Know the warning signs of these cardiovascular killers—and what to do if one of them strikes.

Heart attacks and strokes rank first and third, respectively, as causes of death each year among Americans. But the good news is that doctors now know far more than they once did about treating them effectively. Time can be critical, and quick action can save your life.

A heart attack—or myocardial infarction—is an injury to the heart muscle. It occurs when a blood clot forms in an artery that supplies blood to the heart, usually because fatty deposits have built up in the artery and blocked it. Starved for the oxygen it gets from blood, heart muscle starts to die. Severe chest pain can result, and help should be called for as soon as warning signs appear.

Think of a stroke as a brain attack. It, too, involves a disruption of blood supply. About 80 percent of strokes are ischemic, in which a blood vessel in the head or neck is blocked. In another kind, hemorrhagic, the vessel ruptures or leaks. Either way, brain cells are deprived of oxygen and begin to die.

You should know the warning signs of both heart attack and stroke, so that if one of them strikes you or a companion, you won’t lose precious time. The warning signs of a heart attack are:

• uncomfortable pressure, fullness or squeezing pain in the chest, lasting more than a few minutes
• pain spreading to shoulders, neck, arms or jaw
• light-headedness, fainting, sweating, nausea or shortness of breath

Joseph Marek, M.D., of Midwest Heart Specialists and director of cardiology at Advocate Good Samaritan Hospital in Downers Grove, says too many seniors chalk up one or more of these symptoms to indigestion or fatigue. Understandably, they want to avoid the embarrassment of a false alarm. But such delays can be deadly. Sixty percent of all heart fatalities occur during the first hour after onset of symptoms.

What should you do if the warning signs appear? “The best thing would be to call a doctor,” Dr. Marek says. But if a doctor cannot be reached quickly, he adds, call 911 for emergency help. Describe your condition and your location clearly, and don’t hang up until the dispatcher tells you to.

If the patient is a companion, loosen his or her clothing where it is tight (usually around the neck and waist). Help the patient into the least painful position. Do not give him or her anything to eat or drink, but do administer aspirin if the patient is conscious—and nitroglycerin if it is available, following the prescribed dosage closely. Try to be calm and reassuring.

Not for men only
Heart attacks strike both sexes, but surveys show that women underestimate their chances of having one. A recent study found that 62 percent of women named cancer as the greatest threat to their health, while only 10 percent named cardiovascular disease. In 1998, however, heart attacks and strokes killed 503,927 women, nearly twice the number killed by all types of cancer.

Warning signs can differ by gender, says Dr. Marek. “Women tend to have more nausea and more arm pains,” he says. “Generally, they don’t have the classic elephant-sitting-on-your-chest sensations that men experience.”

Women who have heart attacks do not respond as well as men to lifesaving drugs that open blocked arteries, in part because their arteries are smaller. They are also more likely to die within a year of the first heart attack.

Similarly, women who experience strokes are more likely to die from them than are men—even though the overall incidence of strokes is about 25 percent higher in men.

Silent killer?
Strokes have been called “the silent killer” because they often come without warning. However, Arthur Itkin, M.D., neurologist at Advocate Christ Medical Center in Oak Lawn, explains that for many patients there is a warning. It’s called a transient ischemic attack, or TIA. A TIA is marked by the same symptoms as a stroke, but its effects are reversible, and symptoms go away in a few minutes.

The warning signs of a stroke or TIA are:

• sudden weakness, numbness or tingling in the face, arm and leg on one side of the body
• loss of speech, garbled speech or trouble talking or understanding others
• loss of vision, as if a shade has been drawn over one eye
• sudden dizziness or loss of balance
• sudden severe headaches

The clot-busting agents used to treat stroke can only be administered in the first three hours after onset. So if you think you or a companion is having a stroke, don’t delay. Call 911 or proceed to the nearest hospital emergency room.

Even if you had these symptoms for only a short time and they went away, you should place an urgent call to your doctor and report them.

“Getting help quickly is just as vital for stroke symptoms as it is for chest pain,” warns Dr. Itkin. “If the condition is not promptly investigated, results can be devastating.”

Protect yourself
“While we have very good treatments for stroke and heart attack,” says Dr. Marek, “the best thing we can do is prevent them. People need to take control.”

Exercise, choose a diet low in fat and high in fruits and vegetables, don’t drink alcohol to excess or smoke and see your doctor regularly. He or she can explain the factors that may put you at risk for heart attack or stroke (see chart at bottom of page).

If you are looking for a new doctor, call 1-800-3-ADVOCATE for a free physician referral.