How Well Do You Listen To Your Heart?
This column is the first in a series of four pieces aimed at raising awareness on heart health during February, which is National Heart Month.
In medicine, there are two ways we find that there are problems: When the patient comes to us and tells us they’ve noticed something is wrong, or when we’re checking for something else, such as when we find a patient has high blood pressure during a routine physical exam.
For patients to know when they have a symptom that should be assessed by a medical professional, they need to understand the warning signs. Knowing these can help you listen to your heart, seek help for symptoms and even save your life.
In medicine, certain symptoms are called “mimics.” Simple, non-threatening issues can cause these, but they could also indicate a very serious problem. That’s why we encourage people who experience these to seek medical attention. We would prefer to find the problem when it is minor rather than delay life-saving care.
Several classic, well-known symptoms demonstrate you need immediate medical care. These include:
There are also atypical, or unusual, symptoms that can indicate a heart problem. These include:
- Coughing or unusual burping/belching
- Sensation of heartburn, acid reflux or abdominal pain
- Unusual pain or sensation in one or both arms, the neck, jaw or back
- Non-specific feeling of doom or gloom
These symptoms don’t always present the same way for everyone. The “Hollywood heart attack,” the crushing chest pain that is so recognizable, does not happen in most heart attacks. Women are also much more likely to experience a heart attack as a feeling of pain in their jaw or neck. That is why it is important to know some of the lesser-known symptoms.
Once you consult with your doctor, they can determine if you need further tests or treatment. For non-emergency cases, the next step is a referral to a cardiologist like myself for tests. The test we choose, most of which are non-invasive, depends on the patient’s case. Some work better based on the patient’s body type, gender and medical history. These include:
- Standard stress test: In this test, we conduct an EKG while you exercise on a treadmill. An EKG can tell us if you have a decrease in blood flow in your coronary arteries, which supply blood to the heart itself. When loss of blood supply is severe, the heart muscle can begin to die, which is what a heart attack is.
- Nuclear stress test: During this test, a type of (non-harmful) radioactive dye is injected into your body, which we then watch on a special camera. This allows us to see how blood flows through your heart.
- Stress echocardiogram: This test, which can also be done using radioactive dye, uses sound waves to help us create a picture of the heart. When used during a stress test, we can see the structure and performance of your heart.
Heart diagnostics have advanced greatly in the previous decade. We have more sophisticated technology, which allows to better study the heart and its function. That translates to having a better, clearer picture, of the patient’s heart, and better ability to diagnose and treat problems.
Let’s say we find you do have a blood flow problem in your heart. We could have found it when you came to the emergency room, or we could have found it during a scheduled test. In either case, our priority is to restore blood flow to the heart. In the emergency cases, we simply have to do it more rapidly. The longer the heart goes without blood, the more damage occurs. If the flow is restored quickly, the patient is more likely to have a good outcome.
To restore blood flow, we can use catheterization or surgical procedures such as bypass. My colleague, Dr. Doug Adams, will be writing in this very column next week about surgical procedures and how they’ve changed and advanced over the past few years, so I encourage you to see his column in next Thursday’s Health section.
My area, catheterization, uses three means to restore blood flow:
- Stenting: Tiny devices placed in the blood vessels to hold them open, restoring blood flow.
- Ballooning: Just like it sounds, a tiny medical balloon is inflated in the proper location, widening blood vessels to restore flow.
- Atherectomy: A tiny, sophisticated drill is used to alleviate or remove obstructions in the blood vessels.
One of the biggest advances in catheterization is how we approach the heart. The primary method used to access the heart via the femoral artery, located in the groin area. We still use this artery in some cases, but the vast majority are now done through the radial artery, in the wrist. This is a smaller artery, which makes for shorter and easier recovery for the patient. Patients go home within a few hours, can drive afterward and the biggest limitation is no heavy lifting with the affected arm for a week or so (sometimes longer, if the procedure is more intense). In many cases, patients can return to work in the next day or so.
Getting Back To Living
The most important thing for all individuals, healthy or otherwise, is to take care of themselves. Improving diet, physical activity and managing related conditions is key. Prevention can never start too soon, especially if you have a family history of heart problems, or risk factors like high blood pressure, smoking or diabetes.
Talk to your primary care provider about what you can do to guard your heart health. If you don’t have a primary care provider, get one. All of these will help you take good care of your heart, so it can take care of you.
Dr. Lior Shamai is a board certified cardiologist with Owensboro Health’s One Health medical group. For more information or to request and an appointment with Dr. Lior Shamai, call 844-44-MY-ONE (844-446-9663).
This article originally appeared in the Living Well column in the Health section of the February 4, 2016 edition of the Owensboro Messenger-Inquirer.