How Heart Surgery May Extend Your Life
Routine, but never minor, surgery: Get a second opinion if you're in doubt.
(OWEN FRANKEN/CORBIS)
In 2005 doctors performed about 280,000 bypass surgeries to route new vessels around blocked arteries and 800,000 angioplasties to open blocked arteries. Another 100,000 Americans had heart valves surgically repaired or replaced.
If your doctor says you need an intervention to fix or protect your heart, you'll have some pressing questions.
• What type of procedure is the best choice for you?
• What are the risks?
• What kinds of improvements can you expect?
Can surgery extend your life?
While heart surgery can't cure heart disease, it should relieve chest pain and help you live longer.
Alive and Amazed
"My arteries were really clogged" Watch video
More about heart surgery
The Dilemma of Bypass or Angioplasty
Heart Surgery That Barely Leaves a Scar
How Safe Is Bypass Surgery?
Patients with serious coronary artery disease who undergo bypass surgery are nearly 50% more likely to be alive in five years than patients who receive drug treatment alone.
Angioplasties can also relieve chest pain, but the results are not as lasting. More than 40% of the patients who receive angioplasty need bypass surgery within a decade.
Long-term survival following the two procedures is just about the same, according to a recent overview of both by researchers at Stanford University School of Medicine. Results for almost 10,000 patients from 23 clinical trials in the United States and Europe showed 98.2% survival for bypass surgery and 98.9% for angioplasty.
Next Page: Risks versus benefits of bypass
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Lead writer: Chris Woolston
Kamis, 11 Desember 2008
Statins and Other Drugs
Prognosis for Heart Attack Patients May Depend on What's in the Medicine Cabinet
Skipping this pill can triple your risk of death within a year.
(TOM GRILL/CORBIS/HEALTH)
Whether you're trying to recover from a massive heart attack or hoping to mitigate your risk factors, the right prescription heart drug can put your goals within reach. In recent years doctors have hit upon effective combinations for the most common heart conditions. The future of heart attack and heart disease patients depends in part on the contents of their medicine cabinet, says Sharonne Hayes, MD, director of the Mayo Clinic's Women's Heart Clinic. "Heart patients who go home with aspirin, a statin, and a beta-blocker have fewer second heart attacks and live longer than those who don't," she says.
When lifestyle changes aren't enough
John Maiorana, a 65-year-old retired Navy chaplain living in Virginia Beach, Va., has been taking Lipitor every day since his quadruple bypass surgery 10 years ago. His doctor runs a simple blood test every year to check for signs of liver damage—a standard procedure for anyone taking a statin—but the drug has never caused Maiorana any trouble.
Heart Drugs
"I take so many now" Watch video
More on heart drugs
Beta-Blockers for Coronary Artery Disease
Blood Pressure Medications
Calcium Channel Blockers Can Treat Coronary Artery Disease
Over the years the combination of Lipitor, regular exercise, and a low-fat diet has brought his total cholesterol down from the high 240s to the low 150s and allowed him to enjoy his retirement. "I walk, I jog, and I even eat pizza with cheese on it," he says. "I just don't overdo it."
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Skipping this pill can triple your risk of death within a year.
(TOM GRILL/CORBIS/HEALTH)
Whether you're trying to recover from a massive heart attack or hoping to mitigate your risk factors, the right prescription heart drug can put your goals within reach. In recent years doctors have hit upon effective combinations for the most common heart conditions. The future of heart attack and heart disease patients depends in part on the contents of their medicine cabinet, says Sharonne Hayes, MD, director of the Mayo Clinic's Women's Heart Clinic. "Heart patients who go home with aspirin, a statin, and a beta-blocker have fewer second heart attacks and live longer than those who don't," she says.
When lifestyle changes aren't enough
John Maiorana, a 65-year-old retired Navy chaplain living in Virginia Beach, Va., has been taking Lipitor every day since his quadruple bypass surgery 10 years ago. His doctor runs a simple blood test every year to check for signs of liver damage—a standard procedure for anyone taking a statin—but the drug has never caused Maiorana any trouble.
Heart Drugs
"I take so many now" Watch video
More on heart drugs
Beta-Blockers for Coronary Artery Disease
Blood Pressure Medications
Calcium Channel Blockers Can Treat Coronary Artery Disease
Over the years the combination of Lipitor, regular exercise, and a low-fat diet has brought his total cholesterol down from the high 240s to the low 150s and allowed him to enjoy his retirement. "I walk, I jog, and I even eat pizza with cheese on it," he says. "I just don't overdo it."
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Depression and Heart Disease
Depression and Heart Disease
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Your odds of dying post heart attack are four times higher if you are depressed.
(VEER)
By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Which condition comes first?
The World Health Organization predicts that by 2002 heart disease will be the number one cause of death and disability worldwide and that depression will be second. But the extent to which these two chronic conditions are caused by each other, or happen to occur in tandem, is an area experts are still exploring. How to treat both conditions simultaneously is another.
"Depression as a risk factor for heart disease leads us to question whether we should be treating the mind and the body together," says Leo Pozuelo, MD, associate director of the Bakken Heart-Brain Institute at the Cleveland Clinic.
Heart Disease Blues
"I could only do a few things" Watch video
More on heart disease
Treating Depression Can Help to Heal Your Heart
Why You Must Treat Cardiac Depression
Coping With Depression and Heart Disease
"Depression makes people sicker"
Whichever comes first, depression and heart disease make a devastating combination. Depression can also get in the way of recovery once you have heart disease.
Research suggests that repeat cardiovascular events are more closely associated with depression than they are with smoking, diabetes, high blood pressure, or high cholesterol. A recent Duke University study also found that depressed heart-failure patients were 50% more likely to die or to be hospitalized for their heart condition than patients who were not depressed.
In the first six months after a heart attack, a depressed person's chances of dying are four times higher than a nondepressed person's, even if they have the same heart damage. "Depression itself makes people sicker in ways that we don't really have a clear understanding of," says Kenneth Robbins, MD, professor of psychiatry at the University of Wisconsin–Madison.
Whether you've battled depression for years or only developed symptoms after your heart disease, taking your depression seriously may be the best thing you do for odds of surviving heart disease.
Lead writer: Sharon Kay
Last Updated: May 11, 2008
Share
Your odds of dying post heart attack are four times higher if you are depressed.
(VEER)
By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Which condition comes first?
The World Health Organization predicts that by 2002 heart disease will be the number one cause of death and disability worldwide and that depression will be second. But the extent to which these two chronic conditions are caused by each other, or happen to occur in tandem, is an area experts are still exploring. How to treat both conditions simultaneously is another.
"Depression as a risk factor for heart disease leads us to question whether we should be treating the mind and the body together," says Leo Pozuelo, MD, associate director of the Bakken Heart-Brain Institute at the Cleveland Clinic.
Heart Disease Blues
"I could only do a few things" Watch video
More on heart disease
Treating Depression Can Help to Heal Your Heart
Why You Must Treat Cardiac Depression
Coping With Depression and Heart Disease
"Depression makes people sicker"
Whichever comes first, depression and heart disease make a devastating combination. Depression can also get in the way of recovery once you have heart disease.
Research suggests that repeat cardiovascular events are more closely associated with depression than they are with smoking, diabetes, high blood pressure, or high cholesterol. A recent Duke University study also found that depressed heart-failure patients were 50% more likely to die or to be hospitalized for their heart condition than patients who were not depressed.
In the first six months after a heart attack, a depressed person's chances of dying are four times higher than a nondepressed person's, even if they have the same heart damage. "Depression itself makes people sicker in ways that we don't really have a clear understanding of," says Kenneth Robbins, MD, professor of psychiatry at the University of Wisconsin–Madison.
Whether you've battled depression for years or only developed symptoms after your heart disease, taking your depression seriously may be the best thing you do for odds of surviving heart disease.
Lead writer: Sharon Kay
Last Updated: May 11, 2008
Diet and Exercise
5 Shortcuts to a Heart-Healthy Diet
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Smart heart patients are obsessive label readers.
(ISTOCKPHOTO)
People with heart disease tend to have something in common: Many have spent decades eating too much saturated fat and not consuming enough fruits and vegetables.
After being diagnosed with coronary artery disease and undergoing a quadruple bypass surgery at age 60, Alfred Pasquale, a marketer of cheese products in San Rafael, Calif., learned to eat in moderation. "My wife and I don't go out to eat as much as we used to, because I need to control what is on my plate," he says.
But whether dining out or at home, most people can make dramatic progress by following the guidelines below.
Cut meat intake. "If you had to target one particular food group to help your heart, it would be meat," says Jeffrey Frame, PhD, a registered dietitian and professor of dietetics at Murray State University. "Animal products and saturated fat go hand in hand."
Swap red meat for other protein. Red meat is especially high in saturated fat, says Melissa Ohlson, RD, coordinator of the Cleveland Clinic's preventive cardiology and rehabilitation nutrition program. Cutting portion sizes of steaks—or, better, substituting chicken or fish—goes a long way toward protecting the heart.
Count fat grams. Ohlson also encourages heart patients to read labels of all packaged food. Anything with more than two grams of saturated fat per serving will do the heart more harm than good. You should also avoid any foods that have more than 1 gram of trans fat per 100 calories. Lots of packaged snack foods—including many baked goods, cookies, and potato chips—won't pass the test.
Bulk up on plant foods. The vitamins, minerals, antioxidants, and fiber in fresh produce and beans can help lower blood pressure while protecting arteries from damage.
Keep your weight under control. A study of nearly 30,000 men found that over just three years men with BMI between 25 and 28.9 (which falls within the range typically defined as overweight) had a 72% increased risk of developing coronary heart disease—and obese men with BMI of 33 or above had a 244% increase—compared with lean men with BMI of 23 or under.
Share
Smart heart patients are obsessive label readers.
(ISTOCKPHOTO)
People with heart disease tend to have something in common: Many have spent decades eating too much saturated fat and not consuming enough fruits and vegetables.
After being diagnosed with coronary artery disease and undergoing a quadruple bypass surgery at age 60, Alfred Pasquale, a marketer of cheese products in San Rafael, Calif., learned to eat in moderation. "My wife and I don't go out to eat as much as we used to, because I need to control what is on my plate," he says.
But whether dining out or at home, most people can make dramatic progress by following the guidelines below.
Cut meat intake. "If you had to target one particular food group to help your heart, it would be meat," says Jeffrey Frame, PhD, a registered dietitian and professor of dietetics at Murray State University. "Animal products and saturated fat go hand in hand."
Swap red meat for other protein. Red meat is especially high in saturated fat, says Melissa Ohlson, RD, coordinator of the Cleveland Clinic's preventive cardiology and rehabilitation nutrition program. Cutting portion sizes of steaks—or, better, substituting chicken or fish—goes a long way toward protecting the heart.
Count fat grams. Ohlson also encourages heart patients to read labels of all packaged food. Anything with more than two grams of saturated fat per serving will do the heart more harm than good. You should also avoid any foods that have more than 1 gram of trans fat per 100 calories. Lots of packaged snack foods—including many baked goods, cookies, and potato chips—won't pass the test.
Bulk up on plant foods. The vitamins, minerals, antioxidants, and fiber in fresh produce and beans can help lower blood pressure while protecting arteries from damage.
Keep your weight under control. A study of nearly 30,000 men found that over just three years men with BMI between 25 and 28.9 (which falls within the range typically defined as overweight) had a 72% increased risk of developing coronary heart disease—and obese men with BMI of 33 or above had a 244% increase—compared with lean men with BMI of 23 or under.
What Causes Arrhythmia?
The heart doesn't contract all at once. Instead, each section waits for its cue: an electrical signal that starts at the top of the right atrium and runs downward through the ventricles. As long as nothing disturbs that signal, the heart will beat at a mostly steady, healthy pace.
Damage to the heart—whether from an infection, an inherited condition, or a heart attack—can interfere with the electrical signal and throw the heart off its rhythm. This is arrythmia.
More about arrythmia
What a Skipped Heartbeat Means
7 Symptoms of Arrhythmia
Atrial Fibrillation Causes the Heart to Quiver Instead of Pump
Almost any part of the heart is capable of starting the electricity that drives the beat, and the heart muscle may also immediately jury-rig a new source of electrical signals. These new signals may keep the heart beating, but they disrupt the normal pace or rhythm.
A racing heartbeat—ventricular tachycardia, it turns out—sent Shannon Schroeder, 37, of Poulsbo, Wash., to the emergency room. It's a good thing she went.
Share Your Thoughts
Has coffee ever made your heart gallop?
An echocardiogram showed that the walls of her left ventricle were thicker than they should be, and the muscle showed telltale damage of an earlier silent heart attack. The damage had weakened her heart and harmed the electric circuitry that maintains a normal rhythm.
Stimulants—including caffeine, nicotine, and drugs—can also cause brief arrhythmias. They're usually harmless, but there are case reports of people dying from ventricular fibrillation after overdosing on controlled substances.
Lead writer: Chris Woolston
Last Updated: April 01, 2008
Damage to the heart—whether from an infection, an inherited condition, or a heart attack—can interfere with the electrical signal and throw the heart off its rhythm. This is arrythmia.
More about arrythmia
What a Skipped Heartbeat Means
7 Symptoms of Arrhythmia
Atrial Fibrillation Causes the Heart to Quiver Instead of Pump
Almost any part of the heart is capable of starting the electricity that drives the beat, and the heart muscle may also immediately jury-rig a new source of electrical signals. These new signals may keep the heart beating, but they disrupt the normal pace or rhythm.
A racing heartbeat—ventricular tachycardia, it turns out—sent Shannon Schroeder, 37, of Poulsbo, Wash., to the emergency room. It's a good thing she went.
Share Your Thoughts
Has coffee ever made your heart gallop?
An echocardiogram showed that the walls of her left ventricle were thicker than they should be, and the muscle showed telltale damage of an earlier silent heart attack. The damage had weakened her heart and harmed the electric circuitry that maintains a normal rhythm.
Stimulants—including caffeine, nicotine, and drugs—can also cause brief arrhythmias. They're usually harmless, but there are case reports of people dying from ventricular fibrillation after overdosing on controlled substances.
Lead writer: Chris Woolston
Last Updated: April 01, 2008
Coronary Artery Disease
What Causes Coronary Artery Disease?
content provided by Healthwise
More about CAD
Thriving With Heart Disease
Don't Ignore CAD Symptoms
What Treatments Work for Coronary Artery Disease?
Coronary artery disease is caused by hardening of the arteries, or atherosclerosis. Atherosclerosis occurs when plaque builds up inside the arteries. (Arteries are the blood vessels that carry oxygen-rich blood throughout your body.) Atherosclerosis can affect any arteries in the body. When it occurs in the arteries that supply blood to the heart, it is called coronary artery disease.
Plaque is a fatty material made up of cholesterol, calcium, and other substances in the blood. To understand why plaque is a problem, compare a healthy artery with an artery with atherosclerosis:
A healthy artery is like a rubber tube. It is smooth and flexible, and blood flows through it freely. If your heart has to work harder, such as when you exercise, a healthy artery can stretch to let more blood flow to your body’s tissues.
An artery with atherosclerosis is more like a clogged pipe. Plaque narrows the artery and makes it stiff. This limits the flow of blood to the tissues. When the heart has to work harder, the stiff arteries can't flex to let more blood through, and the tissues don't get enough blood and oxygen.
See a picture of a normal artery and an artery narrowed by plaque.
When plaque builds up in the coronary arteries, the heart doesn't get the blood it needs to work well. Over time, this can weaken or damage the heart. If a plaque tears, the body tries to fix the tear by forming a blood clot around it. The clot can block blood flow to the heart and cause a heart attack.
See a picture of how plaque causes a heart attack.
content provided by Healthwise
More about CAD
Thriving With Heart Disease
Don't Ignore CAD Symptoms
What Treatments Work for Coronary Artery Disease?
Coronary artery disease is caused by hardening of the arteries, or atherosclerosis. Atherosclerosis occurs when plaque builds up inside the arteries. (Arteries are the blood vessels that carry oxygen-rich blood throughout your body.) Atherosclerosis can affect any arteries in the body. When it occurs in the arteries that supply blood to the heart, it is called coronary artery disease.
Plaque is a fatty material made up of cholesterol, calcium, and other substances in the blood. To understand why plaque is a problem, compare a healthy artery with an artery with atherosclerosis:
A healthy artery is like a rubber tube. It is smooth and flexible, and blood flows through it freely. If your heart has to work harder, such as when you exercise, a healthy artery can stretch to let more blood flow to your body’s tissues.
An artery with atherosclerosis is more like a clogged pipe. Plaque narrows the artery and makes it stiff. This limits the flow of blood to the tissues. When the heart has to work harder, the stiff arteries can't flex to let more blood through, and the tissues don't get enough blood and oxygen.
See a picture of a normal artery and an artery narrowed by plaque.
When plaque builds up in the coronary arteries, the heart doesn't get the blood it needs to work well. Over time, this can weaken or damage the heart. If a plaque tears, the body tries to fix the tear by forming a blood clot around it. The clot can block blood flow to the heart and cause a heart attack.
See a picture of how plaque causes a heart attack.
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