Chest pain or discomfort (angina), which can feel like pressure, squeezing, fullness, or pain in the center of the chest. With heart attack, the pain usually lasts for more than a few minutes, but it may increase and decrease in intensity. Discomfort in the upper body including the arms, neck, back, jaw, or stomach Nausea and vomiting   Shortness of breath, which can occur with or without chest pain Breaking out in cold sweat Lightheadedness or fainting Women (and some men) may have atypical symptoms such as abdominal distress, nausea, and fatigue without chest pain

ARE YOU AT RISK FOR The most important factors that increase the risk for CAD are:   Smoking Unhealthy cholesterol and lipid levels High blood pressure Diabetes Lack of exercise Obesity Advancing age

Learn more about High Blood Pressure and Cholestrol in these two articles by NMAC’s Dr. Stanley James   Can’t take the Pressure!     Do you know someone with high blood pressure? That person may be you. Many times people find out when it is too late (heart attack, stroke or kidney failure). That is why high blood pressure is called the silent killer. Yet it does not have to take you out. It is east to and there are effective treatments for high blood pressure. So what if I have high blood pressure? Are you kidding me? High blood pressure can hurt you in many ways. Your heart may enlarge and get weak. Your blood vessels may develop bulges and weak spots than can lead to a heart attack. Your eyes can also be affected by high blood pressure leading to blindness and finally your kidneys may be injured. What can I do if I have high blood pressure? By losing weight and reducing the salt in your diet you are off to a good start. Additionally, if you eat at least 5 servings of fruits and vegetables a day you will help reduce your blood pressure as well. Being physically active (after talking with your doctor) is one of the best things a person with high blood pressure can do. Finally quitting smoking is a must. Do I need to be on medication or drugs for my pressure? It depends, some people are able to get their blood pressure   down into acceptable ranges simply by losing weight, exercising, sleeping well, managing stress and eating right. Yet for other people despite doing these things their blood pressure remains high. The good news is that there are many different types of medications which can be tailored to your needs. Your doctor will work with you to find the right medication for you. What are the side effects? Side effects differ depending on the patient and the drug. For some people there are no obvious side effects. For other people there could be dizziness, others have a cough, increased urination is a symptom or certain drugs and still others have swelling of the ankles. One of the most bothersome side effects is difficulty getting or maintaining an erection. Instead of stopping the medication if you have any of these symptoms just go to your doctor and he will help you sort it out.     What about Cholesterol?   What is cholesterol? Cholesterol is a soft substance that is found in everybody. It is very important for healthy living. However, if there is too much cholesterol in your blood you are at risk for blockage of your arteries. Cholesterol is naturally produced in your body and is found in the foods that you eat. Some people have increased cholesterol in their body even if they don’t eat too much cholesterol in their diet. When you see your doctor regularly the fats in your body are measured. Two types of cholesterol that are measured in your body are the LDL and HDL. Triglycerides, another type of fat, may be measured as well. The LDL cholesterol is often called the bad cholesterol and the HDL cholesterol is called the good cholesterol. If the LDL cholesterol is high you may be at increased risk for heart disease and stroke. The walls of your arteries are vulnerable to being blocked by plaque buildup from the LDL cholesterol. When they get blocked up with plaque they stop the blood flow to your heart and brain. What are the symptoms of High Cholesterol? NONE! There are no real symptoms of high cholesterol. You only know if you have high cholesterol when your doctor does a test which shows high cholesterol. Finding out about your cholesterol level is very important because it can prevent a stroke or heart attack if treated. Your doctor will work with you to reach your target level based upon your past medical history. How high is too high? A high level of LDL puts you at risk for heart disease. There are certain things that put you at risk for heart disease. Among those are the following: Diabetes, high blood pressure, smoking, overweight, older age, male gender, stressed out, inactive and family history. If you have any 2 of these you should definitely see your doctor to determine what is the target LDL and HDL level for you. You should especially see their doctor for evaluation and treatment if you have diabetes, heart disease, stroke or blockage of any of your arteries. What must be done to lower cholesterol? Many people are fighting to lower their cholesterol and winning the battle with diet, exercise and medicines. You can do it too! Eating foods that are fresh vegetables, fruits and avoiding sugary foods and greasy foods will help. Eating fiber in your diet will also help lower your cholesterol along with stopping smoking if you are a smoker. Maintaining a healthy weight is a very important step to lowering your cholesterol and after consulting with your doctor you should start an exercise program. Finally you may need to have medicine to help you lower your cholesterol, it is better to exercise, eat right and possibly take medicine than to have a heart attack or a stroke.

YALE FACULTY AFFILIATE DOCTOR CONDUCTS ABI TRAINING WITH NMAC STAFF   During his monthly visit to the island, Dr. OferSagiv, MD FACC, Yale Faculty Affiliate, conducted training on how to perform the Ankle Brachial Index Exam with the NMAC team. Ankle Brachial Index commonly referred to as ABI test, measures the patient blood pressure at different points down the legs and compare’s this with blood pressure in their arm. It is a relatively simply exam, which is harmless and uses no form of radiation. The ABI study is an excellent screening and diagnostic tool for the evaluation of Peripheral Artery Disease (PAD). PAD is a narrowing or complete blockage of the blood vessels down the legs. The most common symptom of PAD is leg pain. In addition one can feel muscle cramping in the hips, thighs or calves when doing simply things like walking, exercising and climbing stairs. Simply when you do any sort of movement, the muscles to the legs would require increase blood supply, however if there is a narrowing or a blockage; the muscles are simply not going to receive the amount of blood they need. Thus, decrease blood supply results in pain and cramping. Other symptoms of PAD include foot and toe wounds which won’t heal or heal very slowly, gangrene and marked decrease in temperature of the lower legs. Dr. Kyjuan Brown, NMAC Medical Director adds, “The ABI is an appropriate screening tool for anyone over the age of 50 who has a history of smoking or is a diabetic. It is also appropriate for most people over the age of 65, since the prevalence of the disease increases with age. This training gives NMAC the opportunity to not only expand our services but assess our patients in-house and provide valuable, real-time results”.

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