How to save a heart

When it comes to troubles of the heart, romance may be the least of our worries.

According to statistics from the Heart and Stroke Foundation, more than 70,000 Canadians suffer a heart attack each year, but an estimated 19,000 people don’t survive the experience. Another 35,000 to 45,000 Canadians die of cardiac arrest — many because they don’t get the immediate emergency attention they need. Heart disease is a top cause of death, and the number one killer of Canadian women.

If those numbers sound bleak, there is good news. Better education, healthier lifestyles and greater awareness of the warning signs and preventative measures are helping to save lives. In fact, the incidence of heart disease and stroke have been steadily declining for the last 50 years — by 70 per cent since 1956.

Here are three things you should know to protect your heart:

#1 Live a heart-healthy lifestyle

The majority of Canadians have at least one risk factor for heart disease. You can’t control your age, sex, family history or ethnic background, but you can do something about other common risk factors. It’s all about those lifestyle choices you make everyday.

Alcohol: Moderation is key because too much alcohol increases blood pressure and likewise your risk for heart disease and stroke. Some studies suggest that a daily glass of red wine is good for your heart.

Smoking: There’s no such thing as moderation here, and health experts recommend kicking the habit and avoiding smoky environments. Even second and third-hand smoke poses a risk, especially to children.

Diet: Eating right is essential to avoiding two major risk factors, diabetes and being overweight. What should we eat? Plenty of whole grains, plenty of fruits and vegetables, lean meats and fatty fish like salmon. Foods that are high in fat, high in sodium and overly processed are okay once in a while. (See Six keys to healthy eating for more information.)

Physical activity: Exercise is essential for preventing many diseases, but how much is enough for your heart? For adults, the current recommendation is 30 minutes per day, most days of the week. For children, 60 minutes most days is ideal. (For some ideas to get you started, see Planning a heart-smart exercise program.)

Regular screenings: Do you know what your blood pressure is? Cholesterol levels? BMI, or waist-to-hip ratio? Being ignorant of these numbers and skipping regular check-ups can put your health at risk. When you know something is “off”, you can take steps to correct the issue before you wind up in serious trouble. (See Risky Business for the details.)

In addition, talk to your doctor about any precautions you should be taking, such as a daily dose of acetylsalicylic acid (ASA).

It may be a cliché, but you know what they say about an ounce of prevention… Or take the advice of Dr. Akbar Panju, Division Director of General Internal Medicine at Hamilton’s McMaster University: “Either find the time, or you’ll run out of time — permanently .”

#2 Learn how to recognize the warning signs

Can you tell if you or someone you know is having a heart attack or going into cardiac arrest? Here’s what to look for:

Heart attack: Essentially, heart attacks happen when something slows down or blocks blood flow to the heart. Ignore what you’ve seen in the movies or on TV of the chest-clutching pain because it doesn’t always happen that way. Symptoms of a heart attack include:

– Chest discomfort: it could be squeezing pain, but it could also feel like a pressure, heaviness, tightness or fullness. It could be brought on by exerting yourself, and go away when you’re resting.

– Pain and discomfort in one or both arms, your jaw, back, neck, stomach or teeth.

– Unexplained shortness of breath or difficulty breathing.

– Cold sweats or cool, clammy skin.

– Anxiety or denial.

– Nausea, vomiting or indigestion.

– Light-headedness or unexplained fatigue.

In women, these symptoms may be more subtle but the Heart Foundation notes that the most common symptom is still chest pain. In any case, if you’re not sure whether it’s a heart attack or something else it’s best to err on the side of caution. Don’t shy away from “causing a fuss” or inconveniencing anyone. Your friends and family would rather hear “good news, it wasn’t a heart attack” than the alternative.

Cardiac arrest: Not to be confused with a heart attack, it’s when the heart stops beating and a person stops breathing. The majority of cardiac arrests occur outside of a hospital, so don’t expect any alarm bells. Instead, the warning signs include:

– A lack of response (even when the person is called or tapped on the shoulder).

– Loss of consciousness.

– Loss of blood pressure (you can’t find a pulse).

– There are no signs of breathing.

Without immediate help, a person experiencing cardiac arrest will die within minutes.

#3 Know what to do in an emergency

Every minute counts, and the sooner someone gets help the better the outcome will be. Survival rates increase dramatically when bystanders know what to do — even if they aren’t trained experts.

Regardless of the emergency, the first thing you should do is call 9-1-1 or your local emergency number (or get someone to call for you). It’s important to get trained emergency medical personnel on the scene as quickly as possible. Unless there is no other choice (such as no way to reach emergency services), do not drive yourself or the victim to the hospital.

If you think you’re having a heart attack:

– Stop what you’re doing and rest. Sit or lie down, depending on which position is most comfortable.

– If you’re on nitroglycerin, take your normal dosage.

– If you’re experiencing chest pain, chew and swallow one 325 mg tablet or two 80 mg tablets of ASA. Keep some on hand in your medicine cabinet because other pain medications like acetaminophen or ibuprofen won’t help as they act differently. (Note: do not take ASA for a stroke — the stroke could be caused by a ruptured vessel, and ASA could make things worse.)

– Rest and wait for the ambulance to arrive.

You may have seen an email advising you to keep coughing if you’re alone, but the Heart and Stroke Foundation warns that this “life-saving Cough CPR” is a myth, and people shouldn’t pass along this information.

(To keep this information handy, print off a copy of the Heart and Stroke Foundation’s Emergency Wallet Card or Emergency signs, signals, actions — for life brochure.)

If you witness someone having a cardiac arrest:

After calling 9-1-1,

– Send someone to get an AED if one is available, and use it as soon as you can. The device will detect irregular heart rhythms and administer a “shock” automatically. It’s designed to be used by laypeople, so don’t wait until the ambulance arrives. The AED will only work if there’s still something to work with — it can’t revive someone who has “flatlined”.

– Immediately start CPR if you know how.

– If you don’t know CPR, begin Hands-Only CPR by pushing hard and fast on the centre of the chest (aim for a rate of 100 compressions per minute). (See CPR: What you need to know to save a life for details.)

– Continue CPR or Hands-Only CPR until a medical professional can take over. It’s important to keep blood flowing to vital organs like the brain.

It’s important not to hesitate: roughly 95 per cent of people who have a cardiac arrest outside of a hospital will die despite the fact that many of them are with a friend, family or co-worker at the time. Part of the reason is that bystanders don’t react — either because they don’t know what to do or they don’t have confidence in their skills. However, the sooner CPR and an AED are used, the better the chances.

A word of caution: Hands-Only CPR is only recommended for adults where the cardiac arrest was witnessed and not due to a respiratory cause like drowning, electrocution or a drug overdose. When you don’t know what happened — or if the victim is a child or infant — conventional CPR is needed to ensure the body gets oxygen. (For more information, see the Heart and Stroke Foundations’s The 2010 Guidelines for CPR and Emergency Cardiovascular Care.)

Ultimately, it’s important to learn how to recognize trouble and how to respond, but we’d rather avoid the danger in the first place. To save a heart you’ll need to do more than just keep up with the latest news, research and guidelines: you have to be willing to do something about them. You may not see immediate results, but it’s worth the investment of your time and energy.

The American Heart Association
The Canadian Heart and Stroke Foundation
Mayo Clinic Heart Disease Center
WebMD Heart Health Center

Photo © Lisa F. Young

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