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

Recognizing stroke early

Early treatment of the most common type of stroke, ischemic stroke, can limit brain damage and vastly improve outcomes. Ischemic stroke is the kind caused by atherosclerosis, which causes blood clots that block the blood supply to a part of the brain. Yet too few ischemic stroke patients receive important clot-busting drugs, which are most effective when given within three hours after symptoms start. Patients often arrive at the hospital after that window of opportunity has closed. They delay getting treatment because stroke symptoms may not be that pronounced or they are mistaken as coming from other, less serious problems. As a result, doctors are looking for ways to make it easier for the layperson to identify a stroke. The Cincinnati Prehospital Stroke Scale is one such attempt. Some experts say it leaves out too many symptoms. Others say it will cause false alarms because it's not specific enough.. Even so, the Cincinnati scale is a beginning. In one study, if any of the three tests that are part of the scale were abnormal, the chances that the person had suffered a stroke were about 70%. More »

Treating depression after a heart attack

Surviving a heart attack is cause for celebration. It's also a trigger for depression. Up to half of heart attack survivors get the blues, and many go on to develop clinical depression. Early experiences with antidepressants weren't that promising because older tricyclic drugs such as clomipramine and nortriptyline sometimes threw off heart rhythms and further endangered the heart. This made doctors leery about recommending antidepressants, even when selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), and Zoloft (sertraline), and others came along. However, a small study published in 2002, dubbed SADHART, suggested that Zoloft could safely treat depression after a heart attack and might be good for the heart to boot. And an analysis of a larger trial, called ENRICHD, lends support to the notion that treating post-heart-attack depression with an SSRI may also reduce the chances of having, or dying from, a heart attack. More »

Emergencies and First Aid - Cardiopulmonary Resuscitation

When you are alone and have to perform cardiopulmonary resuscitation (CPR), your primary effort should be compressing the chest to help the person's heart pump blood. If there is a second person helping, providing breaths can be done at the same time as compressions are performed. The brief review of CPR on the following pages can help you in an emergency; however, this information should not take the place of a certified course in CPR. Immediate care Assess the situation. Call out for someone to get help or call 911 yourself if the person does not seem to need immediate assistance. You can determine this by gently shaking the person and asking in a loud voice, "“Are you OK?"” If there is no response, begin CPR and continue until help arrives. More »

Resistant hypertension needs special attention

At least half of the 80 million Americans with high blood pressure don't have it under control. Sometimes poor control stems from lack of trying. A growing number of people, though, have what's called resistant hypertension — blood pressure that stays stubbornly above the target (see "Blood pressure goals") in spite of lifestyle changes and medications. Persistently high blood pressure is a problem. It is a key contributor to stroke, heart failure, and other cardiovascular conditions. Strictly speaking, you have resistant hypertension if your blood pressure is still high even though you are taking three or more pressure-lowering medications, or if you need to take four or more medications to reach your blood pressure target. More »

Using smartphone apps for heart health

A cell phone or smartphone can do so much more than make calls, send text messages, and play games. Hundreds of heart-related applications are available for the iPhone, Android, Blackberry, and other smartphones. Many are little more than glorified diaries or pamphlets. A growing number, though, are tapping into the sophisticated technology packed into these phones. Here are a few examples of useful heart-related apps and devices. (Locked) More »

When You Visit Your Doctor - After a Heart Attack

Have you had chest pain or pressure since you were discharged from the hospital? How severe is it? How long does it last? Does it stay in your chest or radiate to other parts of your body? Did you have this pain before your heart attack? What brings it on? How frequently do you get it? What were you doing just prior to the chest pain? Do you ever get chest pain or pressure at rest? What relieves the chest pain? If you take nitroglycerin, how many doses do you usually need to take before the pain goes away? How often do you take nitroglycerin? Do you get short of breath when you lie down or exert yourself? Do you awaken in the middle of the night short of breath? Do your ankles swell? Do you ever feel lightheaded? Have you fainted? Do you get rapid or pounding heartbeat for no reason? Do you know what each of the medications you are taking does? Do you know the side effects of each medication? Are you having any side effects? Are you taking an aspirin every day? Are you doing everything you can to modify the risk factors that can worsen your coronary artery disease (cigarette smoking, high blood pressure, high cholesterol, and diabetes are the most important risk factors)? Are you participating in a supervised exercise program? Are you resuming your normal activities? Are you sexually active? Have you returned to work? Have you been feeling depressed since your heart attack? Have you been able to reduce the stress in your life? Have you been fatigued? Heart rate, blood pressure, and weight Pulses in your wrist, groin, and feet Listen over the major arteries in the neck, groin, and feet (for abnormal noises) Look at the veins in the neck to see if there is extra fluid in your body Heart and lungs Ankles and legs (for swelling) Blood tests for glucose, lipid panel (cholesterol levels) and C-reactive protein (CRP) Electrocardiogram Echocardiogram Exercise stress test   More »

When You Visit Your Doctor - Heart Block

Have you been dizzy or lightheaded? Have you fainted? Have you been fatigued? Have you had chest pain? Do you get it with exertion or at rest? How frequently do you get it? How long does it last? What brings it on? What relieves it? Is this a change from your usual pattern? Do you get short of breath when you lie down or exert yourself? Do you awaken in the middle of the night short of breath? Do your ankles swell? Do you get rapid or pounding heartbeats for no reason? What medications are you taking (including over-the-counter medications, herbal remedies, and vitamins)? Do you have any other medical problems? Heart rate, blood pressure, and weight Pulses in the wrist and feet Veins in the neck Heart and lungs Ankles and legs (for swelling) Electrocardiogram Echocardiogram Holter monitor Electrophysiologic testing   More »

When You Visit Your Doctor - Mitral Valve Prolapse

Have you had an echocardiogram? What did it show? Does your mitral valve leak? Do you get chest pain? What brings it on? How long does it last? What relieves it? Do you ever get a rapid or pounding heartbeat (palpitations) for no reason? How long does it last? Do you feel faint or develop chest pain or shortness of breath? Have you ever fainted? Do you get short of breath when you lie down or exert yourself? Have you ever taken any medications for your heart? Did you develop any side effects from these medications? Heart rate, blood pressure, and weight Heart (sometimes while you are standing, squatting, or performing other maneuvers) Lungs Electrocardiogram Echocardiogram Holter monitor or event monitor   More »

When You Visit Your Doctor - Peripheral Artery Disease

Do you develop pain, cramps, aches, fatigue, or numbness in your leg muscles when you walk? At what distance do you develop symptoms? Do they go away when you stop walking? Do you ever develop these symptoms at rest? Do you have decreased sensation in your feet? If you are a man, do you have erectile dysfunction? Are you doing everything possible to modify the risk factors that can worsen this disease (smoking cessation, treating elevated blood pressure and cholesterol, and controlling diabetes)? Are you exercising regularly and at progressively more strenuous levels? Are you taking an aspirin every day? If you have diabetes, do you practice meticulous foot care (cleaning, applying moisturizing lotions, and wearing well-fitting protective shoes)? Do you know when to seek emergency medical care for peripheral artery disease (if your leg becomes suddenly painful, pale, cold and numb)? Do you get chest pain or pressure with exertion or at rest? If so, you may have coronary artery disease. Do you have sudden brief episodes of blindness (like a shade being pulled over your eyes) or sudden episodes of weakness in an arm or leg, or difficulty speaking? These could be warning symptoms of stroke. Heart rate, blood pressure, and weight Pulses in your feet and groin, and behind your knees Listen with the stethoscope over your carotid arteries in your neck Heart and lungs Neurologic exam (reflexes and sensation in your legs) Muscles (looking for atrophy in leg muscles) Skin, looking for changes related to reduced circulation Blood tests, including glucose and cholesterol levels Ultrasound of your carotid arteries Doppler Ankle-Arm Indices Exercise Stress Test MRI/MRA Angiography   More »