FEBRUARY 1, 2015
February is American Heart Month, a time to raise awareness of the number-one killer of men and women in the United States: cardiovascular disease, also known as heart disease. Heart disease has many different causes, different outcomes and a variety of symptoms, so it’s important to understand the different ways heart disease can present itself – and the ways many cases of heart disease can be prevented.
Some types of heart disease are caused by congenital heart defects which develop in babies while they are still in the womb. Additionally, people can develop heart defects as they age. Heart defects can develop as a result of infections of the heart and diseases such as rheumatic fever, which can damage the heart’s valves.
However, many instances of heart disease develop over time as people age, with lifestyle factors such as diet and exercise playing a role in the likelihood of developing heart disease. Better education about how to reduce the risk of heart disease will go a long way in reducing the number of Americans who die from heart-related problems. According the U.S. Centers for Disease Control and Prevention (CDC), heart disease is also the leading cause of disability in the country, resulting in a lower quality of life for many it impacts.
Types of Heart Disease
Heart disease encompasses numerous health conditions which can lead to disability or death. Some of the most common include:
- Coronary Heart Disease (CHD): This is the most common type of heart disease, according to the National Heart, Lung and Blood Institute at the National Institutes of Health. CHD occurs when plaque accumulates in the arteries, restricting the flow of blood. This condition, also known as atherosclerosis, occurs over many years.
- Stroke: Strokes occur when the arteries that carry blood to the brain become blocked or rupture. The deprivation of oxygen to the brain kills brain cells, leading to loss of physical and/or mental function.
- Arrhythmia: This condition occurs when the heart beats out of rhythm.
- Angina: Angina is chest pain associated with coronary heart disease. When blood flow is restricted due to the buildup of plaque, angina may result.
- Heart Attack: When the supply of oxygen-rich blood to the heart is interrupted, a heart attack occurs. When the heart goes too long without blood flow, the affected portion of the heart muscle will die.
Know the Warning Signs
Strokes and heart attacks come on quickly and must be treated immediately in order to increase the likelihood of survival and recovery. According to the CDC, symptoms of stroke for both men and women include:
- Sudden numbness in the face, leg or arm, particularly if the numbness occurs on one side of the body
- Sudden confusion, difficulty speaking or trouble comprehending what one is hearing
- Sudden vision trouble in one or both eyes
- Sudden severe headache
- Sudden difficulty walking or maintaining balance and coordination
The common trait with all of these stroke symptoms is that they are sudden. With the onset of any of these symptoms, it is imperative to call 911 immediately.
The CDC identifies five major symptoms a person experiencing a heart attack may have:
- “Pain or discomfort in the jaw, neck, or back.
- Feeling weak, light-headed, or faint.
- Chest pain or discomfort.
- Pain or discomfort in arms or shoulder.
- Shortness of breath.”
Sometimes people will experience these symptoms and assume “it’s nothing,” or perhaps heartburn or some other relatively innocuous condition. “If you have even the slightest bit of doubt, call 911 immediately,” says Scott Ewing, D.O., a Texas Health Care Cardiologist. “Too often, people ignore heart attack symptoms only to find out later they did indeed suffer a heart attack. The sooner a heart attack victim receives medical attention, the greater the chance of recovery.”
Reducing Your Risk
“The number of cardiovascular events can be reduced,” said cardiologist Joseph Marcella, M.D. “One strategy is making appropriate therapeutic lifestyle choices, which can significantly reduce our risk of developing heart disease.”
Key risk factors for heart disease include:
- Smoking: According to the Mayo Clinic, heart attacks are more common in smokers than non-smokers. Nicotine causes arteries to narrow, restricting blood flow. The carbon monoxide in cigarettes also damages the lining of arteries, increasing the chance of plaque buildup. Quitting smoking is one of the most important things someone can do to reduce their risk of heart disease, stroke and heart attacks.
- Stress: Stress that is not managed well can strain arteries and the heart.
- Poor diet: A diet which includes unhealthy levels of salt, sugar, fat or cholesterol can increase the risk of heart disease.
- High blood pressure: Hypertension increases the workload on the heart.
- Obesity: Obesity is a key risk factor for heart disease, and is often associated with diabetes, high blood pressure and high cholesterol levels.
- Diabetes: Diabetes and heart disease have similar risk factors, including high blood pressure and obesity. In fact, diabetes is now considered as a risk equivalent to coronary heart disease.
- Physical inactivity: Cardiovascular exercise, such as walking, running and biking, helps to elevate the heart rate for a limited amount of time, improving cardiovascular health. In addition, exercise is associated with higher levels of HDL cholesterol, also known as the “good cholesterol.” People who are physically inactive deprive themselves of these health benefits.
- Alcohol: Too much alcohol consumption can contribute to heart disease in two ways: drinking alcohol causes increased blood pressure and higher levels of triglycerides (a type of fat) in the bloodstream.
- Poor hygiene: Something as simple as regular and proper hand washing can help prevent heart disease by reducing one’s risk of an infection that could impact the heart.
Treatment of Heart Disease
Cardiologists and cardiothoracic surgeons have a variety of tools in their arsenals to fight heart disease, slow its progression and lengthen and enhance the lives of those affected by it. Many forms of heart disease can be managed well, allowing a patient to enjoy a normal and active lifestyle.
First and foremost, it’s important that patients with underlying health conditions or risk factors which lead to heart disease work with their physician to address those and get them under control. This includes proper management of diabetes, high blood pressure, and high cholesterol. In addition, losing weight if obese and quitting smoking if a smoker are two of the most important things your physician can help you accomplish to prevent heart disease, as well as other illnesses. In most cases, your primary care physician will be able to aid you in these efforts through lifestyle changes and in some cases, by prescribing medications.
For patients who have a form of heart disease, there are a number of effective treatments that a cardiologist or cardiothoracic surgeon can provide, depending on a patient’s specific circumstances.
For coronary heart disease patients, a procedure known as angioplasty may be performed in order to open up the blocked artery and promote better blood flow. In this procedure, a thin tube with a balloon on the end of it is inserted into the blood vessel – when the balloon is expanded, the artery expands and blood flow is restored. A mesh stent is then placed in the artery to keep the blood vessel open and the blood flowing. Former President George W. Bush famously underwent this procedure in 2013, when a CT angiogram showed he had a blocked artery.
“Angioplasty and stent placements are quite common procedures and are effective at relieving symptoms such as angina,” said Texas Health Care cardiologist Naresh Patel, M.D. “For less severe cases of coronary heart disease, we can often treat angina with prescription medications that will help to relieve chest pain when an episode occurs.”
Patients who are discovered to have severely blocked blood vessels in the heart may need to undergo coronary bypass surgery. In coronary bypass surgery, the surgeon takes a small portion of a blood vessel from another part of the body, such as a vein in the leg, and attaches it to the heart in order to bypass the damaged or blocked blood vessel, allowing blood to flow freely to the heart.
Coronary bypass surgery is one of the most common surgeries performed in the United States, with more than 500,000 procedures each year. Coronary bypass surgery has traditionally been conducted utilizing cardiopulmonary bypass. In this procedure, a heart-lung machine that provides oxygen to the body is utilized so that the patient’s heart can be stopped while the surgery is performed.
Reza Khalafi, MD, a Texas Health Care cardiothoracic surgeon at John Peter Smith hospital is a pioneer in the use of “off-pump” surgery, in which no heart-lung machine is used and the patient’s heart continues to beat through the surgical procedure. In off-pump surgery, the surgeon uses a stabilizing device to keep still the part of the heart to which the blood vessel is being grafted. Dr. Khalafi has found that off-pump surgery generally results in fewer complications and shorter recovery times.
There are a variety of treatment options for patients with arrhythmia, as well. These can include prescription medications, as well as medical procedures. Arrhythmia can be addressed with the insertion of a pacemaker that helps to regulate the heartbeat or a procedure known as cardioversion, in which the heart is shocked in order to return it to its natural rhythm. Patients may also be prescribed beta-blockers to slow a heart rate that is too fast or blood thinners, which help to prevent clotting, a condition that often occurs in patients with arrhythmia.
Take Care of Your Heart and it Will Take Care of You
We need to be mindful of our heart health year-round, not just in the month of February. By avoiding unhealthy activities like smoking and excess alcohol consumption, eating foods high in fiber and avoiding excess fat, sugar and salt and exercising regularly – at least 30 minutes, five times per week – we can reduce our risk of heart disease. As with anything that feels unusual in your body, see your doctor about it right away. It might be nothing – but it could be something that needs to be addressed. When it comes to your heart, the sooner you see a doctor, the better. Remember, you only have one heart – take care of it, and it will take care of you.