Wang Ping was 65 years old. He one day was walking along when he began to develop serious chest pain. He stopped walking and the pain went away. He rested for several minutes. Then he tried to walk again. This pain came and went as he walked and then stopped. When he arrived back at his apartment he had to walk up two flights up stairs. He knew this would be hard. As he tried his pain became severe, like a band around his chest. Then the pain became associated with shortness, nausea and sweating. A friend coming up the stairs noticed he was having a hard time and helped him to his apartment and called an ambulance. They took him to the hospital. Tests there showed him to have had a severe heart attack. He did not die that day. However, the doctors came to he and his family and discussed several options of treatment.
Many people like Wang Ping in China and around the world have heart attacks. Many people die from these heart attacks. Those who survive often have severe problems later and die soon after. Can people be treated after they have heart attacks and if so how? What treatment can be given to help them?
First and most important in the treatment of heart attacks is the prevention of heart attacks. We have discussed this in other programs. However, once someone gets a heart attack then they are much more likely to die younger from a second heart attack. Thus prevention is much better than treatment. Briefly Dr. Luke will review the prevention of heart attacks since this is so important. How is this done? First is a good diet to keep your weight down. Second are daily exercises of at least 20 minutes per day. Then is watching to see if you have high blood pressure and diabetes. Your doctor can tell you if you have this. Finally if you smoke you should stop smoking. This is a very brief overview of prevention of heart attacks.
How do we treat heart attacks? First, remember that heart attacks are a blockage of arteries that surround the heart and supply the heart with blood. It is when these get stopped up that a heart attack occurs. How can these be treated? There are two main ways. First, is with medicines and the second with different types of surgery. Perhaps nowhere in medicine are advances occurring so fast as with the treatment of heart attacks. So much can be done to help patients who are heart attack victims which even 15 years ago were not available.
What kinds of medicines can be used? There are many types of medicines but there are many new types, which can help the blood pressure, and cholesterol to be lower. Also if the heart is failing or not pumping blood then there are medicines, which can help this as well. There are about 5-8 classes of different, which can help patients of heart attacks.
The most simple and probably important medicine is that of Aspirin. This can do a lot to prevent a further heart attack. In fact as soon as a person has a heart attack we give them an aspirin. Aspirin both can prevent heart and attacks from occurring the first time after a heart attack occurs Aspirin can prevent a second heart attack from occurring. Using as little as 81mg a day helps preventing heart attacks. This is more important in men than in woman. We do not know exactly why this is though. Once a heart attack occurs then using 325mg a day is considered better. Aspirin even in very small doses like this can cause ulcers in the stomach. Thus one should use either coated Aspirin or make sure and take the Aspirin with food in the morning. When should someone start taking Aspirin that is at what age? Men should start taking Aspirin 81mg a day beginning in their late 30’s or early 40’s. Women can start in their late 40’s or early 50’s. Why this difference between men and women?
Women in general start having strokes and heart attacks 10 years later than men. Why is this? Most experts believe this is related to the timing of menopause in women. The estrogen women have in their bodies up until menopause is believe to be protective of heart and stroke disease. Recall women’s ovaries produce estrogen up until they go through menopause. It is this lack of estrogen, which causes women to go through menopause. It is after menopause that women start having strokes and heart attacks. By the time men and women are both in there 60’s they are having strokes and heart attacks at the same rate.
The Bible has a lot to say about people’s heart. In fact the Bible has a lot to say about the condition not only of man’s physical heart but also of his spiritual heart. Do you know that each of us has such a heart? This heart is the center of our thinking and emotions. King David wrote about 1000BC regarding this heart, ‘the fool says in his heart there is no God. They are vile and corrupt, and their ways are vile; there is no one who does good. God looks down from heaven on the sons of men to see if there are any who understand any who seek God. Everyone has turned away, they have together become corrupt; there is no one who does good, not even one (Psalms 53.1-3).
What does this mean? People who are foolish say there is no God. Those people are corrupt. All of these types of people do no good. Why? Their foolish ways ultimately make all of their actions foolish. For example they actually do good just to help themselves and not others. Their real reason for doing so called good is not for the sake of good but to make sure their own lives are rewarded. This is selfishness and not goodness. God says that the people who do not acknowledge him are like this. Is there anything, which can be done about this?
David wrote many poems, all of which are contained in the Bible. The very next one, i.e. Psalms 54 (the Psalms are the collection of David’s poetry), talks about a solution. It says, ‘surely God is my help; the Lord is the one who sustains me…I will sacrifice a freewill offering to you; I will praise your name, O Lord, for it is good. For he has delivered me from all my troubles, and my eyes have looked in triumph on my foes (Psalms 54.4-7). God not only was the sustainer of David but God delivered him from all of his troubles and enemies. What a promise. Who would not like to have that? The Bible says that the person who was the deliverer of us from our troubles was God. God though came to earth as a man named Jesus. Jesus was God himself. Why did God do this? Because God loved us so much. A man named John wrote a book, which is named after him in the Bible, also called John, about 90AD. He said in this book several things about Jesus. First, he said, ‘In the beginning was the Word and the Word was with God and the Word was God (John 1.1).’ This sentence basically says that Jesus was God. Another name for Jesus was the Word or Word of God. Later John says, ‘The Word became flesh and made his made his dwelling among us (John 1.14).’ This sentence says that Jesus became flesh just like us so that he could show that he loves and identifies with our weaknesses. This actually shows that he cares for us because he wants us to understand him and becoming human like us was the only way to do that.
Later John says this about Jesus, ‘For God so loved the world that he gave his only son and that whoever believes in him should not perish but have everlasting life (John 3.16).’ God loved us so much he gave His only son for us. Who of us love someone so much that we would give our only child so that others might live? Only God would. God also wants us to have a full and meaningful life here on earth. With that in mind, lets go back to talking about treating heart attacks once they occur.
After Aspirin there are many other ways to treat a heart attack. Let us talk about treating medical problems with medications first and then talk about treating surgically. First, treating with medicines. There are many different types of medicines, which can be used to treat patients who have just had a heart attack. There are many of these types of medicines. Their names and the use of them are too complicated for this talk. However, they are all very helpful in helping patients who have just had a heart attack.
What I would like to focus on now is the class of medications called ‘the statins.’ They are a group of medications, which have been used since the early 1990’s. How do they work? What do they do? First, they are very helpful medications and literally hundreds of millions of people from around the world are on them now. These medications are especially important because they both prevent the onset of heart attacks and also prevent the occurrence of heart attacks once they have occurred. They can do both of these by over 40% compared to patients who do not take them. How do they do this? They do this by lowering the cholesterol in the body. Cholesterol causes heart damage by blocking the blood flow in heart arteries, which supply the heart. These medicines lower cholesterol in the blood and thus prevent the onset of heart disease or prevent heart disease from occurring, again by about 40%. What is also very important is that these medications are quite safe. They have been used all over the world and the amount of side effects even after years of use is very low.
The second class of medicines is that used for diabetes. Patients with diabetes are at a significant risk of having heart disease. Thus it is important for them to control their diabetes in order to prevent the onset of heart attacks and also to prevent the development of a second heart attack. This can be done by good exercising, watching your diet, and seeing your doctor regularly and also by taking your medications appropriately.
Finally, is the treatment of heart attacks by surgery. There are two primary ways that this can be done. First is by a procedure called a ‘heart cath.’ Which is simply putting a wire through your groin and into the heart to see if there is blockage in the heart vessels. This has been done for about 40 years around the world. Also, it is done quite frequently in China right now. Is there much risk to this procedure? Yes, but in the hands of experienced doctors they are quite safe. If this procedure is done and shows a blockage in one of the heart arteries, then a stent or a small tube can be placed to open up the blocked or diseased artery. This technology is advancing very rapidly and almost monthly the technology is improving. This one procedure alone is able to reduce the recurrence of heart attacks by very large amounts.
The second procedure is that of heart surgery. This is where a surgeon goes in and places a vessel over the blocked part of the artery. This procedure has been done also since the 1960’s. Though the surgery with this is much larger than the placing of the stent in the artery, in the hands of a good surgeon the procedure is very safe. Why would a doctor choose this procedure over the one just mentioned. Many patients have large amounts of diseased arteries and the one surgical procedure has proved better than just placing a tube or stent in one artery. However, in the future all of this can change, i.e. more people might want to have stents placed and this will also prove to be a better procedure.
Regardless, almost no where in medical science has the advances been so great as in the treatment of heart disease, especially heart disease where there are blockages in the heart arteries.
Let us go back and think a little about all of this talk today. Many people in China will have heart attacks in the coming year. You may have been one of these or will be one of these or will know of one of these people. However, what is important is that you get good medical care after the heart attack. If you do not then you will die. Jesus Christ tells us that the body is the temple of the Holy Spirit. Jesus wants our bodies to be healthy. He is called in the Bible the Great Physician. He healed completely many people. However Jesus Christ also recognized that people also have another type of heart disease, one of the soul or spirit which has no longing or desire for God. These people are unhappy, have no hope in life or after life. Jesus Christ came to change that situation. How? By dying on the Cross for our sins. You can have that same peace today.
Simply pray this prayer. Jesus I know that I have sinned and done wrong and I believe that you died for my sins on the Cross. I also believe that after you died on the Cross you rose from the grave to conquer death and I believe that you live now. If you have prayed this prayer and believe it with all of your heart then you are now an eternal child of God and will have a full life now and for eternity.