Heart attack ... me? Never!
		Is it really a heart attack?
		Handling an emergency
		Being prepared
		Rights and obligations for insurance

1. The effects of angina can spill over into your family relationships. Your relatives may also be sad and anxious about your angina.



2. Learn to recognize the signs of a medical emergency, among them: uncomfortable chest pain or pressure, lightheadedness, sweating, nausea, shortness of breath, or pain that spreads to the shoulders, neck or arms.



3. If you believe that you may be having a heart attack, don't take a wait-and-see approach. Call 911 or your local emergency number right away.



4. Create an advance directive, such as a living will. This document tells your doctor the kind of treatment you want if you are no longer able to communicate or make your own medical decisions.

Angina attacks can limit the enjoyment of your regular routine. If you're moving more slowly and avoiding certain activities so you won't get an attack, your family may be as affected by it as you are.

You may no longer do the things that you once enjoyed, such as gardening or going for long walks, and housework duties may shift as family members pitch in to cover the tasks that you once performed. And, on an emotional level, your loved ones are probably also sad and anxious about your angina.

This LifeHeart.com article will help you and your family cope with your condition and prepare for the unexpected—from medical emergencies to smart financial planning and specific directives about your care if, one day, you are unable to express your wishes.

Heart attack ... me? Never!

First, realize that a heart attack could happen to you. You don't need to dwell on it—just be aware of the possibility, and work with your family to plan accordingly. Many people, however, can't imagine a heart attack is in the cards for them.

Why? Imagine: You've been feeling great. Suddenly, you have a strange pressure in your chest. You ignore it and keep going. Sound typical? The problem is, you could be making the biggest health-related mistake of your life. According to The Healthy Heart for Dummies,¹ the following excuses could kill you if you let yourself believe them (but helpful responses are included):

• "If it's just heartburn, I'll be so embarrassed." But what if it's not? Better to be a little embarrassed than to lose your life over it.
  
  
• "I'm not sure if these are the right symptoms." Let your doctor decide whether you're having a heart attack. She or he is trained to recognize the signs, and will do everything possible to save your life.
  
  
• "I'm not old enough to have a heart attack!" Wrong—it can happen at any age. It's not just a disease of old age.
  
  
• "I can handle the pain. It will go away in a while." This is your life—your one and only! Waiting too long to be treated could kill you or, if you survive, could seriously disable you.
  
  
• "Women don't get heart attacks." This is absolutely false—and the reason why the survival rate for women is worse than for men. Women often wait too long to get help.
  
  
• "I've never been sick a day in my life. I can't be having a heart attack." Heart attacks can happen without warning. Sometimes the first sign that you have any heart disease at all is a heart attack.

Is it really a heart attack?

Your doctor has told you that whenever you have angina pain or discomfort, you should rest and take your short-acting nitroglycerin if it has been prescribed for you. Say you're working in the garden and you suddenly have chest pain. You do just as your doctor advised. Your short-acting nitroglycerin has worked before, but this time the pain or discomfort just isn't going away. You're sweating and nauseated, and you may feel as though an elephant is sitting on your chest. You aren't sure whether you should just wait it out and see what happens, or if you should call your doctor. Are you having a heart attack? Quite possibly. If the actions you usually take don't seem to be working, should you call 911 or your local emergency number? Yes, get help immediately. See Handling an Emergency for more information.

Learn how to recognize a medical emergency before it happens. Here is a list of heart attack warning signs for you and your family from the American Heart Association.²

• Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
  
  
• Pain that spreads to the shoulders, neck, or arms.
  
  
• Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath.

Handling an emergency

You and your family need to agree on an emergency plan. Here are some more pointers from The Healthy Heart for Dummies,¹ as adapted from the American Medical Association:

• Stop what you are doing, and sit or lie down.
  
  
• If symptoms persist for more than two minutes, call 911 or your local emergency number and say that you may be having a heart attack. Don't hang up the phone, This will allow medical personnel to find you in case you become unconscious.
  
  
• Take short-acting nitroglycerin, if possible, if it has been prescribed for you. Prepare in advance by asking your doctor how short-acting nitroglycerin should be taken for chest pain and whether you should also take aspirin.
  
  
• Never drive if you're having a heart attack, and don't drive anyone else who is having a heart attack. It might take you longer to get to the hospital than for paramedics to reach you. And paramedics have the drugs and equipment with them that can help save your life.
  
  
• Make sure everyone in your family knows how to perform cardiopulmonary resuscitation (CPR). CPR helps keep oxygen-rich blood circulating through the body while the heart isn't beating. This is especially crucial for the heart and brain. If you've stopped breathing, every second will count until help arrives. Someone should call 911 or your local emergency number and start CPR immediately. (Contact the offices of your local American Heart Association or American Red Cross for more information about CPR training.)



• When you get to the emergency room, be assertive. Announce that you or your relative may be having a heart attack and must be seen right away.

Being prepared

Does your family know how to answer for you if you are unable to communicate? As difficult as this topic is, you and your family must work out all the details now. If something happens to you, your family may be responsible for making decisions about your care and estate at the worst possible time. Plan ahead with this checklist from the American Academy of Family Physicians.³ If you're interested in any of the topics listed in the checklist, be sure to discuss them with an attorney or other expert.

In addition, it is very important to have a current list of all the medications and supplements that you are taking. Be sure to let your family know where this information is kept. You may want to keep the medication list with the other important papers your family needs to be aware of.

Rights and obligations for insurance

Just as you plan for your children's college education or your retirement, you also want to plan for medical emergencies. Here's how to be prepared:

• Health insurance policy. Make sure you know and understand exactly what your policy will cover. Does it cover emergency services? Will it pay for surgery? What about your room, medications, and tests while you're in the hospital? Will it help cover the cost of rehabilitation and recovery after you get home? Will it pay 100% of the costs? If not, how much will you be expected to pay?

  If you aren't sure, call the insurance company directly. An agent will answer questions about your policy more completely than your doctor or hospital staff can. Also, make sure every family member who is covered by the policy has proof of insurance with them at all times.

• Cost of medications. Your insurance plan may not cover all the costs of your medications after you are released from the hospital. Plus, you may be required to make a co-payment for each of the prescription drugs you're taking. If you are concerned about being able to pay for your drugs, talk to your doctor. She or he might be able to provide you with free or low-cost medications to help offset the total cost. Or, you might receive vouchers for free medicine to use at your pharmacy.
  

Also, the Pharmaceutical Research and Manufacturers of America lists drug makers in the United States who have special financial assistance programs set up for needy patients. If your medication is covered through one of these programs, ask your doctor about it. She or he can help you complete the paperwork to enroll you in the program if you qualify.

	The heart is made up of: Click here.

Sources

1. Rippe, James, M.D. The Healthy Heart for Dummies. Foster City, Calif.: IDG Books, 2000. 203-204.
   
   
2. American Heart Association. Heart Attack & Symptoms & Warning Signs. 2004. http://www.americanheart.org/presenter.jhtml?identifier=4595. Accessed June 3, 2004.
   
   
3. American Academy of Family Physicians. Advance Directives and Do Not Resuscitate Orders. 2003. http://familydoctor.org/003.xml. Accessed June 3, 2004.