Heart failure occurs every 29 seconds Published Aug. 31, 2006 By Lt. Col. Anne Heinly 5th Medical Operations Squadron MINOT AIR FORCE BASE, N.D. -- Every 29 seconds, someone in the U.S. has an acute myocardial infarction or in everyday language, a heart attack. Every minute someone dies from a heart attack. Those statistics translate to 1.5 million heart attacks a year with 500,000 dying, usually quite suddenly. There is little difference between male or female, white, black or Hispanic, rich or poor. Heart disease is an equal-opportunity killer. While this number has decreased over the last decade with better medications and procedures, the best way to avoid a heart attack is prevention. An AMI is most commonly caused by coronary artery disease. Coronary arteries carry oxygen-rich blood to the heart muscle itself. Each squeeze of the heart muscle pushes our blood throughout the body delivering oxygen to every organ. Each squeeze is felt as a beat of the heart or at the wrist as a pulse. Like all muscles, if the heart muscle is short on oxygen from its arteries, it starts to cramp up causing chest pain. If the blockage lasts long enough, parts of the heart muscle can die or the whole heart can stop, causing sudden death. Blockage of the artery can be caused by a build-up of cholesterol on the inside of the artery due to spasm of the artery or by a clot of platelets and cholesterol blocking the artery or a combination of all three. While there are some heart attacks that hit out of the blue with no symptoms before the "big one" most of the time there are signals people can watch for before the initial impact. Chest pain is the most common symptom of coronary artery disease. Certainly, central or left-sided chest pain is common, but coronary artery disease may be present with pain in the left shoulder, behind the shoulder blade, in the middle of the back, in the upper abdomen or in the left arm or neck. Some may notice the pain only as they are exercising and it seems to go away as they finish exertion. People may also notice they just can't do as much as they were before without getting short of breath. Other symptoms indicating the heart is not getting enough oxygen is persistent dizziness, palpitations, nausea with abnormally heavy sweating or a sudden overall weakness. Coronary artery disease can cause the heart to work less efficiently and it may show up first as abnormal swelling in the legs or a sudden increase in weight. Many can honestly say they have had one of these symptoms once in their life and it was not a heart attack. The key is usually the intensity and duration that gets one's attention. The pain is usually quite impressive and tends to slow a person down or stop what they are doing. It usually lasts longer than one minute and generally not longer than 30 minutes without progressing. However, a person can have many small events occur with less and less activity. While a cardiac screening examination is not a guarantee of not having an AMI or coronary artery disease, it can go a long way in defining risk, treatment and other diseases that can mimic coronary artery disease. A helpful way to avoid a heart attack is to modify personal lifestyle. Smoking is one of the greatest risk factors. Every cigarette affects the efficiency and size of the blood vessels, decreasing blood and oxygen flow for seven minutes. Cigarettes decrease the number of good cholesterol in the blood- stream, letting and bad cholesterol build up in arteries causing blockages. Central obesity is a risk factor as well. People carrying a lot of weight in the abdomen have a higher risk of coronary artery disease and AMI. A healthy diet and regular exercise can help control risk factors. Controlling high blood pressure and diabetes are other important factors in decreasing the risk of heart disease. Lifestyle changes and early medical interventions can make a real difference in treating coronary artery disease and decrease the likelihood of becoming part of the acute myocardial infarction statistics. People who want to make some lifestyle changes should talk with their provider at the 5th Medical Group or the base health and wellness center.