Ignoring Lessons Learned from Heart Disease

A serious heart attack is as much of an emergency as being shot.

“We deal with it as if it is a gunshot wound to the heart,” Dr. Antman said.

Cardiologists call it the golden hour, that window of time when they have a chance to save most of the heart muscle when an artery is blocked.

Don't think of a clutching your heart pain like you see in the movies.  Consider pressure, a feeling of heaviness, shortness of breath.

Most patients describe something like Mr. Orr’s symptoms — discomfort in the chest that may, or may not, radiate into the arms or neck, the back, the jaw, or the stomach. Many also have nausea or shortness of breath. Or they break out in a cold sweat, or have a feeling of anxiety or impending doom, or have blue lips or hands or feet, or feel a sudden exhaustion.

But symptoms often are less distinctive in elderly patients, especially women. Their only sign may be a sudden feeling of exhaustion just walking across a room. Some say they broke out in a sweat. Afterward, they may recall a feeling of pressure in their chest or pain radiating from their chest but at the time, they say, they paid little attention.

The time in getting to an emergency room in time for treatment hasn't changed in 10 years - it's still 110 minutes,  one hour and 50 minutes.

People drive themselves to the ER or get a friend to do so. And then they wait to get triaged.  They don't come in with sirens blazing, treatment already started, and jump to the head of the line.

They don't call 911 because of embarrassment.  Said Dr. Skopp
“But it is better to be checked out and find out it’s not a problem than to have a problem and not have the therapy,” he said.

The ideal treatment you want is angioplasty, the ideal treatment.

Second best is  a clot-dissolving drug like tPA even though it opens up only 60-70%  of blocked arteries and kills 1 out of 200 patients with a stroke to the brain.

Dr. Antman has a message for patients: With a disease as serious as heart disease, those who take responsibility are often the ones who survive.

Having a heart attack, even if it turns out well, as his did, is a life-altering experience, Mr. Orr said.

The New York Times follows Keith Orr, 44, who thought he was doing great, what with his improved diet and exercise and all,  so he stopped taking his medications. Luckily,  he was in Boston.  Lessons of Heart Disease, Learned and Ignored.