Almost everyone knows what the term "vascular calcification" means – but when it comes to coronary heart disease, many people wonder what it means.
The answer: it is the narrowing of the vessels that supply the heart with blood. The disease is widespread. The
Men have a nearly 50 percent chance of developing coronary heart disease in their lifetime, compared with 32 percent for women! 3.4 million women and 3.16 million men in Germany suffer from it. Many people don't even know about it until, out of the blue, a heart attack strikes them down – for 59 days.000people per year, this is the cause of death. Editor Susanne Stockmann spoke with Professor HeribertSchunkert, Director of the German Heart Institute in Munich, about how best to prepare for a heart attack. The disease has been dormant in the body for years. Sudden infarction. Who has the greatest chance of survival?
Professor SchunkertIn principle, every second counts. A plaque, i.e. a deposit in the veins, ruptures, a clot forms and can completely block a vein within 15 minutes. The heart muscle supplied with blood by the vein does not get enough oxygen and will die off. Those who receive medical help quickly have the best chance of surviving and recovering. But unfortunately, many sufferers wait for hours before calling the emergency doctor. As a result, nearly 30 percent of heart attack patients die before reaching the hospital.
The quick decision is so difficult, because it may only hurt in the arm or suddenly there is cold sweat on the forehead or you feel terribly nauseous.
First aid for heart attack
First aid for heart attack
SchunkertExactly, someone lives his life, tinkers in the hobby cellar, or he stands somewhere at the cash register and suddenly he has complaints and pains, which he does not know in such a way. The person tends to suppress the seriousness of the situation. Studies have shown that it is very good to ask others for advice in such a situation. Wives, for example, are very good advisors when their husbands are unwell, but not vice versa. But in women the symptoms are also more unspecific. For example, they often just feel very nauseous and have to vomit. This also sometimes makes it difficult for doctors to make the correct diagnosis. In the case of typical symptoms, i.e. severe pain behind the sternum – sometimes combined with fear of death – the affected person usually has no choice but to ask for help quickly. This can even be a blessing in disguise, because rapid treatment saves the heart from damage.
To which doctor should I go in case of suspected?
SchunkertIt is best to call the emergency doctor, who will take you to the nearest chest pain unit or, in rural areas, to the district hospital. Long journeys of more than 30 minutes should be avoided at all costs. The 150 chest pain units in Germany are specialized in clarifying quickly, around the clock, whether a heart attack is really present. However, if everything turns out to be more harmless, the patient is then discharged from the hospital and continues to receive outpatient care. There is no need to worry about staying in the hospital for a long time if the suspicion of heart attack is not confirmed.
Does the heart attack really come so out of the blue?
Schunkert: It is now known that atherosclerosis progresses for years and decades without symptoms. For every second person affected, a heart attack is the first symptom of all. In the other half, angina pectoris develops beforehand, i.e. the characteristic feeling of tightness as well as chest pain on exertion. Half of people who have angina often notice worsening of symptoms before infarction. But these patients have a greater chance of survival: because many know of their condition, they usually alert the emergency physician more quickly.
When to get screened for coronary artery disease?
Schunkert: The risk factors of atherosclerosis are well researched: high blood prere, obesity, too little exercise, high cholesterol, diabetes and smoking are the main ones. All these factors should be normalized, the best way is to change your lifestyle. So lose weight, do at least a little exercise regularly, stop smoking and eat sensibly.
You can't compensate for lifestyle sins with pills?
SchunkertNo medication can replace a healthy lifestyle. Especially when it comes to smoking. No medical measure can even come close to neutralizing the consequences of smoking. But if there are deposits in the vessels, it is no longer possible to do without medication.
In the past, even when there was little suspicion of coronary artery disease, catheters were used to look at where the narrow spots were. Why does one not do this more?
SchunkertIf there is a well-founded suspicion, the catheter examination cannot be avoided. But this minor intervention must be carefully considered, as it is associated with minimal risks. It was also thought that stents, small tubes that dilate the veins, could be used to seal the deposits in the veins. But it has been found that patients do not benefit from it. If coronary heart disease does not cause any symptoms and the blood supply to the heart is functioning, observed. High blood prere, cholesterol levels and the other risk factors are monitored. Once in the year a load ECG should be made. Only if there are abnormalities or if the patient develops symptoms, the blood flow situation in the heart must be improved, then the medication is no longer sufficient.
What options do you have as a physician to save a clogged artery??
Schunkert: Today we have fantastic possibilities to reopen the vessels. With cardiac catheterization and the materials that have been developed for stents in recent years, blood flow to the heart can increasingly be completely restored. The materials have become slimmer and slimmer in terms of profile, we are getting better and better at getting to very narrow places. Then coatings ensure that the veins do not clog again. If several vessels are blocked and the muscle has already suffered, then bypass surgery is the best option, because all the arteries can be resupplied with blood in one fell swoop. Bypass surgery is the most common operation in Germany. More than 1,500 heart operations are performed each year at experienced clinics such as the one here at the German Heart Institute. Here, such bypass surgeries are performed every day with great routine.
The brochure "Heart in Danger" explains coronary heart disease in a comprehensible way. The guidebook can be ordered for three euros in stamps (flat rate for shipping) from: German Heart Foundation, Vogtstr. 50, 60322 Frankfurt.
The role of genes
Coronary heart disease usually begins in middle age. Although in 80 to 90 percent of cases it can be traced back to a lifestyle that causes disease. The predisposition to vascular calcification, however, is inherent in people's genetic makeup. Other mammals, z. B. mice, do not have heart attack genes and do not get artheriosclerosis of the heart disease vessels. Those who have many of these hereditary factors in their blood have a higher risk of suffering a heart attack – even though they may have lived a particularly healthy life. One should not rely on the luck of good genes. Professor Schunkert: "If someone smokes, he loses his genetic advantage."The graphic shows a healthy artery on the far left, in the middle the first deposits hinder the blood flow, on the right the blood flow is partially blocked, the heart muscle does not get enough oxygen (dark spots).