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Just had a heart attack

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Re: Just had a heart attack

#82
post #52

Earlier quoted context omitted.

How, about detecting one of the side effects of a heart attack? You can then evaluate if you have a problem by any of the other symptoms. If I'm experiencing chest pain and my smart watches is indicating that my heart rate is irregular, for example, maybe I shouldn't be ignoring this.

A heart attack isn't likely to cause an irregular heartbeat (at least not until well after the damage has been done). It's common for heart attacks to cause cardiac conduction anomalies called 'blocks', but these generally don't result in any irregularity of the pulse.

Yeah, I'm simply throwing out a strawman. I have no idea what's possible or important.

http://en.m.wikipedia.org/wiki/Straw_man

The important idea is that I'm not asking the wearable to tell someone that they're having a heart attack but simply indicate some one "test" is not within range.

Re: Just had a heart attack

#83
post #18
post #4

Can someone with some medical experience write about what are exactly the warning signs for a heart attack? While it's definitely wise to call 911 when in doubt, it's good to have own understanding first so we don't ignore the symptoms AND don't flood 911 with false problems.

Here's the thing - people experiencing a heart attack can have any combination, or none of the symptoms. So here's some of the symptoms, bearing in mind that they may or may not apply to any given situation. Chest Pain The first and most obvious sign is chest pain. It may be radiating down your left side (jaw/arm). It is generally described as a crushing pain. This symptom is less likely to occur for women or people…

If the chest pain is not relieved by resting (i.e. sitting down), it points towards a heart attack.

But if you have repeated episodes of chest pain relieved by resting, it might point to angina pectoris -- not technically a heart attack but potentially serious. If it's unpredictable pain and not relieved by rest, it could be unstable angina and much more serious. Yet another thing that makes heart trouble difficult to distinguish from anxiety.

Re: Just had a heart attack

#84
post #65
post #50

Earlier quoted context omitted.

Literally yesterday I treated a patient who has had 4 presentations this year to emergency with chest pain that sounds cardiac enough, except it lasts for several hours sometimes and sometimes she can 'feel it coming on' and heD it off by relaxing. Still, it could always be a heart attack and until a through work up is done to exclude it (acutely, ECG and troponins, as outpatient, stress test), it is worth investigat…

Amazon has some home ECG monitor device. Do you recommend their use? I execise regularly. If those device are effective, I would love to use them weekly or monthly on myself and collect the data long term for me and possibly my doctor.

the technology is very simple and very old so without knowing what sort of machines they are (if they are like [1] then they are more for monitoring abberant rhythms than detecting infarcts or ischaemia - it doesn't have enough leads to properly detect a heart attack) they may do an ok job; the real question is of benefit. There is little benefit to be obtained from regular ECG in an otherwise healthy person. You can't/shouldn't perform a home exercise stress test as you need to be in a hospital environment so that you could be resuscitated if things go badly.

For data collection or your own interest, a proper 12 lead ECG is a great reference item; but again if the machine is like [1] you are only going to get this simple trace that doesn't tell you much; even serial ECG's on a normal healthy patient (or even someone with moderate heart disease) will be almost perfectly normal day to day, month to month at rest.

So I would be inclined to suggest that it is a bit of a waste of money from any attempt at home diagnostics, however if you were concerned about your cardiovascular risk you should discuss it with your doctor.

[1] http://www.amazon.com/Medical-Real-Handheld-Portable-Monitor...

Re: Just had a heart attack

#85
post #16
post #4

Can someone with some medical experience write about what are exactly the warning signs for a heart attack? While it's definitely wise to call 911 when in doubt, it's good to have own understanding first so we don't ignore the symptoms AND don't flood 911 with false problems.

Doctor here. The 'typical' signs of a heart attack are chest pain usually described as dull, heavy or tight, with radiation to the arm(s) and neck. The patient often also complains of diaphoresis (sweating) , shortness of breath and perhaps weakness. 'Typical' signs do not present in everyone: in particular diabetics are at increased risk of having 'silent' heart attacks, And chest pain that is not typical may also b…

THe only sure fire way to check your heart is to have them pump some fluid in that allows them to see your heart and arteries pumping real time on a screen. A catheter operation in the cath lab. This can be expensive though I have heard there is a good deal in CHicago for a few hundred dollars. The rest, i.e., ECG is not a guarantee of diagnosis, I had several before my infarction as routine check ups and none revealed a 90 percent clogged LAD (Widow maker) and similarly clogged RCA and 50 percent clogged circumflex (which they didn't stent yet because stent cut off line is %70). Perhaps a stress test with the ECG is better. But taking a live camera look is the way to go if you really want to know, you can go in in the morning and be out by the afternoon if all goes well.

Re: Just had a heart attack

#86
post #54
post #30

Earlier quoted context omitted.

Blockages of up to 90%, whilst considered 'critical', typically cause little in the way of symptoms. The gold standard for detecting vessel blockage is angiogram- puncture the femoral or radial artery, feed a catheter to the top of the aorta and squirt some dye and then watch it on X-ray. This has risks however- risks of rupturing artery walls, causing bleeding and bruising, and can be expensive. So it is not routine…

I didn't quite get the 90 minutes, got symptoms starting around 15:30, was in ED at 16:30 and getting the angio at 19:00. The interesting thing (aside from watching the angio, the technology is very cool), was that I'd previously had a minor infarct and didn't know it on a much smaller artery. They found collaterals (I think the terminology is right) where the body "bypasses" the blocked artery.

that is the right term - it happens when there are long term arterial subacute blockages - ischaemia/reduced oxygen flow triggers tissues to release vessel growth factors that will lead to extra artery growth.

Bizzarely this leads to situations where diabetics (who develop lesions all along their vessels, and thus have lots of areas of narrowing) can potentially be more protected from a sudden blockage compared to someone with an area of only one blockage - they have enough collateral circulation that the area of infarct is smaller with less damage resulting

Re: Just had a heart attack

#87
post #65
post #50

Earlier quoted context omitted.

Literally yesterday I treated a patient who has had 4 presentations this year to emergency with chest pain that sounds cardiac enough, except it lasts for several hours sometimes and sometimes she can 'feel it coming on' and heD it off by relaxing. Still, it could always be a heart attack and until a through work up is done to exclude it (acutely, ECG and troponins, as outpatient, stress test), it is worth investigat…

Amazon has some home ECG monitor device. Do you recommend their use? I execise regularly. If those device are effective, I would love to use them weekly or monthly on myself and collect the data long term for me and possibly my doctor.

Reading and ECG is not as easy as it sounds. Without training no a chance in hell it will mean anything to you unless your flat lining and then you won't be reading anything.

Re: Just had a heart attack

#88
You're quite lucky that you could afford that hospital trip. In the US, it would typically go like "My doctor made some tests and he said that it doesn't look like a heart attack but something is wrong with one of the lines on my ECG. He asked me if its ok to call the ambulance for doing more checks at the hospital. I said no, I can't afford that. So I died four weeks later."

This isn't an exaggeration. Many people live paycheck to paycheck and can't afford the thousands of dollars a hospital trip would entail.

Re: Just had a heart attack

#90
I'll also bring to people's attention an uncommon heart condition that won't nrcessarily kill you, but may change your life: pericarditis. I've seen it in myself and too many acquaintances lately - most people have never heard of it.

Basically this is inflammation of the lining of your heart. the most common cause being idiopathic (ie. We don't know), or viral, followed by trama post-surgery or radiation therapy. Sometimes it has been caused by vaccination (influenza and others).

The symptoms make this tricky to diagnose, but if you have some combination of fever, consistent or spamming chest and/or upper back pain, difficulty lying down or adjusting position, lethargy, shortness of breath, change in unrine habits / color, go get checked out - an echocardiogram will often reveal the inflammation. High dose (500-625mg) aspirin helps. Most times it will resolve through such NSAIDs or with steroids.

Left too long this can lead to liver damage and can become a chronic constructive condition that mimics heart failure. This is generally curable by surgery to remove your pericardium.

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