Tag Archives: heart disease

Congenital Heart Defects

The heart is an intricate organ made up of many parts, making open heart surgery a common option when something goes wrong.

Congenital heart defects are the most common kind of birth defect among children born in the United States, affecting nearly one percent of all newborns in the country. There are multiple kinds of heart defect, classified according to the location of the problem within the heart as well as what, specifically, is wrong. The types of heart defect include:

Complete atrioventricular canal defect, a failure of the walls separating the chambers to meet and fully close. This means blood entering the lungs mixes with blood that s to circulate to the rest of the body, causing improper oxygen distribution.

Truncus arteriosus, in which the blood vessels leading in from the lungs and out to the body are fused together, when they are supposed to be separate. This condition also interferes with proper circulation of the blood through the body.

Ebstein’s anomaly, in which the heart valve on the left side cannot fully close.

Tetralogy of Fallot, the co-occurrence of four different malformations. These are a hole between the heart’s lower chambers, the aorta right above this hole and connected to both chambers rather than only the left, a blockage in the link between the heart and the lungs, and a thickening of the wall of the right chamber.

Pulmonary valve stenosis, in which the heart valve doesn’t open all the way and blood sometimes flows back out.

Atrial septal defect, a hole in the wall separating the heart’s upper chambers.

Coarctation of the aorta, a narrowing of the artery that carries blood out of the heart. This can can lead to high blood pressure, which is dangerous in infants.

It is often important that heart defects in newborns and infants be treated, usually with surgery. Because these defects are typically diagnosed so young—symptoms are frequently apparent early on, such as the tetralogy of Fallot, which can result in blue skin—and because infants born with heart defects may have other illnesses as well, there might be limits on the types of surgery that can be performed. In some cases, however, it is possible to leave the defect as is, at least temporarily, and it is sometimes possible for children born with heart defects to grow up quite healthy regardless.

Go Red For Women

Have you considered how exam room layout can affect patient care?

Heart disease kills more women than breast cancer. In fact, it kills more women than every form of cancer combined—one in four American women can expect to die of heart disease, making it the number one cause of death for women in the United States. Not only do more women die of heart disease than die of cancer, more women die of heart disease than men do, in part because people, doctors and patients alike, don’t realize that women don’t show heart disease the way men do. An estimated 42 million women have undiagnosed heart disease, and one reason it is undiagnosed is that health care professionals are looking for male symptoms women don’t have.

On top of that, the symptoms of heart disease in women are more subtle than in men, making them harder to spot as well as harder to recognize. When a woman has heart disease, it affects the main arteries, but is more likely to be in the smaller blood vessels in the chest as well than when a man does. She may experience neck or shoulder ache, abdominal pain, shortness of breath, throat pain, nausea, lightheadedness, dizziness and fatigue, or sweating.

The the symptoms are different, the risk factors for heart disease are largely the same in men and women, though not always to the same degree. Diabetes and stress, for example, are more strongly linked to heart disease in women. Smoking is one of the biggest controllable risk factors for heart disease in anyone, because it narrows the blood vessels, but this is particularly the case with the smaller ones that are more affected in women. The danger of smoking is also exacerbated by hormonal birth control; the hormones make the effects of smoking worse. On top of that, hormonal birth control is itself a risk factor, as are the hormonal changes wrought by menopause, both concerns unique to women.

To raise awareness of the special concerns women have for heart health, today is the American Heart Association’s Go Red For Women Day. Today is the day to start to take steps to lower your risk of heart disease death. That means quitting smoking. It means making the effort to get enough exercise, about 30 to 60 minutes most days. It means a heart-healthy diet with lots of fruits and vegetables and low in saturated fats. It means maintaining a healthy weight. It means talking to your doctor about an aspirin regimen that can help prevent arterial plaque from building up. It’s never too early, and you’re never too young, to start protecting your heart.

Heart Health

heart-attack-check-up

The heart is the body’s motor, and when it stalls out, it can cause problems. The heart doesn’t deteriorate as its person gets older, but when heart disease strikes, it can interfere with the functioning. Heart disease is deadly, and it gets more likely with age. However, just because it is more likely doesn’t mean it’s inevitable. It is estimated that 80 percent of cardiac-related deaths could have been prevented. That would mean saving close to 650,000 people. It’s easy to keep the heart healthy with a few simple lifestyle changes.

Avoiding stress is one of the most important things a person can do to prevent heart disease, and it has a fairly large return on investment, yielding a lot of improvement for simple actions. Destressing can mean slowing down, getting enough sleep, organizing one’s life—through straightening up the home, the office, and the e-mail inbox as well as staying on top of scheduling by making to-do lists and maintaining a calendar. Taking a relaxed attitude and keeping life in perspective also helps. And some destress techniques are also good for the heart in and of themselves, such as quitting smoking, eating a healthy diet, and staying active.

In fact, even simply walking can help the heart—as little as parking at the far end of the lot, or getting off the bus of subway one stop earlier than usual, will make a difference. Just 30 minutes of walking a day provides benefits. More intense workouts are even better for people who can do them. Twenty-five minutes of intense aerobic exercise a day, three days a week is a great way to build a healthy heart.

A heart-healthy diet is also important, but it doesn’t have to be bland or boring. Good menu options for heart health include oatmeal which can be dressed with fruit such as bananas; avocados, including in guacamole; soy; olive oil; and berries. These foods help lower cholesterol, cut fat, and provide protein. Potatoes, tomatoes, red wine, and green tea are all good for the heart, containing substances that actually fight heart disease , such as lycopene in tomatoes and flavonols in red wine. Flavonols are also found in dark chocolate, another indulgence that helps the heart.

Diabetes And Statins

statin

Life is full of trade-offs. One alarming one is that statins, drugs intended to lower unhealthy cholesterol levels and boost healthy cholesterol, thereby reducing the risk of heart disease, seem to raise the risk of type 2 diabetes. Obesity is associated with both high cholesterol and diabetes, but the drug itself seems to raise diabetes risk. In some studies, the risk of diabetes went up as much as 32 percent due to statin use, even as heart disease fell 44 percent. In part because of the obesity link, this side effect is a danger to the 13 million people expected to be on statins, some of the most widely prescribed medications in the world, during their lifetimes. Fortunately, researchers think they may have come up with a way to minimize this effect.

Statin drugs have come under fire recently for perceived over-prescription. Given the consistently high effectiveness of the drugs—lowering heart attack and stroke risk as much as 40 percent—and particularly given the side effects, there is some concern that people are being given statin prescriptions as a one-size-fits-all quick fix when they may be better served by some other approach. The side effects, though rare, can be dangerous or even fatal. In addition to type 2 diabetes, statin users can suffer memory loss, liver damage, and muscle weakness. In some cases, statins can lead to a potentially fatal condition of severe muscle pain, liver damage, and kidney failure called rhabdomyolysis. In light of these dangers, some experts are wary of prescribing these drugs to patients who do not have a high risk of heart disease. Patients who have not had a heart attack, or who do not already have high cholesterol, are unlikely to see enough benefit from statin drugs to offset these risks.

However, at least for diabetes, the risk may be easily manageable. The effect of statin drugs involves an immune response, which is how they achieve their cholesterol-lowering feats. However, another effect of this immune response is to target the pancreas and lower insulin levels, leading to elevated blood sugar. The immediate recommendation is a second drug, called glyburide, which protects the pancreas from this immune response, and helps maintain the production of the needed amount of insulin. The researchers say further investigation of the immune response is needed to find ways to prevent or counteract other side effects.

Life With A Coronary Stent

stent

When someone experiences an acute myocardial infarction, it is literally vital for doctors to open up the blocked artery. A coronary stent does just that. Implanted in a procedure called percutaneous coronary intervention, a coronary stent is a metal tube, typically coated with anti-hyperplasia medication that is released over time, implanted in the coronary artery to ensure that blood flow is not blocked. A stent is a long-term device, interned to shore up the arterial wall and keep it from collapsing for years. Stents are also implanted preventatively in arteries that have not become blocked if doctors feel there is a significant danger of blockage.

Another name for the percutaneous coronary intervention procedure is angioplasty. In an angioplasty, the artery is first unblocked and enlarged using a small balloon, which is inserted through a small incision in the arm or leg and then inflated near the location where the artery is blocked. Once the blockage is cleared, a stent is placed to hold the artery open. The procedure needs to be performed quickly, because the balloon itself blocks blood flow, and needs to be removed as soon as feasible. Angioplasty usually does not require general anesthesia.

The stent is a foreign object and its placement involves injury to the body, which means that the surgery itself triggers clotting and the stent elicits an immune response. That is why modern stents are coated with medication. Unfortunately, the medication in the coating can, in some patients, actually encourage the clotting it is supposed to prevent. Medical researchers have proposed using vitamin C, which is as effective as the medications currently used at stopping growth, because vitamin C also helps avoid the problem of clotting.

In addition to the drugs on the stent itself, angioplasty patients are typically prescribed anti-coagulants—blood thinners—after the procedure. However, almost a third of patients never fill these prescriptions, creating a dangerous situation. Patients who delay taking medication have the highest risk of death in the month following surgery. In one study, delaying medication meant patients were five times as likely to die within 30 days of the procedure, as well as three times as likely to have a heart attack.

Surgery For Weight Loss

gastric bypass

Bariatic surgery is an often controversial procedure to help people lose weight. It is often derided as an "easy way out," but the fact is weight loss is difficult, the human body is deigned so that weight is much more easily gained than lost, and most diets usually don’t work for most people. If anything, patients who have weight loss surgery need to put more effort and thought into how and what they eat than dieters typically, do. The various kinds of bariatric surgery reduce stomach capacity in various ways, which make these restrictions easier, but also make them mandatory.

On of the most common types of weight loss surgery is called Roux-en-Y. The intestine is rerouted in a Y shape around most of the stomach and attached to a small pouch. This limits patients to the capacity of that pouch. Other types of surgery used miniaturized instruments inserted through a small incision to place an adjustable band around the stomach, making it smaller that way.

Regardless of the technique used, the health benefits are many. People with type 2 diabetes, for example, normally need insulin and medications the rest of their lives. However, obese people with type 2 diabetes—of which obesity is a major cause—show marked improvement, and in a study some were able to stop this maintenance treatment or diabetes entirely. Other studies found that obese people who underwent bariatric surgery successfully halved their heart attack risk. People on whom the weight loss operation had been performed had a 40 percent lower mortality rate and 50 percent fewer heart attacks than obese people who had not had surgery.

All this however, is not without a price. People who receive the surgery still need to follow a restrictive diet. In fact, it becomes more important, as failing to stick to the diet can result in not merely failing to lose weight, but in medical complications. Furthermore, the restrictive diet can mean nutritional deficiencies if people don’t carefully plan meals and take necessary supplements. There are also some signs that at least some procedures can make bones more brittle. While many patients find that the benefits more than compensate for the risks, it is still important for someone considering surgery for obesity to discuss both with a health care provider.

Managing Your Stroke Risk

strokebrain

Stroke, an interruption in the flow of blood to the brain, affects more than three quarters of a million Americans each year. A person has a stroke, on average, every 40 seconds. It is the fourth most common cause of death in the country. It’s important to know the risk factors, both in order to better assess a person’s chances of having a stroke and, in some cases, to address bad habits that are making those chances higher than they need to be.

There are some risk factors for stroke that a person simply cannot control. The biggest one is age—every decade of life past 55 doubles someone’s risk. Family history of stroke is another one. Black people are more prone to stroke than people of other races, and women more so than men. There are also some other conditions, themselves due to a mix of controllable and uncontrollable factors, that raise stroke risk, such as diabetes and high blood pressure.

Another such condition is insomnia. The close to one-third of people who have trouble falling or staying asleep are 54 percent more prone to strokes than their well-rested peers. Insomnia was found to exacerbate the effects of diabetes on stroke risk, suggesting a link with the observed connection between insomnia and overeating. In addition, some activities, such as drinking alcohol and smoking, both raise stroke risk and often lead to insomnia. Researchers also suggest that lack of sleep raises blood pressure and causes mild inflammation, heightening vulnerability to stroke.

Marijuana also seems to show a link with stroke, as well as smaller stroke-like incidents called transient ischemic attacks. Though not as harmful as tobacco, marijuana is often smoked, and smoking anything can have deleterious effects on the cardiovascular system. In addition, marijuana is likewise associated with overeating, and also with being sedentary. The effect is most pronounced with heavy use.

People might not consider high stress a controllable risk factor, but it is, at least compared to gender. At any rate, relaxation techniques such as yoga can help lower the risk. A poor diet—high in salt and saturated fats—is something else that can be controlled. Even if saturated and trans fats can’t be cut out entirely, minimizing them in the diet can help. Quitting smoking makes a tremendous difference, particularly for women taking birth control pills. Finally, other illnesses that raise the risk do so less if properly treated.

Effects Of Long Term Sleeplessness

sleep

"Insomnia" refers to difficulty falling asleep or staying asleep, or waking up too soon and not being able to fall asleep again, leading to not getting enough sleep at night—most adults need seven to eight hours. It is the most common seeping disorder among Americans—more than one in ten have chronic insomnia, meaning they have difficulty sleeping three or more nights a week for three or more months, and as many as 40 percent have had trouble sleeping in the past year.

There are a number of possible causes of insomnia. Stress and anxiety are common culprits. Often, clinical depression leads to insomnia, as do other illnesses such as gastroesophageal reflux disease, arthritis, heart failure, Parkinson’s disease, and Alzheimer’s disease. Poor sleep is also a side effect of certain medications, including allergy medications and corticosteroids.

The effects of sleeplessness are not to be trifled with. Tired people have poor decision-making skills, poor concentration, and poor eating habits. In one study, couples were found to be less able to manage conflict and more likely to snap at each other when one or both had slept poorly. It also poses problems for the diet; not sleeping raises the levels of a molecule that stimulates the appetite.

Some people are at greater risk. In a recent study, patients with heart failure who also suffered disrupted sleep were more than twice as likely to find themselves in the emergency room as patients who slept properly. Almost a third of people hospitalized with heart problems had poor sleep a year later, but they accounted for as many hospital visits in that year as did patients whose sleep was unaffected.

For people who have trouble sleeping, treatment may not require medication. Simply sticking to a regular schedule can work wonders, and cutting out caffeine in the afternoon and evening—or entirely—can make a huge difference. Another thing that can help is exercise, especially late in the day. Another thing that helps is staying out of the bedroom, or at leas out of bed, until bedtime.

Tips For A Healthy Heart

DOH-campaign-vs-heart-disease

Heart disease is deadly, but heart health can be easy. An estimated 80 percent of cardiac deaths are preventable—nearly 650,000 people. A few simple lifestyle changes can set you on the road to a strong cardiovascular system. Here are some tips to keep your ticker in top form:

  • Eat a heart-healthy diet that includes plenty of fruits and vegetables and is low in saturated and trans fats.
  • As best you can, get vitamins and minerals from foods rather than supplements.
  • Avoid fad diets. Though maintaining a healthy weight is good for your heart, most complicated or gimmicky weight loss programs fall down on the "maintaining" part. A cycle of losing weight and gaining it back is worse for your heart that simply being overweight.
  • Walking the dog is a great chance to get some walking in yourself.
  • Chose the stairs rather than the elevator if you’re only going a floor or two—or three if you’re up for it.
  • If you use mass transit, try to get off a stop or two early. If you drive, look for a parking space in the far side of the lot, or park a block or two away if you’re parking on the street
  • Don’t smoke.
  • Destress as best you can. Try yoga, meditation, mindfulness, or other stress-relieving techniques.
  • Get enough sleep, six to eight hours every night.

Particularly if you’re overweight, you’re over 60, you have a family history of heart disease, or you have some other risk factor, talk to your doctor about including heart disease screening in your regular check-up. That means a look at your blood pressure and your cholesterol levels. This will help you and your doctor assess your risk and determine a specific strategy you can follow to lengthen your life.

Go Red For Women

red heart

One in four American women will die of heart disease—more than every form of cancer combined. It is the number one cause of death for women in this country, and actually kills more women than men. Unfortunately, most people don’t realize that heart disease looks different in women and men, and so they miss the signs because they don’t know what to look for. It is estimated, in fact, that 42 million women have undiagnosed heart disease. Women who get heart attacks don’t have the obvious signs men do.

The symptoms of heart attack in women are more subtle. Women experience neck or shoulder ache, abdominal pain, shortness of breath, throat pain, nausea, lightheadedness, dizziness and fatigue, and sweating. One reason for the difference is that when women have coronary blockage, it isn’t only the main arteries that are blocked, the smaller blood vessels in the chest are also affected.

The risk factors for heart disease are mostly the same in women as in men—though menopause and hormonal birth control are risk factors as well. In addition, the degree to which these things affect women and men can be different. Diabetes, for example, is more strongly linked to heart disease in women. The biggest controllable risk factor for heart disease in women is smoking. Smoking narrows the blood vessels, making them more prone to blockage, particularly the smaller ones that are more affected in women. The danger of smoking is also exacerbated by hormonal birth control; the hormones make the effects of smoking worse. Similarly, while stress makes everyone more prone to heart ailments, this is particularly the case for women.

To raise awareness of the special concerns women have for heart health, today is the American Heart Association’s Go Red For Women Day. Today is the day to start to take steps to lower your risk of heart disease death. That means quitting smoking. It means making the effort to get enough exercise, about 30 to 60 minutes most days. It means a heart-healthy diet with lots of fruits and vegetables and low in saturated fats. It means maintaining a healthy weight. It means talking to your doctor about an aspirin regimen that can help prevent arterial plaque from building up. It’s never too early, and you’re never too young, to start protecting your heart.