Thursday, 7 November 2019

Before You Shovel Snow, Know the Signs of Heart Attack


Shoveling snow is a strenuous exercise that can put undue strain on the heart. Factor in cold air, which constricts the blood vessels and increases blood pressure, and you have a dangerous combination for people with coronary artery disease or other forms of heart disease. So before you go shovel your walkway or let a loved one shovel their own, take a few moments to review these heart attack symptoms.

Heart Attack Signs that Can Appear in Men and Women

  • Chest pressure or pain  This usually lasts more than a few minutes and can come and go.
  • Ache or soreness radiating through the back, jaw, throat, or arm while your upper body may be aching for the shoveling itself, you should seek medical attention if the soreness is in conjunction with other heart attack symptoms.
  • Anxiety people who have had heart attacks sometimes describe having felt panicked for no apparent reason.

What to Do if You Have Heart Attack Symptoms While Shoveling

Acting quickly in response to heart attack symptoms can save lives. If you feel like you are experiencing symptoms of a heart attack, call 9-1-1 immediately. Do not attempt to drive yourself to the hospital.
If you see someone who exhibits symptoms of a heart attack, call 9-1-1 right away and remain with the person.
Try to keep them calm, and have them sit or lie down. If the person stops breathing, you or someone else who is qualified should perform CPR immediately.
The 911 operator will assist you with CPR until the emergency medical team arrives.
Knowing your personal risk of a heart attack, symptoms, and what to do if you or a loved one has a heart attack can save a life.

Thursday, 31 October 2019

6 Best Exercises to Strengthen Your Heart




6 Best Exercises to Strengthen Your Heart
Strengthening your heart is one of the best things you can do for your health. And as you know, the best way to strengthen your heart is to exercise. In fact, if you don’t exercise you’re more than twice as likely to get heart disease as someone who does. If you have a history of heart disease, or just worry about your heart health, you need to develop a regular exercise routine. Experts recommend you spend at least 150 minutes doing moderate exercise per week.
But is all exercise created equal? Here are the best exercises to strengthen your heart.
1. Walking
Yes, it might seem a little too easy. But walking, especially speed walking, is a great way to strengthen your heart. Walking fast will get your heart rate up and is easier on your joints than other types of exercise. You can walk anywhere at any time. All you need is a pair of supportive shoes. Do a short walk during your lunch break or a longer walk on the weekend. You can listen to music, a podcast, or walk with a friend. The flexibility of walking makes it easy for anyone to do — and to keep doing it.
2. Weight Training 
Building the other muscles in your body will help your heart. Weight training will help you build muscle mass and burn fat. Although you can hit the gym to train with weights, some of the most effective weight training happens when you use your own body weight. Things like push-ups, squats, or even pull-ups all help you build muscle and contribute to bone and heart health.
3. Swimming
Swimming isn’t just for lazy summer afternoons. Taking a water aerobics class or swimming laps can be a full-body workout that will strengthen not only your body but your heart. Unlike other types of exercise, walking is easy on your joints and allows you to move your body without a lot of pain.
4. Yoga
Although it might not seem like it, yoga is great for your heart health. Doing yoga will help you strengthen and tone your muscles. Certain types of yoga can really get your heart rate up, while still providing the calm that will lower your blood pressure.
5. Interval Training
Interval training — which alternates between short bursts of high-intensity exercise with longer periods of active recovery — is a great way to get a full-sized workout in a short amount of time. For example, you can do it by running for one minute and walking for three minutes, then repeating the cycle. Raising and lowering your heart rate helps to burn calories and improves the function of your blood vessels.
6. Cycling
Jumping on your bike can do more than just get you from one place to another. Cycling has been shown to help reduce the risk of heart disease. It uses your large muscles in your legs, which helps to elevate your heart rate. Bonus: Cycling has even been shown to improve your mental health.
Whether you choose to hit a yoga class three times a week, go walking with a friend, or swim every morning, regular exercise is essential to taking care of your heart. Always talk to your doctor before you begin an exercise routine.

Wednesday, 30 October 2019

What is Holter Monitoring Used For?


Wanting to understand more about Holter monitoring because you may need to wear one in your near future? Whenever you are experiencing any medical conditions that relate to your heart, it is often necessary to undergo certain procedures or certain tests in order to find out exactly what is going on. A Holter monitor is a test that records the rhythm of your heart, allowing medical professionals to better understand what is happening so they can offer solutions.

What exactly is a Holter monitor?

Finding out more about Holter monitoring is recommended if you are someone who may need to wear a Holter monitor in your very near future. It is a small device that must be worn close to your body for about two days. It monitors the rhythm of your heart during this time and records all of your heartbeats, which allows for a thorough understanding of your heart’s current condition.

What is Holter monitoring used for?

A Holter monitor checks for irregular heartbeats, which lets a medical professional know whether or not the patient is experiencing heart rhythm problems. This particular heart test is one that is recommended for patients who are experiencing any signs or symptoms of having a heart problem. It is noninvasive and instead uses electrodes that are taped to the patient’s chest in order to monitor the rhythm of their heart.
If the results from wearing the heart monitor for a couple of days do not provide a medical professional with enough information, the patient may need to wear a wireless Holter monitor. A wireless monitor can capture important heart-related information for many weeks, giving medical professionals the information they need to make a proper diagnosis.

Risks

There are not many risks that come with wearing a Holter monitor. Patients may experience some skin irritation in their chest area where the electrodes were put, which is a small price to pay to get necessary heart information. It is important for those who are getting ready to wear a Holter monitor to understand that they cannot get wet. If it does get wet, it will damage the monitor. Patients should also try to avoid getting too close to magnets or microwave ovens and may want to avoid using an electric blanket, an electric razor, an electric toothbrush or metal detectors.

Results

Once a medical professional receives the results recorded by the Holter monitor, they will discuss these results with the patient. Together, they will come up with a treatment plan to address any heart-related conditions that may have been found. If no heart problems were found, the patient may need to undergo additional heart monitoring in the future to make sure that it is performing correctly.

Have any questions for us?

If you have any questions about Holter monitoring, please do not hesitate to contact us when you have a few moments. The more you understand about this common heart test the more comfortable you will feel when wearing the monitor. You only need to wear the monitor for a couple of days, and, once the results come in, you will have a better idea of how your heart is performing.

Tuesday, 29 October 2019

Heart Palpitations After Eating – What Does It Mean?

Heart palpitations are scary, no matter when they occur. The sudden feeling of your heart pounding in your chest, beating faster or thumping much harder than you’re used to is a frightening experience. It makes you wonder and worry. Sometimes, palpitations can be so frightening that you call 9-1-1, fearing heart attack, or stroke. It’s smart to pay attention to those palpitations, but often they aren’t serious at all. Many people talk about experiencing heart palpitations after eating, for example. You can’t very well call 9-1-1 every time you sit down to a meal, can you? Of course not. Here’s what you need to know about palpitations after mealtime.

What Kind of Meal?

Many factors can contribute to heart palpitations after a meal, but one of the first things to look at is what kind of meal you just consumed. If it was a particularly rich meal, your body might just be working a little harder to digest the food. These particular palpitations are not all that uncommon. As long as the palpitations don’t get worse or become particularly bothersome, you shouldn’t have to worry about them.

Pay Attention

For some people, heart palpitations after eating can be an indication of a food sensitivity. The way a food sensitivity presents itself is not always the same from person to person, so if you notice palpitations after eating, consider the circumstances surrounding it. Do you get them after every meal, or only after meals containing a specific food? If you aren’t sure, try journaling your meals for a week or two and noting when you feel these symptoms.

Blood Sugar

If you haven’t eaten for too long, or your blood sugar has dropped, overeating or eating too late can contribute to heart palpitations as well. It’s a complicated process for your body to convert food into the energy you need, and your blood sugar levels at the time of consumption can have an impact on whether or not you feel those palpitations as your body levels out.

Talk to Your Doctor

No matter what the cause, if you’re feeling new or worsening palpitations for any reason, the best first line of defense is to discuss them with your doctor. Any unexpected cardiac activity should be tested and monitored if necessary. Whatever the cause, your doctor or a cardiologist can help you get to the bottom of it and create a plan to adjust your lifestyle and/or add medication to help mitigate the problem.

Monday, 21 October 2019

Mitral heart valve replacement: What to expect before and after the surgery


The mitral valve is located on the left side of the heart, between the left atrium and left ventricle. It has a very important role to play in the circulation. It is one of the four valves in the heart, that ensures that the blood flows throw the heart in the right direction and that the organs receive oxygenated blood from the heart. Oxygen-rich blood flows into the left atrium from the pulmonary veins. When the left atrium fills with blood, the mitral valve opens to allow blood to flow to the left ventricle.
Thus, the malfunctioning of the mitral valve can have serious consequences.

Purpose of the mitral heart valve replacement:

Mitral valve replacement is a procedure whereby the diseased mitral valve of a patient's heart is replaced by either a mechanical or tissue (bioprosthetic) valve.
The mitral valve may need to be replaced because:
  • The valve is leaky (mitral valve regurgitation)
  • The valve is narrowed and doesn't open properly (mitral valve stenosis).
Mitral valve disease is usually caused due to infection, calcification and inherited collagen disease. Current mitral valve replacement approaches include open-heart surgery.

Open Heart Surgery:

What to expect before open-heart surgery?

There are two kinds of valves, which can be used as replacement-biological and mechanical. The doctor decides which is the best for the patient.
  • Biological valves are made mainly from pig, cow, or human heart tissue. Biological valves don’t last as long.
  • Mechanical valves are man-made. However, if one gets a man-made valve, he/she has to take blood-thinning meds for the rest of their lives.
The following precautions need to be taken before the surgery.
  • Avoiding to eat or drink anything since midnight before the surgery.
  • Avoiding smoking
  • Certain medications need to be stopped.
Certain routine tests are done, and about an hour before the surgery, certain medications are given which helps the patient to relax.

What to expect during the surgery?

Anesthesia is given before the surgery starts. The surgery takes several hours to complete. As the surgical procedure is an open surgery, the doctor makes an incision down the chest to access the heart. The patient is then supported using an artificial heart-lung machine during the entire course of the surgery. Then the defective valve is removed, as is replaced by the new valve.

What to expect after the surgery?

Recovery happens in the ICU or recovery room. Most people who have mitral valve replacement notice immediate symptom relief after their surgery. Doctors check for heart rate, and other vital signs. The patient is kept under intensive care. Usually, a breathing tube is kept for proper breathing, but it is removed within 24 hours. There is also a drainage pipe to remove any excess fluid which may have accumulated in the chest in the course of the surgery. The patient is usually kept in the hospital for around 5 days.
Even after getting back home from the hospital, care has to be taken. The stitches are removed in around 7-10 days during the follow-up appointments. Temperature is to be checked daily, and a temp. higher than normal should be immediately reported. Heavy exercises or strenuous jobs should be avoided for several weeks.

Tuesday, 15 October 2019

How anxiety impacts your heart health

Anxiety is the feeling of worry, queasiness, and unease we’ve all felt at one point during our lives. But what if you’re part of the approximately 5-10% of the population that lives with an anxiety disorder? What affect will that have on your heart health?
While some of the most common complications of having an anxiety disorder are co-occurring substance abuse or the development of depression, generalized anxiety disorder is also associated with poor cardiovascular health and coronary heart disease, as well as mortality. Anxiety disorders typically result from multiple and uncontrollable worries, which often change over time, though the common worries are typically about the future welfare of one’s family, money or health. Isn’t it then ironic that to worry excessively about one’s health, is detrimental to one’s health?
As humans, we’ve been pre-programmed with a sympathetic nervous system to help us react in high danger situations appropriately. If you’re running away from a bear, you’ll want your heart rate to be increased to be able to supply sufficient blood flow to your muscles. But what if you’re worrying sitting on the couch, and all that worry has no place to escape? Anxiety disorders cause a dramatic increase in your heart rate during situations that are not a fight or flight scenario and can lead to poorer cardiovascular health in previously healthy people.
A recent meta-analysis looking at over 250,000 patients showed that in patients without previous heart disease, who suffered from anxiety disorders experienced a 26% increased risk of incident Coronary Artery Disease. In other words, a healthy individual with no history of heart problems became much more at risk for early signs of a heart attack, due to issues with anxiety.
One can also argue that worry may be beneficial for health promotion, but no studies so far have shown that such worry would have any benefits for health. Which brings out the perennial chicken or egg question. Does excessive worry lead to poorer cardiovascular health by and in itself, or do patients in already poorer health worry about their cardiovascular health excessively? Multiple studies have shown that in patients who have had an acute heart attack poorer outcomes were associated with additional worry or anxiety. Increased anxiety was also found to be an independent predictor of cardiac complications in other studies.
So why worry? While worrying may be actively helpful in intense situations, it’ll do you no good when it comes to your health, particularly cardiac health. You should try different methods and tools to help keep you calm and to encourage a positive mental attitude.
If you are experiencing anxiety that is prolonged, which you are unable to manage on your own, it is best to speak to your doctor about treatment options. Many people have found ways to cope with their anxiety through holistic or therapeutic methods, and some with medication. This is especially important if you already have heart issues or a family history of heart problems. It is important to make your heart health, as well as your mental health, a priority to ensure a long, happy life.

Monday, 14 October 2019

Statins are Antibiotics…is THAT the Pleiotropic Effect?

Statins have pleiotropic effects, ie the ability to reduce heart disease risk and CV death via an unknown mechanism, certainly beyond the LDL cholesterol-lowering that they can achieve. Researches have known for quite some time about these beneficial effects of HMG-CoA reductase inhibitors (also known as “statins,” such as atorvastatin and rosuvastatin), however, the physiology behind this phenomenon remains unclear. The answer as to why statins have these pleiotropic effects is largely unknown, but let me throw out an interesting theory and you form your own opinion.

Statins are antibiotics that kill the undiscovered organism responsible for the entire process of atherosclerosis.

Let's look at some facts first. Many don’t know that the first statin, mevastatin, was discovered in 1971 in the fungus Penicillium citrinum. As the name implies, this is the same fungus from which the first antibiotic penicillin was found. What was the role of penicillin in this fungus, you ask?
To kill the surrounding bacteria so they do not invade the fungi’s space, allowing the Penicillium citrinum species to grow and spread more easily ... survival of the fittest!
Then, what is the role of mevastatin in this fungus? According to researchers, it is the exact same: To block the cholesterol synthesis in the invading bacteria and other fungi, acting as an antibiotic. 
Think about this, as well: We know it takes decades for atherosclerotic plaques to form, and it is an inflammatory process. We know that the early use of statins immediately during an ACS significantly reduces mortality according to multiple clinical trials, including PROVE IT-TIMI 22 and the MIRACL trial. This benefit is thought to be from acute plaque stabilization, decreased thrombogenicity and decreased inflammation that occurs immediately after statin administration.
How does this make any sense if the only thing statins do is reduce LDL cholesterol levels through inhibition of HMG-CoA reductase? How should that short-term administration improve long-term mortality, considering the chronic nature of atherosclerosis? Why do these beneficial effects occur? Why is inflammation dramatically reduced so quickly? Again, maybe statins are antibiotics!
Quite an intriguing theory, that statins are antibiotics and kill the pathogenic cause of atherosclerosis, isn’t it? Well, of course, I was not the first person to think that perhaps the process of atherosclerosis occurs from an infection. The organisms that have been implicated in contributing to atherosclerosis include Chlamydia pneumoniae (now actually called Chlamydophila pneumoniae), cytomegalovirus (CMV) and Helicobacter pylori. Here is a look at some studies that test this theory.
Interesting side note: Mevastatin caused liver tumors and severe muscle problems in animal studies, and therefore was never brought to market (although it is one of the naturally occurring statins in red yeast rice extract, which millions take ... not good).

Chlamydia pneumoniae

Chlamydia pneumoniae has the most data to show a correlation with atherosclerosis. This pathogen enters through the respiratory tract and is thought to be the 3rd leading cause of upper respiratory tract infections worldwide, with an estimated 50% of the population having been exposed. Circulating monocytes then bring the organism into the vascular wall and induce inflammation. Animal studies with both mice and rabbits show that Chlamydia pneumoniae infection, in the setting of hypercholesterolemia, can induce atherosclerosis. Moreover, giving azithromycin completely blocks this effect.
Translate this to humans. One study of 220 patients after an MI showed that positive Chlamydia pneumoniae antibody titers increase the risk of future events and that treating those patients subsequently with azithromycin reduces the risk down to the level of patients with negative antibody titers.
The largest trials to evaluate antibiotic therapy directed at Chlamydia pneumoniae after acute MI actually failed to show any reduction in cardiac events or mortality. These include subsets in the ACES trial, WIZARD trial, and PROVE-IT trial, totaling close to 16,000 patients.
Perhaps the key is preventing the infection in the first place instead of trying to treat it after the MI has occurred.

Cytomegalovirus (CMV)

The evidence to link CMV and atherosclerosis is less robust. Certainly, in heart transplant patients there is a correlation. The studies to connect positive CMV antibody titers (serologic evidence of prior CMV infection) to CAD patients have been conflicting. Researches have postulated that CMV may play an important role in the initial endothelial cell injury starting the atherosclerotic process.

Helicobacter pylori

Once again, only a casual relationship between Helicobacter pylori infection and CAD has been shown via serologic studies. Helicobacter pylori have not been isolated from atherosclerotic plaque and the use of antibiotics to eliminate this organism with the goal of reducing CV events has not been evaluated.

Immunization for Heart Disease

How about the prospect of developing an immunization against one of these organisms? Could a cure for Chlamydia pneumoniae actually result in, essentially, a cure for atherosclerosis?
Nobody really knows the answer to that question. Researchers are indeed in the process of developing an immunization for heart disease! Interestingly, it has nothing to do with Chlamydia pneumoniae. A protein antigen that inflammatory T cells react to is being targeted in order to prevent the inflammatory response that they create. Let's see how it goes!

C-Reactive Protein, Sepsis, and Statins

We know that CRP (C-reactive protein) is a measurable inflammatory marker that is significantly elevated during states of inflammation, including atherosclerosis, ACS, inflammatory arthritis and, of course, during infection (including sepsis). We know that statin therapy reduces CRP significantly, independent of reductions in LDL cholesterol. So putting these together ... infection increases CRP and statins decrease CRP. This association, of course, does not prove the antibiotic theory but is a bit intriguing.
How about this factoid? Statins have been shown in more than one analysis to decrease the incidence of sepsis (severe infection with a systemic inflammatory response, usually bacterial) AND decrease mortality in patients with bacteremia. Other studies examining statins for community-acquired pneumonia and ventilator-associated pneumonia, however, have failed to show a benefit. Fortunately, further clinical trials are ongoing to evaluate statin therapy in patients with sepsis. Yet another possibility that statins are acting as antibiotics in this setting.

Pleiotropic Effects of Statins - So what’s the deal?

In my search to see if HMG-CoA reductase inhibitors, in laboratory models, have ever been studied to see if they eliminate Chlamydophila pneumoniae, I came up empty. Also, there are no data to see if statin therapy is more effective in those seropositive for Chlamydophila pneumoniae compared with seronegative individuals.
OK, fine, maybe it is a bit far-fetched to say that there is, perhaps, one lone organism causing all of atherosclerosis. There are likely multiple factors that contribute, causing the endothelial injury that starts the process, but infection probably plays a role somewhere along the line. However, could you imagine if there was ONE predominate infectious etiology? A potential cure for heart disease, stroke, and peripheral vascular disease could be developed! I see a Nobel Prize opportunity ... discover the real reason for the pleiotropic effects of statins!

Before You Shovel Snow, Know the Signs of Heart Attack

Shoveling snow is a strenuous exercise that can put undue strain on the heart. Factor in cold air, which constricts the blood vessels ...