The Cutting Edge: Attacking Heart Disease. Innovative Heart Attack Monitoring Approaches.

Heart DiseaseWith heart disease remaining the leading cause of death among men and women, one of three prime-time health specials, Cutting Edge: Attacking Heart Disease produced by Gannett Broadcasting, sets out to explore the latest in innovative procedures and treatments to help us fight back.  Since over a third of Americans are afflicted with cardiovascular diseases of some kind, host Julie Nelson along with cardiology experts from leading medical centers across the country helps us to understand the various types of heart disease, new ways to monitor heart attacks and back to basics heart disease prevention.

What is heart disease?
“Heart disease is any condition that affects the heart…Heart disease comes in various different flavors and it’s not a uniform disease… There are many different types…”

  • Coronary Artery Disease – blockage in the heart arteries from cholesterol plaque which can lead to heart attack and angina. This is the most common and lethal.
  • Heart failures – involves heart muscle problems (cardiomyopathies)
  • Valve problems – heart valves which may be leaky or narrowed
  • Electrical – heart arrhythmias where the heart beat is too slow or too fast.
  • Hypertension (High Blood Pressure) – part of the overall spectrum of cardiovascular disease. About 80 million people have high blood pressure in America.

How do you know if you have heart disease? What are the key indicators we need to be aware of?

Some signs that we should be aware are pain, discomfort, pressure, and burning in the chest especially if it also moves into your arms or into your throat or jaw. Sudden unexplained shortness of breath, palpitations where you feel your heart pounding erratically, and loss of consciousness or near loss of consciousness.

Sudden Cardiac Arrest vs Heart Attack.  What is the difference?

  • Sudden Cardiac Arrest – Sudden cardiac arrest is an electrical problem which causes the heart to stop pumping blood to the body. With sudden cardiac arrest the heart essentially stops.  Every year at least 300,000 Americans fall victim to sudden cardiac arrest.  The chance of dying from sudden cardiac arrest is 95% within the first 10 minutes.  For those who survive or those who are at an increased risk, an implanted cardiac defibrillator is the best treatment option for now. But doctors at Cedars-Sinai Los Angeles are working on a new way to advance the prevention and treatment of the disease. Read More…
  • Heart Attack – A heart attack is caused by a blockage to the heart’s blood flow. One common cause for a blockage is cholesterol plaque buildup in the arteries. With a heart attack a patient will have symptoms such as pain in the chest or pain in the arm.  According to the Centers for Disease Control (CDC), approximately 785,000 people per year will have their first heart attack.  Over 470,000 will have more than one!


A device that allows doctors to monitor your heart disease remotely.

For those at risk of a heart attack or recurring hearts attacks, Cutting Edge: Attacking Heart Disease reports about a new implantable remote monitoring device undergoing trials at Massachusetts General Hospital.  The technology was designed to see if using implanted technology and the Internet can help improve patient/physician communications to manage heart failure.
The device is called the L.A.P. (Left Atrial Pressure) Sensor Device.  90% of patients admitted for heart failure, have pulmonary congestion related to elevated left atrial pressure.

Kimberly Parks M.D., Cardiologist, Cardiac Transplantation, Massachusetts General Hospital, explains  by sharing a case study of a patient, Jeff, who was hospitalized six times the year before, because of symptoms of heart failure.  He had been on an excellent medication regimen and was being treated with the traditional model for heart failure but it wasn’t working.  This was the perfect opportunity for Jeff to try the new implantable sensors, to see if this treatment would actually help his doctors understand what was happening with Jeff and to help keep him out of the hospital.

Here is how the procedure works. First the L.A.P. Sensor Device is implanted within the patient’s heart. A handheld computer is given to the patient. They can then communicate information about pressure changes within the heart to the patient’s handheld device and then directly to the doctor.

On the back of the device is a sensor that communicates with the implanted components.  The patient is given instructions on which medicines to take based on his intracardiac pressure. When the patient comes into the office, the doctor does an assessment of their pressures over time and is able to preprogram in the computer system an algorithm that tells the patient what to do based on his heart pressures.  With using a mobile device the doctor is able to direct care to her patient.  So no matter where the doctor is in the world, she can log on to a computer and as long as the doctor has access to the Internet she is able to communicate with her patient and give the patient instructions on what to do.

A monitoring device that uses ultrasound and your neck to predict heart attack risks.
Dr. John Lourié of the Heart Attack Prevention Center speaks to Cutting Edge correspondent, Heather Van Nest about his new approach in alerting patients of impending heart problems that may need correcting before the problems become heart attacks. He uses an ultrasound monitoring device applied to the neck to tell how healthy and what age your arteries are.

Dr. Lourié explains, “this technology allows us to use your neck as a window into your arterial health, because arterial health is really happening throughout your body. If you build up plaque in your neck, you are building up plaque in your heart and your brain. We can look at your carotid artery in your neck and determine if you have any plaque buildup.”

Dr. Lourié says the device uses harmless ultrasound to do the imaging, not radiation and is noninvasive.  He feels it is more accurate than many of the invasive tests that are used.  On the ultrasound imaging screen, the doctor looks for signs of plaque build up which is in the wall of the artery, not stuck to the inside. …”Many other tests look at the inside of the tube and that’s not where the action is. The action is in the wall of the artery.”  The doctor says some of his patients have big lumps of plaque in the artery wall. They are at very high risk.

If the arteries look good from the imaging device, the doctor takes the screening process further by looking at other risk factors like your genetic risks by testing your DNA, and inflammatory markers.  Inflammation plays a big role in developing heart attack or stroke.

How Can we prevent Heart Disease?

Dr. Lourié says “we know that one in three Americans will die of heart disease. We can’t wait until after you have a heart attack or stroke to deal with it.”

One of the major tenets of Dr. Lourié’s heart attack prevention plan is getting back to basics.  Dr. Lourié said our bodies are not designed to process a lot of the junk foods that we eat today…He says “…this is the problem is in a nutshell.  After decades of eating too many carbohydrates, what can happen is your body becomes resistant to your own insulin which is inviting the glucose into your cells, your muscle. And after years of resistance your blood sugar goes higher and higher and your insulin goes higher and higher and that causes damage to your blood vessels.  Until one day your pancreas wears out and you can’t make enough insulin.”

Dr. Lourié also refered to a published study that just came out from a nurse’s pilot project that’s been going on since the late 70s.  They showed that 92% fewer women had heart attacks and strokes if they exercise 30 minutes a day, keep your body mass index (BMI) less than 25, and don’t smoke.

So getting back to basics, just eating simple foods, and exercising is one way to greatly improve your health.

Gordon Tomaselli, M.D., Chief, Division of Cardiology, John Hopkins Medicine says “It’s much more effective to prevent heart disease than it is to treat it once it is established.  So how do you do that?  We promote a series of health behaviors and want to optimize health factors. And what are they?  They include not smoking, getting an adequate amount of exercise, having a healthy diet and maintaining a good weight. The health factors that follow from these health behaviors are good control of blood pressure, good control of blood sugar and preventing diabetes, good control of blood cholesterol levels to reduce the amount of fat in your blood. Cardiovascular diseases are very prevalent and preventable diseases.”

Cutting Edge: Attacking Heart Disease – References

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