Heart attacks: prevention and screening
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“Smoking, even a small amount, is the main risk factor for a heart attack,” stated Antonio Esteban, head of cardiology at Quirónsalud Málaga. Esteban explained that it is crucial to treat a heart attack as soon as possible and pointed out that women may have atypical symptoms, which can result in a delayed diagnosis. “Women often experience heart attack symptoms that are unusual, which can lead to a delayed diagnosis,” he said.
-Does the body give warning signs before a heart attack?
-The classic symptoms of a heart attack include a feeling of chest tightness, like a heavy weight on the chest that radiates to the neck and wrists, cold sweats, nausea and intense discomfort. However, the symptoms in women can often be less obvious or more subtle. Women may experience sudden shortness of breath, vague discomfort, dizziness or tightness in the jaw and wrists. These symptoms are often less recognisable as a heart attack and can vary significantly from person to person. Chest pain, for example, is less common in women, who may instead experience difficulty breathing and a general feeling of unwellness. As a result of this, the heart attack may be diagnosed later in women, which can worsen the prognosis if treatment is delayed.
-How do these symptoms differ from a panic attack?
- There are other conditions that can cause similar symptoms. Digestive issues, for example, may lead to a feeling of pressure from a spasm in the oesophagus and similar discomforts can occur in cases of asthma or anxiety. In order to get an accurate diagnosis, it's essential to seek medical attention at a hospital. In a young person without any cardiovascular risk factors, the likelihood of having a heart attack is low. However, in a 65-year old man who smokes, has high blood pressure and is diabetic, the risk is significantly higher.
-From most to least significant, what are the risk factors?
-The main risk factor for a heart attack is smoking, which is particularly worrying in young people who have become less cautious about it. It's important to realise that the risk increases with even just one cigarette. Some patients tell me they don't smoke much, but that's like saying, "I only take a tiny dose of poison." It doesn't matter- any amount of smoking is a cardiovascular risk. Of course, the more you smoke, the higher the risk. After smoking, being overweight or obese are the next major factors, often linked to other risks like type 2 diabetes, high blood pressure and high cholesterol.
- What should the cholestrol levels be for a healthy person compared to someone who has had a heart attack?"
-It is very important to differentiate between a healthy person and someone who has had a heart attack. Sometimes patients worry if their cholesterol is over 200, but it's important to understand the balance between "good" and "bad" cholesterol. A HDL (good cholesterol) level of 110 is considered excellent , but even if the total cholesterol is 210, it can still indicate a healthy cholesterol profile. The key is to focus on LDL (bad cholesterol), which should be around 100 for healthy individuals. However, for those who have aleady experienced a cardiovascular event- such as a heart attack, stroke or angina- LDL should be reduced to around 55 to reduce the risk of further complications.
-How can we increase good cholesterol?
-Having a Mediterranean diet, rich in pulses, vegetables, fruit and fish, is key, as well as maintaining a healthy weight and regular physical activity. A brisk walk for an hour every day at a pace that is comfortable for breathing, but would make it difficult to hold a conversation is sufficient. Remember that walking is not the same as strolling; a certain level of intensity is required.
-Are there other factors that increase cardiac risk?
-The most important factor in treating a heart attack is addressing it as quickly as possible. A heart attack occurs when a cholesterol plaque ruptures, causing a blood clot that blocks the artery. It is essential to reopen the artery and restore blood flow, as the heart cells dependent on it will die if not treated promptly. This is done in the catheterisation lab using primary angioplasty, where a catheter is inserted through the radial artery to reach the blocked area in the heart. With dilation techniques, the artery is opened as swiftly as possible. The faster the treatment, the more heart cells are saved, improving the patient's prognosis. Quirónsalud Malaga is the only private centre in Andalucía with two catheterisation labs.
Current technology allows doctors to remotely montior patients with pacemakers or defibrilators and receive real-time information at the hospital. If any issues are detected, they can contact the patients immediately and ask them to come in.
-What are the best sports for heart health?
- The best sports for heart health are aerobic activities:walking, running, swimming and cycling. High-intensity weight training excersizes can increase muscle mass but they also raise blood pressure. The ideal approach would be to combine both, but with light or moderate weights.
- When should you have a heart check-up?
-In young people without symptoms, a heart check up is not necessary. However, if there are cardiovascular risk factors, it is important to see a cardiologist for an assesment and, if there are no problems, repeat it every five years. For recreational athletes, cardiologists are most concerned about those who have led an inactive lifestyle in their younger years and then suddenly start running marathons in their 40s. These individuals, as well as any of those engaging in high-intensity sports, should have a check-up. A sports cardiology unit can provide guidance on the types of exercise that are safe for them. In sport, it is not all about intensity- what matters is being consistent.
-How do difficult times, stress and heartbreak affect the heart?
-Stress can trigger existing health conditions, not just in the heart but also in the immune system. It increases the risk of cardiovascular problems by raising blood pressure and contributing to inflamnation. Managaing stress is crucial for heart health. Heartbreak, being a form of emotional stress, can also have a negative impact on the heart, potentially leading to a condition known as "broken heart syndrome," where the heart temporarily weakens due to extreme emotional strain.
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