Tag Archives: cardiologist

#GoRedWearRed ~ Women’s Heart and Vascular Health

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BW ARA labcoatThe OhioHealth Women’s Heart & Vascular Conference January 30, 2016 was a great opportunity for healthcare professionals to focus on current research and practice for Women’s Heart Health.

It takes dedicated research and study to understand how best to identify heart risk and heart disease in women and dedicated clinicians who will put the research findings into practice. The American Heart Association Wear Red Day, Go Red for Women campaigns work to educate women about heart and vascular disease ~ 

For Wear Red Day 2016, here are a few conference takeaways:

Dr Alton

Dr Alton

  1. Ischemic heart disease is not a “Man’s” disease ~ in fact heart disease is the leading killer of mothers, wives, aunts, daughters, sisters. Cardiac tests may include radiation exposure; ask about the tests your doctor is recommending – are there alternatives that don’t involve radiation.

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Dr. Barac discussing CardioOncology

Dr. Barac discussing CardioOncology

2. Cardio Oncology focuses on heart health in the setting of cancer treatment; either history of cancer treatment or current – the goal is to be sure women can receive the most effective cancer treatments while protecting their heart function ~ As with all heart health, making sure you control risk factors for heart disease (hypertension or high blood pressure for example) also helps the heart stay strong during chemotherapy.

 

Dr Amburgey

Dr Amburgey

3. Consider pregnancy a stress test for your heart  It is important to follow up if you have hypertension in pregnancy, pre-eclampsia, or eclampsia or diabetes in pregnancy because these conditions may improve after delivery but are now included as risk factors for heart disease and stroke for women over the next 30 years.

 

 

Dr. Neff-Massullo

Dr. Neff-Massullo

4. Vascular disease is under-diagnosed in women ~ the role of hormone therapy and venous thrombo-embolism (VTE) or blood clots in veins is significant. While it is not recommended to test everyone who starts hormone therapy, it is important to speak up if you have a family history of blood clots or any signs/symptoms of blood clot (leg swelling, pain) – especially in the first 12 months of hormone therapy.

 

Test of venous disease ~ Doppler showing venous reflux

Test of venous disease ~spectral  Doppler ultrasound showing venous reflux

5. Venous disease can cause leg pain and swelling, over time can be disabling due to skin changes such as ulcers; compression socks and vascular procedures can help.

 

 

 

 

Dr. Rock-Willoughby

Dr. Rock-Willoughby

6. Women suffer from delay seeking treatment AND delay of diagnosis of acute MI (heart attack).    For Women: Don’t wait for symptoms to go away; it might not be chest pain; women can experience fatigue, sweats, shortness of breath, dizziness, nausea or abdominal pain – call 911. For Healthcare Providers : Think Nose to Navel ~ a program designed to reduce the time to EKG evaluation for women.

7. What’s a treatment that reduces risk of death, heart attack, and more heart procedures?  Cardiac Rehab. Why are referrals and enrollment not 100%? Why are both even lower for women? Make time for Cardiac Rehab and for Heart Health; it’s worth the effort.

Dr Albers introducing Dr Amin to discuss Atrial Fibrillation

Dr Albers introducing Dr Amin to discuss Atrial Fibrillation

8. Women are underrepresented in Heart Rhythm Disorders research; we know that being a woman increases stroke risk in atrial fibrillation. Be sure to ask your doctor if you have atrial fibrillation, if you need to be checked for atrial fibrillation, and if you should be taking a medicine to reduce your risk of stroke. Get involved and participate in clinical research.

 

McConnell Heart Health Center

McConnell Heart Health Center

Thanks to conference attendees  ~ the room was at capacity ~ more healthcare professionals learning about the diagnosis and treatment of heart and vascular disease in women.

Hello #HeartMonth

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BW ARA labcoatThe OhioHealth Women’s Heart & Vascular Program CME event on Saturday 1/30 was a fabulous kick off to February ~ Heart Month ~ which includes #WearRedGoRed for Women Friday February 5 and the Go Red for Women Luncheon here in Columbus on Thursday February 25 to benefit the American Heart Association.

We appreciate the American Heart Association support for the conference (see registration table photo below) with Red Dress pins, wristbands, and great Know & Go cards for participants.

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The morning event at the McConnell Heart Health Center brought together health care professionals interested in learning about Women’s Heart & Vascular Health; from Heart & Vascular physicians with keynote presentation from Dr. Ana Barac discussing CardioOncology.

Dr. Mary Alton gave a great opening lecture on Women & Heart Disease, including Yentl syndrome.  She covered cardiac testing for women ~ or how can we choose the best way to learn about a woman’s heart function.

Dr. Barac presented current research in how to protect women’s hearts during chemotherapy for cancer; as well as the risk of high blood pressure (hypertension) and other risk factors that weaken a woman’s heart function when going through cancer treatments.

IMG_6674The OhioHealth Women’s Heart & Vascular Pregnancy Predicts Risk Program ~ why was this started & what’s a risk from pregnancy? was introduced by Dr. Laurie Amburgey, Maternal Fetal Medicine, and discussed by Dr. Ashley Chambers, Internal Medicine. Both providers discussed the fact that a woman’s heart risk with pregnancy issues like pre-eclampsia doesn’t stop with delivery of the baby. Dr. Chambers told us about the OhioHealth program to be sure women have appropriate risk factor management in the years after having a pregnancy that predicts Heart Risk.

Dr. Joddi Neff with Riverside Radiology and Interventional Associates gave a great “Ask the Expert” session on Vascular Medicine – (a big topic that could have its own conference) and focused on risk of blood clots with hormone therapy, and management of venous diseases for women.

Faculty & Course Director Clockwise from bottom left: Dr. Alton, Dr. Nicholson, Dr. Amin, Dr. Rock-Willoughby, Dr. Chambers, Dr. Amburgey, Dr. Neff-Massullo, Dr. Barac, Dr. Albers

Women’s Heart & Vascular CME Faculty 
Clockwise from bottom left: Dr. Alton, Dr. Nicholson, Dr. Amin, Dr. Rock-Willoughby, Dr. Chambers, Dr. Amburgey, Dr. Neff-Massullo, Dr. Barac, Dr. Albers (Course Director)

Dr. David Nicholson and Dr. Jayme Rock-Willoughby with OhioHealth presented the session “From ER to CR” highlighting the “Nose to Navel” goal for early EKG for women with symptoms occurring in that anatomical range, and the Women’s Cardiac Rehab programming launched at the McConnell Heart Health Center in 2015 ~ an effort to get more women through Cardiac Rehab.

Dr. Anish Amin, a Heart Rhythm Specialist closed with an excellent talk on Women’s risk for stroke with atrial fibrillation (a heart arrhythmia).

More to come with take home points for patients from the morning sessions.

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Lexie Sines, with OhioHealth CME

Heart Health Doctors go to Washington DC

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BW ARA labcoatThe American College of Cardiology (ACC) is home to nearly 50,000 cardiovascular care team members including your Heart Health Doctors. I spent 3 days last week in Washington DC with ~ 400 other ACC members who took time away from their patients and practices to visit Capitol Hill together on October 20 and educate our legislators about heart health.

  • HeartHealthDocs goal is education to gain knowledge and maximize heart disease PREVENTION. James Madison’s words can apply to knowledge used to defend against heart disease and optimize heart health:

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Photo above: Library of Congress, Madison building inscription.

Last week I learned more about how our government works; and had the opportunity to talk heart health and present the ACC message to 4 legislators from Ohio: Senator Sherrod Brown’s Legislative Fellow LaTasha Lee, PhD, MPH, Congresswoman Joyce Beatty’s Senior Legislative Assistant Donnica Hawes-Saunders, JD, Congressman Patrick J. Tiberi’s Legislative Correspondent Abigail Finn, and Congressman Steve Stivers’ Legislative Assistant Taryn Dorfman.

The ACC advocacy priorities are inspiring by necessity; despite a 50% decline in heart and vascular related deaths over the last 40 years, heart disease remains the #1 killer in the US (and the world), accounting for 1 in 4 deaths in America (ACC).

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ACC strives to create a value driven health care system, ensure patient access to care and cardiovascular practice stability, promote the use of clinical data to improve care, foster research and innovation in cardiovascular care, and improve population health and prevent cardiovascular disease.

The specific ask for our representatives is 4-fold:

  1. Support legislation to expand patient access to CARDIAC REHAB – by maximizing cardiovascular care team members’ work and programs.
  2. Promote the usability of electronic health records; to maximize your cardiovascular specialists’ time and energy focused on patients’ cardiac health, not on the computer.
  3. Support new funding for the National Institutes of Health and the Food and Drug Administration ~ where funding levels have remained flat for the past 12 years.
  4. Work with medical specialty societies to develop alternative payment models for effective and efficient patient care.

Read more about the importance of Cardiac Rehab here, only through research will we find ways to manage heart disease and promote heart health; without usable workflow, our cardiovascular care team members are limited both in access for patients and range of services offered.

The trip was full- great education and inspiration. October 20 was a remarkably successful legislative day for heart health not just for Americans in general, but also for those of us walking the hill. I logged > 18,000 steps on my pedometer on Tuesday.

Photo is at the 7 am start for the day on Capitol Hill – 

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A great prescription

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BW ARA labcoatWe have written and posted about the heart health benefits of exercise at HeartHealthDocs – including programs like Cardiac Rehabilitation (Rehab)

heart to start book. In the book Heart to Start, Dr. James Beckerman, a cardiologist who lives in Portland, Oregon, writes a detailed prescription for anyone to use to start living heart healthy. The gut-check forward “What’s your legacy?” written by David Watkins is followed by patient examples, vignettes, and Beckerman’s own personal reasons for the book. The Warm Up, Work Out, Cool Down sections echo a training session, and take the reader through the paces – the what, why, how, for fitness assessment and growth toward heart & circulation health.

The chapter Cardiac Reboot asks “Got Rehab?” and points out the current reality that if you (the patient) don’t bring up cardiac rehab, “it is possible no one else will.” This relates to the low numbers (20-30%) of eligible patients being referred to cardiac rehab, and of those only 40% actually completing this effective treatment regimen.

Beckerman goes on to provide readers a toolkit for being active, while showing how an active lifestyle can be habit forming – and be maintained for years (ie. how not to get injured). The book will get you to your 5K and its finish & beyond, and will teach how nutrition, training, and balance (ie. strength conditioning in addition to walking/running) work together.

Dr. Beckerman gives powerful examples of what motivates him – for the book, and for his practice which includes the PlaySmart heart screening program. The proceeds from the sale of his book will support free heart screenings for kids.  The book will help anyone learn about and apply practical, inspiring information for exercise and heart health. A great way to multitask.

Cardiac Rehab~Have you heard of it? #hearthealth @CardioSmart #CardiacRehab #exerciseworks

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BW ARA labcoatHeart and Vascular Health result from a mix of a lot of different ingredients; we cover many of these ingredients here at the Heart Health Doctors (for example exercise, diet). Think of mixing or using the best ingredients possible (healthy weight, not smoking, healthy diet, staying active) as PRIMARY prevention (for someone who has never had a heart event).

Another important way to work on the ‘ingredients’ is by SECONDARY prevention – how to regain strength, heal after injury, and build back to great Heart & Vascular Health after an EVENT.

Cardiac Rehab is how. The event that will trigger going to Cardiac Rehab may be having a heart stent, a heart attack, open heart surgery for bypass of blocked heart arteries, valve replacement or repair, chest pain or angina, or most recently, a diagnosis of congestive heart failure; even a combination of these.

It would be great to have Cardiac PREhab programs; for now that is what we do at our blog – education for maintaining heart and vascular health.

Cardiac Rehab remains the program that can reduce mortality (death) by 25% if people who have had a heart event complete the program when compared with people who have had a heart event who did not complete a Cardiac Rehab program.

This CardioSmart video gives a great overview of Cardiac Rehab.

The benefits of Cardiac Rehab in our communities cannot be overstated. Often patients will tell me that they plan to “exercise on their own” or that (women here) they are busy making sure their families are organized and cared for, so “no time.” One program offers discount rate for a spouse to attend rehab sessions and exercise with the patient to help increase participation. I encourage and – to use doctor terminology – order my patients to enroll and participate in Cardiac Rehab despite excuses.

At Cardiac Rehab the exercise is monitored – so the patient’s physician learns of any heart arrhythmia, or of any blood pressure issue (under or over treatment). The patient learns about their heart disease, heart healthy habits, how to follow their personal exercise prescription, eat heart healthy, and how to identify and manage stress. It is time well spent. A challenge for patients of late unfortunately can be cost; many programs have financial aid to help patients attend and complete a rehab program, but I had no argument for my patient whose co-pays for cardiac rehab would have approached $2000 for his sessions. He simply could not participate. The hope is that that is an exception; insurers have the data that shows Cardiac Rehab programs result in patients having fewer followup procedures, come out with better quality of life, and are more prepared to succeed with SECONDARY prevention.

Often patients have up to a year to enroll in a Cardiac Rehab program after a qualifying heart EVENT.  Make it a priority to include this therapy and improve Heart & Vascular Health.

 

 

Need a great book for Heart Month?

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IMG_9814rtDr. Suzanne Steinbaum’s Heart Book – Every Woman’s Guide to a Heart-Healthy Life published in 2013 is a good one.
Full disclosure: I am a cardiologist. Dr. Steinbaum is a cardiologist. The book is for Women; I bring my own perspective as a physician/provider – I can’t *not* be a cardiologist. Good news that Dr. Steinbaum writes in an approachable style, bringing practical information (lots of it) to Women of all backgrounds/interests (cardiologist or not). The book walks you through an inventory of your life: stress, passion, family, work, habits. You will learn why your heart matters and how you hold your heart health in your hands. Chapter 6 is a good one from my perspective: Inside the Office-The Art and Challenge of Communicating with Doctors. Dr. Steinbaum includes patient examples of what to do to get the most out of your appointment, but also teaches the reader what the doctor may be dealing with on a given office day- What Your Doctor Needs to Know <–> What You Want From Your Doctor.

Dr. Steinbaum’s chapter “Let’s Do Some Tests” is a concise description of heart diagnostics — what your heart specialist may check and why. Beyond doing Translational Medicine so well (meaning, how to write or communicate so our patients understand and are inspired), the book drills down on the advice I try to cover into my 15-minute patient appointments in much more detail: how you can use diet, exercise, stress & weight management, to lower your risk for heart disease. Dr. Steinbaum challenges the reader to a Dietary Action Plan, elaborating well on the many issues we have with food beyond whether or not it is heart healthy. Once you appreciate behavior as outlined here, you can identify opportunity for change. Exercise, also, is given excellent coverage as “The Ultimate Prescription.” Similar to the chapters on diet, The Ultimate Prescription chapters help clarify the behaviors that relate to why or why not people are drawn to exercise. Yes, it benefits your heart health to exercise, but do we all understand why or how to get it done? The book helps.

Dr. Steinbaum asserts, accurately, that Health Care is Self-Care, but goes on to be real and consider “Hormone Hell” and “When Bad Things Happen.” The Heart Book is worth a look. I give a lot of talks teaching women that they can reduce their risk of heart disease by > 80% with lifestyle … not smoking, maintaining a healthy weight, getting regular exercise, and following a heart healthy diet. Using personal and patient stories, Dr. Steinbaum writes for any audience – the book has great information for men and women who want tools for heart health. We all benefit from her effort.