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PTSD strikes one in eight heart attack patients
June 20th, 2012
05:33 PM ET

PTSD strikes one in eight heart attack patients

PTSD – posttraumatic stress disorder – usually is associated with military personnel traumatized by combat or people who’ve been victimized by violent crime or sexual assaults.

But new study finds that one in eight patients develop PTSD after experiencing a heart attack or other major heart event. The study, published online in PLoS One, also reveals that heart patients who experience PTSD face double the risk for another heart event or dying within one to three years, compared to heart patients who do not experience PTSD.

Scientists from Columbia University Medical Center performed the first metanalysis of studies examining PTSD induced by major heart events. The studies included almost 2,400 patients who experienced acute coronary syndrome or ACS, an umbrella term medical professionals use to describe any condition that reduces blood flow to the heart, including heart attacks and unstable angina.

“Everybody is expected to have some disruption after a life threatening event such as a heart attack,” explained lead study author Donald Edmondson, assistant professor of behavioral medicine at Columbia University Medical Center, “ but after a month we expect people to mostly get back to normal.” Edmondson said their research focused on studies of patients who experienced symptoms of PTSD more than one months after their heart event.

“These studies measured PTSD symptoms – intrusive thoughts about the heart attack – out of nowhere… that sort of fight or flight response to these memories. People also have nightmares about the event, they have sleep disruptions, they actively avoid thinking about the heart attack, they try to manage their thoughts,” said Edmondson.

More than 1.4 million people in the U.S. are discharged each year from hospitals after suffering acute coronary syndrome, explained Edmondson,  If 12% of those patients experience clinically significant symptoms of PTSD, that means that 168,000 patients could experience PTSD each year after heart events.

While medical professionals are keenly aware of the association that has been shown between depression and heart attacks, Edmondson believes that making patients, their families and medical professionals aware of the incidence of PTSD after heart events is critical.

Edmondson said when he’s discussed findings about PTSD with cardiologists, they’ve told him 'I thought these were funny depression symptoms. I knew there was something wrong here but I didn’t have a language for it.'  Edmondson said that while PTSD and depression often travel together, "PTSD symptoms are unique – the experience of intrusive thoughts, the nightmares, the inability to shake thinking certain thoughts, the fight or flight symptoms are unique to PTSD. For a patient or a cardiologist who’s not looking for PTSD, once you know the symptoms, they sort of jump out and they’re unique to PTSD."

“Despite the variation in the estimates of the prevalence PTSD appears to be a reasonably common occurrence after ACS and seems to be associated with worse outcomes,” said Dr. Gordon F. Tomaselli, president of the American Heart Association.  "Further study is warranted but practitioners need to be alert to the possibly of PTSD after ACS and should institute treatment.”

“Physicians and patients have to be aware that this is a problem. Family members can also help,”  said Edmondson.  "There are good treatments for people with PTSD,” Edmondson noted, explaining that the best treatment is an “exposure based talk therapy," in which the patient talks about the traumatic experience, reliving it in an effort to desensitize them to the event.


soundoff (54 Responses)
  1. BoFo

    I see absolutely no redeeming value in this article. As if cardiac patients don't enough to worry about, this information serves no purpose other than giving them something further to stress over.
    To me, this is just another example of "tabloid journalism" that is prevalent everywhere.

    June 21, 2012 at 10:33 | Report abuse | Reply
    • lawnninja

      I just don't see your point... How is this "tabloid journalism"? Awareness does save lives. I would rather be aware, particularly after a major health event, of the potential for PTSD and also have access to resources about healthy management of the experience of and after that health event, to better shape my response and processing of it, or to recognize the signs of PTSD and not get mired in self-defeating actions thinking that my post-traumatic experience means there is something fundamentally faulty with me, or a loved one. Too many people go through things like PTSD and depression and don't recognize it and don't treat it because of stigma. Would you also suggest that new mothers shouldn't be exposed to information about postpartum depression because they are under enough stress? I think the information, and the lifting of stigma and judgement, can only improve the outcome for the patient, their family, their friends, the community, the healthcare system, etc... Why suggest the "tabloid" label?

      June 21, 2012 at 20:27 | Report abuse |
    • Sandy

      I was just diagnosed with PTSD. My family said i chaned, i was angry at the drop of a hat into full blown rages. It triggered a sexual experience from childhood that i thought i put away for 30 some odd years. I did not. My son stopped talking to me because i was crazy he thought. I am not. This is stuff people were not looking for and i sure hope it helps someone else. I had a heart attack, triple bypasses and this all was triggered.

      June 22, 2012 at 13:22 | Report abuse |
  2. Mom of 4

    PTSD can attack any one at any time, because it is brought on by a traumatic event. I've seen lifeguards who've rescued small children from drowning have nightmares for a week or 2 afterwards. A spouse who has just put their partner of 40+ years into a nursing home because they can't care for an Altzheimer's patient often experience PTSD. Women who have had abortions and later give birth or experience fertility experience PTSD much more than what is reported in the media because it's not politically correct.

    June 21, 2012 at 10:34 | Report abuse | Reply
    • cel pescadera

      I am a veteran with over 30 years of military service. i have PTSD and Cardio Arterial Disease at the same time. my PTSD actually preceded my heart illness just like my DM2 and Sleep Apnea. It is not uncommon for cardiac patient to have PTSD. The experience of having a CABG itself is very traumatic.. just by thinking of it–you will develop a somatic symptom , an anxiety disorder which is the very symptom of PTSD. However you don't need to be a veteran to have PTSD.. some of the traumatic stressors that I have are acquired off duty though some are combat related. PTSD can hit anyone regardless of who are.

      June 21, 2012 at 18:46 | Report abuse |
  3. jane

    As someone who has ptsd from abuse I find this absurd.

    June 21, 2012 at 11:40 | Report abuse | Reply
    • No wire hangers

      Hmmmm.....I guess some people so treasure their status as a victim that they don't even want to share it with anyone else.

      June 21, 2012 at 12:11 | Report abuse |
    • Casey

      Jane you have no idea how devestating a heart attack can be.

      June 21, 2012 at 12:14 | Report abuse |
    • lawnninja

      As someone who has experienced it from abuse and from traumatic medical events, the difference is in the event that causes PTSD, and not in the resulting PTSD. Of course, the PTSD experience and how to treat it differs from person to person, and possibly there is more treatment and experience similarity between people who experience one type of even or another, but that doesn't change the fact that they all exist under the umbrella of PTSD. I do think that the "source", in my personal experience, has resulted in different triggers for PTSD related events and different ways of managing, but regardless of the initial experience causing the PTSD, the PTSD is pretty much the same as far as how paralyzing and how damaging it can be.

      June 21, 2012 at 19:51 | Report abuse |
    • Grey's anatomy

      Jane,

      How ridiculous. I suffer from CPTSD from childhood s ex ual abuse and I thought this article made complete sense. Do you think that you have the corner on the market for PTSD?

      June 22, 2012 at 11:09 | Report abuse |
    • Sandy

      Ignorance really is bliss, is it not????? Not obsurd at all!

      June 22, 2012 at 13:23 | Report abuse |
    • Rose

      Nothing is absurd about abuse and PTSD! After 22 years with women who had been abused or were the perp. You suffer this as it not a NORMAL event....speaking as mother, wife and counselor – nurse educator.

      June 23, 2012 at 15:19 | Report abuse |
  4. Portland tony

    Just what defines PTSD? Is it just a somewhat normal reaction to an uncontrollable traumatic event? People who are physically damaged or injured experience it. Others, who witness injury to or death of others experience it. Some are diagnosed who have had a near death experience but have suffered nothing more than fright. Is then PTSD a natural response? Puzzles me!

    June 21, 2012 at 12:40 | Report abuse | Reply
    • Roscoe Chait

      You bring up a good point. PTSD is a normal and natural reaction to extreme stress, feeling cornered and helpless, with no way to escape. It is not mental illness. There a number of criteria that define PTSD, but the first 2 state that you must have experienced or witnessed an event that involved actual or threatened death or serious injury–and that you react with extreme fear, helplessness or horror. Be aware that PTSD cannot be diagnosed until 30 days have passed after the event that caused the problem. (Sometimes a series of traumatic events can lead to PTSD). During that first 30 days, the response is called "Acute Stress Disorder," and the symptoms are almost the same as PTSD. After 30 days, if the symptoms persist, then and only then can the problem be diagnosed as PTSD. (Diagnostic and Statistical Manual of Mental Disorders or DSM IV-TR). A good book that explains it all is "CopShock (2nd Ed), Surviving Posttraumatic Stress Disorder (PTSD).

      June 21, 2012 at 12:51 | Report abuse |
    • dt

      I think PTSD is an subjective opinion about what is thought to be an objective observation of an individual's response to a crisis. Some health care professionals seem to label any response they do not expect or understand as PTSD or the patient being traumatized. People handle uncontrollable negative events differently. Uncontrollable events are anything that a person cannot escape by themselves – like some kinds of abuse, violence where the person cannot flee, or a medical condition the person is powerless to deal with themselves. If you have a 'heart attack', you realize that it is very serious – and can kill you – but you are trapped in the illness and totally at the mercy of professional care. You cannot just take an aspirin and walk it off. People behave differently to this. Some people cannot get the event out of their mind, some just forget it and move on. It is a real reaction for some and it is good for others to understand that it happens.

      June 25, 2012 at 08:18 | Report abuse |
  5. Roscoe Chait

    Heart attacks can lead to PTSD if the person involved reacted with extreme fear, horror or helplessness. A good book on PTSD is "CopShock (2nd Ed), Suriviving Posttraumatic Stress Disorder (PTSD)." Primarily a trauma survival/recovery book for cops, military and emergency services people, it helps civilians, too, prevent PTSD or manage its symptoms.

    June 21, 2012 at 12:43 | Report abuse | Reply
  6. will

    interesting

    June 21, 2012 at 13:42 | Report abuse | Reply
  7. BA

    Anyone can develop PTSD if he/she experience a traumatic-enough event and if it is not acknowledged it can really ruin your life. There are many alternative therapies that can help with PTSD such as Kava, art therapy and meditation. To learn more go to http://www.naturalstandard.com

    June 21, 2012 at 14:18 | Report abuse | Reply
  8. clb

    I don't comment on sites but decided too on this one. I was abused by my ex husband in everyway possible. I was sexual preyed on by a 35 yr when I was 12. I also had someone break into my apartment an attack me. My very own brother abused me sexualy. Now I have PTSD. It just hit me one day. Panic attacks, nightmares,deppresion, a sucide attempt. You name Ive had it. I have tried therapy its never worked. I feel better after being dignosed. I take everyday as it comes the good an bad. You can live with this. My family is understanding as my husband. looking back after my life nearly chocked out of me. Im happy to be here, an I forgive those who have hurt me, I know god has bigger plans for me. WE are the same as you, we suffer more though.

    June 21, 2012 at 14:29 | Report abuse | Reply
    • lawnninja

      Glad you are here! (hugs)

      June 21, 2012 at 20:09 | Report abuse |
  9. joebiwanbaloney

    PTSD is becoming yet another over diagnosed condition, like ADHD or autism. Doesn't it stand to reason that, if you had a heart attack, you'd be worried about having another one? That's common sense, not PTSD! Reminds me a bit of someone I knew, who helped a parent thru a terminal illness, and then said she had PTSD. While I can't imagine the pain of such an event, calling it PTSD after the fact trivializes the suffering of soldiers who've been thru battle or victims of violent crime and abuse.

    June 21, 2012 at 15:08 | Report abuse | Reply
    • lawnninja

      Do you have or do you know anyone who lives with ADHD or autism? If you did, you wouldn't be spreading the myth of overdiagnosis that does more harm to kids and adults than possibly doing any good.

      June 21, 2012 at 19:58 | Report abuse |
    • lawnninja

      PTSD is a very broad umbrella, and the differentiation by causes is more likely to happen in diagnosis and treatment/management. However, I would never suggest that giving what someone might experience as a result of a traumatic medical/cardiac event trivializes what abuse & violent crime survivors and soldiers, witnesses to war acts, experiences. Trauma is very personal and traumatic events, and the aftermath, should be respected instead of sorted by outsiders who couldn't possibly comprehend (due to the nature of the trauma experience and the individual, and internalized manner of processing the trauma during and after) what the PTSD experience is truly like for another person. I think veterans should be given more support for PTSD than they are, but I think awareness of PTSD across all causes mentioned, is more important, to help loved ones who might be experiencing it, than passing judgement based on cause...

      June 21, 2012 at 20:07 | Report abuse |
    • Sandy

      Just where did your medical degree come from? I am medical. Everyone is also different.....get a grip!

      June 22, 2012 at 13:25 | Report abuse |
    • Sandy

      Anyone can have PTSD not just soldiers, educate yourself, look it up for pete sakes!

      June 22, 2012 at 13:29 | Report abuse |
    • Annie

      After 2 major heart operations (the first one at age 30) you really don't know what you are talking about. You do relive the experience over and over and then with the help of family and friends who noticed a definite change in me, I got myself back together. I was prepared for the second op. and had no problems. So, I agree that sometimes the term is over used, but don't critisize unless you have been there.

      June 23, 2012 at 21:29 | Report abuse |
  10. bob

    I agree with the othere on this quit trivIalizing others pain such as vetrans or rape victims pain and suffering

    June 21, 2012 at 15:46 | Report abuse | Reply
    • lawnninja

      Might I suggest that everyone stop trivializing everyone's experiences? Saying one trivializes the other does just that and does more harm than good. Nobody will debate the hell of abuse or war, but neither should anyone trivialize others experiences of life threatening/near death experiences/medical trauma.

      June 21, 2012 at 20:12 | Report abuse |
  11. coast watcher

    I have some advice for anyone having a heart event.Get into cardiac rehab a.s.a.p.I had 3 stints put in Jan. and started rehab in Feb. at a local hospital that has a cardiac rehab unit. Insurance paid for the first 12 weeks. 3 Sessions per week.It was amazing how much better I Feel.I finished 12 weeks and have started another 12 weeks. My energy level has doubled and I feel really great.I am woking out 3 times per week and am toning flab back into muscle. And I'm almost 76.

    June 21, 2012 at 19:37 | Report abuse | Reply
    • really

      Wow. Good for you!
      Best wishes for continued good health.

      June 25, 2012 at 12:41 | Report abuse |
  12. lawnninja

    I am wondering if the comments suggesting that medical trauma patients having PTSD "trivializes" the experiences of people who have been abused, victims of violent crime, and soldiers, has anything to do with people projecting blame and stereotypes onto the faceless patients who had major cardiac events that had data contributed to the study... Would the folks commenting still think the PTSD diagnosis would trivialize the experiences of soldiers/abused individuals/etc if the subjects of the study were breast cancer survivors or survivors of another type of cancer that is seen mostly as the luck of the draw or faultless? Just curious...

    June 21, 2012 at 20:19 | Report abuse | Reply
  13. tapati

    I've had both–physical abuse and heart attack/surgery plus a major earthquake thrown in. My triggers are different for the various traumatic events but it's clear to me that I have ptsd for all three. There are a lucky few who don't react to trauma by having ptsd. It is ONE possible normal reaction to trauma and we still have a lot to learn about why some people are more vulnerable. Perhaps personality types or childhood events make one more prone and another less so. I've heard a lot of good things about EMDR therapy (google it if you're curious) from people who've been helped by it. As time goes on the flashbacks lessen in intensity and it's easier to talk myself through them. Oh and despite ptsd and depression I am nearly 11 years post-CABG. I credit my loving family (love really does help survival rates) and my lifestyle. So don't feel doomed if you have heart disease and PTSD! Sending love to my fellow survivors–of whatever you've survived, not just heart disease.

    June 22, 2012 at 16:37 | Report abuse | Reply
  14. alsband

    It is clear that a heart attack and open heart surgery are quite trumatic, but the power of being positive can beat a lot of the
    issues of having one. Getting back to normal life style, eating well, enjoying life, and being positive about one's outlook on life can push heart issues away. Too many think it is over once they have had an attack. As long as stroke issues don't affect functionality then the mind and body can control the issue. 11 years after my triple by pass and new aorta tube put in a year ago I still work full time, travel the world for my company, and more importantly to my well being play in a rock n roll band til 2 in the morning. Focusing on what you like and especially what you want to do in life should still be limitless. Too often we are the limitation to healing ourselves.

    June 22, 2012 at 16:43 | Report abuse | Reply
  15. tapati

    I did all of the positive things following my heart attack and surgery (actually the surgery came first, heart attack later that day). You can't wish away PTSD as any abuse survivor can tell you. As I said, we don't know all there is to know with regard to why some people are more vulnerable to PTSD than others. I suspect that having PTSD from abuse made me more vulnerable. Your mileage may vary. It is good to know that PTSD isn't an automatic death sentence because here I am, it will be 11 years on August 30.

    June 22, 2012 at 17:44 | Report abuse | Reply
  16. mac101

    Knowing how traumatic a heart attack and a stay in the ICU can be, the more fascinating question should be – why did the other 7 out of 8 NOT get PTSD?

    What the study didn't look at is how many heart attack patients already had PTSD from an earlier trauma, and did the PTSD connected to the earlier trauma influence the development of heart disease?

    June 22, 2012 at 22:47 | Report abuse | Reply
  17. Complex PTSD

    A LOT more education and support for families of terminally ill patients and people with PTSD and similar illnessess would be VERY HELPFUL to a LOT of people, cuz it seems half the triggers and abuse comes from the pure ignorance of the matter of PTSD not only in the general public, but in most of the medical and psychological/psychiatry field as well. PTSD is a prime example of the corruption in the medical et. al. field as well as government and higher education, as it is the most common mental illness and the least understood, studied, or recognized in terms of support and understanding human condition, because by doing so – the great war machines would not be so able to be so corrupt and readily supported by the populace whom would be better educated to fully understand and put words and actions to the concept of peace, tolerance, and nonviolent or nonviolence producing communications. PTSD is dollar corruption in the medical et. al. fields, with the governments knowledgeable and deliberate support. Pills are not the answer btw, but the money from the pills feeds the corruption that leads the masses.

    June 23, 2012 at 02:04 | Report abuse | Reply
  18. Multiple Traumas

    As one who got the diagnosis from several traumatic events, I would say the PTSD from having 2 heart attacks affects my daily life more than any of the others. I think anxiety of any kind is hard on the heart, though. When you have a panic attack, your adrenaline surges, just like it does when a person does meth. I believe pills are more like putting a band-aid on a wound that hasn't stopped bleeding. Therapy, EMDR, in particular, is like slowly cauterizing the wound. I'm a very solution-based person though, and would never condemn those who need meds to get relief.

    June 23, 2012 at 17:18 | Report abuse | Reply
  19. Ann Wilson

    I have PTSD and I have studied it. The upshot is this: If you has an event that terrified you or horrified you,
    you are likely to end up with PTSD. Now, what may terrify one person may seem laughable to another.
    It doesn't matter what the event was or whether someone else would not have reacted as you did. What
    matters is how you felt during the event. Those powerful feelings become hardwired into your brain. Don't
    judge someone elses PTSD. If they say they have it, they probably have it.

    June 23, 2012 at 18:22 | Report abuse | Reply
  20. Ann Wilson

    Excuse me, I meant if you had and event.

    June 23, 2012 at 18:23 | Report abuse | Reply
  21. Newyorker

    Good to know these things. I think articles like this that inform and educate readers are better than the same old meaningless frivolous tabloid articles CNN generally publishes.

    June 24, 2012 at 09:04 | Report abuse | Reply
  22. Nunyurbudiness

    I agree that stress and traumatic experiences in the eye of the beholder. I had a near death experience 4 years ago – I had a cardiac arrest , I went into V-tach – almost Sudden Cardiac Death if it weren't for devibulators. I had a rather spiritual experience while I was in V-tach. While is was scary physically to be completely healthy then suddenly dead, it was also very stunning and rather miraculous, like witnessing ones own death and resurrection. I have an implanted devib device now, the idea of getting shocked is scary. But overall, I guess I wasn't traumatized so much as the next person might be during a cardiac. event. I was very amazed to see a glimpse over to the other side. To each his own.

    June 24, 2012 at 19:42 | Report abuse | Reply
  23. Dean

    Twelve years ago I donated my kidney to my daughter, she was 11 at the time. She lost my kidney a year later. I've watched her almost die over the past 12 years a number of time. I had my first heart attack in 2004 one of three, PTSD makes complete sense to me. I've mention this prior to my Doctor's, they weren't aware, thanks for the article.

    June 25, 2012 at 12:17 | Report abuse | Reply
    • curious

      My sympathies. She is lucky to have you as a parent. I am wondering though, what did the doctors do for you to help alleviate your PTSD suffering in conjunction with their interactions with you? Were they able to assist your pain and suffering in any way, or did they simply continue to aggravate your symptoms and ignore your requests for assistance with the PTSD?

      June 25, 2012 at 14:28 | Report abuse |
  24. rdstrahs

    I see relevance in this and can relate it to other disorders as well. Those of us with disorders such as Epilepsy, who work in high stress jobs (such as myself in IT Management), have the same symptoms and effects to our bodies as anyone else with PTSD. The largest risk factor for relapse seizures for myself is stress, and I am in a high stress Environment for 40+ hours a week, so the relationship is very similar to what these Cardiac Patients are experiencing with risk of potential Heart Attacks. Also, patients who have PTSD from a traumatic event in their life, are 10 times more likely to have seizures or as they call them pseudo-seizures caused by stress. My seizures are caused by brain trauma at a young age that accured in a traumatic incident that my minds remembers somewhere deep inside (since I was an infant at the time). If I would call it PTSD from the event, I doubt it, but would I call myself living with PTSD from the lifestyle and stress of worrying about having another seizure in front of my work colleagues or not being able to drive for another 6 months if I have one, with my soon to be 1 year old daughter around. That I believe is more that enough to drive someone to the brink of PTSD symptoms.

    June 26, 2012 at 07:46 | Report abuse | Reply
  25. RN QUITS USA

    Sure attack the cardiac RN enough so that she feels that she died due to the stress that monster american terrorists caused and was judged by them and sent to now hell 36! They should have written a book on MY COURAGE. MY STRENGTH. MY ABILITIES, instead of exploiting and hiding the truth about what they all are and do. Is that why those birds keep crapping on me? Because everyone states that its good luck but getting birds crap on your right shoulder all of the time makes you wonder, "what is up with that!" If there is a land of good vs. evil than which is good, them crapping on the right side or the left side of my shoulders?

    June 28, 2012 at 00:05 | Report abuse | Reply
  26. RN QUITS USA

    You army crashed your trucks.
    You marines I pummeled.
    You coast guards better shut up.
    You air force crash your planes.
    You navy sink your ships.
    Your PTSD upon american women and children, SUCKS American abnorms.
    Hope you got my message today!

    June 28, 2012 at 00:08 | Report abuse | Reply
  27. RN QUITS USA

    Maybe its a balance of Normal Sinus Rhythm. I want my rhythm, phoenix and daisy back, LIARS!

    June 28, 2012 at 00:12 | Report abuse | Reply
  28. thethingis

    the thing is first a person is traumatized.

    then the person suffers illness such as ptsd from the trauma.

    then the person is traumatized further by the stigma and brutality committed against mentally ill persons by most everyone in society, especially those who are paid to work with patients who may exhibit signs of mental illness.

    so the person is re-traumatized over and over again due to the fact that the person got sick to begin with and society, being what it is in terms of knowledge of ptsd, will just want the person dead or gone or eliminated from the gene pool.

    but actually ptsd is a part of intelligence gone awry, and the awryness brings changes – both good and bad, yet still awry.

    like heart or stroke patients, their vary illness causes them to sometimes be irritable, etc.

    and then they get 'smacked' or judged for their behavior, when in actuality, they are having a heart event or stroke or kidney failure, or .... the list goes on.

    then they still get no relief from the ptsd, that then turns into cptsd or worse.

    and the dmv probably doesn't even address this in a logical manner, because then there would be no need for so many wars, prisons, meds, etc., etc.

    major overhaul of the whole medical field needed, for sure. Most doctors and psychologist/psychiatrist aren't even trained in ptsd.

    June 28, 2012 at 03:21 | Report abuse | Reply
  29. Yair

    Addiction to heroin in that the user is it's slave will do abtuolsely anything to get the next hit .addiction will take your money, your mind, your family,,and even your life .Ibogaine is the miracle substance that overwhelms the system, by-passes all withdrawls, creates a new neuro transmitter,,,,,,and brings the person to pre-addictive state,,.I have personally witnessed the tranformational effects of ibogaine and am committed to raising awareness to aid in saving the life of others

    September 14, 2012 at 00:32 | Report abuse | Reply
  30. Filiberto Kirschenbaum

    PTSD can take a very long time to heal. You will need some professional help to manage it. .;",`

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    October 7, 2012 at 12:32 | Report abuse | Reply
  31. Johnson Horney

    The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If you have coronary artery disease, those arteries become narrow and blood cannot flow as well as they should. Fatty matter, calcium, proteins, and inflammatory cells build up within the arteries to form plaques of different sizes. The plaque deposits are hard on the outside and soft and mushy on the inside.'

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    March 13, 2013 at 14:58 | Report abuse | Reply
  32. Nilda Iannelli

    The Vietnam War is one part of our dark history, an infamous conflict during the early 70s. This is a military event between the Communist forces of North Vietnam supported by China and the Soviet Union, and the non-communist forces of South Vietnam which was supported by the United States. It was a fierce battle between the Vietcong forces and the U.S Troops which ended after the Fall of Saigon in April 30, 1975..

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    March 31, 2013 at 02:53 | Report abuse | Reply
  33. Omegahospitals

    The initial experience causing the PTSD, the PTSD is pretty much the same as far as how paralyzing and how damaging it can be.
    Come to my Home Page... http://www.omegahospitals.com/

    July 26, 2013 at 06:28 | Report abuse | Reply
  34. Fran Fukuroku

    Coaching is actually valuable, It transformed my existence

    http://www.thefrenchhypnotist.com

    January 31, 2014 at 23:12 | Report abuse | Reply

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