Heart Attacks on the Rise
In Younger People...
This was my column from the SC Baptist Courier for March, 2023.
https://baptistcourier.com/2023/03/wholly-healthy-heart-attacks-on-the-rise/
You never know what the news will bring in an age of spy balloons and UFOs. However, on the medical front, healthcare problems have changed in the wake of the pandemic. Mental health and addiction issues have exploded. Depression and suicidal thoughts in children are higher than I’ve seen in my entire career. It appears that due to delayed screening tests, late stage cancer diagnoses may be increasing.
In addition, we’re seeing more heart attacks, and deaths from myocardial infarction (the technical term for heart attacks), in people between the ages of 25 and 44. This is not the group where we typically see severe cardiac events. The study below highlights this issue.
https://www.cedars-sinai.org/newsroom/covid-19-surges-linked-to-spike-in-heart-attacks/
While it’s early, it certainly could be that COVID, like other viral illnesses, induces cardiac inflammation resulting in heart attack. It could be that we became a more sedentary people, our diets changed, or anxiety increased.
While I certainly try not to inflame anyone’s fears, I write this to say that people should be attentive to their symptoms. Even a person who is relatively young should be cautious if they have chest pain, difficulty breathing, profound weakness or dizziness/passing out. Of course, associated symptoms can include nausea, unexpected sweating (or diaphoresis), numbness or tingling in arms or face, or pain into jaw, neck or back. Of course, symptoms in women can be more subtle can can simply involve profound fatigue.
What may be equally important is the idea that we should be take good care of ourselves. In the face of an increased level of risk for heart disease, it’s a good time to lose weight, exercise, stop smoking and eat a healthy diet. I would also suggest that everyone take their existing prescriptions, try hard to control their blood glucose in diabetes, manage their blood pressure and all the rest. We can’t control all of our health risks, but the ones which we can, we certainly should.
Furthermore, even young people should find a primary care physician if possible, and establish a relationship with that physician. The screening exams that they perform, the regular exams, the attention to your health that they provide can truly be lifesaving.
It will take decades for us to unravel the consequences COVID-19. Maybe longer to extricate ourselves from the cultural divides and frustrations. It will take careful research to figure out what problems came from the virus and what problems came from our public health response to it.
But in the mean time, it seems clear that there has been an increased risk of heart attack and we should all be careful.
I think that we need to redefine what is considered to be low-risk chest pain. If you have a young patient with a convincing ACS story, he or she may not make the cut for admission. “Sorry; we are not admitting a HEART score of 3.”
COVID is a great masquerader. In spite of vaccination and boosters, I experienced Delta and Omicron, each with a long trailing post-COVID syndrome. After the first episode, I did what many MDs do, "diagnosed myself" and ignored cardiopulmonary symptoms as a disregulated autonomic system. After all, what would anyone actually DO for me, anyway. The second time around, when intense chest pressure was added to the symptoms, I acquiesced to my family health history and personal risk factors and had discussion with my PMD who sent me off to the cardiologist for CAD screening. 3 months and several thousand dollars worth of diagnostics and I was gratified to learn that I did not appear to have significant coronary disease. BUT, I still have that family health history, personal predisposing conditions and frightful health maintenance habits. As an MD, I would advise anyone with my risk factors to take better care of themselves. I went to med school and all that training to advise and help others with their health issues. Perhaps if I had spent 12 years working on my own health preservation behaviors, I'd be a better patient...