack, modify your diet. Important dietary measures include the following:

• Make sure your diet is high in fiber. Not all types of fiber decrease the risk of heart attack, however. The most beneficial fiber appears to come from whole grains, fruits, and vegetables.
• Eat lots of foods that are rich in vitamins B6 and B12 and folic acid. Which are needed to keep homocysteine levels in check. Heart recommendations: Vitamins B6 and B12 come naturally from leafy green vegetables and fruits. Folic acid can be found in some breakfast cereals, asparagus, spinach, chickpeas, and beans.

• Include almonds, brewer’s yeast, grains, and sesame seeds in your diet.
Caution: Brewer’s yeast can cause an allergic reaction in some individuals. Start with a small amount at first, and discontinue use if any allergic symptoms occur. Heart recommendations.

• Enjoy onions frequently. Onions—especially red onions—contain valuable antioxidants. Chop them and allow them to stand for ten minutes before cooking for optimal benefit.

• Add kelp and sea vegetables to your diet for necessary minerals.
• Drink fresh vegetable juices.
• Drink steam-distilled water only.
• Do not eat red meat, salt, sugars, or white flour. A diet high in red meat can elevate homocysteine levels. Eat soy-based protein foods instead. Soy protein can effectively lower high LDL cholesterol levels.

• Avoid salt, sugars, and white flour. Refined sugars produce adverse reactions in all cells by causing wide variations in blood sugar. The high surges are followed by hypoglycemic drops, causing dangerous instability in vital intracellular sugar levels.

• Eliminate fried foods, coffee, black tea, colas, and other stimulants from the diet.
• Refrain from excessive alcohol use, as it has an adverse effect on the heart. Drinking alcohol in moderation may actually be heart-healthy. But do not start to drink if you have not done so before—the potential benefit simply does not justify it.
• Sip barley water throughout the day for its healing and fortifying properties.

❑ Learn to make heart-smart food substitutions, such as the following:

• 1- Instead of whole or 2 percent milk and cream, use 1 percent or skim milk.
• 2- Instead of fried foods, eat baked, steamed, boiled, or broiled foods.
• 3- Instead of lard, butter, palm oil, or coconut oils. Cook with unsaturated vegetable oils such as corn, olive, canola, safflower, sesame, soybean, sunflower, or peanut.

• 4- Instead of eating fatty cuts of meat, choose extra-lean cuts or cut off the fatty parts. Or substitute skinless chicken or fish.
• 5- Instead of one whole egg in recipes, use two egg whites.
• 6- Instead of sauces, butter, and salt, season vegetables with herbs and spices.
• 7- Instead of regular hard and processed cheeses, eat low-fat, low-sodium cheeses.

• Instead of salted potato chips, eat low-fat, unsalted tortilla and potato chips and unsalted pretzels and popcorn.
• Instead of sour cream and mayonnaise, use plain low-fat yogurt, low-fat cottage cheese, or low-fat, light sour cream.

❑ Fast three days a month to cleanse and detoxify the body. Heart recommendations.

❑ To relieve stress and promote relaxation, add a few drops of lavender, sandalwood, or ylang ylang essential oil to a bath, or simply place a few drops on a tissue and inhale the aroma from time to time throughout the day.

❑ Arnica is a homeopathic remedy used to support recovery from a heart attack.

❑ Do not smoke. Avoid secondhand smoke.

❑ The tests you’ll need to diagnose your heart disease depend on what condition your doctor thinks you might have. No matter what type of heart disease you have, your doctor will likely perform a physical exam and ask about your personal and family medical history before doing any other tests. If you think you may be at risk for cardiovascular disease, you should discuss the following tests with your doctor. Heart recommendations. Blood tests, chest X-ray, electrocardiogram (ECG), Holter monitoring, echocardiogram, catheterization, cardiac computerized tomography (CT) scan, and cardiac magnetic resonance imaging (MRI).

Considerations

❑ Research has shown that people typically wait two hours or more before seeking emergency care after the onset of heart attack symptoms. It could be because they are uncertain about their symptoms or are concerned that it might be a false alarm. However, clot-busting medications and other effective treatments that restore blood flow and save heart muscle are most effective in the first hour following a heart attack.

❑ Heart attacks are directly related to a number of other conditions, such as arteriosclerosis, circulatory problems, hypertension (high blood pressure), high cholesterol, and cardiovascular disorders (including aneurysms, angina pectoris, and arrhythmias). It is advisable to refer to all of the sections on these interrelated diseases to learn about all aspects of, and contributing causes to, heart attacks.

❑ The severity of first heart attacks has dropped significantly in the United States—propelling a decline in coronary heart disease deaths, researchers reported in Circulation: Journal of the American Heart Association. This study suggests that better prevention and better management in the hospital have contributed to the reduction in deaths.

❑ Similarly, a study published in The Journal of the American Medical Association (JAMA) found that the chance of dying thirty days after a heart attack dropped from 18.8 percent in 1995 to 15.8 percent in 2006. The drop can be attributed in part to the fact that treatment in hospitals across the United States has become more consistent.

❑ Heart attacks are not, as many think, a male disorder. In fact, women account for nearly half of all heart attack deaths. Forty-four percent of women die within a year, whereas only 27 percent of men do. Heart attacks, not cancer, are the leading cause of death for American women. Twice as many women die of heart attacks each year as die from all forms of cancer combined.

❑ New guidelines call for women to maintain HDL levels above 50 mg/dL, a 25 percent increase over the previous recommendation, 40 mg/dL. Women are also advised to keep triglycerides below 150 mg/dL, rather than the previously recommended 200 mg/dL.

❑ Women experience a heart attack on average nine years later than men. However, many of the risk factors for having one are the same in men and women. These include high cholesterol, smoking, abdominal obesity, poor diet, and stress. These factors explain more than 90 percent of the risk for heart attack, and all are controllable.

❑ It is highly recommended that at least one person in every household receive thorough training in CPR.

Stress Testing

Many physicians recommend that certain individuals undergo stress testing to determine the fitness and health of their hearts and cardiovascular systems. There are actually a number of different variations on stress testing. Following are some points you should know about them.

The most common stress test is an exercise test, which involves walking on a treadmill that increases in speed and grade (steepness) every three minutes. This test normally is stopped when the person undergoing it becomes fatigued or is short of breath, or experiences chest pressure. Heart rhythm and blood pressure are continuously monitored during the test.
Traditional stress testing sometimes can be combined with other techniques to take images of the heart before and after exercise. An exercise (treadmill or bicycle) echocardiogram, informally known as an echo. Can be made that takes ultrasound pictures of the heart to see how it responds.

A nuclear thallium or sestamibi test is another type of imaging stress test. In this procedure, an intravenous (IV) line is placed in the arm and a small amount of radioactive material is injected before and after exercise. Images of the heart’s blood supply then can be made.

For those who are unable to exercise, a medicine such as dobutamine or dipyridamole is given via an IV to gradually increase the workload of the heart, just as if it were exercising. Echo or nuclear images of the heart are then made to determine how well the heart’s overall pumping action increases and whether or not there are any problems with blood supply to one of the walls of the heart.

An angiogram looks at the blood vessels around the heart and can also give information concerning the heart muscle and heart valves.

A special catheter is threaded into the body through a blood vessel in the groin or arm. This catheter reaches the arteries around the heart. Dye is injected via the catheter into the blood vessels while pictures are being shot with an X-ray machine. These X-rays will show blockages in the arteries and their severity.

Your doctor will choose the best stress test for you, if needed, based on your symptoms, risk factors, and a physical exam. Regular checkups by a health care professional, regular exercise, eating lots of fruits and vegetables, and quitting smoking are key to a healthy heart. Heart recommendations.

❑ A technique known as thermography can be used to test for the presence of atherosclerosis by detecting fluctuations in the temperature of the arteries. In healthy arteries, the temperature remains constant, while in arteries that contain plaque, the temperature is different in diseased areas and the healthy areas. Another test for detecting harmful levels of calcium or plaque buildup in the arteries is gated helical computerized tomography (GHCT) scanning. Ask your doctor if he or she thinks either of these is a test you should have. Heart recommendations.

❑ Tirofiban (Aggrastat) is an injectable drug that may help people recover from acute cardiac episodes. Including severe angina or severe chest pain. It is a type of agent called a glycoprotein blocker that stops blood from clotting. Trials conducted in New Zealand found that tirofiban was more effective at preventing a second heart attack than aspirin or heparin. Tirofiban was recommended by the American Heart Association in 2007 for patients who have had a type of heart attack called non-ST-segment elevation myocardial infarction (NSTEMI).

❑ Some compounds known as plant sterols and stanols have been shown to lower LDL cholesterol levels and can be found in some types of margarine and salad dressing. They are also available in tablet form.

❑ Carnitine, coenzyme Q10, fish oil, magnesium, and antioxidants are recommended for the prevention of cardiac arrhythmia, heart attack, and angina. Carnitine protects the heart muscle from damage due to poor circulation or partial arterial blockage.

❑ An Austrian study found that coughing vigorously (“cough CPR”) until help arrives can help to save the lives of people experiencing heart attack or cardiac arrest.

❑ The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) help to reduce the risk of heart attack. Taking both DHA and EPA supplements was shown to reduce the chances of dying from all causes, including heart disease. These data were based on twelve studies including more than 32,000 individuals. Although the best dose is not yet known, the FDA is getting closer to making a DRI for omega-3s. The recommendation will likely be between 250 milligrams and 500 milligrams a day.

❑ Diet is important after a heart attack. Both a low-fat diet and a Mediterranean diet, which is also low in fat but has more omega-3s. Were shown to reduce the chance of having a second heart attack or dying from a heart attack.

❑ Very large doses of vitamin D—over 1,000 international units daily—can be dangerous for people with heart disease. In large quantities, vitamin D is toxic and can cause hypercalcemia (excessively high levels of calcium in the blood), which in turn may lead to deposits of calcium in the arteries.

❑ Among the more recently identified risk factors that may be linked to cardiovascular disease is C-reactive protein (CRP). This is a compound produced by the liver in response to injury or infection, and is a sign of inflammation in the body. Research correlates high levels of CRP with an increased risk of heart attack and stroke. Although the evidence is conflicting, some researchers believe that CRP itself is not a risk factor, but elevated levels of CRP could mean that some part of the cardiovascular system is inflamed, which can lead to stroke or heart attack. Information about CRP and other new risk factors is still emerging.

❑ There is ongoing debate about whether or not taking synthetic estrogen protects the heart after menopause.
Some studies have suggested that it may, but there have also been studies showing it may actually increase the risk of a heart attack. Heart recommendations.

❑ There are many different medications that may be prescribed for people with heart disease. These include the following:

• Angiotensin-converting enzyme (ACE) inhibitors inhibit the formation of the hormone angiotensin, which narrows the blood vessels. Angiotensin II receptor blockers interfere with the action, rather than the formation, of the same hormone.

• Anticoagulants (blood-thinners) are commonly prescribed for people in particular danger of developing blood clots, such as people who are bedridden, cancer patients, people with certain types of arrhythmias, and those who have had heart valve replacement surgery. Heart recommendations. There are also newer drugs known as platelet-aggregation inhibitors that may be prescribed for the same purposes. Sometimes just an aspirin is recommended when a patient is at risk for heart disease, but does not need anti-coagulation drugs. The dose is small (81 milligrams per day) and less likely to cause stomach erosion. But effective enough to slightly thin the blood.

• Beta-blockers induce the heart to beat more slowly and with less force.

• Calcium channel blockers relax blood vessel muscle.

• Central adrenergic inhibitors (central-acting agents) prevent the nervous system from increasing heart rate and narrowing blood vessels.

• Diuretics (water pills) help the kidneys get rid of sodium and water, reducing the volume of blood in the body and, therefore, the strain on the heart.

❑ Most people who have heart attacks experience the characteristic chest pain. However, not all do. Some people have a sensation that feels like indigestion; others have no noticeable symptoms at all. This phenomenon is often referred to as a “silent” heart attack. Older adults and people with diabetes are probably more likely than others to have this type of heart attack.

❑ Many illnesses can mimic heart attacks, such as a gallbladder attack, fibromyalgia that causes pain in the chest wall, or gastroesophageal reflux disease (GERD), but if you have chest pain, you must see a physician. Chest pain or even ill-defined symptoms that you cannot explain just may be a heart attack—these are not conditions you can afford to ignore.

❑ People with high blood pressure should avoid cold weather. Which might trigger heart attacks because the lower temperatures increase blood pressure, putting more strain on the heart.

❑ In some cases, heart attacks are caused by spasms of the arteries that suddenly shut off the flow of blood to the heart.

❑ Sensible, moderate exercise and a proper diet with nutritional supplements can prevent arteriosclerosis of the coronary arteries and myocardial infarction.

Caution: If you are over thirty-five and/or have been sedentary for some time. Consult with your health care provider before beginning an exercise program. See Heart recommendations.

❑ Studies have shown that people who take supplemental coenzyme Q10 following a heart attack are less likely to have a second attack within five years than those who do not.

❑ Researchers have found that eating just an ounce of walnuts a day (about seven nuts) may reduce the risk of a heart attack by 8 to 10 percent.

❑ A heart attack is not the same thing as heart failure. In heart failure, the heart does not supply enough blood to the body; in a heart attack, the heart does not receive enough blood to meet its needs. However, the damage produced by a heart attack can lead to heart failure. Heart recommendations.

❑ An underactive thyroid may increase the risk of heart attacks. An article in the Annals of Internal Medicine reported that women who had a condition termed subclinical hypothyroidism were about two times more likely to suffer from blockage in the aorta that could lead to a heart attack than women who had normally functioning thyroids.

❑ Depression and heart attacks often go hand in hand. It is therefore wise to actively treat depression. Heart recommendations.