Experts available to comment on risk of sudden cardiac death in 30 days following a heart attack

A new study in the November 5th 2008 issue of JAMA finds that during the first month after a heart attack, patients may have an increased risk for sudden cardiac death.

"The study justifies why we are so aggressive in treating patients during and after myocardial infarction," says Howard S Weintraub, MD, FACC, clinical director of Center for the Prevention of Cardiovascular Disease at New York University Langone Medical Center. "If you survive the first thirty days, your risk is lowered over the next months to years."

According to Dr. Weintraub, patients at risk for sudden cardiac death during the first month are those with recurrent chest pain (similar to the symptoms they had with their heart attack) and heart failure. "Identification of people at risk is very important," says Dr. Weintraub. "Patients should be very vigilant reporting symptoms of shortness of breath, especially when lying down, ankle swelling, recurrent symptoms of chest pain, symptoms similar to initial heart attack experience, or problems during exertion or at rest." They should also understand that using the medications that were prescribed on discharge may be influential in preventing recurrent ischemia and the risk of sudden cardiac death.

The use of defibrillator vests may be a possible preventive tool for high risk patients during the first 30 days following a heart attack, according to Dr. Judith S. Hochman, M.D., clinical chief of cardiology and director of Cardiovascular Clinical Research at New York University School of Medicine. "Implanted defibrillators have not shown reduced risk of sudden death if implanted within 30 days. There is an ongoing NIH funded trial testing these vests. NYU has been using external vests for selected high risk patients during the first month."

Tips for Prevention:

• Listen to your body
• Have appropriate careful surveillance by your physician
• Take your prescribed medication to reduce future cardiac events (that may include aspirin, Plavix, high dose statins, Beta blockers, ACE-inhibitors or angiotensin receptor blockers)
• No smoking
• Watch your diet
• Consider starting an exercise program -consult your physician first
• Possible use of external defibrillator vest