In late February 2011 Janice Womble was at work when she noticed a shortness of breath and felt pressure in her chest, which was all the more alarming because she worked out three days a week and was otherwise very active.
Fortunately, her work was as a volunteer at a hospital, so she was conditioned to listen to what her body had to say, and she happened to pass a cardiologist in the hallway and told him of her symptoms.
That set in motion a heart catheter procedure that found a blockage on the top left side of Womble’s heart. It’s location enabled non-invasive surgery by another cardiologist to clear the blockage, and she spent several days in recovery at Mansfield Methodist Medical Center, her home away from home.
“I credit (these cardiologists) with saving my life and for catching this disease before it started to affect my life,” Womble says today. “I went through 36 sessions of cardiac rehabilitation, which everyone should have if they have a heart procedure done.”
“It’s a lot of hard work but gets you back on the right track for the rest of your life,” she adds. “I have a check up every six months and see (the surgeon) every week at the hospital.
Having been in the right place at the right time, with the education she needed from her work as a volunteer who spent time with patients being prepped for surgery, Womble realizes everyone is not so lucky. She implores people to seek immediate medical attention “if something doesn't feel right in your chest.”
“If you are having chest pains, please call 911 because it could save your life,” she says with urgency.
She became a volunteer at the hospital the day it opened eight years ago, and she’s still at it thanks to her heeding those warning signs.
Unfortunately for most of the U.S. population, people don’t know the warning signs and symptoms of a heart attack, according to the Centers for Disease Control and Prevention. The federal agency notes that about 47 percent of heart attacks occur outside a hospital, suggesting that “most people with heart disease don’t act on early warning signs.”
About 600,000 Americans die of heart disease every year, which accounts for one in every four deaths. About 720,000 Americans have a heart attack every year.
Major warning signs of heart attacks include chest pain or discomfort; upper body pain or discomfort in the arms, back, neck, jaw, or upper stomach; shortness of breath; and nausea, lightheadedness, or cold sweats.
Risk factors for heart disease include high blood pressure, high LDL cholesterol, and smoking. People also can be at increased risk of heart disease from some medical conditions and lifestyle choices such as diabetes, obesity, poor diet, physical inactivity and excessive alcohol use.
Prevention starts with seeing your doctor regularly and being evaluated for risk factors that may increase your risk for heart disease, such as high blood pressure, cholesterol, and blood sugar, all of which can be controlled and even reversed with medication, changes in diet, and exercise.
Surprisingly, a study has found that some traditional calculators of risk for heart disease, based on the Framingham Risk Score, may be overestimating the 10-year risk of heart attack. However, the Framingham Risk Score was never intended to be a mandate for initiating medical therapy; it was meant to encourage doctors to tell their patients about the benefits of diet, exercise, and smoking cessation, and to discuss options for preventive medication. Americans have heeded at least some of the advice to change their lifestyles and diet in the meantime.
By continually reviewing the effectiveness of risk assessment scores, medicine is getting closer to being able to individualize people’s risk for heart disease, based on personal history.
But before you pounce on a juicy steak and wash it down with a martini or two, keep in mind that the study’s author’s are not calling for elimination of current risk assessment tools that guide doctors when deciding to prescribe a treatments to control risk factors, such as recommendations for diet, exercise, and smoking cessation, or prescriptions for high cholesterol or high blood pressure.
What the study does do, they say, is encourage more give and take between patients and doctors, to include greater emphasis on personal health history and the understanding that a standardized risk calculator is not a perfect predictor. Although helpful as tools to being talking about heart attack risk, standardized risk calculators come with caveats.
March 03, 2015
Christopher Nystuen, MD, MBA