February, not suprisingly, is American Heart Month. The human heart is about the size of a clenched fist and weighs between 8 and 12 ounces, depending on gender and body size. Heart disease is the leading cause of death in the United States, killing more than 600,000 Americans each year. That’s one out of every four deaths.

There are many types of heart disease – from rhythm disorders to genetic defects to valve conditions to blood vessel diseases. But this blog will focus on the most common type: coronary artery disease, or CAD.

CAD is very common in this country. More than 18 million adult Americans suffer with it. According to the Cleveland Clinic, that’s roughly the combined populations of New York City, Los Angeles, Chicago and Houston.

The coronary arteries are blood vessels that wrap around the outside of the heart and supply it with oxygen-enriched blood and nutrients. With CAD, the coronary arteries become narrowed by a buildup of plaque, which is made up of fat, cholesterol and other substances floating around in your blood. This process of plaque buildup in the arteries is called atherosclerosis.

Atherosclerosis occurs over many years, and you may experience no symptoms while it is happening. But as your arteries become increasingly narrow, you may begin to notice symptoms such as pressure or tightness in your chest (angina), shortness of breath and fatigue.

The buildup of plaque in coronary arteries can eventually block the flow of blood to the heart, leading to a heart attack. Symptoms of a heart attack include chest pain or discomfort; feeling weak, lightheaded or faint; pain or discomfort in the jaw, neck or back; pain or discomfort in one or both arms or shoulders; and shortness of breath.

If you experience these symptoms, seek medical help right away.

Over time, CAD can weaken your heart and cause complications such as heart failure, a condition in which your heart can no longer pump blood efficiently; abnormal heart rhythms; and cardiac arrest, the sudden and unexpected loss of heart function.

There are multiple risk factors for CAD, some you can’t control and some you can. Risk factors you can’t control include age. Men face a higher risk after age 45, and women are at a higher risk after age 55. Another uncontrollable risk factor is family history. Your risk increases if one of your family members has heart disease.

Risk factors you can control include being overweight and physically inactive, eating an unhealthy diet that is high in saturated fat and complex carbohydrates, smoking, and drinking more alcohol than is recommended.

If you’re at high risk for CAD or already have symptoms, your doctor may recommend one or more tests to assess your heart function and make a diagnosis. These tests include:
• Electrocardiogram, which records your heart’s electrical activity.
• Echocardiogram, which uses sound waves to evaluate your heart’s structure and function.
• Exercise stress test, which evaluates how your heart responds to vigorous activity.
• Cardiac catheterization, which involves inserting tubes into your coronary arteries to view the plaque and confirm CAD.

The first step in treating CAD is making positive changes to your lifestyle. Don’t smoke, eat a heart-healthy diet, exercise for 30 minutes most days of the week, limit your alcohol intake, get seven to nine hours of sleep a night and work to control any chronic conditions you may have, such as high blood pressure, high cholesterol and diabetes.

Some people need a procedure or surgery to treat their CAD. Coronary angioplasty is an interventional procedure in which a small balloon is used to widen your narrowed coronary arteries. Your doctor may place small mesh tubes called stents to help keep the arteries open.

Coronary artery bypass grafting (CABG) is a surgery that takes a blood vessel from another part of your body and attaches it to the coronary artery above and below the narrowed area or blockage. This “bypass” restores blood flow to your heart.

CAD can’t always be prevented because some of its risk factors are out of your control. But the positive lifestyle changes used to treat the disease can also be used to lower your risk.

Patti DiPanfilo

It’s February, and you know what that means – it’s American Heart Month. It’s that annual opportunity to review what we know about heart disease. And it’s our chance to be sure we’re doing everything we can to prevent or manage it in our lives.

After all, heart disease is the leading cause of death for both men and women in the US. In fact, one in every four deaths in this country is the result of heart disease, to the tune of about 610,000 deaths each year. What’s more, almost half of all Americans are at risk for developing the condition. The good news is heart disease is preventable in most people.

Heart disease encompasses a wide array of different conditions affecting the heart and blood vessels. These include arrhythmias, cardiomyopathy, congenital heart defects, heart infections and the main form of heart disease, coronary artery disease (CAD).

 

Heart disease is often grouped with stroke and related conditions under the more global term cardiovascular disease (CVD). CVD involves a number of diseases of the heart and circulatory system. Other conditions that fall under CVD include heart attack, heart failure and valve disorders.

While stroke, heart attack and the other CVD disorders are serious conditions, we’ll concentrate our discussion today on heart disease and primarily on CAD, its most prevalent form.

CAD is a disorder of your coronary arteries, the blood vessels that supply your heart muscle with fresh, oxygenated blood. In CAD, the coronary arteries become blocked with a fatty material called plaque, which prevents the oxygen and nutrients from getting to your heart. This can lead to a heart attack and to the death of  heart muscle tissue.

Common symptoms of CAD include chest pain or discomfort, a sensation of pressure or squeezing in the chest, shortness of breath, nausea and feelings of indigestion or gas. Symptoms of heart disease can differ in women and may include dizziness or lightheadedness; anxiety; jaw, neck or back pain; cold sweats and fainting.

There are certain factors that put you at a higher risk for developing CAD. They can also make it more likely existing heart disease will get worse. Some of the risk factors, such as age, having a family history of heart disease or a history of pre-eclampsia during pregnancy cannot be changed.

Age is a big factor. Your risk increases if you’re a women over age 55 or a man over 45. The same is true if your father or brother had heart disease before age 55, or your mother or sister had it before age 65. These are all things you can’t do anything about.

There are other risk factors, however, that you can control. These include having high blood pressure and/or high cholesterol, having diabetes or prediabetes, smoking, being overweight or obese, being physically inactive, eating an unhealthy diet and drinking a lot of alcohol. These are the risk factors you should be putting your energy into.

The best way to determine your risk for CAD or other type of heart disease is by partnering with your doctor. He or she will evaluate your blood pressure, cholesterol level, blood glucose to check for diabetes, weight, personal and family medical history, and lifestyle.

Your doctor can then recommend steps to lower your risk for heart disease or treat the condition if you already have it.

If you are at risk for heart disease or have been diagnosed with it, there are some steps you can take to reduce the chance of getting heart disease or keep it from getting worse. Your doctor may recommend simple lifestyle changes and/or drug treatments.

One of the changes you can make to reduce your risk of heart disease or slow its progression is by controlling your high cholesterol and high blood pressure. This can often be done by adjusting your diet and getting more exercise, but it may require medications. Be sure to have your cholesterol and blood pressure checked regularly.

Lifestyle changes are pretty much common sense. They including eating a heart-healthy diet rich in high-fiber foods and low in saturated and trans fats; becoming more active; getting and staying at a healthy weight; quitting smoking; drinking alcohol in moderation and managing stress, which can have a negative effect on your heart.

If you’re at high risk for heart disease or already have it, your doctor may recommend you take an aspirin every day to reduce your chances of having a heart attack. Don’t take aspirin on your own without talking to your doctor first, however. It isn’t the best course of action for all people.

Now that you’ve been reminded about the basics of heart disease and CAD, you can better take care of your heart health.

They’re sometimes referred to as “massive heart attacks,” but that moniker is not quite accurate. It’s true sudden cardiac arrests, or SCAs, affect the heart, but they’re not true heart attacks. A heart attack occurs when blood flow to a part of the heart is stopped or slowed, generally due to a blockage, causing the death of heart muscle tissue.

Generally, there are signs and symptoms signaling a heart attack, and in most cases, those hearts continue beating. But with SCA, people just collapse, discontinue breathing and their hearts simply stop beating. A very serious heart attack can lead to SCA, but most SCAs are caused by problems in the rhythm of the heartbeats.

According to the National Heart, Lung and Blood Institute, part of the National Institutes of Health, between 250,000 and 450,000 Americans suffer SCA annually. It occurs most often in people in their mid-30s to mid-40s and affects men twice as often as women. SCA is rare in children, affecting one to two per 100,000 each year.

Most of the body’s electrical activity is handled by nerves, but the heart has its own unique electrical system. In the heart, electricity is generated in special pacemaker cells in the atrium, or upper chamber, and is then carried through designated pathways to the heart muscle cells. The cells then all contract at once to produce a heartbeat.

If there is an interruption anywhere along that pathway, the heartbeat can become faster, slower or erratic. The most common cause of SCA is ventricular fibrillation, a very fast or chaotic heart rhythm, or arrhythmia. While ventricular fibrillation is most common, any arrhythmia can cause the heart the stop beating.

Most people at risk for SCA have coronary artery disease (CAD), although some don’t even know it. There are other heart-related risk factors for SCA including having an enlarged heart or cardiomyopathy, valvular heart disease and a congenital heart condition, a condition present since birth.

Some other factors that put you at risk for SCA include the risk factors for CAD. These include being a smoker, having diabetes, high blood pressure, high cholesterol and/or being overweight or obese, as well as living a sedentary lifestyle. Drinking more than two drink a day is another CAD risk factor, as is having a family history of the disease.

Other risk factors for SCA include having had a previous SCA or having a family history of SCA. If you’ve had a heart attack or have a family history of heart disease, your risk for SCA increases. The risk for SCA goes up with getting older, being male, using recreational drugs like cocaine and amphetamines, and having low levels of potassium or magnesium in your system.

Blunt force trauma, like what can occur in a car accident or after taking a direct blow to the chest, can also result in SCA. This is called commotio cordis. Strenuous physical activity can trigger SCA, but in most cases, there is an underlying heart problem that the people doing the activity may or may not be aware of. This is often the case when athletes in top physical condition experience SCA.

Most people who have SCA, about 95 percent, die from it, often within minutes. Rapid treatment of someone suffering SCA is critical not only for that person’s survival, but also to minimize damage to the brain from being without oxygenated blood for too long. Because when the heart stops beating, blood flow to the rest of the body also ceases.

The chances of a positive outcome increase dramatically if the person’s receives CPR and treatment with a defibrillator within minutes. Automated external defibrillators (AEDs) are available in more and more public places, including shopping malls, busses, parks and schools. You can even get an AED for your home, but talk to your doctor before you buy.

AEDs are devices that analyze the heart and if they detect a problem deliver an electrical shock to restore the heart’s normal rhythm. They are designed for use by laypeople and provide visual and voice prompts. They will only shock the heart when shocks are needed to restore normal rhythm.

If you witness someone in SCA, call, 911 immediately, then check to see if the person is breathing. If they’re not, begin chest compressions. If an AED happens to be available, use it on the unconscious, unbreathing person. Follow the instructions and prompts provided with the AED. Use the AED once, then continue chest compressions until emergency personnel arrive.

SCAs happen without notice, so they can’t be diagnosed until after they occur. There are, however, tests to diagnose contributory disorders and steps to reduce the impact of some risk factors. Having routine appointments and physicals with your doctor and getting appropriate screenings when required can help alert you to potential risk factors for SCA.

If you survive SCA or are at very high risk for SCA, your doctor may choose to place an implantable cardioverter defibrillator (ICD). An ICD is placed under the skin in your chest wall, with wires that attach to the heart. The ICD works like a pacemaker. When it detects a dangerous arrhythmia, it sends a shock to the heart to restore the natural rhythm.

Your doctor may also prescribe medication, especially if you’ve had a heart attack or if you have heart failure or an arrhythmia. Types of medications include ACE inhibitors, beta blockers, calcium channel blockers and other anti-arrhythmia drugs. If you’ve got high cholesterol and CAD, your doctor may also prescribe a statin medication for lowering your cholesterol levels.

If you’re aware of a heart condition or other risk factors for SCA, you can help yourself by making some lifestyle changes to reduce your risk of CAD and subsequently SCA. Lifestyle behaviors to put into practice in your life include quitting smoking, maintaining a healthy weight, exercising regularly, eating a low-fat diet and managing diabetes, high blood pressure and other chronic conditions.

For the best outcome in the case of SCA, treatment must be started within minutes of the event. If someone you love is at high risk for SCA, do them a favor and learn the proper techniques for CPR. The American Heart Association and many hospitals and health organizations routinely offer classes you can sign up for.

Think about learning CPR. You can save someone’s life.