What are the common symptoms of a heart attack. How do heart attack signs differ between men and women. What causes a heart attack and what are the different types. When should you call 911 for a potential heart attack. How is angina different from a heart attack.

Understanding Heart Attacks: A Comprehensive Overview

A heart attack, medically known as a myocardial infarction (MI), occurs when blood flow to the heart is blocked, depriving the cardiac muscle of oxygen. This blockage can lead to tissue death and potentially lasting damage to the heart muscle. Heart attacks are serious medical emergencies that require immediate attention.

In the United States, heart attacks affect over a million people annually, with one occurring every 40 seconds according to CDC statistics. While the risk increases with age, various factors such as high blood pressure, elevated LDL cholesterol levels, diabetes, and smoking can contribute to heart attack risk at any age.

Recognizing Heart Attack Symptoms: Key Signs to Watch For

Heart attack symptoms can vary from person to person and even between different heart attacks experienced by the same individual. However, some common signs include:

• Chest discomfort, often described as pressure, heaviness, tightness, squeezing, or pain
• Pain radiating to the arm, back, jaw, throat, or below the breastbone
• Sensations of fullness, indigestion, or choking (sometimes mistaken for heartburn)
• Sweating, nausea, vomiting, or dizziness
• Severe weakness, anxiety, fatigue, or shortness of breath
• Rapid or irregular heartbeat

Gender Differences in Heart Attack Symptoms

Women may experience heart attacks differently from men. Some symptoms more commonly reported by women include:

• Unusual fatigue
• Shortness of breath
• Nausea or vomiting
• Dizziness or lightheadedness
• Discomfort in the gut, sometimes resembling indigestion
• Discomfort in the neck, shoulder, or upper back

It’s important to note that some individuals, particularly those with diabetes, may experience a “silent” myocardial infarction with no noticeable symptoms.

Types of Heart Attacks: Understanding the Differences

Heart attacks can be categorized into different types based on the nature and extent of the blockage:

1. STEMI (ST-Elevation Myocardial Infarction): A severe heart attack where a coronary artery is completely blocked.
2. NSTEMI (Non-ST-Elevation Myocardial Infarction): A heart attack where a coronary artery is significantly narrowed, greatly reducing blood flow but not completely blocked.
3. MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries): A heart attack where no blockages are visible in the main coronary arteries.

Distinguishing Heart Attacks from Other Cardiac Events

It’s crucial to differentiate heart attacks from other cardiac events:

• Sudden Cardiac Arrest: This is not a heart attack but rather a malfunction of the heart’s electrical system, causing it to stop pumping.
• Angina: While sometimes a symptom of a heart attack, angina is chest pain that can occur for other reasons and may not always indicate a heart attack.

The Physiology of a Heart Attack: What Happens Inside Your Body

Understanding the physiological process of a heart attack can help grasp its severity and the importance of prompt treatment:

1. The heart muscle requires a constant supply of oxygen-rich blood, provided by the coronary arteries.
2. In coronary artery disease, these arteries narrow, restricting blood flow.
3. Plaques form in the arteries, composed of fat, calcium, proteins, and inflammatory cells.
4. When a plaque ruptures, platelets rush to the site, forming blood clots.
5. If a blood clot blocks the artery, the heart muscle becomes oxygen-starved.
6. Without oxygen, heart muscle cells begin to die, causing permanent damage.

In rare cases, a coronary artery spasm can also trigger a heart attack, even in individuals without severe coronary artery disease.

Risk Factors and Prevention: Safeguarding Your Heart Health

While some risk factors for heart attacks are beyond our control, many can be modified through lifestyle changes and medical interventions. Key risk factors include:

• Age: Risk increases with age, particularly after 55 for men and 65 for women
• Gender: Men are at higher risk than women, although the gap narrows after menopause
• Family history: Genetic predisposition can increase risk
• High blood pressure
• High LDL cholesterol levels
• Smoking
• Diabetes
• Obesity
• Sedentary lifestyle
• Stress
• Poor diet

Preventive measures can significantly reduce heart attack risk:

1. Regular exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity per week
2. Healthy diet: Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats
3. Stress management: Practice relaxation techniques like meditation or yoga
4. Smoking cessation: Quit smoking and avoid secondhand smoke
5. Regular health check-ups: Monitor blood pressure, cholesterol, and blood sugar levels
6. Medication: Take prescribed medications for conditions like hypertension or high cholesterol as directed

Immediate Response to Heart Attack Symptoms: When and How to Seek Help

Recognizing the signs of a heart attack and taking immediate action can be life-saving. Here’s what you should do:

1. Call emergency services (911 in the US) immediately if you suspect a heart attack. Don’t wait to see if symptoms pass.
2. If prescribed, take nitroglycerin as directed by your doctor.
3. If instructed by emergency services and not allergic, chew and swallow an aspirin.
4. Try to remain calm and seated or lying down to reduce strain on your heart.
5. If you’re with someone experiencing symptoms, be prepared to perform CPR if they lose consciousness and stop breathing.

Time is critical in heart attack treatment. The sooner medical intervention begins, the better the chances of minimizing heart muscle damage.

Diagnosis and Treatment: Medical Approaches to Heart Attacks

When a patient arrives at the hospital with suspected heart attack symptoms, a series of diagnostic tests are typically performed:

• Electrocardiogram (ECG or EKG): To detect abnormalities in the heart’s electrical activity
• Blood tests: To check for elevated levels of cardiac enzymes indicating heart muscle damage
• Coronary angiography: To visualize blockages in the coronary arteries
• Echocardiogram: To assess heart function and identify areas of damaged heart muscle
• Stress tests: To evaluate heart function during physical exertion

Treatment for heart attacks aims to restore blood flow to the affected area of the heart and prevent further damage. Common treatments include:

1. Medications:
   • Thrombolytics (clot-busters) to dissolve blood clots
   • Antiplatelet agents like aspirin to prevent new clots
   • Beta-blockers to reduce heart rate and blood pressure
   • ACE inhibitors to lower blood pressure and reduce strain on the heart
   • Statins to lower cholesterol levels
2. Coronary angioplasty and stenting: A procedure to open blocked arteries and place a stent to keep them open
3. Coronary artery bypass grafting (CABG): Surgery to create new routes for blood to flow around blocked arteries

Recovery and Rehabilitation: Life After a Heart Attack

Recovering from a heart attack is a gradual process that typically involves:

1. Cardiac rehabilitation programs: Supervised exercise, education, and counseling to help patients recover and reduce the risk of future heart problems
2. Lifestyle modifications: Implementing heart-healthy habits like regular exercise, a balanced diet, and stress management
3. Medication adherence: Taking prescribed medications as directed to manage risk factors and prevent complications
4. Regular follow-up appointments: Monitoring heart health and adjusting treatment plans as needed
5. Emotional support: Addressing anxiety, depression, or other emotional challenges that may arise after a heart attack

Recovery time varies depending on the severity of the heart attack and individual factors. Many patients can return to normal activities within a few weeks to months, while others may require more extended rehabilitation.

Long-term Outlook and Prognosis

The long-term prognosis after a heart attack depends on several factors:

• The extent of heart muscle damage
• How quickly treatment was received
• The overall health of the patient before the heart attack
• Adherence to rehabilitation and lifestyle changes

Many individuals lead full, active lives after a heart attack with proper care and lifestyle modifications. However, having a heart attack does increase the risk of future cardiac events, making ongoing management and prevention crucial.

Emerging Research and Future Directions in Heart Attack Care

The field of cardiology is continuously evolving, with new research aimed at improving heart attack prevention, diagnosis, and treatment. Some promising areas of study include:

• Advanced imaging techniques for earlier detection of coronary artery disease
• Novel biomarkers for more accurate and rapid heart attack diagnosis
• Gene therapy and stem cell treatments to repair damaged heart tissue
• Personalized medicine approaches to tailor treatments based on individual genetic profiles
• Artificial intelligence and machine learning for predicting heart attack risk and optimizing treatment strategies

These advancements hold the potential to revolutionize heart attack care, potentially reducing incidence rates and improving outcomes for those affected.

The Role of Technology in Heart Health Monitoring

Wearable devices and smartphone apps are increasingly being used to monitor heart health and detect potential warning signs:

• Smartwatches with ECG capabilities can detect irregular heart rhythms
• Continuous blood pressure monitoring devices provide real-time data
• Activity trackers encourage regular exercise and monitor physical activity levels
• Smartphone apps can help track medication adherence and provide educational resources

While these technologies can be valuable tools, it’s important to remember that they should complement, not replace, regular medical check-ups and professional healthcare advice.

Global Impact of Heart Attacks: A Public Health Perspective

Heart attacks represent a significant global health challenge, with cardiovascular diseases being the leading cause of death worldwide. The impact varies across regions due to differences in lifestyle, healthcare access, and genetic factors:

• Developed countries: Despite advanced healthcare systems, high rates of obesity and sedentary lifestyles contribute to heart attack incidence
• Developing countries: Rapid urbanization and adoption of Western diets are leading to increased heart attack rates
• Low-income regions: Limited access to healthcare and preventive services can result in higher mortality rates from heart attacks

Addressing this global challenge requires coordinated efforts in public health education, healthcare policy, and international cooperation to promote heart-healthy lifestyles and improve access to cardiac care worldwide.

Economic Impact of Heart Attacks

The economic burden of heart attacks extends beyond individual healthcare costs:

• Direct medical costs for treatment and rehabilitation
• Indirect costs due to lost productivity and premature mortality
• Long-term care expenses for those with lasting complications
• Impact on families and caregivers, including potential loss of income

Investing in prevention strategies and improving acute care can potentially reduce this economic burden while improving public health outcomes.

Special Considerations: Heart Attacks in Specific Populations

Certain populations may have unique considerations when it comes to heart attack risk, symptoms, and treatment:

Women and Heart Attacks

Women often experience heart attacks differently from men:

• Symptoms may be more subtle or atypical
• Diagnosis can be delayed due to these differences
• Hormonal factors, including menopause, play a role in heart attack risk
• Pregnancy complications like preeclampsia can increase future heart attack risk

Young Adults and Heart Attacks

While less common, heart attacks in young adults are a growing concern:

• Often linked to genetic factors or lifestyle choices
• Substance abuse, particularly cocaine use, can trigger heart attacks in young people
• Awareness of risk factors and symptoms is crucial for early detection

Elderly Population and Heart Attacks

Older adults face unique challenges with heart attacks:

• Symptoms may be less pronounced or attributed to age-related changes
• Multiple health conditions can complicate diagnosis and treatment
• Medication interactions require careful management
• Recovery and rehabilitation may be more prolonged

Understanding these population-specific factors is essential for healthcare providers to deliver targeted, effective care and for individuals to recognize their unique risk profiles.

Symptoms, Causes, Treatment, and Prevention

A heart attack happens when something blocks the blood flow to your heart so it can’t get the oxygen it needs. It’s a medical emergency. Call 911 right away at the first sign of any symptoms. Don’t wait to see if the symptoms pass.

Heart attacks are also called myocardial infarctions (MIs). “Myo” means muscle, “cardial” refers to the heart, and “infarction” means death of tissue because of a lack of blood supply. This tissue death can cause lasting damage to your heart muscle..

Symptoms of a heart attack include:

• Discomfort, pressure, heaviness, tightness, squeezing, or pain in your chest or arm or below your breastbone
• Discomfort that goes into your back, jaw, throat, or arm
• Fullness, indigestion, or a choking feeling (it may feel like heartburn)
• Sweating, upset stomach, vomiting, or dizziness
• Severe weakness, anxiety, fatigue, or shortness of breath
• Fast or uneven heartbeat

Symptoms can be different from person to person or from one heart attack to another.  Women are more likely to have these heart attack symptoms:

• Unusual fatigue
• Shortness of breath
• Nausea or vomiting
• Dizziness or lightheadedness
• Discomfort in your gut. It may feel like indigestion.
• Discomfort in the neck, shoulder, or upper back

With some heart attacks, you won’t notice any symptoms (a “silent” myocardial infarction). This is more common in people who have diabetes.

More than a million Americans have heart attacks each year.  It happens every 40 seconds to someone in the U.S., according to the CDC. 

Heart attacks happen to both men and women. Although they are more likely as you get old, there are many risk factors – including high blood pressure, high levels of LDL (“bad”) cholesterol, diabetes, and whether you smoke – that you can change.

Types of heart attacks: When someone has a heart attack, you may hear some of these terms used:

• STEMI: A heart attack where a coronary artery is completely blocked 
• NSTEMI: A heart attack where a coronary artery is narrowed enough to greatly reduce blood flow but is not totally blocked
• MINOCA: A heart attack in which no blockages are seen in the main coronary arteries.  MINOCA stands for myocardial infarction with non-obstructive coronary arteries. 

A sudden cardiac arrest is actually not a heart attack. You can think of a heart attack as a problem within the heart’s arteries, and a sudden cardiac arrest as the heart’s electrical system suddenly not working right, causing the heart to stop pumping.

Angina also isn’t a heart attack. It’s a symptom, and sometimes it can signal a heart attack. It means chest pain. And while it can happen with a heart attack, it can also happen for other reasons. The sensations may occur with normal activities or exertion but then go away with rest or when you take nitroglycerin.

With angina, you may feel:

• Pressure, pain, squeezing, or a sense of fullness in the center of the chest
• Pain or discomfort in the shoulder, arm, back, neck, or jaw

Call 911 if it gets worse, lasts more than 5 minutes, or doesn’t improve after you’ve taken nitroglycerin. Doctors call that “unstable” angina, and it’s an emergency that could be related to a heart attack that is about to happen.

If you instead have “stable” angina, which is the most common kind, your symptoms usually happen with predictable triggers (such as a strong emotion, physical activity, extreme high or low temperatures, or even a heavy meal). The symptoms go away if you rest or take nitroglycerin that your doctor has prescribed. If not, call 911.

Your heart muscle needs a constant supply of oxygen-rich blood. Your coronary arteries give your heart this critical blood supply. If you have coronary artery disease, those arteries become narrow, and blood can’t flow as well as it should. When your blood supply is blocked, you have a heart attack.

Fat, calcium, proteins, and inflammatory cells build up in your arteries to form plaques. These plaque deposits are hard on the outside and soft and mushy on the inside.

When the plaque is hard, the outer shell cracks. This is called a rupture. Platelets (disc-shaped things in your blood that help it clot) come to the area, and blood clots form around the plaque. If a blood clot blocks your artery, your heart muscle becomes starved for oxygen. The muscle cells soon die, causing permanent damage.

Rarely, a spasm in your coronary artery can also cause a heart attack. During this coronary spasm, your arteries restrict or spasm on and off, cutting off the blood supply to your heart muscle (ischemia). It can happen while you’re at rest and even if you don’t have serious coronary artery disease.

Each coronary artery sends blood to a different part of your heart muscle. How much the muscle is damaged depends on the size of the area that the blocked artery supplies and the amount of time between the attack and treatment.

Your heart muscle starts to heal soon after a heart attack. This takes about 8 weeks. Just like a skin wound, a scar forms in the damaged area. But the new scar tissue doesn’t move the way it should. So your heart can’t pump as much after a heart attack. How much that ability to pump is affected depends on the size and location of the scar.

After a heart attack, you need quick treatment to open the blocked artery and lessen the damage. At the first signs of a heart attack, call 911. The best time to treat a heart attack is within 1 or 2 hours after symptoms begin. Waiting longer means more damage to your heart and a lower chance of survival.

If you’ve called emergency services and are waiting for them to arrive, chew an aspirin (325 milligrams). Aspirin is a potent inhibitor of blood clots and can lower the risk of death from a heart attack by 25%.

Call 911 and start CPR (cardiopulmonary resuscitation) if someone goes into cardiac arrest, which is when the heartbeat has stopped and the person isn’t responsive. CPR doesn’t restart the heart; but it keeps the person alive until medical help arrives.

An easy-to-use device called an AED (automated external defibrillator) is available in many public places and can be used by almost anyone to treat cardiac arrest. This device works by shocking the heart back into a normal rhythm.

Here’s how to use an AED:

1. Check responsiveness

• For an adult or older child, shout and shake the person to confirm whether they’re unconscious. Do not use AED on a conscious person.
• For an infant or young child, pinch their skin. Never shake a young child.
• Check breathing and pulse. If absent or uneven, prepare to use the AED as soon as possible.

2. Prepare to use the AED

• Make sure the person is in a dry area and away from puddles or water.
• Check for body piercings or outline of an implanted medical device, such as a pacemaker or implantable defibrillator.
• AED pads must be placed at least 1 inch away from piercings or implanted devices.

3. Use the AED

For newborns, infants, and children up to age 8, use a pediatric AED, if possible. If not, use an adult AED.

• Turn on the AED.
• Wipe the chest dry.
• Attach the pads.
• Plug in the connector, if necessary.
• Make sure no one is touching the person.
• Push the “Analyze” button.
• If a shock is advised, check again to make sure no one is touching the person.
• Push the “Shock” button.
• Start or resume compressions.
• Follow AED prompts.

4. Continue CPR

• After 2 minutes of CPR, check the person’s heart rhythm. If it’s still absent or uneven, give them another shock.
• If a shock isn’t needed, continue CPR until emergency help arrives or the person begins to move.
• Stay with the person until help arrives.

Emergency medical workers will ask you about your symptoms and do some tests.

Tests to diagnose a heart attack

Your doctor may order tests, including:

EKG: Also known as an electrocardiogram or ECG, this is a simple test that records the electrical activity of the heart. It can tell how much your heart muscle has been damaged and where. It can also monitor your heart rate and rhythm.

Blood tests: Several blood tests, often done every 4 to 8 hours, can help diagnose a heart attack and spot any ongoing heart damage. Different levels of cardiac enzymes in your blood can indicate heart muscle damage. These enzymes are usually inside the cells of your heart. When those cells are injured, their contents – including the enzymes – spill into your bloodstream. By measuring the levels of these enzymes, your doctor can find out the size of the heart attack and when it started. Tests can also measure troponin levels. Troponins are proteins inside heart cells that are released when the cells are damaged by the lack of blood supply to your heart.

Echocardiography: In this ultrasound test, sound waves are bounced off your heart to create images. It can be used during and after a heart attack to learn how your heart is pumping and what areas aren’t pumping the way they should. The “echo” can also tell whether any parts of your heart (valves, septum, etc.) have been injured in the heart attack.

Cardiac catheterization: You might need cardiac catheterization, also called cardiac cath, during the first hours of a heart attack if medications aren’t helping with the ischemia or symptoms. The cardiac cath can give an image of the blocked artery and help your doctor decide on a treatment.

In this procedure, a catheter (a thin, hollow tube) is inserted into a blood vessel in your groin or wrist and threaded up to your heart. Dye is used to highlight your heart’s arteries. Your doctor can then identify blockages, which are often treated with angioplasty or stents to open the artery and restore blood flow. Your doctor may do several tests to assess your heart. Intravenous blood thinner is an option to open the artery if cardiac catheterization is not available.

Stress testing: Your doctor can do a treadmill test or a radionuclide scan to check whether other areas of the heart are still at risk for another heart attack.

A heart attack is a medical emergency that needs care right away to prevent permanent heart damage or death. Treatment often begins in the ambulance if you called 911, or in the emergency room if someone else took you to the hospital.

What drugs are used to treat a heart attack?

At the emergency facility or hospital, you’ll quickly get drugs to prevent further blood clotting in the heart and ease the strain on the heart. Drug therapy aims to break up or prevent blood clots, stop platelets from collecting and sticking to the plaque, stabilize the plaque, and prevent more ischemia.

You should get these medications as soon as you can (within 1 or 2 hours from the start of your heart attack, if possible) to limit heart damage.

Drugs used during a heart attack may include:

• Aspirin to stop blood clotting that may make the heart attack worse
• Other antiplatelet drugs, such as clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) to stop clotting
• Thrombolytic therapy (“clot busters”) to dissolve blood clots in your heart’s arteries
• Any combination of these

Other drugs given during or after a heart attack help your heart work better, widen your blood vessels, lower your pain, and help you avoid life-threatening heart rhythms.

Are there other treatments for a heart attack?

Treatment may also include a procedure to open the blocked arteries.

Cardiac catheterization: In addition to making a picture of your arteries, cardiac catheterization can be used for procedures (such as angiography or stent) to open narrowed or blocked arteries.

Balloon angioplasty: This treatment can be done, if needed, during cardiac catheterization. A balloon-tipped catheter (thin, hollow tube) is inserted into the blocked artery in the heart. The balloon is inflated gently to press plaque outward against the walls of the artery, to open the artery and improve blood flow. Most of the time, this is not done without putting in a stent.

Stent placement: In this procedure, a small tube is inserted through a catheter into a blocked artery to “prop” it open. The stent is usually made of metal and is permanent. It can also be made of a material that your body absorbs over time. Some stents have medicine that helps keep the artery from getting blocked again.

Bypass surgery: You might have bypass surgery in the days after a heart attack to restore the blood supply to your heart. Your surgeon will reroute blood flow around your blocked artery, usually using a blood vessel from your leg or chest. They can bypass multiple arteries.

What happens in the coronary care unit (CCU)?

If you’ve had a heart attack, you’ll usually stay in a CCU for at least 24 to 36 hours. Once past the critical phase, you’ll continue to get a variety of drugs, including:

• Beta-blockers to slow the heart
• Nitrates to increase heart blood flow
• Blood thinners such as aspirin, Brilinta, clopidogrel, Effient, heparin, or Plavix to prevent further clotting
• ACE inhibitors to help the heart muscle heal
• Statins – cholesterol-lowering drugs such as atorvastatin and simvastatin – to help the heart muscle heal and lower the risk of another heart attack

While you’re in the hospital, medical staff will constantly monitor your heart by EKG in case you get unusual heart rhythms.

Some people may need to be fitted with a pacemaker, a battery-powered device to help keep a steady heart rhythm. If you have a dangerous arrhythmia known as ventricular fibrillation, medical providers will give an electric shock to your chest.

Treatments don’t cure coronary artery disease. You can still have another heart attack. But you can take steps to make it less likely.

The goal after your heart attack is to keep your heart healthy and lower your risk of having another heart attack. Take your medications as directed, make healthy lifestyle changes, see your doctor for regular heart checkups, and consider a cardiac rehabilitation program.

Why do I need to take medications after a heart attack?

You might take certain drugs after a heart attack to:

• Prevent blood clots
• Help your heart work better
• Prevent plaques by lowering cholesterol

You might take medications that treat an uneven heartbeat, lower your blood pressure, control chest pain, and treat heart failure.

Know the names of your medications, what they’re used for, and when you need to take them. Go over your medications with your doctor or nurse. Keep a list of all your medications, and take it to each of your doctor visits. If you have questions about them, ask your doctor or pharmacist.

It sounds obvious, but don’t skip your medications. Many people don’t take their medications the way their doctor told them to. Figure out what keeps you from taking your medicine – it could be side effects, cost, or forgetfulness – and ask your doctor for help.

What lifestyle changes are needed after a heart attack?

To keep heart disease from getting worse and to head off another heart attack, follow your doctor’s advice. You might need to change your lifestyle. Here are some changes you can make that can cut your risk and put you on the path to a healthier life:

Stop smoking: Smoking dramatically raises your risk of both heart attacks and strokes. Talk to your doctor about how to quit. You’ll also be doing your friends and family a favor, since secondhand smoke can also lead to heart disease. You also can call the hotline 800-QUIT-NOW (800-784-8669) and visit the smokefree.gov website.

Keep a healthy body weight: If you’re overweight or obese, you don’t have to get thin to reduce your risk for a heart attack or stroke, but your doctor may recommend some weight loss. If you lose 5% to 10% of your weight, you’ll improve your cholesterol numbers and lower your blood pressure and blood sugar levels.

Follow an exercise plan: Moderate physical activity lowers your chances of a heart attack. It also can reduce your blood pressure and LDL or “bad” cholesterol, raise your HDL or “good” cholesterol, and help you stay at a healthy weight.

Aim for 30 minutes of exercise that gets your heart pumping at least 5 days a week. Brisk walking or swimming are some good choices. On the other 2 days, do strength training, like lifting weights. If you’ve got a tight schedule, break your exercise routine into small chunks.

Eat a heart-healthy diet: Fill your plate with different kinds of fruits, veggies, beans, and lean meats, such as poultry without the skin. Also up your intake of whole grains, like oatmeal, quinoa, and brown rice, and of fish, especially those with omega-3 fatty acids, such as salmon, trout, and herring.

Avocados, olive oil, and flaxseeds also have omega-3s, as do some nuts and seeds. Fat-free or low-fat dairy products such as milk, yogurt, and cheese also are better choices for your heart health than higher-fat versions. 

Cut back on unhealthy foods: Stay away from processed or prepared foods that often are high in salt and added sugar. They’re also filled with preservatives. Avoid fatty beef, butter, fried foods, and palm oil. All are high in saturated fats.

Skip sugary drinks like sodas and fruit punch, which can lead to weight gain. So can packaged baked goods such as cookies, cakes, and pies. They are high in trans fats and can raise your cholesterol levels.

Limit alcohol: If you don’t drink already, don’t start. If you do drink, limit how much you drink. The recommendation is no more than one drink a day if you are a woman and no more than two a day if you are a man. Drinking raises your heart rate and blood pressure. It also raises the level of fat in your blood and can cause weight gain.

Get regular checks of your cholesterol, blood pressure, and blood sugar (glucose) levels: If you have diabetes, make sure it’s controlled. Keeping a check on these numbers can help you be more aware of the changes you need to make to keep these levels within normal limits.

Control stress: You may feel anxious or frustrated at times. Open up to your family and friends about what’s going on. Support groups can help you learn how others adjusted to life after a heart attack or stroke.

You may want to talk to a mental health professional or ask your doctor about a stress management program. You can also reduce stress with plenty of physical activity and mind-body practices like meditation.

Pay attention to your symptoms: Don’t just hope they’ll go away. See your doctor if you feel anything unusual, like shortness of breath, changes in your heart rhythm, or extreme tiredness. Also, watch for pain in your jaw or back, nausea or vomiting, sweating, or flu-like symptoms.

Why should I take part in cardiac rehabilitation?

If you’ve had a heart attack or have been diagnosed with heart disease, your doctor may recommend cardiac rehabilitation. You’ll work with a team of experts to boost your health and avoid future problems.

Your team may include doctors and nurses, as well as specialists in exercise, nutrition, physical therapy, occupational therapy, and mental health. They’ll set up a program to fit your needs. They can also help you make changes in your daily life. If you stick with it, it can make a big difference in your recovery and overall well-being.

When will I see my doctor again after I leave the hospital?

Make a doctor’s appointment for 4 to 6 weeks after you leave the hospital following a heart attack. Your doctor will want to check your recovery. You might need an exercise stress test on a regular basis. These tests can help your doctor find or slow blockages in your coronary arteries and plan your treatment.

Call your doctor if you have symptoms, such as chest pain that happens more often, gets stronger, lasts longer, or spreads to other areas; shortness of breath, especially while you’re resting; dizziness; or uneven heartbeats.

Cyclic vomiting syndrome – Symptoms & causes

Overview

Cyclic vomiting syndrome is characterized by episodes of severe vomiting that have no apparent cause. Episodes can last for hours or days and alternate with symptom-free periods. Episodes are similar, meaning that they tend to start at the same time of day, last the same length of time, and occur with the same symptoms and intensity.

Cyclic vomiting syndrome occurs in all age groups, though it often begins in children around 3 to 7 years old. Although it’s more common in children, the number of cases diagnosed in adults is increasing.

The syndrome is difficult to diagnose because vomiting is a symptom of many disorders. Treatment often involves lifestyle changes to help prevent the events that can trigger vomiting episodes. Medications, including anti-nausea and migraine therapies, may help lessen symptoms.

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Symptoms

The symptoms of cyclic vomiting syndrome often begin in the morning. Signs and symptoms include:

• Three or more recurrent episodes of vomiting that start around the same time and last for a similar length of time
• Varying intervals of generally normal health without nausea between episodes
• Intense nausea and sweating before an episode starts

Other signs and symptoms during a vomiting episode may include:

• Abdominal pain
• Diarrhea
• Dizziness
• Sensitivity to light
• Headache
• Retching or gagging

When to see a doctor

Call your doctor if you see blood in your or your child’s vomit.

Continued vomiting may cause severe dehydration that can be life-threatening. Call your doctor if you or your child is showing symptoms of dehydration, such as:

• Excess thirst or dry mouth
• Less urination
• Dry skin
• Sunken eyes or cheeks
• No tears when crying
• Exhaustion and listlessness

Causes

The underlying cause of cyclic vomiting syndrome is unknown. Some possible causes include genes, digestive difficulties, nervous system problems and hormone imbalances. Specific bouts of vomiting may be triggered by:

• Colds, allergies or sinus problems
• Emotional stress or excitement, especially in children
• Anxiety or panic attacks, especially in adults
• Certain foods and drinks, such as alcohol, caffeine, chocolate or cheese
• Overeating, eating right before going to bed or fasting
• Hot weather
• Physical exhaustion
• Exercising too much
• Menstruation
• Motion sickness

Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.

Risk factors

The relationship between migraines and cyclic vomiting syndrome isn’t clear. But many children with cyclic vomiting syndrome have a family history of migraines or have migraines themselves when they get older. In adults, cyclic vomiting syndrome is also associated with a personal or family history of migraines.

Chronic use of marijuana (Cannabis sativa) also has been associated with cyclic vomiting syndrome because some people use marijuana to relieve their nausea. However, chronic marijuana use can lead to a condition called cannabis hyperemesis syndrome, which typically leads to persistent vomiting without normal intervening periods. People with this syndrome often demonstrate frequent showering or bathing behavior.

Cannabis hyperemesis syndrome can be confused with cyclic vomiting syndrome. To rule out cannabis hyperemesis syndrome, you need to stop using marijuana for at least one to two weeks to see if vomiting lessens. If it doesn’t, your doctor will continue testing for cyclic vomiting syndrome.

Complications

Cyclic vomiting syndrome can cause these complications:

• Dehydration. Excessive vomiting causes the body to lose water quickly. Severe cases of dehydration may need to be treated in the hospital.
• Injury to the food tube. The stomach acid that comes up with the vomit can damage the tube that connects the mouth and stomach (esophagus). Sometimes the esophagus becomes so irritated it bleeds.
• Tooth decay. The acid in vomit can corrode tooth enamel.

Prevention

Many people know what triggers their cyclic vomiting episodes. Avoiding those triggers can reduce the frequency of episodes. While you may feel well between episodes, it’s very important to take medications as prescribed by your doctor.

If episodes occur more than once a month or require hospitalization, your doctor may recommend preventive medicine, such as amitriptyline, propranolol (Inderal), cyproheptadine and topiramate.

Lifestyle changes also may help, including:

• Getting adequate sleep
• For children, downplaying the importance of upcoming events because excitement can be a trigger
• Avoiding trigger foods, such as alcohol, caffeine, cheese and chocolate
• Eating small meals and low-fat snacks daily at regular times

Nausea and Vomiting – KDLmed

Nausea is a painful sensation in the stomach and throat that may be accompanied by weakness, increased salivation, sweating and often precedes vomiting.

Vomiting is a sudden involuntary emptying of the stomach.

Nausea and vomiting are symptoms of many diseases and conditions, from pregnancy to serious pathologies such as brain tumors, epilepsy and myocardial infarction.

In most cases, nausea and vomiting are not harmful to the body. However, prolonged vomiting, often in combination with diarrhea, can lead to severe dehydration and, as a result, disruption of the cardiovascular system, brain, kidneys and other organs. This is especially true for young children, who themselves cannot control the manifestations of dehydration. Pregnant women may experience so-called excessive vomiting of pregnant women, which disrupts the balance of electrolytes in the blood and threatens the life of the mother and fetus.

There are medicines available that can reduce nausea. However, in any case, it is necessary to find out its cause.

English synonyms

Nausea, emesis, vomiting, vomitus, distaste, sickness, retching, bdelygmia.

Symptoms

The duration of nausea and vomiting, the timing of their onset, and the effect of eating on them depend on their underlying cause. For example, nausea and / or vomiting almost immediately after eating may indicate gastritis (inflammation of the gastric mucosa), within 1-8 hours after eating – poisoning.

Prolonged vomiting may cause signs of dehydration:

• dry mouth;
• thirst;
• sunken eyes;
• infrequent urination, decreased amount of urine, dark urine;
• in children, the fontanel can sink in – a soft area at the junction of the child’s cranial bones, which normally closes by 12-18 months of age.

There are also a number of symptoms that are signs of dangerous, life-threatening conditions and require immediate medical attention:

• admixture of blood in vomit;
• severe headache, confusion, impaired consciousness;
• abdominal pain;
• signs of dehydration;
• shortness of breath;
• Vomiting that lasts longer than a day (for children, if it lasts for several hours, especially in combination with diarrhea and fever).

Most often, vomiting and nausea resolve within 6-24 hours. If these symptoms recur within a week and if you suspect a possible pregnancy, you should also seek medical advice.

General information about the disease

Nausea occurs when there is a decrease or absence of gastric peristalsis with simultaneous tension of the initial part of the intestine – the duodenum, which is accompanied by the reflux of part of the contents of the duodenum into the stomach. With vomiting, there is a strong contraction of the diaphragm and muscles of the anterior abdominal wall, holding the breath and a sharp release of the contents of the stomach into the esophagus and further into the oral cavity. This may be accompanied by increased salivation, sweating, weakness, dizziness.

Specific centers in the brain are responsible for the occurrence of nausea and vomiting, which receive information from the organs of the gastrointestinal tract, vestibular apparatus, other parts of the brain, kidneys, and also react to the chemical composition of the blood, including toxins, drugs , metabolic products. These centers trigger and control the activity of the muscles involved in nausea and vomiting.

Causes of nausea and vomiting may be as follows.

• Irritation of the gastric mucosa. In this case, nausea and vomiting are protective reactions of the body aimed at eliminating the damaging agent.
• Intestinal infections – rotavirus, salmonellosis, botulism, dysentery, etc. – in addition to nausea and vomiting, are accompanied by pain in the abdomen, fever. The most common infection is rotavirus. It is especially common among children attending kindergartens and nurseries, and occurs with nausea, vomiting, diarrhea, which usually lasts 1-2 days. After the disease, immunity is formed.
• Food poisoning. In this case, vomiting occurs within a few hours after eating.
• Gastric ulcer – damage to a section of the gastric mucosa due to the action of gastric juice. May be accompanied by belching, heartburn, abdominal pain.
• Gastroesophageal reflux disease is a chronic disease in which there is a regular reflux of stomach contents into the esophagus with damage to the mucous membrane of the esophagus by acidic gastric juice.
• Irritation of the stomach by other substances: alcohol, nicotine, aspirin.
• Effects on the central nervous system and vestibular apparatus. In this case, nausea and vomiting are caused by irritation of certain centers of the brain.
• An increase in intracranial pressure in brain injuries, tumors, infections (meningitis, encephalitis) may be accompanied by nausea and vomiting.
• Stimulation of the vestibular apparatus. It includes labyrinthitis (inflammation of the inner ear), motion sickness in transport, and other diseases and conditions in which excessive irritation of the balance organ occurs.
• Headache, especially in migraine. Migraine is a neurological disease characterized by severe headache, usually on one side, which may be exacerbated by bright lights or loud noises and accompanied by nausea and vomiting.
• Sunstroke. A condition that occurs when the head is exposed to the sun for a long time. Often found in children. May be accompanied by lethargy, weakness, nausea, vomiting, pallor, disorientation, loss of consciousness.
• Diseases of other organs – diabetes mellitus, urolithiasis, hepatitis, pancreatitis, certain malignant neoplasms, mental illness (depression, anorexia, bulimia) and other diseases.
• Medicinal products used in the treatment of oncological diseases, radiation therapy.
• Pregnancy (first trimester).
• In children under one year old, vomiting may be a sign of pyloric stenosis, intestinal intussusception, and often accompanies viral diseases (influenza, SARS). Pyloric stenosis is a narrowing or complete obstruction of the opening between the stomach and the duodenum. Intestinal intussusception is a condition in which a segment of the intestine is embedded in the lumen of an adjacent section of the intestine, which leads to the development of intestinal obstruction.

In adults, the most common causes of vomiting and nausea are intestinal infections, food poisoning, motion sickness; in children, intestinal infections, food poisoning, overeating, as well as a severe cough and any illness with a high fever.

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