Anemia and other risk factors for Type 2 heart attack

Myocardial infarction is the medical term for heart attack. The American College of Cardiology (ACC) reported a new study March 17 showing that among those admitted to emergency departments with chest pain, Type 1 myocardial infarction (T1MI) occurred in 16.4% and Type 2 myocardial infarction (T2MI) was found in 4% .

While T2MI admissions were lower, it was found that death is more likely within that group if hypoxemia, hypotension, or anemia were present. Extensive information about symptoms, prevention and treatment of each condition has been published by the National Heart Blood and Lung Institute, Mayo Clinic, Cleveland Clinic and other medical organizations.

Type 1 and Type 2 heart attacks

Type 1 heart attacks usually involves acute myocardial ischemia. Myocardial ischemia means that the blood flow to the heart is hampered. This prevents oxygen from getting to the heart muscle and is often caused by arteries being blocked. Blocked arteries can lead to irregular heart rhythms or heart attack.

T2MI shows some similarities to Type 1 but a more pronounced imbalance of the supply and demand of oxygen is often present. According to the National Center for Biotechnology information, T2MI occurs more frequently among women and is more often associated with co-morbidities. They include diabetes, impaired renal function, anemia and atrial fibrillation.

Hypoxemia, hypotension and anemia

Hypoxemia is the term for less than normal oxygen levels within the blood. Measured by a device called a pulse oximeter, usual oxygen levels register 90-100%. A reading less than 90% is considered low. The most common symptoms are sudden shortness of breath, shortness of breath accompanied by rapid heartbeat, cough or awakening with a choking feeling.

When blood pressure is too low, hypotension occurs. While sometimes not harmful, if blood pressure becomes abnormally low, problems can arise that may become life-threatening. Among the causes are dehydration to contributing medical conditions. Symptoms include dizziness and fainting.

Anemia occurs when the body does not have enough red blood cells to transport oxygen to tissues and throughout organs the body. Red blood cells carry hemoglobin, a protein that distributes oxygen. They also transport iron, needed throughout the body, as well. Among the reasons hemoglobin may be low is the body’s inability to create enough of it. Additionally, the number of red blood cells themselves may be below normal or the red blood cells may be broken down too quickly.

There are several types of anemia and research has shown that higher risk of developing it occurs in certain groups. Among them are women, people over age 65, and children ranging in age from infant to two years of age. Anemia increases in people using blood thinners, as well.

Symptoms of anemia include dizziness, headache, rapid heartbeat and skin that becomes dry, pale or easily bruised. Soreness in the tongue or unplanned movement in the lower leg, known as restless leg syndrome, may also indicate anemia.

Practices that may help prevent risk factors

While some risk factors to anemia, hypotension and hypoxemia may be hereditary, there are ways to lower the likelihood of developing or exacerbating these conditions. To help prevent anemia, regular hydration and following a healthy diet are recommended, as well as consistent exercise. Avoiding infection is very important and this can be done by practicing good hygiene as well as maintaining good dental health. Infection-causing germs may originate due to bad oral hygiene.

Hypotension preventative methods include improving hydration, not only by drinking enough water but by lowering alcohol consumption. A healthy diet is also recommended, especially avoiding carbohydrates including bread, potatoes and pastry. Avoiding caffeine throughout the day may also help, although moderate use during the morning hours can be beneficial. Being mindful of certain positions of the body throughout the day, such as avoiding cross-legged sitting, may also stimulate blood flow.

To limit the possibility of hypoxemia, a healthy diet and adequate hydration are also recommended. Beyond those methods, also helpful in preventing hypotension and anemia, hypoxemia may also be deterred by deep breathing exercises, mild physical activity, including yoga or walking, and eliminating tobacco use.

If symptoms occur for hypoxemia, hypotension or anemia, a physician should be notified and tests for those conditions should be administered.

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Omar P. Haqqani is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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