Life Expectancy After a First Heart Attack

What is a heart attack?

Did you know that the odds of someone suffering from a heart attack in the USA is one every 26 seconds, and the exact estimate of a patient dying from a heart attack is one every minute? Did you know that most heart attacks happen on Monday mornings? And that women may experience symptoms that differ from men?

Men live for 6.9 years after heart disease, and women live for 7.9 years on average. Many factors can impact heart diseases, such as diabetes, morbidity, stroke, and weight of coronary heart disease. Other relevant factors include lifestyle factors like smoking, alcohol and physical activity. An increase in life expectancy is not the same as living without heart disease but is something sought after in the retired population. Maintaining a healthy BMI and weight will help as can help to minimise the risk of a heart attack. This article will focus on providing valid pointers on how to mantain a healthy lifestyle and reduce chances of developing a heart attack.

Causes/Risk factors 

• Smoking: This is a factor that is positively associated with mortality. Current smokers have a higher mortality risk rate than ever, and former smokers showed an intermediate risk. Cigarette smoking also increases the risk of stroke and diabetes. 

• Alcohol: Alcohol is an increased risk for mortality and other diseases like diabetes. This seems like a non-significant risk factor compared with other factors like smoking and physical inactivity; light drinking was associated with a lower risk relative to heavy drinking.

• Physical activity or fitness: Being overweight and physically inactive are higher risk factors for death associated with heart disease or aberrant living with diabetes and stroke. To increase stress-free living with weight, one must follow an exercise regimen.

• An unhealthy diet will make the arteries thick with fat; cholesterol builds up. It will enable plaque formation by utilising fatty acids in high-calorie, high-fat foods like red meat and animal fats. Thus eating unhealthy food promotes atherosclerosis. It also increases diabetes, hyperlipidemia, and hypertension in high calorie, high fat and high sodium diets. Eating a plant-based diet, DASH, or Mediterranean diet is essential. This would also mean eating whole grains, fruits and vegetables. 

• Physical inactivity is also vital to keep the blood pressure under check-up, low-impact activities like jogging, cycling, and walking. High-impact activities like playing squash and football may not be suitable for you. 

• Excessive alcohol use is a bane for heart health. Alcohol raises blood pressure and cholesterol levels and puts you on a path to heart attack again. Binge drinking is also harmful; binge drinkers are twice as likely to die from a myocardial infarction. The mandatory limit is 14 units of alcohol per week. 

Symptoms

Chances of increasing life expectancy improve if one recognises the warning signs of a heart attack. The better the symptom recognition, The most crucial early warning signs of a heart attack include:

• Chest pain or discomfort: Pain of discomfort in the left side of the chest. It also feels like fullness, squeezing. The symptoms may not be present throughout and may vanish and come back.

• Pain in the upper body: the pain can be felt in different parts of the body like the jaw, stomach, arms or back.

• Shortness of breath: There can be intense shortness of breath associated with this type of patient disease. 

• Nausea, lightheadedness, and breaking out in sweat are some other symptoms. In general, women feel different signs when compared to men. 

Women experience, in addition to this fainting, fatigue, indigestion, pain or pressure in the lower chest or abdomen, and chest pain but not always. 

Diagnosis 

• Electrocardiogram ( ECG or EKG): This records the electrical activity with electrodes attached to the skin. This represents P, Q R, S, T and U waves; cardiologists can detect arrhythmias and myocardial infarction. However, this complex technique requires a better method for accurately detecting heart patients. 

• Cardiac enzymes test: A lab blood test to detect leakage of crucial enzymes. Troponins are the most important biomarker for detecting myocardial infarction. An acute heart attack episode will result in troponin elevation in 2-3 hours. The healthcare provider will order ECG based on the requirement. 

• X-ray: Chest X-ray for the heart, blood vessels and fluid in the lungs. Chest X-ray is very useful for detecting 1-month, and 1-year mortality from adverse cardiac events as X-ray can detect pulmonary congestion, and structural heart damage in its chambers after an initial myocardial infarction²

• Echocardiogram: This identifies the area of the heart where the dysfunction lies to detect the heart attack. It's a highly reliable method to detect myocardial infarction associated with heart abnormalities. This is a non-invasive procedure and can detect even minor cardiac anomalies like regional cardiac dilation that are responsible for increased mortality. An acute coronary syndrome is seen in patients complaining of chest pain with Transthoracic Echocardiography (TTE). The most prominent sign of ischemia is regional wall motion abnormality ( RWMA) of the ventricular muscle on the damaged heart. It works on the principles of ultrasound and captures the heart muscle from different angles with the probe. The heart has four chambers: right ventricle, left ventricle (LV), right atrium and left atrium. The echo devices measure the chamber walls and chambers. The LV wall myocardial infarction can be viewed by apical 4-chamber (A4C) view 2D echos and detects abnormalities that even new and updated techniques can not detect. 

• CT scan: To identify the heart attack and the extent of the damage. This technique produced a high-definition picture of the heart and blocked blood vessels/ coronary arteries. There are two types of CT scan: coronary CT angiogram and coronary artery calcium scan. It is an invasive procedure that uses radiation or an intravenous dye that people with symptoms of heart disease like chest pain or under a moderate risk for heart disease can use. Cardiac stress testing and risk scores are more reliable methods³

• Magnetic Resonance Imaging: This shows a clear image of the heart—magnetic resonance imaging for imaging the artery lumen and wall. MRI can measure plaque burden and constituents. It can measure plaque volume and effectively detect calcium levels in arteries to monitor diseased walls' progression and regression. Coronary MRI imaging achieves high spatial resolution and minimal motion. I referenced studying coronary arteries. A 1.5 T whole-body scanner is used for this purpose, and these have echo-planar capabilities with shorter echo times and spacing. Echo Planar Imaging, fast gradient echo imaging such as turbo fast low angle shot or turbo-flash, use contrast agents like Gadophrin-2 are the techniques used today. They can detect small infarctions that cannot be seen in other imaging techniques. 

Treatment (Brief)

• Taking your medications: This is extremely important to be on top of the health regimen to improve the life expectancy of the heart patient, following the schedule of drugs with the utmost precision and never missing out on medicines.

• Keeping up with follow-up appointments: Regular health checkups with the doctor can help avoid future heart attacks.

• Completing Cardiac Rehab: A cardiac rehabilitation program includes talking to a team of experts like a nutritionist, dietitian, and fitness expert to keep you on track to maintain a healthy diet and weight. 

• Lowering risk factors: High blood pressure, high cholesterol and smoking are increased risk factors and should be kept at bay to reduce heart attack and associated mortality.

• Finding support: Anxiety, stress and loneliness should be controlled as they are at an increased risk for heart attack. This would include mindful living with stress-reducing activities like connecting with friends and family, having hobbies, meditation, taichi and yoga. Volunteering is also suitable for reducing stress. 

Recovery (Brief)

Recovery takes days, weeks and even months after a heart attack. It depends on several factors. First, a cardiac rehabilitation program is a must. Second, it is vital to follow medication. Third, it is essential to keep fit and eat a healthy diet.

Life expectancy after a first heart attack

Age factor

Typically after the age of 45, there is a higher risk associated with the death of a heart attack. For example, 20% of adults have a higher chance of getting a second heart attack after age 45 in 5 years following the first attack, and the risk of heart attack increases with age over 65. 

Why is intensive monitoring required after a first heart attack?

Cardiac monitoring is required, from disease diagnosis and heart attacks to surgeries and recovery and includes a significant aspect of patient management. It is easy to fall back on old ways after an initial attack, but it is imperative to be even more vigilant as the heart is damaged. This means it works below par compared to before a heart attack and in ordinary people. Strict adherence to medications, diet and fitness regimen. This constitutes cardiac rehabilitation and is very important in the path to recovery.

Other lifestyle risk factors influencing life expectancy 

There are many risk factors for heart disease:

• High blood pressure and high cholesterol: High blood pressure increases heart disease and stroke risk. High blood pressure is dangerous as it makes the heart work harder. This is because the force with which blood flows is high. Imagine watering plants with a powerful hose. It will make the plants lose leaves and kill the plant. Likewise, high blood pressure can harm arteries and organs like kidneys, heart, eyes and brain with the increased force of blood flow. It is one of the leading causes of death in America. Blood pressure can be controlled by a DASH or dietary approach to stop hypertension diet that involves less salt and sodium. Normal blood pressure levels are values less than 120/80mm Hg, and anything above is considered high blood pressure. The national guidelines recommend an RDA of 1500mg for sodium consumption⁷ . High blood cholesterol affects about 38% of people. Blood cholesterol is a waxy fat-like substance made by the liver and helps produce hormones and digest fatty foods. High blood cholesterol causes a build-up in the walls of arteries, hardening the streets so that arteries become narrow and blood flow to the heart stops or is blocked, causing chest pain and heart attack. The ideal cholesterol level is less than 200 mg/dL. HDL is good cholesterol and helps protect against heart disease, and it is good to have them around 60 mg/dL. Reducing saturated fats, losing weight, and regular physical activity can affect cholesterol levels.

• Diabetes: High blood glucose from diabetes can damage blood vessels and nerves in the heart leading to a heart attack. Adults with diabetes have twice the risk of heart attack as adults without heart disease. 

• Overweight and obesity: Body Mass Index indicates obesity and being overweight. Obesity affects blood pressure and cholesterol and results in causing a risk for heart disease. Overweight and obese are at a higher risk for serious health concerns, including heart attack. 

Body weight is a poor measure of fatness, and BMI in kilograms is divided by the square of the height in meters; weight reduction is essential for overweight and obese people but non-essential for cardiovascular disease. It is crucial, though, to modify this with physical fitness as this is a controllable factor for heart health. 

• Thyroid disease
• Everyday stress
• Mental health issues, anxiety and depression

How to improve life expectancy?

(Explain the factors like diet, physical activities, regular health checkups etc. to improve the life expectancy)

• Exercise: Regular exercise is a great way to gain energy, recover from a heart attack, control weight, and improve high blood pressure and triglyceride levels. Please consult with the doctor before embarking on an exercise regimen. It is also crucial as it works our heart as a muscular organ. Exercise includes swimming, bicycling, and walking. 

• Diet: A low-fat, low-calorie diet rich in leafy green vegetables is good for the heart. Eating right is a must for preventing a second heart attack. As previously mentioned, eating a DASH diet helps combat acute coronary syndrome. It focuses on potassium-rich food sources like fruits and vegetables, lean meats, and fish. This limits sodium in the diet, along with red meat and saturated fats. 

• Quitting smoking and managing other risk factors. 

What not to do after a first heart attack?

• Do not be unhygienic and take care of personal hygiene like bathing, shaving and dressing.
• Do not have heavy activity during the day, and plan to put in unfinished chores and activities when you get tired.
• Climbing stairs more than once a day. 
• Having a sedentary life and lack of physical activity in a day. Walking restores energy and must be done regularly to regain health.
• Do not do household chores; only indulge in them when you gain energy, such as folding clothes and cooking.
• Ignore the doctor's advice on resuming daily activities like driving a car.
• Ignoring a healthy diet and eating junk food that lacks green leafy vegetables, fruits and whole grains and contains red meat and fatty calories-rich foods instead.
• Less emphasis on eating lower sodium and high amounts of magnesium, calcium and potassium.⁵

When to seek medical attention

A heart attack can recur, and it is crucial to know the difference between acid burn and indigestion. Since acid burn and indigestion originate in the oesophagus close to the heart, it is easy to confuse angina and these types of chest pain. It is critical to understand the difference; it is thought that if the symptoms go away, it is probably unimportant. Shortness of breath and excessive sweating are signs that the problem is heart-related. It is essential to check out symptoms when in doubt, especially for women, as they are least likely to call a doctor with symptoms for themselves. It is better to err on the side of caution for myocardial infarction.

Summary

Lifestyle changes, according to the American Heart Association, are vital in preventing heart disease, heart attacks a second time and stroke. In addition, there are ABCs of heart attack recovery and care, which are as follows:

Avoid Tobacco, become more active, have regular physical activity, and Choose good nutrition. This will reduce stress and depression and help with overweight issues. High blood pressure and high cholesterol levels must also be controlled for a quality of life after a heart attack. 

Good Nutrition will not only help control weight, but it will also help lower blood pressure and cholesterol levels.

These factors are essential to preventing heart-related diseases and diabetes. There is strong evidence of cessation of smoking and fat reduction. Working out and having high and moderate physical activity levels are necessary. The benefits of light drinking are also contradictory and are not recommended lifestyle behaviour for heart disease patients.