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If you call , treatment will start in the ambulance with aspirin and other medicines.

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In the hospital, the doctor will work right away to return blood flow to your heart. You may get medicines to break up and prevent blood clots. You may get nitroglycerin and other medicines that make your arteries wider. This helps improve blood flow and relieve symptoms, such as chest pain or pressure. You also may get pain medicine and oxygen.

Your test results will help your doctor decide about more treatment. You might have angioplasty or bypass surgery to improve blood flow to your heart.

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During angioplasty, doctors inflate a small balloon to open the artery. A stent, a wire mesh tube, may be permanently placed in the artery to keep it open. For hospitals not equipped to do angioplasty quickly, drugs may be used to dissolve blood clots, but more hospitals are making the procedure available in a timely manner, Bolger said.

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After you get out of the hospital, you will continue to take medicines that lower your risk of a heart attack. Medicine may include beta-blockers, aspirin or other medicines to prevent blood clots, blood pressure medicine, and cholesterol

If your doctor has not set you up with a cardiac rehab program, talk to him or her about whether that is right for you. In cardiac rehab, you will get education and support that help you make new, healthy habits, such as eating healthy food and getting more exercise.

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Unstable angina happens when blood flow to the heart is suddenly slowed by narrowed coronary arteries. Or small blood clots form in the coronary arteries and slow blood flow. Typically, there is no damage to the heart muscle. It often happens when you are at rest.

You may have had stable angina You knew when to expect your symptoms, such as when you exercised. Stable angina usually goes away when you rest or take your angina medicine. But the symptoms of unstable angina may not go away with rest or medicine. It may get worse or happen at times that it didn’t before. Unstable angina symptoms may mean that you are having a heart attack.

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A heart attack means

heart attack means a coronary artery has been blocked and the heart has been damaged. Without blood flow and oxygen, part of the heart starts to die.



ACS ranges from a heart attack (myocardial infarction) to unstable angina.

Heart attack (myocardial infarction)

If you have a heart attack, a coronary artery or one of its smaller branches is suddenly blocked. The part of the heart muscle supplied by this artery loses its blood (and oxygen) supply. This part of the heart muscle is at risk of dying unless the blockage is quickly undone. (The word infarction means death of some tissue due to a blocked artery which stops blood from getting past.) In addition to being known as a heart attack, a myocardial infarction is sometimes called a coronary thrombosis.

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Three types of angina:

Stable angina

Unstable angina

Variant angina

Classic angina

Crescendo angina

Prinzmetal angina

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Unstable angina

Unstable angina occurs when the blood clot causes a reduced blood flow but not a total blockage. This means that the heart muscle supplied by the affected artery does not die (infarct).



Critical Congenital Heart Disease (CCHD) accounts for more than 25%  of infant deaths that are caused by birth defects.

Oximetry screening is a low-cost, highly-effective, and painless bedside test for newborns that can be completed in as little as 45 seconds.

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The screening is administered using a pulse oximeter device, which is a light that shines through the skin to measure the percentage of oxygen in the blood.

All parents should ask for a pulse oximetry screening to be administered on all newborns.



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Atherosclerosis is often referred to as “hardening of the arteries.” .It’s the process in which fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque.

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Atherosclerosis is a slow, complex disease that typically starts in childhood and often progresses when people grow older. This disease progresses rapidly in some people in their 20s. In others, it doesn’t become a threat until they’ve reached their 50s or 60s.

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Causes of atherosclerosis

People with a family history of premature cardiovascular disease have an increased risk of atherosclerosis. Other risk factors for atherosclerosis include:

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Cigarette smoking and exposure to tobacco smoke (the chemicals in cigarettes can cause damage to blood vessels accelerating the development of atherosclerosis)

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The inner lining of the artery, called the endothelium, can be damaged due to high cholesterol and triglyceride levels, toxic substances in cigarette smoke, high sugar levels, and other factors in the blood. High blood pressure can also cause damage to the inner lining of an artery. Once the blood vessel is damaged, atherosclerosis begins and a plaque forms.

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the progress of the condition

Because of the damage, fats, cholesterol, platelets, cellular debris and calcium begin to deposit in the artery walls. These substances may stimulate the cells of the artery wall to produce still other materials. This results in more cells accumulating in the innermost layer of the artery wall where the atherosclerotic lesions form. These cells accumulate, and many divide. At the same time, fat builds up within and around these cells. They also form connective tissue. This buildup is called plaque. It usually affects large and medium-sized arteries. These cells and surrounding material thicken the endothelium significantly. The artery’s diameter shrinks and blood flow decreases, reducing oxygen supply.

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How atherosclerotic plaque causes damage?

Plaques that rupture cause the formation of blood clots that can block blood flow or break off and travel to another part of the body. In either of these cases, if a clot blocks a blood vessel that feeds the heart, it causes a heart attack. If it blocks a blood vessel that feeds the brain, it causes a stroke. If blood supply to the arms or legs is reduced or blocked, it can cause difficulty walking and eventually gangrene.

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Stroke and atherosclerosis

There are two types of ischemic stroke caused by blood clots, narrowing of blood vessels to the brain caused by atherosclerosis or other particles. Atherothrombotic stroke is the most common stroke. It occurs when a blood clot forms on a atherosclerotic plaque within a blood vessel in the brain and blocks blood flow to that part of the brain.

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Cerebral embolism occurs when a wandering clot or some other particle, called an embolus, is carried by the bloodstream until it lodges in an artery leading to or in the brain and blocks the flow of blood. The embolism could be due to a piece of clot or plaque that broke off from an atherosclerotic plaque. However, most embolic strokes are due to blood clots that form during atrial fibrillation and enter the bloodstream.

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Due to a family history or other risk factors, even a woman who has always thought of herself as perfectly healthy can find herself suddenly experiencing the symptoms of stroke.

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A stroke happens when either a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot or the vessel bursts. When either of these occur, the brain does not receive the oxygen-rich blood it needs and brain cells begin to die, and quickly. That’s why it’s so important to know the signs and symptoms of stroke.

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Heart Attack Signs in Women

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.

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Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath with or without chest discomfort.

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Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somehow more likely than men to experience these common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Even though heart disease is the No. 1 killer of women, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or normal aging. Heart disease is the world’s biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years.

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Angina in Women Can Be Different Than Men

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Angina (chest pain) is a warning sign of heart disease, and recognizing it and getting treated early may prevent a heart attack. Fatty build-up in your coronary arteries, called plaque, prevents blood flow that’s needed to provide oxygen to your heart muscle.

Women more frequently develop heart disease within the very small arteries that branch out from the coronary arteries – microvascular disease (MVD) and occurs particularly in younger women.

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On the other hand, Heart disease in men usually is due to blockages in their coronary arteries – obstructive coronary artery disease (CAD). Up to 50 percent of women with anginal symptoms who undergo cardiac catheterization don’t have the obstructive type of CAD.

You may have tightness, pressure or discomfort in your chest during physical activity or when stressed. But it goes away shortly after you stop the activity or get rid of the stress.

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Angina symptoms in women can also include feeling out of breath, nausea, vomiting, abdominal pain or sharp chest pain.  Once the extra demand for blood and oxygen stops, so do the symptoms.



Your doctor will ask you many questions about your symptoms and medical history. You will be asked about any conditions you have that may cause heart failure (such as coronary artery disease, angina, diabetes, heart valve disease, and high blood pressure). You will be asked if you smoke, take drugs, drink alcohol (and how much you drink), and about what drugs you take.

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You will also get a complete physical exam

Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

Blood tests

Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia. Anemia is a blood condition that occurs when there is not enough hemoglobin (the substance in red blood cells that enables the blood to transport oxygen through the body) in a person’s blood.

B-type Natriuretic Peptide (BNP) blood test

BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen, and decrease when the heart failure condition is stable. The BNP level in a person with heart failure — even someone whose condition is stable — is higher than in a person with normal heart function. BNP levels do not necessarily correlate with the severity of heart failure.

Chest X-ray

A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

Echocardiogram

This test is an ultrasound which shows the heart’s movement, structure, and function.

The Ejection Fraction (EF) is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present. Your doctor can discuss which condition is present in your heart.

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Electrocardiogram (EKG or ECG)

An EKG records the electrical impulses traveling through the heart.

Cardiac catheterization

This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.

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Stress Test

Noninvasive stress tests provide information about the likelihood of coronary artery disease.

Other tests may be ordered, depending on your condition.



Heart failure is caused by many conditions that damage the heart muscle, including:

Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.

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Heart Attack

heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly.

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Cardiomyopathy

Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.

Conditions that overwork the heart. Conditions including high blood pressurevalve diseasethyroid disease, kidney diseasediabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once.

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