Hidden Epidemic: Heart Disease in America
Take One Step: A PBS Health Campaign
Hidden Epidemic: Heart Disease in America + Take One Step for a Healthy Heart with Larry King  

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Chapter 4 - The Golden Hour [3:51]

Why you should call 911 immediately at the onset of any symptoms. Can aspirin prevent heart attacks?

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Transcript: Chapter 4 - The Golden Hour

Why you should call 911 immediately at the onset of any symptoms. Can aspirin prevent heart attacks?

LARRY KING: Dr. Legato, what do we mean by the golden hour of a heart attack?

DR. MARIANNE LEGATO: I think it's quick reporting to experts.

LARRY KING: If you're going to have one, have it in the hospital.

DR. MARIANNE LEGATO: Have it as close to your doctor and the hospital as you can.

DR. STEVEN NISSEN: There's something important for everybody to understand. Believe it or not, with our advanced healthcare system, only 35% of patients that present to a hospital with a heart attack are going to the cath lab and getting the artery open within 90 minutes. We've actually launched in the American College of Cardiology a national initiative. We want at least 75% of patients to have what we call a door to balloon time, from the door of the hospital to the ballooning open of that artery, we want it to be less than 90 minutes in 75% of patients.

LARRY KING: And in all cases, if you're having unusual pain, go to the hospital.

DR. STEVEN NISSEN: Absolutely.

LARRY KING: Don't monkey around.

DR. PAULA JOHNSON: Don't wait.

LARRY KING: You got chest pain; it's a sign of something.

DR. MICHAEL ROIZEN: Embarrassment is no place near as bad as death.

DR. PAULA JOHNSON: But I would say even more importantly, it's not just chest pain. It's abdominal discomfort that doesn't go away. It's sweatiness. It's nausea. It's all of those things that we need to get the word out about.

DR. STEVEN NISSEN: Something that always has worried me is that people will drive themselves to the hospital. It's important when you have those symptoms to call 911. And let me tell you why. If the heart rhythm disturbance occurs and that ambulance crew is on the site, they can give you a shock and they can restore the heart rhythm.

We have defibrillators now on the walls in airports and in banks and other kinds of places, and people should learn about that. You can really save a life by defibrillating someone who has had a heart attack, whose heart has stopped, and save them right there on the spot. And bystander CPR is very important.

LARRY KING: Dr. Roizen, what about aspirin

DR. MICHAEL ROIZEN: Two baby aspirin or half a regular aspirin decreases risk of heart attack and stroke-- different in men and women a little bit but it's the same overall-- by about 36%. So it's really important. But don't do it because we're saying so, because you should see your doctor before you do any of these things, because there is some risk with aspirin.

DR. STEVEN NISSEN: We have to be a little bit careful here, Larry. And that is that if you had a heart attack, aspirin is mandatory. But only those individuals that are at high risk for first heart attack benefit from taking aspirin prophylactically. So that's why Dr. Roizen says see your doctor. It's not right for everybody.

LARRY KING: But it is a blood thinner, right? And you want thinner blood.

DR. STEVEN NISSEN: You want thinner blood but there are risks associated with that. And the current labeling of aspirin by the FDA is for use after a heart attack but not clearly in everyone before the first heart attack.

LARRY KING: I knew a cardiologist years ago; he thought that every American, male and female, over the age of 40 should take a baby aspirin every day.

DR. PAULA JOHNSON: Well that's a good point, because years ago we didn't have any studies in women to look at that. But two years ago studies from the women's health study were presented, and in fact aspirin is not helpful in women who are under the age of 65 for prevention. It's helpful if you've had a heart attack, but not if you haven't. So it is important to talk with your doctor about it, because newer data are pretty convincing.

LARRY KING: Dr. Roizen, sudden cardiac death. About half a million people die of it. Whack, gone. No pre-- is that preventable?

DR. MICHAEL ROIZEN: Well they've all got symptoms beforehand or signs, most of them. That is, they've had high blood pressure or they smoke or they have abnormal lipids or they have diabetes or one of the other things, or they eat horrible food or they don't have normal sex patterns. So they have things beforehand that should alert them.

But from the time of onset of the acute event, for that first hour, roughly 30% of people with a heart attack die. So you were lucky; you survived and you lived to be able to change not only your health, but a lot of other people's health through the foundation.

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