Heart attack

“ Heart attacks result when the blood supply to part of the heart muscle is severely reduced or stopped. Because many heart attack victims do not recognize the warning signs until it is too late, only one in five is able to reach a hospital quickly enough to benefit fully from treatments. ”

“ The second factor in spontaneous cure of the heart attack is relaxation. The exhaustion from the respiratory muscular efforts, together with the drowsy condition caused by the cerebral hyperemia and from the imperfectly aerated blood, causes finally a dulling of the mental acuity, and the nervous excitement abates, which, with the exhaustion, gives a relaxation of peripheral arterioles: the resistance to the flow of the blood is removed, the surface of the body becomes warm, the heart quiets down by the equalization of the circulation, and the paroxysm is over. ”

“ Fifty years ago, a heart attack meant an end to an active lifestyle, and, for a third of those stricken, it meant death. Thankfully, the past half-century has brought us an array of advances in the prevention and treatment of heart disease. ”

“ And the symptoms of a heart attack can be different for men and women, an often-overlooked fact that can impact when people seek care. For more resources and information, follow your health care provider’s advice or visit www.CDC.gov/HeartDisease. ”

“ Like many women, I assumed heart disease was a "man's disease." But the Heart Truth is this: that heart disease is the leading cause of death among American women. In 2002, the National Heart, Lung, and Blood Institute launched the Heart Truth campaign, and asked me to join.
Over the last five years, I've seen the Heart Truth campaign spread the word to women about how they can protect their heart health. Symptoms of a heart attack can be different in women than in men. Symptoms in women can include persistent fatigue, difficulty breathing, and a pain in the jaw or neck. ”

“ Death in the acute stage of a first attack of inflammation of the heart is of extreme rarity, but the damaged heart is liable to returns of acute mischief, any one of which may prove fatal. Independently of this, life with diseased heart is one of suffering, attended as it is by symptoms similar in kind, though not identical with those which I have already mentioned as attendant on malformation of the organ. ”

“ The campaign also offers educational materials for both the general public and healthcare professionals to encourage communication among doctors, other healthcare providers, and their patients about the importance of recognizing heart attack signs and getting treatment quickly.
Far too many Americans are also unaware of the dangers of cardiac arrest, in which the heart suddenly loses its ability to function. Most cases of cardiac arrest that result in sudden death occur when the diseased heart's electrical impulses become rapid and then chaotic. ”

“ The pulse is generally slow, unless broken compensation occurs; dyspnea on exertion is a prominent symptom; the increased secretion of mucus in the bronchial tubes and throat is often troublesome, and there is liable to be considerable cough. If these patients have an acute heart attack, a feeling of suffocation is their worst symptom and the dyspnea may be great, although there may be no tachycardia, these hearts often acting slowly even when there is serious discomfort. When compensation fails, there is an occurrence of all the usual symptoms, as previously described. ”

“ Today, the person stricken with a heart attack has a much better chance of surviving the acute episode, thanks to continued improvement in diagnosis and treatment. More and more of the stricken are reaching the hospital alive, thanks to better recognition of ominous symptoms, widespread teaching of cardiopulmonary resuscitation by the American Red Cross and the American Heart Association, and better-equipped emergency vehicles with better-trained crews. ”

“ Exertion directly after eating a large meal is especially liable to precipitate an attack. Food which does not readily digest, or food which causes gastric flatulence may precipitate attacks. Any indiscretion in the use of coffee, tea, alcohol or tobacco may be the cause of the attack.
For treatment of the immediate pain, if the physician arrives soon enough, anything may be given which quickly relieves local or general arterial spasm and spasm of the muscles. The moment that the heart and its arterioles relax, the attack is often over. ”

“ In such attacks there are strong radiating pains in the heart region, and a feeling of great anxiety, of utter annihilation, and of instantaneous death; and indeed not so seldom such attacks may terminate in death. These attacks may be considered as a warning of nature that such persons stand on the verge of a precipice and thus urging them to the greatest precautions to avoid anything that may bring about such an attack. From my own observations, rapidly fatal attacks of angina pectoris in such cases of arteriosclerosis happen frequently after a heavy dinner. ”

“ Paroxysmal tachycardia is a name applied to very rapid heart attacks in persons who are more or less subject to their recurrence. They may occur without any tangible excuse, and are liable to occur during serious illness, after a large meal, after a cup of tea or coffee, or after taking alcohol. The heart may beat as rapidly as from 150 to 200 times a minute, or even more, with no other symptoms than a feeling of constriction or tightness in the chest, an inability to respire properly and a feeling of "air hunger." The patient almost invariably must sit up, or at least have his head raised. ”

“ No one knows why heart disease begins. And, while it is known that heart disease develops differently in men and women, the reasons for those variations are still being studied. About 50 million Americans continue to suffer from hypertension, a major cause of stroke, and 1.25 million Americans have heart attacks every year. ”

“ In fatal cases death usually results from exhaustion, the result of the systemic poisoning, but occasionally it is due to a failure of the heart to propel the blood through the solid lung, to suffocation, or a complication, such as inflammation of the covering of the heart (pericarditis) or lining of the heart (endocarditis) . ”

“ Good general elimination by catharsis, warm baths to increase the peripheral circulation, a low diet for a few days, abstinence from any toxin which could cause this cardiac irritation, extra physical and mental rest, sometimes nervous sedatives such as bromids, and perhaps a lowering of the blood pressure by nitroglycerin, if such is indicated, or an increase of the cardiac tone by digitalis if that is indicated, will generally remove the cardiac irritation and prevent the extrasystoles, and the heart will again become regular. ”

“ This form of valvular lesion is the one that is most likely to cause sudden death. In aortic regurgitation Nature causes the heart to beat rapidly. Such a heart must never beat slowly, as the longer the diastole prevails the more blood will regurgitate into the left ventricle, and death may occur from sudden anemia of the base of the brain. Such a heart may, of course, receive a sudden strain, or the left ventricle may dilate, and yet serious myocarditis or fatty degeneration may not have occurred. ”

“ What I wish to maintain is that in cardiac degeneration of any kind, in chronic cardiac dilatation, and in the enlarged heart of Bright's disease and of emphysema, just as in ordinary valvular disease, attacks of distress, alarming both to patient and doctor, often occur which call for nothing more in the way of treatment than attention to some intercurrent influence—an indigestible meal, loaded bowels, a nervous shock, a thoughtless effort, a passing hardship or nervous strain. Digitalis and its allies, strychnine, alcohol, nitrites, iodides and the rest are out of place in such an event. ”

“ And unless you yourself can either cure that, or will make head against it, worry, my dear Lady Montfort, will end not in consumption—you are too finely formed to let worry eat holes in the lungs—no; but in a confirmed aneurism of the heart, and the first sudden shock might then be immediately fatal. The heart is a noble organ—bears a great deal—but still its endurance has limits. ”

“ Cardiac failure accounts for most of the deaths, whether developed gradually with dropsy, which proves to be intractable; or progressing rapidly with great cardiac distress, including angina; or occurring suddenly, as it often does. Aneurysm makes its appearance in other instances, of which the patient dies, or he is carried off by general paralysis or Bright's disease.
What prospect have we to hold out to the man who has strained the walls of his heart by muscular effort? ”

“ Anything which seriously excites him, whether anger or a stimulating drug, is harmful. Any disease which he may acquire, especially lung disturbances, as pneumonia or even a serious cough, requires that he take better care of himself and be more carefully treated and take more rest in bed than a patient who has not a damaged heart. Anything which raises the blood pressure is of course more serious for his heart than for a perfect heart; therefore drinking large amounts of liquid, even water, is inadvisable. It simply means so much more work for the heart to do. ”

“ A normally-sized heart with irregularity, increased frequency, and a variable systolic murmur in the mitral area, is characteristic of tobacco poisoning. A heart enlarged on both sides, and acting irregularly without murmur, is (apart from cardiac failure) suggestive of strain in early life.
Cardiac symptoms taken individually are of less diagnostic value than signs. No symptom is pathognomonic. Palpitation is a nearly universal phenomenon of cardiac disease and disorder. Faintness and actual faints are not uncommon in cases of early cardiac strain, gouty heart, and nervous disturbances. ”

“ Every day—every day—more than 600 Americans die from sudden cardiac arrest. In some cases, the cause is long-term coronary artery disease. In others, it can be triggered by intense emotional or physical stress. Either way, the heart starts beating chaotically and cannot send blood to the brain and other vital organs.
The key of survival is the speed of response. In addition to CPR, most cardiac arrest victims need an immediate electrical shock to restore the heart's normal rhythm. When victims receive that shock within a minute, there's a 90 percent chance of resuscitation. ”

“ You see, she has heart disease, and any sudden shock brings on one of these terrible attacks that may kill her. She bears everything like an angel—I never heard a complaint from her in my life—not even when she was suffering tortures—but the doctors say now that another failure of her heart would be fatal. ”

“ Hence people in Grief, &c. labour under a double Disease, which, on account of the anxiety, weight, and oppression that is felt from the Blood stagnating about the Heart, is commonly termed Heart-breaking.
An Uneasiness or Anxiety, and Palpitation of the Heart, are the last Symptoms that are commonly felt of the [28] Night-mare, which proceed from the cause lately mention’d; as ’tis then necessary that the Heart should contract itself more frequently, in order to discharge the Blood collected in the Vena Cava, the right Sinus Venosus, and Auricle, during the fit. ”

“ The original disturbing heart sensation may be due to nothing more than some slight distention of the stomach by gas, or by a rather heavy meal, but once the dread of the presence of a heart condition of some kind comes over the individual, all the subjective feelings in the cardiac region are emphasized and the discouragement that results further disturbs both heart and patient.
Palpitation of the heart is scarcely more than a solicitous noting of the fact that the heart is beating. ”

“ In addition to extrinsic dangers, particularly those of Bright's disease, cerebral thrombosis and hæmorrhage, and bronchitis, failure of the heart is liable to supervene and prove fatal from the gravest of all intrinsic causes, namely, coronary degeneration. As this increases, the myocardium is steadily more and more impoverished ”

“ If the left ventricle becomes sufficiently weakened or dilated, the same damming back of the blood through the lungs and right heart occurs, and more or less serious signs of broken compensation develop. The main danger, however, with a heart with this lesion, occurring coincidently with arteriosclerosis, is a progressive chronic myocarditis. ”

“ There is always danger from rupture.
MYOCARDITIS.—This is an inflammation of the muscle substance of the heart. It may be acute or chronic.
Causes.—Endocarditis and pericarditis in the course of rheumatism; acute fevers like typhoid, etc.; clots lodging in the heart arteries, coming from diseases such as septicemia and pyemia.
Symptoms.—The heart is weak. The pulse is rapid, small and irregular, palpitation and fainty sensations come on suddenly during the course of diseases mentioned. The outlook is serious and life may end suddenly. ”

“ While angina pectoris and edema of the lungs were not infrequent causes of death in men, it was a rare cause of death in women. Dyspnea is a frequent symptom, and one for which many patients seek medical advice.
A constant systolic blood pressure of over 200 shows a probability that the patient will ultimately die either of uremia or of apoplexy. Janeway found that those patients who are to die from cardiac weakness show cardiac symptoms early in their disease. ”

“ We are justified in concluding not only that every cardio-vascular lesion which may be found in tobacco smokers is not to be put to the credit of tobacco, but, vice versâ (and this is of more interest to us in our present inquiry) , that every præcordial pain, angina, faintness, or irregular pulse in a man of 60 with a full-sized heart is not to be hastily regarded as evidences of grave disease without further inquiry as to his habits. ”