When attending the University of Toronto Medical School, I took a grueling course called Pathology - diseases afflicting the human body. No student passed Pathology and went on to become practicing Medical Doctors without learning the "Five Risk Factors" for "Coronary Heart Disease": smoking, diabetes, high blood pressure, family history of heart disease and high blood cholesterol.
The human heart has fascinated mankind for years. It is a fist-sized muscle that beats continuously 20 billion times in an average 76 year life-span. The heart is the muscular pump that moves fresh oxygen-rich blood from the lungs to the rest of the body. The strong heart muscle pushes blood forward with its mechanical action (systole); the backflow (diastole) is stopped by strong one-way door called valves.
In Canada, blocked coronary arteries to the muscles of the heart is THE major cause of death. Heart and its blood vessel diseases account for the majority of deaths in Canada - 74,000 a year; an entire Rogers Skydome full of victims. When blood vessels to the heart muscles are narrowed and/or blocked, Acute Coronary Syndrome occurs. Heart Attack (myocardial infarction, MI) is the most feared result. Death can occur suddenly due to disruption of the pace-making electric wiring of the heart. Death can occur from loss of the muscular pump action of dead heart cells.
Patients who have blockage of vessels supplying the heart often complain of chest pain, or a crushing heaviness behind the breastbone (sternum). However, the patient may describe it as "gripping", "heartburn", or "palpitating" chest discomfort. Heart patients may also experience shortness of breath or weakness. Women with heart attack can have more variable chest discomfort. If you are worried that you are having heart troubles, SEE A MEDICAL DOCTOR. You will get blood tests, x-rays and EKGs (electric recordings with chest stickers).
Heart attack patients have been treated in the last five years with new clot-dissolving and cholesterol-lowering medicines. Patients can be urgently transferred to the operating room for balloon stretching of the coronary arteries (Percutaneous Coronary Intervention). Sometimes metal stents, resembling metal wire supports used to protect garden roses, can be inserted in patients to splint open coronary arteries. When necessary, the chest bones can be opened for bypass operations around blocked coronary arteries.
When doctors are uncertain about whether or not a patient has blocked coronary arteries, stress testing is ordered. Patients are typically asked to walk for about 7 minutes while attached to an EKG. Sometimes medicines containing mildly radioactive medicines are injected. The combination of the amount of exercise achieved, the electrical EKG changes and the pictures taken of the heart containing the radioactive medicine give your doctor a good idea of whether or not your coronary arteries are open.
If you have further questions, ask your doctor, check www.heartandstroke.ca, or call 416-489-7111.
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