A New Definition Of Heart Attack

  • Posted by a hidden member.
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    Oct 28, 2010 10:48 PM GMT
    So OK, I sat at my hubby's hospital bedside yesterday, and heard his doctor (who is mine too) tell him he had a heart attack.

    And today he was back at his office, the day after he was discharged from the hospital. So what's that all about?

    I don't understand this. I thought when you had a heart attack you were like laid up for months. And he's back at his desk the day after his release?

    I've been on the phone with a number of RJ members here, including one who had a heart attack himself. And I fail to understand this. I want my hubby to be in bed, and doing nothing. He's doing nothing of the sort. He's like all active & involved.

    Am I that stupid & behind the times? Evidently I am. I thought when you had a heart attack it was a major event. I'm being told it's just like having a cold.

    I'm sorry, but I'm not about to accept that view. I dunno, I'm all confused, I don't know what to think anymore. icon_confused.gif
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    Oct 28, 2010 11:02 PM GMT
    A cardiac event is now usually defined as whatever that causes a significant rise in cardiac enzymes (CK, CK-MB and troponin I or troponin T). Now, "significant" means differently to different people.

    You're probably thinking of what people usually think of when they say heart attack, i.e. one that presents with substernal crushing chest pain, radiating to the L arm. We know now that a significant number of patients (including some women and diabetics) will not have this classic pattern. Some present with even worse symptoms (cardiogenic shock, arrhythmias).

    A new LBBB is always abnormal, but it will make detection of an ongoing MI more difficult (because it masks some of the usual EKG findings that are used to tell that an MI is happening). Also, nearly half of patients with LBBB have no chest pain.
    http://content.onlinejacc.org/cgi/content/full/36/3/706

    So if I were to hazard a guess, your partner had an infarct that involved the septum and involved either the LAD or a major branch of it. So you're most definitely right--it is a major event. And he should be prescribed all the right medications (beta blockers, ace inhibitors, aspirin, plavix if he had stenting, and statins).
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    Oct 29, 2010 1:19 AM GMT
    As for not being in bed, your bf--sorry, hubby--might be right and ahead of the curve:

    http://en.wikipedia.org/wiki/Cardiac_rehab
    Participation in cardiac rehabilitation is associated with a 25% decrease in overall mortality over 3 years so when one is asked "is it safe for patients with cardiac disease to exercise ?" an appropriate response would be "it is not safe for cardiac patients NOT to exercise" (after appropriate medical evaluation).

    Cardiac rehabilitation is carried out in three to four phases. Phase 1 is in-hospital and involves nutritional, psychological and physical advice under the guidance of a cardiac rehabilitation consultant. Phase 2 of rehabilitation is the crucial early outpatient phase where the patient undertakes long-term behavioral change incorporating exercise and healthy nutrition into their lives. Medications are also prescribed to meet risk factor goals. Phases 3 and 4 cardiac rehabilitation are long-term maintenance programs that should not be minimized as benefits are maintained only with long-term adherence.
  • CuriousJockAZ

    Posts: 19137

    Oct 29, 2010 1:23 AM GMT
    I would count your blessings that the hubby has the energy and desire to be back at the office so soon. I'm not a doctor, but I would think that this is a really good sign. Staying active is so key to staying healthy. Sometimes you just have to listen to your body, and if his is telling him he's well enough to be back at the office and out and about -- that's awesome!
  • LJay

    Posts: 11612

    Oct 29, 2010 1:32 AM GMT
    As for alpha soup above, I dunno. I do know that "heart attack" is a terms that covers a lot of territory. Maybe it would be best if you would both sit down with the doctor and have a talk about what to do after this event. Doing it together will make it easier to sort out differences of interpretation on the spot.

    It is really good to hear that he is making good progress. Normal days are quite a gift!
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    Oct 29, 2010 1:41 AM GMT
    Bob

    Your head must be reeling. You and your partner have been through a lot over the past several days. On top of it all, you now seem to be confronted with trying to digest the ins and outs of treatment for cardiac issues.

    I can sympathize as I have been working with my cardiologist for the past couple of weeks to look into stable angina that has become unstable recently. It looks like I will have a cardiac catheterization in the next week or so to figure out whether I have occlusions in one or more of my cardiac arteries. My last experience with anything like this was when my dad went through this 20+ years ago.

    Back then a heart attack meant bypass surgery and several weeks of recuperation. Now my situation is unusual in that it look like it will take a relatively invasive procedure like catheterization to figure out what's going on. (In many cases non invasive imaging studies can get diagnosis nailed down.) In any case, if a problem is detected, then we are looking probably at correction via angioplasty, which would mean a couple of days in the hospital and a return to normal activities in days.

    Even if bypass surgery is required, it is now routinely done via scope without use of a heat and lung machine.

    Bottom line: heart problems are best avoided, but, if you have to deal with them, it appears to be very much less traumatic than it used to be.

    I hope you and your partner can get some rest and enjoy some time together.

    Peace

    David
  • JHunter

    Posts: 41

    Oct 29, 2010 1:54 AM GMT
    Art_Deco I am glad to hear that your hubby is out of the hospital and it sounds like he is doing great. Now this is coming from a nurse and not a doctor so please take it as such but I work in the Cardiothoracic Intensive Care unit so I do have experience with MIs, angioplasty, bypass surgery and valve replacements and I can tell you times have definitely changed. People used to be in bed for weeks after open heart surgery and now we have them out of bed and walking the first day after surgery. In general our patients that have myocardial infarctions (heart attacks) are encouraged to be active shortly after the event. Now this is to a lesser extent, I'm not talking strenuous exercise, but walking and moving about is not a bad thing. This is assuming that there heart rate and blood pressure are stabalized. Strict medication regimes are important and if your not sure why a certain medication is prescribed make sure you ask, that is what the doctors are for. Specifically at our hospital we have found that patients that are more active and motivated after these events tend to do better in the long run when we seem them as outpatients. Just make sure that he isint pushing it too hard and you can always ask your doctor what activities he should avoid. Hope he continues to improve. icon_smile.gif
  • Posted by a hidden member.
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    Oct 29, 2010 3:49 PM GMT
    I'm surprised you haven't at the least been given diet and exercise advise, clearly he has heart disease. Maybe check out the American Heart Association, you can get expert advise there.
    Best wishes.
  • neosyllogy

    Posts: 1714

    Oct 29, 2010 4:14 PM GMT
    Um.... what did the doctor say?
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    Oct 29, 2010 4:17 PM GMT
    q1w2e3 said
    Cardiac rehabilitation is carried out in three to four phases. Phase 1 is in-hospital and involves nutritional, psychological and physical advice under the guidance of a cardiac rehabilitation consultant. Phase 2 of rehabilitation is the crucial early outpatient phase where the patient undertakes long-term behavioral change incorporating exercise and healthy nutrition into their lives. Medications are also prescribed to meet risk factor goals. Phases 3 and 4 cardiac rehabilitation are long-term maintenance programs that should not be minimized as benefits are maintained only with long-term adherence.
    After experiencing a LAD MI.. I am now in the beginning of phase 3.. whew......... Im gonna be 20 something again by the time I'm done with it! LOL