Heart attack or cardiac arrest? Experts explain the differences and teach how to reduce the risk of sudden death

Cardiovascular diseases, diseases of the heart and circulation, are the main causes of death in Brazil. There are more than 1100 deaths per day, so cardiovascular diseases cause twice as many deaths as all types of cancer combined, 2.3 times more than all external causes (accidents and violence), three times more than respiratory diseases and 6.5 times more than all infections, including AIDS.

According to the Brazilian Society of Cardiology, an estimated 400,000 Brazilians will die from heart and circulatory disease by the end of this year. But what to do to avoid being victims of a heart attack or cardiac arrest? Exercise regularly, eat right, and always check. According to experts, these are some habits that can be adopted if you want to reduce the risk of a heart attack.

Cada Minuto spoke with Thales Almeida, a professional in Physical Education and personal trainer, who explained how to start an exercise routine in the right way, without taking any risks even while practicing physical activity.

The professional emphasized that “it is necessary to make sure that you are able to exercise”, and that before starting this routine it is necessary to consult a cardiologist to better guide you.

“Having done this, it is essential to understand that the practice of physical activity carried out correctly and in the right dosage will contribute to the improvement of cardiovascular and cardiorespiratory conditioning and, with this, make the heart stronger,” said the professional.

But what is the right way to perform a physical activity? In this case the role of the professional is fundamental, as Thales himself explains. According to him, “the function of the PE professional in this context is to monitor and prescribe the right dosage (intensity) for the specific type of training, to gradually work on conditioning. Therefore, intensity is really a determining factor in this whole process,” he explained.

And if there are doubts about the method, about which exercises to do to take better care of your heart, Thales points out that mixing a little training is essential.

“Combine aerobic training (walking, cycling, light jogging outdoors or the ergometric part in gyms – treadmill, elliptical, bicycle) with resistance training (strength training, bodybuilding, strengthening joints and muscles) to get the best result in the process,” he explained.

But the cure doesn’t stop there. As mentioned, nutrition is also essential for heart care. And one of the questions on the subject is: is there any home-made medicine that helps reduce the risk of suffering a heart attack?

Cardiologist Dr. Carlos Macias explained that there is not necessarily a homemade drug, “but there is high quality homemade food.” And that the ideal “would be to avoid saturated fats, and not to consume monounsaturated fats”.

Dr. Carlos Macias, cardiologist (Photo: Disclosure)

“In particular, there are no home medications, but the lifestyle you can lead, with exercise, eating less saturated fat, eating less carbohydrates, sodas, sweets, etc., would all be a “home medication” that could help reduce the risk of heart attack,” said Dr. Carlo.

And what types of foods can be allies of the heart? For the professional cardiologist it is necessary, first of all, to “reduce saturated fat”. Dr. Carlos went further: “Let’s think of those good for the heart. For example: avocado, which is very good for the heart, because it is rich in monounsaturated gastric acid. It reduces LDL cholesterol, which is responsible for blocking (blood) vessels, which produces those fatty plaques in the heart, which cause a heart attack. And it raises HDL, which is the second benefit,” he explained.

“Another important food would be oil, especially olive oil, of which extra virgin is the best. You can have it in almost any type of food, like salads, fish, all types of food,” the doctor added.

“Fish in general, especially some deep-sea fish, rich in Omega 3, are good for the heart. Chestnuts, almonds, walnuts, pistachios are also indicated for those with heart problems; oatmeal, which contains a substance called beta-glucan, which lowers LDL cholesterol; also the banana, rich in potassium, is another good substance, especially in sportsmen; legumes, such as beans, lentils… All of these are foods that are good for the heart,” Macias explained.

But other questions end up surrounding the theme. A pertinent question is: why is it normal for a person to have a heart attack during the night? Dr. Carlos explained that “it is necessary to remember that most people suffering from heart attacks are hypertensive, diabetic, smokers and have high cholesterol”, and that “these are the main causes that lead to myocardial infarction. The most common time for the individual to have a heart attack or stroke (cerebral vascular accident), better known as a stroke, is usually most frequent between 3 a.m. and 11 a.m.,” he said.

But what is the reason why this happens? According to the cardiologist, “Because upon awakening, the body releases certain hormones into the bloodstream to prepare us for activity such as adrenaline, and this increases the heart rate, supports blood pressure and increases platelets. The blood becomes thicker, as is known, and with the risk of thrombosis. And that’s why heart attacks are more frequent during this time,” he added.

And those who have already suffered a heart attack end up “one foot behind” after recovery. And another question asked is what shouldn’t be done after suffering a heart attack?

“I think it should be: what should you do after you have a heart attack? And what you should do is, first, make a regular appointment with your cardiologist. Lower cholesterol, normalize it, lower blood pressure, control diabetes. It really depends on the heart attack you had and which heart muscle was affected. Only your cardiologist can guide the amount of physical activity you can do. But in summary it means modifying one’s behavior in relation to risk factors, which are: diabetes, hypertension, high cholesterol, smoking, obesity, sedentary lifestyle, all factors that the individual must control after suffering a myocardial infarction. As well as taking regular medications,” Dr. Carlo said.

But what about high-performance athletes? Why even lead a healthy routine, because some of them end up dying of a heart attack?

“First, this brings us a big surprise, because all the media is surprised, it draws a lot of attention for a high performance athlete to have a sudden death. Because the athlete is an example of high perfection. An athlete is expected to have perfect health, but that is not the case. More importantly, we call it a pre-participation assessment. Every high-performance athlete should have a detailed evaluation by a specialist, in this case the cardiologist. So what are the things she dies for? First there are high physical effort exercises, pedaling, running, a very exhausting marathon. There is an excessive increase in heart rate. And we know that excessively increased heart rates increase oxygen expenditure, and often the individual is unaware that they have a coronary artery blockage, an obstruction that they were unaware of, and this high rate can trigger a heart attack,” he explained. the cardiologist.

“There is dehydration, a very frequent cause of sudden death. The individual cannot hydrate in proportion to what he loses, and with this a high alteration in the loss of sodium, potassium, magnesium… And we know that magnesium, sodium and potassium are important in the contraction of the heart. This can lead to arrhythmia, sudden death. Also, sometimes there is hyperthermia in these athletes – a very large increase in temperature. Thus, it consumes a lot of energy. Imagine if this high-performing individual has a problem, this could also be a trigger for a pre-existing disease,” the practitioner added.

“Among the heart diseases, the most frequent, causing sudden death, is hypertrophic cardiomyopathy, which is a problem that the individual is born with. Another problem is arrhythmias, some problems that athletes are born with, a genetic predisposition, these are also causes that are detected by a thorough cardiological examination. So it is important to detail the importance that the individual undergoes a check-up, first with a qualified doctor, because he will know the family history that there could be a sudden death, with coronary heart disease ”, reflected the professional.

“But with that the doctor will do a clinical examination, find out if there is a problem with a valve in the heart. For example, there are individuals who have host stenosis, which can cause sudden death. This is all your doctor will evaluate. An exercise test, a simple, fundamental test is the echocardiogram, which detects this hypertrophic myocardia. So I would advise all athletes who are about to participate in a physical activity to have a good evaluation with their cardiologist,” added Dr. Carlos, who shared his opinion with the physical educator, Thales Almeida, which also called attention to those without an “athlete background”:

“For a person who has no history of being an athlete, it can occur due to: smoking, drug use, diabetes, obesity, high blood pressure, or a genetic predisposition to early heart attacks. Since he is an athlete, with healthy habits and regular physical activity, the strongest factor, logically, is the genetic (hereditary) issue,” Thales explained.

And what are the symptoms of a heart attack? How can the individual know that he is suffering from this complication? And what are the differences between heart attack and cardiac arrest?

Dr. Carlos: “The most frequent symptom that the patient reports when his heart is swollen is shortness of breath. And if he makes great efforts, this can evolve into small and medium efforts. Often, when the situation worsens, the legs may also swell, with edema. But the common thing is shortness of breath when he does more frequent physical activity ”.

As for the differences between cardiac arrest and heart attack, Dr. Carlos said: “Blood normally flows behind the coronary arteries. When the individual has a blockage in that coronary artery, that region of the heart stops getting blood and doesn’t get blood, that region dies. Then there is myocardial infarction.

Cardiac arrest is when the heart stops beating. A heart attack can often lead to cardiac arrest. So cardiac arrest is different from a heart attack.

In a heart attack (the patient) has chest pain, a lot of discomfort, sweating, usually this individual has risk factors for this. And a cardiac arrest is when the individual doesn’t speak properly, or when they have a disease that the heart stops beating”.

Finally, the cardiologist also explained the symptoms in the different age groups in the most varied people.

“No. A heart attack gives pain in the chest, squeezing, sometimes it radiates to the arm, it is usually accompanied by sweating, paleness and it does not matter if you are young, adult or elderly. What happens is that there are often individuals who have a less sensitivity to pain. There is the diabetic patient, the black race, can sometimes have a heart attack without pain, but it is more rare. More commonly, the symptoms are similar,” concluded Dr. Carlo.

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