FEBRUARY 1, 2017
The world was shocked at the end of last year when actress and author Carrie Fisher, best known for her portrayal of Princess Leia in the Star Wars movies, died several days after suffering what was reported to be a massive heart attack. A beloved figure was suddenly gone – and even worse, at the relatively young age of 60.
Fisher’s death was a sobering reminder that heart disease is the leading cause of death in the United States, for both women and men. It’s also, according to the U.S. Centers for Disease Control and Prevention (CDC), the leading cause of disability in both sexes.
How healthy is your heart? February is American Heart Month, a good time to ask yourself that question, review the ways you can reduce your risk of the various forms of heart disease take steps to help keep your heart healthy.
“Many types of heart disease are preventable, or at least can be delayed, through lifestyle choices: eating heart-healthy foods, getting enough exercise, not smoking and in some cases, taking medication to control heart disease risk factors, such as high cholesterol,” says Dr. Sam Nassar, a Cardiologist.
Common Types of Heart Disease
Coronary Artery Disease
Coronary Artery Disease (CAD) – also called coronary heart disease – occurs when plaque builds up in the arteries that supply blood to the heart and other parts of the body. Plaque is comprised of cholesterol and other substances in the bloodstream and as it builds up over time, it can force the arteries to narrow, making it more difficult for blood to flow through them. Reduced blood flow to the heart can cause angina, which creates chest pain and is the most common symptom of CAD. If the plaque builds up to an extent that an artery or arteries are completely blocked, a heart attack can result.
Heart Attacks
Every 43 seconds in the United States, someone has a heart attack. When the flow of oxygen-rich blood to the heart is interrupted, a heart attack results. The longer the heart goes without blood flow, the more damage is done to the heart and the heart muscle will begin to die. CAD is the most common cause of heart attack.
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.”
“If you experience any of these symptoms, call 911 immediately,” warns Dr. Triwanna Fisher-Wikoff, a primary care physician. “Every second counts during a heart attack and getting treatment quickly is essential in order to minimize damage to the heart and increase odds for recovery.”
Arrhythmia
A heart arrhythmia is an irregular heartbeat. The most common type of arrhythmia is atrial fibrillation, commonly referred to as AFib. AFib occurs when the upper chambers in the heart – the atria – do not beat regularly, causing an irregular flow of blood from the atria to the ventricles, the lower chambers of the heart.
Symptoms of AFib include:
- Irregular heartbeat
- Heart palpitations (rapid, fluttering, or pounding)
- Lightheadedness
- Extreme fatigue
- Shortness of breath
- Chest pain
One of the most serious consequences of AFIb is an increased risk of stroke. AFib patients are more likely to develop blood clots, which are the cause of the majority of strokes.
Cardiomyopathy
Cardiomyopathy includes a series of conditions that can cause the heart muscle to stiffen, thicken or thin, reducing the heart’s ability to pump blood efficiently. These conditions can cause irregular heart beats, blood backing up into the lungs and heart failure.
Cardiomyopathy is the most common form of genetic heart disease. However, the condition can be caused by non-hereditary factors as well, such as heavy alcohol use, endocrine disorders and infections of the heart muscle.
Heart Failure
Heart failure, sometimes called congestive heart failure, results when the heart is unable to pump enough blood throughout the body and blood instead pools in the heart. Heart failure may cause extreme fatigue, shortness of breath and swelling in the legs, ankles, feet and stomach.
The only cure for heart failure is a heart transplant. However, lifestyle changes and medication may help to slow the progression of the disease. Risk factors for developing heart failure include smoking, obesity and a diet high in fat and sodium. Diseases such as coronary artery disease, diabetes, and hypertension also increase the risk of heart failure.
Diagnosing Heart Disease
There are a number of tests your physician may conduct to check to assess your heart’s health:
EKG: measures the electrical activity of your heart.
Exercise stress test: measures your heart’s activity while you walk on a treadmill, helping to determine how well the heart is pumping blood.
Echocardiogram: is an ultrasound that creates a picture of the heart.
Chest x-ray: provides images of the heart and lungs.
Cardiac catheterization: is the insertion of a thin tube in an artery in the groin area and is used to determine if there are blockages present in the arteries.
Reducing Your Risk
“Many forms of heart disease can be prevented through lifestyle choices,” explains Dr. Jennifer Motley, an Obstetrician, and Gynecologist. “Our diet, our physical activity level and whether or not we smoke are all heart disease risk factors that we control – each day, we get to choose.”
Key risk factors for heart disease include:
- Smoking: Smoking cigarettes increases the risk of heart disease. 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 risk of heart disease, stroke, and heart attacks, as well as cancer and other diseases.
- 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.
For more information on ways to reduce your risk of heart disease, check out our 2016 Heart Month article, “8 Keys to a Healthier Heart.”
Treatment of Heart Disease
“We have a lot of tools at our disposal to treat heart problems,” says Dr. Scott Ewing, a Cardiologist. “It’s quite common for someone to be diagnosed with a form of heart disease and continue to live a happy and active life if the patient works with the doctor on a treatment plan.”
If a patient has underlying health conditions that contribute to heart disease, the first priority is to work with a physician to address those and get them under control. This includes conditions such as diabetes, high blood pressure, and high cholesterol.
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.
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 and attaches it to the heart, bypassing the damaged or blocked blood vessel.
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 provides oxygen to the body so that the patient’s heart can be stopped while the surgery is performed.
Dr. Reza Khalafi, a Texas Health Care cardiothoracic surgeon at John Peter Smith hospital, is a pioneer in the use of “off-pump” surgery. In this form of bypass surgery, a heart-lung machine is not 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 treated 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 and reduce the risk of stroke.
Taking Care of Your Heart
“Today, we know more than ever about ways to reduce risk of heart disease and effectively treat those who have it. By eating a heart-healthy diet, getting exercise and avoiding tobacco, you’ll do a lot to take care of your heart,” says Cardiologist Dr. Abdul Keylani. “And by working with your physician to manage any underlying conditions, such as high cholesterol, diabetes or high blood pressure, you can further reduce your risk of heart disease.”
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