Category Archives: cardiologist

Q&A: Why is salt bad for your heart?

with Dr. Bussie Evans, Cardiologistdrevans

Why is salt bad for your heart?

Dr. Evans: Our bodies need a little salt for optimal health, however the typical American diet can contain two or three times the amount needed.  Too much salt causes the body to retain water.  This increase in fluid in the body increases blood pressure which puts a strain on blood vessels, the heart and kidneys.  As a result, people with high blood pressure have an increased risk of heart disease and stroke.

Does everyone need to monitor their salt intake?

Dr. Evans: It’s safe to say that everyone eating an American diet could benefit from paying attention to and reducing their salt intake. Most people have no idea how much salt they consume.  People assume that if they don’t use their salt shaker much, they aren’t eating much salt.  But salt / sodium is already present in many of the foods we eat.  Especially processed foods. It is important to pay attention to your salt intake if you have high blood pressure, and if you have heart failure, too much sodium and the accompanying fluid retention can be very dangerous.

How much salt is too much?salt_shaker

Dr. Evans: The Heart Association recommends no more than 2,300 milligrams of sodium a day, however for most adults, especially seniors, no more than 1,500 milligrams is a better guideline.  Our blood pressure tends to increase as we age, so lowering salt intake can help to keep it in check. To give you an idea, one teaspoon of salt is 2,300 mg of sodium.  In packaged foods, the amount of sodium is on the nutrition label, but pay close attention to the serving size.  Let’s say that a can of soup has 800 mgs of sodium per serving, but a serving is only 1/2 a cup. To be realistic, you are likely to eat one whole cup of soup if not more and then you’ve already exceeded your recommended daily sodium intake.  It’s just that easy to take in too much salt if you’re not paying attention.

How can I reduce salt if it’s already in the food I eat?

Dr. Evans: Ideally, eating more fresh foods that are prepared at home rather than packaged foods can make a big difference not just in salt consumption but in your overall health.  And when cooking at home, use more herbs and spices for flavor and less salt.  For recipes and meal plans, there are a lot of free resources you can find online by looking up the DASH Diet. When buying packaged foods, read the labels and look for lower sodium alternatives. It really doesn’t take long for your tastes to adjust to less salt and you’ll soon find that some foods taste way too salty.  Certain foods are known for containing a lot of salt, and unfortunately, they are American favorites:  pizza, sandwiches, soup, breads and baked goods, cold cuts, poultry, cheese, and of course condiments and sauces.  People tend to ignore the nutritional labels on condiments, but soy sauce or barbeque sauce, for example, can really blow up your daily sodium intake.  There are ways to make some of these salty favorites less salty and more healthy like getting the thin crust pizza with more vegetables, half the cheese and an uncured meat instead of pepperoni.  However at the very least, limit your portions of salty foods.

If I limit my salt intake will my blood pressure be normal?

Cutting back on salt is one of the easiest things you can do to help your blood pressure, but it is not a cure all.  There can be other causes of high blood pressure such as family history, poor diet, lack of exercise, being overweight, smoking, and excess alcohol consumption.  Limiting salt intake should be part of an overall heart healthy lifestyle that includes regular exercise, a heart healthy diet, and maintaining a healthy weight.  High blood pressure, much like high cholesterol, is a silent risk factor of heart disease, so having your blood pressure and cholesterol checked regularly can help you and your doctor find lifestyle modifications, or medications if needed, to reduce your risks for cardiovascular disease.

 

What is a Silent Heart Attack?

A study of approximately 9,500 middle-age adults found that nearly half of the heart attacks that occurred during the study period were “silent”. TheDr Haghighat patients were not aware they had a heart attack and did not seek medical attention however, their electrocardiogram (ECG) screening during a regular follow-up appointment showed that a heart attack had occurred.

The study, Atherosclerosis Risk in Communities (ARIC), analyzed the causes and outcomes of atherosclerosis – hardening of the arteries. Over an average of nine years after the start of the study, 317 participants had silent heart attacks while 386 had heart attacks with clinical symptoms.

Amir Haghighat, M.D., interventional cardiologist at the Cardiovascular Institute in Panama City, clarifies that “Silent does not necessarily mean a total lack of symptoms. More likely, it’s that the symptoms were subtle or not recognized as a heart problem.”   Frequently, television and movies depict a heart attack as a dramatic event with crushing chest pain. “Chest pain is a common symptom, however everyone experiences heart symptoms differently.” says Dr. Haghighat. “For some, it may be shortness of breath, pain in their left arm, in their neck or jaw, or even in the shoulder blades, and it may not be as dramatic as you think.”

“The outcome of a silent heart attack is as bad as a heart attack that is recognized while it is happening,” said Elsayed Z. Soliman, M.D., MSc., M.S., study senior author and director of the epidemiological cardiology research center at Wake Forest Baptist Medical Center, Winston-Salem, North Carolina. “And because patients don’t know they have had a silent heart attack, they may not receive the treatment they need to prevent another one.”

Dr. Haghighat stresses that these study results are further proof that patients should see their primary care providers regularly and discuss any unusual symptoms they may be experiencing. “We all know when we’re feeling something different in our bodies and it’s important to discuss it with a healthcare provider,” says Dr. Haghighat. “Take note of when your symptoms occur, do they happen with exertion or at rest? Don’t ignore symptoms just because they come and go. Your primary doctor may be able to identify the issue with basic screenings and prescribe preventative measures. Or in the case of a “silent” heart attack, coordinate treatment with a cardiologist that can lower your risk of having additional heart attacks.”

After following participants in the ARIC study for 20 years, researchers found that having a silent heart attack increased the chances of dying from heart disease by three times. As a result, silent heart attacks should be treated just as aggressively, once discovered, as a heart attack with recognizable symptoms. “For both kinds of heart attacks,” says Dr. Haghighat, “the risk factors and the treatment are the same. Even though a patient may not have experienced a scary heart event in an ER, they still need to be proactive and make lifestyle changes to reduce their risk such as quitting smoking, losing excess weight, eating healthy and getting regular exercise.”

What To Expect at Your Stress Test

A Q & A with Cathy Rodes, MSN, ARNP with the Cardiovascular Institute of Northwest FloCathy Rodesrida

Under what circumstances would a patient need a stress test?

Patients may be scheduled for stress tests to evaluate symptoms of chest pain, for an exercise prescription, to evaluate for exercise induced arrhythmia or for surveillance of known coronary artery disease.

Do all stress tests require physical exercise?

Graded exercise tolerance tests (GXT), whether with or without imaging require exercise on a treadmill to achieve the patient’s target heart rate, which is determined by patient’s age. Pharmaceutical Nuclear stress tests do not require exercise.

When is a nuclear stress test needed versus an exercise stress test?

Pharmaceutical Nuclear stress tests are utilized when patients are unable to exercise, in cases of certain ECG (electrocardiogram) abnormality, when the patient is unable to reach the target heart rate with exercise due to medications, or when a patient has certain brady arrhythmias (slow heart rates requiring pacemaker). Nuclear stress tests, where treadmill exercise is used along with nuclear images, are generally ordered versus a standard GXT when the baseline ECG is abnormal, when imaging is desired because of the patient’s coronary anatomy or a previous standard GXT was not quite normal.

With an exercise stress test, what sort of physical activity should I expect?pic-treadmill-testing2

GXT or Stress Nuclear test requires walking on the treadmill long enough to raise the heart rate to target as well as long enough to be physically stressed (tired, short of breath, etc.). The treadmill gradually speeds up and elevates incline every three minutes. Most patients exercise for 7-9 minutes, depending on functional capacity. Be sure to dress comfortably with appropriate shoes for exercise.

With a nuclear or medication-induced stress test, what should I expect?

With a pharmaceutical nuclear study, the patient does not exercise. Lexiscan Nuclear dilates the patient’s arteries as if they have exercised. They may experience shortness of breath with the medication. Also, patients are encouraged to eat 2 hours prior to the test to reduce any GI effects. Patients must avoid all caffeine products for 24 hours prior to Nuclear stress tests.

How long does the test take?

Patients are usually here for about 30 minutes for a GXT secondary to paperwork, setup and recovery. We ask patients to anticipate being here for 2 hours for a Nuclear stress test to allow for imaging. There is a second day of testing required for Nuclear stress tests, however patients are usually only here for approximately one hour for injection and imaging.

What can be revealed about your heart health during these types of tests?

All stress tests are screening tests and cannot exclude the presence of Coronary Artery Disease (CAD) or progression of CAD, but exercise stress tests give a good idea of functional capacity and prognosis if the patient does have CAD. Also, nuclear imaging gives a good idea of coronary perfusion which helps the cardiologist determine if further testing is needed.

If I “fail” my test, what’s the next step?

If a GXT is abnormal, your provider may recommend a Nuclear stress test or a cardiac catheterization. Every situation is different and other health history comes into play for this decision. Nuclear stress tests that are abnormal may indicate older heart damage or narrowing / blockages in the arteries. Therefore the provider would recommend catheterization vs. medical management based on the particular situation. Next steps are usually discussed at a follow up appointment after all testing is completed.

What is a Heart Murmur?

Cardiovascular Institute cardiologist Dr. Michael Morrow explains the most common causes of heart murmur and how cardiologists make a diagnosis using ultrasound technology for echocardiograms. While many heart murmurs are benign, some are a symptom of valve disease such as aortic stenosis. The Cardiovascular Institute has a nationally accredited echocardiography lab in our main office in Panama City, Florida to make getting a diagnosis quick and easy for our patients.

Heart Disease Patient Benefits from World’s Smallest Heart Pump

Nellie Smith was suffering from severe abdominal cramping and was convinced she needed to have her gallbladder removed. The problem with havingNellie_Smith this routine surgery however was Nellie’s heart. Nellie had survived a heart attack seven years ago and was told that her heart disease was severe. Multiple vessels around her heart were narrowed. She had previously been very active, but following her heart attack found that she tired very easily, was frequently short of breath and experienced chronic chest pain. She hoped to avoid further heart procedures by taking medications.

Eventually, Nellie’s abdominal pain became so severe she found herself at Bay Medical. Her cardiologist Dr. Michael Stokes was called to assess her heart health and delivered dire news. The blockages around her heart had left her with only one main vessel supplying blood flow to her heart and her ejection fraction (a measure of how well the heart is pumping blood) was only 15%. In this condition, it was far too risky to have surgery on her gallbladder and it was very high risk to perform a standard cardiac catheterization to open her heart blockages as well.

Fortunately, Bay Medical is the only hospital in the region with a unique technology designed to support heart function during high-risk cases. Dr. Stokes contacted his partner Dr. Amir Haghighat, one of three local cardiologists trained to use the Impella, the World’s Smallest Heart Pump, to help with Nellie’s case.

The Impella is roughly the size of a small writing pen and, using guide wires, can be inserted through a small incision in the groin area and navigated through the major blood vessels into the heart. The device can continuously keep blood pumping while the dangerous work of opening multiple blockages takes place.

 

Unlike an open surgery, a cardiac cath requires only mild sedation and patients are awake and able to interact with their physician. Nellie was able to see the images on screen of her blood vessels during the procedure and noted that “as he opened each blockage, it was like a road map suddenly began to appear on screen.” The previously blocked vessels filled with blood to feed the heart muscle. “I felt a difference immediately, right there on the table,” said Nellie.

The next day in the hospital, Nellie was up and walking around the cardiac nursing floor. “I feel really good,” she says. “I’m looking forward to going home, cleaning my house and cooking a meal. I know that doesn’t sound like much, but it was too tiring and too difficult to do those things before.” To her surprise, Nellie noted that she was no longer experiencing abdominal pain. She excitedly put her grandchildren on notice to expect “a NEW Granny” when she returned home.

Prior to the availability of Impella technology, patients like Nellie would not be able to have a cardiac procedure to open narrowed vessels due to the high risk involved. In many cases, bypass surgery would be too risky as well, leaving these patients with little hope of recovery. CVI cardiologists Dr. Samir Patel, Dr. Amir Haghighat and Dr. Thompson Maner have used the Impella technology to give many of these patients deemed too high-risk a second chance. “This is why we’re always learning and working to bring the latest technology to Bay Medical,” says Dr. Haghighat. “To have a great save like this one and to give those grandkids ‘a NEW Granny’ is why we do what we do.”

 

CVI Participates in Clinical Trial of Dissolving Stent

Bay Medical Center and cardiologist Dr. Amir Haghighat enroll the first local patient in a US trial of Absorb – a scaffold or stent used to open a clogged coronary artery that dissolves within two years instead of leaving a metal device behind.

Top Rated Care for Heart Attacks

News 13 talks with a heart attack survivor and cardiologist Dr. Amir Haghighat about the importance of getting help fast. Bay Medical is one of America’s 100 Best Hospitals for Cardiac Care with the cardiologists at CVI playing an integral part in these outstanding ratings.