Tag Archives: #cardiachealth

Can your Antibiotic cause an Untimely Death?

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So many people know about the broadband antibiotic Azithromycin, also known as the Z-Pak, and many times people will call their Healthcare Practitioner (HCP) and ask for it by name. And over 55.3 million prescriptions were written for the Z-Pak last year alone! Not only is that a bad idea because using such a powerful antibiotic and not necessarily treating the appropriate organism can lead to antibiotic resistance organisms, but a new study is showing that the use of Z-Paks can also lead to heart arrhythmias, stroke, and death.

Z-PakWhat can happen?

The New England Journal of Medicine recently published a study, showing that people who took the Z-Pak were more likely to die of a heart attack, stroke, sudden cardiac arrest, or an arrhythmia (abnormal beating of the heart) than those prescribed other antibiotics. The Z-Pak is used so much because there are less pills over a shorter period of time than other antibiotics, such as amoxicillin, and there are many people with penicillin allergies that cannot take amoxicillin, so there is an increased use, because patients may be more likely to actually take the medicine appropriately and for the prescribed amount of time. All Medicaid patients on the Z-Pak and other antibiotics from 1992 to 2006 were looked at, at it was found that those on the Z-Pak were 2.5% more likely to die than those on other antibiotics. And, certain patients had a 10% increase for risk of death. Unfortunately they are still looking into the exact mechanism that maybe causing certain patients to die, but they are still researching that further.

Am I at Risk?

Now just because this study came out, and you may be taking a Z-Pak to treat a bacterial infection, it does not mean that you are going to die! The subset of patients that had a higher risk of cardiac death had a history of cardiac disease and/or arrhythmias (irregular heartbeats) for various different reasons. So, while that particular reason is being studied, HCP’s need to ensure that they are utilizing the Z-Pak appropriately and when needed, and using more bacteria specific antibiotics, especially when patients have a cardiac history.  Also, it is important to only use antibiotics when you have a bacterial infection; many people go to their HCP in the throes of a viral infection and insist upon antibiotics, and clearly there are risks.

Trust your HCP that they will treat you with an antibiotic, if necessary, and realize that asking for a specific brand, may not be the most appropriate course of treatment, just because they have more advertisements! Asking for drugs by name, and pressuring your HCP for a specific treatment may not be the best thing for your health.  Seek treatment when necessary and have some faith that your HCP knows what is best!

Yours in Good Health

B

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

 

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

Atrial Fibrillation (AFib): Symptoms, Causes, & Treatments

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Atrial fibrillation is a very common cardiac issue, although I am hearing about more and more people being diagnosed with it, and I am getting lots of questions from readers about this diagnosis.  Again, it is very common, and I think that people should be aware of the symptoms, the causes, and the treatment of this cardiac arrhythmia (and arrhythmia is just when the heart beats at an abnormal rate or rhythm.)

What is Atrial Fibrillation?

It is an abnormal heartbeat, that can be very rapid, and lead to poor blood flow to various parts of the body, as the heart isn’t able to completely fill with blood before contracting (each beat), so only some of the blood that should be going out through your arteries to the extremities is available.  The atria (the top two portions of the heart) are beating faster and not in sync with the ventricles (the lower portions of the heart.)  Normally the Sinus Node (a group of cells in your heart) act as a natural pacemaker for you heart; it sends out a signal that passed through the atria (the upper two chambers of your heart) and causes them to contract and pump blood into the ventricles (the lower to chambers), then the signal hits the AV (atrioventricular) Node, which causes the ventricles to contract and move blood out from the heart into the extremities. in Atrial Fibrillation, the Sinus Node sends chaotic signals, so the atria are quivering in attempting to respond to each electrical signal, and the  AV Node becomes overwhelmed with the electrical signals as well, so the ventricles also beat faster than normal (though not as fast as the atria).  The normal heart rate is 50-90 and in AFib your heart rate can be as fast as 100-175 beats per minute.

It is normally not life threatening, as people live with it chronically, or they flip in and out of it, but it can have some serious complications, and if you go into a rapid a fib, you should be seen immediately by medical services, especially if you are feeling unwell, light-headed, etc.  There are various different treatments, including medications and electrical treatments.  Many people live long lives with chronic atrial fibrillation, it is just important to know the symptoms, treatments, risks of treatments, and when you should seek immediate medical attention.

What are the Symptoms?

*If you have any of these symptoms, you should be seen by your HCP to get your heart checked out and make sure that is the source.  Also, as I said above, there is paroxysmal AFib which comes and goes with symptoms, and chronic, in which your heart is continuously in this abnormal rhythm.

-Palpitations (a fluttering in the chest, rapid/racing heart rate)

-Weakness

-Lightheadedness

-Confusion

-Shortness of breath

*If you ever have chest pain along with any of these symptoms, or alone, you should seek immediate medical attention because you may be having a heart attack. Please go to the nearest emergency department or call 911.

What are the causes of AFib?

-Congenital heart defects (heart defects you are born with)

-Heart Attacks

-High Blood Pressure

-Heavy use of stimulants (caffeine, medications, tobacco)

-Heavy alcohol use

-Sick Sinus Syndrome (a defect of the sinus node where it speeds up on its own)

-Emphysema or other chronic lung diseases (like Chronic Obstructive Pulmonary Disease COPD)

-Abnormal heart valves

-Prior cardiac surgery

-Viral infections

-Sleep Apnea (where you lose your airway for short periods of time while sleeping)

-Stress from Pneumonia or other illnesses

What will put me at higher risk?

-A family history: If anyone in your family, especially a close relative has AFib, you are also at risk.

-Age: The older you are, the more increased your risk becomes. Especially if you have any chronic illnesses

-High Blood Pressure: If you have uncontrolled high blood pressure, you are at a higher risk for AFib.  If you have made the proper lifestyle changes to get more exercise, eat healthy, and take medications to treat the blood pressure, then your risk shouldn’t be increased.

-Heart disease: If you have a history of heart attacks, valvular disease, heart surgery, or other arrythmias.

-Drink Alcohol: Usually binge drinking (5 drinks in two hours) can put both men and women at a higher risk for atrial fibrillation. (take heed college students!)

What are the major Complications?

Well, one of the biggest risks is stroke. When the atria are quivering and not completely expelling all of the blood they fill with to the ventricles, the blood leftover is at risk to clot (little micro clots) and when they get ejected eventually into the blood stream, it can travel to the brain, impede blood flow, and cause a stroke (death of some of the brain cells due to a lack of blood flow.)  Also, when your heart is working so hard constantly, without treatment, it can lead to heart failure; your heart is unable to meet the demand of your body by being able to eject enough blood to get to where it needs to go.

How is AFib diagnosed?

It is early important to bring with you a list of symptoms of your HCP, when you most experience them, all of your past medical history, any and all medications you take, and be very honest with your HCP about your lifestyle (eating habits, exercise, etc.) Your HCP will take that into account when doing your physical assessment, listening to your heart sounds, and checking your blood pressure and heart rate.  You will also most likely 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.

–Blood Tests: your HCP will check to see if you have a thyroid problem or any other electrolyte abnormalities that would cause your heart to beat irregularly.

–Chest X-Ray: Just a quick and less invasive way to see your heart and lungs and diagnose a possible pneumonia that could cause your symptoms.

What are the treatments?

The treatments are aimed at controlling your heart rate and preventing blood clots. If you are caught quickly with the arrhythmia, you can be cardioverted (your heart rate can be attempted to be manipulated and changed) back to a normal rhythm using either electricity (you will be given sedation and get a moderate amount of electricity to shock the heart back into a normal rate)  or you can be given Intravenous medications to do the same thing  (which requires monitoring and a possible overnight in the hospital).  Before any form of cardioversion you will be given a blood thinner to prevent clots from forming and from being ejected into the blood to prevent a stroke. And you will also have to take the medications for 4-6 weeks after a successful cardioversion.  Most often Coumadin (warfarin) is used as a blood thinner, but you have to be careful, as there are MANY side effects with Coumadin (and the other blood thinners commonly used such as Dabigatrand and Rivaroxaban.)

If the cardioversion is NOT successful, you will be kept on a blood thinner and a medication to keep your heart rate 60-90 and prevent the rapid Atrial Fibrillation.  Some of the medications that may be used to rate control your heart are:

-Amiodarone (Cordarone)

-Dofetilide (Tikosyn)

-Metoprolol (Lopressor)

-Sotalol (Betapace)

-Dronedarone (Maltaq)

There are two surgical procedures that can be done that can treat AFib as well.  A radio ablation is when the HCP puts a catheter through your groin artery into your heart, and where there are areas of “hot spots” or cells that are acting like a pacemaker (like your Sinus Node), electricity is used to ill off those hot spots and cause scarring. Electrical impulses in the heart cannot go through scar tissue.  There is also a surgical Maze procedure where there are small cuts made in the heart tissue to also cause scaring and prevent the electrical impulses from causing the quivering of the atria; this needs to be done during open heart surgery so is usually down when someone is having open heart for another reason (such as valvular repair) and if they do not respond to other treatments.  These are both pretty invasive, but if you do not want to chronically be on medications or are not responsive to medications, they are great options.

How do I prevent AFib?

Some of the risks you have no control over, like family history or congenital defects, but overall, living a healthy lifestyle, eating low-fat and low sodium, and getting at least 20-30 minutes of exercise daily greatly helps you in preventing AFib.  Also, quit smoking, and don’t intake too many stimulants (maybe you don’t need that 4th cup of coffee and lay off the 5 hour energy?).  Try to limit your drink in g to 1-2 drinks per day, and just be aware of the symptoms.  If you are at all worried about your risks, or you have any of the symptoms, talk to your HCP and see if there is anything else you can do to prevent AFib.

Yours In Good Health

B