Health Issues in Adulthood: Heart Attack - Case Study Example

Health Issues in Adulthood: Heart Attack Introduction As age advances, the innocence, blissfulness and happiness of childhood are lost and an individual enters a phase of life called adulthood where he or she is burdened with responsibilities, relationships, commitments, employment and health problems. Whether the individual enjoys these or not is dependent on how he moulds these perspectives into creating a peaceful living for himself. Health is Wealth is a famous piece of wisdom advice inherited from our forefathers. Without good health, it is not possible to live a fruitful life with fulfillment and satisfaction. Hence I chose to explore about health issues in adulthood. This is a vast topic and to discuss it is beyond the scope of this essay. Hence I chose to discuss a particular health related issue based on my personal experience. Scenario Recently, I was staying with my 55 year old aunt and her 60 year old husband during a short holiday. Though my aunts over all health appeared good, she was taking many pills for diabetes and high blood pressure. My uncle had no such problems and he was an active man. My aunt appeared obese and was not active. She would watch lot of television and would prefer not to move out of the house. One night, my uncle woke me up and told me that my aunt was sweating profusely and was having difficulty in breathing. He was in panic and did not know what to do. Even I did not have any experience in handling such situations. However, I called the emergency number and asked for help. Within 5 minutes a team of health professionals arrived and shifted my aunt to the hospital. In the hospital, me and my uncle were told that my aunt suffered from heart attack and any delay in shifting her to the hospital would have cost her life. My aunt was kept in the cardiac intensive care unit for a few days where many tests were done. Based on the reports of these tests, a procedure called cardiac catheterization was done. A few days later, she was discharged home. I am thankful to God and the team of doctors for keeping my aunt alive. This episode has a lasting impact in my mind. I have heard of many people suffering from heart attacks. But I visualized this heart attack. This episode made me do a little research on the subject. What I was most interested is What causes heart attack, how can it be prevented and how to identify it? Statistics Cardiovascular diseases are diseases and injuries of the heart and the blood vessels of the body. According to the WHO (2009), globally, cardiovascular diseases are the most common causes of death. In the year 2005, it was estimated that 17.5 million people died from cardiovascular disease which actually represents 30% of all global deaths (WHO, 2009). Cardiovascular diseases include increased blood pressure, cerebrovascular disease, peripheral artery disease, coronary artery disease, rheumatic heart disease, heart failure and congenital heart disease (WHO, 2009). Most of the deaths in cardiovascular conditions are due to heart attacks and strokes. In Canada, it is estimated that every 7 minutes, there is somebody who dies of a heart disease or stroke. Infact, cardiovascular disease accounts for the majority of deaths in the country (Statistics Canada, 2009). In the year 2004, statistics show that cardiovascular disease account for 32% of all deaths in Canada. Also, 31% of all male deaths and 33% of all female deaths were caused by cardiovascular disease. Of these, 54% were due to ischemic heart disease, 20% due to stroke and 25% due to heart attack (Statistics Canada, 2009). Figure 1: Cardiovascular diseases - Global picture (WHO, 2009) Percent self-reported Heart Disease and Stroke, 2003 Age group Percent 20-49 1.3 50-64 6.9 65-79 17.6 80+ 28.0 All (20+) 5.6 Table-1: Statistics in Canada (Heart and Stroke Foundation, 2009). Cardiovascular diseases contribute to increased health care costs. In the year 2004, acute care hospitals handled about 3 million hospitalizations for cardiovascular diseases. About 70,000 heart attacks are expected to occur each year in Canada. Of these, about 19,000 die (Heart and Stroke Foundation, 2009). Definitions Heart attack or myocardial infarction occurs when the imbalance between supply and demand of oxygen to the heart muscle or myocardium becomes critical enough to cause myocardial necrosis. This mostly occurs as a result of rupture of plaque in a coronary vessel leading to sudden reduction of blood supply to the concerned portion of myocardium. Like any other muscle in the body, heart muscle receives blood supply from arteries. The arteries which supply blood to the heart muscle are known as coronary arteries. These arteries arise from the aorta and run on the surface of the heart. There are 2 main coronary arteries, the right coronary artery and the left coronary artery. The right one supplies the right ventricle and the left one supplies the lower portion of the heart. The majority of the left ventricle is supplied by the left anterior descending coronary artery. The circumflex artery supplies the back portion of the left ventricle (Fenton, 2008). Why do heart attacks occur? Over a period of time, cholesterol in the blood gets deposited in the blood vessels of the heart and forms plaques. These plaques narrow the blood vessels and decrease the amount of blood passing through them. This is known as atherosclerotic heart disease or coronary artery disease. When the blood supply decreases, the heart muscles ache. This ache is known as angina. Sometimes, these plaques can rupture and result in formation of small blood clots within the blood vessels. These clots block the blood vessel and cause sudden decrease of blood supply to the heart muscle, resulting in damage to the heart muscle. Complete loss of blood supply to a portion of muscle results in death of the muscle known as myocardial necrosis which is irreversible. When a portion of the heart muscle suffers like this, it affects the function of the whole heart, thus affecting blood supply to other parts of the body including brain and other vital organs. Thus multiorgan dysfunction and death ensues. Heart attack may also occur due to causes other than plaque rupture. These causes include inadequate oxygenation as in profound anemia, respiratory failure and carbon monoxide poisoning; cocaine abuse, coronary artery vasospasm or Prinzmetal angina and anomalous coronary artery. Risk factors for heart attack 1. Age: Heart attack mainly occurs in those older than 45 years. However, in cocaine abusers, in those with type-1 diabetes mellitus, hypercholesterolemia and positive family history of heart attacks, the condition may even manifest at an earlier age (Fenton, 2008). 2. Male gender: In persons between 40 and 70 years, there is a male predilection for heart attack. In those older than 70 years, no sex predilection occurs (Fenton, 2008). 3. Sedentary lifestyle: 4. Smoking 5. Abnormal lipid profile 6. Diabetes mellitus 7. Hypertension 8. Type-A personality 9. Family history What are the symptoms of heart attack? The 3 main symptoms of heart attack, also known as classic symptoms are chest pain or discomfort associated with shortness of breath, severe sweating and nausea. The classic chest pain is usually described by the patients as tightness in the central portion of the chest with radiation of pain to the jaw and also down the arm. Many patients do not develop these symptoms and hence it is important to know other manifestations also like: jaw ache, indigestion, only shortness of breath, pain only in the shoulders and arms and only nausea and vomiting (NHLBI, 2008). Many a times, in women, in the elderly and in those suffering from diabetes, the symptoms can be so minimal, vague and atypical, that heart attack can be easily missed. In these patients, the only complaint may be tiredness. Other atypical symptoms of heart attack include abdominal pain, anxiety, cough, diaphoresis, lightheadedness, syncope and wheezing (Fenton, 2008). About 50% of heart attacks are clinically silent and may go unrecognized. Hence in those with high risk for heart attack, a high index of suspicion should be maintained for heart attack (Fenton, 2008). What to do when a person is suspected to have heart attack? Heart attack is a medical emergency and the patient should be taken to the nearest hospital as soon as possible or an ambulance must be called immediately. Even before these are done, as a part of first aid, the person should taken aspirin immediately to prevent formation of blood clots in the coronary arteries. Also, the person must take rest and not move around. Aspirin makes platelets less sticky and thus prevents further blockage of the artery. Rest is very important, because moving around increases the workload to the already failing heart. Once the patient reaches the hospital safely, the doctors and nurses take heart attack very seriously and go ahead with proper job (Wedro, 2008). What treatment can be expected to be given in the hospital? Once the patient arrives at the hospital, an ECG will be taken to look if the person really has a heart attack. If there is evidence of heart attack, doctors will administer clot-busting drugs to dissolve the clot. Based on the coronary angiogram, heart catheterization or angioplasty will be done to restore blood supply. In the mean time, patient will be managed in cardiac intensive care unit where other aspects of care like oxygen supply, respiration, blood pressure, fluids and diet will be taken care of (Wedro, 2008). Is it possible to prevent heart attack? Every individual, especially those with family history of heart attack must modify his or her diet and lifestyle in such a way that development of coronary artery disease is prevented. This attitude has to develop as early as possible in adulthood. Smoking increases the risk of heart attack and this must be stopped. Even a single cigarette can increase the risk of heart attack. Hypertension, high cholesterol and diabetes must be dealt with appropriately. Sedentary lifestyle must be given up and the individual should exercise regularly. Those at increased risk of heart attack may prevent it by taking a baby aspirin a day, along with other measures. These measures also prevent stroke and peripheral vascular disease. Every individual must develop an emergency plan to deal with heart attack, because it can occur any where, anytime and to anyone! (Wedro, 2008). Support from Government and Social service organizations To decrease the incidence of heart attack, various health organizations and social service supports must provide information and create awareness about heart attack. The importance of healthy lifestyle, regular exercise and good eating habits must be inculcated into the brains of the citizens. People must also be provided information about what to do in case of emergency. 911 is the number to dial for help in case of heart attack or any other medical emergency. Concept Idea Canada Research Chair is a social organization for health care that aims at exploring various strategies for health approaches, services and care delivery so that appropriate care in imparted to the patients at the right time. There are many other private non-profit organizations that bring about awareness of heart attack and initiate prevention programs. The Heart and Stroke Foundation of Canada provides information about heart, stroke and health living in Canada. Conclusion Heart attack is an important health issue in adulthood. Awareness of the risk factors helps in the prevention of the disease. People must adopt proper lifestyles and eat a health diet to be away from heart attack and stroke. Regular consultation with physician helps identify certain conditions like hypertension and diabetes which can contribute to heart attack. When there is a person around us who is suffering from a sudden attack of heart ailment, immediate action should be taken to save the life of the person. References Canada Research Chair. (n.d.). Concept Idea Canada Research Chair: The Social Organization of Health Care. Retrieved on 9th March 2009 from http://72.14.235.132/search?q=cache:Un-c5kTwZzUJ:www.mala.ca/research/committees/researchchairstrategycomm/strategy_docs/SocialOrganizationHealthProposal.pdf+heart+attack+canada+social+service+organisations&cd=1&hl=en&ct=clnk&gl=in Fenton, D.E. (2008). Myocardial Infarction. Emedicine from WebMD. Retrieved on 9th March 2009 from http://emedicine.medscape.com/article/759321-overview Heart and Stroke Foundation. (2009). Cardiovascular Diseases. Retrieved on 9th March 2009 from http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3483991/k.34A8/Statistics.htm NHLBI. (2008). Heart Attack. U.S. Department of Health and Human Services. Retrieved on 9th March 2009 from http://www.nhlbi.nih.gov/health/dci/Diseases/HeartAttack/HeartAttack_WhatIs.html Statistics Canada. (2009). Causes of Death 2004. Retrieved on 9th March 2009 from http://cansim2.statcan.ca/cgi-win/cnsmcgi.pgm?regtkt=&C2Sub=&ARRAYID=1020529&C2DB=PRD&VEC=&LANG=E&SrchVer=2&ChunkSize=50&SDDSLOC=&ROOTDIR=CII/&RESULTTEMPLATE=CII/CII_PICK&ARRAY_PICK=1&SDDSID=&SDDSDESC Wedro, B.C. (2008). Heart Attack. Emedicinehealth. Retrieved on 9th March 2009 from http://www.emedicinehealth.com/heart_attack/article_em.htm WHO. (2009). Cardiovascular Diseases. Retrieved on 9th March 2009 from http://www.who.int/cardiovascular_diseases/en/ Read More