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Providing a speedy diagnosis, followed by proper treatment allows our patients to receive the best possible prognosis in their recovery to full health. Determining what type of cardiac condition a patient is experiencing is vital in expediting suitable treatment.
Cardiac health can prevent heart disease and save lives. Assess your heart health and learn more about maintaining a healthy heart with the
Assess Your Health: Heart Disease Risk
article and quiz.
the most common type of heart disease and a leading cause of death in
the U.S. It can largely be prevented with healthy lifestyle choices.
The coronary arteries supply blood directly
to the heart and are a vital element in the function of the heart
muscle. As fatty material and plaque build up in the coronary artery,
blood flow is slowed or even completely stopped, resulting in chest pain
(stable angina), shortness of breath, heart attack or other related
symptoms. This can quickly become a life-threatening emergency.
Any type of damage or blockage to a coronary
artery directly affects the heart. As plaque builds and narrows the
artery's passageway, the danger of a complete blockage greatly
increases. A small clot of blood may attempt to pass through the narrow
pathway and become lodged, leading to a lack of oxygen to the heart.
Coronary Artery Disease is caused by a condition called atherosclerosis,
or the hardening of the arteries due to plaque buildup. Cholesterol in
the bloodstream is the main cause of the plaque buildup. Cholesterol
enters the bloodstream a couple of ways: through liver production and
consumption of meat and dairy products.
the plaque collects along the artery wall, it begins to narrow and
harden the artery passageway. Eventually, blood flow is slowed and
cannot properly feed the heart, which reduces the effectiveness of the
heart muscle. The heart muscle attempts to compensate for the lack of
oxygen-rich blood by increasing outflow until the muscle becomes
fatigued and can no longer function properly.
Another risk of atherosclerosis is
embolization, the breakaway of a piece of plaque that can travel to a
smaller blood vessel and cause a blockage. This is a common cause of
heart attack and stroke. If the plaque finds its way to the heart, lungs
or brain, it can cause a stroke, heart attack and pulmonary embolism or
contribute to the weakening of an artery wall leading to an aneurysm.
Studies are being conducted on patients with
high levels of inflammation-related substances including C-reactive
protein and fibrinogen. Increased levels of homocysteine have also been
linked to heart attack risk.
It is possible to suffer from coronary artery disease and not experience any symptoms. For others, symptoms are obvious with the most common being chest pain and discomfort (angina).
The pain is an indication that the heart is not receiving the proper
amount of blood or oxygen. It can be particularly noticeable during
increased activity. Patients experience varying levels of discomfort and
Women, the elderly and diabetics are more
likely to have fatigue, shortness of breath and weakness as symptoms of
coronary artery disease.
If it is suspected that a patient may be
suffering from coronary artery disease, a number of physical exams and
diagnostic tests can be performed. Lifestyle changes may be recommended
to reduce symptoms, prevent further complications and improve heart
functioning. The following are helpful in treating and preventing the
effects of coronary artery disease:
Cholesterol and triglyceride levels should
be checked regularly to avoid the progression of coronary artery
disease. It is recommended that adults keep their LDL "bad" cholesterol
levels below 130-160 mg/dL. The balance between "good" and "bad"
cholesterol levels is important for overall health.
If treatment is recommended, a
cholesterol-lowering drug may be prescribed, however, few medications
have been found to clear plaque. Some patients may benefit from aspirin
or anti-platelet drugs to prevent blood clots. Hormone replacement
therapy is sometimes used for menopausal patients. It is important to
consult a physician before beginning any type of treatment regimen
whether using over-the-counter or prescription drugs.
If necessary, surgery can be performed to
treat the condition. Examples of possible surgical treatments include
angioplasty, stent placement, abdominal aortic aneurysm repair, coronary
artery bypass surgery, carotid artery surgery and minimally-invasive
Contact your health care provider if you are
at risk for atherosclerosis, especially if symptoms are present.
Consult your physician when starting any type of exercise plan. This is
particularly important for patients with coronary heart disease or those
who have experienced a heart attack.
recipient of the American Heart Association's "Get With the Guidelines"
Heart Failure and Stroke Gold Performance Achievement Award in 2012,
Littleton Adventist Hospital ensures that each patient receives
excellent care and treatment in cardiac services.
may affect only one side of the heart, however, the condition more
commonly affects both sides. As the heart works to provide enough blood
to feed the body, it overextends itself and eventually becomes weakened.
The kidneys respond to this condition by causing the body to retain
water and sodium. Fluids collect in the arms, feet, ankles and other
organs and the body becomes congested - and is termed congestive heart
Heart failure occurs when disease affects the heart in one of the following three ways:
1. Weakening the heart muscle.2. Stiffening the heart muscle.3. Increasing the demand for oxygen by the body's tissues beyond what the heart can supply.
Your heart fills and empties with each beat.
The filling process is called diastole and the emptying process is
called systole. When the lower chambers (ventricles) of the heart
contract, blood pumps out to the rest of the body. After emptying, the
heart muscles relax and blood flows from the upper chambers (atria) of
the heart into the ventricles.
Both systolic and diastolic heart failure
result in the deficiency of oxygen-rich blood throughout the body. The
effects are particularly noticeable during exercise or increased
Some patients show no symptoms prior to heart failure.
If congestive heart failure is suspected, a full evaluation may be performed to determine the condition of the heart.
The following are tests that may be ordered:
These, along with urine, blood chemistry and
other lab tests can provide further information on the severity of the
condition and help physicians determine the best care for the patient.
Centura Health at Home is the first in Colorado to implement a telehealth system
that allows us to monitor patients through the use of a two-way video
monitoring station. This ability to see patients in-between regular home
visits allows Centura Health at Home to reinforce the education process
and to maintain closer contact with patients.
If the heart is in danger of heart failure,
exams will be scheduled every three to six months to monitor the
progression of the disease. One way to track the condition at home is to
watch for weight gain - increased water retention can be a sign that
the heart is worsening.
Other helpful suggestions include:
Some cases may require heart valve surgery,
coronary bypass surgery (CABG) or angioplasty to improve the functioning
of the heart.
Certain devices may be recommended including:
When heart failure is severe or a patient is awaiting a heart transplant, the following my be required:
These devices are not permanent solutions but can be life saving. If a patient becomes dependent on circulatory support, a heart transplant will be necessary.
Contact a physician if experiencing
weakness, increased cough or sputum production, sudden weight gain or
swelling or unexplained symptoms.
It is the leading cause of
death in the U.S., however, up to 95% of patients hospitalized due to a
heart attack survives. Littleton Adventist Hospital is more than 30
minutes faster than the national standard for heart attack intervention.
commonly referred to as a heart attack, occurs when the blood supply to
the heart has been blocked and prevents oxygen from reaching the heart.
A mild form of myocardial infarction is called acute myocardial
An ST-segment elevation myocardial
infarction (STEMI) is a type of heart attack that takes place when the
coronary artery is completely blocked off by a blood clot. While the
signs and symptoms are similar to a non-STEMI, a STEMI is more severe
with a larger portion of the heart already in danger of damage or death.
A heart attack is often caused by a blood clot
in one of the coronary arteries, which slows or stops the amount of
blood and oxygen to the heart. When the blood flow to the heart is
blocked, the cells in the heart begin to die.
A second cause of a heart attack is a condition referred to as atherosclerosis, when plaque builds up in the walls of the coronary arteries. A heart attack may be induced by sudden, significant emotional or physical stress. Other contributing factors of a heart attack may include:
Symptoms of a heart attack are often slow to
progress and may even come and go. It is important to recognize them
and seek medical attention immediately. Men and women experience
different symptoms of a heart attack.
If any of the above symptoms are present, it is important to call 911 immediately.
Every minute counts. Giving symptoms five minutes to subside may be too
long to wait if you are experiencing an actual heart attack. Dialing
9-1-1 is the fastest way to receive medical attention, as an EMS team is
prepared to care for a patient experiencing heart failure and has
lifesaving equipment on board. A patient riding in an ambulance will
receive medical care up to one hour before a patient riding in a car to
While a heart attack may not always be stopped, there are ways to assist in preventing one.
heart attack is a serious condition. If symptoms of a heart attack are
experienced, it is important to seek medical attention immediately.
Tests a physician can provide to examine the heart include:
There are also blood tests that can be given:
While traditional heart attacks are
generally caused by a physical blockage of an artery resulting from
plaque buildup, these types of heart attacks occur from sudden, reduced
blood flow to the heart produced by a surge of stress hormones. X-rays
of Takotsubo patients reveal a bulging of the left ventricle created by
increased levels of fight-or-flight hormones such as adrenaline and
media attention in the month of February, and on Valentine's Day, this
condition is often referred to as Broken Heart Syndrome because of its
connection to lost love. First discovered in Japan, it is also termed
Octopus Heart, as the ballooning of the left ventricle of the heart
takes the shape of the "Tako-tsubo," a pot used by Japanese fishermen to
Most commonly occurring in post-menopausal women, this stress cardiomyopathy,
or sudden weakening of the heart, is often triggered by the unexpected
death of a loved one, a relationship break-up, a startling medical
diagnosis or a severely stressful emotional situation. Most patients
survive this type of heart attack with a rapid recovery of about one
week to full health, and no lasting side effects, as the patient is
generally in good health and lacks physical indications of heart
problems; thus the mystery behind this condition.
Takotsubo mimics a heart attack with similar symptoms, such as chest pain and shortness of breath. It should be treated as a serious medical emergency - dial 911 immediately.
Some side effects of the condition may
include an irregular heart beat and fluid in the lungs. A short hospital
stay may be necessary to monitor these symptoms. A second occurrence of
Takotsubo is also a risk, particularly if the patient is still
experiencing an increased amount of stress.
Many diagnosis of Takotsubo are performed in
an emergency setting, however, if the appointment is made ahead of time
and symptoms can be explained in detail, it can be helpful. Patient
journals of stress and symptoms should be detailed as to the types of
symptoms experienced, as well as the emotional state of the patient
before, during and after.
Because this condition may first appear to
be a traditional heart attack, it is treated as such until a diagnosis
is confirmed. Treatments used for arterial blockage, such as angioplasty
or stent placement, which would be performed for a regular heart
attack, will not help patients suffering from Takotsubo. Blood pressure
medications may be prescribed as the patient recovers in the hospital
and beta-blockers are sometimes used long-term to help reduce the effect
of stress hormones on the heart muscle. A one-week hospital stay to
monitor a complete recovery is often the extent of the treatment
What are the Signs of Sudden Cardiac Arrest?A
person suffering SCA immediately loses consciousness. The affected
person does not have a pulse and signs of breathing are not present.
What are the Risk Factors?An
individual may be at risk if he/she has a family history of heart
disease, smokes, drinks too much alcohol, has high blood pressure or
high cholesterol, obesity and diabetes. The chance of experiencing
sudden cardiac arrest is increased with age, especially after age 45 for
men and 55 for women. A person may be at risk for SCA if he/she has or
is currently experiencing any of the following:
Early Diagnosis and ScreeningAlthough
sudden cardiac arrest cannot be anticipated, there are several steps
and invasive and non-invasive tests to determine if someone is at risk:
there are factors contributing to sudden cardiac arrest that cannot be
controlled, there are preventative measures that can help reduce the
chances of suffering sudden cardiac arrest:
Automated External Defibrillator (AED)
An automated external defibrillator (AED) is
a medical, mobile device used to check an individual's heart rhythm. An
AED also recognizes when a person's heart rhythm needs a shock and
advises the rescuer that the patient's heart needs a shock. Typically,
an AED is used when a person suffers from cardiac arrest and the heart's
activity is disrupted or unusually fast (ventricular tachycardia) or irregular (arrhythmia). A normal resting heart rate is 60 - 100 beats per minute.
Today, AEDs may be found in common community
locations including police and emergency vehicles, shopping centers,
office buildings, sports arenas, schools and airplanes. Most cardiac
arrests occur in private homes where AEDs are not readily available.
Keeping an AED in private homes is greatly encouraged, as it has proven
to save thousands of lives.
How Does an AED Work?An
AED is an emergency, portable device. It offers step-by-step
voice-automated instructions to guide a user through the process. The
rescuer places electrode pads on the person's chest, and the AED
measures the heart rhythm. The AED will determine whether or not the
patient's heart needs a shock. If the patient requires a shock, the AED
will instruct the user to push the button that sends the shock.
1. Call 9-1-12. Begin Cardiopulmonary Resuscitation (CPR)3. Use an AED4. Receive advanced care - paramedic assistance
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