Ask the Doctor: ‘I lost a friend to a sudden heart attack and worry the same will happen to me — should I get checked?’

“I have recently taken early retirement after losing a friend before his time to a heart attack. I had never put much thought into it but this has really made me reassess myself. I am quite worried about the same happening to me and I often have trouble sleeping from the thoughts. Is it worth having my heart checked? Can I just do this or do I need a reason other than for my own peace of mind?”

Answer from Dr David Barton, Consultant General & Interventional Cardiologist and Specialist Research Director for Cardiology, Beacon Hospital.

Coronary artery disease (blockages in the arteries of the heart) remains the leading cause of death in Ireland, and specifically the commonest cause of someone dying suddenly. I am frequently asked to see patients who have had friends or family suffer a similar fate.

Unfortunately, while we have well validated treatments for patients who have symptoms of blockages, when patients do not have symptoms or warning signs – but have blockages – our understanding of how to assess and treat these folks is lacking.

However, the short answer to the question is yes, all adults should be checked for risk factors that lead to heart attacks. Moreover, if patients are high risk and asymptomatic, or have symptoms (such as chest pain or breathless with exertion), there are a variety of tests we can perform.

What can an individual do to minimise the risk of blockages and subsequent heart attacks? The first answer to this is always the same: prevention. The development of the risk factors – poor diet, smoking, high blood pressure, diabetes, obesity – are all preventable. Lifestyle measures are very effective at preventing these risk factors from developing in the first place.

A healthy diet, regular moderate intensity exercise, stress management, quitting smoking, regular good quality sleep and losing weight are important undertakings. Beyond lifestyle modification, routine health surveillance is very important; all healthy adults should be checked for risk factors. If none are identified, this is not the end, checks should be repeated regularly.

If identified, depending on the individual, medications – always in conjunction with lifestyle measures – frequently are started. These agents: used to treat high blood pressure, high cholesterol and diabetes have been shown to significantly reduce the likelihood of people dying from heart disease.

Beyond prevention and treating risk factors, all patients with symptoms suggestive of underlying blockages, need further testing done, including basic blood tests, electrocardiograms (electrical tracings of the heart), echocardiograms (ultrasounds of the heart), cardiac CAT scans and MRIs can be performed. If warranted, coronary angiography – a procedure involving passing small specifically designed catheters through the wrist up to the heart – can also be performed both to diagnose, and potentially treat blockages with stents.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.