Heart Health Archive

This noninvasive test can predict plaque in the heart's arteries. But it is useful only in certain situations.

Imagine a 57-year-old man (let's call him Bill) who's in pretty good health — a nonsmoker who eats right and exercises regularly. He takes two drugs to treat high blood pressure. Even though his LDL (bad) cholesterol isn't all that high, his primary care doctor suggests that Bill consider taking a statin to lower his risk of a heart attack.

Bill is a little hesitant to add another drug to his daily regimen, so his doctor tells him about a test that may help with the decision: a coronary artery calcium scan. This noninvasive test, which can reveal dangerous plaque in the heart's arteries, has been available for more than a decade. But calcium scans (as they're often called) are now recognized in official guidelines and are being used far more often than in the past, says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital.

Ask the doctor

Q. My brother went to the emergency room because he thought he was having a heart attack. Instead, he was diagnosed with costochondritis. What is that?

A. Costochondritis is caused by inflammation of the cartilage between the ribs and the breastbone, called the costosternal joints (see illustration). This uncommon condition can trigger a stabbing, aching pain that's often mistaken for a heart attack.

Intermittent fasting promises better health and longer life, but does it work?

The obesity epidemic has spawned a cottage industry of weight-loss schemes. Currently in vogue is intermittent fasting, which involves alternating intervals of extreme calorie reduction with periods of normal eating. Proponents of an intermittent fasting regimen claim that it helps shed pounds faster than traditional diets, as well as reduce inflammation and other heart disease risks.

What is intermittent fasting?

All diets achieve weight loss through the same equation — you take in less food energy each day than your body burns for normal activity. Intermittent fasting achieves this goal by severely limiting calories during certain days of the week or during specified hours during the day. The theory is that intermittent fasting will help decrease appetite by slowing the body's metabolism.

There's no mercury to worry about, and flaxseed oil  does contain omega-3 fats...but not the best kind.

Troll the medical literature, and you'll come up with study after study showing that fish and fish oil are good for us, especially for our hearts but maybe also for our moods and immune systems. Various epidemiologic investigations have found that people who eat fish regularly are less likely to have heart attacks, suffer strokes, or die from sudden cardiac arrest. The definition of "regularly" varies, but it usually means at least a couple of times a week, although eating fish even once a month has been shown to make a difference.

Fish, and especially fish oil, have also been the subject of dozens of randomized clinical trials, most involving people with existing heart conditions. In large amounts (several grams a day), fish oil has been shown to nudge various cardiac risk factors ("good" HDL cholesterol, triglycerides, blood pressure) in the right direction.

The DASH diet has already been shown to lower blood pressure, and a new study found that people who followed it closely had a lower risk of heart failure. Try these suggestions to incorporate the DASH diet into your daily eating pattern.

Another study is questioning the healthfulness of eggs, but whether or not you should eat fewer eggs depends on your overall diet and your risk of cardiovascular disease.

Lap swimming is a very effective workout: aerobics, strengthening, and stretching in one activity. Make sure you’re reasonably healthy before diving in, but even if you’re not, or if you don’t know how to swim, aquatic exercises are beneficial, too.

Advice about eating eggs has evolved over the years. Should you go easy on this popular protein source?

Over the years, eggs have taken a bit of a beating, starting in the late 1960s. That's when the American Heart Association advised people to cut back on cholesterol in their diets and to eat no more than three whole eggs a week.

Decades later, eggs got a break after studies suggested that for most people, an egg a day was A-OK for heart health. But a recent report cracked down on eggs once again, suggesting that we return to the yolk-rationed days of yore (see "No yolk: Eggs linked to slightly higher risk of heart disease").

Ask the doctor

Q. I'm getting a pacemaker to treat a slow heart rate and am wondering how it might affect my daily life. For instance, can I still exercise? Is it safe to go through airport security scanners and to have medical imaging tests?

A. Pacemakers are small, implanted electronic devices that monitor your heart's rhythm and, when necessary, generate a painless electrical impulse that triggers a heartbeat. The latest models not only help people stay active later in life, they're also more compatible with today's technology.