While the majority of first heart attacks happen around age 65 for men and 72 for women, there has been an increase in heart attacks in people under age 40, according to the American College of Cardiology, a professional organization of heart doctors. The chances of having a heart attack at a younger age depend on many factors. Symptoms of a heart attack vary between men and women and can be subtle enough in younger people that they go unnoticed.

Here we will talk about what a heart attack is, your risks for having one at any age and signs you shouldn’t ignore.

Understanding heart attacks

A heart attack, also known as a myocardial infarction (my-oh-CARD-ee-ull in-FARK-shun), happens when blood flow to the heart is blocked or restricted. Less blood means less oxygen, and that leads to parts of the heart muscle dying.

“That is why we say time is muscle,” said Gang Cheng, M.D.,  a cardiologist with Norton Heart & Vascular Institute. “The sooner you can see a health care provider if you think you are having a heart attack, the better.”

There are some causes of chest pain that are not due to heart attack, including acid reflux, muscle strain and anxiety.

“We encourage people to be seen for chest pain, no matter their age, especially if it is accompanied by other symptoms of a heart attack,” Dr. Cheng said.

Heart attack age myths

You might think anyone who has a heart … can have a heart attack. That may be true only in the most technical sense. Heart attacks can happen to anyone, but statistically they happen to people of a certain age. Data from the American Heart Association shows the average age of a person at the time of their first heart attack in the United States is 65.5 years for males and 72 for females.

However, those numbers are changing. An ACC article from 2019 notes that the incidence of heart attacks is rising in those under 40.

“The idea that you have to be a certain age to have a heart attack is not exactly true,” Dr. Cheng said. “There are cases of heart attack in adults of all ages. It depends on many factors, but it is possible to have a heart attack at what we would consider a young age — in one’s 40s or even younger, for example.”

Risk factors contributing to early onset heart attacks

A study in 2018 looked at heart attacks in people younger than age 45. Results of that study showed the incidence of a heart attack per 100,000 people was:

• Ages 20 to 29: 2.1
• Ages 30 to 39: 16.9
• Ages 40 to 49: 97.6

The authors noted that, compared with older adults, those who experienced a heart attack under the age of 45 were more likely to:

• Be male
• Smoke
• Have a higher body weight
• Have a family history of premature heart attacks

Other risk factors for heart attack in younger people include:

• Substance abuse, especially cocaine, or excessive alcohol use
• High blood pressure
• High cholesterol levels
• Lack of physical activity
• Diabetes
• Poor diet, without vegetables, whole grains and lean meats

What age can you have a heart attack?  

In general, most heart attacks happen to people around age 65. The younger you are, the less likely you are to have a heart attack, but it is not impossible, especially if you have certain risk factors.

Reducing the risk of heart attack in young people

Although deaths from cardiac arrest in young people are not common, you still can take extra steps to help reduce your chances of having a heart attack as a younger adult, especially if you have a family history or other risk factors:

• Schedule annual checkups with your doctor, especially if you have a family history of heart attack or sudden cardiac arrest.
• Have annual sports physicals if you are very active in sports.
• Eat a balanced, healthy diet.
• Maintain a healthy weight.
• Get regular exercise.
• Stop smoking.

It is important to know the warning signs of a heart attack and what to do if you or someone you know has these symptoms.

If you have many of the risk factors for heart attack, you should talk to your health care provider. Also, know the warning signs of a heart attack and see a doctor if you have sudden symptoms of pain, tightness or pressure. The sooner you are seen for heart attack symptoms, the better your outcomes are likely to be.

The post Average age of a heart attack is younger than you might think, so here are warning signs of a heart attack and what you need to know appeared first on Norton Healthcare.

Also, heart attacks don’t always cause chest pain. One study found 1 in 5 heart people had heart attacks without chest pain. With a heart attack, you may feel pain or discomfort in your back, jaw or arms, and not your chest. You also can feel pain in the stomach area that you might confuse with indigestion. 

When a heart attack does cause chest pain, it begins in the left side or center of the chest and typically spreads to the back, jaw or arms. In men, heart attack pain radiates to the left arm most of the time, but not always. In women, the pain is more likely to spread to either arm.

Unlike the textbook heart attack, where you feel as though you have an elephant sitting on your chest, pain from a heart attack can range from mild to severe. The discomfort usually lasts for a few minutes and can feel like an uncomfortable pressure, squeezing, fullness or more serious pain. It also can go away and return a short time later.

Many women do experience chest pain with heart attacks, but they are more likely than men to get less-common symptoms, such as shortness of breath, indigestion, nausea or back pain — sometimes without any chest pain.

You may have heard taking aspirin will help with chest pain. This a myth. Aspirin is not a pain reliever typically used for chest pain. However, taking aspirin thins the blood, which helps prevent heart-attack-producing blood clots from forming. If you are having a heart attack, call 911. The dispatcher may recommend you take an aspirin, depending on your symptoms.

Chest pain can result from other causes.

For example, a condition called angina (an-JYNE’-uh) also can cause a feeling of squeezing, pressure or heaviness on the chest. Angina is caused by part of the heart not getting enough oxygen and usually occurs during exercise or physical activity. Chest pain from a heart attack lasts longer than angina and, unlike angina, does not improve by resting or taking a nitroglycerin pill.

Chest pain also can be caused by myocarditis, which is an inflammation of the heart muscle, or cardiomyopathy, a disease of the heart muscle.

Straining the muscles between your ribs, called intercostal muscles, by weightlifting or doing other forms of exercise, can result in chest pain. Injured ribs, or chronic pain syndromes such as fibromyalgia, also can result in chest pain.

Chest pain is more common in older people because their hearts need to work harder to pump blood. However, chest pain also occurs in children and adolescents. It is usually harmless in children and teens, but when it occurs with exercise or is accompanied by a fast heartbeat, dizziness or fainting, it may be a sign of a heart issue.

Heart attacks do not only occur in older people. They are becoming more common in people in their 20s and 30s.  Diabetes is a key risk factor for an early heart attack. High blood pressure, another risk factor for a heart attack, is also becoming more common among younger adults.

After a meal of spicy or acidic foods or drinking caffeinated beverages or alcohol, you might experience a burning sensation in your chest known as heartburn, which also can leave a sour taste in your mouth. Heartburn is caused when digestive acid moves into the esophagus, the tube that normally carries swallowed food to your stomach. Heartburn is usually relieved by antacids. Unlike heartburn, a heart attack often is accompanied by fatigue, a cold sweat, or lightheadedness or dizziness.

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Here are some tips on when to worry about chest pain.

Millions of Americans go to the emergency room every year, complaining of chest pain. Only about 20% of them are having a heart attack. Pain, pressure, aches and other feelings in the body can mean different things.

“Chest pain and the potential for heart issues should be taken seriously,” said Abdullahi O. Oseni, M.D., interventional cardiologist with Norton Heart & Vascular Institute. “While there are many conditions that can cause chest pain, you should err on the side of caution and see a health care professional. We want to rule out anything more dangerous.”

Heart attack or chest pain?

While the scenes in TV and movies might make you think sudden, severe chest pain is the prime sign of a heart attack, that’s not exactly true or even true in every case.

“Very few people actually describe the symptom as pain,” Dr. Oseni said. “People say it feels more like pressure, tightness, squeezing or even indigestion. Some just describe a general feeling of discomfort.”

The feeling may travel into the left arm, shoulder, neck, jaw or back. There are often early signs of a heart attack that people ignore.

Everyone experiences heart attacks in different ways, Dr. Oseni said. Heart attack symptoms also can be different in men than in women.  Some people don’t have any discomfort in the chest but may experience other symptoms, including:

• A feeling in the chest often described as pressure, tightness, squeezing or constriction — but not always
• Nausea
• Pain or tightness in the arm, shoulder, neck, jaw or back
• Shortness of breath
• Sweating
• Weakness or dizziness

“Sharp pain that is very focal and you can point directly to with one finger is often not a heart attack but could be another condition that is an emergency,” Dr. Oseni said. “People more commonly describe the chest pain associated with a heart attack as feeling like someone is sitting on their chest.” 

What causes chest pain?

Besides a heart attack, there are other conditions that cause pain in the chest.

Gastroesophageal reflux (GAS’-troh-ee-soff-uh-jee-ul REE’-flux) disease (GERD)

Is it heartburn or a heart attack? Heartburn is a condition where stomach acids push up into your esophagus, the tube that connects your mouth with your stomach. This can happen once in a while, maybe after you eat spicy food. It causes a burning feeling in your chest. If heartburn happens often, the lining of the esophagus can become irritated, and GERD can develop.

Pain from GERD can be managed at home by avoiding certain foods and beverages such as alcohol, caffeine, fatty foods and peppermint, not lying down after a meal or stopping smoking. If GERD is not manageable for you and is interfering with daily life, you may want to speak to your doctor about a prescription antiacid or other ways to treat GERD.

Chest pain from muscle strain

If you have ever “overdone it” with a physical activity and been sore, you may have had musculoskeletal (muss-kyuh-loh-SKELL’-eh-tul) chest pain. This kind of pain affects the bones, muscles and nerves of the chest wall, which are close to the heart. Injury or overuse are the most common causes of musculoskeletal pain.

Most of the time, musculoskeletal pain goes away on its own, especially if you use some treatments such as:

• Taking over-the-counter pain medicine, such as ibuprofen
• Cold or hot compresses
• Gentle stretching
• Reducing the activity that causes the pain, until the pain goes away

See a doctor if the pain does not get better over time, with or without home remedies, or if the pain gets worse.

Emotional stress and anxiety

The link between mind and body is powerful. When we believe we are in danger, our body responds, moving into fight, flight or freeze mode. Muscles clench, breathing become shallow and rapid, and the mind races. While everyone reacts to anxiety differently, anxiety-induced chest pain can feel like a sudden sharp pain or pressure.

People often say a panic attack feels like a heart attack, so it’s best to have a health care provider check you if you have this type of pain.

Angina

Angina (an-JY’-nuh) is another cause of chest pain. It happens when the heart doesn’t get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest. The pain may be felt in your shoulders, arms, neck, jaw, abdomen or back. Angina pain may even feel like indigestion. Some people don’t feel any pain but have other symptoms like shortness of breath or fatigue.

Angina is a symptom of a heart issue, such as coronary heart disease (CHD), also known as coronary artery disease (CAD) or coronary microvascular disease (MVD).

Angina usually happens because one or more of the coronary arteries is narrowed which leads to what is known as ischemia (uh-SKEE’-me-uh ).

You should see a health care provider if you have a personal or family history of heart conditions and develop pain in the chest, shortness of breath or any of the above symptoms.

“It is always better to come have chest pain checked out by your doctor,” Dr. Oseni said. “We would prefer your chest pain to be from a little gas or too many bench presses, and not from something very serious.”

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Heart failure is a condition that means your heart can’t pump blood as well as it should. The Centers for Disease Control and Prevention (CDC) estimates that about 6.2 million American adults have heart failure. Heart failure was mentioned on the death certificates of 379,800 people in 2018.

Heart failure can be caused by or made worse by many factors, including weight, smoking, other health conditions and physical activity level. Even though heart failure can limit your ability to move your body, it doesn’t have to stop you completely. In fact, getting regular exercise can help strengthen the heart muscle, protect against future damage and improve your overall health and well-being.

If you have heart failure, you may be afraid to exercise, but you can if you follow some guidelines.

“You can absolutely still be active with heart failure,” said Natalie K. Kendall, APRN, cardiology nurse practitioner with Norton Heart & Vascular Institute. “It’s important to do that safely.”

What does exercise do for your heart?

No doubt you’ve heard that exercise is good for you, but do you know why? There are many reasons moderate- to vigorous-intensity exercise is good for you, including:

• Strengthening the heart muscle so it can pump blood more effectively, which means more oxygen in your blood to be delivered to cells.
• Widening the blood vessels so more oxygen-filled blood can move through the body and waste can be taken away.
• Prompting muscles and tissues to demand more oxygen and nutrients, which makes the heart pump harder and faster. (Over time, this builds strength in the muscle so the heart can push more oxygen-rich blood out each time.)
• Reducing inflammation throughout the body.
• Lowering blood pressure by widening blood vessels and releasing endorphins, the body’s “feel good” chemicals

Your cardiovascular health affects your entire body, quality of life and well-being. Even small amounts of cardiovascular improvement can allow you to move through your day with less discomfort.

Can heart failure be reversed with exercise?

Heart failure cannot be reversed completely. It can, however, be managed. According to a small study in the journal Circulation, the heart can get stronger and have improved elasticity after a period of regular exercise.

“Since we don’t really have a cure we want to prevent it from happening in the first place, or we want to keep it from getting worse,” Natalie said.

Activities that can strengthen the heart and lungs and build stamina can ease the stress on the heart. Exercise also can help manage weight and blood sugar, which are both linked to heart failure. Physical activity also reduces the likelihood of hospitalization for heart failure, according to the British Heart Foundation.

The experienced team of heart failure specialists at Norton Heart & Vascular Institute can direct your care based on your specific needs. 

What are good exercises if you have heart failure?

As long as your health care team says it’s OK, you can begin with aerobic activity that will increase your heart and breathing rates a little. This could be moving to music or walking. You also could include some light weights or resistance training. Some activities like gardening may include both cardiovascular exercise and weight training. If standing is too tiring, chair-based exercises might be a good start for you.

“There are a few exercises we might not recommend to heart failure patients,” Natalie said. “That would be heavy weightlifting, body weight exercises like planks, and swimming pool-based activities like swimming laps.”

Is it safe to exercise with heart failure?

Never start an exercise program without talking to your health care provider first. They may recommend cardiac rehabilitation, which includes exercise guidance, counseling and education around heart failure and exercise.

Here are some guidelines for getting started with exercise if you have heart failure:

• Start slowly. Try for five to 10 minutes of slow walking and gradually increase as you are able. Your goal should be about 30 to 45 minutes per day total of exercise.
• Cool down at the end of the activity by doing the last few minutes more slowly than you had been.
• Rest when you need to, even if it means skipping an activity because you don’t feel well.
• Some shortness of breath or fatigue is normal at the beginning of any new exercise program, but stop activity if you have excessive shortness of breath, pain or fainting.

You can exercise with heart failure, and it has many benefits for your body, mind and overall health. Talk to your health care provider about starting an exercise program today.

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“If you have early warning signs of a heart attack, don’t dismiss it — it’s a chance for you to get care that could prevent a more devastating attack,” said Abdullahi O. Oseni, M.D., an interventional cardiologist with Norton Heart & Vascular Institute. “When we can provide early heart attack care, it gives us a chance to treat the cause of your symptoms before  significant damage occurs.”

Early heart attack symptoms

Someone may experience few early heart attack symptoms or all of the following. When they start, these symptoms can be mild or come and go. Over days or weeks, early heart attack symptoms and pain increase until the person potentially collapses.

• Feeling of fullness
• Pain that travels down one or both arms
• Jaw pain
• Excessive fatigue
• Anxiety
• Nausea
• Back pain
• Shortness of breath
• Chest discomfort, pain, pressure, squeezing, aching or burning

RELATED:ASTEMI is one of the most dangerous forms of heart attack —here’s what you need to know

Heart attack in men versus women

Men may experience different heart attack symptoms from women. Why does it matter? Women are less likely to seek immediate medical care and are more likely to die from a heart attack.

• Men normally feel pain and numbness in the left arm or side of chest. In women, the pain and numbness may appear on the right side. 
• Women may feel completely exhausted, drained, dizzy or nauseous.
• Women may feel upper back pain that travels up into the jaw.
• Women may think stomach pain is the flu, heartburn or an ulcer.

How can you prevent a heart attack?

Up to 85% of heart damage can occur within the first two hours of a heart attack. Know these early heart attack symptoms and act on them immediately — before any damage occurs.

• Be alert for a heart attack in yourself or someone around you. Becoming an active bystander could save a life.
• When in doubt, call 911 about heart attack signs. First responders have the medical technology to quickly save a life. 

Heart attack risk factors

Several risk factors increase your chance of having a heart attack. Many are controllable by making changes to your lifestyle. Discuss your personal risk of a heart attack with your doctor, including:

• Chest pain, pressure, aching or tightness that may come and go
• A family history of heart disease
• High blood pressure
• Overweight or obese
• Sedentary lifestyle
• Using tobacco products
• Metabolic disease, diabetes or other illness
• For women: using birth control pills, a history of preeclampsia, gestational diabetes or having a baby with low birth weight

What happens in a heart attack

The heart’s job is to pump blood around the body. Like any muscle, the heart itself needs its own supply of oxygen-rich blood to do its job. The coronary arteries supply the heart muscle. When that blood flow is interrupted, robbing the heart of the oxygen and other nutrients it needs to do its job, the result is myocardial infarction — commonly known as a heart attack. Cardiac arrest occurs when the heart suddenly stops pumping.

Cholesterol buildup inside the blood vessels — a heart disease called arteriosclerosis — is a common cause of blockages that lead to heart attacks. Cholesterol buildup, or plaques, can break free from the blood vessel wall and lead to a blood clot that blocks the artery and ends up causing a heart attack or stroke.

When the heart muscle isn’t getting the oxygen it needs, the result can be the common symptom of chest pain and other symptoms. Heart attacks that start slowly can show an early warning sign, such as chest discomfort that lasts more than a few minutes. 

If you’re not sure it’s a heart attack, the American Heart Association advises seeking medical help right away. If you have heart attack warning signs, call 911 immediately.

EMTs typically can respond to you faster than you can get to an emergency room. They can begin treatment right away and are trained to resuscitate you if you go into cardiac arrest.

EMTs can alert heart attack response teams at the emergency room while taking you there.

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Millions of Americans go to the emergency room every year complaining of chest pain. Only about 20% of them are having a heart attack. Pain, pressure, aches and other feelings in the body can mean different things.

“Chest pain and the potential for an issue with the heart should be taken seriously,” said Abdullahi O. Oseni, M.D., interventional cardiologist with Norton Heart & Vascular Institute. “While there are many conditions that can cause chest pain, we want to rule out anything more dangerous.”

Causes of chest pain

There are several conditions that can make your chest hurt. Those include:

GERD

Heartburn is a condition where stomach acids push up into your esophagus, the tube that connects your mouth with your stomach. This can happen once in a while, maybe after you eat spicy food. It causes a burning feeling in your chest. If heartburn happens often, the lining of the esophagus can become irritated and gastroesophageal (GAS’-troh-eh-soff-uh-jee-ul) reflux disease, also known as GERD, can develop.

“GERD can feel like a heart attack,” Dr. Oseni said. “It can feel like burning, squeezing or pressure in the chest that can last hours.”

Like a heart attack, the pain can spread down your arms or to your back.

Chest pain caused by GERD can be managed and treated by:

• Maintaining a healthy weight
• Avoiding certain foods and beverages such as alcohol, caffeine, fatty foods and peppermint
• Not lying down after a meal
• Avoiding eating large meals
• Elevating the head when you lie down
• Stopping smoking
• Taking a prescription antiacid

Talk to your doctor about more ways to treat GERD.

Similar to GERD, gas pain can be mistaken for a heart attack. Sometimes, gas can push stomach acids into the throat, or it can build pressure in the stomach that radiates into the chest.

Chest pain from muscle strain

If you have ever “overdone it” with a physical activity and been sore, you may have had musculoskeletal (muss-kyuh-low-SKELL’-eh-tul) chest pain. This kind of pain affects the bones, muscles and nerves of the chest wall. Injury or overuse are the most common causes of musculoskeletal pain.

Symptoms of musculoskeletal pain include:

• Pain that happens or gets worse with certain movements
• Pain during deep breaths, coughing or sneezing
• Swelling, tenderness or bruising in the area

Most of the time, musculoskeletal pain goes away on its own. Some home treatments include:

• Taking over-the-counter pain medicine such as ibuprofen
• Cold or hot compresses
• Gentle stretching
• Reducing the activity that causes the pain, until the pain goes away

Emotional stress and anxiety

The link between mind and body is powerful. When we believe we are in danger, our body responds, moving into fight, flight or freeze mode. Muscles clench, breathing becomes shallow and rapid, and the mind races. While everyone reacts to anxiety differently, anxiety-induced chest pain can feel like:

• Sudden sharp, shooting pain
• Persistent chest aching
• An unusual muscle twitch or spasm in your chest
• Burning, numbness or a dull ache
• Stabbing pressure
• Chest tension or tightness

People having anxiety attacks often say it feels like a heart attack, so it’s best to have a health care provider check you.

RELATED: ASTEMI is one of the most dangerous forms of heart attack —here’s what you need to know

Treatment for muscle pain from anxiety and stress includes:

• Exercise and yoga
• Meditation
• Dietary changes such as reducing alcohol and caffeine intake and eating more vegetables and lean meats
• Getting enough sleep
• Reducing stress as much as possible
• Anti-anxiety medications

Angina

Angina (an-JY’-nuh) is another cause of chest pain. It happens when the heart doesn’t get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest. The pain may be felt in your shoulders, arms, neck, jaw, abdomen or back. Angina pain even may feel like indigestion. Some people don’t feel any pain but have other symptoms like shortness of breath or fatigue.

Angina is a symptom of a heart issue, such as coronary heart disease (CHD), also known as coronary artery disease (CAD), or coronary microvascular disease (MVD).

Angina usually happens because one or more of the coronary arteries is narrowed or blocked, also called ischemia (uh-SKEE’-me-uh).

Depending on the type of angina you have, there are many factors that can trigger angina pain. The symptoms also vary based on the type of angina you have.

Pain in your chest: Location is key

“If you come to the emergency room or the clinic, we will ask you where the pain is,” Dr. Oseni said. “We also will ask about the kind of pain you’re having.”

Knowing where and what kind of pain you have will help the health care team figure out what is causing it.

Common areas of pain include:

• Center of the chest
• The back
• Jaw and neck
• Arms
• Left arm

Chest pain that’s not a heart attack?

These symptoms are more likely to mean you are having a heart attack:

• Pain, pressure, tightness, squeezing or burning in the chest
• Gradual onset of pain over the course of a few minutes
• Constant pain in the middle of the chest
• Pain in the left arm, neck, back or jaw
• Pain with other symptoms, such as nausea, vomiting, difficulty breathing or cold sweat

These symptoms are less likely to suggest a heart attack:

• Sharp pain when breathing, sneezing or coughing
• Sudden stabbing pain in the chest that lasts only a few seconds
• Pain only on one side of the body or in one specific area
• Pain that lasts for hours or days without other symptoms
• Pain that happens with a specific body movement

“It’s better to be safe than sorry, so we want to see you if you have any unusual pains, or you have these symptoms together,” Dr. Oseni said.

When to seek medical help for chest pain

“If you have a condition that your doctor knows about and is treating, but your symptoms change suddenly or significantly, you should call the doctor,” Dr. Oseni said. “You don’t have to rush to the emergency room, but you definitely should be seen by the health care professional you have been seeing.”

Sudden severe chest pain or discomfort that is different from anything you have felt before means you should call 911 or have someone take you to the emergency room. Minutes count when it comes to your heart, so the sooner you can be checked out by a health care team, the better.

“For most people, it will not be cardiac or life-threatening, but we don’t want to miss anyone,” Dr. Oseni said. “There is no need to be embarrassed about a ‘false alarm’ if it turns out to be gas or something less serious than a heart attack.”

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The draft recommendation by the U.S. Preventive Services Task Force, an independent panel that makes evidence-based recommendations about ways to prevent disease, advises that all pregnant people, regardless of hypertension history, have their blood pressure measured throughout their pregnancy.

“It’s very important for women to have their blood pressure monitored, especially during pregnancy,” said Li Zhou, M.D., Ph.D., medical director, Norton Heart & Vascular Institute Women’s Heart Program. “Having hypertension, also known as high blood pressure, during pregnancy can cause a life-or-death situation for both mother and baby.”

Issues caused by high blood pressure, including preeclampsia, and eclampsia, are among the top causes of the rising maternal mortality rate in the United States. High blood pressure while pregnant also increases the risk of low birth weight and possibly can lead to preterm delivery.

In addition, high blood pressure increases the risk of heart attack, congestive heart failure, stroke, and kidney injury. Over the long term, high blood pressure during pregnancy can lead to a life time of hypertension and resulting in an increased risk of having cardiovascular diseases.

Hypertension that begins during pregnancy is defined as systolic pressure equal to or greater than 140 millimeters of mercury (mmHg) or diastolic blood pressure equal to or greater than 90 mmHg.

“If a woman is planning to become pregnant and she has a history of hypertension, there are important measures that can be taken,” Dr. Zhou said. “Talking to her OB/GYN and even establishing a relationship with the Norton Heart & Vascular Institute Women’s Heart Program can be very important to ensure a successful pregnancy.”

Norton Women’s Care OB/GYNs work closely with the Women’s Heart Program, Norton Children’s Maternal-Fetal Medicine and other specialists, so patients benefit from multiple viewpoints and areas of expertise.

A hypertension disorder affects 1 out of every 7 deliveries in the United States, according to the Centers for Disease Control and Prevention. Patients who are Black, American Indian or Alaska Native, as well as those who are older, are more at risk.

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“I had to stop two or three times on the way up the driveway,” Tony said. “My neck was hurting really badly. At that point, I said to myself, ‘This isn’t right.’”

It was, as Tony called it, his “come-to-Jesus” moment.

What happened in the weeks and months that followed just may have saved Tony’s life. He visited Renee V. Girdler, M.D., his primary care doctor at Norton Community Medical Associates. She referred him to cardiologist James M. Kammerling, M.D., with Norton Heart & Vascular Institute. Tony’s doctors had performed electrocardiograms and stress tests, but the results showed nothing concerning.

When Tony returned for a follow-up appointment a few months later, he still had neck pain. He had no chest pain and no back pain — no other common indicators that something might be off with the longtime telecommunications worker’s cardiovascular health.

“That was when Dr. Kammerling said we needed to do something,” Tony said.

A discovery by a new tool, the computed tomography-fractional flow reserve (CT-FFR) imaging analysis, very likely prevented a heart attack.

Cardiology team springs into action after discovery

The CT-FFR stands out in stories like Tony’s because of its ability to find something other tests can miss. In Tony’s case, it immediately showed a blockage in his circumflex coronary artery.

The finding caught Dr. Kammerling by surprise, according to Tony. His heart care team sprang into action, handling the situation with urgency.

The diagnosis brought back some tough memories for Tony. His father had a stroke in his early 50s and then bypass surgery. To him, news of a blocked artery naturally generated concerns about open heart surgery.

There were, of course, great worries from his family, too. His wife, Debbie, described Tony as “the rock of the family,” the guy everyone goes to for help with car issues or just about anything.

“We call him the beautiful mind,” Debbie said.

Instead of complicated surgery, much to Tony’s surprise and relief, the procedure to open up his blockage was done through a cardiac catheterization at Norton Audubon Hospital. He lauded Dr. Girdler, Dr. Kammerling, Norton Audubon Hospital staff and Norton Cardiac & Pulmonary Rehabilitation Center for taking such great care of him.

“Those folks were absolutely great,” Tony said. “They really set you at ease. I’m sure they see people who’ve never been through it all the time. I was truly amazed at almost immediate results — I felt great!”

Seven months since the procedure, Tony not only feels better but has lost 25 pounds. He and Debbie are quick to add that he is not out of the woods — they still have to watch his diet and keep an eye on his health.

“The technology available now blows me away,” Tony said. “It’s really crazy for people not to get these checkups. It’s so easy to blow things off. I’m so glad I didn’t.”

The post It would have been a surprise heart attack, but new imaging technology revealed a hidden danger appeared first on Norton Healthcare.

Call 911 if your blue fingernails are accompanied by any of the following symptoms:

• Shortness of breath or difficulty breathing
• Chest pain
• Sweating
• Dizziness, lightheadedness or fainting

Fingernails are good for scratching itches, but they are also a window into your health. If the skin under your fingernails has a blue or purple tinge, you might need to see a health care provider or a heart specialist.

Why are my nails blue?

The medical term for blue nail beds is cyanosis. Cyanosis can occur when there is not enough oxygen circulating in the bloodstream, or circulation is poor. Oxygenated blood is red, while blood depleted of oxygen has a blue hue.

What causes blue nails?

There are several reasons your nails could be blue, including heart conditions. Sometimes a heart murmur will cause blue nail beds. When a health-care provider listens to your heart and hears a certain swooshing sound, it’s an indication that the blood is flowing through the heart abnormally.

Heart murmurs can be innocent, or harmless. But murmurs also can be an indication of a structural heart condition such as a hole between two or more of the heart’s chambers — atrial septal defect or ventricular septal defect. While this defect is present at birth, patients can grow into middle age with little or no symptoms. Many aren’t even aware they have the condition.

Other causes of heart murmurs include:

• Anemia affecting the thickness of the blood and blood flow
• Carcinoid heart disease, a slow-growing tumor that can affect the heart’s valves
• Endocarditis, an infection that harms heart valves
• A faulty heart valve that isn’t closing all the way or is stiff, allowing blood to flow in the wrong direction
• Hyperthyroidism (an overactive thyroid) resulting in a rapid heartbeat and a murmur
• Hypertrophic cardiomyopathy, which makes your heart muscle thicker and stiffer

Another cause of cyanosis could be cold temperatures that can make blood vessels constrict, resulting in fingers and toes taking on a blue tint.

“This will go away when you warm up,” said Tara U. Mudd, APRN, nurse practitioner with Norton Heart & Vascular Institute. “Numbness and tingling when you’re cold is common, and as long as it stops when you go inside or get warm, it’s not a concern.”

When should I see a doctor?

“If you have blue nails, call your health care provider,” Tara said. “Evaluation may include using a device called a pulse oximeter, which measures the amount of oxygen in your blood. Your provider may use this data to help diagnose the underlying cause of your cyanosis and recommend treatment options.”

If your blue nail beds are caused by a serious heart issue, your physician may refer you to the Norton Heart & Vascular Institute Structural Heart Program, which brings together the talents of cardiothoracic surgeons, interventional cardiologists and imaging cardiologists to one location on the Norton Audubon Hospital campus. With the input and viewpoints of many specialties, each patient gets a customized treatment plan.

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Some patients with high blood pressure may not notice a difference in how they feel, but over time, the increased stress on your arteries and the heart muscle will decrease the flow of blood and oxygen to your heart and can cause chest pain, heart attack and ultimately heart failure.

High blood pressure in young adults is not uncommon. Nearly a quarter of those between the ages of 18 and 39 had hypertension, according to the National Health Statistics Reports published in June 2021. The condition is more common in men than women, and African Americans are especially at risk.

Knowing what a good blood pressure number is and getting yours checked regularly can help you take the steps to avoid long-term complications.

High blood pressure — even if it isn’t hypertension — is still dangerous.

Even if your blood pressure falls short of the formal hypertension diagnosis, you still could be at risk for heart damage.

High blood pressure in young adults, even if merely “elevated” and not at the level of a hypertension diagnosis, can lead to heart failure at a young age, especially in African American patients, according to cardiologist Kelly C. McCants, M.D., executive medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program and executive director of the Institute for Health Equity, a Part of Norton Healthcare.

“If you’re African American, that target clearly should be under 120 for your systolic, and your diastolic should be less than 80,” Dr. McCants said.

Often, patients with 120/80 blood pressure would be considered at the bottom end of what’s considered “elevated” blood pressure or even in the “normal” range.

According to Dr. McCants, a patient resting in a health care provider’s office may show borderline hypertension, but when stressed or exercising the systolic pressure can double. And for patients who have been going on for years with blood pressure that was short of meeting the hypertension diagnosis, they still can experience significant thickening of the left ventricle muscle.

For some young adults with high or merely “elevated” blood pressure, medication to reduce blood pressure may be an appropriate addition to lifestyle changes. Blood pressure that’s elevated can accelerate to cardiomyopathy — a weakened heart — particularly in African Americans and other people of color, according to Dr. McCants.

“If someone has hypertension in their 30s, you can bet that if they make it 30 more years and their blood pressure remains uncontrolled, there is a good chance they could have end organ damage from prolonged hypertension like kidney failure, stroke or heart failure,” he said.

Medications can include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta blockers and diuretics.

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