Stop a Heart Attack Before it Happens

Walter Groesel (free

Walter Groesel (free


Chest pain…shortness of breath…feeling faint…and/or discomfort in the arm—or even the neck, jaw or back. If you are overcome by such symptoms and perhaps even have an intense and sudden “sense of doom,” you’re likely to suspect a heart attack and rush to a hospital.

But wouldn’t it be better to get a heads-up beforehand that a heart attack is on the way?

What most people don’t realize: For about 60% of heart attack victims, warning symptoms do occur days or even weeks before the actual heart attack. But all too often, these signs are missed or shrugged off as something trivial.

What’s behind this early-warning system? The blockage that creates a heart attack often develops over time, and its symptoms, though they may be mild and elusive, should not be ignored.

 Knowing the early red flags—including those you might not immediately connect to a heart problem—can allow you to see a doctor before a life-threatening heart attack occurs. Women, especially, can have symptoms that do not immediately bring heart disease to mind.

Important: If these symptoms are extreme and last for more than a few minutes—especially if they are accompanied by any of the more typical symptoms such as those described above—call 911. You could be having an actual heart attack. Even if these symptoms are mild to moderate but seem unexplained, call your doctor. If he/she cannot be reached but you’re still concerned, go to the emergency room.

The following are examples of the subtle symptoms that can precede a heart attack—sometimes by days or weeks…

Fatigue. If you feel more tired than usual, it’s easy to tell yourself you’re just growing older or getting out of shape. But pay attention! It could be the early-warning sign of heart trouble.

If your usual daily activities, whether it’s walking the dog or cleaning the house, leave you feeling more tired than normal, talk to your doctor.

Flu like symptoms. If you get hit with extreme fatigue, as well as weakness and/or feelings of light-headedness, you may think you’re coming down with the flu. But people report having these same symptoms prior to a heart attack.

Call your doctor if you experience flulike symptoms but no fever (a telltale flu symptom). Another clue: The flu generally comes on quickly, while flulike symptoms associated with heart disease may develop gradually.  

Nausea and/or indigestion. These are among the most overlooked symptoms of a heart attack—perhaps because they are typically due to gastrointestinal problems.

But if you are feeling sick to your stomach and throwing up, it could be a heart attack rather than food poisoning or some other stomach problem—especially if you’re also sweating and your skin has turned an ashen color. If indigestion comes and goes, does not occur after a meal or doesn’t improve within a day or so—especially if you’re using antacids or antinausea medication—this could also mean heart problems. See a doctor.

Excessive perspiration. If you are sweating more than usual—especially during times when you’re not exerting yourself—it could mean that there are blockages. This can cause your heart to work harder, which may lead to excessive sweating. See your doctor. Clammy skin and night sweats also can be warning signs. This is likely to be a cold sweat, instead of the heat ­experienced in menopausal hot flashes. If sweating occurs with any of the classic heart attack symptoms described above, don’t think twice—call 911.

Shortness of breath. If you notice that you are beginning to feel more winded than usual, see your doctor. Shortness of breath can be a precursor to heart attack. If shortness of breath becomes stronger or lasts longer than usual, call 911. Shortness of breath may be your only symptom of a heart attack and may occur while you are resting or doing only minor physical activity.

Sexual dysfunction. Men with heart problems that can lead to heart attack often have trouble achieving and/or keeping an erection. Because poor blood flow to the penis can be a sign of possible blockages elsewhere in the body, including the heart, erectile dysfunction can be an early-warning sign to get checked for cardiovascular disease. Men should absolutely discuss this symptom with their doctors.


After a woman goes through menopause—when the body’s production of heart-protective estrogen declines—her risk for a heart attack dramatically increases.

Important facts for women: More women die of heart disease each year than men. Nearly two-thirds of women who died from heart attacks had no history of chest pain. The higher death rate for women is likely due to the fact that women don’t seek medical attention as promptly as men because they are afraid of being embarrassed if the symptoms turn out to be nothing serious. Don’t let this fear stop you from seeking immediate care. If the symptoms turn out to be nothing serious, the emergency medical team will be happy!

What to watch for: While most (but not all) men experience crushing or squeezing chest pain (usually under the breastbone), women are more likely to have no chest pain (or simply a feeling of “fullness” in the chest). Also, women are more likely than men to suffer dizziness, shortness of breath and/or nausea as the main symptoms of heart attack. Most women (71%) experience sudden onset of extreme weakness that feels like the flu.

Source: John A. Elefteriades, MD, the William W.L. Glenn Professor of Surgery and director of the Aortic Institute at Yale University and Yale–New Haven Hospital. He serves on the editorial boards of The American Journal of Cardiology, the Journal of Cardiac Surgery, Cardiology and The Journal of Thoracic and Cardiovascular Surgery and is the author of several books, including Your Heart: An Owner’s Guide.

Taking Antibiotics for Traveler’s Diarrhea – Don’t

stomach acheWhen you have a serious infection, you want your antibiotic to work fast and thoroughly and to kill the bacteria before they possibly kill you. But if the bacteria causing infection have learned to outsmart the antibiotic, then you’re in real trouble. Overuse and inappropriate use of antibiotics are key factors in training bacteria to trump treatment.

So if you thought you could avoid a really uncomfortable case of diarrhea by popping an antibiotic—as many travelers do to avoid traveler’s diarrhea—would you?

I hope not. And I’ll tell you why.

When you overuse antibiotics, you are not only setting yourself up for antibiotic resistance, you are also contributing to a looming threat that affects us all. The problem was most recently exemplified by an E. coli outbreak in Illinois caused by a drug-resistant South Asian strain of E. coli and a related deadly superbug outbreak in California. The strain could have originated in a traveler and was spread to others through medical equipment even though the equipment had been properly disinfected. Now, a large Finnish study warns that antibiotic use to prevent or treat traveler’s diarrhea may be the perfect storm for contracting superbugs during your travel, potentially leading to more scenarios like the one seen in Illinois.


Not everything you bring home from a trip abroad fits in your suitcase. Like rats on an old seafaring ship, organisms can stow away in your body. A study involving 430 Finns who were traveling outside of Scandinavia showed how common a transfer of bacteria from one locale to another is. In this study, each participant completed a questionnaire before and after his or her trip. The questionnaires gathered information about each traveler’s personal and medical history, travel itinerary, any medical symptoms that developed during travel and any medications used. Special attention was given to incidence of traveler’s diarrhea and antibiotic use to treat it. Researchers also analyzed travelers’ stool samples before departure and upon return to track what kind of intestinal bacteria they were carrying. And travel destinations were divided into seven regions—South Asia (India, Pakistan and nearby locales), Southeast Asia, East Asia, North Africa and the Middle East, sub-Saharan Africa, South and Central America and the Caribbean, and Europe, Australia and North America.

The results: Among those who got traveler’s diarrhea, a stunning 46% who took antibiotics for it came home with antibiotic-resistant intestinal bacteria in their bodies (namely strains of E. coli)…compared with only 17% of those who didn’t take antibiotics.

The most likely place to pick up these “bugs” was South Asia, where 46% of visiting travelers were affected. Thirty-three percent of travelers visiting either Southeast Asia, East Asia or North Africa and the Middle East were affected, as were 12% of visitors to sub-Saharan Africa. Meanwhile, all travelers to Europe, Australia and the Americas returned home unscathed.


Although antibiotics are extremely useful in quashing bacterial infections, they can disrupt the microbial ecosystem in our guts, where “good” bacteria keep the less friendly disease-causing bacteria in check. When antibiotic use upsets the balance, it becomes easier for pathogens to invade the gut, thrive and, among travelers, hitch rides back to a traveler’s native land where the bugs can spread to others. If they cause an infection, treatment becomes a challenge because these microbes can be resistant to commonly used antibiotics.

Rather than taking an antibiotic to prevent or treat traveler’s diarrhea, the study researchers gave recommendations that mirror those of the US Centers for Disease Control and Prevention (CDC) and noted that travelers to Asia—particularly South Asia—and Africa should be extra vigilant.

Although the CDC affirms that taking an antibiotic is, in fact, effective in preventing traveler’s diarrhea, it recommends that travelers, instead, take bismuth subsalicylate (none other than Pepto Bismol) if they want to take prophylactic treatment. Bismuth subsalicylate provides some protection against harmful gut bacteria without promoting antibiotic resistance, according to the CDC. It recommends two tablets or two fluid ounces of bismuth subsalicylate four times per day but not for more than three weeks. But this prophylactic treatment is not for you if you are allergic to aspirin or on blood thinners, probenecid ormethotrexate—and it should not be used by pregnant women.

Better than taking a drug to prevent traveler’s diarrhea, though, the CDC and Finnish researchers both urge you to simply be careful about food and hygiene while traveling to countries known to be hot spots for traveler’s diarrhea. Avoid…

  • Tap water unless it has been boiled. Use bottled water for drinking and teeth-brushing—and don’t let ice cubes land in your libations.
  • Food and beverages sold by street vendors and at locales that appear to be off-the-beaten-path or unsanitary.
  • Raw or undercooked meat and seafood as well as uncooked vegetables. In fact, make sure that all your meals are served well-cooked and warm.
  • All raw fruit unless the fruit has a thick peel (examples: bananas, oranges and avocados) that you can wash with bottled water before peeling.

If you get hit with traveler’s diarrhea…sure, it’s inconvenient, but it is usually a mild illness that resolves within a few days without treatment and is rarely life-threatening, said lead author of the study, Anu Kantele, MD, PhD, associate professor in infectious diseases at Helsinki University Central Hospital. She recommends loperamide (Imodium) for people with traveler’s diarrhea without fever who need symptom relief—for example, relief from symptoms in order to sit through a long plane flight home.

The recommendation given by the CDC is very basic and what we all know to do—drink lots of clear fluids to stay hydrated. However, the CDC and Dr. Kantele recommend that if symptoms are severe, especially if you are running a high fever or if your stools are bloody, then, taking an antibiotic may be a wise choice despite the risk of contracting antibiotic-resistant bacteria.

Source: Anu Kantele, MD, PhD, associate professor in infectious diseases, Helsinki University Central Hospital, Finland. Her study was published in Clinical Infectious Diseases.

What the Weather Does to Your Heart

snicer (

snicer (

The arctic blast that brought tundra like temperatures to much of the country this winter has left behind more than frozen pipes and frost-nipped noses. During a typical winter, there are up to 36% more circulatory-related deaths than during warmer months.

Flu-Fighting Facts That May Surprise You

Cieleke (

Cieleke (

The flu is an illness that you hear so much about year after year that it’s easy to assume you know all there is to know about it. That’s a mistake. Widely held assumptions about the flu often are wrong—and dangerous. By learning the facts, you can help yourself and loved ones from being among the estimated 36,000 Americans who will die this year due to pneumonia and other flu-related complications. Common misconceptions… Read the rest of this entry »

New Four-Strain Flu Vaccine

zeathiel (

zeathiel (

Is It Right for You?

Have you heard? There’s a new type of flu vaccine that guards against four strains of flu rather than just the usual three strains.

We have some questions about this new quadrivalent flu vaccine, of course. For instance: Is it safe? How well does it work? (A fair question, considering that last year’s vaccine was only 56% effective.) How can you tell whether it’s right for you? And will you be able to find it if you want it? (Another fair question, given last year’s shortages.)

We’ve got these answers and more… Read the rest of this entry »

Relieve Genital Pain

Ana Labate (

Ana Labate (

Remedies That Relieve Genital Pain in Women

Ladies, have you ever worn too-tight jeans that rubbed your crotch raw…developed an itchy all-over rash that really did go everywhere…or had a sore or an infection (or even a cut from shaving the bikini area) that made your private parts painful or tender?

When discomfort occurs “down there”—especially when there is an open sore or when pain is accompanied by other symptoms that could indicate an infection, such as a fever or vaginal discharge—of course you need to contact your doctor so he or she can diagnosis the complaint and prescribe treatment. To relieve simple chafing or other minor injuries or irritations, though, there often are steps you can take at home that bring relief, said Joel M. Evans, MD, gynecologist and director of the Center for Women’s Health in Stamford, Connecticut. In some cases, the remedies suggested below also can alleviate discomfort while you wait for your doctor-prescribed treatment to take effect.

Complaint: A cut or sore in the genital area… Read the rest of this entry »

What You Don’t Say to Your Doctor CAN Kill You

Kurhan (

Kurhan (

The Misdiagnosis Epidemic – How to Answer the Doctor’s Questions

At a major hospital’s emergency department, a 60-year-old patient named May recently told a doctor that she had passed out in the gym locker room after feeling queasy and short of breath during a workout. May answered “yes” to all the doctor’s questions. Yes, she had a headache…an upset stomach…shortness of breath—and chest pain.

When the doctor heard chest pain, he linked it in his mind with the patient’s fainting (a possible sign of a heart condition) and proceeded to give her the standard evaluation for heart disease. The tests turned up nothing, but overnight the patient developed a 102°F fever and her “upset stomach” became extremely painful.

This time, doctors gave May a full physical exam and blood tests. Results pointed to a gallbladder infection that could have been treated with antibiotics but had become so severe that she now needed an emergency operation. How was the real cause of May’s distress missed?

This is a classic example of what can happen when a doctor doesn’t keep an open mind about a patient’s health problems—and the patient doesn’t do a very good job of describing the ailment. This type of scenario occurs every day in hospitals and doctors’ offices across the U.S.

WHAT GOES WRONG Read the rest of this entry »