The Record Special Sections Health Quarterly 02-17-2019 | Seite 4

4 ❚ SUNDAY, FEBRUARY 17, 2019 ❚ THE RECORD
HEALTH QUARTERLY / ADVERTISING SECTION
Heart Attack: Know and Control Your Risk Factors
CONTINUED FROM PAGE 1
Program/ACAP, Heart & Vascular
Hospital at Hackensack University Medical
Center. “Heart attacks are heart attacks,”
said Dr. Salerno. “It’s silent, so there are no
symptoms, but the clock is ticking.”
The fact that one out of four Americans
has cardiovascular disease, “a staggering
figure,” underscores the benefit of aware-
ness about silent heart attacks, said
Dr. Salerno, who specializes in cardiology
and critical care. Too often, there is
a misconnect between patients and the
best care possible. “People are not paying
attention.”
A DAMAGING DELAY
Typically, a silent heart attack is
detected during a routine checkup or when
a healthcare professional is looking for
something else. “Most often that is going
to be picked up incidentally,” said interven-
tional cardiologist Stephen Angeli, MD, of
Holy Name Medical Center. The silent heart
attack is “sneaky,” said Dr. Angeli. Patients
are frequently diagnosed during a routine
check-up by their primary care provider
through a screening test such as an elec-
trocardiogram. While this is a great find,
valuable time when
treatment should
have occurred has
been lost.
Be alert to the
possible consequenc-
es of a heart attack,
such as ongoing
or occasional short-
ness of breath or a
diminished capacity
for exercise, said Dr.
Angeli. Definitely seek Dr. Stephen Angeli
medical attention “if there has
been a change, especially when it comes
to certain activity.” For example, a person
might develop difficulty in climbing stairs
or become fatigued more easily.
As with all heart attacks, the effects
of the so-called silent ones vary. Feeling
crummy and not getting any better? Have
your healthcare provider check you out.
“The prognosis for people with silent
attacks is usually worse,” said Dr. Sotsky.
“We hope to prevent further episodes.
If you have symptoms and are not sure,
don’t assume anything.”
Dr. Angeli recounts the case of the
65-year-old obese patient who after eating
Chinese food, a salty
cuisine, was rushed
to the emergency
department in the
middle of the night.
Her family had called
911 when she expe-
rienced difficulty
breathing as her lungs
filled with fluid. The
patient was diagnosed
with pulmonary ede-
ma, congestive heart Dr. William Salerno
failure and an enlarged heart. An echo-
cardiogram revealed a prior heart attack
that had weakened her heart muscle.
In addition to emergency care, she also
would require cardiac bypass surgery to
get better.
OPTIMIZE YOUR RISK FACTORS
Know your risk factors and work at
controlling them. Your behavior matters.
“Optimize your risk factors, and you get a
huge dividend,” said Dr. Salerno. Risk fac-
tors include obesity, high blood pressure,
inactivity, diabetes, high cholesterol and
the use of burning products such as ciga-
rettes and marijuana. The doctor recom-
mends a body mass index or BMI at 25 or
below and an A1c, which reflects your
average blood glucose level, at 6.5 or
below. Taking prescribed medication for
high cholesterol and high blood pressure is
crucial. A too-common reluctance to do
so is a barrier to lowering the chances for
having a heart attack as much as possible.
DIABETIC? TAKE SPECIAL CARE
Longstanding diabetics whose sugar
is not under control can suffer nerve
damage that causes impaired perception
of pain throughout the body, said Dr.
Angeli. The legs and feet are particularly
vulnerable.
One concerning outcome of numbness
can be the inability to feel a blockage in the
leg. For example, a person might stop tak-
ing walks because of some discomfort, but
not recognize the need for medical atten-
tion. A leg blockage, a serious condition
in and of itself, can indicate the existence
of a heart blockage too.
HAVE A CONVERSATION
Risk profiling is an essential tool in
assessing a patient’s health, said Dr.
Sotsky. This deliberate exercise includes
a discussion that goes way beyond a few
quick questions. “I tell my patients we need
to have a conversation.”
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