Heart Disease

Heart Disease

Heart disease is the leading cause of death among seniors, accounting for one-third of all deaths among seniors in 1999 (Vierck & Hodges, 2003). Deaths due to heart disease become more prevalent with age. In 1999, 29 percent of deaths among those 65 to 74 years old were hear disease-related, but that number rose to 39 percent for those age 85 and older. While there are many forms of heart disease, you will most frequently encounter heart attack, more technically known as acute myocardial infarction (MI). To better understand heart disease you must first understand the phenomena of hypertension, coronary arteries, and angina, and how these interact with each other in heart condition.

Hypertension (High Blood Pressure)

According to the National Academy on an Aging Society, high blood pressure is a leading risk factor for heart disease and stroke and is a serious health issue for about 15 percent of the adult population.
The arteries that carry blood from the heart to various organs in the body have muscles within their walls that allow the vessel to constrict or dilate in response to signals from the body. Constriction increases the pressure within the artery and restricts blood flow. During constriction, greater pressure is required to move blood through the artery. Dilation, on the other hand, increases the size of the artery, allowing blood to flow more easily and with less pressure.
Blood pressure is the force exerted by the blood against the interior wall of the artery. It is commonly reflected as a value of two numbers, the systolic and the diastolic. In a blood pressure reading of 140/90, the first or upper number, 140, represents the systolic pressure, or the amount of force exerted when the heart contracts to pump blood through the artery. The second, or lower number, 90, represents the diastolic pressure, or the force within the artery between heartbeats, when the heart is at rest and there is no pressure pushing the blood through the system. A consistently high pressure within the circulatory system causes the heart to work much harder and increases the risk of heart disease, stroke, kidney disease, and blindness.
Conventionally, a blood pressure of 120/80 is considered an average reading, while a blood pressure consistently above 140/90 is termed hypertension. A person with a reading between 120/80 and 140/90 has pre-hypertensionand is at high risk for developing hypertension. Numerous factors increase the risk of developing hypertension. Among the most common are smoking, high cholesterol (which clogs arteries with plaque), being overweight, and drinking too much alcohol.
Fortunately, these behaviors can be controlled through lifestyle changes. Unfortunately, since high blood pressure can be present for years without any symptoms, many Americans are unaware they have high blood pressure. As such, they do not know they need to make behavioral changes, or, possibly need to take medications (antihypertensive drugs) to control their hypertension.
Knowledge about hypertension among older Americans is quite low. For example, in a survey of 1,500 people age 50 and older, the National Academy on an Aging Society discovered that 46 percent incorrectly believed stress caused hypertension and that 45 percent did not know their own blood pressure (2000). What's more, approximately 28 percent believed prescription drugs to be the only form of treatment. Clearly, such lack of knowledge prohibits full access to the measures that can lower the incidence of high blood pressure and reduce the risk of complications.

What are Coronary Arteries?

The heart is a large and powerful muscle responsible for circulating blood throughout the body. It takes blood enriched with oxygen from the lungs and pumps it out to the body's organs and tissues, supplying them with the necessary nutrients. The heart muscle itself derives nutrients from coronary arteries. The right coronary artery and the left coronary artery, which immediately branches into the left anterior descending coronary artery, feed the front of the heart. The circumflex artery feeds the back of the heart. These arteries supply the heart muscle with both oxygen and nutrients appropriate for the amount of work being performed-the greater the exertion, the harder the heart muscle works to pump blood and the more oxygen it needs to perform satisfactorily.
Atherosclerosisis a process by which the arteries become clogged. Under normal conditions, the inner lining of the artery is very smooth and allows blood to flow unimpeded. With age and poor health habits, these arteries gradually accumulate sludge deposits consisting of cholesterol, debris, and blood platelets. These deposits attach to the artery wall and form plaque that narrows the internal lumen (diameter) of the artery, making the artery wall less flexible and more prone to developing blood clots.


When plaques build up, the arterial lumen becomes smaller and blood flow through the artery is reduced. Blood supply may be sufficient for the heart muscle at rest but cannot keep pace when the heart's work increases (as with exertion). Insufficient oxygen to the heart muscle leads to a type of pain known as angina.This is a sensation that is described variously as pain, heaviness in the chest, or tightness that feels like a band around the chest. The pain usually emanates from the center of the chest under the breastbone, but sufferers may fel it in the neck, jaw, or arm (left more often than right). The pain of angina is short in duration and goes away if activity is stopped. This allows the oxygen supply to catch up to the heart muscle's demand.
Stable angina is a chest pain that has been present at least two months, does not occur at rest, and has not changed in frequency or duration. Stable angina is usually treated medically through weight reduction, smoking cessation, and medications that reduce the work of the heart and lower oxygen demand. Conversely, unstable angina, may be new in occurrence or reflect a change in frequency or duration of painful attacks. Unlike stable angina, unstable angina may occur even at rest. Unstable angina is associated with worsening in the heart's condition and required immediate medical attention.

Heart Attack

As the process of atherosclerosis continues, the artery may become totally blocked, thereby cutting off blood flow entirely to a small section of the heart muscle. Without oxygenated blood, the heart muscle dies in what is commonly known as a heart attack or acute myocardial infarction (AMI).A heart attack is a medical emergency of the first order. In North America, about 500,000 heart attack deaths occur outside the hospital, compared with 60,000 deaths among those who reach the hospital (Khan & Marriott, 1996). Thus, you may save a life by recognizing the symptoms of a heart attack and summoning emergency medical services by dialing 911 immediately.
In the majority of patients, there is no identifiable event that triggers the heart attack-no one knows exactly when a coronary artery will occlude, or become blocked. The individual may state he or she has crushing pain, vise like squeezing, or a heavy weight on his or her chest. The pain may be accompanied by profuse sweating, shortness of breath, nausea, or extreme weakness. The signs of heart attack in women may be more subtle or different in nature, manifested by feeling breathless, unexplained fatigue, and feelings of anxiety. Chest pain may or may not be present. If the person's blood pressure drops significantly or the heart rhythm becomes too fast or highly irregular, he or she may lose consciousness. If such an event occurs int your presence, remain with the individual and call for paramedics. Never attempt to take the individual to the hospital yourself, as the person's condition might deteriorate during transport.

Treatment of Heart Disease

Typical treatments for coronary artery disease include angioplasty, coronary artery bypass grafts, and the emergency administration of medications to clear the clogged artery in an emergency room. Of the three treatments, the oldest is coronary artery bypass graft, or CABG (pronounced "Cabbage"). When one's quality of life is eroded by the combination of chest pain and reduced levels of activity that do not respond to medications or angioplasty (explained below), a CABG offers a reasonable alternative. In this surgical procedure, the section of blocked artery is removed and is replaced by one of the patients leg veins or internal mammary arteries. The new vein or artery is grafted into place, restoring circulation through the coronary artery. With this treatment, approximately 90 percent of patients obtain complete relief for two or more years (Khan & Marriott, 1996).
Another treatment for heart attack is angioplasty (also called percutaneous transluminal coronary angioplasty, or PTCA). Angioplasty, which has been a part of the medical arsenal for a little lee than 25 years, involves passing an instrument through the skin (percutaneous) and into the artery (transluminal). The instrument is advanced into the coronary arteries, where a balloon on the tip of the instrument inflates to crush the atherosclerotic plaques. Successful reopening of an artery can be accomplished in 70 to 90 percent of patients, although about 20 to 35 percent of these patients will occlude again within six months (Kahn & Marriott, 1996).
Khan and Marriott report that the most recent form of treatment focuses on dissolving clots through one of four drugs: streptokinase, tissue plasminogen activase (tPA), reteplase, and anistreplase (APSAC). Used in the emergency department, these drugs are given intravenously within a very short period of time (four to six hours) after the onset of heart attack symptoms and both dissolve the clost and reestablish blood flow to theart muscle.
Aftercare is critical for those who have had heart surgery. Coronary heart disease patients usually undergo some type of physical therapy. Those that successfully follow through with therapy are less likely to suffer another coronary event. Regardless, any medical treatment for heart disease remains incomplete without the necessary lifestyle changes to support a healthy heart, such as losing weight, modifying the diet, quitting smoking, and exercising regularly.
The above information was provided by the Society of Certified Senior Advisors (SCSA)
The following information was provided by Ryan Rivera
How to Tell the Difference Between a Panic Attack and a Heart Attack
As you age, there are certain concerns you always have to have about your health. Perhaps the most common is your heart, since heart issues are a common, inconvenient part of aging. But there are some issues that can affect you regardless of age, and in rare cases, these issues may make it more difficult to monitor your health the way you hope to.
Introduction to Panic Attacks
Anxiety disorders can hit you at any age, and panic attacks are perhaps the most problematic. Panic attacks are sudden, relatively unprompted feelings of intense fear, and the most common subject of this fear is your own health. Panic attack symptoms are so unusual, in fact, that many people end up in the hospital with a fear that they are having a heart attack. The symptoms can be very similar:
· Rapid, intense heartbeat.
· Light-headedness and a feeling of something being "seriously wrong."
· An intense need to sit down, and occasionally feeling very weak.
· Dizziness and problems with clear thinking.
In addition, panic attacks can provide an intense fear that you are in the process of dying, and may create physical symptoms as a result of the placebo effect (for example, experiencing chest pains because you believe that you're suffering from something that creates chest pains).
What makes panic attacks an even greater problem for the aging community is that panic attacks are largely triggered by paying too much attention to your health. You're told to monitor your health regularly, but if you suffer from panic attacks, this type of over-attention to your health can actually trigger more panic attacks, as any time something feels even remotely out of place it can cascade into something far more pronounced.
Responding to a Panic Attack
This brings up an unusual conundrum. How do you tell the difference between a panic attack and a heart attack? Once you reach 50 or older, it may be a good idea to go to a doctor anyway, even if you believe you're suffering from a panic attack. "Better safe than sorry" is a good motto to have. But if yon t to try to differentiate between the two when you're in the moment, here are a few ways to tell the difference between a panic attack and a heart attack.
· Does it Recur in a Common Place?
It's very difficult – potentially impossible – to tell the difference between a panic attack and a heart attack the first time you have a panic attack. But often panic attacks tend to recur in similar places or during similar situations. For example, if you have a panic attack while at the mall, and you start having one again at a mall, it's a bit more likely to be a panic attack. It may not just be places as well. It could also be a result to a similar feeling.
· Were You Worrying About Having a Panic Attack?
Panic attacks can also trigger themselves. If you were worried about getting a panic attack, you may have increased your chances of developing panic attacks. Any time you've been spending most of the day monitoring your body's reactions and worrying that you might get a panic or heart attack, your panic attack risk increases.
· Did You Recently Have a Panic Attack and Your Heart Checked Out?
Panic attacks can often occur in group. If you had a panic attack, went to the doctor, and your heart appeared to be fine, and then the next day when you were out you start experiencing these symptoms again, there's a bit of a better chance that it was a panic attack.
What to Do
It would be dangerous and irresponsible to tell you to assume you're having a panic attack over a heart attack, because heart attacks are a very real concern. That's why it's so unfortunate that panic attacks and heart attacks can have such similar symptoms, because there are very few ways to tell the difference. The above tips potentially work, but going to your doctor just in case is never a bad idea.
However, because of the similarities between the two, it's very important that you seek some type of mental health treatment to reduce the frequency of your panic attacks. Panic attacks can be legitimately terrifying, and if you're already concerned about your own health, it's always a good idea to make sure that you don't allow a mental health disorder to add to your worries.
About the Author: Ryan Rivera was frequently hospitalized for his panic attacks before he learned what they were and how to control them. He supplies information on panic attacks and anxiety symptoms on his website at www.calmclinic.com.