- First Aid
What I Would Do if I Had a Heart Attack to Ensure a Longer Life
Patients with myocardial ischemia being administered with infusion chelation therapy at a clinic in Metro Manila, Philippines
When heart attack strikes dilate arteries to allow more blood flow
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.
Caution on aspirin: continuous consumption allows the accumulation of arachidonic acid that becomes converted to leukotrienes, a mediator of allergy to any drug.
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.
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 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.
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 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.
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.
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.
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.
Hubs on chelation therapy by conradofontanilla: