Category Archives: Heart Disease Diagnosis

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

with Dr. Bussie Evans, CardiologistDr Evans

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 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?using a treadmill for a stress test

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.