Your Heart Questions Answered by Emory Women’s Heart Center

heart-stethoscopeThank you for participating in American Heart Month! We would like to thank our experts Dr. Alexis CutchinsDr. M Carolina GongoraDr. Gina Lundberg, and Dr. Susmita Parashar,  from Emory Women’s Heart Center, for answering your submitted questions.

Review Part 2 questions and answers here!

What services does the Women’s Heart Center Offer?

The Emory Women’s Heart Center offers comprehensive cardiac risk assessments and education for women at risk for heart disease. If necessary, the Center can also assist with referrals. Screenings are beneficial to those who have a family history of heart disease or risk factors such as obesity, hypertension, smoking, and/or diabetes. The initial two-hour screening includes a review of family history of heart disease and a comprehensive global risk assessment that includes age, blood pressure, total cholesterol level, HDL level, blood glucose, smoking history, pregnancy history, hypertension history, and individualized education based on your risk factors. Screenings can be self-referred and start at $75.

You can learn more by visiting our website: www.emoryhealthcare.org/womensheart

Is there a favored blood thinner for use in women versus men or in general? I use warfarin and it is well controlled, but I am tired of the constant checks.

The real question is “why do you take warfarin?”  Warfarin is the only drug approved for mechanical heart valves. But when people take blood thinners for atrial fibrillation, there are other newer, better, and safer options. There is no blood thinner better in women but Eliquis, Xarelto, and Pradaxa are very safe in women and do not require routine blood testing. These drugs are no more risk for bleeding complications than warfarin but provide better protection from stroke compared to warfarin.

How do I know if any of my arteries are clogged? If they are, how can I unclog them? 

A great early detection test for atherosclerosis is the CT scan of the chest for coronary artery calcification (CAC). It shows when atherosclerotic plaque has started to calcify which is an early stage in the development of coronary disease.

All adults should follow a plant-based low-fat low cholesterol diet. All adults should exercise routinely and strive to maintain normal body weight and have their blood pressure, cholesterol, and blood glucose checked for a coronary artery disease risk assessment.

The best way to “unclog arteries” is a healthy lifestyle. When blockages are limiting blood flow to the heart, other interventions may be needed.

I have some shoulder pain at times and pain in both my left and right arms. Could that be a heart problem or just old age?

Pain due to limited blood flow to the heart can give symptoms of heaviness or pain in the neck, jaw, chest, shoulders, back, upper abdomen, or in either arm.  The only way to know if these pains are coming from the heart is through proper cardiac testing. Please let your doctor know if you are having these symptoms and get a proper evaluation. If the symptoms are severe or intense, call 911 and go to the emergency room immediately.

How do you begin healing the heart and lungs after a long period of smoking? Is it even possible?

When someone quits using nicotine through cigarettes, the lungs start to improve immediately. Within a year, the lungs are greatly improved and the risk of cancer is reduced. But reversing the nicotine effects on the heart arteries can take up to 15 years. But it’s never too late to get benefits from smoking cessation.

I have chronic atrial flutter, I would like to know if it can cause a heart attack?

Atrial flutter, which is very similar to atrial fibrillation, can be from many things. High blood pressure, valvular heart problems, sleep apnea, blocked arteries to the heart, and even thyroid problems can cause these heart rhythms. The greatest risks are associated with the underlying causes. Atrial fibrillation and flutter can lead to a stroke and so it is important to get proper medications to reduce these risk. It’s also important to have a proper evaluation to try to determine the underlying cause of atrial fibrillation.

I was told I have costochondritis. Does this have a link to heart failure?

Costochondritis is inflammation of the chest wall, sternum, and ribs. It can be quite painful. It is also rather common. Recurrent costochondritis can be associated with rheumatologic and connective tissue disorders.  But costochondritis is not a heart problem at all and does not lead to heart problems. It is a musculoskeletal problem of the chest wall.

I have tachycardia and my chest hurts very often. My whole arm is numb and when I go to the doctor, the electrocardiogram does not display anything. I come from ancestors who had catalepsy. Do you have any advice for me?

I cannot speak completely to your symptoms from this short description, you may need to see a physician in person. An electrocardiogram in the office may not capture what you are experiencing if your symptoms have subsided by the time you get there. You may need to wear an event monitor to see what your heart rhythm is when it goes fast.

I am a 70-year-old woman. I am in good health, but some nights when l am very concerned about my loved one, I can’t fall asleep and my heart beats are very strong. It doesn’t seem normal. Do I need to get checked by a doctor?

This symptom could be stress-related extra beats which will feel stronger than regular beats but are usually benign. Often times we have extra beats throughout the day but don’t really feel them until lying in bed quietly at night when there are no other distractions. If you are experiencing lightheadedness or shortness of breath with these beats that are concerning and you should be evaluated by a physician who may ask you to wear a heart monitor. Sometimes these extra beats can also be induced by caffeine so avoiding caffeine may help. If your symptoms become more frequent and inhibit your ability to sleep I would recommend an evaluation.

What happens when a person is told that the valve in the heart does not close well when the blood enters and leaves but that the problem is mild? Is there any discomfort in those moments? Can this cause tachycardia or distress?

Many people have mild leaking across some of the valves in the heart. This mild leak should not cause any symptoms and should be very well tolerated. It is not uncommon to find this incidentally on an echo.

I have an enlarged heart. How should I follow up with this situation? Can this condition be helped with diet changes and exercise and holistic living?

There are many different things that could cause an “enlarged heart.” It is actually a very vague term. Without more detail, I cannot really answer the question. Sounds like the first step would be an echocardiogram.

I have Right Bundle Branch Blockage. I don’t understand what it is. I wasn’t put on any medication. Is there anything I need to watch for? Will it go away? What causes it?

Some people are born with a Right Bundle Branch Block, others develop this over time. It is a minor abnormality in the conduction system of your heart. It should not cause any symptoms and does not require treatment or medication. Sometimes, a Right Bundle Branch Block can be an indication of strain on the right side of the heart. If you are at risk for sleep apnea or have other symptoms like shortness of breath, then your doctor may want to order an echo. If this was an asymptomatic, incidental finding then no further workup is needed.

I am about to start my Keto diet for the third time. Is this diet okay for heart health?

We typically recommend the Mediterranean and DASH diets which have shown to reduce the risk of developing and worsening heart disease.

The Mediterranean diet is based on traditional foods from Italy and Greece, hence the name. It consists of daily servings of fruits, vegetables, olive oil, nuts and whole grains. Frequent ingestion of fish, moderate ingestion of low-fat yogurt and cheese and eggs, and infrequent ingestion of red meats, refined oils, refined grains and processed sweets. This diet has been shown to prevent heart disease and stroke.

The DASH diet is meant to prevent hypertension. It favors food lower in sodium and richer in potassium, magnesium, and calcium. It is similar to the Mediterranean diet in recommending intake of plenty of vegetables, fruits, and low-fat dairy products, as well as whole grains, fish, poultry, and nuts.

Can your healthcare facility do anything if you’re in stage 3 congested heart failure? If anything can be done for coronary artery disease, how do you get put on the waiting list for a heart transplant? What are some options if you can’t do anything for coronary artery disease and congested heart failure?

Emory Healthcare has a specialty center dedicated to caring for individuals with congestive heart failure – the Advanced Heart Failure Therapy Center. You may visit the website to learn more about this center including how to make an appointment. Your questions are very specific and difficult to answer without a full medical history and physical examination. We would recommend seeing one of our specialists for a full evaluation.

Review Part 2 questions and answers here!

To learn more about Emory Healthcare’s Heart and Vascular Center, please visit: www.emoryhealthcare.org/heart

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