S

The leading cause of death in America is heart disease. Knowledge is the key to understanding your personal risk factors and seeking preventive measures, diagnosis and treatment for heart disease. Preventive care visits with your primary physician help you remain proactive with your health and enable early management of disease risk factors.

Heart disease is an issue of life and death that affects virtually all Americans. Heart disease manifests with arrythmias, cardiomyopathy and dysfunction of the heart muscle. The most common course of heart disease is ischemic disease (also called coronary artery disease) caused when blood vessels to the heart become obstructed with plaque. Plaque causes narrowing which disrupts the flow of blood and oxygen to the heart. This can lead to heart attack or stroke.

The greatest risk factors for ischemic heart disease are family history, smoking, hypercholesterolemia, diabetes and hypertension. Knowing these risk factors behooves us all to improve our health by modifying the above risk factors. Outside of genetics, the other risk factors can be modified with a healthy lifestyle. These include exercising on a regular basis, getting adequate rest at night, following a healthy diet and smoking cessation. These are all means by which we can modify our risk factors. 

Arrhythmias occur when there is a disruption of the electrical signals to the heart. Our heartbeat fluctuates throughout the day, and we expect changes with exercise and rest. The most common arrythmia is atrial fibrillation (A-fib). With A-fib the chambers of the heart quiver and have an irregular beat. The heart is unable to fill and pump adequately. This irregular rhythm can allow blood to pool, which is associated with clot formation and can lead to strokes.

Risk factors for atrial fibrillation include advancing age, hypertension, obesity, ischemic heart disease, European ancestry, diabetes, chronic kidney disease, moderate to heavy alcohol use, heart failure, smoking, and enlargement of chambers on the left side of the heart. Treatment for atrial fibrillation can include medications, blood thinners to reduce the risk of clot formation, surgery, lifestyle modifications and management of associated risk factors.

Cardiomyopathy is due to weakness in the heart muscle. The heart muscle can thin out, thicken, stiffen or fill with other substances that inhibit the ability of the heart to work efficiently. This alters the heart’s pump action which results in decreased perfusion of blood. This can cause irregular heartbeats and fluid backing up into the lungs or other areas or the body. These signs and symptoms are commonly referred to as CHF.

Cardiomyopathy risk factors include family history of cardiac disease, endocrine disorders, autoimmune disease with involvement of connective tissue, CAD or history of heart attack, diseases that cause heart damage, infections of the heart muscle and long-term use of alcohol or cocaine. Lifestyle modifications under the direction of your physician and treatments with medications related to associated risk factors aim to slow down disease progression.

It is amazing how much advancement has occurred with the treatment of ischemic heart disease. The ability to reverse a myocardial infarct or treatment of advanced coronary artery disease with bypass or coronary angioplasty is now commonplace. In the event anyone has chest discomfort or undue shortness of breath with exercise, appropriate follow-up with your local doctor is paramount. A simple EKG may not reveal the presence of significant disease. In the event of the above-mentioned symptoms, further advanced testing with exercise and/or angiography is appropriate.

Be proactive. Don’t wait until a heart event occurs. Eat healthy, exercise, get your rest, live a peaceful, wholesome life, and see your physician for an oil check periodically.

Dr. Bills is an internal medicine physician at Vanderbilt Internal Medicine in Tullahoma, Tennessee.