DON’T IGNORE THE WARNING SIGNS Every day, across the United States, hundreds of African Americans die simply because they have ignored the warning signs of coronary artery disease (CAD). This is a message that has to be repeated over and over again. And, though we’ve touched on these signs before, they bear repeating:

• •    Pain in the center of the chest-or, mOJ,~ commonly, a pressure experienced as a tightening vice, or as an elephant sitting on the chest. This sensation is felt just under the breast bone, sometimes to the left side of the chest under the nipple.
•     Sometimes, a persistent pain in the left or right arm. Such feelings of pressure often occur while the victim is exercising, running, or out in the cold working, as Mr. Samson was. The pain can be urgent enough to require the victim to slow down or stop what he or she is doing.
•     Any chest pain or pressure that goes down the left arm or up to the throat, or jaw or back, or even to the lower back, and that lasts ten minutes or more.
•   Shortness of breath.

While these symptoms are common to most victims of heart disease, regardless of race, studies show that African Americans are less likely to attribute the symptoms to heart problems. True, the symptoms could simply be the result of an especially bad day or plain old age. But wisdom requires that, when the symptoms per-

sist, they be taken seriously. Only c. doctor, by an appropriate medica: examination, can determine hOIthreatening they are. The sooner thsymptoms are addressed, the bette: the chance of early diagnosis, medic, intervention, speedy recovery, an ;
extended life.

Shortness of breath, heavy breathing, and the feeling ofbeir: ~ hungry for air mean that the heart isn’t doing its job. And the> are other signs:

•   Swelling of the feet or legs
•     Feeling tired all the time and lacking energy
•     Loss of appetite

These last signs may be symptoms of Congestive Heart Failure, a condition we will take up in chapter 7. For the moment, it is enough to say that these symptoms of CHF mean your heart isn’t pumping as efficiently as it should. It isn’t doing its work properly because it isn’t receiving the blood it needs. It isn’t receiving the blood it needs because the arteries that supply the blood are dogged.
The causes of CHF are various. It can simply be a late stage of coronary disease, or the result of high blood pressure or valve problems in the heart. But it can also be caused by viral or bacterial infection or alcohol abuse. Its symptoms too can vary. vVeight gain, shortness of breatl: poor energy, and other unspecific symptoms can be indicators Unlike coronary disease, CHF does not provide such specific symptoms as chest pain. The essential point is that coronary disease results from a blocked artery or arteries, while CHF mean: the heart is not working well because some of the heart muscl: is dead.
But the most common reason for heart failure is underlyin; coronary disease, which is ignored by thousands who suffer fror; symptoms every day, particularly African Americans. Only third of African Americans who su=• fer from the symptoms we”. described will attribute them to tl: c heart, whereas half of the white pOi’” ulation will do so. Part of the prot• lem is lack of knowledge-which tl: book was written to address. B~’ there are other problems: fear of knowing the truth; a gener. paranoia about doctors, nurses, hospitals, and, indeed, a dee. mistrust of health care providers; and a lack of insurance or access to health facilities.

We address the fear and mistrust later in the book. Our 01′ attitude is that knowledge brings power. The earlier the diagn sis, the better your chances. The only way to know if the pain ‘. discomfort you experience in the chest area is a sign of corona .. disease is to get a complete medical workup-that is, a comple medical examination, including an EKG, a chest x-ray, the app:” priate blood or other lab work, and/or invasive or noninvas: cardiac testing. Such a procedure often means the differer . .: between life and death. Lack of knowledge, poor access to health. facilities, and paranoia among black Americans-though they can have real social and economic causeshave too often led to inadequate treatment, treatment that comes too late, and deaths that could have been avoided.
Let’s change that-starting here, starting now. Here’s another lesson that could help you to live a longer and more productive life. The heart is a muscular pump that, like all muscles and organs of the body, needs blood to survive. Blood vessels around the heart deliver blood to the heart muscle. When the heart doesn’t receive enough blood, heart symptoms occur.

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