An implantable cardiac defibrillator (ICD) is a small, battery-
powered device that uses an electric signal to automatically
correct an abnormal heartbeat. Implanted beneath the skin of
the chest, ICDs have been used during the past decade to treat
life-threatening arrhythmias. Now, new research suggests that an
implantable defibrillator can help to extend the lives of people
with heart failure.
About 50 percent of deaths in heart failure are sudden deaths
that are probably due to an abnormally fast heartbeat in one of
the heart’s lower chambers. In a large study of patients with
moderate to severe heart failure, one-third of participants were
treated with an implantable defibrillator, while one-third took
the anti-arrhythmia drug amiodarone (sold as Cordarone or
Pacerone), and another one-third received neither treatment.
The results: ICD treatment significantly reduced deaths over the
next 4 years, while the medication did
not. The benefit from ICD therapy
appeared to be strongest among
those with moderate heart failure.
Getting Help for a
Heart Attack
For many people, the first symptom of heart disease is a heart
attack. That means everyone should know how to identify the
symptoms of a heart attack and how to get immediate medical help.
Ideally, treatment should start within 1 hour of the first symptoms.
Recognizing the warning signs and getting help quickly can save
your life.
Know the Warning Signs
Not all heart attacks begin with sudden, crushing pain, as is often
shown on TV or in the movies. Many heart attacks start slowly
with mild pain or discomfort. The most common warning signs are:
¦ Chest discomfort. Most heart attacks involve discomfort in the
center of the chest that lasts for more than a few minutes.
It may feel like uncomfortable pressure, squeezing, fullness, or
pain. The discomfort can be mild or severe, and it may come
and go.
¦ Discomfort in other areas of the upper body, including one or
both arms, the back, neck, jaw, or stomach.
¦ Shortness of breath. This symptom may occur with or without
chest discomfort.
¦ Other signs include nausea, light-headedness, or breaking out in
a cold sweat.
Get Help Quickly
If you think that you or someone else may be having a heart attack,
you must act quickly to prevent disability or death, and to get the
most benefit from current treatments. Wait no more than a few
minutes—5 at most—before calling 9–1–1.
It is important to call 9–1–1 because emergency medical personnel
can begin treatment even before you get to the hospital. They also
have the equipment and training to start your heart beating again if
it stops. Calling 9–1–1 quickly can save your life.
Even if you’re not sure you’re having a heart attack, call 9–1–1 if your
symptoms last up to 5 minutes. If your symptoms stop completely in
less than 5 minutes, you should still call your doctor right away.
You must also act at once because hospitals have clot-dissolving
medicines and other artery-opening treatments that can stop a heart
attack if given quickly. These treatments work best when given
within the first hour after a heart attack starts.
When you get to the hospital, don’t be afraid to speak up for what
you need—or bring someone who can speak up for you. Ask for
tests that can determine if you are having a heart attack. Commonly
given initial tests include an electrocardiogram (EKG or ECG) and a
cardiac blood test (to check for heart damage). You have the right
to be thoroughly examined for a possible heart attack. If you are
having a heart attack, you have the right to immediate treatment to
help stop the attack.
Delay Can
Be Deadly
Most people who have a heart attack wait too long to seek medical
help—and that can be a fatal mistake. Some delay because they
don’t understand the symptoms of a heart attack and think that
what they’re feeling is due to something else. Others put off getting
help because they don’t want to worry others or “cause a scene,”
especially if their symptoms turn out to be a false alarm. Women
are especially likely to delay. A large study of heart attack patients
found that, on average, women waited 22 minutes longer than men
did before going to the hospital.
Don’t wait. When you’re facing something as serious as a possible
heart attack, it’s much better to be safe than sorry. Waiting too long
can cause permanent disability or death. If you have any symptoms
of a possible heart attack that last up to 5 minutes, call 9–1–1
right away.
Recovering Well:
Life After a Heart Attack
or Heart Procedure
Having a heart attack or a heart procedure can be a frightening and
upsetting experience. It is difficult to discover—often suddenly—
that your body isn’t working the way it should, and to be plunged
into an unfamiliar world of hospitals and high-tech procedures. But
it’s important to know that millions of people have survived a heart
attack, recovered fully, and gone on to resume active, normal lives.
Likewise, most people who undergo heart surgery recover well and
return to their usual activities. Many surgery patients eventually feel
healthier than they did before their procedure.
The time it takes to get back
to normal will depend on
many factors, including your
age and general health.
If you have had a heart
attack, the pace of recov-
ery will also depend on
the severity of the attack.
If you have undergone
surgery, recovery time will
depend partly on the type
of procedure you had.
But whatever your
situation, there
is much you
can do to
improve your health and prevent complications following a heart
attack or major heart procedure.
The first step: Give yourself permission to recover. You and your body
have been through a lot, and it will take some time to feel like yourself
again. Expect to feel quite tired at first, and to gradually regain your
s t rength and energy. While individual needs vary, following are some
overall tips for recovering well from a heart attack or heart surgery.
Your First Weeks at Home
When you first arrive home from the hospital, you’ll need to get a
lot of rest so that your heart can begin to heal. It is very important
to eat healthfully and to get enough sleep. Take the medications
your doctor has prescribed for you. (See “Heart-Healing Medicines”
on the next page.) Avoid heavy yard work, house cleaning, or other
projects that require a lot of energy. Also refrain from physical
activity in very hot or cold weather. Ask family and friends to help
out with chores, childcare, and other activities that may be difficult
to take care of during your first weeks at home.
At the same time, it is important to get up and move around as you
begin to recover. Your heart is a muscle that needs be exercised—
though very gently at first. Pace yourself. Allow plenty of time for
each thing you do during the day, from getting out of bed to taking
a shower to preparing a simple breakfast. Rest between activities,
and whenever you feel tired. Ask your doctor for a list of guidelines
for activity during your first few weeks at home.
Your doctor will want to check your progress 1 to 4 weeks after you
leave the hospital. During your first followup visit, your doctor will
check your weight and blood pressure, make any needed changes in
your medicines, perform necessary tests, and check how your recov-
ery is progressing overall. Use this opportunity to ask any questions
you may have about safe or unsafe activities, medicines, lifestyle
changes, or any other issues that concern you. You may want to
write down your questions beforehand.
For some situations and questions, it is best to call your doctor right
away rather than wait for your next appointment.
