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February 17, 2010 > Have Questions About Heart Attacks?

Have Questions About Heart Attacks?

Upcoming Seminar Has the Answers!

What is a heart attack? Why are heart attacks so unpredictable? How can heart attacks be prevented?

If you'd like to learn the answers to these questions - and others -you should plan to attend a free Health & Wellness seminar on Tuesday, February 23, from 1 to 3 p.m. Washington Hospital cardiologist Dr. Jeffrey Carlson and Lorie Roffelsen, a registered dietitian, will discuss risk factors for heart attacks, common symptoms and preventive measures - including guidelines for a heart-healthy diet.

The seminar will be held in the Conrad E. Anderson M.D. Auditorium in the Washington West Building at 2500 Mowry Avenue in Fremont. To register, visit and choose this session from the "Upcoming Seminars" section on the homepage.

"A heart attack occurs when there is a sudden blockage in one of the main arteries that stops the flow of blood to the heart muscles," Dr. Carlson explains. "If blood flow is not restored quickly, the portion of the heart that is affected will die. Losing more than 30 percent of the heart muscle is usually fatal."

The classic symptom of a heart attack is pain in the center of the chest that lasts more than a few minutes or that goes away and comes back. Other symptoms can include:
* Acute shortness of breath
* Pain or discomfort in one or both arms, the back, neck, jaw or stomach
* Profuse sweating
* Nausea and vomiting
* Unexplained weakness or severe tiredness

"In women, the most common symptom is overwhelming fatigue that comes on fairly suddenly," Dr. Carlson says. "While women can have the same classic symptom of chest pain as men, women would be more likely to experience shortness of breath, nausea and pain in the shoulders and upper back."

Dr. Carlson notes that heart attacks are often unpredictable simply because coronary disease begins slowly with cholesterol accumulating in the arteries and hardening into plaque deposits.

"An artery has to be blocked by more than 50 percent in order to be detected in a stress test, but even a 10- to 15-percent obstruction can result in the surface of the plaque cracking open," he says. "When that happens, a blood clot develops on the surface of the crack and grows to completely block the artery. That can happen quite quickly, within four to eight hours. So it's quite possible that someone could have a 'normal' stress test in the morning and have a heart attack that same afternoon."

Because of the major role that cholesterol plays in heart attacks, Dr. Carlson emphasizes the importance of managing your cholesterol levels.

"There are two types of cholesterol, which you can remember by associating the 'bad' LDL with 'least desirable' and the 'good' HDL with 'highly desirable,'" he suggests. "LDL cholesterol oxidizes and congeals, just like rancid butter. HDL cholesterol carries blood cholesterol back to the liver where it can be eliminated."

High total and LDL cholesterol levels along with low HDL cholesterol can increase the risk of heart attacks. In general, the recommendations are to keep the total cholesterol level below 200, with the LDL level below 160 and the HDL level above 40. For people who have suffered a previous heart attack and those with diabetes or a family history of heart disease, a physician may recommend lower LDL and higher HDL levels.

In addition to discussing cholesterol levels, Dr. Carlson will address a variety of other measures to prevent heart attacks:
* How to prevent blood clotting through low-dose aspirin usage, including different recommendations for men and women.
* Avoiding injury to the arteries by reducing high blood pressure.
* Controlling diabetes, which can change the quality of the blood vessels.
* Quitting smoking, which can affect the blood vessels in numerous ways.
* Recognizing and treating "metabolic syndrome" - a combination of high blood pressure, diabetes and high cholesterol that is common among people who are overweight or obese and lead an inactive lifestyle.

The discussion of metabolic syndrome leads naturally into Roffelsen's presentation on current dietary guidelines for preventing heart disease.

"We'll start off by talking about the foods that can raise the levels of LDL cholesterol," she says. "It's especially important to avoid foods that are high in saturated fats, including fatty cuts of meat, fats that are solid at room temperature such as butter and shortening, and high-fat dairy products."

Roffelsen notes there are good alternatives for getting protein in your diet without consuming animal products that are high in saturated fats. "For example, non-fat and low-fat dairy products provide calcium as well as protein," she explains. "The American Heart Association recommends eating fish twice a week for the benefits derived from Omega-3 fatty acids and because fish is much lower in saturated fat than red meat."

Another way to reduce LDL cholesterol levels is to eat a diet that is high in fiber, such as the Dietary Approaches to Stop Hypertension (DASH) diet. Developed by the National Institutes of Health, the DASH diet calls for eating additional fruits, vegetables and whole grains.

"Fiber, especially the soluble type, acts like a sponge to bind up dietary cholesterol and remove it from the bloodstream," Roffelsen says. "It's best to get fiber from natural food sources, such as beans peas, lentils, citrus fruits, apples and pears, as well as whole grains like oats, barley and flax."

Limiting your sodium intake to less than 2,000 milligrams a day is another preventive measure. "A lot of packaged foods have unhealthy levels of sodium, which contributes to high blood pressure," says Roffelsen. "You can lower your blood pressure pretty effectively by avoiding packaged foods and processed meats such as bacon, sausage and hot dogs."

Roffelsen applauds the current cultural trend toward eating more fresh foods in season that are grown locally. "Also, because of the economy, more people are eating meals cooked at home," she says. "It's not necessarily true that eating fresh foods is more expensive. You can find lots of bargains on seasonal produce. If your budget doesn't allow for fresh fruits and vegetables, frozen produce that doesn't contain added salt or sugar is a good option."

Find a Physician
If you are concerned about your risks for a heart attack, consult your regular physician. To find a cardiologist near you, visit Washington Hospital's website at and click on "Find My Physician."

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