Heart disease is the leading killer among American men and women, putting it at the top of the list of health concerns for many of us – especially if there’s family history. HealthScene Ohio spoke with ProMedica Physicians’ Dr. Praveen Tamirisa, a cardiologist, to discuss the ins and outs of heart health.
HealthScene Ohio: What are some of the best ways to promote a healthy heart?
Dr. Praveen Tamirisa: Promoting a healthy heart requires regular exercise, good diet, healthy habits, and controlling risk factors and underlying diseases such as high blood pressure, diabetes and cholesterol. It is also important to limit alcohol usage, reduce salt consumption and reduce stress in daily life.
HSO: Who should be concerned about maintaining a healthy heart?
PT: Everyone should be concerned about maintaining the health of the cardiovascular system, including the heart. Every year, about 785,000 Americans have a first coronary attack and, on average, someone dies from these diseases every 34 seconds.
Individuals with risk factors should be more vigilant to try to mitigate the risk. These diseases tend to build up over time and, by the time someone experiences symptoms, it may be too late. The key will be to reduce the chances of disease right from the beginning by paying attention to the risk factors and maintaining a healthy lifestyle.
HSO: What are the causes, symptoms and treatments of heart disease? Are there any particular risk factors?
PT: Heart attacks are caused by critical blockages in the blood vessels supplying the heart muscle. Once a blood vessel is critically narrowed or blocked completely, the damage to the heart muscle starts right away. Delay in seeking treatment can cause irreparable damage. Treatment options include medicines, an invasive procedure called cardiac catheterization and potential angioplasty or surgery, depending on the types of blockages.
The risk factors for heart attacks are divided into three main categories. Those factors are:
- Modifiable risk factors such as smoking, high blood pressure, diabetes, obesity, inactivity and high cholesterol. The patients have some control over these factors.
- Non-modifiable risk factors such as gender, age and genetic risk. These cannot be prevented, but treatment may mitigate the impact.
- Contributing factors such as excess alcohol, salt use and diet.
HSO: What are some of the warning signs of a heart attack? Do they look different in men and women, or in people of different ages?
PT: There is a lot of variability in the symptoms of heart attacks. These can present as sudden, severe chest pain that may go to the neck, jaw, back or arms. Sometimes, the symptoms can be very mild, or present as vague tightness in the chest, nausea, upset stomach, difficulty breathing, dizzy spells and/or cold sweats.
Heart disease is the leading cause of death of American women, killing more than one-third of them. More than 432,000 women die from cardiovascular disease each year. More deaths are caused by heart disease than breast cancer annually.
While the heart attack signs in women can be similar to that of men, they tend to have more of the atypical symptoms mentioned above. Combined with the common misconceptions in the general population that heart attacks happen in men only, these atypical presentations make it a challenge to recognize and treat heart attacks in women early.
HSO: What does a visit to a cardiologist look like?
PT: Primary care providers can provide a routine evaluation as well as risk factor recognition and modification. This may involve periodic blood testing, electrocardiogram (EKG) and, in some instances, specialized heart testing such as ultrasound examination of the heart and stress test of the heart.
Sometimes, based on the preliminary evaluation by the primary care team, the patient may be asked to see a cardiologist for further evaluation and treatment.
HSO: How often should you exercise to maintain a healthy heart? Is there a certain kind of exercise that is more beneficial to your heart than other kinds?
PT: Generally speaking, it would be helpful to be physically active every day. If a person has been sedentary, a good starting point may be to simply walk even 10 minutes a day and slowly build up endurance. The minimal goal is 150 minutes of moderate activities a week in divided sessions. A moderate activity would be a brisk walk or activities that cause at least mild sweating. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level.
HSO: What foods contribute the most to cardiac problems? Should these foods be avoided entirely or just eaten in moderation?
PT: It is important to keep in mind that the foods we consume affect a lot of factors including weight, blood pressure, cholesterol and diabetes. In turn, each of these factors can influence heart disease. Portion control will be key to control total caloric intake. Avoiding excessive salt, refined sugars and beverages (even those with zero calories) will be important. Nutrient-rich foods that may be better for heart health include foods with fiber, vegetables, fruits, whole grains, low-fat dairy products, poultry, fish and nuts.
HSO: Do young people and children need to worry about their heart health or just individuals over a certain age?
PT: A heart attack may occur at any age, so it is never too early to start a healthy lifestyle. Frequently, obesity and poor lifestyle habits that are picked up by young people tend to persist for their whole lives. Early education and remediation will have a major impact on reducing future risk.
HSO: Is surgery always necessary when an artery is clogged? Are other treatments available?
PT: The main treatment for heart attacks and clogged arteries is a combination of medical therapy and risk factor modification. Depending on the circumstances, this may be all that is necessary. However, there are instances when surgery or angioplasty may be necessary as well. It is important to emphasize that medical therapy and risk factor modification are necessary even after surgery and should be continued lifelong.
HSO: What is the best way to recover after a cardiac event? Are there activities that need to be avoided?
PT: After a cardiac event, most patients need lifelong follow-up and treatment. Underlying diseases and risk factors need monitoring and treatment. It is important to follow through with prescribed medications and periodic check-ups with medical providers. Depending on the cardiac event, patients may be sent to cardiac rehabilitation, which is a critical component of healing. While most patients are initially well-motivated to make changes, without periodic reinforcement, relapses into bad habits tend to occur.
Most cardiac events require a team approach involving patient responsibility, family members, friends and the health care team to stay healthy. The health care team can provide guidance on the activities that may be safely performed and what needs to be avoided.
Athnie McMillan-Comeaux is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
Dr. Praveen Tamirisa
Dr. Praveen Tamirisa is president of ProMedica Heart Institute. A board-certified cardiologist, Tamirisa earned his medical degree at Osmania Medical College in India. He completed a residency in internal medicine at Albert Einstein College of Medicine in New York and fellowships in cardiology and interventional cardiology at Barnes Jewish Hospital at Washington University Medical Center in St. Louis, Mo. Tamirisa is a member of the American College of Cardiology, American Medical Association, Society of Cardiovascular Computed Tomography and American College of Physicians. He practices at ProMedica Physicians Cardiology in Toledo.
