How A Heart Attack Could Save Your Life

Why one man is grateful for surviving a “widow maker” and how you can prevent one

Actor and Director, Kevin Smith, suffered a massive heart attack in February. From his hospital bed he Tweeted, “The Doctor who saved my life told me I had 100% blockage of my LAD artery (aka “the Widow-Maker”). If I hadn’t canceled show 2 to go to the hospital, I would’ve died tonight. But for now, I’m still above ground!”

What Is A Widow Maker?

Dr. James O’Brien, a board certified cardiologist with Capital Cardiology Associates, agrees that a “widow maker” is a definite life changer. “The widow maker is the form of a blockage in one of the main arteries of the heart called the LAD or the left anterior descending artery. They call it the widow maker because that artery is responsible for a lot of muscle.” In Smith’s case, he started feeling nauseous, sweating heavily and threw up. He also said that his chest felt heavy. He was quickly taken to the hospital. “He was very lucky that he caught this early,” notes O’Brien. “As a result of that, he will be able to make changes in his life.”

After the first show this evening, I had a massive heart attack. The Doctor who saved my life told me I had 100% blockage of my LAD artery (aka “the Widow-Maker”). If I hadn’t canceled show 2 to go to the hospital, I would’ve died tonight. But for now, I’m still above ground! pic.twitter.com/M5gSnW9E5h
— KevinSmith (@ThatKevinSmith) February 26, 2018

Why Men At 40 Should Know Their Risk

There are three main factors that determine your risk for heart disease: stroke, or a heart attack: your diet, exercise or activity level, and family history. In Smith’s case, he was admittedly overweight. In 2010 he said he was booted from a Southwest Airlines flight for being too large for one seat. Smith also admitted to an unhealthy lifestyle, smoking marijuana, working late hours, with little to no daily exercise or physical activity. With his diet and exercise lacking, Smith’s risk of heart attack tripled with a family history of heart disease. His father died from a massive heart attack, as Kevin described as, “screaming for his life.”

Two months after his heart attack, Smith spoke out, encouraging men to use his experience as a life-changing moment for themselves. “The heart attack was the best thing that ever happened to me,” said Smith. “I didn’t know until I was in the operating room that I had a heart attack. I didn’t feel it, I didn’t recognize that it was happening.” He was also told he had to make lifestyle changes. Smith has lost over 30 pounds since the heart attack on a plant based diet. “What worked for me was reading Penn Jillette’s book, ‘Presto‘ where he talks about losing 100 pounds.” In the book, Jillette went on a potato and plant based diet. Smith also joined Weight Watchers with the hopes to lose 25 more pounds.

Dr. O’Brien recommends the Mediterranean Diet for patients with heart disease. “It’s basically a push away from animals (as a protein source) and over to plants. It’s more fruits and veggies, fish as away to cut down on animal products including butter, substituting olive oil.” The Mayo Clinic reports that the traditional Mediterranean diet reduces the risk of heart disease. The diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol that’s more likely to build up deposits in your arteries.

Written by: Michael Arce, Media Specialist

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

National Men’s Health Month

Heart Disease, Heart Health

National Men’s Health Month

If you are a man in your 30’s,
here’s why you need to get
your risk of heart disease
checked this month

“Recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue.” — Congressman Bill Richardson (May 1994)

This month: Eat Healthy, Get Moving, and Make Prevention a Priority

June is the month we celebrate the men in our lives. From the handmade gifts, ties, tools, BBQ accessories, or golf clubs we give dad on Father’s Day the one thing dad could do for us starts with a simple talk with his doctor. The most important men in our lives ironically put their own heart health as a relatively low priority. Dr. Lance Sullenberger, a board-certified cardiologist at Capital Cardiology Associates, urges men to take a more active role in their heart health – today. “Men, as young as in your twenties, you should be thinking, ‘What can I change now to start preventing future problems?’ We were all in our 20’s once, 66 seems a long way away but 40 is not that far. We see plenty of patients with heart attacks and strokes in their 40’s.”

Three Steps This Month

Three simple steps to building good heart healthy lifestyle choices

Eat Healthy

Start by taking small steps like saying no to super-sizing and yes to a healthy breakfast. “Once you enter your 30’s and are about the age of 35 it is much hard to obtain a lower weight after the age of 35. You can’t just exercise your way into it, you have to employ choleric restriction as well as exercise. If you’re learning health habits on how to eat, make exercise a priority, then you are on the right track than most patients,” says Dr. Sullenberger. Eat many different types of foods to get all the vitamins and minerals you need. Add at least one fruit and vegetable to every meal.

Get Moving

Play with your kids or grandkids. Take the stairs instead of the elevator. Do yard work. Play a sport. Keep comfortable walking shoes handy at work and in the car. Most importantly, choose activities that you enjoy to stay motivated for at least 30 minutes a day.

Make Prevention a Priority

Many health conditions can be detected early with regular checkups from your healthcare provider. Sullenberger adds, “Once you move to your 30’s and certainly into your 40’s then you see where those lifestyle changes and especially genetics are playing more of a role. For those patients, I usually sit down and go over what their risk factors are. Is it smoking, high blood pressure, high cholesterol, what’s their family history? And then we start to look at lipid levels, blood pressure levels and see who needs to be medicated. There are multiple different ways to determine that.”

Assessing Your Risk

When a physician is seeing a patient in front of them, from a cardiac perspective there are two major types of patients: patients with symptoms and patients without symptoms. “The vast majority of patients are patients without symptoms, they don’t come in with chest pain or shortness of breath. What I or any other provider are trying to determine is, what is the chance that this person is going to have a heart attack that is unexpected, or die of cardiovascular disease, or have a stroke — unexpectedly? There have been multiple ways over the years that we have tried to determine what that risk is. Initially, it was just with stress testing but that has multiple failures in terms that the people without symptoms in just looking for the unexpected plaque in the patient that doesn’t have any symptoms. Then there are mathematical models based on population studies that we put factors into an app like age, sex, blood pressure, diabetes, cholesterol levels, tobacco use, and race. What comes out is a mathematical prediction of what this patient’s risk of having a heart attack or dying of cardiovascular disease or having a stroke is over the next ten years,” says Dr. Sullenberger.

But those models not only change over time, as do population studies, they include a lot of people who won’t actually have an event and sometimes they miss people. As Dr. Sullenberger shared, “Where we find they miss is in family history because there are certainly people who have a strong genetic predisposition to coronary disease who have normal lipid levels, blood pressure, normal body weight, and do the right things yet are still predisposed. When these mathematical models were created there was no way to account for all the variances and nuances of family history and it didn’t really pan out as something that was included in those mathematical models.”

When your primary care physician assess your risk, they may order a cardiac CT (computed tomography) scan which provides a high-resolution three-dimensional image of the moving heart and great vessels. A CT scan is a low-risk procedure that has been around since the 1990s. The CT scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views of the body. “With this technology, we can see if there is plaque in the arteries. That plaque can then be scored using a software package that uses the number of pixels and density that gives us a score,” notes Dr. Sullenberger”

Studies since the early 2000s have been longitudinal, meaning the patient populations who have been scored have been followed for years; we now have five-year, ten-year, and now twelve-year data on calcium scoring. That data shows us that number, your score, is directionally proportional to event outcomes making it the most predictive model we have for determining whether or not a patient who has symptoms is going to wind up having a heart attack or what their risk of heart attack, stroke, or dying from cardiovascular disease is over the near future. “When I look at calcium scoring, I usually start thinking about calcium scoring people in the mid-30s, especially if they have a strong family history. Certainly people over 40. Above that age, I think everyone should at least consider or discuss with their physician if calcium scoring is appropriate for them,” adds Dr. Sullenberger. What we know from studies that have been done is that a calcium score of zero gives you the best prognostic information of any test that anyone can do for you at any time regarding your cardiac health. A calcium score of zero gives you a risk of somewhere in the range of .5% risk of heart attack over the next five years on an annual basis and there’s nothing else, no math model, no stress test, or anything else. Scores above zero are abnormal and the height of the score is indicative of increased risk. “The highest score I have ever seen asymptomatic person was in the 12,000 range, which is very unusual. The peak high score we see is in the low thousands, I usually tell people 2,000 is the highest we’ll see in a week of doing scoring.”

Dr. Sullenberger with Quinn & Cantara

PYX 106

Listen to Dr. Lance Sullenberger discuss Calcium Scores and CT scanning on the Quinn and Cantara Morning Show, PYX 106.

Women go to the doctor more often than men, particularly in their reproductive years, according to a 2016 study conducted by the University of Sydney. One reason women see their doctor more than men is mainly for gynecological and reproductive health visits. Women also have health screening tests earlier in their lives than men. Since women are more familiar with their health care provider, they also tend to be more forthcoming when discussing their personal health. Dr. Sullenberger noted this difference in visits with his patients. “Women will expound upon their symptoms and tell you about it. With men, you really have to pull out the details. I can tell you that as a physician it’s important that give those details up to make sure that those aren’t important to the development or workup of a symptom.”

During Men’s Health Month one statistic we would like to see changed is this: men are 24 percent less likely than women to have visited a doctor within the past year. Guys, if you haven’t seen your doctor for a check-up this year, you are not alone. “I am around doctors all of the time and I am reluctant to go to the doctor,” admits Dr. Sullenberger. “It is important, much like, you wouldn’t drive your car forever and never take it in to be serviced. That’s just not smart. You need to take your body in, get it serviced, see what’s going on, see what’s under the hood. You are much better off finding things that can be changed before they become life-altering than having that problem develop into an emergency room visit or hospital stay that could have been prevented.”

If you have a family history of heart disease or have questions about your risk of heart disease, stroke, or heart attack — talk with your doctor. “The first person to talk with is your primary care physician,” points out Sullenberger. “Address what your concerns are. Most primary care physicians especially in this area respect that a lot. In this area, primary care physicians are very familiar with coronary calcium scoring and are comfortable ordering the test and dealing with the results of it. If you want more than that, you can always ask your physician for a referral, alternatively at Capital Cardiology Associates, we see all patients even if they don’t have a referral. We have an Enhanced Cardiac Access Suite, our walk-in clinic, for people to be seen. We are always open to seeing patients even if they haven’t been referred by their primary care physician.”

Written by: Michael Arce, Healthcare Marketing Consultant for Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

Traveling with Heart Disease

Heart Disease, Heart Health

Traveling with Heart Disease

How to plan for a summer vacation

Memorial Day signals the beginning of summer vacation season. Whether you are traveling or expecting visitors, vacationing isn’t off limits to heart disease patients. In fact, with a little planning your trip can less stressful, relaxing, and fun!

“The biggest thing to start with is planning,” states Mary Ellen King, Nurse Practitioner at Capital Cardiology Associates. “If I had a patient that had a recent cardiac event, heart attack, stents, or a new pacemaker implant, it is helpful to let your doctor know what your travel plans are. We can offer some suggestions and make sure that we contribute to that plan before you leave.”

Plan with your doctor

Discussing your travel plans with your health care provider helps address many questions you have about medications, safety, and travel restrictions. As King points out, “Making sure that you have all of your medications with you. That you are thinking about where you are going and what access to medical care you will have. The more you plan in advance, the smoother your trip will be.” Whether you are planning a trip by plane or heading up to Lake George for a week, make sure you are aware what medical services will be available to you. “If you are coming to an area like Albany where we have access to medical facilities, hospitals, urgent care that’s pretty straightforward. But if you’re going camping in Montana you need to think differently. How far is it to the nearest emergency room? What resources are there? Again, planning is key. If you know people in the area that you are visiting, find out from them. You can also get help from your primary care doctor and cardiologist on finding nearby medical facilitates. You don’t want to be stuck with an emergency and then have to come up with a plan.”

Traveling can be difficult for anyone, do yourself a favor before you leave and check ahead. King advises patients with pacemakers or Implantable Cardioverter Defibrillator (ICD) to, “Have your wallet card with you so that as you go through airport security or airline check-in areas you can show them.” You should also talk with your doctor about your implanted device and airport security. With most pacemakers, it’s safe to walk through metal detectors now; it’s a good idea to check if yours is one of these. Walking through the full body scanner will not harm your pacemaker either. If you have a stent, it is safe to walk through metal detectors and full body scanners. You should tell the agent before you step in of your implanted devices as they will be seen on full body scans. Your wallet card can help explain your device/implant at security checkpoints. If you are in doubt, ask for a hand search by a TSA agent.

THE WATCHMAN

The One Time Procedure For People With Atrial FIBRILLATION

LEARN MORE

If you are traveling, you will also want to talk with your doctor about your medications. “Give your medications the same level of detail as the outfits or clothing you are packing for your trip,” advises King. “If you are taking insulin, make sure you have a way to keep your medication cool or refrigerated. Patients taking nitroglycerin for chest pain, has your bottle been opened? It will expire after six months of being opened. The medicine has to be in a dark container. The same planning ahead applies; you wouldn’t want to be somewhere with chest pain or discomfort with a medication that is not effective because it wasn’t stored properly or is past the expiration date.” Having a written copy of your current medications which can serve as your personal health passport, is strongly recommended too. “Make sure you have a current list of your medications because I can tell you, there is nothing more frustrating than when asking a patient what pill they take for the blood pressure and their answer is, ‘The little blue one.’ Bring a current list of your medications not the little one that is folded up in your wallet and has been in your back pocket for five years. List out your medications, what the strength of the pill is, how often you are taking it. Make sure you have your local doctors names and phone numbers. If you have to see a provider on your trip, the phone call home for help is much easier. Again, make sure you have enough of your medications. You should keep them in your carry-on bag, not your check-on bag, in case you and your luggage are separated.”

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If Driving or Flying

Avoid sitting for long periods of time. Sitting for long periods of time increases the risk of swelling in your legs which can lead to Deep Vein Thrombosis (DVT). DVT is when a blood clot forms in a vein deep inside your body, most commonly in the legs. This is condition is dangerous because the clot can break free and travel through the bloodstream to the lungs. Your doctor may advise your to wear compression stockings when you talk about your long-distance travel plans as well as recommend that get up to move or walk for 5-10 minutes every hour or two.

Planning Your Home For A Visit

If you are hosting a heart patient this summer there are few things you should know. “Most patients with heart disease and certainly those with heart failure or difficulty breathing; air condition is a must have, fans at a minimum,” recommends King. Besides a comfortable climate, simple accommodations can help provide a relaxing visit for you and your guest. “Making arrangements that your guest can be on the first floor of your home will be helpful for patients that have difficulty moving or getting around. Again, some of this may sound like common sense but a small consideration like, making sure there are enough power outlets in the room. While that may sound silly, if there is medical equipment, like a CPAP (Continuous Positive Airway Pressure) machine, it will need to be plugged in near the head of the bed — that makes a difference,” said King.

As the host of a family member or friend you can also prepare by planning outings that won’t exhaust your company. Make sure plenty of healthy snacks and water is available. As King cautions, “The other important piece of traveling is diet. That is probably the biggest triggers for problems. When we get our of our meal times and routines, that alone can cause problems by itself.” Plan home cooked meals that fit within their diet plan. Get some great tips here along with a tasty twist on a summer salad dish. When dining out, seek out restaurants that respect dietary restrictions and requests. “Vacations are a lovely thing but you still need to take care of yourself.”

Written by: Michael Arce, Social Media Specialist

Information provided on this website is neither intended nor implied to be a substitute for professional medical advice and is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Your should not use information on this website or the information on linked from this site, or the content on the website (or any part thereof), to diagnose or treat a health problem or disease without consulting a qualified healthcare provider If you have or suspect you have an urgent medical problem, promptly contact a professional healthcare provider. CCA advises you to always seek the advice of a physician or other qualified health provider proper to starting any new treatment or with any questions you may have regarding a medical condition. Any application of the recommendations in this website is at the reader’s discretion.

Understanding Stroke

Heart Health

Understanding Stroke

Prevention is the best cure for stroke

May is National Stroke Awareness Month

When blood flow to a part of your brain is stopped, you can have a stroke. Without oxygen and nutrients from the blood, brain cells die quickly. A stroke can damage your brain. It can even kill you. According to The National Stroke Association, stroke is the fifth leading cause of death in the U.S.

What happens

Director of Clinical Research, Dr. Robert Benton explains how a stroke event is similar to a heart attack. “Essentially for both of them you have an instance where you’re losing blood flow to a part of the brain or the heart. That is the common finding in both of them. In the heart, usually, this is caused by a cholesterol plaque that has become inflamed, ruptures because you are smoking, or because you have high blood pressure, and there’s a blood clot that forms and blocks blood flow to the heart. When the heart muscle doesn’t get blood, it dies. The brain is similar in that you can have plaque in your brain but the brain is also susceptible to other findings, that would be emboli that fly either from your neck, clotting breaking off from the arteries or the aorta, or one of the common causes of stroke called, atrial fibrillation (AFib).”

Atrial fibrillation, also called AFib or AF, is a common kind of irregular heartbeat that often rapid heart rate that commonly causes poor blood flow. It is quite common in the United States with more the 200,000 cases reported every year. At least 2.7 million Americans are living with AFib.

Many people with AFib are unaware of the five-times greater risk of stroke as a result of having AFib. The average person with atrial fibrillation, or AFib, is 5 times more likely to suffer a stroke than someone with a regular heartbeat. People with untreated atrial fibrillation may be at greater risk for stroke than people with normal heart rhythms because blood does not flow through the atria regularly, blood clots may form in the heart. If a blood clot escapes from the heart, it can travel through the bloodstream to the brain and cause a stroke.

There are two main kinds of stroke

One is called an ischemic stroke. This can happen when a sticky, fatty material called “plaque” builds up in a blood vessel in your brain. Plaque slows your blood flow. It may cause your blood to clot. This can stop the flow of blood completely. This kind of stroke can also happen when a clot travels to your brain from another part of your body, even if you don’t have plaque in your vessels.

The other kind of stroke is called a hemorrhagic stroke. It happens when a blood vessel leaks into your brain, or into the space around your brain. Hemorrhagic strokes are less common, in fact only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths.

Causes of stroke

There are three main areas of stroke risk factors: lifestyle, medical, and uncontrollable. Dr. Benton advises that we work with our doctor to identify our personal risk factors for stroke as we would with heart disease. “Heart attack and stroke can have very similar risk factors that lead to them. Smoking, hypertension, high cholesterol, diabetes, a sedentary lifestyle… all of those things can contribute to your risk.” Tobacco use and smoking double the risk of stroke when compared to a nonsmoker. Smoking increases clot formation, thickens blood, and increases the amount of plaque buildup in the arteries. “People can have a genetic pre-disposition to stroke: high blood pressure, arrhythmia, cholesterol levels, these things can be genetically programmed. Then you do yourself no big favor by smoking cigarettes, eating a poor diet, not exercising where you can compound your genetic disposition for stroke with poor or bad lifestyle choices. Those two factors really work together,” pointed out Benton.

Prevention is the best cure for stroke

The good news is, 80% of strokes can be prevented. “Strokes are as preventable as a heart attack and they are actually quite similar,” states Mary Ellen King, Nurse Practitioner at Capital Cardiology Associates. “With heart attacks people know eat a healthy diet, manage cholesterol, exercise and a stroke is the same thing.” Ultimately, regular visits with your healthcare provider will assess and monitor your risk for stroke.

Most importantly if you are over the age of 60 and haven’t been checked for AFib, see your doctor. “Most people with AF don’t feel it. We find it on an EKG. Or a pacemaker, heart monitor, or they are wearing their FitBit or Apple Watch, whatever it is, they notice their heart rate is jumping all over the place and it’s faster than what it used to be.” Early detection of stroke is the biggest element in prevention. “The time piece of identifying stroke is so important because the longer that part of the brain goes without blood and oxygen supply, the worse the outcome is. Unfortunately, people live through strokes but they can be very debilitating and life altering,” explained King.

May is National Stroke Awareness Month. Capital Cardiology Associates proudly supports the American Stroke Association and urges all area residents to see your doctor to identify your stroke risk factors and assess your prevention plan.

Written by: Michael Arce

National Women’s Health Week

Heart Disease, Heart Health

National Women's Health Week

The risk for heart disease is now important for women too

During National Women’s Health Week each year, millions of women are reminded to make their health a priority and build positive health habits for life. When it comes to women’s heart health, their risk is often overlooked due to the misconception that heart disease affects men in larger numbers. In fact, cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year. That’s approximately one woman every minute.

Dr. Robert Benton, Director of Clinical Research at Capital Cardiology Associates, explained the need for women to take a more active role in their heart health, “there is sometimes a bias against working up women, they tend to get under treated because they also tend to minimize their symptoms.” After all, only 1 in 5 women view heart disease as their greatest health threat, according to the American Heart Association. “Women are the caregivers and caretakers in families,” says Benton. “If they don’t feel well they tend to say, ‘I think this is something else… I have a virus… I have things to do around the house.’ Whereas men get a little twitch on their toe and they run right in to see their doctor to have it evaluated. Women need to understand that their risk for heart disease, heart attack, and stroke is just as great as a man’s.”

One of the exams covered under preventative services by most health insurance plans is a Well-Woman Visit – sometimes also called an annual physical, wellness visit, or well woman exam. During this annual physical, you and your doctor would discuss your health concerns, identify risks before they become threatening — like heart disease or stroke. Dr. Benton commented that many times, a discussion on the risk of heart disease can take both the patient and their physician by surprise. “I can tell you that many times I have had female patients that have come to the office that had very vague symptoms that even I’m surprised we were able to find heart disease because the symptoms are so mild. Cardiologists, despite our sensitivity for this and looking for the unique heart disease symptoms in women can miss the boat at times without doing proper testing. Women really need to be very cognizant of changes in the way they are feeling, either fatigue, shortness of breath, back pain, upset stomach – those kind of symptoms definitely warrant speaking to your primary care doctor or asking for a referral to be seen by a cardiologist for an evaluation.”

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The biology of women’s bodies produces different risks than men’s. Benton noted that, “A woman’s heart is affected by hormones in a different way. They certainly smaller, and believe it or not, when they do come in after a heart attack we do have trouble treating them. Their arteries are a little smaller, their disease can be a little bit more difficult to diffuse. Women also present with atypical symptoms and usually later in life. They may complain of back pain, fatigue, nausea, maybe sweating. Things you don’t normally think about with heart disease.”

The first step is to know your numbers. If you haven’t talked with your doctor about your Blood Pressure, Cholesterol, Blood Sugar and BMI (Body Mass Index) — schedule an appointment this week. Your heart health depends on it.

Written by: Michael Arce, Media Specialist

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.