June 11, 2012
Do you have a Weak Heart?
Interventional Cardiologist, Dr. Nathan Ho
Dr. Nathan Ho, Interventional Cardiologist at Carson Tahoe Cardiology took a minute to answer some popular questions regarding Congestive Heart Failure.
What is Congestive Heart Failure?
Heart failure, also known as congestive heart failure (CHF), is a condition in which your heart is unable to pump enough blood to meet your body’s needs. This may occur when the heart muscle itself is weaker than normal or when there is a defect in the heart that prevents the blood from getting out into the circulation. As a result of a weakened pump, extra fluid in the circulation system builds up in the lungs, the liver, around the eyes, and sometimes in the legs. This is called fluid “congestion” hence “congestive heart failure”. Unfortunately, CHF is fairly common. Around 5.8 million people in the United States have CHF. About 670,000 people are diagnosed each year. Sadly, about one in five people who have CHF die within one year of diagnosis.
What are the symptoms of Congestive Heart Failure?
- Chest pain
- Fatigue and weakness
- Rapid or irregular heartbeat
- Shortness of breath (dyspnea) when you exert yourself or when you lie down
- Reduced ability to exercise
- Persistent cough or wheezing with white or pink blood-tinged phlegm
- Swelling in your abdomen, legs, ankles and feet
- Difficulty concentrating or decreased alertness
What are the risk factors of Congestive Heart Failure?
- High blood pressure
- Coronary Artery Disease
- Heart attack
- Irregular heartbeat
- Diabetes
- Sleep Apnea
- Congenital Heart Defects
- Viruses
- Kidney conditions
How is Congestive Heart Failure Treated?
Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve and the heart can become stronger.
The key to treatment of heart failure is to treat the underlying cause. For example, repairing a heart valve or controlling a fast heart rhythm may reverse heart failure. However, for most people, the treatment of heart failure involves a balance of the right medications, and in some cases, devices that help the heart beat and contract properly. Medications can improve the signs and symptoms of heart failure and help you live longer.
Lifestyle changes, such as exercising, reducing the salt in your diet, managing stress, treating depression, and especially losing weight, can improve your quality of life.
The best way to prevent heart failure is to control risk factors and conditions that cause heart failure, such as coronary artery disease, high blood pressure, high cholesterol, diabetes or obesity.
Treatment can help you live longer and reduce your chance of complications
If you have any questions or concerns regarding Congestive Heart Failure, please contact your doctor. When in doubt, check it out.
Dr. Ho is a Board Certified Interventional Cardiologist at Carson Tahoe Cardiology.
April 17, 2012
Heart Attack 101: What is Coronary Artery Disease?
Interventional Cardiologist, Dr. Nathan Ho
Dr. Nathan Ho, Interventional Cardiologist at Carson Tahoe Cardiology took a minute to answer some popular questions regarding Coronary Artery Disease.
What is Coronary Artery Disease?
Coronary Artery Disease (CAD) is a condition in which plaque builds up in the walls of the coronary arteries – the vessels that supply blood to the heart muscle. These plaques can gradually obstruct the artery, or they can suddenly rupture, causing a more acute obstruction. Because the heart muscle requires a continuous supply of oxygen and nutrients to survive, obstruction of a coronary artery rapidly leads to significant problems. CAD is caused by atherosclerosis. Atherosclerosis is a chronic, progressive disorder of the arteries in which deposits of cholesterol, calcium, and plaques build up on the inner lining of the arteries. These plaques can cause a gradual but progressive narrowing of the artery, and as a result, blood flow is unable to flow through the arteries that supply the heart.
When the obstruction becomes large enough, the patient may experience angina. Angina refers to the symptoms a patient experiences any time the heart muscle is not getting enough blood flow through the coronary arteries. Angina is usually felt as a discomfort (often a pressure-like pain) in or around the chest, shoulders, neck or arms. Overtime angina includes weakening of the heart, electrical problems (cardiac dysrhythmia or irregular heartbeats) of the heart leading to sudden death in addition to heart attacks. Myocardial infarction, or heart attack, is a critical and serious form of CAD. In this case, the ruptured plaque causes a total (or near total) blockage of the coronary artery, so that the heart muscle supplied by that artery dies. Careful and timely medical assistance is crucial to prevent mortality and death.
What demographic should be most concerned about Coronary Artery Disease?
Generally risk factors are related to age, sex and genetics. The demographic that should most be concerned includes those with a family history of premature CAD. In broad terms, this is a case where there are male family members who have had coronary artery before the age of 50, or in female relatives before the age of 60. In addition to family history, coronary artery disease progresses as we get older. Age is a big factor. Ages 55 or older in men or 65 or older in women are of increased risk. In women, being post-menopausal, or having your ovaries removed puts you at increased risk. Recently we have learned there are other inflammatory disorders such as Rheumatoid Arthritis and Lupus as well as chronic disease processes such as Chronic Kidney Disease that play a role in CAD. Additionally, we have learned that Obstructive Sleep Apnea is a risk factor associated with CAD.
What are the risk factors?
Smoking – Smoking is one of the strongest risk factor at any age, and quitting smoking is the biggest way to prevent CAD.
Cholesterol – High LDL cholesterol, high total cholesterol and low HDL cholesterol levels are associated with a significantly increased risk of heart attack. Click here to learn more.
Weight – Being overweight, and especially having a big waist circumference, has been associated with an increased risk of heart attack. CAD is, for the most part, a disease process of a developed country. Along with obesity, diabetes and glucose intolerance are now considered CAD risks. As the population becomes more overweight, diabetes is becoming much more frequent in the U.S. As such, diabetes and the elevated blood sugars and metabolic syndrome greatly accelerate the development of atherosclerosis.
Blood Pressure – Hypertension and high blood pressure is also a major risk factor for heart attack, and especially stroke. Hypertension is very common in Americans over the age of 55, but is commonly inadequately treated.
What preventative measures can be taken?
There are preventative measures that can be taken to lower your risk of CAD and heart attacks. As we previously discussed, diabetes control is imperative. People who have diabetes or metabolic syndrome have a greatly increased risk of heart disease so controlling your blood sugar is key. Moreover, lowering your cholesterol and triglycerides thru diet and exercise and/or with lipid lowering medications are crucial steps to preventing the progression of CAD. In addition, blood pressure management is critical in preventing future heart attacks. Hypertension is a major risk factor for heart attack and stroke. Properly diagnosing and treating hypertension is critical to reducing your risk of heart disease.
The cornerstone of treatment and prevention of coronary artery disease has to be lifestyle modifications. This includes diet and weight loss. Choosing heart-healthy foods and engaging in exercise and physical activity can make a significant difference when it comes to protecting your heart. Finally, an essential part of lifestyle modification includes quit smoking. Recent studies have found that smoking is a significant cause of heart attacks in younger patients. No matter your age, consider getting rid of the tobacco in your life if you want to improve the health of your heart.
If you have any questions or concerns regarding Coronary Artery Disease, please contact your doctor. When in doubt, check it out.
Dr. Ho is a Board Certified Interventional Cardiologist at Carson Tahoe Cardiology.
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