`Tis the season for heart attacks?

December 14, 2010 by  
Filed under Featured, HEART AND STROKE

‘Tis the season for joy and cheers … and cardiac events. Okay, I don’t want to dampen your high spirits during the holidays but it has been shown again and again that there is a distinct spike in the number of heart attacks during December-January, particular around Christmas and New Year. According to WebMD, there has been generally an overall 5% increase heart-related deaths during the holiday season based on mortality statistics from 1973 to 2001. Let us look at the reasons why.

Is it the weather?

The winter season does have some adverse effects on our heart health. The cold weather causes blood vessels to constrict, which in turn elevates blood pressure. Blood clots also occur more easily. Extremely cold temperatures and physical exertion put too much burden on the heart. These are the ingredients for coronary heart disease and heart attacks.

Is it the holiday season?

A study published in circulation reported:

“The number of cardiac deaths is higher on Dec. 25 than on any other day of the year, second highest on Dec. 26, and third highest on Jan. 1.”

And this pattern is not only true in the cold northern parts of the US. The same trend has been observed in Los Angeles where winters are not necessarily freezing. Some hypotheses put forward by health experts are:

  • People delay consulting their doctors despite feeling ill until after the holidays, mainly to avoid disrupting holiday festivities and travel plans.

“People just tend to put off seeking medical help during the holidays. They tend to wait till afterwards, which I think is a mistake.”

  • GPs are not easily available whereas hospitals and emergency clinics are short-staffed during the holiday. These can lead again to delay in treatment as well as decrease in the quality of care of those who decide to go to the hospital.
  • The holiday season is simply a very unhealthy season when people eat too much, drink too much, forego on exercise, get too much stress and get too little sleep.

“People tend to gain weight during the holiday season and take in more salt, which can put additional stress on a weakened heart.”

However, all the risk factors that may lead to increased heart attacks at this time of the year are actually modifiable. Dr. Robert A. Kloner, a researcher at Good Samaritan Hospital in Los Angeles and a professor at the Keck School of Medicine at the University of Southern California gives us the following tips:

The power to predict a heart attack may be right at your fingertips

April 1, 2009 by  
Filed under HEART AND STROKE

handCould it be that predicting a cardiac event is as easy as raising a finger? Researchers at the Mayo Clinic have studied and seemed be quite satisfied with a test that is simple and noninvasive but is still “highly predictive” of a major cardiac event, such as a heart attack or stroke, for people who are considered at low or moderate risk.

The EndoPAT I a noninvasive finger sensor test device which measures the health status of endothelial cells that line the walls of the blood vessels and regulate blood flow. When endothelial cells are unhealthy, a condition called endothelial dysfunction occurs and can mark the start of atherosclerosis or hardening of the arteries, which in turn lead to cardiovascular disorders. The finger device measures blood flow which is indicative of endothelial function.

During the testing process

“…researchers at Mayo Clinic and Tufts-New England Medical Center in Boston used the device to test 270 patients between the ages of 42 and 66 and followed their progress from August 1999 to August 2007. These patients already knew that they had low-to-medium risk of experiencing a major heart event, based on their Framingham Risk Score. The score is the commonly used risk predictor and was developed from the Framingham Heart Study, a longitudinal study of heart disease.”

The study results showed that 49% of patients who had poor endothelial function as measured by EndoPAT had a major cardiovascular event (e.g. heart attack or stroke) during the 7-year follow up.

The EndoPAT is a product of Itamar Medical. I was approved by the US FDA for diagnostic use in 2003. It consists of a digital recording equipment plus two probes attached to the fingers like large thimbles. During the test, one probe is placed on each index finger and attached to a small blood-flow measuring machine. In parallel, a cuff, the kind that is used during blood pressure reading is placed around one arm. The cuff is inflated, then deflated “to occlude and then release blood flow to assess reactive hyperemia (RH), the normal blood flow response that occurs when occlusion is released.” Three timed readings are performed during the 15-minute test and the results are expressed in RH scores. A low RH score indicates low blood flow response, endothelial dysfunction and impaired vascular health.

This positive news about EndoPA is very welcome because cardiovascular health problems, most of which are preventable, have become a major global health concern. Millions of people suffer from heart attack and stroke each year, sometimes without any warning. Indeed, a predictive but still non-invasive instrument such as EndoPAT can help doctors and patients plan a preventive strategy to battle heart and stroke.

Is there sex life after a heart attack?

March 19, 2009 by  
Filed under HEART AND STROKE

Resource Post for March

Now, more than ever, patients with heart disease are much longer but heart-giftunfortunately their quality of life is not necessarily better. The latest medical advances save people’s lives but the care in the life after – after heart surgery, after discharge, rehabilitation, etc. – sometimes fall short.

Depression is a common aftermath of heart surgery and other cardiac events. A previous study showed that depression is commonly reported among young people aged 18 to 49 years old. They are tended to be female, of African American or Hispanic ethnicity.

I imagine that young people would be depressed since these years are the most active and productive years of their lives. Young women of reproductive age would be worried about their ability to raise their families or even able to start a family at all.

Depression has also been reported among the elderly but not to the extent observed in young people.

It is to be expected that one main cause of depression among young cardiac patients is sex, rather lack thereof. Sexual satisfaction is a part of life. And for the sexually active, the question of whether sex after a heart attack is still possible is another big factor that may contribute to depression and overall poor quality of life. Unfomarried-handsrtunately, Hollywood has erroneously portrayed in films the horrors of having a heart attack in the act of sexual intercourse, scenes which can dampen the spirits of both the heart patient and his/her partner. A report presented at the European Cardiology Society last year stated that heart patients

…may have concerns about resuming sexual activity, feelings of sexual inadequacy, changes in sexual interest or changes in patterns of sexual activity…[They] are worried about chest symptoms during intercourse or even an acute ischemic event during sex. Many lack information about returning to sexual activity.

Researchers looked at the sexual satisfaction of 35 female with either non-STEMI or unstable angina and reported the following results::

  • 49% resumed sexual activity within 12 weeks of hospital discharge.
  • 35% reported being “sexually unsatisfied
  • 41% were “mostly dissatisfied
  • 24% were “somewhat dissatisfied
  • 83% reported sexual desire to be lower compared to desire before the cardiac event.

But is there really room for sexual activity in a heart patient’s life?

Apparently, the answer is a resounding “Yes” but with some caveats.

According to this WedMD article “it is important to remember that sex is a workout. So doctors typically tell patients to abstain from sex after heart disease until they can withstand the cardiac workout.”

gametesThis means that people who are sedentary may have to abstain from postcardiac event sex until they are back on their feet and have passed their stress tests. What the doctors are saying is that if a patient can handle climbing the stairs or light jogging around the block, then he or she is ready to resume sexual activity.

But sometimes fear and the uncertainty can interfere even if the body is physically ready. Here are some tips that you may try to counteract this problem:

Do not blame yourself. It is not your fault and it is alright to feel frustrated. So stop blaming yourself. Erectile dysfunction is linked to heart disease. Some cardiac medications can interefere with sexual drive and performance. Nothing you can do or have done could change this.  However, you have to do something about it and the first step is talk about it.

Talk to your doctor. I know that this topic maybe embarrassing for some people, depending on personality as well as cultural and religious backgrounds. However, your doctor is the best person who can tell you whether you are ready or not and what it takes to get you back into shape. Your doctor can give you all the information you need and can even refer you another professional if necessary.

Avoid self-medication. Be careful about performance enhancing and erectile dysfunction drugs. You see them advertised on the Internet all theone_pill_a_day___ time and your email Inbox is probably flooded by sales pitches on cheap Viagra and penis enlargement pills. However, these drugs may not be what they seem. They may be disguised in the form of dietary supplements, tea, herbal remedy, or energy drinks. Some of these substances can increase heart rates while others can interact with the other drugs you may already be taking. So before you resort to self-medication, talk to your doctor first. He would know which drug would be most appropriate and safest for you.

Talk to your partner. Be open about your fears and worries. For all you know, he or she also has some doubts and worries about the situation. Take him or her when you go talk to your doctor.

Give yourself time. Sex doesn’t have to start at day one. It doesn’t have to be perfect the first time around after surgery. Take your time. Give your body and mind the time to heal and recover.

Go for counselling. Professional help may be necessary and your doctor can refer you to a psychologists or a sex counsellor. These health professionals may also prescribe drugs, devices, as well as therapies that can help.

fruits1Live a healthy lifestyle. You can’t live on sex alone. And your body should be fit to perform normal daily tasks, including sex. That is why you shouldn’t forget to maintain a healthy lifestyle which includes physical activity and the proper diet. Remember: a healthy and active sex life depends on an active and healthy lifestyle.

 

 

 

 

Photo credits: stock.xchng

Football is fun – but dangerous to your heart

July 16, 2008 by  
Filed under HEART AND STROKE

Major sports events are fun – but also dangerous for the heart and the blood vessels of the fans. I have just lived through another major sports tournament this year – the European Football Championships held in Switzerland (my current place of residence) and Austria .

Two years ago, it was the World Football Championships (known as THE WORLD CUP) in Germany (my place of residence then) that I could experience.

Suffice it to say that I’ve lived long enough in Europe to know the importance of football to Europeans. (Yes, it’s called football – otherwise known as soccer to North Americans.) Especially to the men. In Europe, football is almost like a religion, and the men the most fervent of devotees.

A group of doctors in Munich collected statistics on emergency cases from June 9 to July 9, 2006 and answered the question “Is there a link between a major sports events such as the World Cup and cardiovascular events?” And the results are as follows:

On those days when the German team was playing, the rate of cardiac emergency cases was 2.66 times higher than periods outside the tournament dates (May 1 to June 8 and July 10 to July 31, 2006, and May 1 to July 31 in 2003 and 2005). This increased rate of cardiac problems is 3.36 times higher in men and 1.82 times higher in women.

On those days when Germany was having a match, the highest average incidence of cardiac events occurred during the first 2 hours after the match has begun. Cardiac events reported were myocardial infarction (heart attack), unstable angina pectoris, and cardiac arrhythmia.

I and my husband are big football fans and have been to several matches during the European Championships in 2000 as well as last the World Cup in 2006. We didn’t have the luck this year to get tickets for matches in Switzerland but we went to see a couple of matches in public viewing areas set up in major cities. Most matches, however, we saw at home on TV.

In the stadiums and in the public viewing areas, the mood is always fever-pitch high. On most days, the summer temperatures are also high and the amount of alcohol consumed and cigarettes smoked are way above normal. Perfect setting for a CVD event, I’d say.

I don’t think that the conditions are any better when people watch the matches at home. The grill is spewing out ribs and sausages, and the fridge contains seemingly endless amounts of beer (much cheaper than in the stadium).

Sounds familiar? I’d say that this danger would to any major sports event – not only football – be it the SuperBowl, NBA, Rugby World Cup, etc.

The researchers conclude that

“viewing a stressful [football] match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.”

And oh, by the way, call it football, not soccer. Careful, using the “s” word can drive some people’s blood pressure up.

 

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.