Partners Celebrates American Heart Month

background with a heart

We all know the drill

You arrive at the doctor’s office.

Let reception know you’ve arrived for your appointment, sign in, and fill out the paperwork.

Wait.

Follow the nurse down the hall and get your vitals taken; weight, temperature, blood pressure, pulse oximetry.  Talk with the nurse about what brings you in to the doctor’s today.

Wait a bit more.

The doctor comes in and greets you, checks their notes and discusses what brings you in to be seen today. Eventually, the doctor will listen to your lungs and heart with a stethoscope. After a bit more discussion, perhaps the doctor will write a prescription or recommend additional testing or another course of action, and you’re on your way out.

Let’s look at that sequence again:

Let reception know you’ve arrived for your appointment, sign in, and fill out the paperwork.

Wait.

Follow the nurse down the hall and get your vitals taken; weight, temperature, blood pressure, pulse oximetry.  Talk with the nurse about what brings you in to the doctor’s today.

Wait a bit more.

The doctor comes in and greets you, checks their notes and discusses what brings you in to be seen today. Eventually, the doctor will listen to your lungs and heart with a stethoscope. After a bit more discussion, perhaps the doctor will write a prescription or recommend additional testing or another course of action, and you’re on your way out.

Each of these elements in red are a touch-point between you and your medical professionals to assess your heart’s health.

Paperwork – forms usually ask you to confirm established diseases, risk factors, family history, and possible complications due to pregnancy or other conditions.

Vitals - including blood pressure and pulse oximetry; this gives your health care professionals a snapshot of your condition at that very moment.

Weight – one standard medical professionals use to determine the risk of heart diseases. In addition to the measurement taken on the scale, the nurse or technician may ask for your waist circumference or calculate your body mass index (BMI).

Blood pressure - the force of your blood against the walls of your arteries as your heart pumps. It’s measured in systolic (pressure when your heart squeezes, or contracts) and diastolic (when your heart relaxes, or dilates, between heartbeats).  High blood pressure, or hypertension, can stiffen and narrow your artery walls, which blocks blood flow to your heart and can starve and damage the muscle. High blood pressure leads to heart disease and heart attack.

Pulse oximetry – a measurement of the oxygen in your blood. The test is usually performed with a clip on your finger or earlobe.  A low reading (below 95% for most people) could indicate heart trouble since the body’s tissues are not getting enough oxygen from the blood stream.

Listen to your lungs and heart with a stethoscope – the most obvious of the heart assessments. From the sounds available through the stethoscope, a trained medical professional can determine four heart abnormalities including:

  • A narrow heart valve
  • Valve leakage
  • Arrhythmias or abnormal heart rhythms
  • Fluid in the lungs (a sign of heart failure among other things)

Each doctor’s visit helps to build a solid picture of the patient’s current heart condition, and a history that the next visit’s snapshot can be compared to.

“A true hero isn’t measured by the size of his strength, but by the strength of his heart.” – Zeus, Hercules (1997)

What if, at this point, the doctor recommends additional testing during a routine check-up or a visit for non-heart related concerns?

One of the first things a doctor is likely to ask for is a series of blood tests to check levels of sodium, potassium, albumin, and creatinine in your blood. Unusual levels of these elements in your blood could indicate concerns for your kidneys, liver, and could also be signs of possible heart failure.

Blood tests will also measure levels of cholesterol; high levels of cholesterol (which your body creates on its own and which we ingest additional amounts of) can leave to artery blockage and heart failure.

Conditions like anemia or thyroid disease can also be confirmed with blood tests.

Don’t worry! A single needle can draw all the blood needed to check.

Heart health tests tend to be non-invasive. If blood test results warrant, your medical care provider might request an electrocardiogram (ECG) test, an exercise stress test, an echocardiogram (ultrasound) test, a magnetic resonance imaging (MRI) test, or a coronary computed tomography angiogram (CCTA).

For a more complete understanding of your heart’s health, doctors might order a nuclear cardiac stress test, which requires an injection.

Coronary angiograms, or cardiac catheterizations, may be done after a heart attack or other coronary event. This procedure requires local anesthetic and a small incision, and you may receive a sedative to help you relax.

Surely, though, you’d know if you needed a heart check-up, right?

“Beware the frozen heart.” – Ice cutters, Frozen (2010)

Ask yourself this:

During the stresses of everyday life…

  • Have you thought you should make time to be more active, to get up and move?
  • Do you snore loudly? Do others describe it as gasping or choking sounds?
  • Are you fatigued? Exhausted sometimes to the point of dizziness or vertigo?
  • Do you feel out of breath climbing stairs you use every day?
  • Do you have stiff or sore muscles, especially in the back, neck, and/or jaw?
  • Do you have indigestion, heartburn, or even nausea or stomach pains or cramps?
  • How about sweating for no obvious reason, or a cough that just doesn’t go away?
  • Have you noticed your legs, feet, or ankles swelling or puffy?

ALL of these are signs of a problem with the heart muscle. You don’t need to have a sharp, severe pain on the left side of your body radiating down your left arm or collapse clutching your chest.

Any one, or combination of, these symptoms could signal a concern for your heart, or signal another kind of problem. The only way to know is to seek medical attention right away.

“But to make doubly sure you do not fail, bring back her heart in this.”
– Evil Queen, Snow White and the Seven Dwarfs (1937)

Ready for a plot twist?

Women have different symptoms of heart disease than men. According to “Heart Attack Symptoms Women Shouldn't Ignore,” women often don’t present with chest pain and numbness until their heart attack is several days underway. Women don't know they're having heart issues and wait too long for help. Women can be wary of visiting their doctors because they're afraid of being body-shamed; “Just lose some weight and you’ll be fine.” Women often must proactively advocate for themselves with their medical team and specifically request testing, diagnosis, and treatment if the woman suspects a coronary event.

National “Wear Red Day” is Friday, February 3 this year. “Go Red for Women” is a campaign from the American Heart Association that aims to raise awareness about cardiovascular disease and help save lives with a focus on women’s health. Heart disease is the leading cause of death in women of all ages, races, shapes, and sizes in the United States.

Look around during the first Friday in February. Who’s wearing red? Your local newscasters? Politicians? Your health care team? Your coworkers? School teachers and administrators?  Who in your community knows to rock red and be the beat of heart health?

By raising awareness of women’s heart health, you can increase the chances someone else will decide to get that regular check-up at the doctor’s… and you might schedule your own appointment as well.

A second plot twist?

COVID-19. Science shows that this virus can kill in the short-term and has potentially long-term effects.  SARS-CoV2, the virus that causes COVID-19 is known to be a respiratory disease and can also lead to serious heart problems.

“As the virus causes inflammation and fluid to fill up the air sacs in the lungs, less oxygen can reach the bloodstream. The heart has to work harder to pump blood through the body, which can be dangerous in people with preexisting heart disease. The heart can fail from overwork, or insufficient oxygen can cause cell death and tissue damage in the heart and other organs.” according to the Johns Hopkins Medicine website. 

“Some of the symptoms common in coronavirus “long-haulers,” such as palpitations, dizziness, chest pain and shortness of breath, may be due to heart problems — or, just from having been ill with COVID-19.”

The National Institute of Health notes that one way the body responds to the virus is to create inflammation, which is a good way to fight a virus… but in some people with COVID-19, the inflammation goes into overdrive and damages the heart muscle and disrupts the electrical signals that make it beat properly, creating arrhythmia. Some people seriously ill with COVID-19 form multiple small blood clots throughout the body including the heart, which can cause heart attacks and/or strokes.

Being sick with COVID could last a week or more; however, once testing negative for the virus, symptoms can persist. This is known as long-haul COVID, and these post-COVID symptoms can last for years. Long-haul symptoms can include, but are not limited to, difficulty breathing or shortness of breath; cough; chest pain; fast-beating or pounding heart (also known as heart palpitations).

“A dream is a wish your heart makes.” – Cinderella, Cinderella (1950)

So… what do you do with all this?

  • Educate yourself about heart health and how you can improve yours
  • Schedule and attend an annual medical check-up
  • Ask questions at the appointment about your heart health
  • Raise awareness of heart health
  • Consider using the Disney VoluntEAR Grant program for heart health-focused charities

​​​​​​​Let February be a yearly reminder to schedule that annual evaluation.
Heart health is too important assume everything is ok.
​​​​​​​Get a check-up.


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Related Links:

February is American Heart Month (National Institute of Health)

Heart Disease (Centers for Disease Control and Prevention)

American Heart Association

Go Red for Women (American Heart Association)

The surprising reason some women don't get their hearts checked (Today)

Top 10 Myths About Cardiovascular Disease (Heart.Org)

Opinion: My near-death experience teaches a lesson (CNN)



Definitions:

Albumin - Albumin is a protein made by your liver. Albumin enters your bloodstream and helps keep fluid from leaking out of your blood vessels into other tissues. It is also carries hormones, vitamins, and enzymes throughout your body. Without enough albumin, fluid can leak out of your blood and build up in your lungs, abdomen (belly), or other parts of your body. Low albumin levels can be a sign of liver or kidney disease or another medical condition. High levels may be a sign of dehydration.

Anemia - Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak. There are many forms of anemia, each with its own cause. Anemia can be temporary or long term and can range from mild to severe. In most cases, anemia has more than one cause For anemia, your doctor will likely be interested in the levels of the red blood cells contained in your blood (hematocrit) and the hemoglobin in your blood.

Arrhythmias or abnormal heart rhythms - Heart arrhythmia (uh-RITH-me-uh) is an irregular heartbeat. Heart rhythm problems (heart arrhythmias) occur when the electrical signals that coordinate the heart's beats don't work properly. The faulty signaling causes the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly.

Cholesterol - A complete cholesterol test — also called a lipid panel or lipid profile — is a blood test that can measure the amount of cholesterol and triglycerides in your blood. A cholesterol test can help determine your risk of the buildup of fatty deposits (plaques) in your arteries that can lead to narrowed or blocked arteries throughout your body (atherosclerosis). A cholesterol test is an important tool. High cholesterol levels often are a significant risk factor for coronary artery disease.

Coronary angiogram - A coronary angiogram, sometimes called ‘cardiac catheterization’, may be done after a heart attack or angina. A catheter (a small tube) is put into an artery in your groin, arm or wrist. The catheter is moved up inside the artery until it reaches your heart. A special dye is injected into your coronary arteries and an X-ray is taken. The X-ray shows your doctor where and how much your coronary arteries are clogged or blocked. It also shows how well your heart is pumping. Coronary angiograms help your doctor decide the best treatment for you.

Coronary computed tomography angiogram (CCTA) - This is a specialized type of computed tomography (CT) scan that may be used to help diagnose coronary artery disease. It is a non-invasive test for people who may be experiencing unusual cardiac symptoms.

Creatinine - Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine. A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working.

Echocardiogram (ultrasound) - An echocardiogram is a common test. It gives a picture of your heart using ultrasound, a type of X-ray. It uses a probe either on your chest or down your esophagus (throat). It helps your doctor check if there are any problems with your heart’s valves and chambers and see how strongly your heart pumps blood.

Electrocardiogram (ECG) - An ECG reads your heart’s electrical impulses. It shows how well your heart is beating. Small sticky dots and wire leads are put on your chest, arms and legs. The leads are attached to an ECG machine which records the electrical impulses and prints them out on paper. Your doctor may use an ECG to diagnose a heart attack or abnormal heart rhythms (called ‘arrhythmias’).

Exercise stress test - A stress test, sometimes called a ‘treadmill’ or ‘exercise’ test, is a type of ECG that is done while you are exercising. It helps your doctor to find out how well your heart works when you are physically active.

Magnetic resonance imaging (MRI) - An MRI uses very strong magnets and radio waves to create detailed images of your heart on a computer. It can take still or moving pictures of your heart. Sometimes a special dye is used to make parts of the heart and coronary arteries easier to see. This test shows your doctor the structure of your heart and how well it is working, so they can decide the best treatment for you.

Narrow heart valve - Aortic valve stenosis. The flaps (cusps) of the aortic valve become thick and stiff, or they fuse together. These problems cause the valve opening to become narrow. The narrowed valve reduces or blocks blood flow from the heart to the rest of the body.

Nuclear cardiac stress test - This test is sometimes called an ‘exercise thallium scan’, a ‘dual isotope treadmill’ or an ‘exercise nuclear scan’. A radioactive substance called a ‘tracer’ is injected into your bloodstream. It goes to your heart and releases energy. Special cameras take a picture of this energy from outside your body. Your doctor uses this picture to see how much blood flows to your heart muscle and how well your heart pumps blood when you are resting and doing physical activity. This test also helps your doctor to see if your heart muscle is damaged.

Potassium – The mineral potassium helps your nerves and muscles “talk” to each other, moves nutrients into and waste out of your cells, and helps your heart function. Potassium is one mineral that plays an important role in controlling the amount of fluid in the body. Potassium balances the effects of sodium and helps keep fluid levels within a certain range. Too much potassium is called hyperkalemia; too little potassium in the blood is called hypokalemia.

Sodium – The mineral sodium is key to helping send electrical signals between cells and controlling the amount of fluid in your body. Your body needs it for your cells to work the right way. If your sodium levels are too high for the amount of water in your body, it’s called hypernatremia. If the levels are too low, that’s called hyponatremia. Too much sodium -- which the body mainly gets from salt -- leads to the body retaining fluid. This can lead to high blood pressure (hypertension) and other issues.

Thyroid disease - The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.  Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones. 

When the thyroid makes too much thyroid hormone, your body uses energy too quickly. This is called hyperthyroidism. Using energy too quickly will do more than make you tired — it can make your heart beat faster, cause you to lose weight without trying and even make you feel nervous. On the flip-side of this, your thyroid can make too little thyroid hormone. This is called hypothyroidism. When you have too little thyroid hormone in your body, it can make you feel tired, you might gain weight and you may even be unable to tolerate cold temperatures.

Valve leakage - Leaky Heart Valve (Mitral Valve Regurgitation) The heart valves control blood flow through the heart. A leaky valve doesn’t close properly and can let blood leak through. Some cases are mild, but others place stress on the heart and can cause symptoms, heart failure or cardiac arrest. If needed, there are many ways to repair or replace a heart valve.