Heart Health
February 22, 2010Heart disease is the leading cause of death for men and women. But you can take steps to keep your heart as healthy as possible with some simple tips. For Heart Month, Uma Krishnan, MD provided advice, resources and support on MultiCare’s E-Health Connect Live Chat.
Chat Host
10:53 AM
Welcome to our second E-Health Connect web chat.
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10:54 AM
We'll get started in just a few minutes.
Chat Host
11:00 AM
Today's topic is Heart Health. Dr. Krishnan can provide advice on how to protect your heart, what your risk factors are and what numbers you should know.
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11:00 AM
To ask a question, simply enter your name and email address, click join, then ask your question in the message box. Please note your email address will not be used for any other purpose than to contact you if needed about the chat.
Chat Host
11:01 AM
We'll start with a question that came in via email from Nancy: My doctor has prescribed Niaspan, can I take Niacin instead? It is less expensive.
Dr. Uma Krishnan
11:04 AM
Niacin is short acting and Niaspan is long acting. The chances of flushing with Niacin could be higher. Since Niaspan is a prescription medication it is more regulated by the FDA. Please check with your doctor before you make the change.
Shirley G. Mathis
11:04 AM
Do PANIC attacks effect the heart?
Dr. Uma Krishnan
11:07 AM
Panic attacks can cause palpitations. The symptoms of panic attacks can mimic symptoms of heart disease mainly chest pain, palpitations and shortness of breath. It is important to differentiate if the symptoms are actually due to the heart or due to panic attacks. There is no clear study that shows panic attacks directly affect the heart. Depression is a common symptom in people with heart disease.
Renee Fisher
11:08 AM
What do you think about bioidentical harmones compared to conventional harmones for women with menopausal symptoms and coronary artery disease?
Dr. Uma Krishnan
11:09 AM
When you are referring to conventional hormones are you referring to estrogen progesteron supplements?
Renee Fisher
11:10 AM
yes
Dr. Uma Krishnan
11:11 AM
It's a class III indication which means it is contra-indicated for treatment of post-menopausal with use of hormone supplements according to the ACC/AHA guidelines.
Chat Host
11:12 AM
Here's another question that came in via email from Gretchen: What are the treatment options for an elderly (85 year old) patient for aorta stenosis?
Dr. Uma Krishnan
11:15 AM
It depends on the severity of the aortic stenosis. For mild and moderate aortic stenosis based on the symptoms usually we get an echo cardiogram once every one to two years. No other treatment would be recommended. For severe aortic stenosis aortic valve replacement would be the option. Symptoms to look for would be exertional (or any physical activity) chest pain, shortness of breath, syncope. (Passing out spell or dizziness.)
Stacey
11:16 AM
I’m a 30 year old healthy female tri-athlete and my fellow competitors all are fans of wearing a the heart monitor. Is this really necessary? Are their benefits?
Dr. Uma Krishnan
11:19 AM
I don't see any reasons/benefits for you to wear a heart monitor if you do not have any symptoms. Keep up your exercise regimen.
Stacey
11:20 AM
I have been taking fish oil to help my heart health. Is there a type with less side effects – like the fishy aftertaste and nausea?
Dr. Uma Krishnan
11:21 AM
Unfortunately most fish oil caps that are available in the market do have the fishy after taste. Try freezing the tablets/capsuls and then taking them. I've heard from my patients they have less of an after taste that way.
Chat Host
11:22 AM
Another question that came in via email: Is there anyway to reverse mild heart thickness due to uncontrolled high BP?
Dr. Uma Krishnan
11:24 AM
Yes. Mild heart thickness is clinically referred to as left ventricular hypertrophy. There are proven medications mainly betablockers or ACEinhibitors taken in proper doses can help reverse mild heart thickness.
Jessica
11:25 AM
Is there a birth control that you can recommend that has fewer side effects than others? I keep hearing about how birth control can affect the heart and am worried.
Dr. Uma Krishnan
11:29 AM
You'll have to check with your OB/GYN about taking a birth control pill with the least amount of estrogen/progesteron in it. Normally, we worry about clots in the legs (DVT )when young women are on birth control pills. DVT sometimes can cause clots to the lungs (pulmonary emboli). Usually women who live a healthy lifestyle and are non-smokers have a lower risk.
Kevin
11:29 AM
I'm 30 and my dad has had some seemingly electrical problems (hasn't really been figured out yet) with his heart. What kinds of tests might I have done going forward and do they have to be done by a specialist or can my general doc take care of that?
Dr. Uma Krishnan
11:32 AM
1. Do you have any palpitations, dizziness or syncope. As far as you are concerned certain arrhythmias (electical problems) can run in the family or be genetic. WPW Syndrome can have a genetic background. As far as tests are concerned getting a baseline EKG would be necessary. If you do have any of the above mentioned symptoms then you would need to be seen by a cardiologist for monitoring using a holter.
Kevin
11:34 AM
I don't have any symptoms but am more just thinking about preventative maintenance (aside from diet, exercise, etc).
Dr. Uma Krishnan
11:35 AM
If you do not have any symptoms just get a baseline EKG and wait for the diagnosis from your father's doctor about him.
Karen
11:35 AM
I recently started taking Metformin for early signs of diabetes. Can this cause heart palpitations?
Dr. Uma Krishnan
11:36 AM
It is not a common side effect from the medication. However, if you become hypoglycemic, which means your blood sugars are low, that can cause heart palpitations.
Mary
11:37 AM
How and/or should women take aspirin as a preventative heart attack measure?
Dr. Uma Krishnan
11:41 AM
Excellent question. Women above the age of 55 can benefit from use of Aspirin 81 miligrams a day but it is important to know whether a person falls into the low, intermediate or high risk category for development of heart disease. Studies have clearly shown than women in the intermediate (two or more risk factors) and high risk categories clearly benefit from use of Aspirin. In the low risk category, it is still controversial secondary to a small risk of bleeding.
Joan
11:41 AM
Is it ok to have a brief sharp pain in the chest, under my breast, that goes away with controlled breathing and no other signs? After having the Holter monitor before, someone explained it to me that air gets trapped between your lungs and compresses (?), causing this sharp pain, but then goes away? Something like that???
Dr. Uma Krishnan
11:45 AM
Any pain in the anterior chest would need further evaluation. Sounds like you have had some evaluation done. With chest pains the usual evaluations would comprise an exercise treadmill test, and/or a echocardiogram to further evaluate the chest pain. Most symptoms releated to the heart tend to be exertional which means they can be brought on by physical activity.
Diane
11:46 AM
Is there a relationship between heart health and early hysterectomy? I had one at 39. What can I do to help?
Dr. Uma Krishnan
11:49 AM
As long as your ovaries are still intact, you would not be considered post menopausal. Following a heart healthy lifestyle which included the AHA diet, moderate physical activity at least five times a week, non smoking and knowing your numbers would help you maintain a healthy heart.
Erica
11:50 AM
I am currently taking Toprol-XL for high blood pressure. Since starting to take it I have been getting dizzy at times. I know that is one of the side effects. Can you recommend some other options I can talk to my doctor about?
Dr. Uma Krishnan
11:53 AM
Dizziness could be related to either the medication itself or due to low blood pressure. Since it is long acting, one option would be to try taking it at bedtime. Other options as far as medications are concerned could be ACEinhibitors and/or diuretics.
Dr. Uma Krishnan
11:54 AM
February is national heart month. We all need to be aware that heart disease is the number one killer of women and men. However, 80% of heart attacks could be prevented. Knowing your risk factors is extremely important.
Dr. Uma Krishnan
11:54 AM
Risk factors include:
Dr. Uma Krishnan
11:56 AM
Age > 45 in men and age >55 in women. Smoking, high blood pressure, high cholesterol, family history of having heart problems, and diabetes. Diabetes in women is considered as a CHD equivalent which means they are considered as very high risk for developing heart disease.
Dr. Uma Krishnan
11:57 AM
30 minutes of moderate physical activity at least five times a week and following the AHA diet will help us keep our hearts strong.
Kevin
11:59 AM
Can you provide a link to more info related to the AHA diet?
Dr. Uma Krishnan
12:00 PM
Sure. Please visit aha.org. (American Heart Association) It should have the information to the diet on their website.
Chat Host
12:01 PM
Thanks everyone for participating. Take a personal heart risk assessment on our website at http://www.multicare.org/home/heart-disease-risk/ .