Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Oxygen also is commonly administered during the acute phase of a heart
attack as are narcotics such as morphine; these agents aid in the reduction of
discomfort and actually help minimize the amount of heart damage.
Coronary artery bypass
In some patients, PTCA can be technically difficult or dangerous to perform.
In others, PTCA and clot-dissolving medications may fail to achieve reperfusion
or maintain open arteries. These patients may be considered for coronary artery
bypass grafting surgery. For more information, please see the Coronary Artery
Bypass Graft article.
Heart attack patients are monitored in the hospital for three or more days
prior to discharge home. Rhythm disturbances, shortness of breath due to heart
failure, or recurrent chest pain are reasons for further therapy such as balloon
angioplasty or coronary stenting, additional medications, or bypass surgery.
Patients gradually increase their activity under observation. Before
discharge, a low-level exercise stress test may be performed to detect important
residual narrowing in the coronary arteries, exercise-induced cardiac rhythm
abnormalities, and heart muscle failure, and to help guide the doctor in
prescribing an activity regimen after hospitalization. An abnormal stress test
prior to hospital discharge following a heart attack predicts a high risk for
subsequent cardiac events; if the patient has not yet had a coronary angiogram,
an abnormal pre-discharge stress test is a strong reason for doing angiography.
Since most patients usually receive angiography early, the use of pre-discharge
stress testing has declined.
Before resuming full activity or work, several weeks may
be needed for the heart muscle to heal. After a small heart
attack (little damage to heart muscle), patients usually can resume
normal activities after two weeks. These activities include returning to work as
well as normal sexual activity. A moderate heart attack
(moderate damage to heart muscle) requires limited, gradually increasing
activity for up to four weeks, while a large heart attack (much damage to heart muscle) may result in a recovery period of six weeks or
longer. These time frames are necessary in order for the dead heart muscle to
substantially complete the scarring process. During this healing period,
patients should avoid vigorous exertion and heavy lifting (over 20 pounds) or
any strenuous activity that causes shortness of breath or undue fatigue.
Cardiac rehabilitation typically begins during hospitalization and continues
during the months following a heart attack. Cardiac rehabilitation programs
provide a helpful transition to a safe and full return to a normal lifestyle. In
addition, cardiac rehabilitation allows the prescription of a long-term exercise
program tailored to each patient and helps patients and their families adjust to
lifestyle changes and the difficult and conflicting emotions that often follow a
heart attack.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
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.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
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.
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.
Fabry disease (Fabry's disease, alpha-galactosidase-A) is a genetic disorder with symptoms such as burning sensations in the hands, small-raised reddish-purplish blemishes on the skin, fever, decreases sweating, and GI difficulties. Fabry disease patients are at increased risk of heart attack, heart disease, kidney failure, and stroke. Symptoms of Fabry disease can be treated with medication.
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.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Vitamins and exercise can lower your risk for heart attack and heart disease. Folic acid, vitamins, and homocysteine levels are interconnected and affect your risk for heart disease or heart attack. Antioxidants and exercise also play a key role in heart attack and heart disease prevention. Lower your risk factors for heart disease and heart attack by lowering cholesterol, lowering blood pressure, diabetes prevention, and smoking cesssation.
Smoking increases the risk of heart disease in women and men. Nicotine in cigarettes decrease oxygen to the heart, increases blood pressure, blood clots, and damages coronary arteries. Learn how to quit smoking today, to prolong your life.
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