Menstuff® is actively compiling information, books and
resources on the issue of the heart. For years I've asked men if they
knew the first warning sign of a heart attack. Virtually no one can
answer the question correctly. It isn't severe pain in the chest,
loss of mobility on one side of the body, etc., etc. The first sign
is "Death". And, add it up. More people die from sudden cardiac
arrest each year than from breast cancer, prostate cancer, AIDS,
handguns, house fires, and traffic accidents combined. Don't wait for
"symptoms." Change your health habits now before the first
warning sign hits!
What Happens During a Heart
Attack?
A Heartfelt Warning to
Giants, Pats Fans
A Short Fuse Could Be a Time
Bomb
Year's
Biggest Game Puts Men at Risk
Exercise for a Healthy
Heart
Safe Exercise for Heart Disease
Patients
Lifestyle Vital to New Heart
Diet
How to Reamin Calm When You Want to
Explode
Three Who've Learned The Hardest
Way
Waiting for a Heart
Heart Attack
Quiz
Heart Health for Men,
Women
A Short Fuse Could Be a Time Bomb
Nothing in particular set off the attack, he recalls; what stands out was that anger had become his reflexive response to stress. By his own account, he would morph into a yeller, a fist-clencher, a vein-popper. "I did more than once throw the phone and pick up a book and throw it against the wall to the point where it scared my employees," he said.
On the other hand, Mr. Seidel said, hospital tests after his attack showed his blood contained high levels of homocysteine, a byproduct of protein that is known to clog arteries. As he rebuilds his health and learns to manage his anger, Mr. Seidel said, he often wonders whether it was chemistry, psychology or some combination thereof that nearly killed him.
A connection between anger and an increased risk of heart disease has been suspected since at least the 1950's, when Meyer Friedman and Ray Rosenman, San Francisco cardiologists, used the term "Type A behavior" to describe their impatient, often hostile patients. These days, in an age of gene-splitting precision, the Type A label is considered too broad, even simplistic. But its underlying assumption is inspiring more research into the links between negative emotions and cardiovascular disease.
Anger has yet to be sanctioned as an established, biologic risk factor, said Dr. Janice E. Williams, a cardiovascular epidemiologist with the Centers for Disease Control and Prevention in Atlanta. But, she said, it is considered an emerging risk factor.
"What we're finding is that the risk of heart attacks associated with anger is comparable with that of smoking and high cholesterol," Dr. Williams said.
Deconstructing anger can be tricky, and remains controversial, partly because anger is harder to measure than conventional risk factors like cholesterol, hypertension and diabetes. One measurement is a standardized, 50-question form known as the Cook-Medley Hostility Scale. But the subject's self-awareness is often so limited that spouses are asked to rate their partner's levels of anger, too.
It is also difficult to separate anger from depression. Some recent research suggests that low levels of serotonin in the brain cause not only sadness but also hostility, and that some heart patients could benefit from drugs used to treat depression. So someone once regarded as hotheaded might now be understood as serotonin-deficient, said Dr. Andrew Littman, a Boston psychiatrist who specializes in preventive cardiology at Massachusetts General Hospital.
"What's striking is that a high proportion of people who have heart disease are people who have something psychologically going on," Dr. Littman said.
What is still unclear is whether anger sets in motion a specific metabolic reaction that clogs the arteries, or whether it makes people smoke and overeat, which in turn affects blood pressure and cholesterol. Either way, more attention and effort to change unhealthy behavior are merited, said Dr. Valentin Fuster, the director of the cardiovascular institute at the Mount Sinai School of Medicine in New York, and a former president of the American Heart Association.
"I personally believe that coronary artery disease is an acquired disease of modern development," Dr. Fuster said. It's generally accepted by doctors that intense emotion can touch off a heart attack. But in one developing study led by the Beth Israel Deaconess Medical Center in Boston, researchers hope to understand more about anger and sudden death by tracking patients with implanted defibrillators. The participants, who are currently being recruited, will be asked to report on their activities and emotions every time they experience arrhythmia and feel their defibrillators respond.
"The nice thing about these devices is they have a memory, an electrocardiogram recorded inside so we can confirm exactly what the rhythm disturbance was," said Dr. Murray Mittleman, the coordinator of the study and the director of cardiovascular epidemiology at Beth Israel Deaconess.
Anger's long-term effects are another aspect of research. By causing repeated wear and tear on the arteries, chronic rage may contribute to atherosclerosis, said Dr. Ichiro Kawachi, an associate professor at the Harvard School of Public Health.
One landmark study, published last year in the journal Circulation, found that participants with no existing heart disease or hypertension but high anger traits were nearly three times more likely to suffer nonfatal heart attacks, fatal heart attacks or require bypass surgery than counterparts with less anger. The study involved nearly 13,000 men and women, black and white, who were tracked up to six years in four regions of the country, said Dr. Williams, who was the lead author before she joined the C.D.C.
Another recent study in the journal Cardia found that adults age 18 to 30 were more likely to develop calcifications in their arteries if they had high hostility ratings.
"There's been continuing studies that document that the tendency to have a low threshold for anger — a short temper — is putting people at higher risk for developing coronary disease," said Dr. Redford B. Williams, a professor of psychiatry and the director of the Behavioral Medicine Research Center at Duke University.
Dr. Williams, widely regarded as the guru of anger management, has developed a life- skills training program with his wife, Virginia, that urges people to evaluate their angry reactions. The couple are marketing their techniques, including making a self- help videotape and workbook.
Some doctors remain skeptical, cautioning that the healing power of anger management has yet to be proven.
"It's not whether there are connections between the mind and the body, of course no one questions that," said Dr. Arnold S. Relman, a professor emeritus at the Harvard University School of Medicine and former editor in chief of The New England Journal of Medicine. "The question is, can you show us evidence that by improving your emotional state you can objectively change the natural history of physical illness?"
Results from at least one small study suggest that you can. Dr. Karina Davidson, a clinical psychologist at the Mount Sinai School of Medicine, tested life-skills therapy on two-dozen heart attack survivors from Halifax, Nova Scotia. Half received the therapy and half did not. Those who did emerged with less cynicism and hostility, as well as lower blood pressure.
Dr. Davidson said she has documented similar results within a small set of New York patients. The more recent work involved women and African-Americans, as well as white men. It is promising, Dr. Davidson said, because it suggests that the higher rates of hypertension among blacks may stem from environmental causes like racism, rather than from genetic origins.
One convert to anger management is Mr. Seidel, the lawyer. In his weekly support group at the New York Hospital-Cornell Medical Center, he gently offers hard-won wisdom to newer members. He meditates. He knows he gets an adrenaline rush when he plays basketball, so he recently quit his amateur league. Heeding the advice of his psychotherapist, Dr. Robert Allan, he tries to swim past the hooks of injustice and incompetence that used to lure him into angry waters.
"It's got to be a factor," he said. "Even if it wasn't a solo factor, it has to have exacerbated whatever else was going on."
Source: www.nytimes.com/2001/06/24/health/24BERG-MH.html
How to Remain Calm When You Want to
Explode
By recognizing hooks for what they are — bait for the prey's free- floating hostility — you should be able to swim past them.
Similarly, Dr. Redford B. Williams, the director of the Behavioral Medicine Research Center at Duke University, recommends asking four questions whenever the bile starts to rise:
The situation warrants action only if you get four yeses. Otherwise, Dr. Williams said, let it slide.
See our Time Out card.
Source: Leslie Berger
Safe Exercise for Heart Disease
Patients
Here are some things to discuss with the doctor:
General Workout Tips for Heart Disease Patients:
Source: www.webmd.com/heart-disease/guide/safe-exercise-heart-disease-patients
Three Who've Learned The Hardest Way
RICHARD BROWN, 54, was a playground legend with a taste for the high life. Now, after losing a leg to diabetes and receiving a diagnosis of an enlarged heart, he takes better care of himself, and works to help youngsters.
AMIT, 36, with his wife and son, fears that divulging his last name will affect his insurance coverage. He suffered a mild heart attack last year despite exercising and eating sensibly. It only made him more determined to lower his high cholesterol count. ``If I think something is not good,'' he says, ``I will disallow it.''
N a cramped room at the Mount Sinai Hospital's Cardiac Care Center, time is marked by the loud, mechanical beating of Louis Fantauzzi's artificial heart. It is the sound of a tethered life, a life in suspension.
Now in his fifth month of waiting for a real heart, Mr. Fantauzzi embraces distraction. He loses himself in books. He soars with the voice of Celine Dion on his headset. Twice a day he attaches a battery-operated power pack to his stand-in heart and takes 15-minute walks through the antiseptic corridors. Most of all, he longs for his doctor to stride into the room and say: we have a match.
It would mean that a healthy heart had become available to replace the scarred, useless muscle in his chest. It would mean walking with confidence, climbing stairs without pause and sleeping in his own bed beside his wife of 30 years, Zaida. These are the modest hopes of one 56-year-old man, and — despite the formidable obstacles before Mr. Fantauzzi — they are well within reach.
Just as poets continue to plumb the symbolic possibilities of the heart, so too do medical researchers continue to learn about an organ at once so basic and so complex: the heart remains a central riddle of life. After years of being overshadowed by cancer, AIDS and other public-health matters, diseases of the heart have returned to the spotlight — thanks in part to two men who might have preferred other ways to contribute to the public good.
Early last year, David Letterman, the late-night talk- show host, underwent quintuple bypass surgery, after a test that indicated an artery leading to his heart was severely constricted. Mr. Letterman was only 52 at the time, but he knew that he had high cholesterol and that heart disease ran in his family.
And last November, Dick Cheney, the future vice president, suffered a heart attack at age 60. It was his fourth, and his travails were not over. In March, the vice president returned briefly to the hospital because a blockage had developed around a wire-meshed stent that had been implanted in a coronary artery after his heart attack.
Some cardiologists welcome the renewed attention prompted by the Letterman and Cheney cases, given that heart disease is the nation's leading cause of death. Although more women than men have died of cardiovascular disease since 1984, men appear to be particularly susceptible to certain manifestations of the disease. According to the American Heart Association, more men undergo angioplasty and bypass surgery, and they account for 74 percent of all heart transplants in the United States.
"I think it's been taken for granted by some professionals and by the public that things are going well, and that we have it under control," said Dr. George Sopko, a cardiologist at the National Heart, Lung and Blood Institute in Bethesda, Md. "Not necessarily. There's still room for a lot of education" — for researchers and the public.
Still, for all the sobering statistics, Dr. Sopko and other cardiologists stress that remarkable advances in preventing and treating heart disease have been made in just the last 15 years or so — from realizing the blood-thinning benefits of aspirin to decoding the complex relationship between heart disease and genetics.
Stents, which are essentially interior scaffolding for clogged blood vessels, have become common hardware for cardiology. Statins, a class of drugs, not only lower cholesterol, they also stabilize vessel walls, have anti-inflammatory properties and are tolerated well. Even heart transplants, once considered the most extreme of surgical procedures, have become almost standard.
For Mr. Fantauzzi, the clinical details are mundane. It is the
specific details, of his case and those of two other men, that make
it personal — and therefore unique.
The discomfort intensified. After some internal debate, Mr. Fantauzzi left the subway platform, returned home and was admitted to a neighborhood hospital. That evening he had a massive heart attack, delivering a pain so intense that his voice lowers with respect as he talks about it today. Two months later he had a double bypass operation, then returned to his normal routine — only this time he watched his diet and rode an exercise bicycle every evening after work.
By now, though, the best of intentions could not overcome the damage done to the heart. Dr. Alan Gass, the director of transplant cardiology at Mount Sinai, said the scarring caused by Mr. Fantauzzi's heart attack was so extensive that — coupled with his genetic makeup — "he was already destined to need a heart transplant."
In 1995, Mr. Fantauzzi suffered an aneurysm of the heart, a result of his earlier heart attack. He tried to return to his job, but he was too weak. "It was like picking up that bed," he said, motioning to his hospital bed. "It was too much." And when his family moved from the apartment to a house in Queens, he could do nothing more than watch everyone pack and unpack.
As his strength flagged, so much so that driving his wife to the store became a private marathon, Mr. Fantauzzi began to attribute his condition to age. "You're 55 years old, you've got a bum heart, this is the way it is," he said. "That's how I was rationalizing it."
That changed one day in January, when he began to perspire profusely and could not summon the strength to climb the stairs into his house. As one of his sons carried him to the sofa, his wife called 911. Mr. Fantauzzi has been in hospital care ever since.
"It's the extreme end of heart disease," Dr. Gass explained. "He
was in cardiogenic shock. Because of the heart attack, there is not
enough blood going to his vital organs, and his kidneys were
beginning to shut down."
Source: www.nytimes.com/2001/06/24/health/24BARR-MH.html
 |
|
 |
