Berkshire Senior Online

By Dr. David R. Finck

If and when an individual feels symptoms that he/she believes may be cardiac in origin (representing either a heart attack or angina), time is key, and it is important to get to an emergency room for an evaluation quickly. If there is a blood clot acutely blocking one of the coronary arteries, there is a window of opportunity for at least the first six hours and probably a bit longer during which medical therapy with a clot-dissolving drug (tPA or Streptokinase) in an attempt to dissolve the blockage, reopening the vessel and either preventing actual heart muscle injury or reducing the amount of such injury. These drugs are not as effective after six to twelve hours have passed from the time the clot initially forms.

The majority of individuals experiencing a heart attack use words such as "pressure, tightness, burning, constriction" or similar ones to describe wheat they feel rather than calling it "chest pain." The discomfort may spread to the neck, shoulders, or arms (left or both) and sometimes are associated with profuse sweating and/or nausea and vomiting.

If these symptoms were to occur, I would suggest that the individual call 911 for emergency transport rather than driving himself/herself or having a family member take that responsibility. If you are not aspirin allergic or have no history of significant stomach or intestinal bleeding, it may also be helpful to take an aspirin (either the 81 mg. "baby" size or a full 325 mg. Pill) at the onset of suspicious symptoms.

One should not feel "embarrassed" about going to the emergency room for symptoms that make you wonder whether they may be from a blocked, narrowed coronary artery. (Angina is a discomfort, which is usually milder than an actual heart attack, occurring when a portion of the heart muscle transiently is not getting sufficient blood flow but resolving before there has been any heart muscle injury.)

Pains which intensify when you inhale or which seem to worsen when a part of the chest wall or rib cage is touched, are less likely to be indicative of angina or heart attack.

The most important issues in prevention of coronary artery disease remain attention to the four modifiable/treatable risk factors, diabetes, hypertension, smoking and elevated cholesterol levels, as well as participating in a regular physical activity program, maintaining ideal weight, and eating a prudent low-fat diet. In fact, data has clearly shown that there is definite benefit from optimally controlling blood pressure and cholesterol levels in elders in particular. "It is never too late."