Minoru Kameoka writes:

        1) We should inform him of the fact that heart attack is the single largest killer of males and females in the developed world. And a sudden death occurs at from four to six times the rate of the general population among people who have had a heart attack. Besides this fact, we must explain the details of myocardial infarction. To illustrate, a myocardial infarction occurs when the heart muscle does not receive enough oxygen, because of a temporary narrowing of one of the coronary arteries that supply it with oxygen-rich blood. The area of heart muscle that does not receive blood begins to die. The seriousness of a heart attack depends on how much of the heart is affected. Therefore, he must go to a hospital as soon as possible when he has another heart attack.

        On the other hand, he should know the risk factors about another myocardial infarction too. He has five factors for coronary disease: cigarette smoking, high cholesterol, physical inactivity, being overweight, hypertension. Because a coronary disease has a close relation to a myocardial infraction, he must avoid these things. Also, he had better know that a myocardial infarction occurs during physical exertion or emotional stress.

        2)I think the reason why he delayed seeing a doctor was he was not sure it was a heart attack. To tell the truth, heart attack symptoms can be vague. Therefore we should suggest several things, for example, getting prompt treatment for a heart attack can be lifesaving. If he experiences one or more symptoms of a heart attack, he should act quickly and take the following steps. "At first, sit down or lie down. If symptoms persist for 2 minutes, call your local emergency telephone number and say you may be having a heart attack. Leave the phone off the hook so that medical personnel can locate your address if you should become unconscious. If you have nitroglycerin tablets, take up to three pills, one at a time every 5 minutes. Ambulances are well equipped to provide emergency care for people who are having heart attacks. It is usually better to have medical personnel come to you than for you to start off for the hospital. If you can get to the hospital faster by car than by ambulance, have someone drive you. Do not drive yourself--it could be dangerous. "

        The best thing he can do, overall, when he has another heart attack is to go to the hospital.

        3) Mr. O, I think, should be sure to follow his regular doctor's instructions. Stay on his medication. He would be given some tablets, nitroglycerin probably. Nitroglycerin is a drug that reduces the pain of angina by widening blood vessels to allow more blood to reach the heart muscle. He should place nitroglycerin tablets under his tongue whenever he feels the pain of angina or anticipates it coming on. People who have angina should have nitroglycerin with them at all times and should take it immediately if they feel pain in their chest.

        4) As mentioned before, high blood pressure is one of the large causes of myocardial infarctions. So, after provisional cures, for instance, medication, he should take other cures. Dietary and lifestyle changes also may help control high blood pressure. About lifestyle, he should stop smoking completely. And about diet, he should be moderate in drinking and eating. Some people with mild hypertension can lower their blood pressure by reducing sodium in their diet. Does Mr. O think he takes in too much salt? If so, he needs to change his diet and eat less salt. Also, excessive alcohol intake (more than two ounces daily) raises blood pressure in some people and should be restricted. Blood pressure also returns to normal in many obese people when they lose weight. In fact, he has 20kg extra weight too! So, he should lose weight. Increasing physical activity can reduce blood pressure in some people too. I'd like to suggest that many obese people should do swimming as a method of exercise, because swimming is good exercise for the whole body and doesn't injure the knees or waist. And as a consequence, many people can reduce their weight without burden on bodies.

         

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