Tag Archives: cardiology

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.



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




What are we talking about when we talk about heart disease?

By Lance Bezzina, D.O.

As one of the top killers in the United States, “heart disease” is a term that is thrown around quite a bit, especially during Heart Month. Today we’ll discuss the kinds of complications that fall under the umbrella of heart disease and can be treated with cardiothoracic surgery, which involves the treatment of conditions affecting the heart, lungs, esophagus and blood vessels throughout the body.

Medical Associates has the only surgeons in the Dubuque area with the ability to perform these potentially life-saving procedures. In reference to the heart, we commonly perform surgery on aneurysms and heart valves, and we perform bypasses of affected arteries. When we talk about heart disease and the surgeries we perform to treat it, here’s what we’re talking about:

When the heart valves struggle: stenosis
The human heart is divided into four chambers and has four valves working to keep blood moving through it. Stenosis is the term we use when there is a problem with a valve’s ability to open, and the aortic valve most commonly requires surgery for stenosis. Aortic stenosis is a progressive disease, and patients can remain asymptomatic for many years. When symptoms do present, they typically include chest pain (angina), fainting (syncope), difficulty breathing (dyspnea) and heart failure.

Common causes of aortic stenosis are rheumatic fever as a child, calcific degeneration (a common side effect of aging) and a bicuspid aortic valve (the condition of being born with two leaflets of your aortic valve instead of three).

When a blood vessel expands: aneurysms and dissections

A healthy blood vessel has a wall strong enough to resist the pressure of blood flowing through it. Aneurysms occur when the arterial wall is too weak to hold up against the pressure, causing the blood vessel to expand and the wall to grow thinner—like when you blow air into a balloon.

Aneurysms of the aorta most commonly pose a risk to patients if they rupture or dissect. If the blood vessel expands too much and the wall becomes too thin, a rupture or leaking of blood outside the wall of the artery begins. Another complication is called a dissection. The aorta has rings like a tree, and as the aorta gets larger the inner layer can develop a tear and blood can get between these layers and cause heart attacks and strokes, among a host of other problems.

When an artery is blocked: coronary artery disease

Coronary artery disease (CAD) is the current leading cause of death in Americans. CAD develops when cholesterol-filled plaques block arteries that feed blood to the heart, and it can occur in any tissue that is fed by blood. If the disease progresses far enough, it can cause a heart attack. This is the same disease process that causes strokes when the blockages occur in arteries that feed blood to the brain or can cause leg pain if it occurs in the leg arteries.

Medical Associates is proud to be able to perform the cardiovascular surgeries necessary to treat these common forms of heart disease. 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.