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

Arterial Blood Flow Studies of the Legs (Segmental Doppler Pressures)

People who have leg pain when exercising may need an evaluation to make sure they have normal blood flow through their leg arteries. Normally blood pressure is similar whether it is measured in the legs or in the arms. If blood pressure is lower in the legs, it usually means that cholesterol buildup inside the leg arteries is interfering with circulation. By taking accurate blood pressure measurements at different locations along your legs, your doctors can determine if you have any arterial narrowing and, if so, where. In order to get accurate blood pressure measurements, your doctor uses a technique called Doppler ultrasound. Doppler ultrasound is a painless way to detect blood flowing through a small artery. It uses sound waves and a type of sonar detection system to make noise when blood flow is detected. For arterial studies of the legs (called segmental Doppler pressures), Doppler ultrasound is used in place of the stethoscope that doctors usually use when taking blood pressures. You may want to wear shorts for this exam, and your feet should be bare during the test. If you are not wearing shorts, you may have to change into a hospital gown. (Locked) More »

Cardiac Catheterization

Cardiac catheterization is a procedure in which a heart specialist inserts a small tube (catheter) through a large blood vessel in the arm or leg, and then passes the tube into the heart. Once inside the heart, doctors use the catheter to evaluate how the heart is working by measuring pressure and oxygen levels within the heart's chambers. Through the catheter, doctors inject a special dye that provides an X-ray image of the heart's internal structure and blood flow patterns. The procedure is often done to look for narrowed and blocked coronary arteries. The X-ray dye also is injected into each of the three largest coronary arteries. This is called coronary angiography. (Locked) More »

Carotid Ultrasound (Carotid Doppler)

Ultrasound uses sound waves instead of radiation to generate snapshots or moving pictures of structures inside the body. This imaging technique works in a manner similar to radar and sonar, developed in World War II to detect airplanes, missiles, and submarines that were otherwise invisible. After coating a small area of your skin with a lubricant to reduce friction, a radiologist or ultrasound technician places an ultrasound transducer, which looks like a microphone, on your skin and may rub it back and forth to get the right view. The transducer sends sound waves into your body and picks up the echoes of the sound waves as they bounce off internal organs and tissue. A computer transforms these echoes into an image that is displayed on a monitor. Doppler ultrasound is a variation of this technique that not only shows internal structures but also examines the flow of blood through blood vessels. Using the Doppler effect—the change in the frequency of sound or light waves as they bounce off a moving object—this kind of ultrasound produces an image of blood in motion. A Carotid ultrasound shows the amount of blood flow in the carotid arteries, the major blood vessels to the brain located on either side of your neck. With this imaging technique, your doctor can see if there is any narrowing of your carotid arteries because of cholesterol deposits or some other problem. This test is often used to evaluate people who have had a stroke or who might be at high risk for one because of reduced blood flow in the carotid arteries. (Locked) More »

Electrophysiological Testing of the Heart

If you have an arrhythmia (abnormal heart rhythm), cardiologists can use an electrophysiologic study (EPS) to find out what part of the heart is causing this change in rhythm and what medicines will work best to bring that rhythm back to normal. Sometimes doctors will recommend a treatment called ablation that can be done during EPS testing. Ablation uses radiofrequency waves (like microwaves) to destroy a very small area of heart tissue to stop the arrhythmia from happening. You will need to sign a consent form giving your doctor permission to perform this test. Tell your doctor if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist's office. Also tell your doctor if you have ever had an allergic reaction to any heart medicines. Talk with your doctor ahead of time if you are taking insulin, or if you take medicines that affect blood clotting. It may be necessary to stop or adjust the dose of these medicines before your test. You may need to have a blood test done some time before the procedure to make sure they are not at high risk for bleeding complications. (Locked) More »

Heart Transplant

A heart transplant is surgery in which a patient with a life-threatening heart problem receives a new, healthy heart from a person who has died. In a heart transplant, the patient who receives the new heart (the recipient) is someone who has a 30 percent or greater risk of dying within 1 year without a new heart. Although there is no absolute age limit, most transplants are performed on patients younger than 70 years old. The person who provides the healthy heart (the donor) is usually someone who has been declared brain dead and is still on life-support machinery. Heart donors are usually younger than 50, have no history of heart problems, and do not have any infectious diseases. The recipient and donor must be a good match, meaning that certain proteins on their cells (called antigens) are similar. A good match will reduce the risk that the recipient's immune system will see the donor heart as a foreign object and attack it in a process called organ rejection. (Locked) More »

Heart-Lung Transplant

A heart-lung transplant is surgery for someone with life-threatening heart and breathing problems. Surgeons remove the damaged heart and lungs and replace them with a healthy heart and lungs from a person who has died. The person receiving the new heart and lungs (the recipient) is someone with a high chance of dying within one to two years without a transplant. The person providing the healthy heart and lungs (the donor) is someone who is brain dead, but still on life-support machinery. Currently, surgeons perform very few heart-lung transplants each year in the United States. This number is small because there is a shortage of suitable donors and the requirements for heart-lung donation are stricter than those for heart donation alone. Only a small percent of people who are suitable heart donors also fit the criteria for donating both heart and lungs. (Locked) More »

Holter Monitor and Event Monitor

A Holter monitor is a portable EKG device that records your heart rhythm over time, outside the hospital or doctor's office. Whereas a regular EKG examines your heart's electrical activity for a few seconds, the Holter monitor examines changes over a sustained period of time-usually a 24- to 48-hour period-while you go about your daily activities and even while you sleep. One type of Holter monitor, called an "event monitor," can be used to record rhythms over a longer time, such as a 30-day period. Doctors use Holter monitor or event monitor tests to evaluate symptoms that come and go and that might be related to heart-rhythm changes or coronary artery disease. Men with a lot of hair on their chest will probably have to shave it. Otherwise, there's no special preparation. A technician in your doctor's office or a diagnostic lab fits you with a Holter monitor and explains how to use it. Five stickers are attached to your chest. Wires snap onto each of these stickers and connect them to the monitor. The wires detect your heart's electrical pattern throughout the day, while the monitor records and stores the data for doctors to interpret later. You can fit the monitor into a purse or jacket pocket or wear it over your shoulder by its strap. (Locked) More »

Implantable Cardioverter Defibrillator (ICD)

An implantable cardioverter defibrillator (ICD) is a potentially lifesaving medical device that is placed inside the body. An ICD treats life-threatening abnormal heart rhythms (called arrhythmias), including ventricular fibrillation, which makes the heart's large muscular chambers (the ventricles) quiver without actually squeezing and pumping. When this happens, there is no real heartbeat and not enough blood flows to the brain or other organs, including the heart. As a result, a person with ventricular fibrillation passes out and can die within minutes. An ICD is made of two parts. The pulse generator looks like a small box. It is implanted under the skin below the collarbone. The box contains a lithium oxide battery (which lasts about five to nine years) and electrical components that analyze the heart's electrical activity. Connected to the pulse generator are one or more electrodes, which travel to the heart. When the ICD senses an abnormal heart rhythm, it administers a brief, intense electrical shock to the heart, correcting the abnormal rhythm. Many people say that the shock feels like being punched in the chest, although the amount of discomfort varies. In addition to "zapping" the heart back to a normal rhythm, ICDs also can generate milder electrical impulses. These impulses can artificially regulate or "pace" the heartbeat if the heart develops other types of arrhythmias. For example, ICD impulses can help to slow down the heart when a person has ventricular tachycardia, an abnormally fast heartbeat. ICD impulses also can speed up the heartbeat in cases of bradycardia, an abnormally slow heartbeat. (Locked) More »