Up until about two years ago, the idea, or anything about myocardial infarction (a heart attack), had hardly ever crossed my mind. I didn’t really know much about them, nor did I have any relatives or close friends that had been directly affected by them. All I was aware of was that it was something that could be fatal. It wasn’t until this heart condition impacted my family directly that I became somewhat knowledgeable on the subject. After only being away from home, starting my new chapter at FSU, for two short weeks, I received a call I had never expected. My father had suffered from a severe heart attack, and thankfully survived. Ever since this personal experience, I became more interested in this heart condition, how exactly it can occur, and all the factors that play a significant role. In this paper, I will discuss the history of heart attacks based around the 19th and 20th centuries including symptoms of heart attacks, how they happen, the involvement of genetics, and preventative measures to consider.
When trying to better understand how heart attacks happen, we must first learn how the heart works. Being the size of a fist, your heart is a muscular organ that acts as a pump. There are two sides to the heart: the right and the left. The right side of the heart consists of the right atrium and ventricle, and its job is to gather and pump blood to the lungs by traveling through the pulmonary arteries. This process enables the lungs to rejuvenate the blood with a fresh supply of oxygen. The lungs also allow us to exhale carbon dioxide, a product of waste. Following this, oxygen-rich blood enters the left side of the heart, consisting of the left atrium and ventricle. The left side of the heart is in charge of transporting blood through the aorta to provide tissues amongst the body with oxygen and nutrients (Heart Disease, 2018). This organ is one of the most important in the human body. It helps us to continue surviving every second on a daily basis through giving us fresh oxygen and getting rid of waste.
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In the 18th and 19th centuries, many doctors were uncertain and confused when it came to angina, a tightness in the chest that is often an indicator of ischemic heart disease (the result of a heart attack). William Heberden claimed that it had something to do with blood circulating in the coronary arteries, and many believe this. However, some thought it was a harmless condition. Later on, William Osler, physician in chief and professor of clinical medicine at John Hopkins Hospital, worked extensively on angina and came to realize it was not a disease, but rather a syndrome. After this discovery, American cardiologist James B. Herrick concluded that the “slow, gradual narrowing of the coronary arteries could be a cause of angina” (Cherney, Nall & Story, 2018). As the 1900s approached, an increased interest in heart disease was at hand. People were wanting to understand it better, and study it more. As the years passed, doctors developed many things based around heart disease, such as heart catheterization, diagnostic images, and so on (Cherney, Nall & Story, 2018). The history of heart attacks dates back to several, several years ago and it is extremely intriguing to recognize and appreciate the growth that researchers have experienced when it comes to learning more about this salient part of the body.
Having a heart attack is an experience like no other, and I could never imagine the toll it must take on someone who has experienced having one. I recall a specific thing my dad told me when I was trying to understand what exactly it felt like for him and he proceeded to tell me, “I felt like I was dying, like I had just been ran over by a bus.” This statement was quite shocking to me, and it made me upset to imagine my own father in that much pain. Not only did he have to experience having a heart attack, but it affected him afterwards by having to be out of work for a year. Thankfully for disability, it didn’t hurt him financially, but it did in the physical aspect in that he is someone who has always been working with his hands and on the go. Some symptoms to be aware of when it comes to heart attacks are chest pain, chest tightness, chest pressure, and just overall chest discomfort (angina). Shortness of breath, arm pain, neck pain, jaw pain, and back pain are also common symptoms (Heart Disease, 2018). I know that the main things my dad experienced was chest pain, arm pain, and then he began to vomit. I believe it is important to be extremely aware of these symptoms and take the necessary measures if one feels that they may be encountering a heart attack.
Another thing to examine when trying to better understand the history behind myocardial infarctions is how genetics play a role. While cardiovascular diseases are the world’s leading cause of death, myocardial infarction (commonly known as a heart attack) is the third leading cause of death in Croatia (Heffer, Milic, Peterlin, Skrlec, & Wagner, 2018). In the last several years, many genetic forms have been recognized that contribute to a higher risk of MI. It has been found that many physiological factors can cause MI, and many of these elements are known to fall back on circadian rhythms. These elements may include blood pressure, glucose homeostasis, vascular endothelial function, myocardial contractile function, and metabolism. Further research was done to come to the conclusion that daylight was the prime regulator of the human circadian rhythm, and sunlight cycles are critical for maintaining a healthy cardiovascular system in humans (Heffer, Milic, Peterlin, Skrlec, & Wagner, 2018). It is interesting to see how our circadian rhythms can directly affect our cardiovascular health, because I personally would have never expected the two to relate.
It is unfortunate that one may live as healthy as can be, and eat a very clean diet, yet heart disease could still impact them due to genetics. Unfortunately, genes are always going to dominate whatever health lifestyle we lead. According to the July 1985 edition of the Science Digest, high levels of LDL (low-density lipoprotein) can definitely result in heart disease. Something that can be done to reduce this from happening, is having a diet low in fat and high in fiber, as well as engaging in regular physical activity (Science Digest, 1985). Digging deeper, it is commonly known that the main antagonist in dealing with MI is cholesterol. High cholesterol can lead to many bad things, one being the build-up of plaque in the arteries that can eventually cut off blood flow, thus causing a heart attack (Science Digest, 1985). This is what my father experienced, one artery was 80% blocked and the other 100%. Due to my father having a high metabolism and working out daily, he was never overweight. However, he was addicted to eating sweets. My mother and I would always remind him that even though he sees no signs on the outside, does not mean his insides aren’t suffering. Low and behold, he ended up facing some consequences. It is not only important to maintain a healthy diet and engage in physical activity regularly to keep yourself in shape on the outside, but on the inside as well. Many times it is forgotten that even if we do not see signs physically, we could still be damaging ourselves internally.
Preventing heart disease, and keeping ourselves as healthy as possible in general, is something everyone should find to be a top priority. When it comes to preventing heart disease, there a three prevention measures to focus on: primary, secondary, and primordial prevention. Secondary prevention deals with efforts given after someone experiences a heart attack. Some secondary prevention consists of taking medications such as aspirin and/or cholesterol control medication, quitting smoking, losing weight if necessary, making more time for physical activity, and maintaining a healthier diet. To some, these measures may sound like beating a dead horse, however they can be helpful in preventing a second heart attack from occurring (Preventing Heart Disease, 2019).
Primary prevention is something for those to consider, who may be at risk for heart disease, from preventing experiencing a heart attack. This type of prevention is typically directed toward those who may already have cardiovascular problems such as high blood pressure or high cholesterol. However, it is likely that the appearance of these cardiovascular problems have already left their mark and there is no turning back. This is all the more reason to take secondary prevention very seriously and take care of yourself in every way that you have control over.
Lastly, there is primordial prevention. This deals with taking preventative measures from the very beginning, before even showing any signs of anything. This is the ideal prevention for any potential cardiovascular problems. This prevention aims to prevent inflammation, atherosclerosis, and endothelial dysfunction and preventing factors such as high blood pressure, high cholesterol, excess weight, and ultimately heart disease. I believe it is so important that people are aware of their health, and not only cardiovascular health, but all health in general. With that being said, we only have one body to live in and it is (mostly) in our control whether we choose to nourish it, or treat it with little care. Just like any living thing on this earth, it has to be treated with things that fuel it to keep it healthy and thriving. A poor diet, lack of exercise, and things such as smoking do nothing but damage to our bodies, and, ultimately we are shortening our lifespan if we choose to fill it with those toxins.
In 1999, an article was published that gave MI a more positive note: they were becoming less lethal. This is highly due to the fact that people were starting to live healthier lifestyles, as well as the medical industry becoming more efficient. While heart attacks still remain a severe problem, research has proven that those who suffer from a heart attack have an increasingly higher survival rate compared to previous decades. While this was great news at the time, Dr. Melissa Austin stated that they must stay attentive, alert, and on top of the matter. Just because the death rates due to MI had decreased in recent years, didn’t mean it was guaranteed to stay that way. According to statistics, there were 477,000 American deaths in 1999 due to coronary heart disease, and had the rate been the same as it was in the 1960s, there would have likely been close to 1.1 million deaths (Health, 1999). This is a tremendous decrease and something to be very grateful for. To be able to better comprehend this huge adjustment in the fatality of heart attacks, Dr. David C. Goff Jr. of Wake Forest University, studied a few thousand heart attack victims over the course of eight years in a couple different communities. Some things he found to be relevant to the severity of a heart attack was the level of creatine kinase, an enzyme given up by damaged heart tissue. Goff came to the conclusion that “average peak blood levels of this enzyme fell 5 percent per year during the study period.” Another physician, Dr. Carole Derby, dissected heart attack trends in a couple towns between 1980 and 1991. She found that while the number of survivable heart attacks did in fact increase, deaths due to heart attack fell in half. Overall, people were experiencing heart attacks that were much less serious, and physicians were getting better and better at treating them in the most efficient way. However, the amount of heart attacks in general was not declining (Health, 1999).
When it comes to diversity in our country, there is much to be discussed. Back in the day blacks were treated so poorly compared to whites when it came to medical needs and assistance. They were often given the least amount of concern and would be treated with hardly any care. An example of this, not quite related to the history of heart attacks, is the Tuskegee Syphilis Study. Many African Americans point to this study in that it is evidence to support their views on genocide. They were convinced that the black men taking part in the study were purposefully injected with the disease. They were then left untreated and were killed by the disease (Under the Shadow of Tuskegee, 1997). This is very disturbing and quite disgusting to look back on, and it is unreal to think that people were treated differently due to the color of their skin. I believe this is relevant because not only was this an issue with syphilis, but I assume it was an issue with all different kinds of medical needs, such as one suffering from a heart attack. It seems correct for one to assume that blacks were mistreated in all areas regarding medical needs, according to research and evidence. I strongly believe that with strong and adequate efforts, letting others hear our voices, and putting our foots down when necessary, that one day everyone in this world will be treated 100% equal no matter what. We have come a long way, but we certainly have much more to accomplish.
Every year in the United States, about 1 in every 4 deaths is due to heart disease. Annually, roughly 735,000 Americans experience having a heart attack. Of these, about 70% are considered first timers, while the other 30% have already experienced having at least one heart attack before. An important thing to make note of is how heart disease varies by race and ethnicity. While it is the leading cause of death in African Americans, Hispanics, and whites, for American Indians, Asians, and Pacific Islanders it is the second leading cause of death, falling right behind cancer (Heart Disease, 2017). The best way to effectively care for a heart attack, is taking early action. Chances of survival and quicker rehabilitation will be increased significantly (Heart Disease, 2017). I know that when my father went through his heart attack, he was on the night shift at work and had been feeling extremely ill all night. However, due partly to him being hard headed and partly to him not even thinking he could possibly be experiencing a heart attack, he continued to work all throughout the night. It wasn’t until he came home that my mom immediately noticed something wasn’t right, and rushed him to the hospital (we live about two blocks from the ER, so it was quicker for her to just take him than calling 911). Because of him ignoring his symptoms, is heart attack wasn’t treated immediately and was a lot worse than it could have been.
When it comes to gender and heart disease, there are some differences in men versus women that should be discussed. While men and women generally share the same typical risk factors, the extremity of the factors can be different. In regards to smoking, it is more damaging in women than men during younger ages, with a greater negative affect of the total amount of cigarettes smoked per day. So overall, smoking increases women’s chances of myocardial infarction more than it does men (Clinics, 2010). Another factor that is different between men and woman is excess body weight, and other negative outcomes it can cause. During the first years of menopause, a women’s body can go through much change, including weight gain. With increasing body weight, comes a correlation with type 2 diabetes. Thus, women with type 2 diabetes are at a much greater risk for cardiovascular problems than males. Another problem that is not in favor of women deals with systolic blood pressure. It tends to rise at a greater pace in ageing women versus ageing men. This is due to the fact that after menopause, there is an increase in the cellular component renin-angiotensin which then leads to an increase in plasma-renin activity. The result of this is that during older age, specifically 75 and older, isolated systolic hypertension is 14% more common in women and a cause of left ventricular hypertrophy, heart failure, and strokes (Clinics, 2010). On the other hand, men are dealt their unfortunate deck of cards when it comes to the risk of hypercholesterolemia. During menopause, women’s cholesterol and low-density lipoprotein levels rise by 10 to 14% respectively. This allows for women to have a lower risk of coronary heart disease mortality compared to men (Clinics, 2010). While it seems that women are significantly more prone to risk factors of heart disease, I believe it is very important for both men and woman to be very aware of any of these risk factors and take care of themselves accordingly.
In short, I believe something as serious and fatal as heart disease, specifically myocardial infarction, is so important for all individuals to be aware of. Whether it comes to being aware of the symptoms, taking early action, knowing the genetics that run in your family, leading a healthy lifestyle, and doing anything possible that we are in control of to keep our bodies as healthy as can be, can allow us to live our longest, healthiest, and most prosperous life. So many lives have already been lost from this fatal disease, and unfortunately, we cannot gain them back. I hope that future generations continue to stress the importance of not only heart disease, but all health issues in general, making them extremely known and stressing the importance of taking care of ourselves and one another. There is so much to gain from this paper and the research and history on myocardial infarction, as well as all other heart diseases, but I hope the one take home message people can gather, if not anything else, is how important it is to feed our bodies with things that fuel it, and keep all toxins out. We are only given one body with one opportunity to have life on this earth and make our mark, so we must do it to the very best of our abilities.
References
- Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health,87(11), 1773-1778. doi:10.2105/ajph.87.11.1773
- Heart attacks have become less lethal, studies say. (1999, March 25). The Telegraph Herald, p. 11B. Retrieved April 26, 2019, from https://books.google.com/books?id=gVlFAAAAIBAJ&pg=PA13&dq=heart attack&article_id=6593,5512949&hl=en&sa=X&ved=0ahUKEwianpuCoO7hAhWFzVkKHTC6Ccc4ChDoAQgpMAA#v=onepage&q=heart attack&f=false.
- Heart disease. (2018, March 22). Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118
- Heart Disease And Genetics. (1985, July 17). The Mount Airy News, p. 8B. Retrieved April 26, 2019, from https://books.google.com/books?id=zHc_AAAAIBAJ&pg=PA11&dq=genetics and heart attack&article_id=6702,5349541&hl=en&sa=X&ved=0ahUKEwjbnZWV4uzhAhVhzlkKHcMvC_EQ6AEIMjAC#v=onepage&q=genetics and heart attack&f=false.
- Heart Disease Facts & Statistics. (2017, November 28). Retrieved April 27, 2019, from https://www.cdc.gov/heartdisease/facts.htm
- Maas, A. H., & Appelman, Y. E. (2010, December). Gender differences in coronary heart disease. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018605/
- Preventing Heart Disease. (2019, January 30). Retrieved from https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/preventing-cvd/
- The History of Heart Disease: From Egyptian Mummies to the Present. (n.d.). Retrieved from https://www.healthline.com/health/heart-disease/history
- Škrlec, I., Milic, J., Heffer, M., Peterlin, B., & Wagner, J. (2018). Genetic variations in circadian rhythm genes and susceptibility for myocardial infarction. Genetics and Molecular Biology,41(2), 403-409. doi:10.1590/1678-4685-gmb-2017-0147
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