Heart attack

Heart attack may be Australia's biggest sudden killer, but the majority of people survive the experience. What you probably aren't aware of is what happens next; the costly medical treatments and months spent in rehab.

Every 25 minutes, someone in Australia dies from coronary heart disease, most often heart attack. While a healthy lifestyle and regular check-ups can help you substantially reduce your risk of cardiovascular disease, it by no means guarantees immunity. Sometimes, it's the people you'd least expect who are struck down.

Unless you are close to someone who's been in this predicament, you probably wouldn't have a clue about what happens next. Indeed, the financial stress many people experience after a heart attack is what prompted heart surgeon Dr Marius Barnard to pioneer trauma insurance in the 80s. The prevalence of critical illnesses, like heart attack, is what makes trauma insurance (also known as critical illness insurance) such an important component of the risk plan for many people.

Trauma insurance almost reducing your risks

While the Heart Foundation says no single cause of coronary artery disease has been identified, controllable risk factors include raised blood cholesterol, smoking, high blood pressure, lack of physical activity, obesity, excessive alcohol consumption, diabetes and stress. The corresponding statistics relating to these risk factors are scary:

one in two Australians over 25 has raised cholesterol levels(2)
three in 10 have high blood pressure(2)
one in two do insufficient physical activity(2)
one in four adults smoke(1)
two thirds of men and half of women are overweight or obese(1)
an estimated one million people over 25 have diabetes(1)
one in four people has three or more risk factors, placing them at heightened risk of heart attack(2)

Michael's Heart Attack Story

Michael Wicks was the last person you'd expect to have a heart attack. Yet early one Monday morning, Wicks was driving through the Sydney Harbour Tunnel when he felt a tightening/swelling feeling in his throat. Within minutes his arms 'felt useless'. He pulled into a breakdown bay and asked his 17-year-old son to drive him to nearby St Vincent's Hospital. "It was unlike anything I have ever experienced," says Wicks, who at the time was not yet 50.

Because Wicks had no known family history of heart disease and no other risk factors, it took a while for doctors to identify that he'd suffered a heart attack. The day before, Wicks had been kayaking solo on Sydney Harbour. Wicks was extremely lucky. He was treated within the 'golden hour' after the onset of symptoms, when many people die from heart attack, and he underwent angioplasty to insert a stent in his heart. "There was no muscle damage and I felt better than new," says Wicks. After the operation, Wicks could not walk 50 metres. But with supervised cardiac rehabilitation, it was only a matter of time before he was back to his old self and jogging 45 minutes a day.

Heart attack warning signs and trauma insurance

The symptoms of heart attack (myocardial infarction) can vary widely from one person to the next. An adviser, who had a heart attack earlier this year, likened his symptoms to a severe bout of indigestion. In Wicks' case, the discomfort was in the upper body rather than the chest.

Others experience more obvious symptoms, like pain or discomfort (tightness/pressure/heaviness) in the centre of the chest, which can range in intensity from mild to severe and come on suddenly or develop slowly. The discomfort can spread to other areas of the body, including the neck, throat, jaw, shoulders, back, arms and hands.

The Heart Foundation says people have described the feeling as being like "a steel band tightening around my chest", "an elephant sitting on my chest" and "a red hot poker in the centre of my chest". Symptoms usually last for at least 10 minutes and can be accompanied by breathing difficulties, nausea, vomiting, a cold sweat and light-headedness. The Heart Foundation recommends people seek urgent medical help if symptoms are severe, get worse quickly or last for 10 minutes, even if mild.

What causes a heart attack?
The most common underlying problem is atherosclerosis. This is a build-up of plaque inside the artery that suddenly breaks open and causes a blood clot. The clot in turn blocks the blood supply in a branch of one of the coronary arteries. Unless the blood flow is quickly restored with drugs or other procedures, part of the heart muscle can die.

What happens next?
First, the bad news: coronary heart disease is the most common cause of sudden death in Australia.

One in four Australians will die within an hour of developing their first ever symptoms, while 40% will be dead before the year is out(1). But the majority of people survive.

Surgery may be required to help rectify the problem; a coronary artery bypass operation, angioplasty (inserting a catheter containing a balloon into the narrowed section of artery) or the insertion of stents (an expandable mesh tube that acts as miniature scaffolding). Various medications may also be needed to help prevent another attack, including drugs to reduce blood pressure and cholesterol levels. Doctors can assess the extent of the muscle injury through blood tests, electrocardiograms (ECGs) and echocardiograms (ECHOs).

The Heart Foundation says that most people make a good recovery: "The heart is a tough muscle and heals very well, although healing can take some time. The injured heart muscle starts to heal soon after the attack and (this) takes six to eight weeks. Psychological healing is also important and this may take longer. There is usually a lot of fear and anxiety associated with having had a heart attack."

After being discharged from hospital, people usually attend cardiac rehabilitation outpatient programs, supervised by exercise specialists, usually for between four to 12 weeks. They may also need to make other lifestyle changes, such as improve their diet, reduce stress levels and quit smoking. While most people go back to work, often within four to six weeks after leaving hospital, this timeframe can be longer depending on the individual's level of muscle damage, rate of recovery and occupation. In turn, survivors remain at heightened risk of future heart problems.

Can't work?
Being unable to work for over 12 weeks and having no financial assistance can seriously hinder your rate of recovery. Upon suffering a heart attack or stroke you need to focus on rehabilitation, not financial stresses!

That's why it is important to take out appropriate life insurance and trauma insurance. Life insurance will pay a lump sum to your nominated beneficiary (or estate) if you die, and trauma insurance will pay a lump sum payment on diagnosis or occurrence of a covered trauma such as heart attack or stroke.

Heart attack help available through trauma insurance

Speak to an xLife specialist financial adviser today to request a trauma insurance quote to help cover medical and living costs associated with serious illnesses such as heart attacks or strokes.

Source:
1 "The shifting burden of cardiovascular disease report 2005" by Access Economics and the Heart Foundation
2 Heart Foundation Information Sheet, April 2008

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March 2009