Kamis, 22 Maret 2012

COMMON MISCONCEPTIONS ABOUT HEART DISEASE


COMMON MISCONCEPTIONS ABOUT HEART DISEASE

1.  Most heart attacks are due to sudden blockage of heart vessels which are severely blocked


2.  Atherosclerosis or hardening of the arteries, which causes heart disease, begins at about the age of 40.


3.  If you keep your cholesterol level within normal ranges, you will be safe from getting a heart attack  


4.  Majority of heart attacks occur in people with chest pains and these signs will appear weeks before the actual event.


5.  Your treadmill stress ECG was normal, therefore you don't have heart disease and will not get a heart attack.


6.  If you have no risk factors and lead a stress free lifestyle, then you will not develop heart disease.


7.  After balloon angioplasty or bypass surgery a heart patient is "cured" and will not suffer from any more heart attacks

Misconception 1: Most heart attacks are due to sudden blockage of heart vessels which are severely blocked.

Not true. Until the early 90's cardiologists believed this to be true, but when studies were conducted with clot dissolving medications such as streptokinase, it was discovered that about 65-70% of heart attacks were due to the so-called "insignificant" narrowing of arteries which are less than 50% blocked. Recent studies have established that most heart attacks are caused by rupture or erosion of an unstable plaque. he culprit lesions are usually mild blockages of <50%. An unstable plaque has the following characteristics. hin fibrous cap which can tear, ulcerate or rupture, and a soft lipid core. When an ulceration or tear in an unstable cholesterol plaque happens, there is sudden clot formation and complete blockage of the artery.

Misconception 2 Atherosclerosis or hardening of the arteries, which causes heart disease, begins at about the age of 40.

Not true. Many people believe so but the truth is atherosclerosis starts as early as childhood, and is already evident by the time a person reaches 20. A recent study looking at the prevalence and extent of atherosclerosis in the adolescents and young adults found that in 2876 autopsies of accident victims age 15-34 years old, fatty streaks was seen in the aorta in 99.93%, and atherosclerosis was already evident in the heart arteries in 50% of teenagers age 15-19 yrs old.

Misconception 3 If you keep your cholesterol level within normal ranges, you will be safe from getting a heart attack

Not true. A high cholesterol level is a definite risk factor for heart disease. However most patients with heart attacks have normal or borderline cholesterol levels (200-220mg/dl, 5.2-5.6 mmol/L) and only 30% have high cholesterol levels. (ref: Rumberger et al Mayo Clinic Proc 1999; 74:243-252) One should not be complacent even if one has a normal cholesterol level.In the Framingham Heart Study, an epidemiological study on prevalence of heart disease, the percentage distribution of serum cholesterol levels in males who did or did not subsequently develop coronary heart disease was almost identical

Misconception 4 Majority of heart attacks occur in people with chest pains and these signs will appear weeks before the actual event.

Not true. Most people think that if they have no symptoms they do not have heart disease. his is the reason why heart disease is called the Silent Killer. In a study on what were the first signs or symptoms of heart disease, typical angina or chest pains occurred in only 10%of patients, 70% had no warning signs, in 35% death was the first and last symptom. (haulow - American Journal of Cardiology; 1993:72:629 )

Misconception 5  Your treadmill stress ECG was normal, therefore you don't have heart disease and will not get a heart attack

Not true. his is because signs and symptoms of coronary artery disease will appear only when the narrowing is greater than 75% Many people feel reassured when they have a negative treadmill exercise stress test and doctors traditionally use this test to detect coronary artery disease.

But what does the American College of Cardiology and American Heart AssociationGUIDELINES FOR EXERCISE ESING ;tell us about this test? Stress testing detects abnormality in heart function caused by obstructive narrowing of heart arteries of GREAER than 75%.

The Guidelines states that Exercise Stress esting is most useful for diagnosis of obstructive coronary artery disease in adult patients with an intermediate pretest probability of CAD, based on gender, age, and symptoms. In other words, adults with chest pains. But unfortunately it is not useful if you do not have any symptoms. It is also important to realize the test's limitations. How sensitive and accurate is the exercise test? his test will pick up 68% of patients with blocked coronary arteries but 32% can be missed,

Misconception 6 If you have no risk factors and lead a stress free lifestyle, then you will not develop heart disease

Not true. Conventional risk factors listed below, of which cholesterol is but one, puts a person at 2-3 times increased risk of having coronary artery disease.

Age
Sex
Family History
Cigarette smoking
Obesity
Hypertension
Diabetes mellitus
Physical Inactivity
Cholesterol
High LDL Cholesterol
Low HDL Cholesterol

Conventional risk factors help to identify only 70% of heart patients . 30% of heart attack patients do not have any conventional risk factors . Conventional risk factors are also poor predictors of future heart attacks or death.

Misconception 7 After balloon angioplasty or bypass surgery a heart patient is "cured" and will not suffer from any more heart attacks

Not true. Angioplasty or bypass surgery alleviates symptoms but does not cure the atherosclerotic plaque disease. he plaque is still present and the patient is still at risk. hat is the probably the reason why no long term follow up study has shown that angioplasty and bypass surgery in stable angina patients improved survival nor prevented future heart attacks compared to medical therapy alone. (Ref: RIA trial, AVER trial)

Five heart disease misconceptions

It's easy to get lost in a labyrinth of data about the planet's No. 1 killer. Yes, it's true. For both males and females, heart disease is the # 1 killer. It kills more people than all forms of tumours combined. It's an equal opportunity destroyer. Anyone, at any place, at any time may be at risk of having a cardiac event. his risk is even greater if you happen to be black or if you happen to be over the age 65. Yet, despite the prevalence of this deadly killer, many myths and misconceptions still exist. Here are the 5 most common myths debunked:

Myth #1: Only older adults need to worry about their cardiovascular system

Factors that may actually lead to a heart attack build-up over years. Being a couch-potato, boredom eating and rarely exercising are all really bad habits that often begin in childhood days. An increasing number of medical experts are witnessing stroke patients in their 20's and 30's rather than the usual patients in their 50's and 60's. Simply being healthy and at the correct bodyweight does not make you immune, however, exercising regularly and maintaining a good body weight does help. You still need to check your high cholesterol and blood pressure level. he right cholesterol (or lipid profile) quantity should be below 200 mg/dL and a good blood pressure is about 120/80.

Myth #2: I'd feel sick if I had high blood pressure or high-cholesterol

High blood pressure and high cholesterol are termed "silent killers" because they do not exhibit signals. One-third of all mature people have high blood pressure and, of those, one-third are unaware that they have got it. High cholesterol levels are a measure of the fats stocked by your blood. Fats can be dropped anywhere in your physique, but tend to congregate around internal organs as well as your heart. his tends to run in family members so even if you're at a good weight and do not smoke, you need to have your cholesterol and blood pressure examined frequently. Once isn't enough.

Myth #3: Men and women DON' feel the same signals

Males and females can, in fact, experience any of the warning signs, however, they typically don't. Ladies usually tend to have the subtler symptoms while males more regularly experience the more expressive forms. Both men and women may experience the "grab-your-chest-and-fall-down-gasping" kind of heart attack, but not necessarily. It is quite common to experience subtler symptoms such as jaw achiness, nausea or vomiting, breathlessness and intense low energy. Unfortunately, these subtler symptoms often tend to get described away. "My jaw hurt simply because I chewed my lunch too hard," or, "I'm probably out of breath because I ate too much." You need to pay close attention to your own body and to all the signs and symptoms.

Myth #4: Assuming that high blood glucose levels or being diabetic isn't a heart threat

Although trying to keep your blood glucose level with a proper range (80ml-120ml) will help keep you healthy, simply having the extra glucose in your blood increases the risk for heart attack, stroke, angina, and coronary artery disease. Nearly 65 per cent of people with diabetes will die from heart disease and stroke. In fact, diabetic adults are two to four times more likely to have heart disease or suffer a stroke than people without diabetes. Healthy adults should get at least 30 to 60 minutes of physical activity, eat the proper foods, eat more fibre, quit smoking and take medications as directed in order to help control blood glucose levels. Don't forget to also test your blood pressure and cholesterol.

Myth #5: My medical doctor would order medical tests if I were at risk of cardiovascular disease

Quite often, most people fail to inform their doctor of the little pains they feel. he medical doctors, not knowing most of the things we considered 'unimportant,' might pass over heart tests. Heart scans can find plaque build-up in your arterial blood vessels before you even know you have a problem but unfortunately heart scans aren't usually performed unless the doctor believes the patient is at risk of an immediate cardiovascular issue. hat means all those "unimportant issues" we fail to report may leave our doctors just as unaware of our budding heart disease as we are, leaving far too many people go undiagnosed and untreated. With early detection, there is time to slow or even reverse the course of heart disease.

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