Details of topcat trial
TOPCAT trial shows no benefit of spironolactone in terms of death, hospitalization, aborted SCD in heart failure with preserved ejection fraction.
The new ACC–AHA guidelines for the management of cholesterol would increase the number of adults who would be eligible for statin therapy by a large number, with the increase seen mostly among older adults without cardiovascular disease
Renal denervation in resistant hypertension doesn’t show significant BP reduction.
improved survival with TAVI as compared to surgery in high surgical risk patients.
Marked activation of the sympathetic nervous system occurs during and after noncardiac surgery. Low-dose clonidine, which blunts central sympathetic outflow, may prevent perioperative myocardial infarction and death without inducing hemodynamic instability.
POISE-2 study shows no benefit and increased risk
Myocardial infarction is the most common major vascular complication that occurs after noncardiac surgery. this Canadian study examines the issue of prophylactic aspirin in patients undergoing non-cardiac surgery. Read more @ POISE-2 study
Heart attack is a dreaded event for anyone. Ever thought how you can know that you are having a heart attack. The fact is an early recognition of attack results in early treatment. This in turn leads to less suffering and risk of death.
What are the symptoms?
Heart attack can present in different ways. One of the classical presentations is the “movie type” sudden severe chest pain or someone collapsing, then there is of course no doubt. But in most of the cases the the symptoms are less typical.
What are the premonitory symptoms?
In some cases before the actual heart attack, there are premonitory symptoms like extreme fatigue, generalized feeling of being unwell, low mood etc. But they are very nonspecific symptoms and sometimes are difficult to correlate with a heart attack.
At what hours heart attacks happen?
It can happen anytime. But books say that the morning hours 6 am to 12 pm are particularly dangerous for having a heart attack.
Symptoms of a heart attack:
The commonest symptoms are :
- Chest pain
- Pain in other parts of upper body
- Shortness of breath
- Cold sweating
- Pain abdomen, nausea, vomiting
- Alteres sensorium
- Atypical symptoms
Pain in chest and other areas:
The commonest symptom of heart attack is pain in the centre of the chest which lasts for more than a few minutes and is not relieved with rest. The pain might initially get received only to recur again. Pain is usually in the middle of the chest with radiation to left arm. The pain can be predominantly felt in other parts of upper body like – neck, jaws, back etc. In patients with diabetes and in females the pain may be less and more atypical.
Chest pain is usually associated with shortness of breath, or a sense of suffocation. In more severe cases there can be accumulation if fluid in lungs when there will be severe shortness of breath with inability to lie down straight.
Some patients have pain abdomen, nausea or vomiting as predominant symptoms. But even these symptoms are associates with some degree of shortness of breath
Cold sweating can occur in heart attack.
Other atypical symptoms like extreme fatigue , dizziness , altered sensorium are more serious manifestations and signify high risk.
What to do?
Are are two things prevention and treatment.
For prevention risk factor reduction, regular intake of medicines for diabetes , high BP , elevated cholesterol. Every attempt including treatment should be done to stop smoking.
For treatment always consult a doctor for symptoms of chest pain, shortness of breath. Consult early and don’t delay thinking that it will go away, as a timely treatment can be live saving.
Concluding message: know the symptoms of a heart attack and act early.
Dr Anupam Jena