Terrorism is on the minds of every American as we wage the war on terror. National security and vigilance has not been this heightened since World War II, and appropriately so. However, the greatest threat to American lives is not Osama Bin Laden. Ironically, it is a terrorist who has stalked us all since the founding of the Republic, that being heart disease.
Heart disease comes in various forms with the most common types being coronary artery disease and congestive heart failure. These two illnesses account for more American deaths than any other cause and just like the terrorist threat, there are effective methods for protecting ourselves and loved ones from their attack. Coronary artery disease (CAD) also known as ischemic heart disease is the cause of “heart attacks”. This is the gradual development of blockages in the arteries feeding blood to the heart muscle. After the blockage has increased to a level where blood flow is impaired, angina or chest pains will develop indicating the heart muscle is not getting enough oxygen. Not uncommonly, these blockages or plaques as physicians refer to them may at anytime rupture causing a blood clot to form at the blockage. This typically causes a sudden and total occlusion of blood flow past the blockage causing a “heart attack” or at least life threatening unstable angina. We now refer to this event as Acute Coronary Syndrome (ACS). When this occurs, the person’s life is in immediate jeopardy with rapid administration of treatment directed at blood flow restoration being imperative and highly effective.
The symptoms of ACS include usually severe chest pain located in the center of the chest and often radiating into the arms and neck. It typically will be sustained even at rest but made worse with exertion. It can be accompanied by nausea, severe sweating, shortness of breath, and irregular heart beat. Immediate treatment at the nearest Emergency Department is mandatory with these symptoms as untreated it can progress to sudden death or severe disabling heart wall damage. When severe heart damage occurs it may well cause the development of Congestive Heart Failure.
Congestive Heart Failure or Cardiomyopathy can be caused by several factors with ischemic heart disease being very common. This is the disease process that used to be known as the “dropsy”. Other causes include hypertension, valvular heart disease, and congenital heart disease. There is even a form of cardiomyopathy caused by pregnancy. Cardiomyopathy from any cause is the result of a process which weakens the contractile strength of the heart muscle resulting in a weak pump. The common symptoms of congestive heart failure include shortness of breath at rest or with exertion, shortness of breath while trying to sleep flat, and increased fluid retention with leg swelling. The shortness of breath while trying to lie flat is known as orthopnea and is typically relieved by propping up on pillows or it may occur suddenly while sleeping causing the person to sit bolt upright to be able to breathe. This is known as paroxysmal nocturnal dyspnea and all of these symptoms indicate that the pumping action of the heart is inadequate causing the “congestion” of congestive heart failure. Although we work aggressively in medicine to prevent CHF from developing, thankfully we have ever improving treatments which are greatly improving quality of life and long-term survival.
However, what is best for everyone is to prevent these diseases from ever developing thereby reducing pain, suffering, incredible expense, disability, and even death. Three basic life style modifiers will eliminate the majority of heart disease. Smoking cessation, exercise, and healthy diets low in fat, sodium, and cholesterol are the mainstay for risk factor modification. We have proven definitively that these steps save lives. Following your blood pressure readings and cholesterol levels with your physician and working aggressively to normalize these readings is also important. They are imperative should you have a strong family history of heart attacks or sudden death, especially if these events occurred in first degree relatives before age fifty.
If we as Americans will be as vigilant against the causative factors for heart disease as we are against terrorism, we can eliminate a great burden on our society. The greatest burden is caused by the suffering and death these issues cause. Not just a burden on the patient, but also the ones who love and care for them and the rest of us who fund the expensive cost of care for heart disease and its complications. No longer can we ignore the threat of terrorism, and when we find the members of the heart disease terror cell, we must “pull the trigger” and save a life.
God bless you and be well,
Dr. Dan Edney
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