February is Heart Month and Dr. James Storey, a cardiac electrophysiologist, discusses top concerns regarding heart health with KC Counts.
KC Counts:
So, I'd like to start, Dr. Story, by just talking a little bit about the basics that you want people to know during Heart Month. Of course, the number one thing is it remains the number one killer all over the world, right?
Dr. James Storey:
That's right. Heart disease is still the number one killer across the world with cancer at #2. One of the things that I specialize in is taking care of patients with abnormal heart rhythms. And one thing that's very common that I see is called atrial fibrillation, and that's the most common cause of a stroke. And so I can tell you a little bit about that if you would like.
KC Counts:
Absolutely. So what are we seeing in terms of numbers from atrial fibrillation and stroke.
Dr. James Storey:
Right. So atrial fibrillation affects about 10 million people in the United States and over 30 million people worldwide. And atrial fibrillation causesalmost one-fourth of all strokes. And furthermore, patients that have atrial fibrillation have an increased mortality compared to those that don't, and what it is, it's the atria or the upper chambers of the heart, and they start to quiver, and when they quiver, they don't contract normally, and there can be pooling of blood inside the heart and if the blood pools it can form a blood clot and then the blood clot can be expelled out of the heart up into the brain and clog one of the arteries so the brain is and the brain when the artery is clogged that area of the brain isn't getting any oxygen and that's what causes the.
KC Counts:
Now, obviously, if people are going to their doctor on a regular basis, that's what we want everyone to do to make sure everything's functioning as it should. But is that difficult to find, or how do you know that you might be suffering from atrial fibrillation?
Dr. James Storey:
That's an excellent question. So some of the more common symptoms are feeling of what we call palpitations, which are the sensation of you're having a rapid heartbeat or an irregular heartbeat. Another symptom might be shortness of breath. Another less common but possible is chest pain with this or dizziness. And it's also not uncommon for patients that have no symptoms at all. And some patients are detected incidentally. For example, they go for a checkup with their regular doctor and the doctor listens to their heart and notices it's irregular. Another one is nowadays we have patients with certain watches that are capable of detecting it. So we have some patients coming in to the clinic having self-diagnosed themselves with AFib without ever, without feeling it.
KC Counts:
Do you find that to be fairly reliable?
Dr. James Storey:
Yeah, they're actually very, overall, they're very accurate. They do require, you know, a doctor to look it over and make sure that's what it is, because they're not completely reliable, but they're pretty reliable.
KC Counts:
So what can someone expect to have happen next if there is suspected AFib? atrial fibrillation. What is the next thing that happens?
Dr. James Storey:
Well, the next thing that happens is, you know, we like to, probably the most important thing is to assess the patient's risk for a stroke. And we have some scoring systems. We look at certain parameters and their health history and so forth. And we determine whether or not they would be candidate for either a blood thinner, which can help prevent the stroke with AFib, or in some cases, We have a little device that can be put inside that atrium, that left atrium called the either, the most common one is called the Watchman device, which patients may have heard about. But not everybody, not all the patients need either of those. Some patients may be at a very low risk of a stroke based on their absence of other parameters, and they don't necessarily need to be on a blood thinner or get one of those. So it really just depends on the patient. So that's the most important thing, probably.
KC Counts:
Let's talk a little bit about blood pressure and cholesterol. I've heard from heart doctors in the past and from doing a little research that people should probably be starting to monitor these things a lot younger than they are.
Dr. James Storey:
That's right. Blood pressure is another important cause of stroke. High cholesterol is for sure too, and cause of heart attack as well, and it is very important to monitor those. And the current guidelines of blood pressure emphasize that the blood pressures on average should be more often than not below 130 over 80. And the guidelines for cholesterol, we're mainly looking at the bad cholesterol called the LDL cholesterol. And the treatment for that really depends, again, on other factors, whether the patient may have heart disease or not, and other conditions and so forth.
KC Counts:
Let's talk a little bit about the role that dental hygiene plays in our heart health and what people need to know about how those things interact.
Dr. James Storey:
Dental hygiene is incredibly important. I mean, across all aspects of cardiology, it is associated with increased risk of heart disease in general. In my own specialty as a electrophysiologist, one of the other group of patients that I take care of is patients that have pacemakers or defibrillators who in most cases have wires running through the bloodstream. And so it's really important for patients to have good dental hygiene. If the patient were to get an infection in their teeth, it could spread quickly into the bloodstream. and seed one of the wires. Another group of patients who need to be concerned about that are patients that have abnormalities of the heart valves. So the same thing there, the valves may have rough edges and bacteria from the... teeth could enter the bloodstream and cause an infection on the heart valves.
KC Counts:
All right.
Dr. James Storey:
So it's super important.
KC Counts:
Let'stalk about what you know about how certain communities are disproportionately impacted by heart disease, because that's something that in our region, people will be experiencing.
Dr. James Storey:
There definitely is evidence that socioeconomic factors can play a significant role in heart disease. Patients may not have access to treatments or preventative care, or it could be that harder to get, make good choices with regard to food choices and so forth that could lead to increased risk of heart disease. And so there definitely is an association there.
KC Counts:
Well, why don't we spend the time we have left - you mentioned food. Let's talk about prevention. What are your top recommendations for people to protect their heart health?
Dr. James Storey:
Again, I'm going to go to my own specialty, looking at other patients I see with arrhythmias, in particular AFib, and this applies, these suggestions apply to all patients with heart problems. Definitely, with regard to habits, one of them is smoking is probably the number one thing. You know, we don't want patients to smoke. It's not good. It increases your risk of a stroke or heart attack, increases your risk of having AFib. Another one that's no longer in favor is any type of alcohol. The less alcohol, the better. There's no amount of alcohol that's felt to be good for someone. With regard to the patients with AFib, it's now recommended if they can't abstain completely, have no more than three alcoholic drinks per week by the experts. Other ones are obstructive sleep apnea. That's very common. And patients, if they have a history of snoring, they may want to get checked out for that. That's linked to heart disease as well. And so those are some of the common ones that I think about in my own practice.
KC Counts:
And of course, back to those dietary things when we talk about how to plan for heart health when we're thinking about what we're going to do for our meals throughout the course of the week. Well, it's the things we hear over and over again, right?
Dr. James Storey:
Yes, the most common thing is try to avoid Foods that are high fat, high in saturated fat in particular, try to have lots of servings of vegetables and fresh fruit and if we're going to have a protein, try to have a lean piece of meat or chicken or fish in particular. You know, red meat is okay in small quantities and with, you know, lean pieces, you know, and with regard to butter, I'd say try to minimize that, you know, I think so.
KC Counts:
All right, well, we started the conversation talking about Heart Month, and so I'd just like to give you an opportunity to let our listeners know what message you'd like them to take away.
Dr. James Storey:
I think, you know, one of the most important things is don't ignore serious symptoms. You know, get checked out, go to the hospital. Certainly any type of chest discomfort, pressure, tightness, and the chest could be a serious sign you're having a heart attack, and patients need to get immediately to the hospital to get checked out for that. Other symptoms of shortness of breath or palpitations or things like that also, likewise warrant immediate attention. So don't ignore any types of symptoms. And also, you know, we talked about during this interview, some of the things patients can do for themselves, whether it be with diet and other habits to try to prevent heart disease in the 1st place.
KC Counts:
All right. Well, Dr. James Storey, thank you so much for spending this time with us and happy Heart Month.
Dr. James Storey:
Okay. Thank you for having me.
