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New Guidelines Suggest Risk Factors, Not Cholesterol Levels, Should Determine Cardiovascular Treatment Options

Statin Medications for patients with cardiovascular Risk FactorsThe American Heart Association (AHA) in collaboration with the American College of Cardiology recently released new, more aggressive cardiovascular treatment guidelines.  The new guidelines indicate that patients should be evaluated by their risk factors instead of a cholesterol number to determine if they should be prescribed medications.  Many patients who in the past would not have been prescribed statin medications will now be evaluated to determine if the medication is necessary.

Some of the risk factors physicians will take into consideration when evaluating a patient are:

  • Has the patient been diagnosed with heart disease?  This includes if the patient has ever had a heart attack or stroke.
    • If yes, your cholesterol should probably be managed with medication.
  • Does the patient have diabetes, type I or type II?
    • According to Emory Women’s Heart Center clinical director, Gina Lundberg, MD, “heart disease is the number one killer of all diabetics”.  Diabetics often need to manage their cholesterol with statin medications.
  • Does the patient have an LDL cholesterol (bad cholesterol) level of over 190.
    • According to the new cardiovascular treatment guidelines, if a patient is over 21 years old and has an LDL level above 190 he/she should be prescribed a statin medication.
  • Does the patient have a heart attack risk greater than 7.5%?

If a patient falls into any one of the risk factor categories above, they should be put on a statin according to the new guidelines. The new guidelines will hopefully prevent heart attacks and strokes in many patients who were previously not on statins to control cholesterol.

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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.

About Gina Lundberg, MD

Dr. Gina LundbergGina Price Lundberg, MD FACC is the Director of the Heart Center for Women. She founded and directed The Women’s Heart Center, the first women’s cardiac prevention program in the state of Georgia in 1998.

She was named by Governor Sonny Perdue to the Advisory Board for Women’s Health, Georgia Department of Women’s Health, Department of Community Health for 2007-2008. She is a Clinical Associate Professor of Medicine at Emory University and teaches cardiology fellows at Grady Hospital. She also teaches medical students from the Medical College of Georgia in preventive cardiology. She is a member of the American College of Cardiologist’s Prevention of Cardiovascular Disease Committee.

She has been a Board Member of the American Heart Association for Atlanta since 2001. She has been involved with the Go Red for Women campaign since it launched in 2004. She has been on the Southeast Affiliate for the AHA’s Strategic Initiative Committee representing Go Red for Women. She is national speaker for the American Heart Association. She has also been working with the national organization, Sister to Sister Foundation from 2004 till the present with their Atlanta program.

She has been interviewed on the subject of Heart Disease in Women in Glamour Magazine, MD News, the Journal of the Medical Association of Georgia, the Atlanta Business Chronicle, the Atlanta Journal Constitution and other magazines. She has been interviewed on numerous local news shows and many radio programs over the years. Dr. Lundberg has published articles in several medical journals and contributed to several text books.

Dr. Lundberg has lived most of her life in Atlanta, GA. She attended the Medical College of Georgia and trained in Internal Medicine at Atlanta Medical Center (Georgia Baptist). Her cardiology fellowship was at Rush University in Chicago. She has been in private practice in Atlanta since 1994. She is Board Certified in Cardiology and Internal Medicine and re-certified in both in 2002. She has two children and considers motherhood her first and foremost career.

Dr. Samady talks George W. Bush, Cardiac Angioplasty with Associated Press

Many of the Associated Press new stories on former United States President George W. Bush’s recent surgery to unblock an artery in his heart feature discussion from Emory Heart & Vascular Center’s Director of Interventional Cardiology, Habib Samady, MD, who was interviewed to discuss details of the former President’s cardiac angioplasty and how arteries in the heart become blocked.

During a routine physical, doctors found a blockage in Bush’s artery. In order to open up the artery blockage, cardiologists at a Texas hospital performed a cardiac angioplasty procedure.

Dr. Samady says it takes 20 to 30 years for cholesterol to build up in the arteries. When the narrowing of the blood vessel gets to 80– 90 % then the blockage will limit blood flow. When this occurs patients may experience symptoms of heart disease such as:

• Chest pain
• Pressure in chest
• Shortness of breath
• Fatigue

Learn more about cardiac angioplasties and the former President’s heart surgery in this AP video featuring Dr. Samady!

Cardiac angioplasties are fairly common procedures and many times the patients go home the same day or the next day. They can be performed for outpatients with symptoms of angina or evidence of low blood flow on a stress test or for inpatients with heart attacks or “near heart attacks”. Emory cardiologists were pioneers in developing the angioplasty procedure in the 1980’s. Former Emory cardiologist Andreas Gruentzig performed the first balloon angioplasty in 1977 in Zurich, Switzerland before immigrating to the United States and coming to Emory from where the procedure was taught and disseminated through out the world. In 1987, Emory interventional cardiologists were the first to deploy coronary stents in the United States and currently are national leaders in determining which patient needs to have a blockage unblocked by measuring blood flow in each artery as well as in the use of miniaturized ultrasound and infrared cameras for the optimal deployment of coronary stents.

Dr. Habib SamadyAbout Habib Samady, MD
Dr. Samady is the Director of Interventional Cardiology at Emory Hospitals as well as an Associate Professor of Medicine at Emory University School of Medicine. He has been practicing medicine for over 20 years and has been on faculty at Emory since 1998. Dr. Samady has been instrumental in the development of the interventional cardiology program at Emory. He specializes in cardiac cauterization, interventional cardiology, nuclear cardiology and valve disease. He is a published author and has published several articles in peer reviewed publications.

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Take a Tour of the Cardiac Rehabilitation Center at Emory

In this post, I’d like to introduce you to the Cardiac Rehabilitation Center at Emory Healthcare. The facility offers state-of-the-art amenities, panoramic views, and experienced staff to care for patients following heart attacks, open heart surgery, angioplasty, and stent placement.

Our mission is to help reduce risk factors for heart disease through exercise, education, and support. If you’d like to visit us in person, please call 404-778-2850 to arrange a site visit. We’re available Monday through Friday (except on major holidays) and are located within the Earle B. and Stephanie Blomeyer Fitness Center at 1525 Clifton Road NE in Atlanta. We’ll help you to identify your risk factors and generate a plan to make you healthier.

Here, you can join me on a virtual tour to learn more about what we can offer patients as they recover from heart procedures:

If you have any questions or comments about our facility, please feel free to let me know in the comments section.

Heart Transplant Patient Story: ‘I Feel Really Good’

A year and a half ago, Rachel Moore was readying to have her heart transplant at Emory. The surgery followed years of heart troubles, and Rachel spent two years with an LVAD as she awaited her transplant. Still, she was unsure if the heart transplant could really return her to good health. “My doctor told me, ‘After the transplant, you are going to feel so much better,’” Moore recalled recently during a phone chat. “It’s almost like I didn’t know what that meant.”

Now, 18 months later, Moore knows. “Before, when I was ill, I often wanted to just take a nap,” she said. “Now, when I’m up, I’m up all day and I exercise about five days a week for about an hour a day. I don’t feel winded or short of breath.” Moore, 45, visits Emory every three months for her check-up. Her medical team here checks her blood work and runs tests on her heart. If everything is running smoothly, she continues to take medication, and she returns in three months.

You can listen to Rachel Moore talk about how much better she feels since heart transplant surgery by clicking on the play button below:

“Sometimes I don’t know the right words to use, but I feel really good,” said Moore. “It’s almost like sometimes you have to remind yourself that there used to be something wrong. Like sometimes I’ll think to myself, ‘You had a heart transplant.’” For more information on Moore’s heart transplant and the effect it’s had on her life, visit her website at http://www.heart4rachel.org/ and watch this video:

A Special One-Year VAD Anniversary

William Shaw & Kris Wittersheim (VAD Coordinator)

In May of 2009, William Shaw, who has suffered from congestive heart failure for years, figured he had about two weeks left to live. Shaw, 72, had been in and out of the hospital for four months due to various heart-related troubles.

“I was just going down,” Mr. Shaw remembered during a recent visit to the Emory Transplant Center. “At the time, I was so weak that I couldn’t even sit up on the bed. If you sat me up, I’d fall over.”

But on May 22, 2009, Mr. Shaw underwent surgery and was implanted with a Ventricular Assist Device (VAD). The VAD procedure, discussed in detail here, is an emerging option for three types of heart failure patients: transplant candidates who are too sick to wait for a heart to become available, patients who may be heart transplant candidates but aren’t currently eligible for various reasons—such as obesity or smoking—and are getting sicker, and patients who aren’t transplant candidates due to other medical issues, or who (as in Mr. Shaw’s case) are elderly.

Simply put, the surgeons place a rotary pump under the heart (in the abdomen) to take over the function of the left side of the heart. This pump is dependent upon electricity—either batteries or AC power—at all times. The VAD does what the ailing heart can no longer do – it sends blood and oxygen to all areas of the body. Consequently, the VAD decreases heart failure symptoms, increases activity and drastically improves quality of life.

On May 18, 2010, almost one year after undergoing surgery, Mr. Shaw came in for his monthly checkup with me. So, how’s he doing? Not only is he now sitting up on his own, he’s enjoying life again. He took a hunting trip last November to South Dakota with his two sons, he works out three times a week, and he takes part in a number of retirement activities.

“My lifestyle has improved from one year ago,” Mr. Shaw said. “On a scale of 1-10, if 1 is the poorest and 10 is the best, I’ve gone from a 1 or 2 to a 7 or 8.”

In Mr. Shaw’s case, the VAD is destination therapy – meaning he’s not waiting for a heart transplant to make him better. The VAD is the cure.

Since receiving the procedure, Mr. Shaw has become a positive example for other heart transplant patients as they consider VAD surgery. He was even recently featured on a FOX 5 news report:

And when he visits Emory Clinic for his monthly check-ups, he spends time talking to other heart patients, and always asks if there is someone waiting in the hospital or being evaluated for a VAD that he may be able to talk to. His hope is to help them understand what they might be facing. His newfound independence, age, and story of recovery are an inspiration to others.

“When you’re my age, we all have things we have to work around,” Shaw said during his visit. “I’m just very thankful that it has worked out for me. They have taken care of me very well at Emory.”

Exploring VAD Therapy

In this video, I go into more detail about VAD therapy and show you an actual VAD device: