Information on likelihood and prevention of heart disease in women, with Cindy Schicker of High Point Regional Health and Cathy Weaver, columnist for the Greensboro News & Record.

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Arrhythmias of the Heart included live broadcasts of a diagnostic study of electrical firings of the heart and an internal cardiac defibrillator (ICD) implant that shocks the heart into a normal rhythm if necessary.

Electrophysiologists, electricians of the heart, Dan Dan, M.D., Joseph Poku, M.D., and Bobby Smith, M.D., performed and narrated the procedures. Viewers emailed questions to the physicians during the procedure.

CLICK HERE to see the videoNationwide, there are 400,000 people walking around with ICDs implanted in their chests,?

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Everyone - not just people with heart problems needs to know the answer to this one. Among the most common symptoms is pain, pressure or a sense of fullness under the breast bone that lasts two minutes or more.

Men often say it like having a horse on my chest, women typically experience a milder pain. The sensation may radiate to the shoulders, neck, jaw, back or arms but it may not. Women usually experience the radiating pain throughout the neck, jaw, shoulders, arms, back or abdomen; in general their symptoms are more subtle.

Men tend to have sharp pain in their arms and shoulders. Dizziness, sweating, nausea and shortness of breath may also occur.

Should I call 911 even if I don’t have all the symptoms?

Not all symptoms may be present. If you think you might be having a heart attack, seek medical attention immediately.

Is there anything I should do while I am waiting for emergency medical to arrive?

Chew and swallow one regular uncoated adult aspirin (325 mg). It has been estimated that chewing and eating this aspirin if it were widely used. Would save 10000 lives in the USA each year.

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Today’s modern medicine has made great strides in determining the causes of heart diseases, as well as ways to treat and prevent it.  Just fifty years ago, most people didn’t go to the doctor unless they were sick, and the medical profession itself didn’t really warn its patients about heart disease, unless the person showed serious signs of it or had a close family member with the disease.  Now, thankfully, a much more pro-active approach is taken by both the patient and the doctor in preventing heart disease, as well as treating it.

An Ounce of Prevention

Perhaps one of the best ways to prevent heart disease is to change the patient’s outlook on diet and exercise.  It has been shown, time and time again, by such medical groups as the American Medical Association and the American Heart Association that a diet low in fat and low in calories is a great way to lower a person’s cholesterol, which is a major risk factor when it comes to heart disease.  Add to that a regular doctor approved exercise routine and regular monitoring by the family doctor, and you will be an active participant in the battle to prevent heart disease.

One thing to always remember, of course, is that you and your doctor should be a team in the challenge to prevent heart disease.  Routine monitoring of such things as your blood pressure, cholesterol level, general weight and health, as well as indications of other diseases that might complicate the situation are all very important things that both you and your chosen medical professional should be on the look out for.  So, even if you’re not overly concerned about preventing heart disease, see your doctor on a regular basis and talk with them.  Depending on what is uncovered, you can possibly get a head start on your race to prevent heart disease.

When Exercise and Diet Aren’t Enough

While good diet and regular exercise are great ways to help prevent heart disease, sometimes they simply aren’t enough.  Occasionally, your doctor will prescribe different medicines, to help with the battle.  The most common ones are those that either help regulate and lower high blood pressure or help the body process and lower the concentrations of cholesterol.  Whether or not prescription drugs are needed for your situation should be decided after a serious consultation with your doctor and some monitoring of your health and lifestyle.  There are many drugs out there to help prevent heart disease, and your doctor can discuss all the options available.
Trying to prevent heart disease is definitely something that should be on the forefront of everyone’s mind.  It is one of the leading killers of both men and women in the United States today.  By working with your doctor, and following a sensible low fat diet and exercise plan, your efforts to prevent heart disease will not be in vain.

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When we think of a victim of heart disease, we tend to think of men, but unfortunately, heart disease is the leading killer of both men and women in the United States.  Heart disease includes the narrowing of the arteries that bring oxygen to the heart, heart failure, diseases of the heart muscles, inborn defects, and other conditions.  Five hundred thousand American women die each year from heart diseases, and the risks increase as a woman ages.

The Change of Life

The Cleveland Clinic Heart Center explains that menopause changes the risks for women and heart disease.  Post-menopause, a woman’s body experiences reduced estrogen production, changes in cholesterol levels, changes in the structure of blood vessels, and increased production of the clotting agent fibrinogen. 

No one yet knows exactly how much a woman’s risk is affected by each of these changes, but they are definitely associated with greater heart disease risk.  Women who have gone through menopause are two to three times more likely to suffer heart disease than a pre-menopausal woman of the same age.  Women that have had a hysterectomy experience these same raised risk factors. 

In the past, scientists studying women and heart disease hypothesized that hormone replacement therapy could help post-menopausal women fight heart disease; however, long-term studies do not confirm that preliminary idea and doctors no longer recommend hormone replacement therapy to battle heart disease.  Menopause we cannot change, but other risk factors are under our control.

Using hormonal birth control (the pill or the patch) is considered safe for women under thirty-five. As of now, doctors do not have proof that birth control hormones can increase or decrease problems for women and heart disease, especially after the age of thirty-five.  When talking about your heart disease risk factors with your doctor, get his or her opinion on your personal situation.   

A Change of Lifestyle

Scientists studying women and heart disease find that women are knowledgeable about what lifestyles are associated with heart disease, but are also prone to having those lifestyles.  For example, according to the National Institutes of Health, fifty-six million American women have high cholesterol, 33% of women have high blood pressure, and 62% of women are overweight.  Despite these risks, women are less physically active than men, on average. 

For women, as for men, there are a few good guidelines to a healthier heart.  Habits such as not smoking, maintaining a healthy weight by regular activity or exercise, cutting down on the fatty foods, and getting your cholesterol tested can dramatically help prevent heart disease.  Don’t become another statistic about women and heart disease. 

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Rheumatic heart disease, also called rheumatic fever, occurs when an untreated strep throat infection migrates to the joints and heart, causing fever, muscle aches, and possible permanent heart valve damage.  Just as “rheumatism” refers to joint pain, “rheumatic” fever gets its name because one of its main symptoms is actually pain in the joints rather than the heart. 

The National Institute of Health estimate that rheumatic heart disease develops in about 3% of untreated strep throat infections in the United States. Because mainly young people get strep, accordingly rheumatic heart disease mostly strikes people aged between six and fifteen years old.

Most people in the west who get strep will never develop rheumatic heart disease, because the strep throat infection is treated effectively with antibiotics.  However, if fever, irregular heart beat, nodes under the skin, and other symptoms appear after a strep infection, a doctor will perform lab tests to diagnose rheumatic fever. 

Penicillin treats rheumatic heart disease symptoms, including the contraction of the heart, which may damage heart valves; however, there is no cure for the disease, and patients must continue with penicillin injections.  Some doctors argue this treatment should continue for the rest of the patient’s life.  Left untreated, besides the symptoms of physical pain, rheumatic heart disease can cause permanent heart valve damage.  Without surgery, heart valve damage can lead to fatal heart failure. 

Cases And Treatment Worldwide

Doctors working with the Australian National Heart Foundation are working on a vaccine to prevent rheumatic fever.  After an unexplained jump in the number of cases among the Aboriginal population of Australia from 2004 to 2006, doctors launched the world’s most advanced investigation of rheumatic heart disease.

In New Zealand as well, rheumatic fever is a problem among some populations, and the treatment there is penicillin shots every month for ten years.  One famous rugby player, a childhood victim of rheumatic heart disease, admits to “getting lazy” about having his shots, and the symptoms of the disease returned to him as an adult.  Luckily, he knew his problem and how to get help.  Some people, especially those with little access to health care, simply suffer through fever attacks, and fall victim to heart valve failure. 

In fact, the World Heart Federation in Geneva, Switzerland calls rheumatic fever a disease born of poverty.  Though it is easily prevented by a good strep throat treatment, many young people of the world do not have access to the healthcare that would keep their heart valves healthy and extend their lives. 

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Reversing heart disease can be done by adopting a few lifestyle changes.  By avoiding certain risk factors that put you in harm’s way of the disease to begin with, you can turn back the clock, so to speak, and continue to live a long, healthy life despite having a heart disease.

There are many different kinds of heart disease, but one of the factors that leads to most heart disease is a blockage to the arteries that feed blood to the heart.  When the heart no longer gets a fresh supply of blood, it can die, and the result is a heart attack.  By unclogging these arteries, you are essentially reversing heart disease and, therefore, healing your heart.

How You Can Reverse Heart Disease

Diets high in saturated fats and cholesterol can contribute to the blockage that causes most diseases of the heart.  Reversing heart disease can be as simple as cleaning up your diet, by eating more fruits and vegetables, foods with a higher fiber content, and staying away from foods with too much saturated fat.  By changing to a cleaner diet, you are one step closer to reversing a heart disease that has already claimed so many lives.

Another technique that works in reversing heart disease is getting more exercise.  When you exercise, you increase your cardiovascular health, and your heart begins to work better.  Exercise can be had anywhere, anytime, simply walk instead of drive your car, take the stairs instead of the elevator, or just walk around the block every night after dinner.

A more drastic move for reversing heart disease is surgery.  Surgeons have been able to unblock arteries or bypass clogged arteries to improve blood flow to the heart.  In many cases, surgery helps those who are afflicted with this horrible disease; however, for surgery to be effective, the heart disease must be caught early, just like most other diseases.  Surgery can be an effective means for reversing heart disease, but the most effective way is to adopt good living habits once you find out you have it.

By adopting good living habits, eating right, getting more exercise, and reducing stress levels, you can go on to live a long, healthy, productive life even if you already have heart disease.  Reversing heart disease does not need to inhibit your life or hold you back in any way; instead, by adopting good living habits, you can improve your life by turning back time to look and feel better. 

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“You have coronary heart disease.” When your doctor says those words to you or to someone you love, it’s frightening and confusing.  You probably have dozens of questions: What is coronary heart disease? Do I need to change my lifestyle?

Coronary heart disease (CHD), also called coronary artery disease (CAD) or ischemic heart disease, is a form of heart disease that’s caused by narrowing of the coronary arteries that feed the heart.  If you or someone you love has been diagnosed with CHD, it may  help to know that you are not alone. In fact, CHD is the most common form of heart disease, affecting at least 12 million Americans.  It is the single largest killer of both men and women in the United States, responsible for nearly a half million deaths each year, or about 1 out of every 5 deaths.  CHD causes nearly all heart attacks (myocardial infarctions). Every 29 seconds, an American suffers a coronary event (a heart attack or fatal CHD), and every minute one of us will die from one.  The american Heart Association estimates that this year alone, more than a million Americans will suffer from a new or recurrent coronary event, and nearly 40 percent of those will die from it.

Coronary heart disease isn’t just an American problem. CHD is very common in other Westernized countries, too, such as many in Europe. Diseases of the heart and circulation such as heart attacks and stroke (a “brain attack”) kill more people worldwide than any other cause. The World Health Organization estimates that as many as 30 percent of all deaths are caused by heart and circulation diseases like CHD.

The good news is that you don’t have to become another CHD statistic. There is a lot you can do to reduce your risk of having a heart attack or dying from CHD. Sometimes just changing your lifestyle - following a heart-healthy diet, exercising regularly, and reducing the stress in your life-can prevent a heart attack or even reverse the narrowing in your arteries. There are a number of medications-and new ones being developed every day-that can help lower your heart attack risk. Surgical procedures such as angioplasty and stenting or bypass surgery can help compensate for blockages in your arteries and help keep your heart supplied with the blood it needs. By educating yourself about your treatment options, and working closely with your doctor you and your doctor can choose the best treatments that will enable you to live a long and healthy life.

The Circulatory System

The first step in taking charge of your CHD is to learn all you can about the disease. To understand what CHD is and how it affects your heart, you need to understand a little about your heart and how it works.

Your circulatory system, also called your cardiovascular system, is made up of the heart, the lungs, and blood vessels called arteries and veins. This system carries blood, food, and oxygen to every cell in the body. It also carries waste products away from the cells and out of the body. (A cell is a building block of every tissue and organ in the body.) Think of your circulatory system as a busy highway system composed of massive freeways and large streets that feed into smaller and smaller streets, and finally into tiny lanes and alleyways. This system is made up entirely of one-way streets. In our imaginary highway system, cars, or in this case, blood, can flow in only one direction. The one-way streets called arteries and arterioles (small arteries) carry blood enriched with oxygen and nutrients away from the heart to the cells in the body. The one-way street called veins and venules (small veins) carry blood loaded with waste products from the cells back to the heart.

Between these two one-way street systems are tiny blood vessels called capillaries. Almost too tiny to see and often thinner than a strand of hair, capillaries connect the smallest arteries with the smallest veins. They are the brides that connect our two systems of one-way streets. The walls of these tiny capillaries are so thin that food and oxygen in the blood pass through them into the surrounding cells. These thin walls also allow waste products from the cells to pass into the capillaries. This enables the blood to carry waste from the cell to be removed by the kidneys, liver, and lungs.

If you can imagine a single drop of blood flowing through this system, it might look something like this. The blood droplet, full of oxygen and nutrients, (fuel), is pumped out of the left side of the heart into the largest arteries. There is flows into progressively smaller arteries and finally into the capillaries, where it delivers its load of oxygen and food for the cells. At the same time, the blood picks up waste products from the cells and flows into tiny veins, then into larger and larger veins. Finally, the blood droplet arrives back at the right side of the heart, where it’s pumped into the lungs and unload carbon dioxide, pick up a fresh supply of oxygen, and begin its circular journey again.

The Heart: An Amazing Pump

The heart is the pump that keeps the blood flowing around and around in an endless circle throughout the body. Think of it as the traffic cop that coordinates the flow of traffic throughout our highway system. The heart is a hollow muscle that weighs less than a pound and is about the size of a man’s fist. Despite its small size, this amazing organ an average of 100,000 times a day, pumping about 2,000 gallons of blood every day. If you live to be 70, your heart will beat more than 2.5 billion times.

Located in the center of the chest and protected by the breastbone and rib cage, the heart is actually a double pump thats divided into four chambers, two upper ones and two lower ones. A thin wall of muscle separates the left and right sides of the heart. The top chamber (atriums or atria) and lower chambers (ventricles) are connected by valves that act like one-way doors. These valves make sure blood flows only in one direction. In the heart, the blood is pumped from the left and right atriums to the left and right ventricles. The right side of the heart sends blood to the lungs. The left side of the heart pumps blood out to the cells in the body.

Coronary Arteries

Just like other muscles in the body, the heart needs its own supply of blood and oxygen to work properly. Even though the heart pumps blood through its chambers, the heart itself receives no significant nourishment from this blood. There is a separate set of arteries that branch off the aorta (the main artery that receives blood from the left ventricle) that provide the heart’s blood supply. These are called coronary arteries. The coronary arteries encircle the top and sides of the heart bringing plenty of oxygen-rich blood to the heart. The two major coronary arteries are the left coronary artery and the right coronary artery. These vessels divide into many smaller coronary arteries that feed the heart.

What Is Coronary Heart Disease?

Healthy coronary arteries have smooth, flexible walls that provide plenty of blood to the heart. However, over many years, these flexible walls can become progressively irritated and damaged by such substance as fats, cholesterol, calcium, cellular debris, and platelets (tiny cells responsible for blood clotting). When the walls of the arteries are damaged, these substances are able to “stick” to them. Coronary heart disease (CHD) occurs when these coronary arteries become narrowed and clogged.

This buildup inside the artery walls is a process called atherosclerosis, which produces a substance known as plaque. As it builds, plaque is a lot like the dirt, fat, and minerals that build up inside your home’s plumbing. As the buildup becomes thicker, the flow through the pipes becomes less and less and may even completely stop. Similarly, when your heart doesn’t get enough oxygen due to narrowed arteries, you may feel chest pressure or pain called angina. If the blood supply to part of the heart is completely cut off, the result is often a heart attack.

Everyone has a certain amount of atherosclerosis as they age. For many of us, atherosclerosis begins in childhood. Some people have a rapid increase in the buildup of atherosclerotic plaque after age 30. For others, plaque buildup does not become a problem until we’re in our 50s or 60s.

What Causes CHD

We don’t know for sure why atherosclerosis occurs or even how it begins, but  there are several theories. Some medical experts believe the atherosclerotic buildup in the inner layer of the arteries may be caused by several conditions, including:*Elevated levels of LDL cholesterol (low-density lipoprotein) and triglycerides in the blood*Low levels of HDL CHOLESTEROL (high-density lipoprotein)*High blood pressure*Tobacco smoke*High blood sugar levels (diabetes mellitus)*Inflammation.

It’s likely that more than one process is involved in the buildup of plaque. Many researchers believe that when excess fat combine with oxygen, they become trapped in the arterial wall. This attracts white blood cells which help prevent infection when tissue is damaged. Then substances call prostaglandins, which are involved in blood clotting and altering tone (firmness) within arteries, become active. Any injury to the artery wall, such as damage caused by smoking, can activate prostaglandins. The activated prostaglandins stimulate more plaque growth and narrow arteries and/or cause blood clots to form.

Regardless of how plaque forms, advanced plaque is made up mostly of living cells. In fact, about 85 percent of advanced plaque consists of cell debris, calcium, smooth muscle cells, connective tissue, and foam cells (white blood cells that have digested fat). About 15 percent of advanced plaque is made up fatty deposits.

Once the plaque develops, plaque containing cells can be easily damaged. This can lead to blood clots forming on the outside of the plaque. Small clots can further damage other layers of the blood vessel wall and stimulate more plaque growth. Larger blood clots can partially or totally block the artery.

In addition to interfering with or totally blocking blood flow, plaque can hinder the arteries ability to dilate and contract. In order to respond to the bodies ever-changing need for blood, the arteries need to be strong and elastic. For instance, when you exercise, your body needs more blood. The heart responds by pumping faster, and the arteries respond by expanding to accommodate the increased volume of blood expanding to accommodate the increased volume of blood coming from the heart. As the artery becomes narrowed and hard, that elasticity is lost. Arteries that have atherosclerotic plaque are more apt to spasm (temporarily narrow), causing even less blood to flow to the heart and possible causing chest pain or heart attack.

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Certain medical conditions (e.g., diabetes), disorders, personal habits (e.g., smoking), and drugs or chemicals are known to increase the risk of coronary heart disease, particularly a heart attack. Such factors that lay the groundwork for heart problems are called coronary risk factors. To prevent heart attack, you should be fully aware of various coronary risk factors. They include High blood pressure, abnormal blood cholesterol levels, and smoking; these factors must be modified or even eliminated.

Some risk factors, such as age and male gender, are beyond our control, but we can modify many other factors and even eliminate them altogether. Family history of a heart attack is a very strong risk factor, but it can be limited to a certain degree. For instance, obesity, high blood pressure, hyperlipidemia, and cigarette smoking frequently run in the same family, but certain life styles and eating habits often influence these factors and can influence a family history of heart attack. Many individuals have been shown to have multiple risk factors. Typically, obese people have a tendancy to have high blood pressure, elevated cholesterol, and diabetes, and all that may be worsened by a sedentary life style.

Coronary risk factors can be summarized as major and minor. Major risk factors include:
* Genetic factors (e.g., a family history of premature coronary artery disease).
* Age and gender (e.g., men who are over 45 years of age, and women who are over 55 years of age).

Coronary heart disease risk factors also include:
* High blood pressure
* elevated blood lipods
* Diabetes Mellitus
* cigarette smoking
* obesity
* A sedentary lifestyle
* emotional stress

Emotional stress is a major risk factor that you might consider less important because it is not evident as a physical process. However, such stress often raises blood pressure, and it may cause overeating or smoking from nervous tension. Anger also does not always exhibit physical signs or effects. Yet angry young men are prone to premature coronary heart disease, particularly a heart attack.

One type of minor risk factor is the excessive use of alcohol. Excessive alcohol drinking can raise blood pressure and triglyceride blood levels, and overuse of alcohol often triggers the onset of various abnormal heart rhythms. Nevertheless, some medical reports state that consumption of a moderate amount of alcohol is said to be protection against heart attack. Another well known fact is that drinking large amounts of alcohol often produces heart muscle damage.

Another minor risk factor is type A personality. The term type A personality describes a person who has an aggressive, ambitious, and competitive character. Such people seem to have heart attacks more often, but this theory is smewhat controversial.

Homocysteine is a further minor risk factor. Abnormally high blood levels of amino acid Homocysteine are considered to create an increased risk for coronary heart disease and stroke. Homocysteine may harm the lining of the arteries and contribute to blood clotting. Excessive Homocysteine levels are reported to occur with the dificiency of vitamins B6, B12, and folic acid, so it may be beneficial to ensure that you get sufficient amounts of these vitamins to prevent high Homocysteine levels.

Other vitamins may also be beneficial in prevention of heart attacks. Vitamen E seems to reduce the risk of coronary heart disease, but its role is still controversial. Vitamin C may improve the function of the inner layer of the blood vessel called the endothelium, which can effect blood flow. High intake of beta carotene and other carotenoids from dark colored fruits and vegetables may also help t`o reduce the risk of heart attack.

Depression has adverse biological effects on the immune system, on blood clotting, on blood pressure, on the blood vessels, and on heart rhythms. This factor can even impair a patients desire to comply with heart medicines. Somewhat related are seasonal variations: More deaths from heart disease occur in the winter months , and the fewest occur in the summertime. Short daylight hours in gloomy or rainy weather often cause emotional depression and therefore an increased risk for heart attack.

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The national institutes of health sponsored the diet heart feasibility study to determine if it was possible to lower the blood cholesterol levels of Americans eating at home by changing the kind and amount of fat in their diet. About 1000 men aged 45 to 54 in five cities, all healthy volunteers, were assigned to one of three diets. Diets 1 and 2 were low in cholesterol and saturated fats but high in polyunsaturated fats; that is, they had a higher ratio of polyunsaturated to saturated fats, or P/S ratio. Diet 2 differed from diet 1 in that it contained more polyunsaturated fat and monounsaturated fat. The control diet (diet 3) was similar to a typical American diet, that is, high in cholesterol, total fat, and saturated fat but with low P/S ratio.

The men picked up all their food at special distribution centers. The food containers did not list the ingredients, and neither the participants nor the doctors who conducted the study knew who was assigned to which diet. This research  design, called “double blind” is designed to reduce unintentional bias on the part of either the study subjects or the medical scientists, since neither knows who is in what program until the end of the study.

After one year on the assigned diets, the blood cholesterol levels fell between 11% & 12% in the men on diets 1 and 2. The average cholesterol level in the group on the typical American diet fell only 3%.

The next question was ” Will lowering blood cholesterol by diet in healthy Americans decrease the rate of coronary heart disease?” There were several problems in trying to answer this question. First, the symptoms of coronary heart disease usually take four or more decades to manifest themselves. Second, although coronary heart disease is the major cause of death and disability in this country, the actual rate of new cases per year in middle aged  people is relatively low, about five to ten new cases per 1000 middle aged male adults. Third, what control group might such a study use?

Ideally, neither the participants nor the staff conducting the study should know which participants are in the treatment group and which are in the untreated control group. Diets that are high or low in animal fat and cholesterol are clearly different, and unless unlabeled foods were given out at a commissary, everyone  would realize whether he was assigned to a diet low or high in cholesterol and saturated fat. Because 100,000 men were needed for a definitive diet heart study, it was not feasible to have a blind control group of the necessary size.

Because of these difficulties and a prospective price tag of about one billion dollars, another approach was taken. First, only patients with very high blood cholesterol levels were selected; second, a drug treatment was chosen that lowers the blood cholesterol level to a greater extent than diet alone. This approach reduces the number of participants needed to a manageable level. A drug trial can replace a diet trial, provided that the drug has a specific effect on lowering blood cholesterol (and LDL cholesterol). This permits a direct test of the hypothesis that a decrease in the blood cholesterol level reduces coronary heart disease. Further, a drug trial allows medical scienttists to develop  a suitable inactive medication or placebo that will not lower the blood cholesterol level, thus permitting the study to be double blind.

About 4,000 healthy middle aged men with high levels of blood total and LDL cholesterol were assigned to either a treatment group, which received an active medication called cholestyramine, or to a control group that received placebo. Cholestyramine was known to produce a significant decrease (10 to 20 percent) in the level of total and LDL cholesterol in the blood. Both the treatment and control groups were put on the same diet. Neither the participants nor the medical staff knew to which of the two groups a participant was assigned. Cholesterol levels were checked every other month. After one year the results of the study were as follows:

Man from group that took active drug: his cholesterol level at the beginning of the trial was 281, and at the end was 199. Man from group that was on placebo starting cholesterol level was 273, and at the end was 274. The men taking the cholestyramine had significantl greater decrease in there blood cholesterol than the men taking placebo. Therefor it is known that you can reduce the risk of coronary heart disease.

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