Transcription:
Heart Attacks in Young Adults 

Melanie Cole (Host):  Roughly, 700,000 Americans experience a heart attack annually and while most heart attack victims are middle-aged or older, those in their 20’s and 30’s can suffer them, as well. My guest today is Dr. Vivek Sailam. He's a cardiologist with Lourdes Health System. Welcome to the show, Dr. Sailam. So, tell us about young people and heart attacks and why you're seeing them. What are you seeing?

Dr. Vivek Sailam (Guest):  Well, thank you very much for having me. You know, in recent times, in the past couple of years, I've noticed in clinical practice that the age of individuals who are suffering from a heart attack or a myocardial infarction has become younger—specifically, less than 50- years old. I think the main reason for this is the fact that we're seeing an increased incidence of early diabetes, early hypertension or high blood pressure and a significant increase in obesity. These are also followed by an increased use of tobacco use in certain populations and this combination has been surfacing as increased numbers of heart attacks. I have recently, in the past few months, seen several individuals in their early 40’s who've, unfortunately, suffered from a heart attack.

Melanie:  So do you think the majority of these are these lifestyle threats to heart health versus any genetic component?

Dr. Sailam:  I think that, from what I've been seeing in the area that I practice here in South Jersey, I think the lifestyle choices and the lifestyle changes are a big component of it. There certainly is a genetic component in it in terms of having premature coronary disease, but what I've been witnessing, personally, and I think a lot of my colleagues, is because of these lifestyle issues that we're facing with sedentary lifestyles and poor habits.

Melanie:  Dr. Sailam, while women experience heart attack signs differently than men, and we've been learning that, do younger individuals experience kind of the similar media that we see in symptoms? What would they experience?

Dr. Sailam:  I think that the symptoms that we've been seeing with some of the younger individuals: for men, they are similar to the symptoms you see on TV shows or movies in terms of the men. The women, who are younger are, again, very difficult to discern because their symptoms are not typical. They don't have the classic, you know, chest discomfort coming into the emergency room with a heart attack. Their symptoms are a little bit more difficult to discern and I think we all have to be very vigilant when women come in in terms of deciphering what they're telling us in terms of symptoms.

Melanie:  So, what are they telling you because stress can mimic some of these. We all have anxiety nowadays, so what are you seeing when women come in?

Dr. Sailam:  Well, stress is the main component. You see people coming in, especially in their mid-40’s, if they have high blood pressure, diabetes, and obesity, when they have an abnormal amount of stress--whether it be their personal life, their work--stress can cause significant impact on the coronary arteries, it can cause plaque rupture in the coronary arteries, and women can usually present with symptoms as simple as fatigue. They can come in and say, "You know, I've been feeling very tired over the past few weeks and I can't do what I was normally doing. I may be having some shortness of breath when I'm going up the stairs." These are all very, very atypical symptoms that we've been seeing and when we investigate some of these people, or if they come to the emergency room with these symptoms, it turns out that they, in some cases, may be having a heart attack, but, again, the symptoms have to be investigated very carefully.

Melanie:  Is the treatment different when somebody is under, say, 60?

Dr. Sailam:  The treatment's not different, the key is to getting treatment early and that way you know, time is heart muscle. Time is myocardium. So, if you are having symptoms that are concerning you, whether it be shortness of breath, chest discomfort, fatigue, palpitations--these are all symptoms that should be evaluated early rather than later. The old edict of "it will go away if I ignore it" is not true, so, coming in early is key.

Melanie:  Dr. Sailam, that's an interesting point because young people feel those things, they brush them off and they are not usually getting these types of screenings every year. They're not getting a stress test; they're not getting some of these blood workups when they're, say, in their 30’s, early 40’s. So, what do you want them to know about screenings and keeping an eye out for these things?

Dr. Sailam:  Well, and that's a great question. Screening, obviously, has to be done according to the guidelines and if your clinical suspicion is high with certain individuals and they have certain risk factors along with genetic components, it's important that these individuals come in to get a thorough evaluation and the appropriate test has to be done. Now, obviously, to convince someone to come in is another story, but, you know, hopefully, with us getting the message out there, people will be more aware of their symptoms and more cognizant of their symptoms. And we have facilities available.

Melanie:  Well, and for these folks in their 20’s, 30’s, 40’s that might be at risk, what do you want them to know about lifestyle and keeping track of their blood pressure knowing their numbers at that age?

Dr. Sailam:  Right. Individuals in their 20’s, 30’s, and 40’s who have risk factors--whether it be high blood pressure, whether it be diabetes--what I've seen in clinical practice is that some of these individuals, especially the very young ones, may not take their medications and they may not get the proper follow-up in the office. I think for these individuals, it's very important to stress with them that if the proper follow-up and the proper care is not given at the young age, we're going to have serious consequences when they get older. So, the people that I'm seeing in their 30’s and their 20’s and their early 40’s, I'm being very, very aggressive in terms of making sure that their blood pressure is controlled, making sure that their diabetes is controlled and that they have the proper lifestyle map for the future.

Melanie:  And while we're talking about heart attacks in young adults, I do want to just touch on sudden cardiac death because there are kids in college and even in high school that have this issue. What do you want parents and listeners to know about the knowledge of this and it's severity?

Dr. Sailam:  Right, and that's a whole another . . .

Melanie:  It is. We could do whole other show on it, for sure.

Dr. Sailam:  Absolutely. We could do a whole other show because there's been a whole setup now where there's actually clinics where cardiologists have been screening athletes and young adults for these issues. There are guidelines set forth by the ACC and other organizations which give us the tools and the map in terms of screening individuals, whether it be via clinical exam, EKGs, there's genetic testing, and there's also, of course, imaging that can be done for congenital abnormalities and for structural abnormalities. There is a whole set of guidelines that are in place for these people now, just because we know so much more now than we did in the past. So, hopefully, the incidence of sudden cardiac death and the things that we used to see about the past, such as professional athletes going down, hopefully, that will all dwindle down in significant numbers.

Melanie:  So, in just the last few minutes, and while young adults who are stricken with heart attacks is far less frequently than older adults, Dr. Sailam, what's your best advice for really kind of all the ages of the spectrum, as a cardiologist that we should all be aware of?

Dr. Sailam:  My best advice overall, what I tell my patients every day, is to be very, very knowledgeable about your own health. I always tell people don't ignore signs and symptoms, don't ignore your health, because your health is extremely important. With the technology that we have today, we're able to keep people in good health as long as people follow the proper protocols. I always tell people that the lifestyles are key. Our medicines are there to help you when you need it but much of what we see today can be prevented through lifestyle changes. Whether it be better diet, or better exercise, or a combination of both of those items, trying not to be sedentary and to be active in your life, and also limiting stress because stress is the "X Factor" in things that we see. Stress is not something that we can put a handle on, but stress is very important in terms of managing symptoms and also managing heart attacks in some individuals. But, overall, being aware, and being cognizant and paying attention to your health is very, very important.

Melanie:  And why should listeners come to Lourdes Health System for their care?

Dr. Sailam:  Well, I think it's an easy answer. Lourdes, right now, has the premiere, comprehensive heart care program in South Jersey. Last year, we did over 800 cardiac surgeries We've done several thousand cardiac catheterization, and we absolutely, without a doubt, have the premiere cardiac service here in South Jersey. Bar none. You'll see the reviews. You'll see the advertisements. They're all true. Our patients are very impressed with the care that we're giving and the level and the technology; everything's cutting edge. We have procedures now that are being done which are not being done in other facilities. Everything is at the forefront of cardiac care--it's only going to get better. We are continually improving and our  clinicians are second-to-none.

Melanie:  Thank you so much, it's such great information and Lourdes Health System is one of the largest providers of cardiac services in the entire Delaware Valley. That experience that comes from this also helps to make Lourdes among the best in the nation. You're listening to Lourdes Health Talk, and for more information on Lourdes cardiology, you can go to lourdesnet.org. That's lourdesnet.org. This is Melanie Cole, thanks so much for listening.