Heart disease is the leading cause of death in the U.S.A. and has accounted for 614,348 deaths in year 2014. 747,451 deaths were from heart disease and stroke combined out of 2,626,418 total deaths. The majority of cardiac deaths are the result of Coronary Artery Disease, Congestive Heart Failure, and heart attacks. Other causes include Hypertrophic Cardiomyopathy, inflammation of the heart, and more rare structural, genetic, and environmental heart abnormalities.
Symptoms to Know
Heart Attack:
-Persistent chest pain: Persistant pain that is sharp, squeezing pain that feels deep within the left side of the chest, and persists for more than a few minutes. It is important to catch this type of pain early, and seek evaluation before it has persisted for 30 minutes or more in order to avoid damage to the heart. If you have chest pain that is accompanied by other symptoms listed below, if the chest pain occurs during times of exertion and goes away after exertion, or if the pain spreads to your jaw, back, arm, neck, or stomach, contact a healthcare provider to be evaluated. There are many causes of chest pain that are not heart related. Acid coming up from the stomach into the esophagus, and pain of the muscles and tendons are common causes of chest pain.
-Shortness of Breath/Dizziness/Passing out: Experiencing shortness of breath, if accompanied by chest pain, or palpitations, could indicate a heart condition. If you experience excessive shortness of breath at resting(not from physical activity), dizziness or passing out, you should be evaluated by a medical professional. You can also check your own pulse. If your pulse is out of the normal range of 60-100 beats per minute(at resting), notify a healthcare professional of this finding. There are many possible causes of shortness of breath which are not heart related such as conditions of the lungs and blood.
-Irregular heartbeat (a heart rate that is not between 60-100 beats per minutes at resting)
Heart Failure:
-Wheezing or coughing up pink or white phlegm, or blood
-Swelling of the lower extremities(ankles, legs, feet), or abdomen (weight gain)
-Shortness of breath when lying down or during exertion
-Irregular heartbeat (a heart rate that is not between 60-100 beats per minutes at resting)
These symptoms may or may not be accompanied by(for heart attacks and heart failure):
-Nausea or Vomiting
-Sweating, cold sweats, clamminess
-Excessive, unexplained fatigue
-Confusion or Anxiety
Risk factors for heart disease: Assessing, controlling, and minimizing these risk factors will decrease your chances of getting heart disease.
- Dyslipidemia: Ensure that your LDL, HDL, and triglycerides are at the appropriate levels.
- Smoking tobacco or marijuana
- Family history of heart disease: An important strategy to prevent and monitor the development of heart diseases is analyzing your family history. This includes informing your doctor if a close family member has any history of heart attacks, Coronary Artery Disease, Sudden Cardiac Death at a young age, or other heart conditions. It is important to discuss prevention and monitoring of these conditions with your doctor.
- High Blood Pressure: Ensure that your blood pressure is being controlled and is within a normal range. See our lifestyle tab for more information on diet and exercise.
- Diabetes
- Obesity
- Sedentary lifestyle: Engaging in high intensity aerobic exercise for 25 minutes 3 days a week, or moderate intensity aerobic exercise for at least 30 minutes for 5 days a week can increase your cardiovascular health and decrease your chances of developing diseases that are the leading causes of death in the U.S.A. (22). Resistance training also offers many benefits for cardiac health. Muscle training 2 days per week will have added health benefits. (22). If you have heart disease, talk with you cardiologist about what exercise regimen is right for you.
- Previous heart attack
- Low ejection fraction(less than 35%)
- Excessive alcohol consumption, cocaine use. Limit alcohol consumption to less than 2 drinks per day for males, and less than 1 drink per day for females. Some research has shown that even moderate or low alcohol consumption may do more harm than good including increasing the risk of cancer, atrial fibrillation, and can increase risk of cardiomyopathy at high levels. Other studies have shown benefits on cardiac health of limited alcohol consumption.
- Vitamin/electrolyte deficiencies such as deficiencies in B vitamins, potassium, vitamin D and magnesium.
- Coronary artery disease
- Autoimmune disease, amyloidoses, or other conditions that lead to changes in heart function
- Thyroid conditions (high thyroid hormone)
- Chronic infections
- Old age
-Diet high in sodium, fats, and cholesterol: Some key features of a heart healthy diet are a high intake of omega 3 fatty acids(from consumption of fish or other seafood), soluble fiber, insoluble fiber, and vitamins(fruits and vegetables), and low in calories, added sugars, trans fat, saturated fat, and sodium. (see our lifestyle tab for more diet information or AHA http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WEGvmSMrJaU).
-High stress: Chronic severe stress has a negative effect on many bodily functions. (For more on stress reduction, see our lifestyle tab).
-Not seeing a doctor for screening: It is important to get regular physical examinations and communicate any symptoms to your doctor.
Supplements to support heart health:
By following a healthy diet, most of these vitamins and minerals are already kept at adequate levels. Most of the benefits shown through research has been from consuming foods that contains high amounts of these vitamins and nutrients. Side effects can occur from taking supplements. As people age, they are more likely to become deficient in vitamin B12, B6, Folate, vitamin D and other nutrients.
Magnesium: Magnesium supplementation has shown to treat and prevent irregular heart rhythms such as atrial fibrillation, torsade de pointes, and premature contractions, along with decreasing calcification/hardening of arteries, lowering blood pressure. Some studies have demonstrated that higher magnesium intake is associated with a lower chance of developing Coronary Artery Disease and lower C-reactive protein levels. Magnesium helps to regulate the transport of sodium, potassium and calcium in the electrical cells of the heart. It has shown to relax and dilate smooth muscle including that found in blood vessels, improving blood flow. An adequate dietary intake of potassium and calcium is also important for heart function.
Co Enzyme Q10: Co Enzyme Q10 is a naturally occurring substance within the human body. The heart naturally contains a high concentration of Co Enzyme Q10. It's primary beneficial effects are from acting as an antioxidant, energy(ATP) production, and regulation of ion channels of the heart. It has shown benefits of lowering blood pressure, decreasing heart related chest pain after a heart attack, and is an essential nutrient for the heart.
Omega 3 Fatty Acids: A diet high in Omega 3 Fatty Acids has been associated with a lower risk of developing heart disease, lowering triglycerides, lowering inflammation, and other health benefits. The dietary ratio of Omega 3 Fatty Acids to Omega 6 Fatty Acids is optimal at 1:1- 4:1. Most individuals in the U.S.A. have a ratio closer to 10:1 - 30:1. Omega 3 supplements are available. Green leafy vegetables, fish, walnuts and oils contain Omega 3 Fatty Acids.
Taurine, l-Arginine and Carnitine: There has been a few case studies of individuals, where taurine has shown benefit in restoring normal heart rhythm from atrial fibrillation, and has eliminated premature contractions(ectopic beats) of the heart when used in combination with l-arginine. Taurine can be consumed or synthesized by the human body. Taurine has shown cell membrane stabilization effects, antioxidant effects, and can regulate the amount of calcium within cells (overload of calcium within cells has been shown to cause arrhythmias). It has also been shown to block the effects of angiotension, which increases blood pressure and can cause oxidative damage. It also has shown to have a protective affect on blood vessels against LDL cholesterol. l-Arginine is an nitric oxide precursor and can potentially open and relax arteries. Carnitine deficiencies have been noted in patients with cardiac arrhythmias.
Vitamins C and D: Numerous studies have shown that Vitamin C is beneficial to the health of blood vessels, blood pressure., and inflammation/immune responses. Vitamin D deficiencies have been noted in patients with heart disease.
Garlic: Garlic has shown to decrease the progression of atherosclerosis or hardening of the arteries. More research is needed to determine all of the possible benefits of garlic.
Aspirin: Aspirin can be given to a person who is having a heart attack if they have no allergies or conditions that contraindicate them to taking aspirin. Aspirin is also given regularly to prevent heart attacks in patients over age 50 depending on their risk of heart attack or stroke. Check with your doctor before taking aspirin daily in order to determine if it is the best preventative therapy for you.
B Vitamins: Deficiencies in vitamins B12, B6, and folic acid are common. These vitamins are essential in energy production, and cell growth/division. Vitamin B12 can not be synthesized by the human body and requires adequate dietary intake or supplementation. B12 and Folic acid have shown to reduce the levels of homocysteine in the bloodstream. High homocysteine is known as a risk factor for developing cardiovascular disease. It is unclear if lowering homocysteine decreases the chances of developing these diseases. Vitamin B1 deficiency indicates a higher risk of developing dilated cardiomyopathy.
Resveratrol: Resveratrol is still being studied to determine its potential cardioprotective effects. Studies have demonstrated that Resveratrol has the ability to stop platelet aggregation, which would decrease the likelihood of blood clots forming within the arteries. Resveratrol has also shown effects on nitric oxide mechanisms( in rat hearts), which improve blood flow throughout the heart and regulation of receptors within heart cells that help avoid intracellular calcium overload(in mice). Resveratrol appears to have cardioprotective ability.
Genetics
One option that individuals have is to get a genetic analysis of their DNA. There are many companies who will provide the customer with a full analysis of all the genes present in their DNA, which can indicate risk of developing certain heart conditions. Many heart conditions that can be inherited from parents consist of a variety of genes which code for and build certain parts of the cells within the body. Genetic testing allows the individual to see if they have all or some of these genes. Patients who have a higher risk can monitor themselves more closely, and communicate with their doctor to make lifestyle modifications in order to minimize the impact of these conditions.
Ways to stop a tachyarrhythmia(fast heart rate)
Vagal Maneuvers: Vagal maneuvers can activate the vagus nerve, which slows down the heart rate. These maneuvers include triggering your gag reflex/coughing, dipping your face/head in ice water for about 10 seconds, holding your breath and then exerting force on some of the muscles that allow you to use the bathroom, and massaging the carotid artery (applying firm pressure high under the jaw, on the neck). Talk to your doctor to see if they recommend for you to use any of these manuvers.
By Evan Redmond, Pharm.D.
Sources
1. XU J, BAI Y, JIN J. Magnesium modulates the expression levels of calcification-associated factors to inhibit calcification in a time-dependent manner. Experimental and Therapeutic Medicine. 2015;9(3):1028-1034.
