Cardiac Care

What your doctor wants you to know

The human body has built-in redundancies: two eyes, two ears, two arms, two legs, two kidneys, two lungs. You can live with just one eye, one arm, one kidney. Your heart, though, is a vital organ that acts alone. And that one amazing, well-designed, small organ—about the size of your fist—has to keep beating to keep us alive. In order for this muscle to stay healthy and strong, we have to take care of it.

Coronary artery disease is caused by the buildup of plaque on the inside of the coronary arteries, the blood vessels that supply oxygen-rich blood to heart muscle—so you want to make sure that buildup doesn’t occur. You can take steps to prevent progressive heart problems through lifestyle changes: quitting smoking and lowering both your blood pressure and “bad” cholesterol levels. Exercising regularly (walking 30 minutes a day can go a long way), eating a balanced diet full of fruits and vegetables, and finding healthy ways to manage stress are all good for your heart.

Over the past 20 years, the field of cardiology has changed tremendously. People are living longer, with a better quality of life, than ever before.

Revolutionary break-throughs include the development of drug-eluting stents and various closure devices as an alternative to open-heart surgery; advances in the treatment of acute MI (heart attacks); sophisticated devices to prevent sudden cardiac death; better imaging modalities with less radiation exposure; ablation to restore an irregular or rapid heartbeat back to a normal rate and rhythm; and advancements in CPR techniques.

“A lot of statin medicines lower cholesterol and help reduce the risk of cardiovascular death in a pretty significant way so that people are living a lot longer today,” says Dr. Ken Kephart, medical director of geriatric services at Fairview Healthcare System. “There’s more awareness, there are more preventative measures, and there is better treatment. This combination of factors has really made an impact on reducing cardiovascular disease.”

If you have a family history of heart disease, are 65 or older, smoke, have high cholesterol, have high blood pressure, are physically inactive, have diabetes, or are obese, you could be at risk for heart disease. h

The good news is that more people are aware of these cardiac risk factors and ways they can lessen their risk, says Dr. Wendy S. Shear, FACC, medical director at North Memorial Heart and Vascular Institute.

The bad news is that—even with this awareness—heart disease remains the No. 1 cause of mortality in men and women.

“Although many patients become more aware of maintaining a healthy lifestyle, there is a big difference between knowing and doing,” says Dr. Marek J. Kokoszka, chief of cardiology and medical director of the Heart and Vascular Center at Park Nicollet. “I think the biggest progress in lowering cardiovascular diseases in the year to come will result from implementation of a better diet and regular exercise habits.”

Dr. Shears is quick to point out that having a stent (a small mesh tube used to treat narrowed or weakened arteries) placed in an artery is not a “cure.”

If patients don’t make healthy lifestyle changes, they may find themselves back in the hospital with new lesions in other arteries, carotid artery disease, peripheral arterial disease, heart attacks, and strokes. If they know their numbers for cholesterol, blood sugar, and blood pressure—and what their targets should be—fit exercise into their lives, and substitute healthier foods (fish for red meat, brown rice for white, olive or canola oil for butter), their hearts will be in much better shape.

Dr. C. Jennifer Dankle, D.O., F.A.C.C., director of Women’s Heart Program, Fairview Southdale/University of Minnesota Heart Physicians wishes people were aware of the mortality gender gap between men and women, with more women dying from heart disease than men each year. “I have focused my practice on tackling this issue by improving and providing community education, offering a primary prevention women’s clinic, and starting a support group for young women suffering with heart disease,” she says.

Part of the problem is the misconception that you must have chest pain in order to be having a heart attack.

“In fact, anywhere from one-third to half of women who present with a heart attack have no symptoms of chest pain,” Dr. Dankle says.

Heart attack warning signs in women can include shortness of breath, a spreading upper abdominal pain, weakness, unusual fatigue, lower chest pain, indigestion-like symptoms, and upper back pain.

Heart attack symptoms vary widely. One thing applies to everyone, though: If you suspect you’re having a heart attack, call for emergency medical help immediately.

North Memorial Heart and Vascular Institute: 763-581-5402

Park Nicollet Heart and Vascular Center: 952-993-3246

University of Minnesota Physicians Heart at Fairview: 612-365-5000

Doctor’s Advice

When your doctor asks you questions about your lifestyle, answer them truthfully.

Sometimes people are embarrassed to admit that they smoke, or drink, or eat fast food, but your doctor needs to know these things to make an accurate assessment of what’s going on. Your doctor isn’t there to judge you, he/she is there to help you.

Make sure you understand any diagnosis your doctor gives you and any tests ordered or treatments prescribed.

Take notes if you need to. Don’t feel “stupid” asking questions— every question you have is important when it comes to your heart health.

What Questions Should I Ask my Doctor about Heart Disease?

• What is my risk for heart disease?

• What is my blood pressure? What does it mean for me and what do I need to do about it?

• What are my cholesterol numbers (including total cholesterol, LDL or “bad” cholesterol, HDL or “good” cholesterol, and triglycerides)? What do they mean for me and what do I need to do about them?

• What are my “body mass index” and waist measurement? Do they indicate that I need to lose weight for my health?

• What is my blood sugar level, and does it mean I’m at risk for diabetes?

• What other screening tests for heart disease do I need? How often should I return for checkups for my heart health?

• What can you do to help me quit smoking? (if applicable)

• How much physical activity do I need to help protect my heart?

• What type of exercise should I be doing to control my risk?

• What is a heart-healthy eating plan for me? Should I see a registered dietitian or qualified nutritionist to learn more about healthy eating?

• What types of foods will help me control my risk or disease?

• What can I do to lower my risk of heart disease?

• What kinds of tests are available to diagnose heart disease?

• What are the treatment options for heart disease?

• How can I tell if I’m having a heart attack?

• How will this affect daily activities, such as having sex, playing golf, or babysitting my grandkids?