In the wake of Jim Flaherty鈥檚 sudden death, more than a few of us probably worried 鈥� that could have been me. Flaherty, sa国际传媒鈥檚 finance minister until his resignation last month, suffered a massive heart attack. He was 64.
What鈥檚 particularly unsettling is the abrupt, unexpected nature of many such deaths. About 115,000 Canadians have a heart attack each year.
While the majority get medical treatment and survive, roughly a third succumb at home or at work without ever making it to hospital. A look at the underlying cause of heart attacks shows why.
There are two main forms of the disease. The more lethal type, called cardiac arrest, occurs when a piece of plaque 鈥� a fatty deposit on the inside of an artery 鈥� breaks off and blocks the flow of blood completely. This is probably what happened to Flaherty.
In these situations, the heart stops beating almost instantly. The only treatment is CPR followed by an electric jump-start from a defibrillating machine. But time is the killer here.
The patient鈥檚 chance of survival drops 10 per cent with every minute that passes. If help doesn鈥檛 come almost immediately, there is only the faintest hope of recovery. Of the 45,000 Canadians who suffer a cardiac arrest each year, 90 per cent die. That鈥檚 more than the number of fatalities caused by breast cancer, prostate cancer, lung cancer, traffic accidents and suicides combined.
The more common form of heart attack occurs when plaque builds up in the arteries. That places undue strain on the pumping muscles, and eventually damage occurs.
This is usually a gradual process, and there are often warning signs such as breathlessness or chest pain. Outcomes are better in these cases, because the heart doesn鈥檛 stop beating right away, and there is time for the patient to reach hospital.
As treatment options improve, the odds of surviving this form of heart attack have risen dramatically. Nevertheless, about 70,000 Canadians are stricken each year and about 16,000 die.
Given this enormous toll of death and injury, it seems natural to ask: Why can鈥檛 medical science do a better job of predicting heart attacks in advance? Why is there no screening program that might catch the disease before it becomes life-threatening?
It鈥檚 not as if the entire adult population would have to be tested. It鈥檚 an easy matter to identify individuals with heightened risk factors, such as high blood pressure, history of smoking, high cholesterol, obesity and advancing age.
Unfortunately, the only reliable diagnostic procedures are either too invasive 鈥� such as threading a flexible tube through the arteries 鈥� or too expensive, to be widely used.
As a practical matter, these tests are reserved for patients who already have symptoms.
But not every heart-attack victim experiences warning signs.
There is also the problem that cardiac arrest can occur in patients with only a small buildup of plaque. Yet most elderly Canadians have some plaque in their arteries.
It would make no medical sense to give several million people a heart-bypass operation purely as a precaution.
So what can be done? The sa国际传媒 Health Ministry is installing defibrillators at 450 public places around the province. These include arenas, playing fields, recreation centres and parks.
So far about one-third are in place. Anyone calling 911 from these locations is told how to use the device. That should help reduce the number of cardiac arrest deaths.
And community agencies like the St. John Ambulance service offer CPR training.
After that, the rest is up to us. Diet and exercise are important. So is an annual checkup to monitor blood pressure and cholesterol levels.
And if symptoms such as chest pain occur, call an ambulance, sit down and wait. Do not drive to the hospital.
