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Wednesday, March 12, 2014

The Recommendation of a Book.

Thanks to Doctors Gillinov and Nissin of the Cleveland Clinic, we have a book titled Heart 411 (Three Rivers Press). It is a well-organized, comprehensive, 500+ page treasure trove of information.

The book contains an interesting chapter on how a woman's heart is different and similar to a man's.

The primary symptom of coronary heart disease is chest pain for both sexes. Also the principal strategies for prevention and treatment apply to both men and women: healthy lifestyle, medicine, angioplasty, and surgery.


  1. Since 1984, more women than men have died from coronary heart disease each year. Prevalence is dropping in men but rising in women.
  2. For men, a heart attack is the first sign of heart disease. For women, the first sign is more commonly angina - a discomfort or fullness in the chest that generally occurs with exercise or stress and is relieved with rest.
  3. About 25% of all heart attacks occur without chest pain - more commonly in women than in men. Shortness of breath is often the clue in the absence of chest pain, as are indigestion, nausea, vomiting, sweating, fatigue, and weakness.
  4. Women tend to wait longer than men before seeking treatment, and they are more likely to go to their doctor's office than to the Emergency Department.
  5. Eighty percent of women (vs. fifty percent of men) report having experienced early warning symptoms one month or more before a heart attack. The early warning signs for women include unusual fatigue (72%), sleep disturbance (48%), shortness of breath (42%), indigestion (39%), anxiety (36%), and chest discomfort (30%)
  6. The standard exercise cardiac stress test is less reliable in women (more false positives) and fewer catheterizations for chest pain reveal blockages, thus raising the risk and lowering the benefit of these important procedures.
  7. Young women - less than fifty years old - have twice the risk of dying in the hospital following admission for a heart problem than do men.
  8. Men have heart attacks at an earlier age than women.
And what's all this doing in a blog usually dedicated to Cardiac Arrest and CPR? While most heart attacks are not fatal - i.e., don't trigger a cardiac arrest - some of them do.

What I didn't know about CPR

I've seen four different ways to perform CPR with your hands in the past weeks.

  1. Lock your arms straight, get your shoulders over the hands, and rock from the hips. So far, no surprise.
  2. Perform #1 but use your abs to accelerate your shoulders downward.
  3. Perform #1 but start with your arms slightly bent and straighten them as you start the downward push.
  4. Perform 1, 2, and 3 simultaneously.
For those who lack the physical training and endurance to perform alternatives 2, 3, & 4, you'll have to stick with alternative #1.

A fifth alternative - not available to those performing CPR as part of their employment - is to perform pedal compressions. It's the only way I know of where the average person at home - where two-thirds of all cardiac arrests occur - can perform chest compressions from the time they witness an arrest to the time the ambulance crew is "hands on" at the victim of a cardiac arrest. See how to perform Pedal CPR  I'm a paramedic. I've gotten a lot of CPR experience over the past decade, and I am absolutely positive that I can perform pedal compressions on someone for the ten-minute average period from the moment I see someone collapse and the time that help is "hands on." 

I hope this is something that you never need to know.