Thursday, February 26, 2015

Angry heart attacks

The day after the Paul Wellstone funeral, I was driving down I-35 listening to Minnesota Public Radio. They had a panel on to discuss the "controversy" surrounding the political remarks Paul's friends had inserted into the proceedings. A Republican clown by the name of Sarah Janacek starting lying her fool head off—at one point claiming that the crowd had only cheered these remarks because the closed captioning system had put "cheers" on the big screen (because the crowd was actually cheering).

Wellstone was a friend. I was upset that he had died so suddenly. I was REALLY upset that the Republicans were now trashing his funeral. Suddenly, I began to have major chest pains. Long story short, I wound up at St. Mary's in Rochester (Mayo) where they inserted a stent in my heart.

A couple of months ago, I found out that the stent they had put in was utterly unnecessary. The doc looked at the old records and said, "Based on what I see here, you should not even have had symptoms." So I told him how angry I had been. He claimed that serious anger was not enough to have triggered the event that got me to Rochester in the first place.

I am going to send him a copy of this article.  And in the meantime, I really try not to let myself become enraged about whatever madness is threatening to destroy us all—although goodness knows, there is an excess of provocation out there waiting to drive up the rage index in anyone minimally curious or aware.  In the name of my poor ticker, the appropriate response would have been to turn off the radio.

Of course, that doesn't let the Mayo system off the hook for an unnecessary stent insertion.  It's difficult to criticize the folks at Mayo because in many ways large and small, they really have earned their reputation for being the best in the land.  The level of competence from every level of employee is breath-taking—the nurses are spectacular.  But this place is also a perfect example of what is wrong with USA medicine because it has to be the global epicenter for expensive and unnecessary testing.  Show up as a middle-aged male with chest pains, and they have tests to run and boxes to check.  Lots of Republicans in medicine and they simply could not believe I could be so overcome with grief over the death of a left-wing Democrat as to trigger an MI (or at least the symptoms.)  So it was run the angio and while they were there, insert a stent anywhere that looked like it could develop into a problem.  They were institutionally disposed to sell me a stent—a big hospital like that probably does at least 100 procedures a day like mine.  And apparently a lot of people love all this attention—folks fly in from around the world to get their medical treatment in Rochester.  It really is quite amazing.

Confirmed: An Angry Rage Could Actually Trigger A Heart Attack

Anthony Rivas  February 23, 2015
Posted with permission from Medical Daily

We’ve all heard some rendition of it before, usually in the midst of an argument: “Stop it before your father has a heart attack.” While the warning is sometimes enough to calm things down, chances are none of us ever really believe it will happen — until it does. Now, a new study confirms what most of us have believed: Intense bouts of anger can certainly trigger a heart attack.

Now that’s not to say the next time you get dad — or anyone — angry, they’re going to have a heart attack. But researchers at the University of Sydney and Royal North Shore Hospital found people who regularly reached above a certain level of anger were 8.5 times more likely to a heart attack (myocardial infarction, or MI) within two hours of becoming enraged. This is “most likely the result of increased heart rate and blood pressure, tightening of blood vessels, and increased clotting, all associated with triggering heart attacks,” said Dr. Thomas Buckley, a senior lecturer at the university, in a press release.

While stress is one thing to worry about when it comes to cardiovascular and mental health risks, anger and anxiety are on an entirely other level, amplifying stress’ effects. People who stay angry or anxious for extended periods of time are more likely to have difficulty coping with smaller aggravations. De-stressing becomes harder, and having a good, fun time might as well be impossible. It can also lead to feelings of remorse, guilt, and regret among those who realize the error of their ways. All of this obviously affects mental health, but it also affects physical health, as evidenced by the current study.

For the study, Buckley and his team looked to patients admitted at the Royal North Shore Hospital in Sydney, who were suspected of having a heart attack. Of the 687 patients first assessed, 313 enrolled after confirmation through a coronary angiogram that they had indeed suffered a heart attack. Each patient responded to a questionnaire asking about their anger over the 48 hours prior to having a heart attack. They were asked rate their anger on a seven-point scale with 1 defined as “calm” and 7 as “enraged, out of control, throwing objects, hurting yourself or others.” They also used level 5 as the threshold for acute anger, defined as “very angry, body tense, maybe fists clenched, ready to burst.”

They found that seven of the participants had reached an anger level of at least 5 within the two hours before heart attack symptoms developed, while another reached the same level within the four hours prior to symptoms. Meanwhile, two patients reached an anger level of 4 — moderately angry, so hassled it shows in your voice — within the two hours before symptoms, while three reached the same level within four hours. The researchers included the frequency with which patients reported getting angry into their calculations for determining heart attack risk, thus arriving at 8.5 times greater risk among those who reached a level 5 or higher.

The findings add to a growing “acceptance of the role of psychological factors, both acute and chronic, in the onset of acute MI, sudden cardiac death, and stroke.” Considering constant anger can lead to symptoms of depression, and depression itself can lead to heart problems, there’s a good chance that, when combined with acute anger, a person’s risk of a heart attack will worsen. For this, the researchers urge health care providers to include assessments for anger and anxiety when managing or determining risk of heart disease in their patients. They also suggested anger management and avoidance of intense situations. As for everyone else, it could be worth sucking up any pride in an effort to prevent a trip to the emergency room. more

4 comments:

  1. Like many north Iowans, my parents used the Mayo Clinic as their primary health care facility. They like old farmers because they're good at living through surgery. And that's what the Mayo operation is all about: surgery and procedures. If you go there, they will cut you.

    I know I don't know as much as their doctors, but taking charge of my own wellness has been the best health care I've ever received. For starters, I've never prescribed a statin for myself, or tried to insert a stent.

    The Mayo is great if you need surgery. Otherwise, they're best avoided.

    ReplyDelete
    Replies
    1. Good points. Yes their care is well-organized. Mayo's problem is what they are organized to do—which is sell a lot of medicine. And yes, they DO seem to be over-enthusiastic about statins. Of course most CV types are true believers.

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