Thursday, August 8, 2013

Before Your Heart Attack
8 Potential Predictors of Future Cardiovascular Disaster

In the months, and perhaps years, leading to a heart attack there are signs your heart health may be headed down the wrong road.

1. Erectile dysfunction (ED)

Erectile dysfunctional men aged 40-49 are twice as likely to develop heart disease.
The retrospective Cologne study found two out of three men treated for cardiovascular disease had suffered from erectile dysfunction, usually for years, before being diagnosed with heart disease.
Narrowing and hardening of arteries leads to decreased flow to the penis. As these are smaller arteries than those at the heart, they may show signs of disease early.
What do these  have in common:  Obesity, Smoking, High Blood Pressure, Diabetes, High Cholesterol, Lack of Exercise?
They are all risk factors for both ED and heart disease.

Side note: Depression is linked to high cortisol levels. This raises blood pressure and heart rate and could lead to heart disease. Heart disease correlates to ED. Depression correlates to ED and heart disease.

2. Snoring and Sleep Apnea

Plus he gets a video of the entire night!

Snoring is caused by airway obstruction. In sleep apnea breathing actually stops briefly.
Either way, less oxygen to the blood means less oxygen to the heart.
Have severe sleep apnea? You are three times as likely to die of a heart attack within 5 years.

3. Swollen legs/feet

When you remove your socks does your calf look like it's been strangled by argyle?
Swelling from fluid retention (Edema, or oedema to our Brit cousins. Ain't American English grand?) in regard to heart disease occurs because a) the heart is not pumping strongly, b) the feet are furthest from the heart, and c) the fluids that should be carried away pool.
There are many causes of edematous extremities from clots to medications.
What's causing yours?

Bonus: A simple test shows whether your leg circulation is adequate. This is of particular interest in diabetes.

4. Gum disease

Looks like novelty store hillbilly teeth.
Is poor circulation a cause of gum disease, or does gum disease allow infection leading to heart disease?
Either way it's a curious sign of potential heart trouble to come.

5. Arrhythmia-- Irregular heart beat

Your heart is racing or plodding, pounding, or skipping beats.
Coronary artery disease  is the main cause of arrhythmia, and the leading cause of death in the US. (Sleep apnea is also a cause of arrhythmia.)
As blood vessels narrow the heart receives less blood flow, weakens, and an electrical system failure occurs resulting in irregular contractions.

6. Angina-- Weight on your chest

Frank Henry Netter: The superlative medical illustrator.

Angina is a temporary decrease of blood to the heart. It is triggered by exertion and relieved by rest.
It is usually a symptom of coronary artery disease.
Angina feels like a chest constriction or pressure. It can also feel like indigestion or pain in the jaw, neck, upper back, or  arm.

7. Dyspnea--Shortness of Breath


Shortness of breath in heart disease occurs because the heart can't properly fill and empty. This causes increased pressure on blood vessels of the lung.
A doctor once told me he uses spirometry because it is an excellent baseline indicator of health.
That sentiment is borne out here with the sentence, "shortness of breath was a significant predictor of death from cardiac causes, as well as death from any cause." And here, "Vital capacity is a predictor of death from respiratory and cardiac disease and abnormal spirometry is associated with an increase in 'all-cause' mortality."

8. Insomnia

Watch the clock. That always helps.

During the weeks before a heart attack patients report unexplained bouts of insomnia.
Is it the stress of chronically poor sleep that leads to high blood pressure and increased heart rate?
A recent study of 54,000 makes the connection here, though no one is going out on the cause and effect limb yet.

ED gets smirks and snickers. But it is serious business. With that in mind...

A man goes to his family doctor to get a Viagara prescription. Doctor says, "You're fifty pounds over weight,  have high blood pressure, diabetes, and angioplasty last year.
I'm not going to give you Viagara!
That would be like putting a new flagpole on a condemned building!"

Argentina best look out for their condemned buildings.

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