“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
Last week a friend from long ago asked for advice after he developed heart failure. I told him that such dramatic changes have occurred in the care of patients with heart disease that locating an expert familiar with the new approaches might prolong his life.
- Major advances have transformed treatment of heart valves that have become dysfunctional from either narrowing or leaking. Many of these valve repairs or replacements can be achieved without the need for open heart surgery by using catheters placed in a leg blood vessel and manipulated to treat the abnormal valve. The hospital stay is usually just overnight or even same day discharge in some instances, with prompt resumption of normal activities.
- Key advances in creating stents to prop open clogged arteries to the heart have yielded impressive results for patients with arteriosclerotic heart disease due to cholesterol-related problems. Interventional cardiologists implant these stents to restore blood flow to areas of deprived heart muscle.
- Administration of statins, a new concentrated fish oil medication called icosapent ethyl, and a complex drug called PCSK9 inhibitor have been able to drive abnormal cholesterol (LDL) levels to new lows that might even reverse some arterial obstructions.
- Innovations in treating heart rhythm problems with implantable pacemakers, defibrillators, and monitors have saved hundreds of thousands of lives. Electrophysiologists can pinpoint the precise site of abnormal rhythm activity in the heart and eliminate it by destroying the tissue with a catheter directed to that site. This approach has revolutionized treatment of arrhythmias. Early work indicates that finding and eliminating the abnormal rhythm may soon be accomplished noninvasively.
- We have also made important progress in drug development for treating weakened heart muscle responsible for heart failure. A combination drug, sacubitril/valsartan, has been shown to improve outcomes in patients with heart failure. A revolutionary group of gliflozin drugs called SGLT2 inhibitors that began as treatment for diabetes has had spectacular results in improving heart failure in patients whether or not they have diabetes or kidney disease.
Sir William Osler, a famous Canadian physician and co-founder of Johns Hopkins Hospital, once said that the young physician begins his life using twenty drugs to treat one disease while the old physician concludes his life with one drug to treat twenty diseases. This aphorism is no longer applicable, if it ever was, since the choice for treating most heart problems has expanded beyond the capability of any one drug or even one cardiologist unless they specialize in that particular area. While the choice may not be twenty drugs for one disease, but more than one is often the rule and not the exception.
Thus, my advice to patients questioning their care is to seek a second opinion from a cardiologist specializing in the area of their problem. Do not be afraid of hurting the feelings of your present doctor. Any physician truly interested in your wellbeing values a second opinion from another specialist that may help direct your care.
Finally, do not let the present pandemic prevent you from seeking appropriate medical support. Delaying needed treatment will only adversely affect your health.
Featured image: Oleh Slepchenko / Shutterstock
Sometimes you can get huge benefits from small changes. For example, a recent study suggests you can reduce the risk of heart disease by eating chile peppers.
Chile peppers are a common ingredient in the Mediterranean diet but may be more important than previously considered. In a study of almost 23,000 men and women, regular consumption of chile peppers was associated with a lower risk of total death and death from heart disease independent of cardiovascular risk factors or adherence to a Mediterranean diet.
The benefits of eating chile peppers have been ascribed to capsaicin, its major pungent compound. Capsaicin can improve cardiovascular function and metabolic regulation and exert anti-inflammatory and analgesic properties, but the exact beneficial action remains unknown, and none of the biological mechanisms tested could explain the health benefits. However, it is not unusual in medicine for the benefits of a substance to precede understanding how it works. For example, the health benefits of penicillin were known long before we understood how it killed bacteria.
Speaking of heart disease, I was surprised to learn recently that half of individuals in the U.S. are unaware of the constellation of common signs and symptoms of a heart attack. That’s unfortunate; prompt recognition is critical to seeking emergency care that can save a life. Delay in seeking help increases the risk of dying.
So, remember the big five: 1) chest pain or discomfort, 2) shortness of breath, 3) pain or discomfort in arms or shoulder, 4) feeling weak, faint, or lightheaded, and 5) jaw, neck, or back pain. If you experience any of these symptoms, call 911 and seek medical aid promptly. (Of course, several of these also could be indications of COVID-19.) Shortness of breath, weakness, or lightheadedness accompanied by fever may be sign of viral infection.
Don’t forget: moderation in all things, including moderation.
Don’t miss “Your Weekly Checkup” by Dr. Douglas Zipes for updates on medical breakthroughs and advice on healthy living at saturdayeveningpost.com/checkup.
This article is featured in the July/August 2020 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.
Featured image: Brent Hofacker / Shutterstock
There’s solid proof that omega-3s support cardiovascular, cognitive, and joint health. But an important question lingers in the air: Do seafood and fish oil supplements offer equal protection?
“Fish oil supplement is not the same as eating whole fish. In fact, recent research found that omega-3s in capsule form may not provide any actual benefits to your heart health. That’s why I recommend my patients follow the Dietary Guidelines for Americans and consume 2 to 3 servings (8 to 12 ounces) of seafood each week,” says Dr. Lori Mosca, Professor of Medicine at Columbia University Medical Center and Director of Preventive Cardiology at New York-Presbyterian Hospital.
Interestingly, both women and men need the same amount of fish each week to support heart health and reduce heart disease risk. One serving is about the size of the palm of your hand, says Dr. Mosca who offers these simple ideas for powering family meals with omega-3s by replacing your usual protein with fish:
Breakfast option: Top a multigrain bagel with canned tuna.
Lunch option: Fill tacos with fish, or add fish to a green salad.
Dinner option: Grill salmon, or stir fish into a pasta sauce.
For more recipes visit GetRealAboutSeafood.com.