American Medical Association Family Medical Guide - American Medical Association [328]
• Have regular medical checkups to help ensure early detection and treatment of health problems.
• Keep your blood pressure under control and have your blood pressure checked as often as your doctor recommends.
• Have your blood cholesterol levels checked as often as your doctor recommends.
• Do not smoke or use other tobacco products.
• Maintain a healthy weight.
• Eat a low-fat diet that includes plenty of whole grains and fresh fruits and vegetables.
• Exercise regularly.
• Resume sexual activity when it is safe to do so (ask your doctor for advice).
• Manage your stress.
• Drink alcohol only in moderation.
• Take all medication exactly as prescribed.
Before you leave the hospital, your doctor will refer you to a cardiac rehabilitation program designed to help you recondition your heart, lungs, and muscles, and improve your cholesterol profile. Cardiac rehabilitation begins in the hospital and continues for weeks or months after you return home. The program usually includes diet, exercise, and lifestyle counseling. You also may need to take medication that reduces strain on your heart, improves its efficiency, and prevents irregular heartbeats. Medications may include:
• Antiplatelet agents or anticoagulants (see page 563)
• Beta blockers (see page 562)
• Angiotensin-converting enzyme (ACE) inhibitors (see page 563)
• Cholesterol-lowering medications (see page 564)
• Calcium channel blockers (see page 563)
Congestive Heart Failure
Congestive heart failure develops when the heart is weakened and is no longer able to pump an adequate supply of blood to the lungs and other body tissues. Heart failure does not mean that the heart stops pumping, but that it is not pumping efficiently. A number of disorders can lead to heart failure, including heart disease, heart attack, high blood pressure, heart valve disorders, arrhythmias (irregular heartbeats), anemia (a condition in which the oxygen content in the blood is reduced), or cardiomyopathy (a degenerative disease of the heart muscle). Heart failure can occur when the heart muscle is not able to contract effectively (called systolic, or left-sided heart failure) or when the heart muscle is not able to relax (called diastolic, or right-sided heart failure). Other risk factors include smoking, a poor cholesterol profile, high blood pressure, and being overweight.
After a Heart Attack
After you have had emergency treatment for a heart attack, you may be admitted to the hospital’s coronary care unit (CCU) or intensive care unit (ICU), where specially trained nurses will monitor your condition continuously for signs of any complications. If you had a minor heart attack, without complications, you will probably be encouraged to get out of bed after 48 hours. Even if the attack was severe, you will probably be encouraged to get out of bed and use a bedside commode. Doctors think that even a little exercise helps to reduce the risk of blood clots. Before leaving the hospital, you will probably have an exercise stress test (see page 560) to see if your heart muscle is getting enough oxygen. If not, your doctor will discuss possible treatment options with you.
Many people are anxious or depressed after a heart attack, and some people may hesitate to resume sexual activity. If you are feeling anxious or depressed, or if you are having sexual problems, talk to your doctor. He or she can diagnose and treat any underlying disease or condition or refer you to a support group or mental health professional who can help you deal with your feelings. By making an effort and maintaining a positive outlook, most people are able to lead full, active lives after a heart attack.
Heart failure occurs more frequently in men than in women and is twice as common among blacks as among whites. Up to 3 million Americans