What I Would Do if I Had a Heart Attack to Ensure a Longer

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I would take nitroglycerin or aspirin
Before we go ahead with our discussion, I will answer the hypothetical question. I think the question
should be: "What would you do if you had a heart attack?"
Immediately, I would take one tablet of nitroglycerin, the one usually placed under the tongue that
comes with the brand name Isordil. This dilates the arteries. I would take 3 tablets at an interval of 5
minutes. This would enable me to get first aid and get or go to a doctor. Three tablets of Isordil
would give me 15 minutes, more than enough to beat 5 minutes mandatory to avoid serious damage
to the heart before getting to the emergency room of a hospital.
Call a doctor or go to a doctor within five minutes, that is, before five minutes expires. Or if a nurse
were around get help for a resuscitation. The nurse can only provide first aid. The doctor will know
what to do. Five minutes is mandatory to avoid serious damage to the heart (Ornish, D., MD. Dr.
Dean Ornish's Program for Reversing Heart Disease. 1996).
Nitroglycerin is available over the counter in tablet form or patch without a doctor's prescription. It
is safe to take or apply without a doctor's on-the-spot advice. You may verify this with a certified,
licensed doctor.
Even with just an episode of angina I would take nitroglycerin. I would not wait to ascertain whether
it is angina or heart attack that is causing my excruciating chest pain and other symptoms of heart
attack.
Nitroglycerin produces nitric oxide (NO) catalyzed by endothelium nitric oxide synthase (eNOS). NO,
a gas free radical, is a messenger that signals the artery to dilate that allows more blood flow. The
endothelium, one-cell-thick inner wall of the artery, normally releases NO. But an artery that had
been injured by atherosclerosis or plaque does not produce It. Instead it leaks copper and iron that
catalyze the production of more free radicals that contribute to heart attack.
Aspirin prevents the aggregation of blood platelets resulting in clot. A heart attack might be brought
on by thrombus, a blood clot that lodges on an occlusion or plaque and further increases blockage of
artery. An added blot clot exacerbates heart attack. Aspirin actually blocks the action of the enzyme
cyclooxygenase (COX) on arachidonic acid and produces superoxide, prostacyclin and thromboxane
(Sears, B. Ph.D. The Zone. 1995). This promotes the aggregation of blood platelets. Prostacyclin
does the opposite: It dilates arteries and counters platelet aggregation.So, when aspirin blocks
cyclooxygenase only a small amount of thromboxane and prostacyclin are produced. It is essential
that prostacyclin is not blocked altogether. Other COX inhibitors like Vioxx (withdrawn from the
market) block prostacyclin that is why they induce stroke and heart attack when consumed
continuously for a long time.
heart supplements and vitamins
Caution on aspirin: continuous consumption allows the accumulation of arachidonic acid that
becomes converted to leukotrienes, a mediator of allergy to any drug.
Spasm
Heart attack may be sudden as when spasm in a heart artery occurs. Spasm is like putting a clamp
on a soft drinks straw that blocks the flow of fluid. Spasm may be triggered by a shock or lack of
magnesium such that the calcium/magnesium pump in the heart does not work. Another pump, the
sodium/potassium pump may also fail to work. Spasm is also caused by calmodulin, a protein that is
carried along by calcium (more of this below). These pumps are a kind in action potential where ions
in lesser concentration move against the gradient driven by energy. For example, in
sodium/potassium pump, 3 ions of potassium moves against 4 ions of sodium. When the balance of
calcium and magnesium goes out of whack, calcium accumulates in the cell, poisoning it.
Heart attack may not come so suddenly. The "slow" variety had been developing for sometime, may
be years before the heart attack occurs.
Heart attack strikes when enough heart muscles had died such that the heart is unable to pump
Heart attack, also called by doctors as myocardial infarction, is different from cardiac arrest. The
latter is triggered by arrhythmia (irregular heart beat) that should be remedied within 6 minutes
(Ornish, D. MD. Dean Ornish's Program for Reversing Heart Disease. 1996). It is different from heart
failure that is a situation wherein the heart is unable to pump to supply oxygen to different organs
like kidney or liver. It is different from cardiomyopathy that is due to deterioration of heart muscles
resulting in failure to pump. Of course, it is different from rheumatic heart which consists of a scar
(stenosis) in a heart valve that allows the backflow of blood.
Don't ignore a warning
A person stricken by heart attack may not get unconscious at once. He can still walk that sometimes
he brushes aside some pain in the chest as indigestion. Well, indigestion is a symptom of heart
disease. An attack that occurred one week earlier can be detected by the MB fraction creatine
kinase (CK-MB) test.
Let's say you have had angina pectoris before. Angina is also called chest pain. It is a symptom of
some occlusion in at least one coronary artery. Coronary arteries wrap around the heart like a
crown, that's why the name. Their job is to provide blood for the heart muscles. (I prefer writing
"you" than "I")
I surmise that if you have had angina you have consulted a doctor about it. You must have been told
that you have a heart disease, called in medical jargon, myocardial ischemia. This disease is
narrowing of the artery, lessening the flow of blood to the heart thereby lessening the amount of
oxygen because the blood carries oxygen.
When heart muscles are starved for oxygen they produce a chemical that stimulates the pain
receptors. This pain impulse is transmitted to the brain and the brain tries to transmit the impulse
back to the origin which is the heart. Sometimes the message does not land to the heart but to
somewhere else, most likely to the left shoulder and hand. Sometimes in the chest that is why it is
called chest pain.
I suppose you had been examined with the use of electrocardiogram or ECG, the one with printouts
zigzagging up and down. But this test did not show a definite heart disease. So the doctor might
have required you to go through a stress test in combination with ECG that showed more definite
patterns. Still a definite kind of heart disease could not be discerned. So the doctor required a more
sensitive test that is the two-dimensional echocardiogragh or 2Decho for short. Here is a machine
with a screen like a TV where you could see your heart pulsating. 2Decho can show whether you
have healthy heart muscles or not. It can show whether you have a heart enlargement, most likely
the left ventricle. Usually a person with a myocardial ischemia has a slight enlargement of the left
ventricle because it is the part of the heart that pumps out blood. And it gets enlarged because of
working harder.
With your doctor
If you were now with the doctor attending to your heart attack, stay calm, The more you get
nervous, the harder your heart works and it might beat faster which is bad. Anyway, the doctor will
give you a tranquilizer to make you more comfortable, or to level down your hypertension.
(Hypertension usually accompanies a heart disease owing to atherosclerosis). He will give you a
blood thinner like aspirin or warfarin or both. Blood thinners prevent blood clot that exacerbate
heart attack. Aspirin helps by controlling thromboxane A2 that induces aggregation of blood
platelets resulting in blood clot or thrombus (Sears, B., Ph.D. "Aspirin the Wonder Drug." The Zone.
1995:113-118).
Some doctors might give Imdur that might be unwarranted because it might dilate arteries in places
that are inappropriate to dilate. An alternative medicine doctor discontinued Imdur prescribed by a
conventional medicine doctor in an acquaintance of mine for the same reason.
The doctor may make a test for one kind of enzyme that indicates a heart attack. That enzyme is
called MB fraction creatine kinase (CK-MB). The "heart muscle is the only tissue in the body
containing more than 5 percent of CK-MB" (Clayman, CC., MD. editor. Your Heart. 1989:62). This
test, in combination with 2Decho, can confirm by 100%, a heart attack that occurred as far back as
one week.
Counters
If needed, you will be confined in the hospital which is usually the case in conventional medicine. If
necessary you may be placed in the intensive care unit. During your confinement and may be after
your discharge, you might be prescribed a medication like diltiazem which is a calcium channel
blocker (brand names Angiosem or Dilzem or Zandil). This blocker slows the entry of calcium
through the volt-gated channel of cells that allows the entry of calcium. Calcium carries along a
protein, calmodulin, that increases oxygen demand. Increased oxygen demand increases heart rate
that should be avoided. Calmodulin also triggers spasm (Cranton, E. MD and A. Brecher. Bypassing
Bypass. 1984:207). You may be prescribed anti-hypertensive treatment like losartan (Kenzar) or ACE
inhibitors (Lexotan).
The same kind of medication will be given by http://www.answers.com/topic/ischaemic-heart-disease
alternative medicine doctor. In addition, he will prescribe nutriceuticals like coenzyme Q10, omega 3
fatty acid, trivalent chromium, vitamin C. CoQ10 is concentrated in the heart; it is involved in the
production of energy. If your coQ10 level hits as low as 25% you may die (Bliznakov, E.G, MD and
G.L. Hunt. The Miracle Nutrient Coenzyme Q10. 1986). Always keep some Isordil tablets in your bag
or pocket that you can put under your tongue when an angina episode comes.
You will adjust to a new diet that a nutritionist or dietitian prescribes. Usually doctors do not bother
about detailed diet because they had not been so trained. The dietitian calculates food intake as
detailed as by the cube-inch. The most obvious one is stay away from fats. Balance your diet with
fruits and vegetables that contain antioxidants.
Beware of perfusion injury
When heart attack had been remedied there usually comes perfusion injury. This is a kind of injury
caused by superoxide, a free radical. It happens this way: During heart attack oxygen is lacking in
the heart. Oxygen is the signal for the production of superoxide dismutase (SOD) in cells that
converts superoxides, reacting with each other, into hydrogen peroxide. Now hydrogen peroxide is a
reactive oxygen species that acts like a free radical. It would look like SOD had worsened the
situation. (We will see below how hydrogen peroxide is dismantled).
A free radical is an atom or a molecule (like molecular oxygen, the kind that we breathe and use in
respiration) or a fraction of a molecule that has at least one free unpaired electron. This electron is
unstable and to stabilize itself grabs one electron from a neighboring molecule of a tissue. By
grabbing, it inflicts injury. Superoxide is a free radical that inflicts that perfusion injury. To recall,
lack of oxygen during heart attack will trigger perfusion injury when blood flow had been restored in
the heart. That is, to repeat, after the heart attack had been remedied. When blood returns to the
heart no SOD is around to mop up superoxides. This injury is usually overlooked by conventional
medicine because it ignores free radicals.
Unfortunately, you cannot get away from superoxide; it is so much a part of life of an aerobic
organism like man. In the metabolism of glucose to produce energy, adenosine triphosphate,
superoxide is one of the by-products, in addition to water and carbon dioxide. There are other
sources of superoxides like cyclooxygenase, NADH, xanthine oxidase and nitric oxide synthase.
"Perfusion injury causes serious damage to cell membranes, proteins, and DNA in the ventricles of
the heart" (Sharma, H. MD. Freedom from Disease. 1993:86)
Hubber Laura Ray says lipoic acid can remedy perfusion injury. I think lipoic acid comes through
glutathione peroxidase. Glutathione is composed of glutamate, cystine, cysteine and co-factors
selenium, zinc, lipoic acid and vitamin B-2. The involvement of glutathione peroxide is not fortuitous
because it is responsible for dismantling hydrogen peroxide into safe water (Sharma, H. MD.
Freedom from Disease. 1993). Some doctors use hyperbaric oxygen (HBO) to counter perfusion
injury. It delivers 100% oxygen to the patient (Cranton, E., MD and A. Brecher. Bypassing Bypass.
1984). Unfortunately, HBO chambers are now so few; this device may now be for the museum.
Lipoic acid may come handy.
Conventional approach
Some conventional doctors order for an angiography that can locate the blockage in the artery and
enable him to estimate its size. The dye used in angiography can damage the kidneys. Angiography
is expensive and your HMO (health maintenance organization) or insurer must approve of it so that
your insurer will pay for it. (That is, if you are a member of HMO in the USA). Angiogram is usually a
ticket for angioplasty or coronary artery bypass graft surgery (CABG, pronounced cabbage) in
conventional medicine. Angiogram expires in one year; it puts you at risk at 0.2% or two out of one
thousand patients. Both angioplasty and CABG are invasive (DeBakey, M., MD and A. Gotto, MD. The
New Living Heart. 1997) and expensive. In CABG, the breast bone is sawed and breast is opened to
provide access to the heart (while the patient is under complete sedation). CABG has a mortality rate
of 2 to 5 percent. (I have a Hub on "HMOs might chose a hospital with a medium to high rate of
mortality in heart bypass surgery"). Angioplasty also puts you at risk at 2 to 5%. A CABG team is
always on hand to perform surgery in case angioplasty goes awry. And you also pay for that team
even if it had been on a stand-by only. Many a conventional medicine doctor still believe that plaque
is irreversible. However, it can be reversed by niacin and soluble fiber (also found in oats), according
to conventional medicine literature. Dr. DeBakey and Dr. Gotto wrote in their book ("The Living
Heart," 1977) that plaque is irreversible. In the sequel of their book ("The New Living heart," 1997)
they wrote that plaque can be reversed by cholesterol-lowering drug and lifestyle changes consisting
of halt in drinking alcohol and smoking. However, in the 1997 edition of their book, they did not
elaborate a protocol for reversing plaque. Dr. DeBakey is a renowned cardiac surgeon, mentioned by
Ross Perot (once an independent candidate for president of USA) in one of his books. Dr. DeBakey
invented the pump that prevents destruction of blood platelets, an adjunct to the heart-lung
machine. Angioplasty and CABG can remedy angina and heart attack as treatments. The vein used
as graft may develop plaque in 5 yeas. (More on treatment and cure below).
The absence of angina after a CABG should be given the following considerations: The vagus nerve
is responsible for carrying messages between the heart and the brain. During CABG vagus nerves
are cut so that the transmission of pain messages to the brain and back to the heart is also cut. If
another plaque had developed in the coronary arteries no pain will be felt by the person who had
had CABG. However, the plaque will grow larger then may block the artery resulting in heart attack.
All the while, without the benefit from an angina episode that could have served as a warning.
Alternative: reverse blockage
Angina is a warning for heart attack that can be prevented. Chest pain is felt when about 50% to
75% of the diameter of at least one coronary is blocked. Discounting spasm or thrombosis, it takes a
lot of time for a heart attack to develop from this extent of blockage. When you have angina, counter
the causes at once. Blockage of arteries can be reversed with infusion chelation therapy. For more
information on this method open the internet cv chelation therapy and read updated articles by Dr.
Cranton, MD and J.P. Frackelton, MD. The occlusion may grow to eventually block the artery which
http://www.encyclopedia.com/topic/heart_disease.aspx is a guarantee to heart attack.
In thrombosis, some parts of the plaque is dislodged and may block blood flow in another part of an
artery with another plaque or it may block a heart valve, resulting in heart attack.
Assuming that you have angina, you may be prescribed a blockage dissolving program of
intravenous (IV) chelation therapy consisting of 45 sessions. It is like taking dextrose, seated, able to
converse with somebody, or watch TV. It is non-invasive except for the insertion of a pediatric needle
into one artery of the hand or foot if it is difficult to get an artery on your hand. One session takes
1.5 hours to infuse, by drip, 250 ml of solution containing EDTA (ethylene-diamine-tetra-acetate).
Sixteen sessions may be enough to eliminate possibility of heart attack (and control angina). But you
must complete the program. IV chelation therapy can provide primary prevention (first heart attack),
or secondary prevention (second heart attack if a first attack had already occurred) with 60 sessions.
The cost is much less than that for angioplasty or CABG; angiogram is not needed. However, if you
already had an angiogram the result will help the alternative medicine doctor.Chelation therapy has
no adverse side effect. If you could drive your car going to the chelation clinic you could also drive it
home after a session. Chelation therapy is safe, legal and ethical.
I have Hubs "Chelation and Stem Cell Therapies Completely Repair the Heart," "Free Radicals With
Unpaired Electrons In Alternative Medicine, " "Framework and Treatment of Heart Disease (Free
Radicals) Chelation Therapy, (Risk Factors) Heart Bypass Surgery."
Heart attack, angina in the first place, can be prevented by taking antioxidants.
Prevent complications
One complication that may arise from heart disease is hypoglycemia or low blood sugar. It is the
opposite of diabetes. [I have a Hub "How to Counter Hypoglycemia (Low Blood Sugar)]
The main reason is that chronic anxiety brought about by heart disease triggers hypoglycemia.
Chronic anxiety makes the release of adrenalin unusually high. Adrenalin overrides both insulin and
glucagon, the hormone that converts glycogen (glucose stored in the liver) into glucose. That is,
adrenalin takes over the work of glucagon and insulin but does their jobs erratically. An episode of
hypoglycemia can be mistaken as heart attack because of dizziness, blurred vision, sweating and
nausea. However, chest pain is absent that ensures that it is not heart attack. But a person unaware
of this situation might get nervous owing to hypoglycemia episode that nervousness triggers
hypertension or arrhythmia (irregular heartbeat) then cardiac arrest owing to very fast heart rate
such that there is no time for the heart to fill in blood.
Group support
A person suffering from angina and hypertension, and threatened by heart attack is irritable.
Sometimes, s/he is unreasonable. The main reason is that s/he has anxiety over his/her disease. This
is especially so if s/he is ignorant about the disease, and without finances for medication.
Sometimes, the conventional doctor is also a source of anxiety by admonishing the patient to go
through angioplasty or CABG. A conventional medicine doctor (like a member of the American Heart
Association) is not conversant about chelation therapy or s/he is antagonistic to it. In countries
where a medical malpractice law is in force, the patient or his proxy can demand for explanation of
alternative means of treatment or cure for angina or heart disease. Failure on the part of the doctor
to explain alternative modes makes him liable under the medical malpractice law. The USA has such
a law; the Philippines does not have one, only code of ethics which does not suffice to protect the
patient from malpractice.
Sometimes members of the family don't understand the anxiety of the patient and quarrel with
him/her. Such situation will exacerbate anxiety of both the patient and health care support.
A person recovering from heart attack needs more compassion and understanding but not pity. Talk
about pleasant things. Avoid stressors like meeting unpleasant persons or encountering unpleasant
events and things.
Group support is one of the factors that can alleviate anxiety and accelerate recovery from heart
attack (Ornish, D. MD. Dr. Dean Ornish's Program for Reversing Heart Disease. 1996). Dr. Ornish
recommends, in addition, reversal diet, vitamins, meditation and yoga.
A person with angina, threatened with heart attack or recovering from heart attack should not
entertain self-pity. S/he should go for exercise, a walk about 30 minutes everyday or every other day.
Swimming is better but of course seek the advice of the doctor. S/he should go out to meet friends
and engage in some social work. S/he should educate herself/himself on heart disease because
uncertainty is a source of worry.
Take control
Don't let the doctor have sole knowledge about your disease and decide for you your medication or
recovery. Take over control or at least participate in decisions over your health. Be optimistic.
Occlusion in the heart artery is preventable and reversible. Heart disease is curable. CABG is only
treatment, not cure, according to Dr. John Ambrose, cardiologist and angiologist at the Mount Sinai
Hospital in New York (Klein, T. A User's Guide to Bypass Surgery. 1996).. Together with angioplasty,
it may remedy an occlusion in one part of an artery but another occlusion may develop in other
parts. Other arteries may develop occlusion because the underlying causes, free radicals and
reactive oxygen species, are not dealt with.
Treatment and cure
Treatment and cure are two different things. For example, in hypertension. If you take losartan
(Kenzar) that lowers your blood pressure, that is treatment, because your hypertension will occur
again once provoked by anger or irritation. A medication or intervention that deals with the cause of
hypertension such that it will not return is cure. Chelation therapy will make hypertension go away
never to return. It is a cure for hypertension.
Dr. Ornish claims that his program cures heart disease without the use of drugs. Infusion chelation
therapy can treat and cure hypertension and heart disease.