Picture of apple and RVMC surgeons in our cardiac unit.

Heart Facts

If you think you might be having a heart attack or stroke,
don’t waste time denying it.

Call 9-1-1 and get prompt medical attention—it can save your life.

Heart Attack Warning Signs
The bad news is that heart disease is still the number one killer of adults in America. But the very good news is that damage to the heart from a heart attack can usually be reduced if the patient is treated within the first few hours after symptoms begin.

Heart Attack Symptoms
During a heart attack, you may have one or more of the following symptoms:

  • A tightening, pressure, squeezing, or aching feeling in the center of the chest or down the arms.
  • Severe indigestion, fullness, or heartburn.
  • Burning, aching, or cramping that starts in or spreads to the neck, jaw, throat, shoulder, back, or arms.
  • Numbness or tingling in the arms.
  • Discomfort in the neck or upper back, mostly between the shoulder blades.
  • In addition to any of the above symptoms, nausea and/or vomiting, weakness, dizziness, sweating, shortness of breath, and/or a cold, clammy feeling.

Take Action
It is common for a person having a heart attack to deny it. If you or someone close to you shows signs of a heart attack, get to a hospital immediately. There are new treatments that can reduce damage and save lives if it is begun within the first few hours after the symptoms of a heart attack start. Don’t waste precious time trying to reach your doctor! Get medical help immediately. DO NOT DRIVE YOURSELF.

Call 9-1-1 and get prompt medical attention—it can save your life.

  • Call your local emergency rescue service—for most communities,
    call 9-1-1.
  • Stop whatever you are doing and sit or lie down.
  • Loosen tight clothing.
  • If you have nitroglycerin (NTG), take it.
  • If three NTG taken one at a time do not stop your angina or you have other warning symptoms, chew one uncoated adult aspirin (unless you are allergic to it).

The thought that you may be having a heart attack is scary and hard to accept. Do not hesitate to get help—by acting quickly, you are more likely to survive and recover.

Stroke Warning Signs
Knowledge is your best defense

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking, or understanding.
  • Sudden blurred or double vision in one or both eyes.
  • Sudden severe headache with no known cause.

Call 9-1-1 and get prompt medical attention—it can save your life.

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Risk Factors
Because coronary artery disease (CAD) is progressive, the risk factors that may cause damage to arteries should always be watched and managed. Some of these risk factors are inherited; others are learned. Managing your risk factors can slow CAD or atherosclerosis and reduce the chance of death or disability from a heart attack. Having any one of the risk factors increases your chance for CAD, but the more risk factors you have, the greater your risk. Some risk factors are unavoidable—but some you can control, on your own or with your doctor’s help.

Risk Factors You Can't Control

Heredity
If your family has a history of CAD, you are at greater risk. This means that if your mother, father, or other immediate family member has heart disease, or especially a heart attack before the age of 60, your risk of having heart disease increases.

Age
As you grow older, your risk of heart disease increases.

Gender
Men under 50 are more likely to develop heart disease than women who have not reached menopause. This is due to female hormones providing a protective effect women until that time.

Risk Factors You Can Control

High Blood Pressure
Blood pressure is the force put on an artery wall as blood moves through it. When the pressure against the artery wall goes over the upper limit of 140 mm Hg (called systolic blood pressure) or the lower limit of 90 mm Hg (called diastolic blood pressure) for long periods of time, high blood pressure (hypertension) exists. High blood pressure usually has no clear symptoms and no early warning signs. It is truly a “silent killer.”

High Blood Pressure:

  • Makes the heart work harder.
  • Over time, can cause the heart to enlarge.
  • Puts arteries under greater strain, causing them to become less elastic and damaged; hardening and scarring of the lining in artery walls leads to atherosclerosis.
  • May lead to heart failure, as well as strokes in the brain and kidney.

What You Can Do:

  • Have your blood pressure checked regularly (free blood pressure checks are available in the main lobby of Rogue Valley Medical Center (RVMC), Monday through Friday, 1 to 4 p.m.).
  • Stop smoking.
  • Exercise to reduce stress and control weight.
  • Reduce the amount of sodium (salt) in your diet.
  • Maintain your ideal weight.

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Smoking
Smoking is one of the worst things you can do if you have CAD. A smoker’s risk of a heart attack is more than double that of a nonsmoker. Each year smoking probably causes about 350,000 deaths, mostly from heart attacks. When people stop smoking—no matter how long or how much they have smoked—their risk of CAD declines. Ten years after quitting, their risk of death from heart disease is almost the same as if they had never smoked.

Smoking:

  • Causes atherosclerosis, because the carbon monoxide in tobacco smoke poisons and damages the lining of artery walls.
  • Speeds up the process of atherosclerosis once it has begun.
  • Replaces oxygen in the blood with poisonous carbon monoxide (oxygen is needed to feed the heart and other organs).
  • Makes the heart work harder and raises blood pressure (the nicotine in tobacco smoke can cause an artery to clamp down, spasm or constrict).
  • Increases the chance of a blood clot forming by causing the platelets (red blood cells) in the blood to become sticky and cluster together; arteries already narrowed could become totally blocked or occluded this way.

What You Can Do:

  • If you don’t smoke, don’t start.
  • If you do smoke, quit.
  • The first step is to decide to quit. Choose a method, but probably the best method is to quit “cold turkey” or all at once.
  • Smoking is a psychological and social habit. Try to avoid social situations where you have always smoked, such as with drinking coffee after meals; they can increase your urge to smoke. Change your routine.
  • Get support from family, friends, and/or an ex-smokers support group. Say no to the first cigarette. This is your best line of defense.
  • Talk to your doctor about using a nicotine skin patch or nicotine gum to help you quit. But remember, these aids will not replace your own commitment.
  • Secondhand or passive smoking is almost as harmful as active smoking. Switching to a pipe or cigar or being around smoke gets smoke into your lungs and bloodstream—you are still smoking.
  • Chewing tobacco contains high levels of nicotine, which causes spasms in an artery. Spasms decrease the blood flow in the artery and can lead to angina. Do not use chewing tobacco instead of cigarettes. Try hard candy or gum as a substitute.
  • It is very important, especially at first, to get enough rest, drink six to eight glasses of water a day between meals, avoid alcohol, exercise, and practice relaxation.
  • Have low-calorie snacks on hand. Food will taste better, so it is common to gain a few pounds at first, but this is healthier than smoking. Eat healthy snacks and stay within your “fat-budget” guidelines.

Obesity
You are at greater risk for CAD if you are more than 30 percent overweight.

Obesity:

  • Raises blood cholesterol levels.
  • Raises blood triglyceride levels.
  • Raises blood pressure.
  • Lowers the HDL (good cholesterol).
  • Can induce diabetes.
  • Promotes an inactive lifestyle.
  • Makes the heart work harder.

What You Can Do:

  • Find your ideal weight and the “fat budget” for that weight. Then replace high-calorie, high-fat foods with healthy fresh fruits and vegetables to stay within the budget.
  • Eat smaller portions.
  • Skip second helpings.
  • Eat slowly.
  • Consider getting involved with a support group such as Weight Watchers or Overeaters Anonymous. It is helpful to share concerns and experiences with others.

Diabetes
When the pancreas is unable to produce enough insulin, the body cannot use glucose (sugar) properly. This results in high blood sugar levels which:

  • Can raise cholesterol and triglyceride blood levels.
  • Can damage the lining of artery walls, causing them to thicken and narrow (atherosclerosis).
  • Can speed up the process of atherosclerosis once it has begun.

What You Can Do:

  • Follow a good diabetic diet. If you need help, see a dietitian.
  • Get regular exercise.
  • Take your diabetic medication.
  • Maintain your ideal weight.
  • Have regular check-ups.
  • Check your blood sugar often.
  • Attend a diabetic class at least once to help you better understand and deal with diabetes.

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Stress
There may be a link between CAD and a person’s emotional stress and tension. When you feel you are not in control of your life, and feel tense and unable to relax, the body produces adrenaline. Chronic stress that produces chronic levels of adrenaline in the blood:

  • Causes the heart to pump faster and harder.
  • Can cause the blood vessels to clamp down (spasm).
  • Can cause atherosclerosis by damaging the lining of artery walls.
  • Can raise your blood cholesterol level.

What You Can Do:

  • Learn to listen to your body and notice what produces a stressful response.
  • Choose to avoid a stressful situation if you can. Walk away and come back to it when you are calmer and feeling more in control.
  • Learn techniques that help you relax and keep you calm so that you may better handle stressful situations.
  • Don’t overload yourself—learn to say no without guilt.
  • Finish one task before starting a new one. Set priorities so you don’t overwhelm yourself.
  • Set realistic goals for yourself and others in your life.
  • Begin an exercise program geared to your level of fitness and stick with it. Anger or frustration can be worked off.
  • Make time to relax and have fun.

Lack of Exercise
Physical inactivity can lead to changes that increase the risk of heart disease because it:

  • Promotes weight gain.
  • Raises blood cholesterol levels.
  • Raises triglyceride blood levels.
  • Reduces the heart’s efficiency.

Regular Exercise

  • Helps decrease or maintain weight.
  • Promotes cardiac fitness.
  • Lowers high blood pressure.
  • Creates a sense of well being.
  • Reduces stress.
  • Often helps diabetics require less insulin.

The American way of life, with its conveniences and leisure time, has led to an inactive lifestyle for many individuals. You may feel that you work hard enough at your job or in your home and yard, but that type of exercise does not produce the benefits of dedicated exercise. Vigorous or aerobic exercise is best because it helps your body use oxygen more efficiently. You should exercise about 30 minutes at least three to four times weekly.

Getting Started:

  • After your doctor has released you to start an exercise program, choose one or two activities that you enjoy or feel you could learn to enjoy. Be aware of any limitations you may have. Types of exercise may include walking, jogging, swimming, aerobics, bicycling, stationary biking, and using a treadmill.
  • Many good books can help you get started, no matter what type of exercise you choose. Change activities to prevent boredom.
  • Always start with a warm-up and end with a cool-down period. Stretching is ideal for this.
  • Slowly increase your program time and intensity to reach the target heart rate (THR) prescribed for you by your doctor. Your THR is your safe, effective pulse. If you do not know your THR, ask your doctor. The THR prescribed by your doctor is based on your heart condition and the medications you are taking. Some medications are prescribed to keep a person’s heart rate low, so their THR will also be low.
  • Take your pulse before, during, and after exercise. If your pulse is too high, you should slow down. If your pulse is low and not around your THR, you need to increase the intensity of your exercise. The talk/sing test helps you know if you’re near your THR. If you cannot talk comfortably while exercising, you should slow down. If you can sing, you’re not working hard enough.
  • Make fitness a fun habit. Commit yourself. Find a friend to share it with. Start a walking club in your neighborhood or join others in the early-morning hours at the Rogue Valley Mall.
  • Listen to your body. If you feel chest discomfort or are overly tired the rest of the day, you may be working too hard. Let your doctor know right away.

Exercise Distress
Notify your physician immediately or call 9-1-1 if you experience any of the symptoms of exercise distress, including:

  • Dizziness or nausea
  • Prolonged or extreme shortness of breath.
  • Angina (chest discomfort).
  • Extreme fatigue.
  • Leg pain.
  • Blurred vision.
  • A heart rate that is racing, pounding, doing flip-flops, or has irregular beats.

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Healthy Heart Tips
Quitting smoking, getting regular exercise and avoiding a high-fat/high-cholesterol diet will measurably reduce your odds of developing cardiovascular disease. Here’s the degree to which each of the assessed lifestyle changes, taken individually, can reduce your risk of a heart attack:

  • If you stop smoking, you will reduce your heart attack risk 50 to 70 percent within five years, compared with current smokers.
  • If you exercise regularly, your heart attack risk is 45 percent lower than that of people who lead sedentary lives.
  • If you maintain your ideal weight, you have a 35 to 55 percent lower heart attack risk than that of people who are 20 percent or more overweight.
  • If you are a woman, post-menopausal estrogen replacement therapy will lower your risk 44 percent, compared with non-users.
  • For each 1 percent reduction in your blood cholesterol levels, your heart attack risk decreases 2 to 3 percent. (With diet therapy, the average cholesterol level reduction is 10 percent and can often exceed 20 percent with diet and medication.)
  • Each one-point (1 mm Hg) decrease in your diastolic blood pressure produces a 2 to 3 percent decline in heart disease risk. (With diet and medication, the average decrease in diastolic pressure is five to six points, though decreases of 20 points or more are frequently achieved.)
  • Taking one low-dose aspirin tablet daily lowers your risk 33 percent, compared with non-users. These figures are for men; comparable trials of the benefits of this therapy for women are still in progress.

These figures treat each risk independently. The combined advantages of stopping smoking, starting to exercise, and losing weight would almost certainly be significantly greater than the best individual effort.

Helpful Phone Numbers

Bartels Community Health Library
This library of health-related information is open to the public and is free of charge. Information on a variety of topics is available by calling or stopping by the Smullin Health Education Center at RVMC. Library hours are Monday and Friday, 10 a.m. to 1 p.m., and Tuesday through Thursday, 10 a.m. to 4 p.m. For more information call (541) 789-5913.

Cardiac Rehabilitation
An 8- to 12-week outpatient Cardiac Rehabilitation Program is available through RVMC in Medford and Three Rivers Community Hospital in Grants Pass. If you or your doctor feel that Cardiac Rehab would benefit you, your doctor will need to refer you to the program. For more information call (541) 789-4466.

Cardiopulmonary Resuscitation (CPR)
For information on where CPR classes are taught in your area, call a local hospital, fire department, or the Red Cross. For more information on CPR classes offered in the Rogue Valley, call (541) 789-4148.

Nutrition Programs: Heart-Healthy Food Preparation
Counseling is offered for an hourly fee by a registered dietician on weight control, eating disorders, vegetarian nutrition for good health, and special diets. Private outpatient diet consultations are available through RVMC by Mary Stansell, RD, LD. Most insurance plans will pay for this service with a doctor’s referral. For more information call (541) 789-4513.

Dare to Be Healthy
Christy Hatzel, RD, LD
1307 West Main Street, Suite 3, Medford, OR 97501
(541) 770-9120

Asante Senior Source Advantage Program
This is a free membership program in partnership with Asante Health System for residents 55 years of age and over. The program offers activities, information, and support. It focuses on the health and wellness of older adults in the community. For more information call (541) 789-5675.

Smoking Cessation
RVMC Stop Smoking is an educational and group support program with six 90-minute sessions. The fee is $65. For more information call (541) 789-4813.

Walking Programs
The Take-A-Hike mall-walking program sponsored by Asante Health System and the Rogue Valley Mall provides the opportunity to participate in a routine exercise program in a secure and climate-controlled environment. The mall doors are open daily at 6:30 a.m. for walking. Free blood pressure testing is offered every Thursday from 8 to 10 a.m. in front of the Education Resource Center. After your first 50 miles, you are eligible for membership in the Take-A-Hike Club, which allows you discounts at various stores in the mall. There is also a Heart Walk—a specially designed one-mile loop encircling the RVMC campus. Health information tips, benches, and drinking fountains are located at two rest areas along the route. You are encouraged to take advantage of this safe walking site. For more information on either Take-A-Hike or the Heart Walk, call (541) 789-4241.

Mended Hearts
The Mended Hearts, Inc., is a national volunteer organization with 220 chapters. Chapters consist of people who have heart disease, their family members, medical professionals, and other interested individuals. The objectives of Mended Hearts are to offer encouragement and support to patients and their families through visits, educational and social programs, and the distribution of information. Mended Hearts also supports and assists community health care organizations and research activities pertaining to heart disease. The local Mended Hearts chapter meets monthly.
For more information call (541) 772-0478.

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