By Eva Briggs, MD
As I write this in early December, winter really hasn’t arrived full force.
But here in Central New York we are bound to get some cold weather and snow — which brings the risk of winter heart attacks.
First a review of what constitutes a heart attack, also called a myocardial infarction.
Your heart is mostly muscle which contracts to circulate blood to the body. And just like your biceps, triceps and quadriceps, your heart muscle needs a steady supply of blood to keep working.
The coronary arteries supply that blood. If the coronary arteries are narrowed, they may deliver enough blood to the heart muscle when you are sedentary. But when the heart is working harder and narrowed arteries can’t supply sufficient blood to meet demand, that’s called ischemia.
Common symptoms are angina (chest pain) and shortness of breath. If the artery becomes completely blocked the heart muscle dies. That’s an infarction or heart attack.
Several factors contribute to the risk of heart attacks in the winter. First is cold. It constricts the blood vessels. This raises the blood pressure making the heart work harder. And it diminishes blood flow to the heart. Your body must work harder to maintain its temperature especially when it’s windy.
Increased physical activity makes the heart work extra hard. Shoveling snow, slogging through deep snow, scraping ice off your car put extra demand on the heart, especially if you are out of shape.
The emotional stress of holidays increases the production of stress hormones and raises the risk of heart attacks.
You can reduce the risk with some commonsense measures.
• Dress for the weather. Choose clothes made from materials like wool, polar fleece, down or down alternative insulation. Wet cotton becomes heavy and loses all of its insulating power. Dressing in layers is warmer and allows you to adjust your clothing more easily. As you heat up you can remove layers to avoid drenching your clothes in sweat. When you cool down you can add layers back.
• Come indoors for a break to warm up when you are cold.
• Avoid excess alcohol. It makes you falsely feel warmer.
• Don’t shovel for long periods of time. Check with your doctor as to whether it is safe for you to shovel snow at all.
• Follow measures to reduce the chance of respiratory illness, which is a risk factor for heart attacks. Keep away from sick people, stay home if you are sick and wash your hands frequently.
• Seek immediate medical care if you develop symptoms of a heart attack; even if it is night or a holiday. The more time you delay, the more heart muscle damage you develop.
Signs of a possible heart attack
• Acute severe chest pain. People often describe it as a weight or tightness. It can be in the center of your chest, the left side, the right side or even upper abdomen. It may spread to the shoulder, arm or jaw. It’s possible for a heart attack to cause pain in these locations without chest pain.
Other possible heart attack symptoms:
• Nausea or vomiting
• Shortness of breath
• Pain, numbness, or tingling in the jaw, back, neck or shoulders
• Cold sweat
• Sudden fatigue
If you think you or someone you are with might be having a heart attack, calling 911 and going to an emergency room is the safest option. The patient should never drive him or herself.
If you have no contraindication to aspirin, it’s OK to take a dose. The correct dose is 324 mg of chewable aspirin which equals four baby aspirin. If you take aspirin, still go to the ER. Don’t wait around to see if the pain goes away. Aspirin acts as a blood thinner and can buy time, but aspirin alone is NOT a cure or the only needed treatment.
Don’t go to the urgent care or a doctor’s office if you have heart attack symptoms. These locations lack the resources to diagnose and treat heart attacks!
Stay safe and enjoy winter.
By the time this article appears in print the days will be getting longer.
Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.