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Alyssa Diaz (Host):  And this is the Well Within Reach podcast. I’m your host, Alyssa Diaz. And today, I’m joined by Dr. Eric Leser, an Emergency Medicine physician at Riverside Medical Center. Thank you for joining us Dr. Leser and welcome to the podcast.

Eric Leser, MD (Guest):  Heh, thanks for inviting me.

Host:  And today we’re going to be talking about the topic of heart attacks which is something unfortunately that you see in your everyday life as an Emergency Medicine physician. But first, let’s find out a little bit more about you and let’s talk about where you started schooling and how you became an Emergency Medicine doctor.

Dr. Leser:  I ended up going to undergrad very late. I was living in Colorado Springs and I was a member of the US Figure Skating Team at the Olympic Training Center. And I had a series of injuries that kind of left me unable to compete any longer so I was kind of trying to move on with the next phase of my life and ended up going to De Paul in Chicago and then Loyola for Medical School and was very fortunate enough to earn a spot at Cooke County Hospital, John Stroger downtown, a very, very like heralded like very historic Emergency Medicine program and was fortunate then to get a job at Riverside after residency. So, I’ve been very fortunate to stay in this area throughout my medical education.

Host:  And did anything in particular draw you to emergency Medicine in particular?

Dr. Leser:  I think it was the excitement. It was the aspect of being able to help people with acute problems and get a sense of satisfaction from helping people with very acute issues right there and then and being able to see the improvement and also kind of just a change of pace. Like the patient in this room has this problem, the patient in this room has that problem and it’s just a good variety.

Host:  Right, right. And pace is definitely part of it and fast pace I’m sure of.

Dr. Leser:  Yeah, you got to be able to keep up. Most days in the Emergency Room are pretty fast so it definitely weeds out slower people and fortunately I’m frequently well caffeinated so I can hang.

Host:  That’s good. Well we will go ahead and get right into our topic o heart attacks which is something that time is of the essence and to keep on pace is extremely important in these scenarios. I found a statistic that says that in the United States, coronary heart disease which includes heart attack is the cause of one in seven deaths. So, it’s extremely important to recognize the signs and symptoms of heart attacks in order to prevent deaths and even save lives. And some heart attacks are sudden and intense but then some start slowly with mild pain or discomfort. What are some of the signs that can mean a heart attack is happening to you?

Dr. Leser:  So, unfortunately, there’s no kind of simple answer to this. It kind of varies depending on gender, age and what other medical problems the individual has. Younger people, specifically younger males end up having what you kind of see on TV which is like the crushing chest pain, radiating to like the jaw or the arm and a lot of times, females can have that too, but females and senior citizens can end up having kind of more like gradual vague symptoms. A lot of times people come in with like this like vague feeling of nausea, some dizziness, generalized just like upper stomachache, feeling of unwellness, tingling in their face or their left arm and these are all worrisome signs of a heart attack as well. And men can have these symptoms as well. This isn’t something that follows a cookbook approach unfortunately, but both men and women can have either chest pain or just kind of these vague symptoms that I was talking about.

Host:  And so, bottom line, if something feels off, it’s always best to get it checked out.

Dr. Leser:  Yeah, if there’s something that is acutely different from how an individual normally feels and it sticks around for longer than just a few minutes; it’s good to go get it checked out. Because a lot of times people who end up ignoring these symptoms can have a significant heart attack or cardiac condition that could have been treated if they came in to the hospital at an earlier time than they do.

Host:  Right. And so if someone is experiencing some sort of symptoms related to these, is they think heh maybe it could be a heart attack, what should they do?

Dr. Leser:  So, first and foremost, if you think that you are having a heart attack, you should absolutely call 9-1-1. That is the best thing that you can do. Because a lot of our treatment for these types of cardiac issues actually starts when the paramedics get to your door. They can start treating you and start reversing some of the physical effects of the heart attack as well as pain within seconds of starting the IV. So, it’s important to – and it’s not just for you personally, but also if you have a loved one that may be is having a heart attack; not bringing them in yourselves because our entire process from the minute you call the ambulance is streamlined to get you to either myself the ER doctor or the cardiologist as quickly as possible.

Host:  And it’s pretty incredible technology inside those ambulances. You started to touch on it. And it’s true that we can actually perform an EKG in the ambulance en route to the hospital.

Dr. Leser:  Absolutely.

Host:  And that’s really key so that everybody, the entire care team in the emergency department knows what’s coming in before they hit the door.

Dr. Leser:  And it’s not just the emergency department. They actually are able to email us or fax us depending on the technology that we have the EKG before the patient hits the door and I in turn can give that to the cardiologist so, a cardiologist the heart specialist can be looking at the EKG when you are still ten minutes away. Making a diagnosis and preparing what needs to be prepared to get you on the road to recovery.

Host:  Yeah and that’s key when these moments matter. It’s so important to remember to survive, don’t drive. Even if you are driving a loved one, you may think that you’re doing them a favor, by thinking oh I can get them there quick and things like that. No, it’s so much more beneficial to go by ambulance in these scenarios.

Dr. Leser:  Absolutely beyond a shadow of a doubt, I cannot stress that enough. Definitely call 9-1-1 because we will get you there faster and more efficiently.

Host:  Right and the sooner the treatment begins, the better and we also know that the type of heart attack determines the treatment. So, there are some different types of heart attacks and treatments. What are some of the differences in these?

Dr. Leser:  So, just not making it overly complicated. Basically, what causes a heart attack is a plaque formation in the arteries on the surface of the heart that supply the heart itself with necessary blood and nutrients and certain types of plaques can rupture and then cause clots on top of the rupture. It basically, the plaque will damage the internal structure of the artery and then cause a clot and how bad – how much the clot occludes the blood vessel will determine the severity of the heart attack. So, the important thing to remember here though, the take away is that it’s all part of the same disease progression. So, if you are at risk for one, you are at risk for all.

Host:  That’s important to remember. And what are some of the treatments for heart attacks in general. People hear all of these terms and things like that but what could a possible list of treatments be?

Dr. Leser:  So, early on if somebody is just coming in with chest pain and we are not sure what it is; the cardiologist will end up doing a stress test, many times, either an exercise stress test or a chemical stress test which is basically like putting EKG leads on the patient and then having them walk on the treadmill and seeing how their heart responds to stress. And that would be on one end of the spectrum.

But all the way on the other end of the spectrum, our cardiac catheterization lab is fully equipped to basically do a cardiac cath where the cardiologist will essentially squirt some dye into the arterial system while they are taking what’s kind of like a real time x-ray of the arteries in the heart and then seeing how well this dye gets through the arteries and then they are able to locate the occlusion and then they can actually open them up with a small balloon and then insert a stent to keep that artery open. And the effects of doing this quickly can really save heart muscle and life. So, that’s one of the reasons why it’s important to call 9-1-1 when you are having these symptoms is because the sooner that we get you into the cath lab, if you are having a heart attack, the sooner we can restore blood flow to the heart and then the less amount of heart tissue dies.

Host:  Yeah, exactly. And understandably treatment can be really complex so, be sure that you or if you are there with a loved one or asking a lot of questions to learn more about your treatment plan and your lifestyle moving forward. But before any of this even happens prevention is so important to discuss.

Dr. Leser:  Prevention is very important.

Host:  And what are some of the tips that you can share with us from having a primary care physician onward to help prevent and eliminate some of these risk factors that could lead to something like a heart attack.

Dr. Leser:  So, the first and most important thing you can do is have a primary care doctor. No football team is going anywhere without a quarterback. You need somebody quarterbacking your health and even physicians themselves need doctors, their own doctors. So, have a doctor. Make your follow up appointments. If your doctor is trying to get you to go in for some specialty exams, definitely follow up with those. But then aside from having a regular physician, lifestyle management, cutting down on obesity in this country, hypertension, diabetes, cigarette smoking, getting all these under control and managed can have profound positive impacts on your cardiovascular health.

Host:  Yeah and then there’s always that risk factor that nobody can change and that’s your family history. But it’s so important to be aware of what that family history is so that you have maybe a closer watch on what could progress.

Dr. Leser:  Yes, sometimes it’s going to happen just based on genetics. Genetics are tricky. But what you still can do is know your family history, ask questions, ask about your grandparents, ask your parents what their health problems are because chances are, if grandma and grandpa had heart problems at an early age and mom and dad have heart problems at an early age; that could easily be you too so staying on top of it and staying ahead of it and maybe getting some cardiac screening earlier than you normally would can have a profound positive effect on your long term health.

Host:  Absolutely and Riverside does have many resources for screenings and even help getting a primary care provider. So, for any information on topics like that, just visit www.riversidehealthcare.org and you’ll find what you’re looking for there. Dr. Leser, thank you so much for talking to us about the signs, symptoms and treatments of heart attack and also the important prevention factors that go along with it. So, how might individuals learn more about cardiovascular conditions or is there a certain resource that you would recommend for heart attack related information?

Dr. Leser:  The American Heart Association, their website is very easy to find. It is www.AHA.org. And they have a huge amount of resources available that are easy to comprehend and easy to read for anyone from just a normal nonmedically trained person all the way up to physicians. It’s a great website and it’s a great resource.

Host:  Absolutely. Well thank you Dr. Leser for joining us and this has been the Well Within Reach podcast with Riverside Healthcare.