Heart Health

The heart beats about 2.5 billion times over the average lifetime, pushing millions of gallons of blood to every part of the body. This steady flow carries with it oxygen, fuel, hormones, other compounds, and a host of essential cells. It also whisks away the waste products of metabolism. When the heart stops, essential functions fail, some almost instantly.

Given the heart's never-ending workload, it's a wonder it performs so well, for so long, for so many people. But it can also fail, brought down by a poor diet and lack of exercise, smoking, infection, unlucky genes, and more.

A key problem is atherosclerosis. This is the accumulation of pockets of cholesterol-rich gunk inside the arteries. These pockets, called plaque, can limit blood flow through arteries that nourish the heart — the coronary arteries — and other arteries throughout the body. When a plaque breaks apart, it can cause a heart attack or stroke.

Although many people develop some form of cardiovascular disease (a catch-all term for all of the diseases affecting the heart and blood vessels) as they get older, it isn't inevitable. A healthy lifestyle, especially when started at a young age, goes a long way to preventing cardiovascular disease. Lifestyle changes and medications can nip heart-harming trends, like high blood pressure or high cholesterol, in the bud before they cause damage. And a variety of medications, operations, and devices can help support the heart if damage occurs.

Heart Health Articles

Abdominal aortic aneurysms: Triple A, double trouble

An abdominal aortic aneurysm is a widening of the artery where it passes through the stomach. AAs are responsible for at least 9,000 deaths in the United States each year, making them our 13th leading killer. The size of the aneurysm helps determine the risk of rupture, and whether it should be repaired surgically. New advances in diagnosis and therapy are dramatically improving the management of this condition. (Locked) More »

Alternative to warfarin

People with atrial fibrillation are at higher risk of having a stroke because they are more susceptible to the blood clots that cause stroke. When the atria (the top two chambers of the heart) fibrillate (beat chaotically), blood collects in the heart, giving clots a chance to form. One of those clots can travel to the head, get stuck in a blood vessel there, and cause a stroke by depriving a part of the brain of the oxygen and nutrients it needs; some of the cells of the brain die, possibly taking with them the ability to move, speak, feel, think, or even recognize people. Warfarin prevents blood clots by making the platelets in the blood less sticky. It's a good, time-tested drug. But warfarin is tricky to use. Some experience bleeding problems like nosebleeds. Yet if you take back the dose too far to avoid bleeding, you're back to where you started: running the risk that a blood clot may form and cause a stroke. Doctors try to steer people down the middle by monitoring them with international normalized ratio (INR) tests, which measure how fast the blood clots. But people's response to warfarin is variable, and the drug interacts with a lot of food and medications. A good alternative to warfarin has been on the wish list of many "afib" patients — and their doctors — for years. (Locked) More »

Alcohol after a heart attack

My husband just had a mild heart attack, and now he wants to have wine with dinner every night. We've both heard that wine is good for the heart, but I'm worried that it may not be safe so soon after. I hope you can reassure me or restrain my husband. (Locked) More »

Ask the doctor: Alternative to warfarin

  For several years, I have been taking warfarin because of atrial fibrillation. I recently suffered nosebleeds, which took two days to control. The trauma of those episodes makes me want to swear off warfarin, but I am not sure what other options I have.   (Locked) More »

Ask the doctor: Headache and stroke

I have heard that one symptom of a stroke is "the worst headache you can imagine." I recently had a migraine that was so much more painful than previous ones that I worried it was a stroke. Is there any way to tell a migraine from a "stroke headache"? (Locked) More »

Ask the doctor: Nuclear stress tests

I recently had a nuclear stress test and the contrast agent got stuck in my gut, so the image couldn't be read. Is this a common problem, and is there anything that can be done about it? (Locked) More »

May 2011 Heart Letter references and further reading

Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation 2011; 123:933-44. Schober P, van Dehn FB, Bierens JJ, Loer SA, Schwarte LA. Public Access Defibrillation: Time to Access the Public. Annals of Emergency Medicine, published online Feb. 2, 2011 Schwartz BG, Kloner RA. Clinical cardiology: physician update: erectile dysfunction and cardiovascular disease. Circulation 2011; 123(1):98-101. (Locked) More »