Heart Health 101 – What You Need to Know

By  May 27, 2008

Harry Balian, MD FACC, FSCAI
Diplomate of the American Board of Internal Medicine, Cardiovascular Diseases, Nuclear Cardiology, and Interventional Cardiology
Medical Director
Cardiology Cardiac catheterization lab and Special Procedure Services
Glendale, California Adventist Medical Center
The Heart and Vascular Institute

(His email for fact-checking is: md4hart@yahoo.com)

1) At what age, should a woman start being proactive about her heart health?  What is your best advice for preventing heart disease?
There is no specific age that a woman should start being proactive about heart disease. This health conscious effort should be a lifelong practice from early teenage years. In general, however, women who maintain lower cardiovascular risk than men catch up with men by age 65. It would be prudent for women to exercise lifestyle and dietary modification starting at age 55.

2) What is a heart attack?  What are the telltale signs of a heart attack? Are the signs of a heart attack different in women versus men and how so?
A heart attack is heart muscle damage due to a blockage of an artery that supplies blood flow to that muscle distribution. The blockage can be partial or complete and that can lead to crushing chest pain with diaphoresis or shortness of breath. Women and men in general will experience similar signs of a heart attack but studies have shown that women are commonly underdiagnosed as having coronary artery disease and that most of their signs and symptoms are partially ignored by health care professionals.

3) What should be done if you are experiencing these symptoms?
Aspirin should be taken right away-at least 162 mg (that’s 2 baby aspirins)-call 911

4) What causes a heart attack?
Heart attack is due to a plaque rupture within the coronary arteries of the heart that cause clot formation at the site of the plaque rupture and subsequent occlusion of the artery

5) What are traditional and non-traditional ways of treating heart attacks and/or preventing heart attacks in the first place?
Traditionally, heart attacks were being treated with bedrest and aspirin Clot buster medicine (i.e, thromolytics) and that was the standard of care in the 80s and 90s. We now know that primary angioplasty (i.e, using a balloon to open an occluded artery in the cath lab) yields much better results when done in a timely fashion-within 90 minutes of presentation to the emergency room.

6) What does a cardiologist’s job entail?
A cardiologist’s job is to recognize the patient with a heart attack and and get the patient to the cath lab for evaluation of the arteries of the heart. Aspirin, bplavix beta blockers and blood thinners are the initial treatment strategies.
An interventional cardiologist opens arteries with a balloon and delivers a stent without having to cut the chest open. A heart surgeon is one that performs open heart surgery.

7) How does stress affect the heart’s health?
Stress can trigger plaque rupture and heart attacks because it causes the body to release high amounts of stress hormones (or catecholamines).

8) Does depression affect the heart’s health?
Depression can cause heart attacks and heart failure for the same reasons mentioned in #7.

9). Which people are most at risk for a heart attack?
People who are most at risk for a heart attack are:
a. Diabetics; b. smokers; c. those with high cholesterol; d. males; e. obese people;  f. those with a family history of heart disease. g. those with a sedentary lifestyle.

10) What are you the greatest advances in treating a blocked artery in the heart?
The cardiologist’s ability to open arteries wih a balloon and stent has enabled us to effectively treat an occluded artery and thus prevent patients from needing open-heart surgery.

11) Any new medical treatments for patients with heart trouble?
Stents now are coated in drugs that diminish the risk of stent renarrowing. Cypher Stents (coated with sirolimus drug), Taxus stent coated with paclitaxel drug, and endeavour stent in general decrease the risk of stent reocclusion within a 6 month period from 25% to 8%.

12) What about new studies regarding heart disease treatment?
Studies have outlined the importance of aspirin and plavix intake especially when a patient has the drug-coated stents as there are reports of clot buildup within the stents as late as 18 months from the initial stent insertion.