Category Archives: Cardiovascular

Know the Signs of Heat-Related Illness

As the weather heats up, it’s very important to take precautionary steps against the heat, but also to know the signs of heat-related illness should a problem arise.

First, always wear appropriate clothing. Choose lightweight, light-colored, loose-fitting clothing. It’s also important to stay hydrated. Drink more fluids, regardless of how active you are. Don’t wait until you’re thirsty to drink. Alcoholic drinks are not recommended – these actually cause you to lose more body fluid. Taking a cool shower or bath is also a great way to cool off.

Next, stay cool indoors with air-conditioning on particularly hot days. If your home does not have air conditioning, go to the shopping mall or public library—even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. It’s also smart to use your stove and oven less to maintain a cooler temperature in your home.

When you do go outside, try to limit your outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas. This gives your body a chance to recover. Also remember to pace yourself. If you’re not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP. Get into a cool area or into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Finally, remember to wear sunscreen. Sunburn affects your body’s ability to cool down and can make you dehydrated. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher 30 minutes prior to going out.

If a problem should arise, it’s important to know the signs of heat-related illness and take action right away. If you or someone near you is exhibiting any of the following symptoms, take the appropriate action listed.

Heat Stroke

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Heat stroke can cause death or permanent disability if emergency treatment is not given. Symptoms include: confusion, altered mental status, slurred speech, loss of consciousness (coma), hot, dry skin or profuse sweating, seizures, very high body temperature.


  • Call 911 for emergency care.
  • Move to a shaded, cool area and remove outer clothing.
  • Cool quickly with cold water – wet the skin, place cold, wet cloths on the skin, or soak clothing with cool water.
  • Circulate the air around to speed cooling.

Heat Exhaustion

Heat exhaustion is the body’s response to an excessive loss of the water and salt, usually through excessive sweating. Most people prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment. Symptoms include: headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, elevated body temperature, decreased urine output.


  • Go to a clinic or emergency room for medical evaluation and treatment.
  • If medical care is unavailable, call 911.
  • Remove from hot area and drink liquids.
  • Remove unnecessary clothing, including shoes and socks.
  • Cool with compresses or have the person wash head, face, and neck with cold water.
  • Encourage frequent sips of cool water.

Heat Syncope

Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization. Symptoms include: fainting (short duration), dizziness, light-headedness during prolonged standing or suddenly rising from a sitting or lying position.


  • Sit or lie down in a cool place.
  • Slowly drink water, clear juice, or a sports drink.

Heat Cramps

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion. Symptoms include: muscle cramps, pain, or spasms in the abdomen, arms, or legs.


  • Drink water and have a snack and/or sports drink (with electrolytes) every 15 to 20 minutes.
  • Avoid salt tablets.
  • Get medical help if the person has heart problems, is on a low sodium diet, or if cramps do not subside within 1 hour.

Heat Rash

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms include: red cluster of pimples or small blisters. Usually appears on the neck, upper chest, groin, under the breasts, and in elbow creases.


  • When possible, a cooler, less humid environment is the best treatment.
  • Keep rash area dry.
  • Powder may be applied to increase comfort.
  • Ointments and creams should not be used.


Are you unsure if you or someone near you needs help? The 24 Hour Help Nurse for Patients and Members of Medical Associates is available to assist you 24 hours a day, 7 days a week. They provide a staff of professional, registered nurses available by the telephone.

Do you need advice on a medical symptom, question, or problem? Do you have questions pertaining to a medication? Do you need help determining whether your symptoms require immediate medical attention? The Patient Services – Help Nurses can assist patients and members of Medical Associates with all of these and more. Call (563) 556-4357 or 800-325-7442



7 Recommendations for a Heart Healthy 2017

AMA President Andrew W. Gurman, MD, recently said, “This is the perfect time of year for all of us to reflect on our personal health goals and resolve to make healthy lifestyle choices in the coming year.” It is important, as Dr. Gurman said, for people to understand “where they can make the most impactful, long-lasting improvements in their health.” Here are seven ideas to keep your heart health on track for 2017.

1. Limit your consumption of beverages with added sugars. Avoid sports drinks and soda which have over 100 calories of added sugar per container. Try drinking water, coffee, unsweetened tea or other calorie-free drinks instead. When you do drink beverages with sugar, go for milk or all-fruit juices.

2. Know your risk for Type 2 Diabetes. Take a self-screening test now to determine your risk at Eating healthier, exercising regularly and losing between 5 and 7 percent of your body weight can help prevent diabetes.

3. Be more physically active. Adults between ages 18 and 65 need at least 30 minutes of moderate-intensity aerobic physical activity five days a week, such as walking briskly, bicycling slowly or gardening. Or if you prefer a more intense workout, like running or tennis, 20 minutes of vigorous-intensity aerobic physical activity three days a week is recommended.

4. Avoid processed food and added sodium. Be mindful of sodium counts in packaged foods such as meat, poultry, seafood, pasta, dressings, sauces, soups or gravies. Opt for fresh, frozen or canned foods without any added sauces or seasonings when possible, then try other fresh herbs and spices for flavor.

5. If you drink alcohol, do so in moderation. For women over age 21, that means up to one drink a day, and two drinks daily for men over the age of 21, as defined by the U.S. Dietary Guidelines for Americans.

6. Talk with your doctor about tobacco use and quit. Your physician will help you drop the tobacco habit for good with evidence-based, FDA-approved cessation aids.

7. Declare your home and car smoke free to eliminate exposure to secondhand smoke.


By the Medical Associates Clinic Heart Team
The Department of Cardiology provides a wide range of services including initial evaluation and management of all types of cardiac and peripheral vascular diseases. The Department of Cardiovascular & Thoracic Surgery provides multiple types of surgical treatment of diseases related to the heart, coronary arteries, major blood vessels, chest, lungs, and esophagus. This department serves as consultants to primary physicians, but will accept self-referrals by patients.

I was more than ‘just another patient’ at Medical Associates

By Sam Lynch, patient

In 2014, I was diagnosed with monophasic synovial sarcoma, leading to surgery on my neck at Mayo Clinic in Minnesota.  When I went in for my follow-up at Medical Associates in 2015, doctors discovered that it had reoccurred – this time in my lung.

I’ll admit, I was a little nervous to continue with surgical care at Medical Associates at first, thinking I may receive better care at the same facility I had previously treated at.  However, Dr. Lance Bezzina and the Cardiovascular and Thoracic Surgery team at Medical Associates made sure I felt confident about being in their care.


Dr. Bezzina took his time to make sure I understood every part of my treatment.  He sat down with me and my husband and we discussed options.  He explained the different surgical options, gave his recommendation and explained why he was recommending that course of action.

I didn’t feel like “just another patient.”  I am sure Dr. Bezzina, the nurses and the rest of the team deal with cases like mine all of the time but I never felt that way.  My nurse was very personable and great to work with, and you could tell Dr. Bezzina truly cared about the outcome of the procedure for me.

SamLynch_post_opIt helped to hear Dr. Bezzina’s background at Baylor College of Medicine and other prestigious institutions – I felt completely confident they were going to do as good of a job as a facility like Mayo Clinic.  I came to appreciate the fact that I could receive excellent care at a local facility.  Being treated locally meant I did not have to be away from my family for an extended period of time and I was grateful for that.

In January 2015, I had surgery at Medical Associates to remove the two spots on my lung.  Dr. Bezzina guided me through the process from start to finish – from diagnosis to treatment to recovery.  I felt very comfortable with the level of care I received there and I would recommend the doctors in the Medical Associates Cardiovascular and Thoracic Surgery Department to anyone going through what I am – especially if they are looking for individualized, personal care.  I know I matter to the team at Medical Associates.

Cardiovascular surgery: mending a broken heart

By Lance Bezzina, D.O.

You may have read about common forms of heart disease, but did you know that Medical Associates has the only surgeons in the region with the ability to perform these potentially life-saving procedures? With experienced and highly-trained doctors and surgeons, Medical Associates has the expertise to mend broken hearts through various cardiovascular surgeries.

Stenosis requires valve repair

Stenosis, or the disability of the heart valves to open properly, can lead to heart failure. Once symptoms of stenosis occur in a patient, they first visit a cardiologist before being referred to a cardiothoracic surgeon. While we can operate on all four valves, we commonly only operate on two: the mitral and aortic valve. The surgeon will determine whether it is necessary to replace the damaged valve using either a tissue valve, which lasts around 15 years before needing replacement, or a mechanical valve, which rarely needs further intervention but requires the patient to be on a blood thinner for the rest of his or her life. In the case of mitral valve complications, the native valve can be repaired, offering a permanent fix with no need for blood thinners.

Aneurysms and dissections require emergency surgery

If there is a tear (dissection) or rupture of the aorta—the main artery of your body—emergency surgery is required. Ideally, surgical correction would be performed before dissection or rupture complications occur, so it’s fortunate that your risk of these serious complications can be determined through screening and monitoring the size of the aorta, which allows doctors to intervene before the critical size is reached. Of course, prevention is another key tool in protecting yourself from aneurysms and dissections. The best way to prevent an aneurysm is to abstain from smoking and maintain blood pressure control, and anyone with first degree relatives with a history of aneurysms should be screened, which can be done with ultrasounds and CT scans.

Coronary artery disease requires bypass surgery

Coronary artery disease (CAD) is the number one killer in the United States. Luckily, it is a manageable disease. There are numerous ways to treat CAD, including medicine, stenting and bypass surgery. If there are serious or numerous blockages of coronary arteries, you are at risk of a heart attack, and a referral to a cardiothoracic surgeon needs to be arranged for potential bypass surgery.

In bypass surgery, similar to how one would take the service drive to avoid an accident on the highway, cardiothoracic surgeons create the service drive around the blockage so the blood “bypasses” the blockage. Typically, bypass surgery involves placing a patient on a heart-lung machine and suturing (stitching) veins harvested from the leg and arteries from the inside of the chest to reroute blood past these blockages. After the two to three hour procedure, the patient is monitored, discharged and placed on a cardiac rehabilitation program to take full advantage of their surgery.

Bypass surgery started in the 1960s and has a proven mortality rate of only around 1 percent. This surgery is also extremely durable—around 90 percent of people still have functioning bypasses 12 years after surgery.


The good news is that heart attacks are preventable. While some risk factors such as advanced age and a family history of CAD are beyond your control, many others are. Unfortunately, fewer than 10 percent of U.S. men are free of all preventative risk factors, which include high blood pressure, diabetes, obesity, high cholesterol, a sedentary lifestyle and smoking. Smoking nearly doubles your risk of dying from heart disease.

Luckily, a healthy lifestyle and daily exercise can prevent the onset of heart disease. A heart-healthy diet consisting of foods low in calories, salt and saturated fats can decrease your risk of obesity and diabetes and assist with healthy blood pressure and cholesterol levels. Getting your blood pressure and cholesterol levels checked on a regular basis through your doctor are further preventive measures you can take, and an annual physical after age 40 is recommended to keep up your cardiac health.


Medical Associates has the only surgeons in the Dubuque region with the ability to perform these life-saving procedures. It is important to schedule annual physicals with your healthcare provider and receive cardiac screenings if appropriate. If at any time you experience chest pain/pressure, left arm or shoulder pain, shortness of breath or you feel faint or weak, you should immediately go to the nearest emergency room. These could all be warnings signs of heart disease, and, if treated promptly, could save your life.

Lance Bezzina D.O. practices at Medical Associates in Dubuque. He is board certified in general and cardiothoracic surgery. He is on staff and performs surgery at Unity Point Health-Finley Hospital and Mercy Medical Center Dubuque. In addition to performing the entire scope of cardiac, thoracic and vascular surgery, he is also department chair for cardiothoracic surgery and director of cardiac rehab at Mercy Medical Center. For an appointment please call 563-584-3445.