6 HEART HEALTH | 2019 | www.elitecme.com sodes of crushing chest pain or shortness of breath. This would be even more imperative for patients that presented with positive con- trollable risk factors for heart disease, which could include obesity, smoking, hypertension (untreated or uncontrolled), physical inactiv- ity, elevated cholesterol (untreated or uncon- trolled), and chronic stress. Women with heart disease may have symp- toms of a heart attack that are much harder to identify. Women need to be encouraged to be suspicious of any episodes of extreme exhaus- tion or shortness of breath that has a sudden onset, or pain that might occur in either arm, or in the jaw. Nausea or flu-like symptoms could also disguise a heart attack, as well as symptoms of dizziness or lightheadedness. Heavy sweating or a feeling of pressure across the chest could also occur.1 Whenever symptoms occur with either sex, time is of the absolute essence. About 40 per- centofheartattackvictimsnevermakeittothe hospital.Almost120,000peoplediefromheart attacks each year because they didn’t call 911, or they chose to have a family member drive them to the hospital. Even worse, they drove themselves! Calling 911 ensures that a hospital with lifesaving equipment comes to you rather than the other way around. Every minute that a defibrillator gets closer to someone having a heart attack means that the patient has a better chance of having a good outcome.3 If you are with someone who suspects they might be having a heart attack, don’t drive them to the hospital. Call 911. While waiting for the paramedics to arrive, have the patient chew a non-enteric-coated aspirin. The aspirin may limit myocardial damage, but it won’t stop the actual heart attack. Keep calm until para- medics arrive. 3 For people that survive a first heart attack (and/or heart intervention) they have the best quality of life by changing aspects of their life- style that could potentially lead to a second attack. During a hospital stay for myocardial infarction, tests are performed to determine how much tissue damage was sustained during the attack, and what medications would be needed to optimize whatever CVD and risk factors remained. Cardiac Rehabilitation is almost always prescribed for patients when they begin to be more ambulatory. Returning home after a heart attack is frightening for almost all patients, but the big- gest fear is “will I have another heart attack?” Patients need to be encouraged to commu- nicate their fears with family and especially with their physician. They may feel weak or tired initially, but they should be encouraged to dress each day and engage in walking and simple activities. The heart muscle takes about two months to heal, during which time they will gradually gain strength and begin to feel normal.4 Any chest pain during this time is abnor- mal, and should be promptly reported, even if just a twinge. Generic questions along the road to nor- malcy are best answered by the patient’s physician or Cardiac Rehabilitation nurses. Patients have returned to work as early as two weeks to two months after suffering a heart attack, but almost all survivors should expect to be on medication and a heart healthy diet. Approximately 25 percent of patients feel depressed, angry, or afraid after surviving a heart attack, but they admit these feelings begin to lift after returning to more normal activities, especially during the camaraderie they feel in Cardiac Rehabilitation.5 Cardiac Rehabilitation is a medically super- vised program prescribed by the patient’s doctor. The program focuses on exercise coun- seling and training, as well as education for healthier living after a heart attack or heart intervention such as angioplasty, stenting, or bypassgrafting.Classesincludemanagementof risk factors, including smoking cessation, stress management, and increased exercise tolerance. Patients find the active partnership of Rehab to be a blessing, a location for meeting people with similar diagnoses while being supervised through an active program that eases them back to an improved functional status. 5 A heart-healthy diet will also be an import- ant part of the survivor’s lifestyle for them to remain in optimal health. They may be placed Patients need to be encouraged to communicate their fears with family and especially with their physician. They may feel weak or tired initially, but they should be encouraged to dress each day and engage in walking and simple activities. COVER STORY  |