Heart Disease

There are many types of blood vessel and heart diseases, a group of conditions referred to as “cardiovascular disease.” One of these, coronary artery disease, occurs when blood that carries oxygen to the heart is blocked by a blood clot or a build-up of fatty substances. This disease accounts for more than one-half of cardiovascular deaths, and about one-third of all deaths in the U.S. are a result of this disease.

High blood pressure—or hypertension—is a serious medical condition that can lead not only to heart disease, but also to stroke and kidney failure. There are no special symptoms of high blood pressure, so regular following check-ups are essential, as well as periodic blood pressure checks at community-based stores, and medication regimens as prescribed.

Types of Heart Conditions
Coronary Artery Disease: Over the years, cholesterol plaques can narrow the arteries heart supplying blood to the heart. The narrowed arteries are at higher risk for complete blockage from a sudden blood clot, leading to a heart
Stable Angina Pectoris: Narrowed coronary arteries cause predictable chest pain or discomfort with exertion. The blockages prevent the heart from receiving the extra oxygen needed for strenuous activity. Symptoms typically get better with rest.
Unstable Angina Pectoris: This is chest pain or discomfort that is new, worsening, or occurs at rest. It is an emergency situation, as it can precede a heart attack, serious abnormal heart rhythm, or cardiac arrest.
Myocardial Infarction (Heart Attack): A coronary artery is suddenly blocked. Starved of oxygen, part of the heart muscles dies.
Arrhythmia (Dysrphythmia): This is an abnormal heart rhythm due to changes in the conduction of electrical impluses through the heart. Some arrhythmias are benign, but others are life threatening.
Congestive Heart Failure: The heart is either too weak or too staff to effectively pump blood through the body. Shortness of breath and leg swelling are common symptoms.
Cardiomyopathy: This is a disease of the heart muscle in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart’s ability to pump blood is weakened.
Myocarditis: Most often due to a viral infection, this is inflammation of the heart muscle.
Pericarditis: Inflammation of the lining of the heart (pericardium), common causes of this condition are viral infections, kidney failure, and autoimmune conditions.
Pericardial Effusion: Fluid between the lining of the heart (pericardium) and the heart itself. Often, this is due to pericarditis.
Atrial Fibrillation: Abnormal electrical impulses in the atria cause an irregular heartbeat. Atrial fibrillation is one of the most common arrhythmias.
Pulmonary Embolism: Typically a blood clot travels through the heart to the lungs.
Heart Valve Disease: There are four heart valves, and each can develop problems. If severe, valve disease can cause congestive heart failure.
Heart Murmur: An abnormal sound is heard when listening to the heart with a stethoscope. Some heart murmurs are benign; others suggest heart disease.
Endocarditis: This is inflammation of the inner lining or heart valves of the heart. Usually, endocarditis is due to a serious infection of the heart valves.
Mitral Valve Prolapse: The mitral valve is forced backward slightly after blood has passed through the valve.
Cardiac Arrest: Sudden loss of heart function.
Sudden Cardiac Death: Death is caused by a sudden loss of heart function (cardiac arrest).

Risk Factors
Men, African-Americans, Native Americans, Hawaiians, and those over 65 are at greater risk and should pay close attention to the risk factors below:

One of the biggest risks is a high LDL (bad) cholesterol level. Too much cholesterol, which is a soft, fat-like, waxy substance in the blood, leads to coronary heart disease and strokes. Fortunately, a healthy diet and proper medication when needed can control bad cholesterol and reduce this risk. There are other risk factors. The most serious of these are:

  • High blood pressure
  • Cigarette smoking. A smoker’s risk of developing heart disease is 2 to 4 times that of a non-smoker. Even exposure to second-hand smoke increases the risk of heart disease
  • Diabetes
  • Low HDL (good) cholesterol levels

Prevention

  • Have a lipid panel, or tests ordered separately that require a 12-hour fast, which include a total cholesterol test; Medicare will pay for it. Reduce LDL cholesterol to less than 100 and HDL to more than 60 Triglycerides should be less than 110 mg/dL. This reduces the chance of death by 24 percent.
  • Reduce blood pressure to less than 120 systolic (top number) and the diastolic (bottom number) to less than 80. This reduces the chance of death by 20 percent High blood pressure does not mean excessive emotional tension — it represents increased pressure in the arteries.
  • Stop smoking. This reduces the chance of death by 12 percent.
  • Find a dental floss that you can use with ease, and floss daily; the bacteria in your mouth can be damaging and lead to heart disease.
  • Increase physical activity by joining such as Start Walking Now, a program of the American Heart Association. It’s free and easy to do. Register online and track your progress and success.
  • Manage your weight and know your Body Mass Index (calculate your BMI here or as follows:
  • Divide your weight by your height in inches
  • Divide that calculation by your height again
  • Multiply that number by 703. Round to the second decimal point.
  • Example: A 5 5 foot tall (65 inches) woman who weighs 140 pounds would have a BMI of 23.
  • A BMI of 30 or higher is considered obese
  • Reduce caffeine from coffee, tea and soda and avoid diet soda. This alone will immediately improve your blood pressure and your general health.
  • Reduce stress and anxiety in your life.
  • Reduce salt intake.

Screening
Take the Life Simple 7 Success Plan as part of My Life Check. To use this tool effectively you will need to answer questions about your eating habits, exercise patterns, weight, smoking status, cholesterol levels, blood pressure levels, and blood sugar. The tool provides you with goals and actions to improve your heart health.

Take blood pressure frequently. This chart outlines blood pressure categories and the corresponding pressures:

Normal Systolic < 120 and Diastolic <80
Pre-Hypertension Systolic 121–139 or Diastolic 80-89
Hypertension Stage I Systolic 140–159 or Diastolic 90-99
Hypertension Stage II Systolic >160 or Diastolic >100

 

Cholesterol Guidelines
Have Your Cholesterol Levels Checked Annually
Total Cholesterol LDL/Bad Cholesterol HDL/Good Cholesterol
Optimal total cholesterol:
<200
Optimal:
<100
Ideal:
>60
Borderline total cholesterol:
200-239
Borderline:
130-159
Major Risk:
High total cholesterol:
>240
High: >160

Diagnosis
To make a diagnosis, a health care professional will check the heart’s rate, rhythm and regularity by taking a pulse. The pulse is the number of times the heart beats in one minute. The health professional will also evaluate the heart and valve function by listening to the heart sounds, rate, and rhythm with a stethoscope. Finally the health professional may order any or all of the following Medicare covered tests (a co-pay may apply):

  • EKG
  • Chest X-ray
  • Stress test to determine how the heart responds to exertion
  • Tilt Table Test to find the cause of fainting spells
  • Echocardiogram
  • Cardiac Catheterization
  • Electrophysiology Test
  • CT Heart Scan
  • Myocardial biopsy
  • Heart MRI
  • Pericardiocentesis

Medicare will pay for a one-time ultrasound screening for abdominal aortic aneurysm (AAA) for beneficiaries who are at risk with a referral as a result of the Welcome to Medicare physical exam. Patients considered at risk include a family history of AAA and men age 65 to 75 who have smoked at least 100 cigarettes in their lifetime.

Questions For Your Doctor

  • What form of heart or cardiovascular disease do I have? What is the severity? What is my prognosis?
  • What does high blood pressure have to do with heart and cardiovascular disease?
  • What role does cholesterol play in heart and cardiovascular disease? Do I have high cholesterol? Do I need to lower my cholesterol? If so, how?
  • What role does diabetes play in heart disease? Do I have diabetes? Do I need to lower my blood sugar? If so, how?
  • Am I at risk for a heart attack? What symptoms would indicate a heart attack?

Tips

  • Eat these foods regularly to help lower your cholesterol: extra-virgin olive oil, beans (kidney, lima, black, navy, pinto), oatmeal and oat bran, omega-3 fats (salmon, sardines, anchovies, soybeans, fortified eggs), blueberries, cranberry-grape juice, yogurt with live cultures, and alcohol (small amounts, especially red wine).
  • Bring your readers to the store and check food product ingredient labels. If you see the word “hydrogenated” — put it back on the shelf. This indicates there are trans-fats in the food item.
  • Also reject food items with high fructose corn syrup; these contribute to weight gain
  • Empower yourself by taking actions to control your stress level. Set goals that are reasonable to achieve. Consult the American Heart Association for strategies and action plans to manage stress.

Measuring Your Pulse
To measure your pulse, all you need is a watch with a second hand.

  1. Place your index and middle finger of your hand on the inner wrist of the other arm, just below the base of the thumb. You should feel a tapping or pulsing against your fingers.
  2. Count the number of taps you feel in 10 seconds.
  3. Multiply that number by six to find out your heart rate for one minute (pulses in 10 seconds x six = ____ beats per minute).
  4. When feeling your pulse, you also can tell if your heart rhythm is regular or not.

Helpful Resources
American Heart Association or call 1-800-242-8721

Download This Heart Disease Monogram