Heart Disease

Heart Disease in Men

Heart disease is one of the leading health risks facing men today. Heart disease is the leading cause of death for men in the United States, killing 347,879 men in 2017—that’s 1 in every 4 male deaths [1]. According to the American Heart Association, more than one in three adult men has heart disease, and men comprise more than 51 percent of the deaths that occur due to heart conditions [2].

When we think of heart disease in men, we tend to think of coronary artery disease—the narrowing of the arteries leading to the heart—but heart disease is actually an umbrella term that includes a number of conditions affecting the structures or function of the heart. These conditions can include:

  • Abnormal heart rhythms or arrhythmias
  • Heart valve disease
  • Heart failure
  • Congenital heart disease
  • Heart muscle disease (cardiomyopathy)
  • Aorta disease

Signs & Symptoms

You’d think that with such a serious disease you’d have significant warning signs, but you may be developing heart disease without knowing it. In fact, half of the men who die suddenly of coronary heart disease have no previous symptoms [3]. Even if you have no symptoms, you may still be at risk for heart disease.

The first sign of heart disease is often a heart attack or other serious event, but there are a few key signs to be aware of that can help recognize problems before they progress. In the early stages, symptoms include but are not limited to:

  • Difficulty catching your breath after moderate physical exertion
  • Erectile dysfunction – studies found that even minor erection difficulties could be indicators for heart disease. Erection difficulties are mainly caused by blockages in the small arteries that supply the penis. This is a good indicator of what is happening in other larger arteries in the body, including those that supply the heart.
  • A sense of discomfort and/or pain in your chest
  • Unexplained pain in your upper torso, neck, and jaw
  • A change in your extremities (e.g., pain, numbness, tingling)

Risks

Apart from the above symptoms, there are certain risk factors that can make you more prone to heart disease. The good news is that many of the major contributing factors can be controlled, including:

  • Hypertension (high blood pressure)
  • Tobacco use
  • Raised blood glucose (diabetes)
  • Physical inactivity
  • Unhealthy diet
  • Cholesterol/lipids
  • Overweight and obesity

There are also other risk factors that are not modifiable such as age, gender and family history.

What You Can Do

Lots of things affect whether you get heart disease, and you control many of them. Some immediate steps you can take are the following:

Keep an eye on your blood pressure. In terms of global attributable deaths, the leading CVD risk factor is raised blood pressure (to which 13 percent of global deaths is attributed). High blood pressure is now classified as a blood pressure greater than 130/80.

Stop tobacco use. Tobacco use is second in factors leading to attributable deaths, with 9 percent attributed [4]. More than 20 of every 100 adult men (20.5%) smoke cigarettes compared to 15.3% of women, putting men at a higher risk [5].

Work on your weight. Many Americans are overweight. Bringing your weight to a healthy level is a plus for your heart. This can be accomplished by being physically active and enjoying healthy eating.

Maintain your social and emotional health. Cut out as much stress as possible. Find ways to ease the stress you can’t avoid. Exercise, meditation and talking to people you trust are three ideas to start with.

Be aware of cholesterol levels. High cholesterol is another controllable risk factor that can increase a person’s chance of heart disease. Men aged 20 or older should maintain a total cholesterol level of 125 to 200mg/dL. LDL should be less than 100mg/dL, HDL should be 40mg/dL or higher.

Limit your alcohol use. Anything more than moderate drinking is considered unhealthy. What’s moderate drinking? Up to 1 glass a day for women, and up to 2 glasses a day for men.

Lastly, consult your physician. Your doctor can help you develop healthy habits, prescribe appropriate medications, and figure out if your family’s medical history puts you at risk. Even if you have heart disease, you can live a healthier, more active life by learning about your disease and treatments and by becoming an active participant in your care.

To learn more about heart disease and treatment at Emory, visit the Emory Heart and Vascular Center website at emoryhealthcare.org/heart


About Dr. Sperling

dr laurence sperlingLaurence S. Sperling, M.D., FACC, FAHA, FACP, FASPC, is the founder and director of Preventive Cardiology at the Emory Clinic. He is currently Katz Professor in Preventive Cardiology at the Emory University School of Medicine.  In addition, Dr. Sperling is a professor in the Rollins School of Public Health in Global Health.

Dr. Sperling Is a member of the writing group for the 2018 Cholesterol Guidelines, serves as co-chair for the ACC’s Cardiometabolic and Diabetes working group, and is co-chair of the WHF Roadmap for Cardiovascular Prevention in Diabetes. He was awarded The American College of Cardiology Harry B. Graf Career Development Award for Heart Disease Prevention and The American Heart Association Council on Clinical Cardiology Scholarship for Physical Activity and Public Health in 2001.

Sources:

  1. https://www.cdc.gov/heartdisease/men.htm
  2. American Heart Association. “2020 Heart Disease & Stroke Statistical Update Fact Sheet Males & Cardiovascular Diseases”: https://professional.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_505484.pdf
  3. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–220.
  4. World Heart Federation. “Cardiovascular Disease Risk Factors.” http://www.world-heart-federation.org/press/fact-sheets/cardiovascular-disease-risk-factors/
  5. Center for Disease Control (CDC). “Current Cigarette Smoking Among Adults in the United States.” http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/

More Atlantans Avoid Open-Heart Surgery with Latest Valve Treatment

It started with shortness of breath, which Donna Jan Green had become used to given a history of heart issues going back to childhood. But it became worse. When she’d visit one of the craft shows she loved attending, she couldn’t walk far without having to sit down. It grew so bad that even going to check the mail required a long rest at the mailbox before she could muster the energy to walk back inside.

The calcifying valves within Green’s aorta—the body’s largest artery, which carries oxygen-rich blood away from the heart—were taking her breath away. It was why Green found herself at Emory’s Structural Heart & Valve Center, mentally preparing herself for open-heart surgery of the type she’d endured many years ago when her mitral valve began to fail.

At least, until she was introduced to a four-letter acronym.

“They told me, ‘You’re a good candidate for a TAVR,'” recalled Green, now 73 and a Jonesboro resident. “I said, ‘TAVR? What’s a TAVR?’ I had never heard of it before.”

She was in the right place to have her questions answered. TAVR, short for transcatheter aortic valve replacement and pronounced “ta-ver,” had been pioneered by physicians at Emory, who performed the first TAVR in the state of Georgia in 2007. Rather than the traditional procedure of opening the chest, TAVR involves replacing the valve via a catheter typically inserted in the femoral artery, reached by making a small incision in the groin. The less invasive method leads to quicker recovery times and sooner trips home.

A Leader in TAVR Research and Usage

TAVR was originally available only for frail or older patients deemed too high risk for traditional open-heart surgery. TAVR became an option for medium-risk patients after a second clinical trial, with Emory as one of the leading enrollers, which found those using the less invasive method fared better after one year than others who had undergone traditional surgery. Patients who received TAVR had roughly half the one-year risks of stroke and mortality compared to those who underwent the much more invasive open-heart route.

Emory has performed more TAVR procedures than any other health care system in Georgia. It was one of just five approved centers in the U.S. to participate in the first stages of the original PARTNER I clinical trial in 2007. Emory Healthcare has gone on to perform more than 3,000 of the procedures since 2007.

But when Green was preparing for her surgery in August of 2016, she still needed to be convinced. The findings of the clinical trial had been published only five months earlier, prompting plenty of questions about what this treatment meant.

“I said, ‘No sir, give me the old surgery,'” Green recalled. “Put me on a heart-lung, give me a titanium valve and let me go home.”

But her previous heart surgery to replace her mitral valve, in addition to breast cancer removal she underwent later, simply left too much scar tissue, doctors told her.

Green and a friend spent an entire day praying over the decision, and at last she agreed.

The TAVR procedure took approximately 45 minutes and, soon afterward, Green was awake, sitting up and trying to go back to her room to watch her beloved Boston Red Sox on TV.

It was a stark contrast to her open-heart procedure, when her mitral valve had been replaced.

“It was a long time getting better after being cut open. For about the first 24 hours, I was incoherent. I was in the hospital six or seven days. I had a hard time getting up and I couldn’t get up without help. I had a long recovery. I’m talking probably three to four months,” Green recalled.

“With my TAVR, 20 minutes after I came out of surgery, I was awake. I felt fine. I sat up on the side of the bed and everyone said, ‘Whoa, whoa, where are you going?’ I said, ‘I want to get up.'”

‘Nothing Like It Was Before’

More than two years later, “I’m doing great,” she said.

Following her TAVR surgery, she went through six weeks of heart therapy. In 2017, she was able to fly to Irvine, Calif., to meet the people who had made her replacement valve, and others who had undergone the life-changing procedure.

“It was wonderful. We had meetings, and they told us all about the TAVR. There were 50 patients and 50 caregivers, and they pumped our brains for three days. They wanted to know: Did you hurt? How did the surgery go? How do you feel now?” she said.

Green was asked to give a speech about how she decided to proceed with the TAVR surgery.

“I was really apprehensive about having it, and I let them know that they needed programs to get this information out there, because the TAVR is a wonderful invention,” she said.

The crippling fatigue that once forced her to rest at the mailbox is gone. She now takes aerobic classes three days a week.

“I struggle through it, but I continue to do it,” Green said. “I still get short of breath, and I probably always will because I’m a heart patient. But it’s nothing like it was before.”

Emory Structural Heart & Valve Center

The Emory Structural Heart & Valve Center most recently participated in the PARTNER III clinical trial that made the technique available to low-risk patients. Certain approved patients can undergo the procedure without general anesthesia and recovery takes place on the cardiac telemetry floor rather than the ICU.

Patients can make an appointment at Emory Structural Heart & Valve Center by calling 404-778-7777 or visiting emoryhealthcare.org/structuralheart to fill out an online form requesting an appointment.

Dark Chocolate: The Heart Healthy Gift for Your Valentine

For Valentine’s Day, go ahead and give your sweetheart some dark chocolate this year … to consume in moderation.

In past years, more research has suggested a beneficial link between higher levels of chocolate consumption and the reduction of the risk of cardiovascular events. In one study, participants with the highest levels of chocolate intake had a 37 percent reduction in cardiovascular disease and a 29 percent reduction in stroke compared with participants who consumed the lowest levels of chocolate.

The secret behind chocolate’s beneficial effects on the heart is the effect of powerful micronutrients – flavonoids and phenols found naturally in the cocoa bean. These compounds function like antioxidants found in fruits and vegetables where free radicals are neutralized and destroyed, helping the body resist damage to cells. For example, flavanols help keep LDL cholesterol from becoming oxidized and clogging up coronary artery walls.

Studies also suggest that the phenols found in dark chocolate may help lower blood pressure by an average of 5 points for systolic and an average of 2 points for diastolic blood pressure. Improvement in blood pressure has been found in people who consumed as little as 3 1/2 ounces of dark chocolate every day for 15 days. But, the effect may be short lived as one study found that after only two days without chocolate blood pressure returned to previous higher levels.

Finally, researchers believe that dark chocolate can help improve endothelial function. This refers to the cells that line the blood vessels to help keep them dilated and elastic. Coupled with reducing inflammation, normal endothelial function promotes free flowing blood and prevents platelets from sticking together and forming a clot which can lead to stroke and heart attack.

Unfortunately, there can be a down side to the chocolate we eat every day. First, as chocolate is processed to eliminate the natural bitter flavor, the beneficial flavonoids and phenols are also removed. Second, the chocolate we consume is usually processed with excess fat and sugar. These extra calories can lead to obesity and diabetes, which can reverse any positive effects that chocolate may have on the heart.

So, like all things in life, the best solution is to eat dark chocolate in moderation:

  • Look for a cocoa content of at least 65 percent and remember the higher the better in terms of flavonoids and phenols. Milk chocolate has lower levels of cocoa, and white chocolate does not contain any cocoa. Even worse, both have more fat and sugar than dark chocolate.
  • Limit yourself to no more than 3 ounces (85 grams) a day.
  • Balance the extra calories from chocolate by eliminating calories from your diet.
  • Don’t wash down your chocolate with milk, as it may interfere with the absorption of antioxidants from chocolate.
  • Don’t forget about other sources of flavonoids and phenols like fruits, vegetables and red wine.

To make an appointment with an Emory Healthcare Cardiologist, call 404-778-7777.

 

 

 

Your Heart Questions Answered by the Women’s Heart Center – pt 2

Heart Failure Live Chat 7/25/17Thank you for your patience and for your participation in American Heart Month! We received so many great questions, it took us a while to get through them all. We hope you find our Part 2 answers helpful. Thank you to our Emory Women’s Heart Center experts  Dr. Alexis CutchinsDr. M Carolina GongoraDr. Gina LundbergDr. Susmita Parashar, and Stacy Jaskwhich for answering these submitted questions.

Review Part 1 questions and answers here!

What are the signs of heart disease? Are there any silent signs? 
Signs of heart disease may include the ones we would typically think about:

  • chest pain
  • shortness of breath
  • palpitations

Some other signs of heart disease that may not be as distinguishable (or considered silent as they are not recognized as a heart problem) could be:

  • dizziness
  • nausea
  • sweating or flushing
  • neck pain
  • jaw pain
  • back pain
  • general fatigue

All symptoms are more suggestive of heart disease when they occur with exertional activity or are triggered by emotional stress.  Some symptoms occur over time and people acclimate to them or shrug them off as “being out of shape” or “going through menopause”.  Progressive symptoms, such as increased shortness of breath with walking up stairs, can be a worrisome change and you should definitely mention to your physician.

How do you know when you have heart disease? 
Bottom line is, you won’t know if you don’t look. Studies have shown that 2/3 of women have no previous symptoms prior to their heart attack. There are many types of heart problems that an individual could have such as an enlarged heart, electrical abnormalities of the heart (arrhythmias) or blood flow issues.  We usually think of heart disease as blood flow issues or blockages that might cause a heart attack. You will likely notice some signs or symptoms in this scenario, but the best way to know for sure is by having a screening or seeing a Cardiologist for testing. Common sense would tell us that the more risk factors that you have for heart disease, the higher the probability.

There are many screening tests which can be performed to give you a better idea of your cardiac status.  You can actually have heart disease for a long period of time prior to having an event.  If you have a strong family history of heart disease or multiple risk factors, it may be a good idea to have a Coronary Calcium Score.  This is a CT of your heart that identifies hard, calcified plaques in your heart arteries.  It really helps to determine if you have the disease and to quantify the amount of disease that is present.  The result will be given in an age-matched reference so that you can see how you are doing in comparison to other women/men in your same age group.  The more plaque you have, the more aggressive your treatment plan should be.  If you are having any type of symptoms, you should have diagnostic testing.  Most people start with a simple EKG, but a treadmill stress test is a better tool.  If the stress test is positive for EKG changes with exercise, further tests may be indicated.

What are the most common kinds of heart troubles? 
In a cardiology practice, we commonly see a multitude of heart problems, many of which are brought about by the risk factors such as:

  • high blood pressure
  • high cholesterol
  • sleep apnea
  • being overweight
  • diabetes
  • depression
  • lifestyle choices

Think of your heart as a house with 3 basic responsibilities: pump, plumbing, and electricity.

  • You can have a pump issue in which your heart muscle is enlarged, thickened or damaged. Consequences of this can result in a condition called congestive heart failure.
  • You can have a plumbing issue in which you have plaque build up that eventually closes your arteries and prevents well-oxygenated blood from reaching your heart muscle. Consequences of this could lead cause a heart attack.
  • You can have an electrical issue in which your heart loses the ability to normally conduct impulses.  These can stem from the upper and lower chambers of the heart and some are more worrisome than others- the most common electrical problem that we see is Atrial fibrillation. Consequences of Atrial fibrillation can lead to blood clots or stroke when the heart beats irregularly and sets up the perfect scenario for a blood clot to form and then be lodged into the systemic circulation.

While all of these consequences seem very frightening, many can be avoided if we prevent risk factors from occurring by maintaining heart-healthy lifestyles in the first place.

By what percentage is the reduction of heart disease changed, as backed by scientific studies, when one makes positive changes.  
It is somewhat difficult to predict because it depends on different variables. Some risk factors are non-modifiable, such as genetics, age, gender, and race.  Of the modifiable risk factors, several studies have highlighted the critical importance of lifestyle modifications in heart disease prevention.  A Nurses’ Health Study demonstrated that women were able to reduce their risk of coronary events by >80% by not smoking, maintaining healthy body weight-BMI< 25, consuming a healthy diet, participating in moderate to vigorous exercise for 30 minutes a day, and consuming no more than a moderate amount of alcohol.

Another study named INTERHEART identified 9 easily measured risk factors (smoking, lipids, hypertension, DM, obesity, diet, physical activity, alcohol consumption, and psychosocial factors) that account for over 90% of the risk for acute heart attack.  This study also demonstrated that although the magnitude of the cardiovascular risks for men and women were similar, the impact of modifying the risks was greater in women.

What are some natural supplements that keep our hearts healthy?  
Heart health starts with exercise and a healthy diet.  The majority of the diet should come from vegetables, lean protein, low glycemic fruits, and some whole grains while limiting carbs and sugars.  Diet should consist of low sodium and high fiber.  It should include healthy fats such as nuts and olive oil.  Certain foods can be especially helpful for different cardiac problems.  For example, blueberries, leafy greens, seaweed, mushrooms, and celery have been shown to be beneficial in lowering blood pressure.

To further support your heart health, certain supplements may be helpful; however, these should always be recommended by a healthcare provider who has experience and training in the use of supplements. If you have a heart condition or are high risk for a heart attack, you must always follow your doctor’s advice before using any supplement.  Some supplements may interfere with blood thinners. Actually being tested for certain deficiencies prior to taking certain vitamins and minerals, may be the safest practice. It is way too risky to treat a serious health condition on your own with over-the-counter supplements. Some commonly used supplements for the heart are:

  • Omega 3 fish oil
  • flax seed
  • plant sterols
  • CoQ10 enzyme
  • Vitamin D
  • certain B Vitamins
  • Vitamin C
  • Zinc
  • Folate
  • Garlic
  • Magnesium
  • Turmeric

What are the best types of vegetables and fruits to eat when you have blood clots?  
If you have a blood clot, you are likely on a blood thinner.  If you are on Coumadin, you will have to be aware of the vegetables that contain Vitamin K as it acts as an antidote for Coumadin (blocking blood-thinning properties).  Most green, leafy vegetables contain Vitamin K.  This doesn’t mean that you should avoid these vegetables if, on Coumadin, you just have to eat them consistently in order to keep your blood levels of Coumadin therapeutic.  We currently have much better options for blood thinners though (Eliquis, Xarelto, Pradaxa) which work on a different bleeding pathway and don’t interfere with foods that we eat.

Many patients are prescribed an aspirin a day to reduce the risk of blood clotting. The component in aspirin that is responsible for reducing blood clotting risk is called salicylates. Salicylates can also be found in a wide variety of fruits and vegetables such as oranges, blackberries, blueberries, pineapple, plums, prunes, raisins, raspberries, strawberries, grapes, cranberries, tangerines, hot peppers, olives, radishes, and tomatoes.

Omega-3 fatty acids are essential nutrients that aid in the regulation of normal blood clotting. Most people believe that in order to receive omega-3 fatty acids, they must consume a high a diet that is high in fish. While fish is a good source of omega-3 fatty acids, they can also be found in many vegetables including brussel sprouts, kale, spinach and salad greens.

Vitamin E is also capable of inhibiting platelets (the cells responsible for clotting) that works as a natural anticoagulant. Vitamin E can be found in spinach, broccoli, kiwifruit, mangos, and tomatoes.

Review Part 1 questions and answers here!

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

Emory Healthcare welcomes and encourages open discussions on all of Emory Healthcare’s social media sites. We look forward to any comments, stories, interactions, and experiences you want to share online. Before posting, please be mindful that Emory Healthcare’s social media sites are open to the public. DO NOT disclose any personal information that you do not want to be shared. By sending any content over the internet, you acknowledge that you assume full responsibility related to security, privacy, and confidentiality risks. The information presented here is NOT intended to replace a consultation with a qualified medical professional or take place of professional medical care. Due to a large number of questions we received, we are unable to answer all questions. The questions selected above are (in our opinion) of value to all readers.  

Hope For the Broken Hearted

Heartbreak, heartache, and heartbroken are not words you would typically associate with the day of love (Valentine’s Day)…Or are they?

When February rolls around each year, we’re bombarded with messages and sentiments of love.  Couples, families, and friends begin to plan for Valentine’s Day, the day of love and dinner reservations are made, gifts are purchased, cards are written, and for those that are really lucky, the decadence of chocolate awaits. For some of us though, Valentine’s Day can be difficult if that special someone is no longer around. The overwhelming symbolism of love may cause them to reminisce and feel a deep pain. We know this pain, usually felt in the heart, as a broken heart, but in the medical world, this condition (yes, it’s a real medical condition) is known as acute stress cardiomyopathy.

Acute stress cardiomyopathy or “broken heart syndrome” is a relatively temporary heart condition brought on by stressful situations, such as a death of a loved one, or the complete shock of an unexpected breakup. The syndrome can lead to congestive heart failure, high blood pressure, and potentially life-threatening heart rhythm abnormalities.

It’s been reported that patients, mostly women, have gone to the emergency room due to classic heart attack symptoms caused by the shock, but when doctors performed diagnostic tests, such as an electrocardiogram, the results tended to look very different from regular heart attack EKGs. Furthermore, subsequent tests showed that the heart tissue was not damaged at all.

Luckily, the symptoms of broken heart syndrome are treatable and the condition usually reverses itself in a matter of time. So if you’ve lost a loved one or experienced a break up recently, although Valentine’s Day may be more difficult than most days, fear not–the once a year holiday and the detriment of loneliness will pass. Perhaps take the holiday as an opportunity to do something healthy for yourself. Relax, or knock a few things off your to-do list, try out a new recipe or craft, or even use the holiday as an opportunity to remind a friend how much they mean to you.

Tell us, have you ever experienced the broken heart syndrome? If so, how’d you get through it?

Related Resources

Heart Failure Live Chat Transcript

Heart Failure Live Chat 7/25/17

Thank you to those of you who joined the Heart Failure Live Chat on 7/25/17 hosted by Dr. Divya Gupta from Emory’s Heart & Vascular Center. Dr. Gupta provided valuable insights into the causes of heart failure including contributing factors like heredity and medical conditions, treatment options and lifestyle changes. The live chat had a good turnout and the transcript is now available below.

Heart Failure Live Chat Transcript

 

Overview: If you or a family member has been diagnosed with heart failure you likely have many questions. Here’s your chance to ask an expert about living with heart failure, treatment options, second opinions, prevention; whatever’s on your mind. Join us on Tuesday, July 25 when Dr. Divya Gupta, a board certified heart failure cardiologist with the Emory Heart & Vascular Center, will answer all your questions.

12:01 P.M.
EmoryHealthcare: Hi everyone, please note that all questions are moderated before appearing in the stream, so you may not see yours appear right away, but we will do our best to answer all your questions today.

12:01 P.M.
EmoryHealthcare: We received some questions that were submitted in advance of the chat, so we’ll get started by answering a few of those first.

12:05 P.M.
EmoryHealthcare: Is a patient with pulmonary hypertension more likely to develop CHF than a patient a heart that is comprised?

12:05 P.M.
EmoryHealthcare: A patient with pulmonary hypertension is more likely to develop heart failure on the right side of the heart vs. left side of the heart. Heart failure on the right side is associated with swelling of the legs and abdomen which can cause physical limitations.

12:09 P.M.
EmoryHealthcare: Is heart failure hereditary?

12:09 P.M.
EmoryHealthcare: Yes, heart failure can be hereditary. Many times, we’re not able to figure out what the genetic alteration is that leads to it, but we do have evidence that it can run in families when looking at their family tree.  However, not all heart failure is heredity and different medical conditions can lead to heart failure. If there is a significant concern, genetic testing and counseling is recommended. With this data, the geneticist can identify the genetic alteration that runs in your family and preventative treat

12:12 P.M.
EmoryHealthcare: How safe is it to become pregnant with a leaky heart valve?

12:13 P.M.
EmoryHealthcare: The safety of becoming pregnant with a leaky heart valve depends on which valve and to what extent it is leaking. This would require close monitoring and consultation with cardiologist and high- risk obstetrician.

12:16 P.M.
EmoryHealthcare: We have a dedicated clinic for congenital heart conditions that specializes in treating patients with leaky heart valves, the Adult Congenital Heart Center. These physicians work closely with high-risk obstetricians within the Emory Healthcare system.  Please call HealthConnection to set up an appointment at 404­–778–7777.

12:19 P.M.
Guest5115: Are there differences in symptoms or treatment between heart failure caused by congenital heart defects and acquired heart failure?

12:20 P.M.
EmoryHealthcare: Heart failure is a clinical diagnosis and so the symptoms are similar in both populations. Typically, symptoms include tiredness, shortness of breath, issues with fluid retention.

12:21 P.M.
EmoryHealthcare: Another pre- chat question:  I was recently dx with left sided heart failure with an ejection fraction of 31- 40%.  I’ m on Coreg twice a day.  Is there anything else I need to know to help me improve my condition?  Also, I was working out before diagnosis.  I have literally stopped.  What type of exercise do you recommend?  And I Ian having a pulling sharp pain in the center of my chest.  Could that be relevant to my condition?  Work up show no cardiac relations.

12:25 P.M.
EmoryHealthcare: Coreg is an excellent medicine that has been shown to improve left side heart function, we typically increase the dose of this medicine so that a patient is taking 25– 50 mg twice a day, over several months. Also, we typically put patients on Lisinopril.

12:29 P.M.
EmoryHealthcare: Exercise is strongly recommended to help improve heart function as well.  Aerobic exercise is best, walking, running, biking or swimming are all acceptable forms of exercise. We don’t recommend heavy weight lifting and typically restrict weight lifting to no more than 50 pounds total.  When beginning an excise routine, start slow and increase as tolerated.  Make sure you listen to your body.  If you need to take a break and rest, that’s fine before starting again. The American Heart Association recommends 30 min

12:35 P.M.
EmoryHealthcare: There are two types of implantable devices often used in patients with low ejection fractions, defibrillator, and pacemaker. Anyone with an ejection fraction equal or less than 35% should be considered for a defibrillator, these devices monitor heart rhythm 24/ 7 and will function to save your life in the event of a life- threatening heart rhythm. Patients with low ejection fraction are at greater risk of having these life- threatening heart rhythms.

12:36 P.M.
EmoryHealthcare: Pacemakers are beneficial to some patients with low ejection fractions, the need for a pacemaker would be determined by your cardiologist. If they feel it would be beneficial, the pacemaker would help improve heart failure symptoms and help you live longer.

12:39 P.M.
Carol B.: My 86-yr. old Mom with a valve problem can barely stand without back pain and so tired?  Is this caused by lack of exercise or heart valve?

12:40 P.M.
EmoryHealthcare: The fatigue portion could be attributed to her valve problem, unfortunately, the valve issue could be preventing her from exercising which in turn may cause the back pain.  She would benefit from an evaluation of her valve and cardiac issues. You can make an appointment by calling HealthConnection at 404–778–7777.

12:43 P.M.
EmoryHealthcare: Is a BMT a good tool to diagnose CHF, versus lung disease?

12:44 P.M.
EmoryHealthcare: Yes. Another name for BMT is Cardiopulmonary Exercise Test. This is an excellent way to determine what is causing a patient to be tired and short of breath. It can not only help diagnose heart failure and lung disease but can also help determine if the lack of exercise is playing a role.

12:46 P.M.
EmoryHealthcare: These questions have been great! We have time for just one more question today. Any remaining questions will be answered by Dr. Gupta in a post- chat Q& A blog on http://advancingyourhealth.org

12:48 P.M.
EmoryHealthcare: My mom has congestive Heart Failure and needs the best heart doctor.

12:49 P.M.
EmoryHealthcare: Emory Heart & Vascular Center has many excellent physicians who are board certified in Advanced Heart Failure & Transplant Cardiology. Our nurses at HealthConnection can help you find the best physician for your Mom. They can be reached at 404–778–7777.

12:50 P.M.
EmoryHealthcare: Are there any other questions?

12:52 P.M.
EmoryHealthcare: That’ s all the time we have for today. Thanks so much for joining us! As we mentioned, we’ll follow up with a blog post to answer any questions we didn’t get a chance to address today. Thank you!


Want to Learn More?

At Emory Healthcare’s Heart & Vascular Center, your health is our priority. Our program is consistently recognized by U.S. News & World Report as one of the top heart health centers in the nation.

or call 404-778-7777 to make an appointment.

 

 

Heart Disease and Emory Women’s Heart Center

According to the American Heart Association, heart disease is the number one killer of women and is more deadly than all forms of cancer combined. It is also preventable. The Emory Women’s Heart Center is a program dedicated to the screening, prevention and treatment of heart disease in women.

The number of women at risk is startling. “Believe it or not, a very small percentage of women fall into the low risk category for heart disease, and those people are mostly in their twenties,” says Stacy Jaskwhich, a nurse practitioner at Emory’s Johns Creek’s Women’s Heart Center. “When you consider family history, age, diet, activity levels and other existing conditions such as diabetes or rheumatoid arthritis, most women are at some level of risk.”

“Most heart disease is preventable, so we want to reach these women, ideally between the ages of 40-60, to evaluate their individual risks and educate them on risk reduction. Starting treatment early, when it’s necessary, will help save lives,” says Gina Lundberg, MD, clinical director of Emory Women’s Heart Center and assistant professor of medicine, Emory University School of Medicine. Dr. Lundberg founded Georgia’s first women’s cardiac prevention program in 1998. She also launched the Emory Saint Joseph’s Heart Center for Women in 2007.

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. Gift certificates are also available to purchase for loved ones.

Women often experience symptoms that are different than those experienced from men. For example, women may not experience chest pain. Because of this, women must understand that heart attack symptoms may be similar to those of panic disorders, muscle strain, indigestion or influenza.

Rapid intervention is most effective in beginning stages of a heart attack. Damage to heart muscle starts within 30 minutes of the onset of symptoms, and according to the Society of Chest Pain Centers (SCPC), 85% of heart damage occurs within the first two hours – sometimes irreversible. Call 911 as soon as the first symptoms of a heart attack appear.

Symptoms of a Heart Attack

  • Chest pain or discomfort: It may feel like a squeezing, pressure, heaviness, tightness or fullness.
  • Heaviness or pain in areas other than the chest: This symptom is more common in women. The pain or pressure can be gradual or sudden. It may come and go, gradually intensify, or awaken one from sleep. Areas that are common include the back, neck, jaw or arms.
  • Cold sweats: This symptom can occur without chest discomfort. If there is no obvious reason for sweating, such as exercise or hot flashes, consider contact your physician.
  • Fatigue: Some women may experience an inability to complete routine tasks. This can be due to extreme tiredness or a decrease in energy level.
  • Nausea: This can be mistaken for other problems, such as influenza, heartburn, or stomach ulcers.
  • Shortness of breath: This can occur with minimal activity or with activities that previously did not cause difficulty with breathing. This is especially important for people with diabetes, as they are less likely to experience chest pain.
  • Lightheadedness: This symptom may occur with activity or in conjunction with any of the other symptoms.

 

A Disease You’ve Probably Never Heard Of

fmd-smallHave you ever felt sick enough to visit a doctor, only to feel much improved soon after leaving your physician’s office? Receiving an accurate diagnosis often makes us reassured, even before receiving treatment.  However, patients with rare diseases sometimes wait several years before discovering what causes their symptoms. Fibromuscular Dysplasia, commonly known as FMD, is a vascular disease often resulting in a delayed diagnosis due to lack of awareness.

What is FMD?

FMD is a non-atherosclerotic, non-inflammatory vascular disease most often affecting the renal and carotid arteries. Although it predominantly affects middle-aged women, the disease can present in men, women, and children of all ages. FMD causes abnormal cell growth in artery walls, most often presenting as a “string of beads.” On an angiogram, you would see sections of bulging and narrowing in the affected arteries.

Common symptoms

Sometimes FMD is entirely asymptomatic and is only discovered incidentally. However, carotid FMD often presents with headache and pulsatile tinnitus (a “swooshing” sound in your ears). Renal FMD can cause hypertension due to the narrowing of the renal arteries. Aneurysm, stroke, and carotid or renal artery dissection are also possible.

How are patients diagnosed?

FMD is diagnosed by angiography. Noninvasive techniques such as duplex ultrasound, MRA, and CTA can provide an accurate image of the vessels, but catheter angiography remains the most reliable method for diagnosing FMD. Unfortunately, there is no cure for FMD and the cause is unknown.

What treatment options are available?

While there is no cure, FMD rarely progresses. Some patients only need to be monitored with surveillance of the affected arteries. Your doctor may prescribe medications such as anti-hypertensives or antiplatelet therapy in order to prevent complications. In cases of severe stenosis or events such as stroke and dissection, invasive procedures may be necessary.

What resources are available for patients with FMD?

Emory is one of 14 centers participating in the US registry for Fibromuscular Dysplasia. This registry has enrolled over 1400 patients, and has contributed valuable information to the continuing research on the disease. Not only do hospitals such as Emory provide excellent care from doctors familiar with FMD, but they also allow patients to contribute toward further research and become part of the FMD community. The registry does not require experimental therapies, and all patient data is kept anonymous. Patients only need to provide consent for their medical information to be used in the data analysis. If you have been diagnosed with Fibromuscular Dysplasia, consider enrolling in the registry at your next appointment with Emory Healthcare.

What should I do if I am diagnosed with FMD?

Though many patients experience a variety of symptoms and vascular events, there is a very low mortality associated with FMD. It is a manageable disease, and once diagnosed, most patients are able to better control their symptoms. It is important to make follow-up appointments and continue to monitor your health. The Fibromuscular Dysplasia Society of America is also a good resource for both patients and physicians. FMDSA not only funds the FMD registry, but also holds annual meetings and conferences, and provides information that is both helpful and accessible to patients.

For more information, contact:

Emory University Hospital Midtown: 404-686-4411

Or Theresa Sanders MN, RN: 404-686-3872

Or Bryan Wells, MD: 404-686-8203

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Emory Women’s Heart Center Wear Red Events

womensheartwearredHeart disease is the number one killer of women in the United States, but in many cases it’s preventable. That’s why Emory Healthcare would like to invite you to join us at one of our women’s heart health events in celebration and recognition of Heart Month in February, as well as Mother’s Day in May.

During these fun, educational events, participants will have an opportunity to meet Emory Women’s Heart Center physicians and staff and learn about how to prevent, detect and treat heart disease. You will also have the opportunity to purchase products and services from our vendors who will be on hand providing consultations, displaying jewelry, sharing healthy foods, etc.

To learn more, please call Emory HealthConnection℠ at 404-778-7777. The events are free! Parking will be available in hospitals’ main parking lots.

Emory Women’s Heart Center Wear Red Event Details

Friday, February 5, 2016
Emory Saint Joseph’s Hospital
Doctors Building Atrium
7:30 a.m. – 1 p.m.

Friday, February 19, 2016
Emory University Hospital
Hospital Auditorium
Open House from
7:30 a.m. – 1 p.m.

Friday, May 6, 2016
Emory University Hospital Midtown
Medical Office Tower Atrium
Open House from
7:30 a.m. – 1 p.m.

View more Wear Red Event information here

About the Emory Women’s Heart Center

Emory Women’s Heart Center is a unique program dedicated to screening, preventing and treating heart disease in women. The Center, led by nationally renowned cardiologist Gina Lundberg, MD provides comprehensive cardiac risk assessment and screenings for patients at risk for heart disease as well as full range of treatment options for women already diagnosed with heart disease care. Find out if you are at risk for heart disease by scheduling your comprehensive cardiac screening. Call 404-778-7777.

Women & Heart Disease Live Chat- February 23, 2016

women-hrt-disease260x200Heart disease kills 6 times more women than breast cancer each year, making it the number one killer of women.

Many people consider heart disease to be a predominantly male-oriented condition. However, heart disease is the number one killer in women and affects one out of every three in the United States, according to the American Heart Association. Heart disease occurs when fatty build-up in your coronary arteries, called plaque, prevents blood flow that’s needed to provide oxygen to your heart. When the blood flow that brings oxygen to the heart muscle is severely reduced, or completely cut off, a heart attack occurs.

The Emory Women’s Heart Center is dedicated to screening, diagnosing, treating and preventing heart disease in Atlanta’s women. We’re thankful the awareness about heart disease, and the unique challenges faced by women, continues to be on the rise. The most important weapon against heart disease is awareness. Women need to research their family history and take time to educate themselves on not only the risk factors and symptoms of heart disease, but preventive medicine as well.

How can you educate yourself? Join Emory Women’s Heart Center physician, M. Carolina C Gongora, M.D., on Tuesday, February 23 at 12pm EST for an online web chat on women and heart disease. She will be available to answer your questions such as: unique challenges women face specific to heart disease, what women can do to prevent heart disease, the importance of getting treatment right away and the research underway to combat heart disease in women. Register for this live chat.

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