Only about one-third of U.S. adults are aware of the five major warning signs of heart attacks, according to a CDC survey in MMWR.
The telephone survey of 72,000 people, conducted in 2005, found that, nationally:
48% recognize pain or discomfort in the jaw, neck, or back as a warning sign;
62%, feeling weak, lightheaded, or faint;
85%, pain or discomfort in the arms or shoulder;
92%, chest pain or discomfort;
93%, shortness of breath.
The numbers were even lower among non-Hispanic blacks and Hispanics, men, and those with less than a high school education.
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Only One-Third of Adults Know Heart Attack Signs
Only about one-third of U.S. adults are aware of the five major warning signs of heart attacks, according to a CDC survey in MMWR.
The telephone survey of 72,000 people, conducted in 2005, found that, nationally:
48% recognize pain or discomfort in the jaw, neck, or back as a warning sign;
62%, feeling weak, lightheaded, or faint;
85%, pain or discomfort in the arms or shoulder;
92%, chest pain or discomfort;
93%, shortness of breath.
The numbers were even lower among non-Hispanic blacks and Hispanics, men, and those with less than a high school education.
In addition, 86% said they would dial 911 if they thought someone was having a heart attack or stroke.
Showing posts with label Heart attacks. Show all posts
Showing posts with label Heart attacks. Show all posts
Friday, February 22, 2008
Thursday, December 20, 2007
Diagnosis of Heart Attack Can Be Wrong Study finds false positives occur 9.2% of the time in emergency rooms
Diagnosis of Heart Attack Can Be Wrong Study finds false positives occur 9.2% of the time in emergency rooms
TUESDAY, Dec. 18 (HealthDay News) -- When doctors in the emergency room believe that someone is having a heart attack, they are mistaken 9.2 percent of the time, a new study indicates.
Given that minutes matter with these patients and doctors have to act quickly in this setting, that percentage is tolerable, say researchers from the Minneapolis Heart Institute Foundation.
"Our conclusion is that an 8 to 10 percent false positive rate is acceptable," said study co-author Dr. Timothy Henry, who is director of the institute.
However, every effort should be taken to reduce the number of false positive diagnoses of heart attack, Henry added. The report, which is published in the Dec. 19 issue of the Journal of the American Medical Association, gives a benchmark for other institutions to meet, he said.
"The whole issue of false positive has never been presented," Henry said. "This is the first time it has been presented in a systematic way."
Henry and his colleagues studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions to activate the cardiac catheterization laboratory to treat for suspected heart attacks. Such decisions usually must be made in a matter of minutes, often without a record of a patient's previous cardiac history.
All the patients were suspected of having a STEMI heart attack, characterized by a specific electrocardiogram pattern. It turned out that 187 of them (14 percent) did not have obvious blockage of a coronary artery, with 127 (9.5 percent) having no significant coronary artery disease and 149 (11.2 percent) having negative results on cardiac biomarker tests. There was a significant difference in survival, with a 4.6 percent 30-day death rate for those with a blocked artery and 2.7 percent for those without blockage.
Hospitals should run a continuing check on such emergency room diagnoses and decisions, Henry said. "If they are too high, corrective action should be taken," he said.
Heart attack diagnosis has been the focus of "a number of quality improvement initiatives," said Dr. Frederick A. Masoudi, an associate professor of medicine at the Denver Health Medical Center, who wrote an accompanying editorial.
"It is well known that timing is of the essence in treating these patients," Masoudi said. "The outcome is better when the artery is opened in a timely way."
False positives are inevitable in some cases, he said. "It is really impossible to say from this one study whether there are too many or too few," Masoudi said. "Ultimately, it is important for us to evaluate the extent to which it occurs and why it occurs. We must build into the system a balance, so that only those patients who need reperfusion get it."
SOURCES: Timothy D. Henry, M.D., director, research, Minneapolis Heart Institute Foundation; Frederick A. Masoudi, M.D., associate professor, medicine, Denver Health Medical Center; Dec. 19, 2007, Journal of the American Medical Association
TUESDAY, Dec. 18 (HealthDay News) -- When doctors in the emergency room believe that someone is having a heart attack, they are mistaken 9.2 percent of the time, a new study indicates.
Given that minutes matter with these patients and doctors have to act quickly in this setting, that percentage is tolerable, say researchers from the Minneapolis Heart Institute Foundation.
"Our conclusion is that an 8 to 10 percent false positive rate is acceptable," said study co-author Dr. Timothy Henry, who is director of the institute.
However, every effort should be taken to reduce the number of false positive diagnoses of heart attack, Henry added. The report, which is published in the Dec. 19 issue of the Journal of the American Medical Association, gives a benchmark for other institutions to meet, he said.
"The whole issue of false positive has never been presented," Henry said. "This is the first time it has been presented in a systematic way."
Henry and his colleagues studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions to activate the cardiac catheterization laboratory to treat for suspected heart attacks. Such decisions usually must be made in a matter of minutes, often without a record of a patient's previous cardiac history.
All the patients were suspected of having a STEMI heart attack, characterized by a specific electrocardiogram pattern. It turned out that 187 of them (14 percent) did not have obvious blockage of a coronary artery, with 127 (9.5 percent) having no significant coronary artery disease and 149 (11.2 percent) having negative results on cardiac biomarker tests. There was a significant difference in survival, with a 4.6 percent 30-day death rate for those with a blocked artery and 2.7 percent for those without blockage.
Hospitals should run a continuing check on such emergency room diagnoses and decisions, Henry said. "If they are too high, corrective action should be taken," he said.
Heart attack diagnosis has been the focus of "a number of quality improvement initiatives," said Dr. Frederick A. Masoudi, an associate professor of medicine at the Denver Health Medical Center, who wrote an accompanying editorial.
"It is well known that timing is of the essence in treating these patients," Masoudi said. "The outcome is better when the artery is opened in a timely way."
False positives are inevitable in some cases, he said. "It is really impossible to say from this one study whether there are too many or too few," Masoudi said. "Ultimately, it is important for us to evaluate the extent to which it occurs and why it occurs. We must build into the system a balance, so that only those patients who need reperfusion get it."
SOURCES: Timothy D. Henry, M.D., director, research, Minneapolis Heart Institute Foundation; Frederick A. Masoudi, M.D., associate professor, medicine, Denver Health Medical Center; Dec. 19, 2007, Journal of the American Medical Association
Tuesday, December 11, 2007
Depression Linked To Death Following Heart Attack
Depression Linked To Death Following Heart Attack
ScienceDaily (Dec. 10, 2007) — Depression nearly triples the risk of death following a heart attack, even when accounting for other heart attack risk factors, according to research presented today at the American College of Neuropsychopharmacology (ACNP) annual meeting, which showed that among 360 depressed, post myocardial infarction patients followed for more than six years, those who did not recover from their depression in the first six months were more than twice as likely to die.
This study was one of several presented at a panel which examined the links between depression and vascular disease. "There is an unequivocal link between depression and heart disease, but it is not clear what causes this link," said Alexander Glassman, M.D., Professor of Psychiatry at Columbia University, College of Physicians and Surgeons and ACNP member.
"There is a whole series of factors that link depression and heart disease and we are just beginning to understand how antidepressants act in people who have these conditions together."
Additional risk factors that tend to be major medical predictors of death from a heart attack include the severity of the heart attack and variability in various measures of heart function during recovery.
Depression has increasingly been recognized to increase the risk for cardiovascular disease. Possible reasons for this association include sticky platelets, a condition depressed patients are likely to have, or autonomic nervous activity, which increases heart irritability.
Ronald S. Duman, Ph.D., professor of psychiatry and pharmacology at Yale University School of Medicine and an ACNP member, also presented research on this topic. His work examined molecular mechanisms and the identity of the protein, vascular endothelial growth factor (VEGF). VEGF is a key growth factor in the formation of vascular cells and was originally identified and studied for its role in the formation of vascular tissues.
"We found that different classes of antidepressants increase the expression of VEGF in the hippocampus (the part of the brain which influences memory), which may partly explain how certain antidepressants are more effective than others," said Duman. "Changes in brain levels of VEGF contribute importantly to the antidepressant response and that's why studying VEGF function may be useful in developing medications that are more effective and rapid acting."
The panel also included presentations from Kevin Tracey, M.D. and Gregory Miller, Ph.D., who presented evidence indicating the brain has significant control over the levels of inflammatory molecules called cytokines in other parts of the body, and that these levels are altered in depression and associated with an increased risk for heart disease. And Charles Nemeroff M.D., Ph.D., and professor and chair of the department of psychiatry at Emory University, presented data showing the impact of stressful events early in life on the response to stress later in life.
These events precede either depression or heart disease and could potentially contribute to vulnerability for both conditions.
Adapted from materials provided by American College of Neuropsychopharmacology.
ScienceDaily (Dec. 10, 2007) — Depression nearly triples the risk of death following a heart attack, even when accounting for other heart attack risk factors, according to research presented today at the American College of Neuropsychopharmacology (ACNP) annual meeting, which showed that among 360 depressed, post myocardial infarction patients followed for more than six years, those who did not recover from their depression in the first six months were more than twice as likely to die.
This study was one of several presented at a panel which examined the links between depression and vascular disease. "There is an unequivocal link between depression and heart disease, but it is not clear what causes this link," said Alexander Glassman, M.D., Professor of Psychiatry at Columbia University, College of Physicians and Surgeons and ACNP member.
"There is a whole series of factors that link depression and heart disease and we are just beginning to understand how antidepressants act in people who have these conditions together."
Additional risk factors that tend to be major medical predictors of death from a heart attack include the severity of the heart attack and variability in various measures of heart function during recovery.
Depression has increasingly been recognized to increase the risk for cardiovascular disease. Possible reasons for this association include sticky platelets, a condition depressed patients are likely to have, or autonomic nervous activity, which increases heart irritability.
Ronald S. Duman, Ph.D., professor of psychiatry and pharmacology at Yale University School of Medicine and an ACNP member, also presented research on this topic. His work examined molecular mechanisms and the identity of the protein, vascular endothelial growth factor (VEGF). VEGF is a key growth factor in the formation of vascular cells and was originally identified and studied for its role in the formation of vascular tissues.
"We found that different classes of antidepressants increase the expression of VEGF in the hippocampus (the part of the brain which influences memory), which may partly explain how certain antidepressants are more effective than others," said Duman. "Changes in brain levels of VEGF contribute importantly to the antidepressant response and that's why studying VEGF function may be useful in developing medications that are more effective and rapid acting."
The panel also included presentations from Kevin Tracey, M.D. and Gregory Miller, Ph.D., who presented evidence indicating the brain has significant control over the levels of inflammatory molecules called cytokines in other parts of the body, and that these levels are altered in depression and associated with an increased risk for heart disease. And Charles Nemeroff M.D., Ph.D., and professor and chair of the department of psychiatry at Emory University, presented data showing the impact of stressful events early in life on the response to stress later in life.
These events precede either depression or heart disease and could potentially contribute to vulnerability for both conditions.
Adapted from materials provided by American College of Neuropsychopharmacology.
Wednesday, October 3, 2007
Heart attacks can occur in teenagers
Heart attacks can occur in teenagers
Tue Oct 2, 2007 12:44 PM ET
By Megan Rauscher
NEW YORK (Reuters Health) - Although quite rare, heart attacks can occur in adolescents without heart defects; and a case series reported by two cardiologists from The Heart Center at Akron Children's Hospital, Ohio, serves as a of reminder this.
Reporting in the current issue of Pediatrics, Drs. John R. Lane and Giora Ben-Shachar describe nine healthy adolescents (eight boys and one girl), ages 12 to 20 years, who developed severe chest pains and met the criteria for a diagnosis of heart attack.
Eight of the patients had abnormal EKGs, all of them had abnormal cardiac enzyme levels, and three had abnormalities revealed by echocardiogram. Heart rhythm abnormalities were seen in four patients. Although several other types of irregularities were detected, none of the patients has abnormal anatomy.
Tests for drug abuse, cholesterol levels, and blood coagulation rate were all negative, the authors report.
Heart attacks in teens are "obviously rare but not an impossible diagnosis," Lane told Reuters Health. When an adolescent develops severe chest pain typical of a heart attack, it should not be dismissed lightly.
Lane also noted that this is a "different disease" than heart attacks in adults - the young patients did not have any obvious risk factors, they had normal coronary arteries and they tended to recover without any long-term problems.
None of the patients had blood clots, so drugs to break up a clot would not have been useful, Lane said. On the other hand, drugs to expand the arteries of the heart can be helpful, which suggests that a heart spasm may be the cause of the heart attack.
SOURCE: Pediatrics, September 2007.
Tue Oct 2, 2007 12:44 PM ET
By Megan Rauscher
NEW YORK (Reuters Health) - Although quite rare, heart attacks can occur in adolescents without heart defects; and a case series reported by two cardiologists from The Heart Center at Akron Children's Hospital, Ohio, serves as a of reminder this.
Reporting in the current issue of Pediatrics, Drs. John R. Lane and Giora Ben-Shachar describe nine healthy adolescents (eight boys and one girl), ages 12 to 20 years, who developed severe chest pains and met the criteria for a diagnosis of heart attack.
Eight of the patients had abnormal EKGs, all of them had abnormal cardiac enzyme levels, and three had abnormalities revealed by echocardiogram. Heart rhythm abnormalities were seen in four patients. Although several other types of irregularities were detected, none of the patients has abnormal anatomy.
Tests for drug abuse, cholesterol levels, and blood coagulation rate were all negative, the authors report.
Heart attacks in teens are "obviously rare but not an impossible diagnosis," Lane told Reuters Health. When an adolescent develops severe chest pain typical of a heart attack, it should not be dismissed lightly.
Lane also noted that this is a "different disease" than heart attacks in adults - the young patients did not have any obvious risk factors, they had normal coronary arteries and they tended to recover without any long-term problems.
None of the patients had blood clots, so drugs to break up a clot would not have been useful, Lane said. On the other hand, drugs to expand the arteries of the heart can be helpful, which suggests that a heart spasm may be the cause of the heart attack.
SOURCE: Pediatrics, September 2007.
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