March 28, 2009 -- Hurricane Katrina destroyed Madeline Saavedra's home in 2005. But it was 14 months later that the storm could have cost her her life.
Saavedra, 58, who resides in St. Bernard Parish, La., one of the hardest-hit areas in metro New Orleans, was evacuated during Katrina as her home flooded with 12 feet of water. She and her husband returned seven months later to find the entire neighborhood, including their house, destroyed.
They moved into a FEMA trailer on their front lawn to begin the task of shoveling out the three feet of mud the storm left inside their home. But about five months into the process, Saavedra began complaining of pain on the right side of her body and between her shoulders.
"I thought, 'Gee whiz, I must have picked up something [heavy] that I shouldn't have,'" Saavedra recalled.
But the pain worsened to the point where she could no longer lift her right arm. One day in October 2006, she finally took a break from the stress of rebuilding the home she had lived in for 25 years and checked into the emergency room at Tulane Medical Center.
Further testing revealed that she had suffered a heart attack and still had several blockages in her arteries. Saavedra was immediately taken in for open-heart surgery, a triple bypass operation.
"I think that might have pushed it over the edge, the stress of it all," Saavedra said. "[There were] so many people who we knew who drowned or died or moved away, moms and dads and young people, people who weren't sick before the storm. It took a lot from us."
Disasters Have Real Health Consequences
New evidence finds that Saavedra is not the only one whose stress levels in the aftermath of Katrina may have led to a heart attack. Researchers from Tulane University in New Orleans looked at hospital records for heart attack patients admitted to Tulane Medical Center in the two years before and the two years after the hospital reopened, which was five months after Katrina hit. They found a three-fold increase in heart attacks at the Tulane University Hospital more than two years after Hurricane Katrina wreaked havoc on the city.
Katrina, Other Disasters Have Lingering Heart Effects
Moreover, the researchers found that those treated for heart attacks post-Katrina were more likely to undergo dramatic surgeries aimed at re-opening clogged arteries, a possible indication that these patients were suffering more severe heart attacks.
The study echoes past research, which has found that rates of heart problems and other illnesses tend to spike after tragedies and natural disasters. In one 2008 study, for example, researchers found that even those with no prior history of cardiovascular disease experienced heart problems three years after the 9/11 terrorist attacks.
Lead author of the latest study, Dr. Arnand Irimpen, associate professor in the department of cardiology at Tulane University, said the rise in heart attack rates in the wake of Katrina owes a great deal to the impact of stress on those who lost their homes, loved ones and even the basic necessities of every day life such as food, water and health care.
"I think a lot of [the rise in heart attacks] is [because of] the stress and what everyone has to go through after Katrina," Irimpen said. "I think that emotional stress contributes to the neglect of health care because your priority is to find a place to live and food to eat, and a lot of people have lost health care and many doctors left for a time. ... There is a domino effect."
Saavedra said she has witnessed this "domino effect" firsthand. Although she's healthy, happy and "incredibly blessed," many of her friends were not so lucky, she said.
"It was amazing to me how many funerals I attended in the months after [Katrina], and not just for those who drowned," Saavedra said. "We most definitely have friends who the stress took a huge toll on their health. We attended about five or six funerals after the hurricane, until I finally stopped going to them because I just couldn't take it anymore."
Cardiologists in the New Orleans area not involved in this research said they have also experienced the increase in heart attacks first hand.
Dr. Chip Lavie, medical director of preventive cardiology at the Ochsner Medical Center in New Orleans, said the increase in heart attack patients after Katrina is something that local doctors have been aware of for some time.
Doctors Noticed Heart Attack Spike Following Katrina
"We all noticed it and our impression was that the rate of heart attacks was very significant in the year or two post-Katrina," Lavie explained.
Lavie also believes the biggest contributor to the increase in heart attack rates is the psychological impact of stress on those who lived through the storm.
"Leading thing is the psychological stress; it is a big, big factor," Lavie said. "It's a problem by itself, but it brings with it bad eating habits, people resuming smoking [and] the loss of preventive health care."
Lavie has also conducted a number of studies looking at the link between psychological stress and increased risk for heart attack. One such study, published in the Ochsner Journal in November 2007, found that enrolling heart patients in programs aimed at reducing their psychological stress, depression and anxiety also helps to reduce these patients' heart risk.
Dr. Randal Thomas, director of the Cardiovascular Health Clinic at the Mayo Clinic in Rochester, Minn., explained that it is not uncommon to see an overall increase in heart risk within a population that lived through a natural disaster.
"Strong emotional stressors, such as natural disaster, produce 'fight or flight' responses within our bodies," Thomas said. "During habitual but brief bouts [of] such stress, similar to when we exercise for 30 minutes a day, our heart risk may go down. However, during longer-term exposure to prolonged stress, almost as if we are running a perpetual race all day long, our heart risk can go up."
Heading Off Heart Ills
Thomas said there are healthy ways to reduce one's stress -- and therefore heart risk -- after a natural disaster such as Katrina.
"Those who experience a natural disaster can reduce the negative effects of stress by first recognizing that they are going through a stressful experience and then dealing with the stress in healthy ways, counseling, meditation and other stress management techniques," Thomas said.
For Saavedra, however, and many others in the New Orleans area, taking the time and spending the money to see a doctor have proven to be nearly as difficult as rebuilding their lives and their homes.
Fighting Stress Following a Disaster
"A lot of the hospitals closed down." Saavedra said. "In our parish, for example, we still don't have a hospital. But more than that, people are just so busy putting their lives back together and helping their families and neighbors that they don't have time to think about their health or see a doctor."
But Lavie of the Ochsner Medical Center suggested that these patients adopt one simple (and cost-effective) habit to reduce their heart risk.
"One of the things that most people can do is some physical exercise, which helps stress," Lavie said. "It relieves tension and then you can deal with the problems life deals you. You burn calories and it helps with the physical stress; it's a simple thing that can really help."