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Being Well 1210: All Things Heart Related

[music playing]
Lori:They’re the ones who raise the bar. The ones dedicated to providing care in the
most demanding of circumstances. The ones that understand the healing benefits
of kindness and compassion. They’re the people of Sarah Bush Lincoln,
and they set the bar high. Sarah Bush Lincoln, trusted, compassionate
care, right here, close to home. Male Voice:Carle is redefining healthcare
around you. Innovating new solutions, and offering all
levels of care, when and where you need it. Investing in technology and research to optimize
healthcare, Carle with Health Alliance, is always at the forefront to help you thrive. Rameen:
Meeting the ever changing in healthcare needs of our communities. Paris Community Hospital/Family Medical Center
is now Horizon Health, with the same ownership, management, providers and employees. Horizon Health provides patient care and promotes
wellness to the communities of East Central Illinois. Jeff:
At HSHS St. Anthony’s Memorial Hospital we are at work transforming heart care, rebuilding
knees and hips, delivering new generations, and focused on providing healthcare to you. We are HSHS St. Anthony’s Memorial Hospital. Ke’an: Hi. Thank you so much for joining us today for
this episode of Being Well. I’m your host Ke’an Armstrong, and today we’re
going to be talking about all things heart related and I have Dr. Mehta and Dr. Wiarda,
both from Carle Cardiologists, and they’re joining me today to talk about heart issues
and new advances and all kinds of things, introducing heart problems and what we can
do about them. So, thank you so much for joining me today. Sanjay: Thank you for having us here. Ke’an: Thank you for coming. So let’s get a little introduction here. Tell me who you are, what you do, and what
your role is. Karen: So again, Dr. Karen Wiarda. I’m a noninvasive cardiologist here in Mattoon. I do outreach cardiology, and my focus is
on clinical and testing, and we have cardiac rehab in our office. So I do a lot of the imaging like echoes,
stress tests, cardiac rehab, which is exercise, either general exercise or exercise after
a cardiac procedure like a stent or bypass or valve replacement. We do that in our office. And then, of course, Holter monitors to evaluate
for rhythm problems and EKGs. Ke’an: And you, Dr. Mehta? Sanjay: I am an interventional cardiologist. I practice out mainly in Champaign, but this
is my outreach area so I come and like to see patients here so they don’t have to travel,
and we offer a variety of things that Carle at the main campus and, being an invasive
guy, we do heart attack patients. Try to fix them if they have a heart attack,
try to open up the vessel. If somebody needs a bypass surgery. We get our surgeons on board and we are started
doing a lot of new things. In the last couple of years, we have started
putting new valves for patients who are elderly so they don’t need surgery. They don’t need to go for open heart surgery. They can be done. So the groin approach and the people stay
in for a day and then they go home. We have recently started doing an appendage
closure device, which is what patients who have irregular heartbeat. So if they are at a risk of bleeding, we can
put this device and they don’t need blood thinners for a long term. Besides, we have other procedures, which are
going on to close the hole in the heart, and, in future, a lot of new exciting things that
are coming at Carle. So I’m very happy to help our patient population. We all do clinical, VA, see them in the office,
and reasonably, I think we try to help as much as possible, and we don’t like sending
patients out unless they have a real need. We send them to tertiary on a higher level
centers for a second opinion. Ke’an: Well it sounds like there’s lots of
things that we get to discuss today, and I’m glad that you’re here because heart problems
are something that seems pretty common these days that a lot of folks are dealing with. What are some major causes for heart problems
for women and men? And are they similar? Are they different? Let’s talk about that a little bit. Karen: So the most common causes for having
heart problems are diabetes, high blood pressure, high cholesterol, smoking, and excessive alcohol
use, and being overweight or more importantly obese. So weight certainly plays a role as well. So those are really the risk factors that
are common for everyone, and those are all fixable risk factors. The one risk factor where you really can’t
change but you can make changes to improve the risk is genetics. So if your parents or your siblings or your
grandparents have heart disease, then certainly you’re at risk. So really the genetics apply to every aspect
of heart disease, and, honestly, a lot of the other diagnosis as well, but a lot of
the lifestyle changes can really have an impact. Ke’an: Okay. Sanjay: I think, more or less, the risk factors
are quite similar for males as well as females where it’s mainly sometimes the presentation. When they have these factors, when they have
heart disease, the present symptoms are a little different in women, so we hear all
the time that most of the women will say if they are not feeling well, they may not have
the classic symptoms, but if they have the risk factors, we always tell them to get an
opinion from a physician and get it taken care because that could be the only symptom
of not feeling well and you could be still having a heart attack. There are a lot of male population who always
comes with chest pain. They have discomfort in the arms. They have discomfort with the jaws. They have sweating, shortness of breath. The men may present with that. However, there is certain group who never
complained anything, and they’re just symptom is fatigue or tiredness, and we still like
if they have risk factors, like Dr. Wiarda just mentioned, then we would still like them
to be checked out. Ke’an: Okay. So when you say classic symptoms, those are
some of the classic symptoms that folks should pay attention to? Sanjay: Correct. We always say that usually if somebody has
not had any discomfort in the chest before, and that is the first symptom, chest pain,
shortness of breath or discomfort with the neck, sometimes the jaw and sometimes in the
back. I think these are the real classic symptoms. People should really get a checkup done. If they have not had those symptoms, better
get it checked with the primary care and then can take an opinion from a cardiologist. Ke’an: Okay. Now, how prevalent are a heart problems in
our region? We live here in the Midwest. Is there a distinctive factor across the United
States where people live, maybe their health choices, the food they’re eating, different
things like that, that contribute to health problems, distinguishing our region from others? Karen: So certainly obesity is an epidemic
in this country, which increases the risk of all the risk factors that I spoke about. So it increases the risk of diabetes and high
blood pressure, high cholesterol. It also increases the risk of sleep apnea
and all these things increase overall risk. We’re also too sedentary, and so we have too
much processed food and so just simple changes like changing your diet, having less processed
food, more fresh vegetables, more fresh fruit, less junk food, less fast food, and preparing
your own food at home as much as possible can make a tremendous impact. The other thing that is critically important
is exercise, not smoking, which is of course a huge risk factor, limiting alcohol. These things can have a tremendous impact. Ke’an: Since you mentioned that not smoking,
what is it about smoking that is so crucial to heart problems? What does it do? Karen: It actually disrupts the vasculature,
or the vessels of the heart, the vessels of the legs, the vessels of the brain, and it
can make plaques cause so if you already have a plaque in the artery, it can actually cause
the plaque to be ruptured and cause a heart attack. So there’s stable angina heart disease and
there’s unstable heart disease, and it’s the unstable heart disease that causes the significant
heart attacks. Sanjay: Then like she said, sometimes it increases
the blood coagulability so it makes the blood a little thicker, tends to stick around, and
that’s how the plaque starts building up. And it can make the plaque little softer so
when you’re doing a strenuous activity, those plaque suddenly opened up and the blood clots
over it and it triggers heart attack. It makes the small vessels of the leg become
diffused, the disease and people can get problems in the leg, walking, just like the heart attack,
you can get trouble in the legs, you can get stroke. So interestingly, all these risk factors,
they affect the whole vasculature, not just the heart, and affect the arteries in the
neck causing stroke, can affect blood flow in the leg arteries causing peripheral vascular
disease and amputation eventually. So smoking is a very big risk factor. Ke’an: Okay. You also mentioned obesity and it’s a struggle
for a lot of folks to change the way they’re eating and to change their healthy lifestyle,
and to do different things and get up and move. What are some tips or how do you encourage
folks to make that change and to know what to do and also be careful? Because I think some people are scared like,
“Well what if I exercise? Am I going to be pushing myself too far?” What are some things that you talk to people
about in making a lifestyle change? Karen: So I think, first of all, it’s really
important to have a very in depth conversation of where you’re at now, what you’re comfortable
doing, and what your ultimate goals are. And when you look at obesity, it’s more than
just people eat too much or they exercise too little because fat is actually an organ,
and fat does what it can to keep itself going. And when you have fat cells, it’s not so much
the number of cells, it’s actually the quality of cells and the cells actually start growing
and it just causes a lot of medical problems. So then you have issues with not being satiated
or when you eat you feel like you just want to eat more and you don’t want to stop eating,
and you’re always hungry. So when you’re diabetic, you have insulin
resistance and when you’re have obesity, you have what’s called leptin resistance. And so leptin, so issues with another hormone
called ghrelin. So those hormones actually make you always
hungry, never feeling satiated. So it’s important to really make changes to
your diet and changes to activity. And one other thing that’s the most important
is just do it slowly and do what’s most comfortable for you. So in terms of exercise, even just walking
can have a tremendous impact for patients. So even just going on a walk every night,
and you don’t have to start walking three miles, you start walking a block and if you’re
comfortable, you keep going. But always try to just do a little bit more. And if you have any symptoms of significant
chest pain or dizziness or lightheadedness or shortness of breath that feels out of proportion
to the fact that you’re beginning to exercise, then you should seek help before starting
an exercise program or before continuing that exercise program, and in turn, go ahead, sorry. Sanjay: Just like she said, it has become
an epidemic. And with the all newly available gadgets we
see derived from [inaudible 00:10:22] now. Obesity has become a big problem, and there
should be real public awareness made. It’s good to watch media all the time, but
people should be active otherwise. That’s the reason we see nowadays heart disease
occurring at younger age. We still have certain group of population
in town here that they are eighties, nineties. They are still fine and healthy, and we see
the other extreme who are 35, forties presenting with all kinds of medical history and medical
problems, and it’s not even genetics, but sometimes those factors are modifiable. That’s why they always said in the past, get
off the couch, don’t be a couch potato. Ke’an: Right, it’s not good. Even though we’re a TV station here, we offer
PBS kids programming and we say don’t sit and watch TV all day. It’s not good for you, but take what you’ve
learned and go do something with it, and get active, and that’s what we try to educate
people on. So I’m glad that we’re getting that awareness
out. Karen: And it’s interesting because of course
there’s lots of technology. I love my Fitbit. There’s apps, I mean there’s things to help
you, but I think the most important thing is actually just education. A lot of people truly don’t know what healthy
food is. And so you need to talk to your doctor or
meet with a dietician and actually understand ways that you can help. When you go to the grocery store shop the
periphery hit the vegetables, hit the fruits. Everything in the middle is usually not healthy,
so shop that periphery. And Fitbit’s are nice because they just make
you accountable and they make you look at your steps. And say move more. One of my med school teachers said, “Look
at everything as an opportunity for movement.” And that’s my husband and I’s mantra, and
it’s true. Just move as much as you can. Get off the couch and even if it’s walking
and if it’s going to the gym, if you have joint problems, go join a pool. Even if you just walk the pool, you’re still
exercising. Ke’an: Yeah, that sounds good. Some of the wearable trackers these days,
like you mentioned Fitbit, some different things like that. Maybe some of the older folks aren’t sure
how to utilize that type of equipment. Maybe some of the younger population will. Do you encourage people to use those types
of things to track what they’re eating, to track their fitness and things like that? Is there a difference in the age and what
people are using and what they’re not these days? Sanjay: I think, like she said, most of the
digital devices nowadays, they have apps. It tells you and reminds you that it’s time
to get up from the bed or get up and do some exercise. You can enter your calorie count, what you’re
eating. A lot of things, with the apps, you can scan
on what you’re buying from the store. So buying healthy, getting off the couch,
doing regular exercise, all these things can be easily monitored. You don’t need an expensive gadget. These are all from the same newer smart phones. You can get all these things done. Ke’an: Okay. Something that I think is interesting, when
you go into the produce section you see all these different types of fruits and vegetables,
but when you start tracking and looking into them, some of them do have a lot of sugar
and some of them have more carbohydrates than what you would normally think about. Karen: The differences is if you have a sugar
and a carbohydrate in a fruit versus that same sugar and carbohydrate in a cookie, you’re
doing much better having all the fruit. The single best food you can eat, in terms
of just straight antioxidants, are actually berries. Blueberries are incredibly healthy. Ke’an: Love berries. Karen: And whole grains, whole wheat pastas,
whole grain bread and plenty of fruits and vegetables and then limiting meat, limiting
fat. But if you are going to have fat, healthy
fats like olive oil or avocados, healthier fats. Ke’an: And just keep yourself mindful of those
things, there’s lots of things out there to help keep you that way. Karen: Exactly right. Ke’an: So let’s talk about some treatment
options that are available, both minimally invasive as well as full blown surgeries. Let’s talk about some of the things that both
of you do for patients. Sanjay: So I think it depends on how the patient
presents to you. The minimal invasive, the catheterization
is a simple step we do. Previously, we used to do it through the groin. Nowadays, we do it from the hand what we call
the radial approach, and you put a small local anesthetic, go with a catheter inside, if
the patient has come with a heart attack, take pictures of the heart artery for the
stent, and the procedure gets done in 45 minutes, and patient gets off the table and can sit
up immediately. Previously, we used to do this from the groin,
but now this has become very comfortable, and we have seen significant reduction in
bleeding. So this is the current standard of care. All these procedures for heart attack, checking
of the arteries and then from the hand. Then if you find a block and we put a stent,
balloon them, and if, sometimes, there is significant amount of blockage all over, then
we refer them for bypass surgery. We also do different kinds of procedures for
an elderly population living in this area who have got valve problems. As we get older, one third of the population
will get narrowing of the heart valve, and, previously, there was only open heart surgery. Nowadays, we can give a get this done through
the groin. And people come in. We had patients last week of 95, but if they’re
sharp, they’re fully active, and there is a family to take care of them, we bring them,
they put a new one and the next day they are out. Ke’an: That’s amazing. Sanjay: So this has remarkably improved the
care for the elderly, and as technology keeps on coming new and new, interesting things
are coming so that people don’t have to stay in the hospital. The morbidity is less, the infection rate
goes down, and they’re out of the hospital next day. Ke’an: That sounds great. Do you have anything you’d like to add to
that as well? Karen: I think from a noninvasive perspective,
clearly if people need stents and they need valves, then we’re sending them there. Our goal of course is attempt to make lifestyle
changes always. That’s the first attempt for any approach. And then of course medicines can make people
feel significantly better, improve blood pressures, improve cholesterol levels. But then we do testing so echocardiograms
to look at the structure of the heart, to look at the chamber sizes, the chamber thickness
and to look whether or not there’s leaky valves, things like that. So that gives us a lot of information structurally
about the heart as well as hemodynamically or how the impact of blood pressures on the
heart. And then stress testing, of course, we can
do it multiple different ways. Just a treadmill versus a chemical stress
test. One that involves echocardiogram and one that
involves nuclear where we’re looking to see the profusion of the blood and whether or
not it’s equally profused or if it’s not profusing equally and if it looks like there’s been
a heart attack versus maybe blockage that we can fix with a stent. Ke’an: Okay. Sanjay: And a lot of new things are coming
for human heart failure patients where you know that you trying medications, you have
tried stents, you have tried bypass surgery. They have bad heart function. We have a pacemakers. We have defibrillators, and they’re newer
defibrillators, which tries to resynchronize the whole heart, which also tends to improve
the heart function. And our heart failure doctors are managing
the patients, and there are a lot of newer medications coming out. Ke’an: Exciting. Sanjay: And we are having a new heart surgeon
joining us shortly who is going to be an expert in putting an assist device so people can
be out of the hospital rather than staying in the hospital all the time. Ke’an: Okay. That’s good news. So there’s lots of good things coming down,
lots of good things that you’re doing now that may not be as scary to some folks and
maybe they’re thinking, “Well, this isn’t so bad. I can get in, I can get out, and I can feel
better quicker.” So that’s good to know. I wanted to ask you about some at home tracking
or monitoring. What should people be doing at home if they’re
concerned about heart issues, if they have heart issues, what are some things that they
can do at home? Karen: I think, first of all, it’s really
important to know your numbers. So you should always know your cholesterol
number. You should always know your blood sugar or,
if you’re diabetic, your hemoglobin A1c which looks at the average blood sugar over three
months. It’s important to know your blood pressure. It’s even important to know your heart beat. I think it’s important to even know how to
take a pulse to see does it feel regular or irregular, especially if you’re feeling bad. So I think having a blood pressure cuff at
home and documenting your blood pressures and bringing them in to the physician, it’s
always helpful for them to make decisions. Cause when you go to the office, you have
a snapshot and some people have what’s called white coat hypertension, so their blood pressure’s
high because they’re in the doctor’s office, and they’re nervous. But then if they go home, it’s good. Or vice versa. Sometimes people actually have a great blood
pressure in the doctor’s office, and then they go home and it’s actually quite high
and they’re not understanding why they have symptoms when they’re walking. But it could be that their blood pressure
is going really high or they have atrial fibrillation or extra beats called premature ventricular
contractions- Ke’an: Are their trackers, I’m sorry, are
there trackers for folks who do have an Afib because you hear about that these days? Sanjay: Yes, so this all the newer devices,
which comes out and obviously we have heard on TV about Apple, which has come out with
its monitoring system. There are other systems, which would take
one or two leads at a time. Usually it’s only one lead, but it records
their heart rhythm and, if you have some palpitation, you can look at it and if you see that as
not regular, you can talk to a doctor. And they have studies in which have shown
that there’s a little long way to go, but it really helps to pick up what kind of healthy
meals you’re having. They also give patients when they come, which
is a multi lead, which requires much more, and we give it to our patients to take it
home. But on a later day, a wristwatch, you can
have that gadget. It will tell you the heart rate. There are newer things, which are coming out,
which will be sensing your blood pressure. Eventually, they are going to come out for
blood sugar also. So a lot of new technologies coming out. It’s still a year out, but many more things
to come out. Ke’an: Okay, well we’ve got about two or three
minutes left, and I wanted to ask about what if folks are not going to the doctor? Are heart problems always life-threatening? What is something that you can tell people
right now who may be watching if you are concerned, you have a heart problem, what do they do? What’s the first steps that they should do? Sanjay: We usually say first, if you have
a symptom, which you have never had in your life before, if you have those symptoms, first,
always go to the nearby hospital or call nine, one, one. That’s the first thing to do. If you already have a history of heart disease,
talk to a doctor during the day. But if the symptoms are worsening, don’t waste
time. Call nine, one, one. Go to the hospital. And always, like Dr. Wiarda just said, take
a blood pressure at home, check your weight at home, check you blood sugar at home. So when you’re talking to a doctor’s office
or an ambulance person, you’ve already given them some information. It saves time. Ke’an: Okay. Would you like to add onto that? Karen: I think it’s just really important
to get your annual physicals to make sure that, again, that you’re discussing any symptoms
of concern with your doctor. You can always call the doctor’s office and
certainly make followup appointments, but it’s really important to follow regularly
with a physician. Ke’an: Okay, sounds good. Well, I think that we’ve covered a lot of
topics. Is there anything that we haven’t covered
that you’d like to get out to the viewers right now? Sanjay: Well, if you really feel that you’re
having some problem, don’t waste time. Call us. Ke’an: Time is of the essence. Sanjay: Time is money. That’s very important. Ke’an: Yeah, absolutely. Anything else you’d like to add? Karen: Do yourself a favor, eat healthy, keep
moving, and look for every opportunity for movement. Ke’an: That sounds good. Well, I appreciate both of you being on today. Sanjay: Thank you very much. Ke’an: Thank you again for being here. Karen: Thanks. Ke’an: Thank you, and thank you for tuning
in for this episode of Being Well, and we’ll see you next week. Jeff:
At HSHS St. Anthony’s Memorial Hospital we are at work transforming heart care, rebuilding
knees and hips, delivering new generations, and focused on providing healthcare to you. We are HSHS St. Anthony’s Memorial Hospital. Rameen:
Meeting the ever changing in healthcare needs of our communities. Paris Community Hospital/Family Medical Center
is now Horizon Health, with the same ownership, management, providers and employees. Horizon Health provides patient care and promotes
wellness to the communities of East Central Illinois. Male Voice:Carle is redefining healthcare
around you. Innovating new solutions, and offering all
levels of care, when and where you need it. Investing in technology and research to optimize
healthcare, Carle with Health Alliance, is always at the forefront to help you thrive. Lori:They’re the ones who raise the bar. The ones dedicated to providing care in the
most demanding of circumstances. The ones that understand the healing benefits
of kindness and compassion. They’re the people of Sarah Bush Lincoln,
and they set the bar high. Sarah Bush Lincoln, trusted, compassionate
care, right here, close to home. [music playing]

One thought on “Being Well 1210: All Things Heart Related

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