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Surviving heart attacks and getting a second chance.

Cardiovascular disease is the leading cause of death not only in developed countries but also in developing countries, including the Philippines. We are in the midst of a global cardiovascular disease epidemic. This broad term includes acute coronary syndrome, stroke, heart failure, hypertension and other disorders.

Fewer people are familiar with the condition called "acute coronary syndrome," but more are aware of the term "heart attack." Acute coronary syndrome (ACS) is the medical term for heart attack. It encompasses a disease group characterized by a decreased heart muscle blood flow due to a blockage in the blood vessel (coronary artery) supplying the heart. Cholesterol deposition causes narrowing within the vessel, which, when combined with sudden blood clot formation, leads to further obstruction of blood flow, resulting in ACS.

Several risk factors increase your ACS risk, ranging from high cholesterol, diabetes, high blood pressure, smoking, obesity and genetics. Patients usually present with compressing chest pain or discomfort, which may radiate to the shoulder, arm, neck or jaw. In some patients, the condition presents unusually and may be misdiagnosed as indigestion. In rare instances, ACS may present fatally as sudden death or cardiac arrest wherein the heart suddenly stops beating. Therefore, when one survives a heart attack, he or she is given a "second chance" at life.

We have seen major advances in ACS treatment, which have improved one's chance of surviving and further improving this "second chance" at life. However, early symptoms recognition and rapid medical attention are critical. Medical therapy consisting of blood thinners called antiplatelets improves outcomes of patients. More aggressive intervention in the form of coronary angioplasty is lifesaving and can be done in most tertiary hospitals. In severe ACS cases, heart surgery may be necessary to increase patient's survival or, putting it in another way, to decrease one's chance of dying. If a person survives the initial acute episode, several medications can decrease the chance of getting another heart attack. Equally important are other measures to prevent a second ACS; these include a healthy lifestyle, proper diet, smoking cessation, blood pressure control, diabetes management (if present) and cardiac rehabilitation.

In summary, heart attacks can be sudden and unpredictable events with debilitating and often catastrophic consequences. Getting a good chance at surviving a heart attack requires knowing one's risks of having it, recognizing the symptoms and getting prompt treatment. Surviving a heart attack and getting this second chance is a gift that should not be taken for granted. While it is the responsibility of every physician to ensure that each patient gets the best treatment that will sustain this second chance, it is the duty of each patient to make sure that this chance does not go to waste.

Dr. Marcellus Francis Ramirez is a cardiologist and the current director of the Fellowship Training Program of the University of Santo Tomas Section of Cardiology and a faculty staff of the Department of Medicine, University of Santo Tomas Faculty of Medicine and Surgery. The A to Z of Health Information Advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.
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Publication:Philippines Daily Inquirer (Makati City, Philippines)
Date:Jan 17, 2015
Words:535
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