Category Archives: Cardiovascular

Heart Health for the Entire Family

As the leading cause of death for men and women in the United States, heart disease is commonly discussed with the older, adult population. However, the conditions that lead to heart disease are happening at younger ages causing heart disease to develop in younger adults increasingly more often. Heart care and prevention is important for everyone. Being aware of what causes heart disease, while also developing heart healthy habits with your family, are both great forms of defense.

What can you do to take control?

Make heart-healthy choices in your diet. Diets high in trans-fat, saturated fat, and added sugar increase the risk for heart disease. Sodium (or salt) increases blood pressure, and most Americans eat too much of it, including children. Pay attention to the nutrition labels on food packaging. A food’s sodium content is something that is clearly listed. By replacing foods high in sodium with fresh fruits and vegetables, you can help lower your blood pressure. In fact, only 1 in 10 adults is getting enough fruits and vegetables each day.

Other helpful ideas to use with children include focusing on the quality of what your child is eating and that they eat until they are full. In other words, no clean-plate club. Quality over quantity. Remember to use kid-sized portions. A good rule to keep in mind is one tablespoon of food per age of the child for each meal option (about two or three foods). It’s also good to serve one meal for your entire family. Plan meals to include at least one thing that everyone likes. Try healthier options for celebrations, and instead of rewarding children with food, give verbal praise or hugs for good behavior. Finally, if you have some particularly picky eaters, get creative to make fruits and vegetables fun. Try using unsweetened raisins or small pieces of fruit to make faces on healthy foods.

Stay active. Physical activity helps keep the heart and blood vessels healthy. Yet, only 1 in 5 adults meets the physical activity guidelines of getting 150 minutes a week of moderate-intensity activity. In fact, more than 1 in 3 American adults – and nearly 1 in 6 under the age of 18 is obese. Carrying around this extra weight puts stress on the heart. It can also contribute to more serious conditions like diabetes. This disease causes sugar to build up in the blood, causing damage to blood vessels and nerves that help control the heart muscle. Simply taking an evening walk as a family or playing an active game together in the back yard each night can help everyone meet their daily cardio goal.

Don’t smoke. Smoking damages blood vessels in our body and can cause heart disease. Despite the decades of health warnings, smoking is the leading cause of preventable death in the United States. More than 37 million U.S. adults currently smoke on a regular basis, and thousands of young people start smoking every day. If you don’t smoke – fabulous! Don’t start and be sure to talk with your older children about the dangers of smoking as well. If you do smoke, learn more about our smoking cessation services. Quitting smoking takes a lot of emotional energy and can be very stressful. Let our qualified staff help develop an individualized quitting plan.

Be consistent in managing any current health conditions. Millions of Americans (of all ages) have high blood pressure, and about half don’t have it under control. Having uncontrolled high blood pressure is one of the biggest risks for heart disease, as well as other harmful conditions including stroke. Work with your healthcare team to manage conditions such as high blood pressure and high cholesterol. Be honest and work together with your provider. Take medications as prescribed.

Heart disease can often be prevented when people make healthy choices and manage their health conditions. By making some simple changes to your family diet and exercise habits, you can help keep your family on the heart-healthy track. Set attainable goals and try to be consistent. Modeling these behaviors will also help your kids form these great habits. When communities, health professionals, and families work together, living heart healthy is possible.

 

Medical Associates is proud to provide advanced heart care that’s close to home. All of our cardiologists are board certified and bring many years of exceptional cardiac care to the community, making it the most complete and up-to-date cardiology program in the Tri-State area. Medical Associates also offers the only cardiothoracic surgeons in the area, and we have the experience and expertise to perform a full array of complex surgeries and techniques. These departments work closely with Internal Medicine, Gastroenterology, and others to provide comprehensive medical management, diagnosis, and treatment of patients.

 

Sources:
cdc.gov/features/heartmonth
Heart.org
healthfinder.org
uwhealth.org

Heart Failure and the Importance of Staying Active, even in the Winter Months

Young trainer helping senior woman in aqua aerobics. Senior retired woman staying fit by aqua aerobics in swimming pool. Happy old woman stretching in swimming pool with young trainer.

When thinking of things that are bad for your health, sitting isn’t often the first thing that comes to mind. However, inactivity or sitting for extended periods of time can be harmful to your health. It is especially harmful to those with heart failure. But when many feel cooped up during these winter months, how can you stay as active? Karena A. Sauser, DNP ARNP, from the Cardiology Department at Medical Associates shares more on the importance of staying active and tips to do it safely in the winter months.

For a patient with heart failure, difficulty breathing and fatigue resulting in diminished exercise tolerance are among the main factors that contribute to decreased social and physical functionality and quality of life. Exercise is a safe, non-pharmacological intervention in stable patients with heart failure. Along with medical therapy, exercise has positive effects on both morbidity and quality of life. Remember to speak with your healthcare provider before starting any form of exercise.

Some patients with heart failure may qualify for cardiac rehab. During cardiac rehab, exercise occurs under supervision with monitoring of blood pressure, heart rate, and heart rhythm. The added responsibility of showing up for appointments gives cardiac rehab patients more motivation to exercise. Cardiac Rehab Programs are offered in the following regional locations: Mercy-Dubuque, Maquoketa, Independence, Anamosa, and Manchester in Iowa; Galena in Illinois; and Darlington, Dodgeville, Boscobel, Lancaster, and Prairie Du Chien in Wisconsin.

However, if your provider tells you it is okay, it is also acceptable to exercise on your own. Just remember to start slow and gradually increase the length and intensity of your workout. You can start with 5-10 minutes/day at a slow pace and increase time and speed as you get stronger. An ideal goal for patients with mild to moderate heart failure is to exercise at least 150 minutes per week (30 minutes 5 days/week or 20-25 minutes daily). It is best to pick activities that you enjoy and are low-impact, such as walking, biking, or swimming. It is important to have a five minute warm-up/stretching period and five minute cool-down/stretching period. Avoid abruptly stopping exercise or immediately sitting or laying down after exercise to prevent dizziness or lightheadedness. It is also important to exercise year-round, even during the bitter cold of winter. If fitness centers are not an option or do not fit into your budget, there are many other heated places to exercise as the weather turns cold. You can always walk in churches, shopping malls, bigger “boxy” stores (like Wal-mart), or at the Mystique ice arena on the upper deck.

When in doubt, remember to follow these tips to exercise safely with heart failure:

  • Avoid exercises that require or encourage holding your breath.
  • Wait at least one hour after eating to exercise.
  • Avoid exercises or actions that require short bursts of energy (interval training).
  • Exercise when you have the most energy. For most heart failure patients, this is in the morning.
  • Think about exercising with a friend or family member. This can make it more enjoyable and social. It also keeps you more accountable/committed.
  • You should be able to talk while you exercise. If not, then you are probably exercising too hard and need to slow down.
  • The day after exercise, you may feel more tired. It is important to balance activity and rest.
  • Avoid exercising in extreme weather conditions. Find safe spaces to exercise that are between 40 and 80 degrees Fahrenheit and under 80% humidity.
  • Avoid exercise when you are not feeling well, have a fever, or your heart failure symptoms are not controlled.

One of the most important ways people with heart failure can maintain their sense of well-being is to stay active. The impact of movement, even leisurely movement, can be profound. Remember to speak with your healthcare provider before starting any form of exercise. Window shopping the mall aisles with a friend, roaming your local museum or art gallery, or stretching and doing some light exercises throughout your daily tasks at home are a few great ways to stay active during the cold months. It all helps burn calories, increase your energy, maintain muscle tone, as well as improve your mental well-being, especially as you age.

 

Sauser_Karena_2017_ultipro

Karena A. Sauser, DNP ARNP
Department of Cardiology
Medical Associates Clinic

 

 

 

Sleep Apnea and Heart Disease, Stroke

Elderly man lost in thought

Plain old snoring can get a little annoying, especially for someone listening to it. But when a snorer repeatedly stops breathing for brief moments, it can lead to cardiovascular problems and potentially be life-threatening.

It’s a condition known as sleep apnea, in which the person may experience pauses in breathing five to 30 times per hour or more during sleep. These episodes wake the sleeper as he or she gasps for air. It prevents restful sleep and is associated with high blood pressure, arrhythmia, stroke and heart failure.

Heart disease is the leading cause of death in the United States, and stroke is also a leading cause of death and disability. High blood pressure is a major risk factor for both.

“The evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that,” said Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at the University of Alabama at Birmingham and the incoming president of the American Heart Association.

A Common Problem
According to Dr. Arnett, one in five adults suffers from at least mild sleep apnea, and it afflicts more men than women. The most common type is obstructive sleep apnea (OSA), when weight on the upper chest and neck contributes to blocking the flow of air. OSA is associated with obesity, which is also a major risk factor for heart disease and stroke. Besides obesity contributing to sleep apnea, sleep deprivation caused by sleep apnea can, in an ongoing unhealthy cycle, lead to further obesity. In OSA the upper airway closes off because the muscles that hold it open lose tone. The more weight, the more loss of tone and the more severe the sleep apnea. Each time the airway closes, there is a pause in breathing.

A less prevalent type of sleep apnea is called central sleep apnea (CSA). In CSA the brain doesn’t send regular signals to the diaphragm to contract and expand. There is limited snoring and it has been associated with brain stem stroke because the brain stem is where the impulse to breathe comes from.

Listen to Those Snoring Complaints
A roommate or sleeping partner of someone with sleep apnea often notices it. “It’s really hard to detect if you live alone, unless you go through a sleep study,” Dr. Arnett said. People with sleep apnea may be more tired during the day and therefore prone to accidents or falling asleep.

Getting Proper Treatment
Through treatment known as continuous positive airway pressure, or CPAP, blood pressure is stabilized. The CPAP device involves wearing a mask while sleeping. It keeps air pressure in the breathing passages so they don’t close down.

In a sleep study, doctors count pauses in breathing to determine whether the patient has mild sleep apnea, characterized by five to 15 episodes per hour; moderate sleep apnea, defined by 15 to 30 per hour; or severe sleep apnea, meaning more than 30 each hour.

It’s certainly possible to have simple, loud snoring without sleep apnea. But with regular snoring, the person continues to inhale and exhale. With sleep apnea, the sleeping person tends to have periods when he or she stops breathing and nothing can be heard. The good news is treatment that keeps the breathing passages open and oxygen flowing can yield fast results, Dr. Arnett said. “Blood pressure comes down really quite quickly.”

Getting Good Rest
If you’re struggling to get a good night’s sleep follow some of these suggestions:

  • Get regular physical activity, but don’t do it right before bed because that gets your adrenaline pumping and can keep you awake.
  • Limit alcohol consumption to one drink per day for women and two drinks for men; too much alcohol interferes with sleep.
  • Avoid caffeine before bed.
  • Develop a pre-bedtime routine such as taking a warm bath, dimming the lights or having some herbal tea.

If you are experiencing symptoms of sleep apnea, be sure to discuss this with your primary care provider. A referral to a pulmonologist may be necessary. At Medical Associates, Dr. Mark K. Janes is Board Certified in sleep medicine and provides diagnosis and treatment of sleep disorders including sleep apnea. Examination of abnormalities of sleep is available with overnight trend oximetry and polysomnography.

 

Source: www.heart.org

 

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.

Treatment:

  • 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.

Treatment:

  • 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.

Treatment:

  • 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.

Treatment:

  • 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.

Treatment:

  • 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

 

Source: www.cdc.gov