What should I ask my doctor about my heart health?

Heart Attack – Questions You Need to Ask Your Doctor

A heart attack happens when the flow of blood to the heart is blocked. Hearts attack is a leading cause of death worldwide even today. Most of the deaths can be prevented by creating public awareness about heart disease. For more awareness and preventing deaths due to heart attacks, you need answers to the following questions.

1. Is Heart Attack an Emergency?

A heart attack is a medical emergency. Heart muscle is dying every fraction of a second during a heart attack due to lack of oxygen supply. Damage to the heart muscle can lead to heart failure or death. Non-emergency heart diseases can be treated with a detailed evaluation.

2. What could be the symptoms of a heart attack?

• Chest discomfort
• Chest pain with unexplained sweating
• Sudden onset of breathing difficulty
• Irregular heartbeat
• Tiredness or fatigue or loss of consciousness.
• Mitral valve disorders
• Giddiness or dizziness 

Patients with any of these symptoms should immediately consult the nearest hospital get an Electrocardiogram (ECG) done. In 90 to 95 percent cases, ECG will provide the diagnosis. Doctors follow their own protocols to do blood tests and repeat ECG if clinical suspicion is high. 

3. Where and how to shift the patient with a suspected heart attack?

Patients with typical symptoms and ECG/ blood test suggestive of heart attack should be given utmost priority.  Every heart attack patient should be shifted in an ambulance to the nearest center where angiogram/ angioplasty can be done within 120 minutes. If it is not possible to shift in time or, where facilities are not available, then the patient should receive clot-dissolving medicine in less than 30 minutes.

4. Who gets the heart attack?

Anybody can get a heart attack if they have certain risk factors.  Heart physiology is similar in all human beings. However, risk factors may vary. A heart attack doesn’t occur on the basis of good or bad individuals. Hearts blockages are manmade and heart diseases occur due to changes in the lifestyles.

5. What are the risk factors that can cause a heart attack?

Age, family history and gender are non-modifiable risk factors. Modifiable risk factors are smoking, diabetes, hypertension, high blood cholesterol, lack of exercise, unhealthy food habits and type A personality.

6. How to prevent a heart attack?

Lifestyle changes like regular exercise, balanced diet, sound sleep, stress management, quitting smoking, moderation of alcohol and weight reduction will help in reducing your risk of a heart attack. Lifestyle changes should start early in life. Periodic heart health check-up and keeping a check on risk factors, such as diabetes, hypertension, and cholesterol, etc. may also help in prevention. You have to take Annual preventive health checks with echo-cardiogram and treadmill tests to diagnose blockages before they can cause a heart attack.

7. Do second opinions matter in a heart attack situation?
Every minute counts in a heart attack. Undue delay can cost a life. In non-emergency situations, second opinions from another qualified specialist can be obtained. Understand the implications of the treatments. Do not do Google search when your house is burning. Trust the doctor who can rescue the patient at best of his/her efforts.

8. What am I suppose to do as a relative of the patient?
Don’t breakdown, give courage to the patient.  Get the required financial support and also get health insurance for all your dependents. Heart attacks need life-saving, treatments that are unpredictable, unavoidable, unplanned and expensive. Don’t make decisions based on emotions, have rational thinking. Learn about “Basic Life Support“. Counsel the patient about the importance of lifestyle changes, compliance with medicines and de-addiction. If you are the first-degree relative, then get a comprehensive heart health check-up. You can also avail a Complete Heart Health Check Package offered by some healthcare providers closer to you.

9. What is the best treatment option in a heart attack?
Primary angioplasty should be done wherever possible in a heart attack. If it’s not suitable then a bypass surgery can be considered. Clot-dissolving medicines can be used where there are no facilities for an angiogram. Blood thinners, statins are universally given to all patients.  Medical line of treatment or angioplasty or bypass surgery each has specific recommendations based on scientific evidence in each case.  Decisions based on the evidence should be encouraged than individual’s choices or opinions or preferences.

10. What are the risks or the complications of the treatment?

All the recommended medicines or surgeries have specific proven scientific data about their benefits. Most of the patients die because of lack of treatment or complications of the disease rather than the complications of the treatment. No medical/scientific body will approve a treatment option which is more harmful than the benefits to the patient. All qualified practitioners perform their skills within the medico-legal boundaries with proven scientific methods. If you notice any new symptoms (example, bleeding risk with blood thinners) report to the doctor who decides whether it is related to the side effects.

11. What are the other diseases of heart apart from a heart attack?

Following are few other heart diseases apart from a heart attack

• Birth defects of the heart and its development (at early stages of life).
• The disease of heart valves (narrowing or incompetence) either congenital or acquired.
• Heart failure/ pump failure/ heart muscle weakness due to various causes.
• The disease of the great arteries or the pericardium (cover on the heart).

Most of these diseases are identified by echocardiogram. Most of the structural disease can be corrected by elective surgeries. Elective surgery is chosen by a patient rather than urgently needed

12. What is the rule of TMT positivity or Elective Angiogram?

TMT is done for screening the blockages if the patient is having only exertional (precipitated by physical exertion) related symptoms. TMT positive for ischemia (insufficient blood supply to an organ) implies need for an angiogram for further risk stratification.  Based on the blockage severity and their physiological significance either elective angioplasty or coronary bypass surgery or medical management can be advised. Elective angioplasty or bypass surgery carries very minimal risk compared to emergency procedures. Elective cases give enough time in the decision-making process and scope for second opinions. Shared information and precise decisions improve the outcomes.

13.  Alternative medicine –  is it useful?
No animal experiments are allowed in the present time. So, don’t become a guinea pig for your own experiments.  All qualified doctors follow universally accepted guidelines or protocols for the treatment of a patient.  Right to know is every civilian right but right to treat is doctor’s right. Qualified doctors have gone through a certain level of training before practicing medicine. They don’t need suggestions from Google. Respect the time of specialist, discuss relevant issues with the intent of understanding the disease process. The good doctor-patient relationship can save a lot more hearts or lives.