Many of you have questions regarding what we do or about a specific illness or procedure. We've collected this list of frequently asked questions in hopes of helping you with some of those. Remember, however, that these answers are not meant to be used in place of a physicians advice. 

When in doubt, ask your doctor!

1) Many members of my family have had some type of heart disease. I am a male, 42 years old, have never smoked, exercise 2 - 3 times a week. Is there something more I can do to reduce my risks or is heart disease inevitable?

A. There are no guarantees that heart disease can be prevented, however, not smoking and exercising regularly are two important steps you can take to reduce your risks. Studies have shown that men and women who exercise regularly have a lower risk of heart disease. The death rate among nonsmokers is lower than smokers and those who have quit, the death rate eventually declines almost to that of people who have never smoked. While there are members of your family with heart disease, it does not mean you will develop it. Regular check ups with your primary care physician is important to detect and treat conditions. Uncontrolled high blood pressure and blood sugar levels in diabetics can increase risks for heart disease. Under the supervision of your physician, high blood pressure and diabetes can be controlled. Other actions you can take are to reduce the total fat and saturated fat intake in your diet and maintain a healthy weight. 

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2) I am a 27 year old female on birth control pills. I also smoke and am trying to quit. My Mother has told me that smoking and birth control pills are a dangerous combination for heart disease. If this is true, will you explain why? 

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A. The pill has been known to cause an increase in blood pressure in some women, especially those who have had high blood pressure when they were pregnant, or who have kidney disease or family members with high blood pressure. Risks for heart disease are increased with elevated blood pressure. Nicotine in the smoke temporarily increases blood pressure and heart rate. Nicotine also increases the amount of blood pumped by the heart and the blood flow in the heart's arteries causing the heart to work harder. The carbon dioxide in cigarette smoke also reduces the oxygen available to the heart and other parts of the body. Smoking also causes the platelets in the blood to become stickier, making the blood thicker and causing the heart to work harder. The combination of smoking and birth control pills work with each other to increase the risks of heart disease, especially during the child bearing age. Check with your physician for help to quit smoking. 

3) I have many friends who have had some type of cancer, yet I continue to hear that heart disease is the number one killer of women. My Mother does not have cancer or heart disease. Should I be concerned about either of these?

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A. Nearly twice as many women in the United States die of heart disease and stroke as from all forms of cancer, including breast cancer. Additionally, more women die of cardiovascular diseases than the combination of all forms of cancer, chronic lung disease, pneumonia, diabetes, accidents and AIDS combined. Of even higher risks are black women. The death rate from heart attacks for black women is nearly 40% higher than for white women and from stroke nearly 75% higher. There are some risk factors that you can't change, such as age, sex, family history or race, however, other risk factors can be modified to lower your chances for heart disease. Smoking, lack of exercise, uncontrolled diabetes, high blood pressure, obesity and a diet high in total fat, saturated fat and cholesterol are factors that can be modified. 

4) My doctor told me my Triglycerides were too high after I had a complete blood test. What are Triglycerides and what should I do to lower them?

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A. Triglycerides are the most common type of fat in the body and it is normal for the level of Triglycerides to increase after a meal. The most accurate test is done after fasting 12 - 14 hours. The National Heart, Lung and Blood Institute has classified levels below 200 milligrams per deciliter as being normal. Borderline high levels are 201- 400 milligrams per deciliter and high as 401 - 1000. A triglyceride level over 1000 milligrams per deciliter also increases the risk for acute pancreatitis. High triglyceride levels have been linked to heart disease. If cholesterol levels are also high, the risk for heart disease is stronger. Research has shown that high triglyceride levels in women are a stronger indicator of heart disease than in men. Triglyceride levels are higher in overweight people and in those with poorly controlled diabetes. Excessive intakes of alcohol and simple sugars may also raise Triglycerides. 

5) I am a 55 year old man who recently had a mild heart attack and my doctor tells me I'm doing very well. Should I be concerned about another heart attack in the future?

A. Studies have shown that men have more heart attacks than women, have them earlier in life and have a greater chance of surviving them than women. Only one in four men die from a second heart attack within the first year. During the first six years following a heart attack, the rate of having a second attack is 23% for men. Continue to have regular check ups with your physician and follow his advice for you to reduce your risks of a second heart attack.

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6) My friends' doctor suggested that she start taking fish oil after having a heart attack. What does fish oil have in it that would be helpful for her and would eating fish be good for her too?

A. Fish oils have been shown to interfere with the bloods' ability to clot, which can be helpful for reducing the risks of heart disease. Fish and fish oil are particularly rich in omega 3 fatty acids, a type of polyunsaturated fatty acid. Polyunsaturated fats lower blood cholesterol levels, helping to reduce a major risk of heart disease. Omega 3 fatty acids have been shown to reduce Triglycerides, one type of blood cholesterol. The American Heart Association recommends the regular consumption of fish and suggests no more than 5 - 7 ounces of fish, poultry or lean mean per day. 

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7) I have been walking about 30 minutes 3 - 4 times a week during the summer and want to continue during the winter. I am taking Lipitor to control blood cholesterol. Should I be concerned about walking in the cold weather?

A. Continuing your exercise into the winter is an important part of healthy living. Walking outside can be a part of your regular exercise routine, if you keep these things in mind. Since most body heat is lost through the top of your head, be sure to wear a hat or scarf. Protect your ears and hands, too, since they are particularly susceptible to frostbite. Wear layers of clothing to create pockets of warm air and making it easier to take off a layer if you become too hot. Pay attention to the weather forecasts. Exposure to icy winds, snow and freezing temperatures can steal body heat. The wind is especially dangerous, so pay attention to the wind chill. Dress according to the wind chill and not the temperature. A moderate outdoor exercise program can be maintained during the winter if you dress properly and pay attention to weather conditions. For severe cold days, consider indoor alternatives such as walking at the mall or using exercise equipment such as stationary bikes or a treadmill.

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8) My doctor recently ordered a "lipid" test and told me that the LDL was too high and the HDL too low. What is a lipid and what is the difference between LDL and HDL?

A. A lipid is simply any fatty substance in the blood that will not mix with the blood, such as cholesterol and Triglycerides. Just like oil and water don't mix, cholesterol and Triglycerides won't dissolve in the blood, unless they are mixed with proteins. Lipids travel in the blood in a package of fat and protein, called lipoproteins. The two major types of lipoproteins are low-density lipoprotein, abbreviated LDL and high-density lipoproteins, abbreviated as HDL. A high level of LDL can signify an increased risk of heart disease, which is why they are often called the "bad cholesterol". HDL helps to carry cholesterol away from the arteries back to the liver where it is passed from the body. Because of this important function, HDL cholesterol is often called the good cholesterol. 

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9) My primary care doctor is sending me to a cardiologist and thinks that I may need a PTCA. I know what a bypass is, but what is a PTCA? 

When the arteries surrounding the heart become blocked or partially blocked by plaque (a combination of cholesterol, calcium and certain other elements), a cardiologist has several treatment options, including a bypass or a PTCA. PTCA (percutaneous transluminal coronary angioplasty) is a nonsurgical procedure used to widen or expand arteries affected by plaque. 

The cardiologist will insert a small plastic tube (catheter) into an artery in your leg (occasionally the arm is used). The catheter will be guided to the arteries surrounding the heart. A special x-ray camera is used to guide the catheter to the coronary arteries. When the catheter is in place, a second smaller catheter with a balloon on its tip is passed through the first catheter. Once the catheter is in place, the balloon is inflated and compresses the plaque to open up the artery. The benefit of this procedure is that blood can flow more easily through the formerly narrowed part of the coronary artery. 

As you know, a bypass surgery creates a detour around the blocked part of the artery. During this surgery, an incision is made above the heart and a vein, taken from another part of your body , is sewn into place to create the detour. Your doctor may perform a variety of tests to determine which procedure will be best for you, however, the result will be the same: increase the blood flow to the heart muscle.

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10) My Grandfather has been diagnosed with 'heart failure'. What are the symptoms and treatments for this?

Heart failure doesn't mean that your Grandfather's heart has stopped beating or that he is about to die. Heart failure is a condition where the heart function is weakened resulting in a build-up of body fluid. This condition can be caused by many forms of heart disease, such as: narrowed arteries that supply blood to the heart, previous heart attack resulting in scar tissue that interferes with the heart muscle contracting and relaxing, uncontrolled high blood pressure, heart valve disease due to past rheumatic fever or other abnormal heart condition present since birth, or infection of the heart valves or muscle. These diseases are usually present for years, worsening over the years.

Once heart failure is diagnosed, the first treatment is typically rest and reduction of sodium (salt) in their diet. Sometimes a water pill (diuretic) is prescribed, which helps to reduce the amount of excess water and sodium in the body. This reduction reduces the amount of work the heart has to handle. His doctor may also prescribe a digitalis to help strengthen the heart muscle's pumping ability. Another option may be to prescribe medication that reduces the work of the heart by dilating the arteries and/or veins in legs. 
If the heart failure is caused by a diseased valve, surgery to replace the valve would be considered. Another option his doctor may consider is a coronary artery bypass graft surgery. 

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11) What is the difference between an echocardiograph and an angiograph?

A. Both of these are tests used to help your cardiologist may use to make a diagnosis. An echocardiogram used pulses of sound that are transmitted into the body. The sounds bounce off the surface of the heart and are electronically plotted and recorded to provide a picture of the heart.
An angiograph is performed during a cardiac catheterization. A liquid dye, visible to x-rays, is injected into the catheter. High speed x-rays record the course of the dye as it flows through the arteries and identifies any areas of the arteries that may be blocked.

Another test that is used involves the use of special radioactive isotopes that are injected into the blood Unlike the dyes used in the angiograph, the isotopes identify diseased tissues of the heart, performance of the heart, distribution of the blood flow in the heart and/or abnormal movements in the heart.

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12) What are the treatment options for people with problems with a heart valve? 

A. Abnormalities with heart valves may exist at birth and may require early medical attention. Other problems may go unnoticed until later in life. Rheumatic fever or infections may cause the valves to not open freely (stenosis) or to close completely (regurgitation). Both these conditions increase the work load of the heart muscle and may cause the heart to become abnormally large.

After treatment, people may lead normal lives with careful medical management. Others with more severe damage to valves may require surgery to repair or replace heart valves. In some cases, people with stenosis or leakage may be helped by repair procedures of the valves. The cardiologist may request a variety of tests to determine the cause of the valve problem before making any treatment recommendations. 

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13) My husband's cardiologist diagnosed him with an ischemic heart. What does this mean? How does this differ from a heart attack?

Ischemia is a local and usually temporary deficiency of blood in some part of the body that is often caused by a constriction or a blockage in the blood vessel. A heart attack, also called a coronary occlusion is an obstruction, usually a blood clot in a branch of one of the coronary arteries that blocks the flow of blood to the heart muscle. This part of the heart muscle dies because of the reduced blood flow. 

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14) How do I find The Care Group's new office at the Medical Office Building ?

Please click here for directions.

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