After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore.
Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.
What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snowblower can do the same thing. Cold weather is another contributor because it can boost blood pressure, interrupt blood flow to part of the heart, and make blood more likely to form clots.
When a clot forms inside a coronary artery (a vessel that nourishes the heart), it can completely block blood flow to part of the heart. Cut off from their supply of life-sustaining oxygen and nutrients, heart muscle cells begin to shut down, and then die. This is what doctors call a myocardial infarction or acute coronary syndrome. The rest of us call it a heart attack.
The so-called classic signs of a heart attack are a squeezing pain in the chest, shortness of breath, pain that radiates up to the left shoulder and down the left arm, or a cold sweat. Other signs that are equally common include jaw pain, lower back pain, unexplained fatigue or nausea, and anxiety. Read more »
Here’s an important equation that all of us — doctors include — should know about healthcare, but don’t:
More ≠ Better
“More does not equal better” applies to diagnostic procedures, screening tests meant to identify problems before they appear, medications, dietary supplements, and just about every aspect of medicine.
That scenario is spelled out in alarming detail in the Archives of Internal Medicine. Clinicians at the Cleveland Clinic describe the case of a 52-year-old woman who went to her community hospital because she had been having chest pain for two days. She wasn’t having symptoms of a heart attack, such as shortness of breath, unexplained nausea, or a cold sweat, and her electrocardiogram and other tests were fine. The woman’s doctors concluded that her chest pain was probably due to a muscle she had pulled or strained during her recently begun exercise program to lose weight.
To “reassure her” that she wasn’t having a heart attack, the emergency department team recommended she have a CT scan of her heart. This noninvasive procedure can spot narrowings in coronary arteries and other problems that can interfere with blood flow to the heart. When it showed a suspicious area in her left anterior descending artery (a key artery nourishing the heart), she underwent a coronary angiogram. This involves inserting a thin wire called a catheter into a blood vessel in the groin and deftly maneuvering it into the heart. Once in place, equipment on the catheter is used to make pictures of blood flow through the coronary arteries. Read more »
It seems the Washington Post, cloaked under an anonymous author, wants to use scare tactics to keep most of us from enjoying Thanksgiving with their ominously titled article, “And for dessert, a heart attack?” They spew all kinds of garbage with very little data about how eating a high-fat diet might give you a heart attack.
If you want to know more, consider this article* from some pretty smart folks at Harvard. Then eat, drink, and be merry without guilt (courtesy of Dr. Wes). Happy Thanksgiving!
– WesMusings of a cardiologist and cardiac electrophysiologist.
*REFERENCE: Renata, M. and Mozaffarian, D. “Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence.” Lipids, 31 Mar 2010.
[Photo credit: Lambert]
*This blog post was originally published at Dr. Wes*
How fast does sudden cardiac arrest cause unconsciousness? In just seconds.
Here’s a video of Salamanca soccer player Miguel Garcia’s episode. At the start of the video, Mr. Garcia can be seen in the background of the image kneeling behind the players in the foreground. Watch carefully as he stands after tying his shoes.
Although it is difficult to see, it appears an automatic external defibrillator arrives in about two minutes, though given the fact his shirt is still on as he’s taken from the field, we note the device is on his gurney as he’s hurried to a nearby ambulance. Reportedly, he survived this sudden cardiac arrest event:
This was NOT a heart attack, but rather a loss of cardiac function caused by a rapid, often disorganized heart rhythm disorder. Compare the relatively long time to resuscitation using an external automatic defibrillator verses the very rapid response afforded to Belgian soccer player Anthony Van Loo, whose internal defibrillator was already installed before he played as primary prevention of sudden death from right ventricular dysplasia.
-WesMusings of a cardiologist and cardiac electrophysiologist.
Nobody is in the hospital these days feeling good. Regulations have made it so sick people are hospitalized and not-so-sick people are usually outpatients. People who are horizontal are there to have procedures, take heavy duty meds, rest and, hopefully, get better.
Hospitals have increasingly put in sophisticated television systems so you can be in bed and distracted and entertained. But that is not restful for everyone. Here’s an example from this past weekend that stands out:
Mark Dantonio, the coach of the Big Ten’s Michigan State Spartan college football team, was diagnosed with a heart attack right after last week’s game. Boom. He was hospitalized. Boom. He had a stent put in to unblock at least one artery. This past Saturday he was still in the hospital resting and recovering, right? In the hospital, yes. Resting, no! Are you kidding? Keep the coach down during the big game against Wisconsin, a Big Ten rival? Read more »
*This blog post was originally published at Andrew's Blog*
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After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore.
Nobody is in the hospital these days feeling good. Regulations have made it so sick people are hospitalized and not-so-sick people are usually outpatients. People who are horizontal are there to have procedures, take heavy duty meds, rest and, hopefully, get better.
