Category Archives: Cardiac Health

Breathe Better in 2013

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I know smokers hear a mouthful from us non-smokers all the time, between the dirty looks, the coughing as we walk by, the comments that people feel the need to shout out….I get it, it’s annoying, but your habit of smoking, affects us non-smokers! We are exposed to the carcinogens that you are burning, inhaling, and then exhaling into airspace that we are also using. It seems trite, I totally get that, but you are not only exposing me as an adult, but children, animals, and other innocent people who may already have some health issues (think about a child with asthma; they should be able to walk down the street without having an increased risk of an asthma attack because someone is smoking near them).  But it’s a new year, and a great time to make a commitment to yourself and to better health! If you won’t quit for anyone else, quit for you!

Why should I quit? 

-443,000 people die a year from smoking related deaths, which is more deaths than from suicide, alcohol, illegal drugs, motor vehicle accidents, and murders combined!!!

– It increases your risk of lung cancer by 23 times (versus non-smokers)

– Heart disease and stroke risk increases by 2 to 4 times

– Increases you risk for other cancers: oral, larynx, skin, gums, cervix, bladder, kidneys, pancreas, stomach, esophagus….among others

– And specifically for women, smoking can cause: low weight births, stillborn births, infertility, and Sudden Infant Death Syndrome (SIDS).

AND, in case no one else has noticed, tobacco products are EXPENSIVE!!  I couldn’t afford to smoke a pack or more a day.

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What are the immediate benefits of quitting?

Within 12 hours of quitting, your blood oxygen levels increase back to a “normal” (pre-smoking) baseline and your carbon monoxide levels drop down to normal.

In 24 hours your chemical withdrawal symptoms will start (and will peak in 72 hours.)

Within 48 hours your nerves that have been damaged will reverse, and your sense of smell and taste will start to return.

Within 2 weeks your anxiety levels reduce (anxiety will be higher right after you quit in a response to stopping nicotine) and your blood circulation has restored to your gums and teeth.

At around 8 weeks, your risk of heart attack/disease starts to decrease significantly, and your lungs start to work better and more efficiently.

After 1 year of quitting, your risk of heart attack and stroke are at around 1/2 the risk of a smoker, and when you reach that 5 year milestone your risks are that of a non-smoker!!

The effects reverse, and your body starts feeling better so quickly after you quit, you just have to get through the cravings!

How do I quit?

Quit with a friend/buddy/significant other: it makes it easier if you keep each other in check. Or get support from help groups (1-800-QUIT-NOW, for teens Smokefree Teens, and women Smokefree Women) that can coach you through cravings, or talk to you about what you might be feeling every time you reach for that lighter and that pack of smokes.

Use nicotine replacement gum, inhalers, patches, etc and slowly wean yourself off of the nicotine so you just have to deal with changing your behavioral patterns, not the physical chemical cravings. There are also some medications and other treatments your Healthcare Practitioner (HCP) can prescribe for you, but there are quite a few side effects so you should be under the care of an HCP if you choose to take that route.

Make some lifestyle changes (just like when you are trying to lose weight) that you can stick with.  If you normally smoke when you drive to work, change routes. If you light up after dinner, go for a walk, get up and do something active that will change your “smokers routine”.  If you smoke when you hang out with certain people, don’t hang out with them for a while. I am NOT saying that it is easy, but it is hard work that you are putting in to make yourself healthier, and to live a life free of disease.  Life is hard enough, why add medical issues that you don’t need/want to deal with? And, again….the cost just blows my mind; wouldn’t you rather buy something cool that you’ve coveted with the money you save from not smoking??

Talk to your HCP, get a baseline physical, and then a year after your successful cessation of tobacco use, and you will see a HUGE difference in your health, all for the positive.

Yours in Good Health

B

 

What does my blood pressure actually mean?

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People are getting their blood pressure checked before every appointment they have with HCPs, but I feel like many times people are told what their pressure is, then they are reassured that “it’s good” or “we need to watch that”…and’s that’s it!  It seems to be a big question to many people of what their blood pressure should be and what the numbers actually mean? It’s a shame that more Healthcare Practitioners (HCP’s) don’t explain it to you, but increasing your own blood pressure (bp) IQ is a great place to start to improve your wellness!

What is the top number?

If you are told that your bp is 120/80, the top number (120) is also known as the systolic pressure. Basically, every time your heart beats, it is using pressure to force the blood from the heart our to your hands, feet, head, and all of those vital organs that help you to live. Blood that leaves the heart to get to all of these other areas, is full of oxygen, so that the oxygen can be used at those sites far from the heart and lungs, and the blood travels through arteries to get there. So, the force that is required by the heart to push that blood out through the arteries is your systolic blood pressure. A systolic blood pressure of 120 mmHg (millimeters of mercury) or below is considered good. A systolic pressure of 121-139  is considered pre-hypertension or “borderline” hypertension, and any reading greater than 140 is considered hypertension (AKA high blood pressure).

What is the bottom number?

If your blood pressure is 120/80, then 80 is your diastolic pressure (the bottom number.) Your diastolic pressure is the pressure in your arteries between your heart beats (so when the blood is not rushing out from the heart).  And, similar to high systolic pressures, high diastolic pressures can also be a sign of decline in health and we need to make some changes. A diastolic pressure less that or equal to 80 is good, 80-89 is pre-hypertension, and 90 or higher is considered diastolic hypertension.

What does this mean?

If you are in the “pre-hypertension” zone, you can sometimes make some healthy lifestyle choices that will help to decrease your pressures like eat a low salt diet, decrease your fat and cholesterol intake, start working out (or work out more), and drink more water. Also, cutting out red meats and eating more lean proteins can help to decrease the fat and cholesterol intake and make some pretty big changes in your blood pressure.  Sometimes it is also related to stress, so learning some de-stress techniques, doing yoga, meditation, acupuncture, can all help with decreasing stress and anxiety and do wonders for blood pressure. Work with your HCP to create a plan, but if these measures don’t work, and sometimes they don’t because of genetic high blood pressure, then you may need to start a medication to help regulate those pressures.

How often should I get checked?

If you are healthy, and your blood pressures are normally below the 120/80 mark, with no other health issues, you can go two years between getting checked ( I usually suggest annual screening, and even just checking your blood pressure at the pharmacy).  If you are pre-hypertensive, you should go every 6 months just to see if the interventions you are making are having an effect on your pressures.  And if you are hypertensive and starting medications, your HCP may have you getting your blood pressures checked regularly while you are starting your medications to make sure you are getting the correct dose and then you don’t need to check as often.  My personal suggestion, if you are on any sort of blood pressure regulation medication is to purchase a blood pressure cuff (electronic) from the pharmacy, and have it just to check your blood pressure every once in a while to make sure that you are on the right track! Plus if you ever get symptoms like light-headedness or headaches that won’t go away, you can check quickly to see if your blood pressure (either low or high) may be the culprit!

It is a good idea to know what your blood pressure is, and now you know what those numbers mean.  Talk to your HCP if you have any concerns, or are worried about treatment options, they will work with you to find the best treatment that works with your lifestyle.

Yours in Good Health

B

 

How do you help in Sudden Cardiac Arrest?

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Sudden cardiac arrest (SCA) is one of the worldwide leading causes of death and in the US alone, around 250,000 people die each year, according to the Center for Disease Control and Prevention (CDC). More people die each year from SCA than they do from colorectal, breast, and prostate cancer, AIDS, car accidents, and guns.  That’s pretty remarkable, when you think about it in those terms, right? There are some pretty simple things that you can do to help a victim of sudden cardiac arrest, and you never know when you might be in the position to help save someone’s life!

What is Sudden Cardiac Arrest (SCA)?

SCA is different from a heart attack, but a heart attack (which is a build up of plaque in the arteries that bring blood to the heart, leading to a decreased blood flow, so the heart is not working optimally, but still getting some blood flow) can lead to SCA.  SCA is a sudden and  immediate loss of cardiac function, that also causes respiratory issues (i.e. trouble breathing/moving air in and out of your lungs), a loss of consciousness, and an arrhythmia (a disorganized rhythm that doesn’t allow your heart to pump blood out to your brain, arms/legs, or other organs).  This can be really troubling because many times people do not know that they may have some sort of underlying heart disease, or be at risk for SCA.  It can just happen, at the most unexpected times, and a victim will literally just drop unconscious without any warning signs.  Without immediate treatment (i.e. within 10 minutes, but preferably less) people will die from SCA, or suffer major brain injuries due to a lack of blood flow and oxygen to the brain, even if we can restart the heart in a normal (perfusing) rhythm.

Compressions (CPR) 2 inches (4cm) in at least 100 times/minute

 

How to visualize an AED in public


What can I do?

Well, the immediate treatments for SCA are cardiopulmonary resuscitation (CPR) and defibrillation.  The days of having to give “mouth to mouth” are long over, and the American Heart Association encourages bystanders to do “hands only CPR” in which you check to see if the person is responsive, and if they are not, call 911 (or your emergency number) to get help, and push on the lower half of the breast bone with your two hands interlaced, using the palms to push at least 2″ (4cm) in on the chest, and allowing for the chest to go back to its normal position, and continue on at a rate of at least 100 times per minute (to the beat of “Stayin’ Alive”.) Immediate CPR alone can help victims of SCA tremendously, and getting trained healthcare professionals called out to help ASAP is key.  But there is one other thing that you can do: defibrillate (AKA Shock). What does that mean?!?  Basically, defibrillation is a large electrical shock that you give to a victim to try to kick them out of that arrhythmia where there heart is not pumping blood out, and get them back into a normal perfusing rhythm.  Defibrillating, is like hitting a “reset” button for the heart.  And it sounds scary thinking that you are sending an electrical shock into someone’s heart, but it can only help them, and it won’t hurt them; if you don’t do it they could die, and if you do it, you can immediately save their life!!  How great is that.  Plus, it couldn’t be easier!

How do I defibrillate someone?

In the hospital, we have some pretty fancy defibrillators that definitely need some training to use, but in public places like libraries, gyms, hotels, sports arenas, restaurants, office buildings, stores, etc. there are automatic external defibrillators (AEDs) that could not be easier to use, and have three steps:

1. Turn the AED on (for most, opening them up turns them on) and the machine will prompt you through  the next steps

2. Attach the two pads to the victim (there are pictures on the AED and on the pads): one on the upper right chest, right below the collar-bone, and the other on the left side of the chest, under the arm on the lower half of the ribcage. Once these are attached, you need to ensure you are not touching the victim, and it will analyze the rhythm.  If it determines the victim needs to be defibrillated (get shocked), it will charge itself.

3. Press the defibrillate/shock button (it will light up) then immediately start compressions again.  If no shock is indicated, immediately restart compressions.

*The machine will prompt you the rest of the time to continue CPR and count down the two minutes until it needs to analyze the heart’s rhythm again and the sequence will restart.  It truly could not be easier!

To think that somethings that seem so easy, can save someones life?  I understand that it could feel scary and uncomfortable if you aren’t used to it, but you are helping to save someone from death, and the feeling of goodness that comes over you from saving a life is amazing, and really can’t be put into words.

To recap when you find a victim of SCA:

Make sure that it is safe for you to help (you don’t want to get hurt trying to help another person, so think of your safety first)

Check for responsiveness (if they cannot speak, are not awake, then they are considered unresponsive)

Call emergency services for back up

Start chest compressions (2 inches in at a rate of at least 100 compressions per minute)

If there is an AED nearby, have someone grab it, attach the victim ASAP and follow the prompts

Continue until emergency services comes, or someone to take over from you…..if no one comes, keep going until you are exhausted.

It may seem like common sense, but when you are alone with someone in SCA, it’s important to practice and remember these steps, because your actions can help to save a victims life. I know you can do it, even if you are scared, because if you were in SCA you would want someone to help you!  If you are interested in taking a Heartsaver (CPR/AED) training class, check out the American Heart Association‘s website that can tell you where local classes are held. The more training, the better!

Yours in Good Health

B

 

Your Blood Type Can Determine Your Risk of Heart Disease?

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There has been some interesting research coming out lately looking at various blood types (Type A, B, AB, or O) as an indicator for risk of heart disease.  To me, this is really fascinating, because there are so many times that people come up to me and tell me a horrible story about someone who is totally fit, eats right, young, and then “drops dead of a heart attack” (a quote I hear a lot).  I always think that there has to be a family history, something undiagnosed, or a predisposing factor. So, this research is important because maybe it really is part of those “genetics” that cause some people to be at a higher risk for certain diseases without having any other risk factors!

What is your Heart Disease risk based on your Blood Type?

There are two very large, ongoing studies that Harvard University runs, looking at various healthy populations, and they collect data on these research participants in all aspect of their lives: diet, nutrition, health issues, pregnancy, sleep, etc. and they continue to collect this data on these people for the duration of their lives. Between these two ongoing studies, the researchers looked at just shy of 90,000 people, analyzing data from 24 to 26 years for each participant, and what the data showed was pretty amazing.  People who have blood Type AB, have a 23% higher risk of heart disease as a baseline, whereas Type B put a 16% higher risk, and Type A was a 6% increased risk, as opposed to people with Type O blood, who have minimal risks (basically none).  Strange, right?  Just having one blood type, in particular, can seem to put you at a higher risk for heart disease and heart attacks.

How can your Blood Type determine your risk?

This part is still being studied for a more exact reasoning, because the way that the human body works, especially with blood and the clotting cascade, it is very difficult to pin point one factor (or explanation) for why different blood types carry within their cells innate varied risks for heart disease.  But the researchers have a hypothesis (a suggested reason) for why this phenomenon may occur: people who have Type O blood tend to bleed more (take longer to clot), so they would be less at risk for their blood spontaneously clotting to cause a heart attack or stroke. Also, people who have Type A blood, have been found to have higher Low Density Lipoprotein (LDL) levels (which is the bad cholesterol) circulating in their blood, as they lack an enzyme (that Type O has) which makes removing cholesterols more efficient.  Cholesterol is bad because it builds up in arteries and causes plaques and hardening of the vessels, which leads to an increased risk of plaques breaking off and causing a heart attack, less blood flow to the heart, and also increases the risk of clots forming that can lead to a stroke or heart attack.  So, if you have more circulating cholesterol, you have a higher risk of heart disease which can cause heart attacks.  Now, again, it is not truly known why people with Type O tend to bleed more or why people with Type A have more cholesterol circulating, but it is being studied to find more exact reasonings.

Is there anything I can do to decrease my risk for heart disease?

You cannot change your genetics, which is a bummer, but you can live a healthy lifestyle to promote heart health:

– Stay at a healthy weight

– Exercise at least 30 minutes per day 5-6 days a week

– Avoid smoking and using other tobacco products

– Avoid a high fat diet and load up on fresh fruit and veggies

– Get regular check ups to monitor your blood pressure, heart rate, and cholesterol levels

Talk to your HCP about your risks, and have an open communication about what is the BEST way to maintain a healthy heart based on your life and lifestyle, and when/if you need to be on any blood pressure medication.  It is always good to be monitored for healthiness, especially if you have a family history or Type AB blood, as we now have learned.  And….if you don’t know your blood type, that test can be performed in about 30 seconds (I learned in 8th grade science class- we all took a drop of blood and figured out our blood types- which I am now learning from various people is really strange.)  So figure out your risk factors, talk to your HCP, and live a healthy lifestyle (as best you can!)

Yours in Good Health

B

 

Belly fat may be worse for your health than obesity?

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I guess it is one more reason to get into shape: there has been recent research to support that those of us with belly fat but a “normal” weight are at a higher risk for cardiovascular death than those that are obese. Good gravy.  Another thing to be worried about, but I guess it goes back to the whole “fat” skinny thing.  You can be within your appropriate weight but if you don’t work out and tend to have a lot of belly fat, this might be the inspiration you need to improve your diet and tighten that tummy!

What’s the Scoop?

New research (within the past two months) from the Mayo Clinic highlights the fact that people with a “normal” Body Mass Index (BMI) with belly fat present are at the highest risk of cardiovascular death, even when taking into account various risk factors such as race, age, sex, diabetes, and hypertension (high blood pressure).  Yikes.  It has been known that people with centrally based fat (thick around the middle) are at a higher risk for complications from their increased fat, but this is a new finding that people of a “normal” BMI are in this increased risk category.  This study was performed on 12,785 people over the age of 18 for over 15 years, and they found that people within their “normal” BMI with extra belly fat were 2.8 times more likely to die of cardiovascular causes, and 2.1 more likely to die from all other risk factors.  That is pretty significant. You think that you are at your normal weight, you could use to lose a little in the middle, but you are actually at a much higher risk for cardiac death?!?!  Ugh.  One more thing to worry about.

What can I do to decrease that risk?

– Get 30 minutes of cardiovascular activity a day (running, walking, biking, swimming, whatever gets you moving!)

– Drinks lots of water and ditch the high sugar sodas and other beverages

– Eat lots of fiber (whole grains, fruits, and vegetables)

– Get your green leafy vegetables in your diet (power packed with vitamins and fiber to fill you up)

– Don’t smoke (or quit if you do!)

– Eat less saturated and trans fats (they fill you up but they sit in your arteries and slow your metabolism)

– Coenzyme Q10 supplementation may be beneficial (still being researched but is thought to help reduce circulating cholesterol to prevent plaques from building up)

– Keep your Cholesterol levels in check

– Get regular check ups with your HCP

Basically, the best thing that you can do is eat a clean diet full of whole grains, fruits, and vegetables, getting in your exercise, and talk to your HCP about your risk.  It is also a good idea to check your blood pressure, if you have a tendency towards high blood pressure- just buy one Over The Counter (OTC) from your local pharmacy to make sure that your blood pressure is in check even when you aren’t getting a physical! Talk to your HCP, see what your personal risks are, and try to minimize that belly fat!

Yours in Good Health

B

Does your Heart ever flutter?

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Now I am not talking about seeing someone that you have a crush on and your heart, figuratively speaking, “skips a beat”, I am talking about when it literally skips a beat…and you do feel a little flutter in your chest, which can happen at any time.  Most often when that happens, something is occurring in your heart which is known as a premature ventricular contraction (a PVC). It can happen to anyone at any time, but there are certain things that can put you at risk and can make you have them more frequently.

What are PVCs?

Premature Ventricular Contractions (PVCs), are an abnormal (or extra) beats that  can cause a disruption in the normal contractions of your heart.  Basically, these extra beats, can cause a problem with the impulses that normally occur in your heart; it is a domino effect, and when the other beat occurs, it throws everything out of whack and most often your heart misses a beat altogether. It is normal that these beats happen, and if you are, in general, a healthy person, there is nothing to worry about. But, if you do have an underlying heart disease or heart problem, and these beats are more frequent, it is something that you need to talk to your Healthcare Practitioner (HCP) about.  When PVCs are occurring you will feel a fluttering in your chest, a pounding heart rate, or you will feel like you missed a heartbeat, but there are usually no other symptoms.

What causes PVCs to happen?

Well, as I’ve described before, there are four chambers of the heart: the right and left atria, and the right and left ventricles. The Sinus node (SA node) os the pacemaker of the heart and it sits within the right atrium, it shoots off electrical impulses that allow the cellular pathways to create contractions in the other atrium and ventricles, thus causing a heartbeat which pumps blood out to the lungs, brain, and the rest of the body through your  arteries.  With PVCs the contraction of the heart is started in the ventricles, and it initiates a heart beat sooner than the heart is ready. When this system is messed with, there can be missed beats, or an irregular rhythm and less blood is pumped out to the body than during a normal heart contraction.

PVCs can be brought on by underlying cardiac/heart disease, electrolyte imbalances in the body (like if you are extremely dehydrated from a hard workout and your potassium or sodium levels may be low OR if you take diuretics), high levels of stimulants (like caffeine or taurine/guarana/ephedra), anxiety and heavy exercise (strain on the heart), certain medications (like decongestants), and any injury to the heart/cardiac muscles (from coronary artery disease, cardiac surgery, myocarditis- infection of the heart), or high blood pressure.  Also heavy use of alcohol and illegal stimulant drugs (cocaine, meth, crack, bath salts, etc) put you at a much higher risk.

Are there any complications?

If you do not have underlying cardiac disease, normally it should not be a problem.  If you do have cardiac disease, or use stimulants (legal or illegal) despite feeling the PVCs, you are putting yourself at risk for arrhythmias (abnormal rhythm of the heart beat) and a lethal arrhythmia which can lead to sudden cardiac arrest/death.

*If you ever feel faint, light-headed, lose consciousness, or heave chest pain with these irregular beats, you should seek immediate medical attention and/or call 911/emergency services.

How will I be diagnosed?

Your HCP will perform a few tests if you come in complaining about PVCs or if you think you are having them, they will most likely draw some blood to check your electrolyte levels and make sure that they are all normal levels.  Also you may have:

–An EKG: an Electrocardiogram which is a 12 lead assessment of the electrical impulses of your heart. 12 little stickers are placed on the skin on your chest, and little plastic/metal leads are connected, you will be asked to stay still for about 30 seconds, then a print out of your hearts impulses comes out.  It shows what is going on and is not very invasive at all, and a snap shot of your heart.

–A Holter Monitor: A monitor with about 5 leads is attached to your for 1 to 2 days, and is worn under your clothing, it constantly checks the rhythm of your heart and if you feel symptoms, you push a button, and all of that information is downloaded by your HCP so they can correlate symptoms and your heart rhythm.

–An Event Recorder: Similar to a Holter monitor, but worn for a month, and it only records when you have an arrhythmia, and it sends signals to your HCP when you have those events, and it helpful at showing when arrhythmias happen at unexpected times (like during sleep.)

–Echocardiogram: basically an ultrasound of your heart through your chest wall, there is some lubricant applied to your chest, and a hard plastic wand is moved over it to show how your heart is functioning and can give  a 3D view of the actual functioning of the heart. It can help to diagnose if you have any structural abnormalities.

Are there treatments?

Most often, they are benign, meaning they come randomly and do not do any damage, so there is no real reason to treat them.  But if they are causing problems and your  HCP feels that there should be a treatment, usually they will suggest lifestyle changes such as exercising, eating healthy, increasing your water intake, cutting out alcohol/tobacco/caffeine/other stimulants.  The other treatment, is to decrease your heart rate by taking a beta blocker, which is a medication given to slow heart rates and decrease blood pressure.  Sometimes, depending on the origin of the PVCs other anti-arrhythmia drugs may be administered.

What can you do to prevent them?

Primarily, you can take note of when they occur: during stress? After cigarettes? When you drink? After using drugs?  WHen working out? And alter your lifestyle to include making healthy lifestyle changes, including cutting out tobacco, decreasing your alcohol intake, increasing your water, and eat a healthy diet.  To cut down on stress, you may want to include adding yoga or meditation to your daily routine, or taking to your HCP about other ways to de-stress.  If your PVCs occur with regularity after something easy to cut out (like smoking) then problem solved, but the tests run by your HCP will better help you to figure out the source of the PVCs.

Yours in Good Health

B