Want to know more about heart disease, the risk factors, symptoms, and what you can do to become more heart healthy? Read our frequently asked questions. If you don't find your answer here, Ask a Question and receive a response from one of our cardiac health professionals.
Alcohol and The Heart
Q: Can drinking alcohol actually be beneficial to your heart?
A: For some people, drinking even the smallest amount of alcohol carries major risks. For others, research shows moderate consumption may actually offer a degree of protection against heart disease. Researchers continuously are studying the relationship between alcohol consumption and the heart. And, some more recent findings suggest moderate alcohol consumption can offer some protection against heart disease for some people. But determining exactly who might benefit and who might actually be at risk is difficult.
Q: What are some of the possible heart-related benefits of moderate alcohol consumption?
A: Some of the possible heart-related benefits of moderate alcohol consumption include:
- Raising the "good" HDL cholesterol level
- Lowering blood pressure
- Inhibiting the formation of blood clots, which can be good because it may prevent a heart attack; but, it also could increase the risk of bleeding.
- Helping prevent artery damage caused by the "bad" LDL cholesterol
Q: How do I know what "moderate drinking" is?
A: According to the American Heart Association, moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men. One drink is qualified as 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof liquor, or 1 ounce of 100-proof spirits.
Q: Is moderate drinking safe for everyone?
A: No. Even moderate alcohol consumption is not right for all people. In fact, alcohol consumption can be quite harmful to some. Anyone who has had heart failure, cardiomyopathy, high blood pressure, diabetes, arrhythmia, a family history of cardiac death or stroke, obesity, high triglycerides, or are taking medications should speak to their doctor before consuming alcohol. Also, if you are pregnant or have a history of alcoholism, you should not drink alcohol. Given the potential risks created by drinking alcohol, the American Heart Association cautions people not to start drinking if they do not already drink alcohol.
Q: How does alcohol affect heart disease risk?
A: How alcohol affects cardiovascular risk merits further research. Drinking alcohol in hopes of gaining potential health benefits is not recommended. Instead, talk to your doctor about lowering cholesterol and blood pressure, controlling weight, getting enough exercise and following a healthy diet. There is no scientific proof that drinking an alcoholic beverage can replace these conventional measures.
Q: What is atrial fibrillation?
A: A heart condition that affects an estimated 2 million Americans, atrial fibrillation (AF) is rapid, irregular electrical activity in the heart's upper chambers.
Q: What happens during atrial fibrillation?
A: Normally, your heart contracts and relaxes to a regular beat controlled by electric signals that are produced by cells within the heart. In atrial fibrillation, part of the heart beats irregularly and too fast, causing your body to not receive the proper amount of oxygen.
Q: Who normally suffers from atrial fibrillation?
A: AF can occur in otherwise healthy people with no known heart disease, and is most often detected during stress or exercise. AF also shows up in people who've had coronary heart disease, heart attack, heart failure, heart valve disease, an inflamed heart muscle or lining, or who recently have had heart surgery. People with atherosclerosis (arteries lined with fatty deposits) and angina (chest pain) sometimes have it, and it also has been linked to congenital heart defects.
AF sometimes appears in people with chronic lung disease, pulmonary blood clots, emphysema and asthma. Other factors that affect risk for AF are thyroid disorders, diabetes, high blood pressure, excessive alcohol consumption and cigarette smoking-some of which are modifiable.
Q: Can atrial fibrillation cause other health problems?
A: AF can lead to other heart rhythm problems, chronic fatigue, heart failure and stroke. If AF is left untreated, the overactive heart muscle can weaken and stretch, making it harder for the heart's upper chambers to contract properly. Not only does this increase your risk of stroke, it also can lead to congestive heart failure.
Q: What are the symptoms of atrial fibrillation?
A: See list below:
- Irregular heart beat,
- Heart palpitation or rapid thumping inside the chest,
- Dizziness, sweating and chest pain or pressure,
- Shortness of breath, and
- Tiring more easily when exercising.
Q: How is atrial fibrillation diagnosed?
A: AF most commonly is diagnosed with the help of an electrocardiogram, which allows the physician to see if your heart's electric signals are normal.
Q: How is atrial fibrillation treated?
A: Once diagnosed, AF traditionally is treated by medication to prevent blood clots. In some cases, surgery may be required or electric shock is used to change the beat of your heart. There is no known cure for AF, therefore the goals of treatment are to prevent blood clots from forming, control your heart rate within a relatively normal range, and restore a normal heart rhythm, if possible.
Bypass Surgery: All-Arterial Revascularization
Q: What causes coronary artery disease?
A: Coronary artery disease is caused by atherosclerosis, the buildup of a hard, waxy substance called plaque inside your arteries. Over time, this buildup can cause narrowing inside your arteries, limiting the flow of oxygen-rich blood to your heart. In some cases, pieces of plaque may break off and completely block an artery or cause an artery to clot off.
Q: How does bypass surgery treat coronary artery disease?
A: Bypass surgery creates a detour around the blocked artery and forms an alternate route for blood to flow to the heart.
Q: What happens during bypass surgery?
A: A piece of blood vessel is taken from somewhere else in the body and then reattached below the narrowed or blocked section of the diseased coronary artery. The earliest techniques used the saphenous veins found along the inside of the legs. Then, surgeons began using the internal mammary artery behind the left ribcage. The left internal mammary still is used more than 95 percent of the time because the mammary artery already is attached to a large artery on one end, leaving only one end of the artery to be detached and then grafted to a coronary artery.
Q: What is the latest bypass surgery technique?
A: Over the past five to six years, cardiovascular surgeons also have been using the radial artery found in the forearm. They often start with the radial artery in the patient's nondominant arm and should another artery be needed, they then may use the right internal mammary artery in addition to the left internal mammary artery. This combination has proven to help people live longer.
Q: How is bypass surgery performed?
A: Simply put, when bypass surgery is performed:
- The patient is put to sleep with general anesthesia.
- The surgeon exposes the heart surgically.
- The surgeon harvests a piece of healthy blood vessel from the chest, arm or leg.
- Connection to a heart-lung bypass machine allows the surgeon to stop the heartbeat while he or she works on the arteries. Or, the surgeon may use newer stabilizing devices to do the bypass on the beating heart.
- The surgeon uses the harvested blood vessel to create bypass grafts around the narrowed or blocked parts of the arteries.
- The surgeon then allows flow through the bypasses and closes the incisions.
- The patient wakes up once the anesthesia wears off.
Q: What is recovery like after bypass surgery?
A: Bypass surgery is a detailed procedure that varies in length depending on the complexity of each patient's problem. Recovery involves four to seven days in the hospital, and then anywhere from three to 12 weeks of rehabilitation as the patient returns to his or her prior activities. There are no long-term restrictions and exercise, especially in the form of cardiac rehabilitation, is encouraged.
Children and Exercise
Q: Why should children exercise?
A: According to the American Heart Association, increased physical activity has been associated with increased life expectancy and decreased risk of cardiovascular disease. Children who exercise regularly improve their cardiovascular health, strengthen their heart muscles and maintain better endurance in sports. How often should children exercise?
To reap benefits, children ages 2 and older should participate in at least 30 minutes of enjoyable, moderate-intensity activities every day. They also should perform at least 30 minutes of vigorous physical activities -such as horseplay, dancing, biking and swimming-a minimum of three to four days a week. This large-muscle movement at a rapid rate helps achieve and maintain a good level of heart and lung fitness.
Q: What other benefits do children gain from exercising?
A: Children who exercise may experience:
- Lungs that stay healthier longer;
- Less depression and stress;
- Reduced blood pressure;
- Raised HDL ("good") cholesterol;
- An increase in the burning of calories;
- A decreased risk of type I and type II diabetes; and
- More self- confidence and self-esteem.
Q: How can I help my child like exercise?
A: Any form of physical activity that is regular, enjoyable and sustainable will help your child embrace exercise. The goal is to teach them to enjoy exercise while they are young so they may develop lifelong passions for activities that will keep their hearts and bodies in the best health possible.
Battle of the Bulge: Fighting the Childhood Obesity Epidemic
Q: Why has obesity reached epidemic proportions?
A: With some 30 percent of American children and adolescents overweight-and half of them obese-obesity is an epidemic that is linked to lifestyle. Children are less active, do not get enough regular exercise and have unhealthy diets.
Q: What health problems are overweight and obese children at risk for?
A: The earlier the body is exposed to such conditions, the greater the potential for organ injury and long-term health problems. Obese children are increasingly developing traditional adult diseases, such as hypertension. Historically children have experienced hypertension as a secondary condition due to kidney problems, but now it's a primary one.
Q: What is hypertension?
A: Also known as high blood pressure, hypertension is an extremely aggressive condition that can lead to secondary organ damage targeting the eyes, heart, brain and kidneys.
Q: What can parents and caregivers do to raise healthier children?
A: Parents and caregivers must teach healthy eating and exercise habits to their children when they are young. Healthy eating can be implemented by planning meals containing whole grains, fruit and vegetables, and eliminating fast food, sugary snacks and drinks. It also is important to control portions and to not use food as a reward, or lack of food as a punishment.
Encourage daily aerobic activity by taking a family walk after dinner, playing sports together, and assigning active household or yard chores. Limiting the amount of time your children spend in front the television or computer also is essential.
The Heat is On! Warming Up on Warm Weather Exercise
Q: What are the benefits of regular exercise as an older adult?
A: Older adults benefit from regular exercise just as much as younger folks. Regular exercise slows, even reverses, the effects of aging, benefiting you physically and psychologically. It builds strength, endurance and self-esteem, and reduces stress.
Benefits include lowered risk of cardiovascular disease, higher good (HDL) cholesterol, higher bone density, weight loss or maintenance, controlled diabetes and lowered risk of osteoporosis.
Q: How do you adjust to exercising in warmer weather?
A: It's important to adjust before summer begins. Exercise in the early morning or evening, as these will be the coolest, most comfortable times of day.
Q: What should I wear while exercising?
A: Wear loose, light-colored clothing, a protective hat or visor, sunscreen and supportive shoes. Avoid long, thick pants or stockings. Do not wear dark-colored fabric, which absorbs more heat.
Q: Staying hydrated is important during exercise. What signs should I look out for?
A: Dehydration can be a serious problem, so make sure you are hydrated throughout your day. While exercising, pay attention to signs of fatigue, such as dizziness, headaches, cramps or thirst. If you are thirsty, this is a sign that you already are dehydrated. Have a bottle of water handy while exercising.
Q: What if I do not want to exercise outside? What are my options?
A: Try walking in malls, which are safe, flat and climate-controlled. Or consider exercise programs and classes at your local gym, community center or hospital.
Q: What is HAPI?
A: Palmetto Health's Healthy Aging Program Initiative (HAPI) offers a variety of group classes for all ages and ability levels, on land and in water. Classes are offered in an ongoing, four-week long series. For more information, call 296-2273 or visit www.palmettohealth.org.
Q: Why is it important to know and manage your total cholesterol?
A: The risk of coronary heart disease rises as blood cholesterol levels increase. When other risk factors are present, this risk increases even more.
Cholesterol is a necessary component of our bodies, but additional dietary cholesterol is not needed. Excess cholesterol in the blood stream can form a thick, hard deposit called plaque in the artery walls. This build-up causes arteries to become thicker, harder and less flexible. When blood flow is restricted, chest pain called angina can result. When blood flow to the heart is severely restricted and a clot stops the flow completely, a heart attack results.
Q: What should my total cholesterol level be?
A: Medical experts recommend that total cholesterol levels be less than 200 mg/dL in order for an individual to be at lower risk for heart disease. Borderline high cholesterol is 200 to 239 mg/dL; high blood cholesterol is 240 mg/dL and above. A person with this level has more than twice the risk of heart disease as someone whose cholesterol is below 200 mg/dL.
Q: What's the difference in "good" versus "bad" cholesterol?
A: About one-fourth to one-third of blood cholesterol is carried by high density lipoprotien (HDL). Often called the "good" cholesterol, high levels of HDL seem to protect against heart attack because it carries cholesterol away from the arteries and back to the liver where it is passed from the body. Optimal HDL levels are 40 mg/dL and higher.
When too much low-density lipoprotein (LDL) cholesterol circulates in the blood, it can slowly build up in the artery walls that feed the heart and brain. Together with other substances, it can form artery-clogging plaque that can eventually cause a heart attack or stroke. LDL cholesterol of less than 130 mg/dL is the optimal level for most people.
Cholesterol Management in Your Golden Years
Q: Why should cholesterol be managed in older adults?
A: High cholesterol levels that go untreated or unmanaged increase one's risk for coronary heart disease (CHD), which is the leading cause of death in both men and women over 65 years old and can cause long-term disability. Cholesterol treatment in high-risk individuals who are 65-80 years old is beneficial and reduces the likelihood of a heart attack or other coronary heart disease event.
Q: How do you know if you are "high-risk" for coronary heart disease?
A: You are considered high-risk if you have known CHD: you have had a heart attack, angioplasty, bypass operation, abnormal stress test, other diagnosis of atherosclerosis or you have diabetes mellitus.
Q: Am I still at high-risk if I have not had a heart attack?
A: You still are at high-risk, if your cholesterol level is high and you have one other major risk factor, such as high blood pressure, diabetes, obesity or smoking.
Q: What must I do to lower my cholesterol?
A: To lower your cholesterol, live a heart-healthy lifestyle. Eat a heart-healthy diet that includes fresh vegetables, fruit, whole grains, low-fat dairy products, and limit fatty foods. Exercise regularly, avoid smoking, control high blood pressure, manage your diabetes and maintain a healthy weight. Your doctor also may recommend cholesterol-lowering drugs.
Q: What is the healthy range for cholesterol?
A: A healthy range for total cholesterol is less than 170 mg/dL and an LDL cholesterol of less than 100, or less than 70 mg/dL if you are in the high-risk category.
Clinical Trials at Palmetto Health Seek to Improve Patient Care
Q: What is a clinical trial?
A: A clinical trial is a study done with humans. The trials are designed to answer very specific questions, such as the impact of a new treatment or diagnostic test on a patient. They result in concrete information to add to the body of knowledge that exists in a particular area. They determine if something works or not. Once a drug or diagnostic treatment is approved through a clinical trial, it may take months or years before it becomes part of the standard of care.
Q: What are the potential benefits of clinical trials?
A: Clinical trials help researchers, physicians and other medical professionals to better understand and improve patient diagnosis methods, treatments and procedures. They also provide the public access to new ways of care.
Q: What clinical trial work is done at Palmetto Health?
A: Palmetto Health administers various clinical trials across all areas of medicine. It also is a site for several national registries designed to improve patient treatment and outcomes.
Trials are directed and administered through the Palmetto Health Clinical Trials Department. A group of experienced research nurses handle all aspects of administering the clinical trials and work under the supervision of physicians, who are the principal investigators.
Q: What should I do if I think the person with me is having a heart attack?
A: If you understand the "chain of survival," which includes knowing how to perform Cardiopulmonary Resuscitation (CPR), you'll know where to start. You could possibly prevent the cardiac arrest death of a loved one, friend or neighbor by knowing when to phone 9-1-1 and when to begin CPR. Early access to trained emergency responders through 9-1-1, knowing how and when to begin CPR, and getting early advanced care for a heart attack or stroke victim can save his or her life.
More specifically, the American Heart Association 's adult chain of survival has four links of actions to perform should you be with an adult who becomes suddenly unresponsive:
- Phone 9-1-1.
- Begin CPR.
- Perform defibrillation (performed by emergency responders).
- Transfer to a hospital.
Q: What is "CPR?"
A: CPR is a means of providing breathing and circulation to an unresponsive person. It is best taught in a training class. In general, the steps of CPR can be remembered as ABC:
- Airway: place the victim flat on his back on a hard surface and open his airway by tilting the head back with one hand while lifting up the chin with your other hand.
- Breathing: look, listen and feel for signs of breathing. If the victim is not breathing normally, give two slow rescue breaths.
- Circulation: Check for signs of response to the rescue breaths (such as normal breathing, coughing or movement). If the victim is responding but not breathing normally, continue giving rescue breaths (one breath every five seconds). If there are no signs of circulation, begin chest compressions by placing the heel of one hand on the lower part of the victim's sternum and then placing the other hand on top of the first hand. Depress the sternum 1.5 to 2 inches and perform 15 compressions to every two breaths. If the victim responds, stop the compressions. If the victim begins breathing normally, turn him onto his side and wait for rescue personnel.
Q: How can I learn CPR?
A: Palmetto Health regularly offers CPR training courses in the basement of 1501 Sumter St. on the Palmetto Health Baptist campus. Call 296-2273 for more details.
Diabetes and Low-Carb Diets
Q: Is weight a concern if someone has diabetes?
A: Yes. For anyone, maintaining a healthy weight is one of the many ways to fight off heart disease. But if you have diabetes, watching your weight is even more important because the two risk factors together-obesity and diabetes-dramatically increase your risk for heart disease.
Q: How do carbohydrates affect diabetics?
A: For someone with diabetes who has to maintain control of high blood sugar, a carb is not just a carb. Most of the food we eat is turned into sugar for our bodies to use for energy. The pancreas produces a hormone called insulin to help the sugar get into our bodies' cells. With diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should, or both. This causes sugars to build to high levels in your blood.
One hundred percent of carbohydrates, 50 percent of proteins and 10 percent of fats are eventually turned into sugar for our bodies to use for energy. Foods that have similar carbohydrate content can result in varying blood sugar levels when the carbohydrates are eaten without protein, fiber or fat.
Q: What is the glycemic index?
A: The blood sugar level in a person with diabetes depends on the glycemic index (GI) and amount of the food eaten, plus the combination of carbohydrate, protein, fiber and fat eaten at the same time.
When carbohydrates only are eaten during a meal or snack, the GI number of the carbohydrate has a greater influence on the blood sugar level. The glycemic index rates foods on a scale of 0 to 100. Carbs with a GI of 55 or lower (such as most fruits, vegetables, whole grains and legumes) tend to be slowly released into the blood and raise blood sugar gradually. Carbs with a GI of 70 or higher (including foods high in table sugar or corn syrup, white potatoes, breads or pastas, and highly processed cereals) are quickly released into the blood and raise blood sugar faster and, perhaps, higher than lower-glycemic carbs.
Q: What's the best way for a diabetic to lose or maintain weight?
A: Typically, it is recommended that people with diabetes eat balanced meals and snacks. This helps control blood sugar levels by slowing the release of sugar into the bloodstream. When meals and snacks are balanced, those with diabetes can enjoy a wider variety of foods. However, they still must keep portion control in mind. It's wise to consult with a doctor, registered dietitian or a certified diabetes educator about the best eating plan for them.
Q: Is the GI system recommended instead of a low-carb diet for diabetics?
A: The GI system offers one method for diabetics to monitor their sugar intake while reaching and maintaining a healthy weight. However, it may not be the right approach for everyone and diabetics should consult with their physician before using this system.
Diet and Exercise
Q: How important is it to get regular exercise?
A: A regular exercise program benefits your health and may lessen the risk of a number of diseases, including heart disease. The heart is a muscle that needs exercise to stay in shape. Physical inactivity is a key risk factor for heart disease.
Adding just a little exercise to your daily routine also reduces the risk of high blood pressure, osteoporosis, certain cancers, depression, anxiety and stress. It enhances your overall well-being.
Regular exercise, even walking briskly for as little as 20 to 30 minutes a day, totaling at least three hours of exercise a week, provides the following benefits:
- Improves circulation
- Improves muscle tone
- Improves overall body fitness
- Helps reduce obesity
- May help lower risk of age-related disorders
Q: How do you get started and what's a good exercise regimen?
A: Individuals should consult with their physician about safe exercise levels for their current health situation. Then, chose an exercise you enjoy that works with your lifestyle, and one that involves large muscle groups such as the legs and arms. Experts recommend a combination of aerobic and strength-training activities for maximum benefit.
Start off exercising a minimum of three days a week, working up to five to seven days a week. Try to exercise at least 30 minutes per day, and intensify the workout as you progress.
Q: How do I make exercise part of my daily routine?
A: Some simple steps include the following:
- Use the stairs instead of the elevator
- Walk instead of driving if you're doing errands
- Take a 15-minute "walk break" from work to help your heart and relieve stress
- Find a friend to exercise with you. This provides an incentive on the days you don't want to exercise.
- Vary your exercise routine
- Set goals and reward yourself for reaching them.
Q: How does regular exercise help keep LDL cholesterol levels in check?
A: Low-density lipoprotein (LDL) or the "bad" cholesterol we hear about is most dangerous when it appears as small, compact particles. Even moderate exercise like walking or gardening can help keep LDL cholesterol large and "fluffy." That's a step in the right direction.
Q: What constitutes a healthy diet? Do you have to be vegetarian to be heart healthy?
A: Make heart healthy eating part of your daily routine. Eat a variety of foods you like in moderate amounts, choosing from all food groups, such as complex carbohydrates, proteins, fruits, vegetables, dairy and minimal fats and sugars.
Eliminating or reducing red meat, refined sugar and flours, and caffeine can help point you in the right direction toward more healthy eating. Adding fiber also boosts healthy eating and has been proven to help lower blood sugar and cholesterol levels. Consider reducing your sodium intake to no more than 3,000 mg daily. And don't forget to drink at least eight 8-ounce glasses of water a day to help your body's digestive functions and to curb your appetite.
Q: What percent of daily calories should come from fat?
A: A normal diet should consist of less than 30 percent of calories from fat. The percentage is even less--20 percent--for people working to prevent heart disease, and even lower-10 percent-for people working to reverse heart disease.
Q: What are electrophysiology studies?
A: Having an irregular heartbeat can be a sign of more serious heart problems. Electrical-activity based technology-called electrophysiology (EP) -studies the electrical activity of the heart to detect the presence of irregular heart rhythms in patients and helps the physician determine necessary treatment.
Q: What is an arrhythmia?
A: An arrhythmia is an irregular heartbeat that often results from a change or malfunction in the heart's conduction system. The conduction system is where normal electrical activity travels where normal electrical impulses travel through the heart. An arrhythmia can occur when the heart's natural pacemaker develops an abnormal rate, the normal conduction pathway is interrupted, or another part of the heart takes over as pacemaker. Arrhythmias can be unusually fast, called tachycardia, or unusually slow, called bradycardia.
Q: Should I be worried if I have an arrhythmia?
A: Some arrhythmias are signs of a more serious problem, while others are not. The irregular heartbeat can be brief and unnoticeable, but it also can be quite bothersome or even fatal. Because an occasional skipped heartbeat is not medically significant in the majority of cases does not mean that arrhythmias should be ignored. Notify your physician if you feel any skipped beats or feel that your heart is beating differently than normal.
Q: How is an EP study performed?
A: At Palmetto Health Richland's Heart Hospital, EP studies are done in the EP Lab, which is part of the Catheterization Lab. The lab is equipped with the necessary monitoring devices, video display equipment and X-ray cameras. Once the patient is made comfortable, heart and blood pressure monitoring begin and an intravenous line is inserted. The area where the thin tube-like catheter will enter the body is locally anesthetized.
A long, thin tube-like catheter is inserted in an artery or vein in the arm, neck or groin. The catheter then is guided into the heart. Small pacemaker catheters then are inserted through the catheter. The physician sends electrical impulses through these catheters to check for problems with the heart's electrical system.
Once in place, the electrode catheter performs specific, essential measurements of the heart's electrical activity and pathways. The catheter records heart sounds to assess the presence of arrhythmias.
Q: What happens if an arrhythmia is detected?
A: If the abnormal source of an arrhythmia is detected, the physician may use the opportunity to perform treatment such as radiofrequency ablation. Radiofrequency energy from the tip of the catheter is used to heat and destroy the heart cells that are creating the arrhythmia.
Some reasons for having an EP study include fainting, irregular heartbeat, and a very fast or slow heartbeat.
Q: How long does an EP study take?
A: An EP study that includes ablation treatment can take up to six hours.
Q: What happens after the EP study?
A: Once the procedure is concluded, the catheter is withdrawn, pressure is placed on the puncture point and the patient is watched for four to six hours before being released. The patient may go home the same day, or, occasionally, is watched overnight in the hospital.
Q: How quickly are results available?
A: Results from the study often are available to the patients at the time of the procedure.
Q: What treatments are available if the EP study shows an arrhythmia?
A: If the EP study reveals that an arrhythmia is being caused by abnormal electrical impulses, treatments (in addition to the catheter ablation) include a pacemaker, an implantable cardioverter defibrillator, or antiarrhythmic medications.
Q: Are arrhythmias common?
A: Approximately 4 million Americans have periodic arrhythmias. And, an estimated 2 million Americans are living with atrial fibrillation, which is the most common "serious" arrhythmia. The prevalence of arrhythmias tends to increase with age, even when there's no clear sign of heart disease.
Q: What are the symptoms of arrhythmia?
A: Arrhythmias occur throughout the population and their severity varies widely. Some people with arrhythmia have no symptoms, while others experience obvious discomfort. Some of the symptoms experienced by people with arrhythmia include:
- "Galloping" or strong heartbeat,
- Skipped heartbeat,
- Dizziness, fatigue or fainting,
- Chest pain, pressure or discomfort, and
- Shortness of breath.
Q: Can an arrhythmia be fatal?
A: In severe cases, arrhythmia can result in cardiac arrest and death. If you think you may be suffering from any of these symptoms, contact your physician.
Folic Acid and Your Heart
Q: What is folic acid?
A: Folic acid is a nutrient also known as folate or vitamin B-9. It is used for the production, repair and functioning of your body's DNA. Folic acid helps break down homocysteine.
Q: What is homocysteine?
A: Homocysteine is an amino acid in the blood that is regulated by folic acid. Elevated homocysteine levels have been linked to birth defects, blood clots, heart problems and other serious conditions.
Q: What heart problems are elevated homocysteine levels related to?
A: The American Heart Association reports that elevated homocysteine levels are related to a higher risk of:
- coronary heart disease
- peripheral vascular disease (fatty deposits in the peripheral arteries)
- atherosclerosis (fatty deposits in blood vessels)
Q: If I am at high risk for heart disease will my physician screen for homocysteine levels, along with my blood pressure and cholesterol?
A: Screening homocysteine levels maybe helpful for patients who have a family history of heart disease yet do not exhibit other risk factors.
Q: How much folic acid should I get a day?
A: People should get enough folic acid, B-6 and B-12 vitamins in their diet, about 400 micrograms (mcg) per day.
Q: What foods are good sources of folic acid?
A: Good sources include whole grains and legumes such as lentils and chickpeas. Dark greens such as collards, asparagus and broccoli and fruit like papaya, strawberries and oranges are also good sources.
Q: Should I take folic acid supplements?
A: Take supplements only if you are not able to get enough folic acid from your daily diet or if your physician recommends it.
Food and Drug Interactions
Q: Aren't you supposed to take medications with food?
A: Many prescription medications are to be taken with food. But some combinations of food and drugs actually can make you more sick. Medicines, such as those prescribed to cardiovascular disease patients, can have powerful ingredients that interact with our bodies in negative ways. Diet often plays a role in a medication's ability to work properly. Certain foods can interact with some medications, making them less effective or causing dangerous side effects.
Q: How will I know whether or not to take my medication with certain foods?
A: Carefully following your doctor's instructions is the best way to maximum your medication's effectiveness and minimize your risk. Although each person's body is different, there are some common food and drug combinations that heart disease patients should avoid. Those include:
- Diuretics help rid the body of water, sodium and chloride. Diuretics are a little tricky because they vary in their interactions with food and specific nutrients. Some diuretics cause loss of potassium, calcium and magnesium.
- Contrarily, triamterene (known as Dyazide and Maxzide) is a potassium-sparing diuretic. It blocks the kidneys' excretion of potassium, which can cause increased potassium. Excess potassium can cause irregular heartbeat and heart palpitations. If you take triamterene, avoid eating large amounts of potassium-rich foods such as bananas, oranges and leafy green vegetables, as well as salt substitutes that contain potassium.
- Beta Blockers decrease the nerve impulses to the heart and blood vessels, which in turn decreases the heart rate and the heart's workload. One beta blocker called propranolol (brand name Inderal) should not be mixed with alcohol. Combining the two can lower blood pressure too much.
- Nitrates relax blood vessels and lower the heart's demand for oxygen. Anyone taking nitrates should avoid alcohol consumption. Drinking alcohol may add to the blood vessel-relaxing effect of nitrates, resulting in dangerously low blood pressure.
- Angiotensin Converting Enzyme (ACE) Inhibitors also relax blood vessels. Consuming food with certain ACE inhibitors can decrease the absorption of the drugs. If you take captopril (brand name Capoten) or moexipril (Univasc), take your medication at least one hour before or two hours after meals.
- ACE inhibitors also may increase the amount of potassium in your body. Too much potassium can be harmful, so avoid eating large amounts of foods high in potassium.
- Statins are used to lower cholesterol. If you take a statin, avoid drinking large amounts of alcohol because it may increase the risk of liver damage. Lovastatin, also known as Mevacor, should be taken with the evening meal to enhance absorption.
- Anticoagulants help prevent blood clot formation. Vitamin K may reduce its effectiveness, so limit intake of foods such as broccoli, spinach, kale and cauliflower. Also, high doses of Vitamin E may prolong clotting time and increase the risk of bleeding.
Q: Is it true that drinking grapefruit juice with certain medications can be harmful?
A: Believe it or not, drinking grapefruit juice can be harmful to your health if you're taking certain medication. Drinking grapefruit juice together with certain medications can increase blood levels of the drug to harmful levels. The juice inhibits a chemical in the liver needed to break down many drugs in the body. The absence of this chemical can lead to high blood level, which can actually make a drug more potent.
This effect has been observed in nearly all calcium channel blockers, a group of drugs used to control blood pressure. Heart patients taking calcium channel blockers or cholesterol-lowering statins should talk to their physician about possible food-drug interactions.
Genetics: Heart Disease and Your Family Tree
Q: How do I know if heart disease runs in my family?
A: Get to know your family health history by collecting information about your relatives and tracing your health history back at least three or four generations. If a parent and/or family members has heart disease or died from a heart attack, you are at risk of developing other risk factors, such as high cholesterol, obesity, high blood pressure or diabetes.
Q: If I have a family history of heart disease, what should I do to reduce my risk?
A: Visit your physician for a complete medical evaluation, lipid profile, and blood sugar and blood pressure check. Make sure he or she knows what medications or drugs you are using as well as any type of stress or other situations you may be facing.
Eat a diet of foods rich in fruit, vegetables, fish and healthy oils, and match your calorie intake to physical activity. Limit your salt intake and avoid concentrated sweets and saturated fats, as well as trans fats. Exercise for at least 30 minutes a day, most days of the week.