By Dr. Harshad Sanghvi, MD, FACC, an experienced Cardiologist and Medical Director of ICC’s Lifestyle program
As many of you may know, February is a Heart Health Month. To assure a Healthy Heart – education, awareness, and actions to intervene are extremely important to keep the heart healthy. Fact is, heart disease is a leading cause of death in the USA and globally claiming more lives each year than all types of cancer, chronic lung disease, and accidents combined. Most of these deaths result from a heart attack in people with coronary artery disease. As South Asians, we face much higher risk contributing 60% of the burden of global heart disease with only 25% of the world population.
HEART MYTH 1: Chest pain is the only warning sign of a heart attack.
Although chest pain is a classic symptom of a heart attack, there are often other symptoms of a heart attack that can occur in absence of pain, pressure, tightness or heaviness in the chest area. You may experience pain or discomfort limited to only the left arm, both arms, neck, jaw, center of the back, across the shoulder blades, or in the stomach area. You may have no discomfort anywhere, and may get only unexplained shortness of breath, profuse sweating, nausea, indigestion, or lightheadedness. Diabetics and women are more likely to have atypical presentation of a heart attack. Take these symptoms seriously and seek medical help immediately.
HEART MYTH 2: Total cholesterol is the only number that matters.
Elevated total cholesterol has been associated with an increased risk for heart attack and stroke. But, total cholesterol is the sum of both the “good” cholesterol and “bad” cholesterol. So, it does not tell the whole story. Elevated cholesterol, if related to high LDL or bad cholesterol, can increase your risk of heart disease. However, if elevated cholesterol is related to high HDL or good cholesterol and normal LDL or bad cholesterol, it can protect you against developing heart disease. Current guidelines recommend a full lipid profile to look at all components of cholesterol to better assess individual risk for heart disease.
Want to learn why South Asians are 3 times more likely to get heart disease at an younger age? Come join us for a free Webinar on February 13th, 2021 at 10 AM. You will also learn what you can do to prevent it. Registration is required – click here to learn more about the Free Webinar and register
HEART MYTH 3: Only men have to worry about heart disease.
Heart disease is a major concern for women. Cardiovascular disease kills more women in the US than any other cause. Yet many women worry less about heart disease than cancer even though nearly twice as many women die from heart disease than all forms of cancers combined, and almost four times more than breast cancer.
Heart attacks strike men at younger ages than women early on in life because women are protected by estrogen hormone. But, they catch up fast after menopause. The death rate has steadily declined among men during the past 25 years. Unfortunately, the same is not true for women. Even after accounting for age, within a year of heart attack, survival rates are lower in women than in men. Within 5 years, 47% of the women will die, develop heart failure, or suffer from a stroke, compared with 36% of the men (Circulation 02-23-2016).
HEART MYTH 4: My heart is beating very fast. I must be having a heart attack.
Some variation in your heart rate is normal. Your heart rate increases normally with moderate to strenuous physical activity like walking briskly, climbing stairs, jogging or running. It can also go up when you get excited or after drinking too much caffeine, and slows down when you are sleeping. Most of the time, a change in your heart beat is nothing to worry about. Sometimes you may experience palpitations or an irregular heart beat. This is generally not a cause for concern unless it’s very frequent, occuring at rest, and with associated symptoms like dizziness, lightheadedness, or fainting. If this is the case, you should see a cardiologist for work up to rule out cardiac arrhythmia. Remember, palpitations by itself is not a symptom of a heart attack.
HEART MYTH 5: The pain in my legs must be a sign of aging. I am sure it has nothing to do with my heart.
Pain in the muscles of your legs with predictable level of activity like walking on an incline or level ground, and relieved by rest could be a sign of a plaque buildup causing blockage of the artery in the legs, known as peripheral arterial disease. People with this condition are at a greater risk for a heart attack or stroke. This is one of the subtle signs of heart disease. People who smoke or have diabetes are at higher risk to develop peripheral arterial disease. If you are experiencing this symptom, you should see your physician for further evaluation and diagnostic work up.
HEART MYTH 6: I would know if I had high blood pressure or high cholesterol.
The only way to know if you have high blood pressure or high cholesterol is by getting your blood pressure checked and cholesterol test done to look at the levels. Cardiac risk factors are usually silent, meaning they have no obvious associated symptoms until they have affected different organs of the body including heart, brain, kidney, eyes, and circulation system. That’s why hypertension is called the silent killer. Early diagnosis and treatment is essential to prevent or delay end organ damage which is often irreversible, like heart attack, stroke, kidney disease and circulation problem.
The blood pressure should be checked at an early age by the pediatrician. People age 18 and older with normal blood pressure and no cardiac risk factors should have BP checked at least every 2-5 years. People age 40 and older, or younger with other risk factors, should have BP checked every year. American College of Cardiology and American Heart Association recommends getting cholesterol checked every 5 years starting at age 20.
HEART MYTH 7: I would only agree for stenting and decline bypass surgery because stenting is much safer.
It’s true that stenting is less invasive than bypass surgery, and allows patients to recover faster, and is just as safe. But, it requires good targets and not too many blockages to open up with the catheter to do the complete job without compromise. There is no doubt that coronary artery bypass surgery is major surgery. But when it is advised by your cardiology team to prevent a heart attack, you are not a good candidate for noninvasive stent procedure because of more extensive and diffuse disease with multiple blockages and poor targets to dilate with the catheter. Coronary bypass surgery can offer a complete thorough job taking care of multiple areas of blockages with operative risk less than 1% if performed by an experienced surgeon. Some people are likely to do better with one procedure than other depending on their individual situation with their coronary anatomy. In these cases your cardiologist or cardiac surgeon will explain why they have opted for one over the other.
HEART MYTH 8: Running and intense exercise for 2-3 hours a week is required to benefit your heart.
To lower your risk of death from coronary artery disease and cancer, you need five or six sessions of moderate to vigorous activity per week. You don’t need to be a diehard exerciser to benefit from increased activity. Recent study in JAMA (2020) looked at the relationship between step count, intensity and mortality (death rate) among 4840 participants. They found a significant reduction in cardiovascular disease, cancer, and all-cause mortality between people walking 8000 steps per day (6.9 all cause, 2.1 CVD per 1000 person-years) compared to 4000 steps per day (21.4 all cause, 6.6 CVD per 1000 person-years), and 2000 steps per day 76.7 all cause, 31.6 CVD per 1000 person-years). They did not find any association between higher step intensity and mortality after adjusting for total steps per day. Your heart will benefit from any activity, and the more you do, the more you will gain. You also get the benefit of lowering blood pressure, lowering bad cholesterol, raising good cholesterol, and improving insulin sensitivity, which is a protector against diabetes.You have to get off the couch and move. Take the stairs instead of the elevator, vacuum your house or rack the leaves. Aim for 30 minutes of activity a day which may be divided into 10-15 minutes sessions, and your heart will thank you!