Heart Health

Do All Heart Attacks Present With Chest Pain?

women heart painChest pain is the most common symptom of a heart attack in both men and women. However, it is important to understand that the exact nature of chest pain can be quite different in women and is often not the most prominent symptom of a heart attack.

Most of us probably think of a heart attack the way it is portrayed on television and in the movies: A sudden, dramatic occurrence that causes the victim to clutch his or her chest in agony. Women, however, may report chest pressure, discomfort, fullness or a burning sensation. In addition, they often experience pain in adjacent areas, such as the upper abdomen, upper back, neck, arms and jaw.

As a result of this variation of presenting symptoms, women who have complaints other than chest pain during a heart attack may be overlooked or not evaluated in a timely fashion. Women are more likely than men to have already sustained heart damage by the time they reach the emergency room. A heart attack can begin to cause damage within minutes of the start of symptoms, and sometimes this damage is irreversible. This is why it is critical that women and their loved ones learn to recognize the typical and atypical symptoms of a heart attack and seek emergency care immediately.

Screening is one way for women to determine their risk for heart disease. Through screening efforts, individuals can identify ways to reduce their risk of a heart attack and find out if they need to see a cardiologist for additional evaluation and testing. The Emory Women’s Heart Center offers comprehensive cardiac risk assessments for women who may be at risk for heart disease or want to learn more about what they can do to reduce this risk. As part of these comprehensive screenings, we review strategies to improve overall cardiovascular health and offer treatment options if appropriate.  Schedule your screening today!

Heart Disease Screening

About Dr. Isiadinso

Ijeoma Isiadinso, MDIjeoma Isiadinso, MD, MPH, is an assistant professor of medicine at Emory University School of Medicine. Dr. Isiadinso completed her undergraduate studies at Binghamton University in New York, majoring in biology and sociology. She then pursued a joint degree in medicine and public health at MCP Hahnemann (Drexel University) School of Medicine. Dr. Isiadinso completed a residency in internal medicine and a fellowship in cardiology at Temple University Hospital in Philadelphia. She served as chief fellow during the final year of her cardiology fellowship.

Her commitment to public health has led to her involvement in several projects focused on heart disease and diabetes. She has participated in research projects with the Philadelphia Department of Public Health and the Centers for Disease Control and Prevention (CDC). She has been the recipient of numerous awards and presented her work at national conferences. Her research interests include inequalities in health care, community and preventive health, lipid disorders, women and heart disease, and program development and evaluation.

Dr. Isiadinso has served as the health advisor to nonprofit organizations. She has participated in panel discussions at high schools and universities and with the Black Entertainment Television Foundation.

Dr. Isiadinso is board certified in internal medicine, cardiovascular diseases, nuclear cardiology, echocardiography and cardiovascular computed tomography. She is a member of several professional organizations, including the Association of Black Cardiologists, the American College of Cardiology, the American Society of Preventive Cardiology and the American Public Health Association.

About the Emory Women’s Heart Center

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

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What Is Arrhythmia?

arrhythmiaAn arrhythmia refers to an abnormal pattern or rate of the heartbeat. Arrhythmias can include heartbeats that are too fast, too slow or irregular, as is the case with atrial fibrillation , the most common arrhythmia in the United States that requires medical attention.

The normal rhythm of the heart is a tightly regulated but dynamic electrical phenomenon that changes according to the needs of the body. The heart has built-in pacemakers and “wiring” that coordinate contractions in the organ’s upper chambers (the atria) and lower chambers (the ventricles). Glitches in this complicated electrical system can cause the heart to “misfire.”

Everyone has felt their heart “skip” a beat or two or speed up in times of fear or excitement or during exercise. Too much caffeine and certain medications can also cause heart palpitations (rapid thumping in the chest) in some people. These types of arrhythmias are generally harmless.

If irregular heartbeats are frequent or chronic, they can be serious. The consequences of having an arrhythmia usually depend not only on symptoms they can cause (such as faintness), but also on the presence of heart disease or structural abnormalities. In serious cases, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart and other organs.

Common symptoms of arrhythmia include:

  • Shortness of breath
  • Chest pain
  • Palpitations
  • Feeling tired or light-headed
  • Passing out

Call your doctor if you have any of these symptoms of arrhythmia, especially if you have heart disease or have had a heart attack.

If you have experienced an irregular heartbeat, palpitations, a racing heartbeat or other heart irregularities, we recommend that you schedule an appointment with a specialty-trained Emory Healthcare Nurse Practitioner who will begin a comprehensive screening evaluation to determine whether you need follow-up care with an Emory Electrophysiologist. Call 404-778-7777 to schedule your screening appointment. You can also learn more about the Emory Arrhythmia Center online .

About Dr. Lloyd

Michael Lloyd, MDMichael Lloyd, MD , began practicing medicine at Emory in 2007. He specializes in cardiology and cardiac electrophysiology. His areas of clinical interest and research include arrhythmias in athletes, arrhythmias in young adults with congenital heart disease, atrial fibrillation and implantable devices for the treatment of heart failure. Dr. Lloyd is the program director for the Cardiac Electrophysiology Fellowship Program at Emory and holds organizational leadership positions with the American College of Cardiology, the American Heart Association and the Heart Rhythm Society.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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How Does Heart Disease Present Differently in Women?

Women's Heart DiseaseHeart disease is the leading cause of death in both men and women in the United States, but it can manifest differently in women. In addition, certain types of heart disease affect women more often than men.

The most common type of heart disease is coronary artery disease (CAD). This occurs as a result of plaque buildup in the arteries (atherosclerosis) causing a decrease in blood flow to the heart muscle. It is well known that women may experience different symptoms of CAD than men. One of the most common symptoms is chest pain, also known as angina, which occurs when the heart does not receive enough oxygen-rich blood. In men, angina tends to manifest as a pressure or squeezing sensation in the chest. Although women also have chest pain, they are more likely to have atypical symptoms such as indigestion, shortness of breath or pain in the neck, jaw, stomach or back.

Coronary microvascular disease (MVD) is similar to CAD in that it affects the blood supply to the heart muscle. Instead of the major coronary arteries being blocked by significant plaque, in MVD there is spasm of the smaller arteries of the heart. This disorder affects women in greater numbers than men. Risk factors for coronary MVD are similar to those for CAD, such as high blood pressure, diabetes, smoking and high cholesterol. As with CAD, angina is the most common symptom. However, in MVD, the angina tends to occur during normal daily activities and at times of mental stress.

Broken heart syndrome is another type of heart disease that is more common in women. Broken heart syndrome is also known as stress-induced cardiomyopathy or takotsubo cardiomyopathy and is characterized by chest pain and shortness of breath. Although, the symptoms are similar to a heart attack, stress-induced cardiomyopathy is not associated with significantly blocked coronary arteries. As the name implies, this syndrome develops as a result of extreme emotional or physical stress. Most individuals completely recover within a short amount of time with appropriate treatment.

Because heart disease often affects women differently than men, Emory created the Women’s Heart Center, a unique program dedicated to diagnosis, screening, treatment and prevention of heart disease in women. The Emory Women’s Heart Center physicians understand these differences and have specialized education and expertise in this area.

About Dr. Isiadinso

Ijeoma Isiadinso, MDIjeoma Isiadinso, MD, MPH, is an assistant professor of medicine at Emory University School of Medicine. Dr. Isiadinso completed her undergraduate studies at Binghamton University in New York, majoring in biology and sociology. She then pursued a joint degree in medicine and public health at MCP Hahnemann (Drexel University) School of Medicine. Dr. Isiadinso completed a residency in internal medicine and a fellowship in cardiology at Temple University Hospital in Philadelphia. She served as chief fellow during the final year of her cardiology fellowship.

Her commitment to public health has led to her involvement in several projects focused on heart disease and diabetes. She has participated in research projects with the Philadelphia Department of Public Health and the Centers for Disease Control and Prevention (CDC). She has been the recipient of numerous awards and presented her work at national conferences. Her research interests include inequalities in health care, community and preventive health, lipid disorders, women and heart disease, and program development and evaluation.

Dr. Isiadinso has served as the health advisor to nonprofit organizations. She has participated in panel discussions at high schools and universities and with the Black Entertainment Television Foundation.

Dr. Isiadinso is board certified in internal medicine, cardiovascular diseases, nuclear cardiology, echocardiography and cardiovascular computed tomography. She is a member of several professional organizations, including the Association of Black Cardiologists, the American College of Cardiology, the American Society of Preventive Cardiology and the American Public Health Association.

About the Emory Women’s Heart Center

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

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Emory Opens Heart Rhythm Clinics to Treat Growing Problem

arrhythmia screening centerEmory Healthcare is launching new screening centers across the Atlanta area to help diagnosis abnormal heart rhythms, or arrhythmias. An arrhythmia is a disorder of the heart that occurs when the body’s electrical impulses, which direct and regulate heartbeats, do not function properly and cause the heart to beat slowly (bradyarrhythmias), rapidly (tachyarrhythmias) or in an uncoordinated manner.

The new clinics will offer screening and, if needed, state-of-the-art care by some of the country’s leading arrhythmia experts. Clinics in Villa Rica, Conyers and Johns Creek are already operating, and a fourth location in Decatur will open later this summer.

Emory has been a pioneer in shaping arrhythmia treatment options, serving as primary and principal investigators for many national clinical trials. We rank among the world’s leaders in cardiac resynchronization therapy and have performed more cardiac ablation procedures than anyone in the Southeast.

According to the American Heart Association, atrial fibrillation (A-fib) is the most common chronic cardiac dysrhythmia and affects nearly 2.3 million people in the United States. The prevalence of arrhythmias is age-related and is expected to rise substantially as the baby boomer population continues to age.

Emory has one of the most wide-ranging and innovative treatment programs for heart rhythm disorders in the United States. Anyone who is experiencing palpitations, heart racing or other rhythm symptoms can visit one of our new screening locations to determine if their condition is serious and requires treatment by a specialist.

To learn more about arrhythmia screening, treatment and heart rhythm management services at Emory, please visit emoryhealthcare.org/arrhythmia.

About Dr. Hoskins

Michael Hoskins, MDMichael Hoskins, MD , is an assistant professor of medicine and electrophysiologist who practices primarily at Emory University Hospital. Dr. Hoskins received his medical degree from the Medical College of Wisconsin in Milwaukee, after which he completed his residency in internal medicine at Emory. He was chief resident in Internal Medicine from 2005 to 2006. He then completed fellowships in cardiology and electrophysiology, also at Emory, and has been practicing here since 2010.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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A Heart Attack May Look Different in Women

Heart Attack in WomenWhile the symptoms of a heart attack are often similar in men and women, women are more likely to experience “atypical” symptoms than men. That’s why it’s particularly important for women to be familiar with the full range of heart attack symptoms, including those that aren’t as common, but may be more common in women than men.

  • Chest Pain or Discomfort

This symptom isn’t always “painful.” It can also feel like squeezing, pressure, heaviness, tightness or fullness, and be anywhere from mild to severe.

  • Heaviness or Pain in Other Areas

These may include the back, neck, jaw or arms. This 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.

  • Cold Sweating

This can occur even without chest discomfort. If there is no obvious reason for sweating, such as exercise or hot flashes, consider having your physician investigate this further.

  • Fatigue

Some women may experience extreme exhaustion even during routine tasks, a gradual or sudden decrease in energy level, or an inability to complete tasks they were able to do in the past.

  • Nausea

Nausea can be a symptom of other problems, such as the flu, heartburn or stomach ulcers. However, nausea can also be a symptom of heart disease or angina.

  • Shortness of Breath

This can occur with minimal activity or with activities that previously did not cause breathing difficulty. This is especially important because people with diabetes experiencing a heart attack may not necessarily have chest pain, and this may be their only symptom.

  • Lightheadedness

This may occur with activity or in conjunction with any of the other symptoms.

In the case of a heart attack, no symptom should be taken lightly. If symptoms exist, call 911 as soon as they appear – even if you’re not sure it’s a heart attack. It could save your life. And remember, with heart attacks, TIME = MUSCLE: A heart attack can begin to damage the heart within 30 minutes of the start of symptoms, and sometimes the damage is irreversible.

About Dr. Lundberg

Gina Lundberg, MDGina Price Lundberg, MD, FACC , is the clinical director of the Emory Women’s Heart Center and a preventive cardiologist with Emory Clinic in East Cobb. Dr. Lundberg is an assistant professor of medicine at Emory University School of Medicine.

She is a national American Heart Association (AHA) spokesperson and was a board member for the Atlanta chapter from 2001 to 2007. Dr. Lundberg was the Honoree for the AHA’s North Fulton/Gwinnett County Heart Ball for 2006. In 2009, she was awarded the Women with Heart Award at the Go Red Luncheon for outstanding dedication to the program. She is also a Circle of Red founding member and Cor Vitae member for the AHA.

She has been interviewed on the subject of heart disease in women by multiple media outlets, including CNN and USA Today. In 2007, Governor Sonny Perdue appointed Dr. Lundberg to the advisory board of the Georgia Department of Women’s Health, where she served until 2011. In 2005, Atlanta Woman magazine awarded Dr. Lundberg the Top 10 Innovator Award for Medicine. In 2008, Atlanta Woman named her one of the Top 25 Professional Women to Watch and the only woman in the field of medicine.

Dr. Lundberg attended the Medical College of Georgia and trained in internal medicine at Atlanta Medical Center (Georgia Baptist). She completed her cardiology fellowship at Rush University in Chicago. She has been in practice in Atlanta since 1994. She is board certified in cardiology and internal medicine and was recertified in both in 2002. Dr. Lundberg has two children and considers motherhood her first and foremost career. Dr. Lundberg has lived most of her life in the metro Atlanta area.

About the Emory Women’s Heart Center

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

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Congenital Heart Defect Repair in Childhood: Will I Need Another Surgery?

congenital heart repairNot too long ago, most babies born with serious heart defects died in childhood. Thanks to advances in cardiac care, some estimates indicate that today as many as 90% of children with congenital heart disease (CHD) are able to live well into adulthood. In fact, there are now more adults than children living with CHD, and it has become increasingly clear that this growing population requires ongoing, specialized care. For instance, even if their defects are treated surgically in childhood, many patients will require additional surgery as adults to keep their hearts functioning correctly.

When many surgical procedures were first performed to correct congenital heart defects in children, the medical community generally assumed they were curative. But as the first generation of post-operative patients survived into adulthood, some began to develop late complications associated with the procedures they underwent as children.

Unfortunately, many of these late complications develop gradually and are associated with non-specific symptoms. In addition, CHD is so closely associated with infancy and childhood, that many patients assume they no longer need to worry about their condition once they have reached adulthood. Consequently, they may not make the connection between the symptoms they develop as adults and their CHD—especially if it was successfully corrected in childhood.

This relatively recent phenomenon bolsters the argument that patients with CHD—even if their defect was surgically corrected in childhood—need to continue regular follow-up with a congenital heart specialist into adulthood so that he or she can monitor for subtle changes that may indicate a serious problem.

Another issue with managing CHD in adulthood is that adult cardiologists may have difficulty treating conditions in hearts repaired—often effectively re-configured—by pediatric surgeons years earlier. Conversely, pediatric surgeons may be unfamiliar with the unique complications that can arise years later as “corrected” anatomy ages, and in general may not have the specific training and experience required to address congenital disease in adults.

In response to this growing crisis, Emory and Children’s Healthcare of Atlanta have teamed up to help ensure that patients with CHD don’t get lost to follow-up as they transition into adulthood. The Congenital Heart Center of Georgia combines the expertise of Children’s Sibley Heart Center with that of Emory’s Adult Congenital Heart Center to address this crucial need. It is the first program of its kind in the South and one of the largest in the country.

About Dr. Kogon

Brian E. Kogon, MD , is chief of Pediatric Cardiothoracic Surgery at Children’s Sibley Heart Center and Emory University Hospital , surgical director of the Adult Congenital Heart Disease Program at Emory University Hospital and director of the Congenital Cardiac Surgery Fellowship at the Emory University School of Medicine.

Dr. Kogon received his medical degree from the University of Cincinnati and completed his residency in general surgery and a fellowship in cardiothoracic surgery at Indiana University. He then went on to complete his fellowship in pediatric cardiac surgery at Emory University, joining the staff in 2004.

Dr. Kogon is now a nationally recognized leader in pediatric and adult congenital heart disease. He has numerous publications in peer-reviewed journals and presents nationally at the major cardiothoracic surgery society meetings. He has earned various awards over the years, most recently the Teacher of the Year award for Pediatric Cardiac Surgery from the Sibley Cardiology Fellowship Program and Emory University.

Dr. Kogon’s major areas of interest include pediatric cardiac surgery, cardiac transplantation and adult congenital heart surgery.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease (CHD) that provides a continuum of lifesaving care from before birth through adulthood. The program is led by Emory Healthcare cardiologist Wendy Book, MD, Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center, and Brian Kogon, MD, chief of Pediatric Cardiothoracic Surgery at Children’s Sibley Heart Center and Emory University Hospital and surgical director of the Adult Congenital Heart Disease Program at Emory University Hospital. To schedule an appointment please call 404-778-7777.

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What You Should Know about Hypertensive Heart Disease

anginaHypertension, also called high blood pressure, occurs when blood flows through the arteries with too much force. Left untreated over time, hypertension can cause other heart disorders, collectively called hypertensive heart disease. Two of the most common hypertensive heart disorders are hypertensive coronary artery disease and hypertensive left ventricular hypertrophy.

Hypertension causes arteries to stretch beyond a healthy limit, resulting in tears in artery walls. Though the body naturally repairs these tears with scar tissue, that tissue also traps plaque and white blood cells, which can turn into blockages, blood clots and hardened, weakened arteries. When this process occurs in the arteries that supply the heart with oxygen-rich blood (coronary arteries), the result can be a decrease in heart function (heart failure) or a heart attack.

Hypertension also causes the heart to have to work harder to move blood through the body. Like any muscle, this increased workout results in the wall of the heart thickening and hardening, most notably in the left ventricle, the chamber primarily responsible for pumping blood out to the rest of the body. These changes in the ventricle wall can eventually decrease the heart’s pumping capability. This condition is called hypertensive left ventricular hypertrophy.

Common symptoms of hypertensive heart disease include:

  • Dizziness
  • Shortness of breath
  • Chest pain (angina), especially after exertion
  • Rapid, fluttering heartbeats (palpitations)

Left untreated, hypertensive heart disease can lead to heart failure, stroke, heart attack and kidney disease.

The good news is that hypertension can be controlled with lifestyle changes and medication, and the sooner the condition is discovered, the less serious damage it will cause to your heart.

If you are a woman who has hypertension or simply wants to learn more about your potential risk for heart disease, call 404-778-7777 to schedule a comprehensive cardiovascular risk assessment with an Emory Women’s Heart Center specialist.

Heart Disease Screening

About Dr. Lundberg

Gina Lundberg, MDGina Price Lundberg, MD, FACC , is the clinical director of the Emory Women’s Heart Center and a preventive cardiologist with Emory Clinic in East Cobb. Dr. Lundberg is an assistant professor of medicine at Emory University School of Medicine.

She is a national American Heart Association (AHA) spokesperson and was a board member for the Atlanta chapter from 2001 to 2007. Dr. Lundberg was the Honoree for the AHA’s North Fulton/Gwinnett County Heart Ball for 2006. In 2009, she was awarded the Women with Heart Award at the Go Red Luncheon for outstanding dedication to the program. She is also a Circle of Red founding member and Cor Vitae member for the AHA.

She has been interviewed on the subject of heart disease in women by multiple media outlets, including CNN and USA Today. In 2007, Governor Sonny Perdue appointed Dr. Lundberg to the advisory board of the Georgia Department of Women’s Health, where she served until 2011. In 2005, Atlanta Woman magazine awarded Dr. Lundberg the Top 10 Innovator Award for Medicine. In 2008, Atlanta Woman named her one of the Top 25 Professional Women to Watch and the only woman in the field of medicine.

Dr. Lundberg attended the Medical College of Georgia and trained in internal medicine at Atlanta Medical Center (Georgia Baptist). She completed her cardiology fellowship at Rush University in Chicago. She has been in practice in Atlanta since 1994. She is board certified in cardiology and internal medicine and was recertified in both in 2002. Dr. Lundberg has two children and considers motherhood her first and foremost career. Dr. Lundberg has lived most of her life in the metro Atlanta area.

About the Emory Women’s Heart Center

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

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Signs and Symptoms of Congenital Heart Defects

CDH BabyBecause congenital defects can decrease the heart’s ability to pump blood and deliver oxygen throughout the body, they often produce telltale signs. Below are some of the more common symptoms that indicate a baby may have congenital heart disease (CHD).

  • Heart Murmur

A heart murmur is often the first sign of CHD. In basic terms, a murmur is just an extra heart sound, in addition to the regular sounds of a beating heart. Heart murmurs usually don’t indicate the presence of any heart problem. Sometimes a doctor can use a stethoscope alone to determine whether a particular murmur is a sign of heart disease. In other cases additional tests are necessary to determine the exact nature of a murmur.

  • Breathing Difficulties

Breathing difficulty caused by blood building up in the lungs (lung congestion) is a sign of a serious defect that will likely need medical or surgical intervention in the first year of life. Lung congestion may be the result of excessive blood flow from the left side of the heart to the right side through an abnormal connection, such as a hole in the heart or a connection between major blood vessels that allows blood to bypass the heart. Congestion can also be the result of an obstruction in blood flow on the left side of the heart that causes blood to back up in the vessels returning blood from the lungs.

  • Blue Skin

Some CHDs result in an inadequate amount of oxygen in the blood, which can cause the baby’s skin to have a bluish tint, especially in the lips, tongue, fingernails and toenails—called cyanosis. Cyanosis can result from an obstruction of blood flow to the lungs or a hole within the heart that allows oxygen-poor blood to flow from the right side to the left side and out to the body. It can also be related to other heart issues, including an abnormal positioning (transposition) of the arteries leaving the heart.

  • Failure to Thrive

Another result of inadequate oxygen in the blood is that an infant may lose weight or not gain enough, or may take longer to reach developmental milestones. These symptoms can result directly from the body not receiving enough oxygen to thrive, or they may be an indirect consequence of the infant tiring during feeding because of a lack of oxygen and, as a result, not receiving enough nutrients.

  • Excessive Sweating

Many CHDs can cause excess blood flow through the lungs, which makes breathing more difficult. The increase in exertion required to breathe can, in turn, result in excess sweating. Because feeding is a common form of activity in babies, this excess sweating is often closely associated with feeding, though any activity that causes an increase in the infant’s breathing rate can also cause increased sweat production. Excess blood flow to the lungs can also accelerate the infant’s metabolism, a side effect of which is increased sweating.

If you notice any of these signs in your baby or child, call your doctor right away. If your doctor notices these signs, you may be referred to a pediatric cardiologist.

About Dr. Rodriguez

Fred Rodriguez, MDFred Rodriguez, MD, is a pediatric cardiologist who practices pediatric cardiology at the Children’s Healthcare of Atlanta Sibley Heart Center and adult congenital heart disease at the Emory Clinic and Emory University Hospital. Dr. Rodriguez earned his medical degree from the Louisiana State University at New Orleans School of Medicine, where he also completed his combined residency in both internal medicine and pediatrics. Following his residency, he completed a cardiology fellowship at Texas Children’s Hospital in Houston, with additional training in adult congenital heart disease. He is board certified in pediatrics, pediatric cardiology and internal medicine.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease that provides a continuum of lifesaving care from before birth through adulthood. It is the first comprehensive congenital heart disease program in the South and one of the largest in the country. The program is led by Emory Healthcare cardiologist Wendy Book, MD, Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center, and Brian Kogon, MD, chief of pediatric cardiothoracic surgery. To schedule an appointment, please call 404-778-7777.

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Tasty, Heart Healthy Summer Breakfast recipe!

struedel1Grab some healthy summer fruits and mix up a heart healthy summer breakfast muffin that your family will love! This fat – free streusel muffin recipe is delicious and filling. Try it out to add some spice to your summer meals!

Fat – Free Streusel Muffins

Ingredients

  • 1 ½ cups all –purpose flour
  • ¾ cup sugar
  • 2 teaspoons baking powder
  • 1 teaspoon baking soda
  • ½ teaspoon salt
  • 2/3 cup non-fat plain yogurt
  • 2/3 cup skim milk
  • ½ cup blueberries or diced apples

Streusel Topping:

  • 1/3 cup sugar
  • ½ teaspoon cinnamon

Directions

In large bowl, combine flour, sugar, baking powder, baking soda and salt. Gently stir in the yogurt and milk, blending just until dry ingredients are moistened. Fold in fruit. Fill lightly greased or paper-lined muffin cups ½ full with batter. Place 1 teaspoon of cinnamon-sugar mixture on top of each, and add batter to fill the cups ¾ full. Bake at 400 degrees for 18 minutes or until well browned. Serve warm.

*Makes 12 muffins

Nutritional Information

  • Calories – 138
  • Fat – > 1 gram
  • Cholesterol – < 1 milligram
  • Sodium – 230 milligrams

This heart healthy summer recipe will fill you up and give you the energy to attack all your fun summer activities!

The Emory Women’s Heart Center is a unique program dedicated to screening, preventing and treating heart disease in women. Take the online heart disease risk assessment quiz to see if you are at risk for heart disease and if so, schedule your Cardiac Screening today to get individualed action plan for ensuring your heart is ready for the fun of summer! Call 404-778-7777 to learn more.

Heart Disease Screening

About Dr. Shirazi

Farheen Shirazi, MDFarheen Shirazi, MD is Assistant Professor of Medicine at Emory University School of Medicine. Dr. Shirazi completed medical school at Morehouse School of Medicine before completing her internship at NYU, residency at Stanford University and fellowship at Emory University. She is passionate about teaching patients how to reduce their risk for heart disease and stroke. Her practice encompasses the scope of general cardiology, with a focus on cardiovascular disease prevention and women’s health. Dr. Shirazi has published in the arena of preventive cardiology and is currently working on literature in the field of women’s cardiovascular health.

Dr. Shirazi is board certified in Internal Medicine (2009) and Cardiology. She is a member of several professional organizations including the American Heart Association, American College of Physicians, American Medical Association and the American College of Cardiology.

Dr. Shirazi will see patients at Emory at East Cobb – Heart & Vascular as well as Emory Heart & Vascular Center at 1365 Clifton Road. She enjoys drawing, painting and reading classical literature in her spare time.

10 Tips for a Heart-Healthy Diet

Veggie Heart HealthyA healthy diet is one of the best ways to combat heart disease. And including healthier choices in your diet isn’t hard, since there are lots of delicious heart-healthy foods available, including whole grain breads, fruit, vegetables, fish, extra virgin olive oil, nuts and even chocolate. There are also some things you should avoid—or avoid too much of. Below are 10 tips to help you get on the path to a more heart-healthy diet.

  1. Eat Fish Regularly 
    Omega-3 fatty acids (eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA) that are found naturally in fish can provide numerous cardiovascular benefits, including reducing blood triglycerides, reducing blood clotting and regulating heart rhythms.
  2. Include Lycopene-Rich Foods in Your Diet
    Lycopene is a plant nutrient that has been associated with reducing the risk of heart disease. There is lots of lycopene in tomato products (particularly cooked ones), pink grapefruit and watermelon.
  3. Eat the Right Kinds of Fat
    Aim for a balance of monounsaturated and polyunsaturated fats. Research indicates that both types have benefits, including reducing the levels of cholesterol and triglycerides in your blood. Try choosing extra virgin olive oil or canola oil instead of butter or margarine, and natural peanut butter rather than the kind with hydrogenated fat added. Also, almonds, cashews, pistachios and walnuts are good sources of healthy fat and make for easy snacks.
  4. Eat Plenty of Colorful Fruits and Vegetables
    In general, richly colored fruits and vegetables contain lots of helpful plant nutrients, and many have been shown to help protect against heart disease, among other health conditions.
  5. Include Plenty of Fiber in Your Diet
    A diet high in both soluble and insoluble fiber can help reduce the risk of heart disease. Soluble fiber, in particular, helps lower cholesterol levels. Good sources of soluble fiber include oats, oat bran, fruits (such as apples, pears, citrus fruits and berries), vegetables, (like carrots, cabbage and sweet potatoes) and legumes. Insoluble fiber is found in grain products like whole-grain breads, cereals and pastas.
  6. Eat Chocolate—in Moderation
    Milk chocolate, dark chocolate and bittersweet chocolate all contain a unique kind of saturated fat — stearic acid — that doesn’t raise blood cholesterol levels, and dark chocolate is also a good source of substances called antioxidants that are helpful in combating heart disease and other health problems. But chocolate also contains added sugars and caffeine , which should be consumed in limited portions (see below), so don’t eat too much.
  7. Try the DASH Eating Plan
    “DASH” stands for “Dietary Approaches to Stop Hypertension.” The DASH diet is low in total fat, saturated fat and cholesterol, and rich in fruits, vegetables, low-fat dairy foods, whole grains, poultry, fish and nuts. In addition to helping with hypertension, the DASH diet may also help lower cholesterol. Learn more about the DASH Eating Plan.
  8. Reduce Salt
    Salt makes the body retain fluid, which can strain the heart. This can lead to increased blood pressure and added burden on your heart muscle. Try replacing added salt in your diet with fresh or dried herbs, lemon, onion or no-salt seasonings. Get ideas for other tasty salt substitutes.
  9. Limit Caffeine
    While there isn’t a consensus on the effects coffee can have on your heart, many experts recommend limiting caffeine intake to the equivalent of no more than three or four cups of coffee a day. But remember that other foods and drinks, such as tea, chocolate and many soft drinks, also contain caffeine and factor these into your daily total as well.
  10. Curb Added Sugars
    More than sugars found naturally in fruit and dairy products, added sugars are associated with elevated bad cholesterol and triglycerides and low good cholesterol, which increase the risk of heart disease.

If you are a woman who thinks you may be at a higher risk of developing heart disease, call 404-778-7777 to schedule a comprehensive cardiovascular risk assessment with an Emory Women’s Heart Center specialist.

About Dr. Cutchins

Alexis Cutchins, MDAlexis Cutchins, MD is an assistant professor of medicine at Emory University School of Medicine. Dr. Cutchins completed medical school at Emory University School of Medicine before going to New York Presbyterian Hospital for her internship and residency in internal medicine. She completed an NIH-supported research fellowship in vascular biology and a clinical fellowship in cardiovascular diseases at the University of Virginia in 2012. She has a special interest in heart disease in women, in addition to heart disease prevention and risk reduction in cardiology patients.

About the Emory Women’s Heart Center

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

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