In a large multi-center study (Second International Study
of Infarct Survival
of the ISIS-2 trial) of patients having acute heart attacks, early treatment
(within 24 hours of the onset of symptoms) with aspirin (160 mg/d) was found to
reduce deaths from the heart attacks by 23%. The improved survival is believed
to be due to aspirin's ability to quickly prevent further blood clots and the
expansion of existing clots and thus limit the amount of damage to the heart's
muscle.
Aspirin is easy to use, safe at the low doses used for its
antiplatelet action, and fast acting. Aspirin at moderate doses (160-325 mg/day)
produces an antiplatelet effect rapidly (within 30 minutes). The current
recommendation is to give aspirin immediately to almost all patients as soon as
a heart attack is recognized at a dose of 160-325 mg/d and to continue it for
one month. The only reason for not using aspirin is a history of intolerance or
allergy to aspirin or evidence obvious active bleeding (such as actively
bleeding stomach ulcers).
Performance of vascular procedures
Aspirin is not the only treatment for heart attacks and
unstable angina. Sometimes percutaneous transluminal coronary artery angioplasty
(PTCA), with or without placement of an arterial stent, is necessary to open
narrowed or blocked coronary arteries. In rare instances, PTCA may be
technically impossible, or not practical, to do, and coronary artery bypass
graft surgery (CABG) becomes
necessary to improve the flow of blood to the heart.
Some patients with heart attacks are treated with thrombolytic agents
(medications that dissolve clots) to open blocked arteries. It is important to
make the distinction that aspirin generally does not open an existing blood
clot, but it acts to prevent propagation of the existing clot and the formation
of new ones. In all of these instances, there is a risk that blood clots will
form again inside the arteries, leading to further heart attacks. In all of
these cases, aspirin has been shown to be beneficial in preventing new clots,
thus reducing the risk of heart attacks and improving both short and long-term
survival.
Prevention of further heart attacks
There are two types of heart attack prevention, primary and secondary.
Preventing the first heart attack is called primary prevention. Preventing
further heart attacks among patients who already have had a heart attack is
called secondary prevention.
Within six years after the first heart attack, 16% of men and 35% of women
will have a second heart attack. Long-term, daily aspirin (75-325 mg/d) has been
shown to reduce the risk of second heart attacks and improve survival among both
men and women. Additionally, long-term secondary prevention with aspirin also
has resulted in fewer ischemic (lack of blood flow due to blockage in blood
vessels from clot formation) strokes. Therefore, survivors of heart attacks
usually take daily low dose (75 mg-160 mg/d) aspirin indefinitely to prevent
further heart attacks as well as strokes.
Aspirin taken long-term is an important part but NOT the only measure for
preventing heart attacks.
Treatment of exertional and unstable angina
Aspirin is particularly useful in preventing heart attacks
and heart attack related deaths in patients with
unstable angina. The Canadian Multicenter Trial, and the
Montreal Heart Institute study all demonstrated significant reductions
(approximately 50%) in the risk of heart attack among patients with unstable
angina who are treated with aspirin. A study by the Research on
Instability in Coronary Artery Disease Group (RISC) showed a 70% reduction in
the risk of death or heart attack in patients with unstable angina treated with
aspirin. Aspirin usually is started as soon as the diagnosis of unstable angina is made and then continued
indefinitely.
In patients with prolonged chest pain due to unstable
angina (a situation in which heart attacks are frequent), percutaneous
transluminal coronary artery angioplasty (PTCA) with or without stenting may be
necessary to open blocked coronary arteries. Aspirin is often used in
combination with another antiplatelet agent, such as
eptifibatide (Integrilin),
and an anti-coagulant (heparin or low molecular weight heparin) to prevent heart attacks while
awaiting the PTCA procedure. Aspirin then is used long-term (either alone or in
combination with another antiplatelet agent) to prevent blood clots from forming
inside the coronary arteries and stents.
In patients with exertional angina (chest pain brought on by exertion), low
dose aspirin (75 mg-325 mg daily) given long-term has been shown to
significantly reduce the risk of heart attacks, sudden death, and ischemic
strokes.
Treatment of ischemic strokes
Ischemic stroke is a process similar to a heart attack. In general, ischemia means injury
to a tissue in the body due to lack of blood flow. Accordingly, an
ischemic
stroke is injury to the brain tissue due to lack of blood perfusion. This
usually happens because of atherosclerosis (narrowing and hardening of the blood
vessels) of the arteries in the brain. Heart attack is the ischemia of the heart
caused by similar process. Another major process for ischemic stroke may be due
to an embolism (a blood clot that dislodges and travels from some other
location in the body) to the blood vessels in the brain stopping blood from
passing through the blood vessel.
When aspirin at moderate doses (160-350 mg/d) is given to
patients as soon as an ischemic stroke is recognized (usually within the first
48 hours of the onset of symptoms), survival is improved, and the risk of
additional strokes is reduced. Aspirin is believed to benefit patients having
acute ischemic strokes by preventing the propagation (extension or growth) of
the blood clots and preventing the complete obstruction of the arteries.
However, aspirin is not effective in treating or preventing hemorrhagic strokes. In fact, some studies
suggest that long-term aspirin use may increase slightly the risk of developing
hemorrhagic strokes.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Peripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include: intermittent claudication, rest pain, numbness in the extremities, and more. Treatment for peripheral artery disease include: lifestyle measures, medication, angioplasty, and surgery.
Sickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is cause by an inherited abnormal hemoglobin. Symptoms may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
Kawasaki disease is a rare children's disease characterized by a fever that lasts more than five days and at least four of the following five symptoms are present: rash, swollen neck lymph gland, red tongue, swelling or redness of the hands or feet, and conjunctivitis. High doses of aspirin are used to treat Kawasaki disease. Cortisone and antiinflammatory drugs may also be used during treatment.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Vascular disease includes any condition that affects your circulatory system. Vascular disease ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Reye's syndrome (RS, or Reye syndrome) is a sudden, sometimes fatal, disease of the brain with degeneration of the liver. Reye syndrome occurs in children and comes after the chickenpox or an influenza-type illness, is also associated with taking medications containing aspirin. Symptoms include vomiting, listlessness, irritability or combativeness, confusion, delirium, delusions, convulsions, and loss of consciousness. Treatment depends on early diagnosis and focuses on protecting the brain against irreversible damage by reducing brain swelling, reversing the metabolic injury, preventing complications in the lungs, and anticipating cardiac arrest.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO syndrome is an eponym for the combination of synovitis, acne, pustulosis, hyperostosis, and osteitis. SAPHO syndrome is related to arthritic conditions such as ankylosing spondylitis and reactive arthritis. Treatment is directed toward the individual symptoms that are present, and includes medications such as nonsteroidal antiinflammatory drugs (NSAIDs), and cortisone medications.
Eosinophilic fasciitis is a skin disease that causes thickening and inflammation of the skin and fascia. Symptoms include redness, warmth, and hardening of the skin, as well as occasional tissue and joint pain. Treatment for eosinophilic fasciitis aims to eliminate inflammation through the use of aspirin, NSAIDs, and cortisone. Aggressive forms of eosinophilic fasciitis may require the use of immune suppression medications.
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay inlcudes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack.
Stroke is the third leading killer in the United States. Some of the warning signs of stroke include sudden confusion, trouble seeing with one or both eyes, dizziness, loss of balance, and more. Stroke prevention and reatable risk factors for stroke include lowering high blood pressure, quit smoking, heart disease, diabetes control and prevention.
Guinea worm disease (GWD or dracunculiasis) is an infection caused by the parasite Dracunculus medinensis. After a person drinks water contaminated by water fleas that harbor Guinea worm larvae, the larvae grow into adult worms (2-3 feet) in the small intestine and then migrate and emerge from the skin. Symptoms and signs include fever, swelling, and pain near the blister on the skin where the worm will emerge. As there is no medication to treat GWD and no vaccine to prevent infection, treatment focuses on minimizing pain and swelling (with the use of ibuprofen or aspirin) as the worms are slowly pulled from the wound over the course of a few days to a few months.
Heart RSS
Healthy Living Tips
