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On February 21, visitors to www.Turnto10.com received online advice about heart health from Rhode Island Hospital cardiologist Ed Keating, MD. Below are excerpts from the chat. Moderator: Welcome everyone to NBC10's hosted chat room. Today's guest is Dr. Ed Keating from Rhode Island Hospital. He can answer your questions about heart attacks and heart health. You can also find additional cardiac information on www.lifespan.org. Hydrowt: Sometimes as I lie down and breath out, I feel a "click" at the end of the breath....could that be the heart valve or would that be with the lungs? I am young and fairly healthy. Dr. Keating: It is probably more likely to be in the lungs or throat rather than the heart. Hydrowt: Thank you. Skyler: How high does your BP need to be to be put on medication? Dr. Keating: In general, if it's checked at the doctor's office and it's more than 140/90 on several occasions. At home, over 120/175 is probably too high. Mercedes: How common is it for women in their 40s to have heart attacks? Dr. Keating: Mercedes, it is increasingly common. Women before menopause have a lower risk. But during and after menopause the risk is actually higher than for men, particularly if they have extra risks. Hydrowt: I heard that there is an interaction with licorice and some cardiac drugs, as well as grapefruit juice with procardia....why is this? Dr. Keating: The chemicals involved with medicines or absorption of the various foods can alter the amount of medicine that is absorbed. Cmbs: What is a normal pulse rate? Dr. Keating: Normal pulse rate varies from 60 to 90 at rest, to 90 to 130 with mild or moderate exertion. Kris8: What types of preventive measures should a person with high risk for a heart attack take? Dr. Keating: Stop smoking, exercise regularly and eat a low-fat, low-processed sugar diet. Cmbs: What types of problems might be associated with a consistent pulse rate of 98. Dr. Keating: First, that may be normal, but fevers or thyroid problems, as well as heart disease. Kris8: Are there any tests available that would show if there are problems? Dr. Keating: There are a number of tests, including an exam with a stethoscope, an electrocardiogram and a stress test. FDog: Sometimes, when I first get into bed at night, I feel my heart pounding, then it seems to skip a beat and then it begins to race again. Is that normal? Kris8: My husband has the same thing--but it happens at different times of the day. Dr. Keating: It may be normal, as the body's adrenaline settles back down. It may also be related to abnormal heart rhythms or the influence of things like coffee or stress. Mercedes: One of my doctors tells me I have a heart murmur, but the other swears that I don't. Can a heart murmur come and go? Dr. Keating: Yes, a heart murmur can come and go. Kris8: How do you find out if it's normal or not? Dr. Keating: First, test and see if the heart is normal--a stress test and then a monitor the patient takes home with them, which records the heart beat. Skyler: I have had thrombophebitis in one arm. The top figure on the BP in that arm is always 15 points higher than the other arm--is that a problem? Dr. Keating: Not necessarily. It's probably not related to the thrombophebitis. Rrff: I have had shortness of breath for 1 month.present more so with exertion but also at rest.symptoms are intermittent.started while on hormones for IVF.chest X-ray and PFTs negative.EKG normal.positive history of MVP with minimal regurgitation.feels as if cannot get full, deep breath in. Does this sound cardiac or respiratory in nature? Dr. Keating: Could be either. A stress test might help sort it out. Mercedes: Should I be concerned? Should I get a third opinion? Dr. Keating: The fact that the murmur comes and goes could mean it is completely normal. Mercedes: Thanks, Dr. Keating. Kris8: Who should I contact to have a stress test done? Does insurance cover this? Dr. Keating: Contact your primary doctor. Insurance usually covers the expense. Kris8: Thank you Dr. Keating-now I just have to get my husband to go! Tigerlili: My husband has been diagnosed with cardiomyopathy; he is 29 years-old and currently is on a beta blocker and coreg. He has constant pain in his back on his left side. No one has been able to answer our question as to whether this could be a related condition. Is there any correlation with this symptom and his condition, in your opinion? Dr. Keating: Pain in the chest in a young male is usually not related to the cardiomyopathy. Gaff: I have a family history of heart disease on my mother's side, am a non-smoker and am overweight. My PCP has sent me for a stress test due to some tightness in the chest which I was experiencing. The test came back negative. Anything else I can do at this point? Dr. Keating: It sounds like you do not currently have heart disease, but with your family history you should exercise, lose weight and keep your cholesterol low. Skyler: Is there any BP medications that have the least side effects for someone that is highly allergic? Dr. Keating: There are dozens of blood pressure medicines and its very likely that a doctor can find a medicine to treat anyone's high blood pressure. BRS1Matt: I am 15 years old. Had an EKG, and had right ventricular conduction delay. Is this serious? Dr. Keating: Probably not, if you do not have any other symptoms or problems. Gaff: Understood, thanks. Can you recommend a weight loss program? Dr. Keating: Try calling 401-444-4800. They can
recommend a program. Tigerlili: The pain is in his back and he has already been diagnosed with cardiomyopathy. We do not understand why the back pain is also present and is only on his left side behind his heart. The back pain only began with the onset of the cardiomyopathy, which his cardiologist feels was brought on by a virus. Dr. Keating: It's hard to give specific answers. His cardiologist should be able to help. BRS1Matt: Can I still participate in outdoor track? Dr. Keating: That's up to a doctor who has examined you. Mercedes: Can you briefly describe congestive heart failure? Dr. Keating: Congestive heart failure occurs when the heart is unable to pump a normal amount of blood forward into the body and it then often backs up into the lungs. Kris8: My mom is on estrogen therapy and it keeps sending her blood pressure sky high. She actually gets dizzy from it. What should she do? Dr. Keating: First, she should stop eating all salt and then discuss the estrogen dose with her doctor. Mercedes: Is congestive heart failure common for people with Parkinson's disease? Dr. Keating: No, they are separate diseases, Mercedes. Mercedes: Thank you. BRS1Matt: What is right ventricular conduction delay. Dr. Keating: The conduction delay is a variation on an EKG that may or may not be abnormal. Hydrowt: Can a valve disorder be detected on a stress test? Dr. Keating: A stress test with echocardiography will detect valve disease. Tigerlili: Is it true from all the information I have read on cardiomyopathy that the expected life span of someone diagnosed with this condition is only about 5 years. And would it be helpful to try to discover what brought this on in someone so young? Dr. Keating: The prognosis in a cardiomyopathy is often related to how easy it is to stabilize and control it. Finding out which virus caused it will probably not be helpful. Hydrowt: Thank you for your help, Keating. FDog: My sister was diagnosed with pulmonary hypertension about 30 years ago. They gave her phenoxybenzamine and she doesn't like the side effects. Are there newer drugs to treat this problem? Dr. Keating: This is a very rare and serious problem. There are some newer experimental trials. She probably should ask to be referred to a pulmonary center. Tigerlili: What can be done to increase the risk of the heart enlarging further, or the condition progressing to CHF? Dr. Keating: Medication is usually effective at preventing the heart from expanding. If not, there are new pacemaker, heart failure trial just starting at Rhode Island Hospital. Tigerlili: Can you tell me how to get information on this new trial? Dr. Keating: Call the electrophysiology department at Rhode Island Hospital. Skyler: How is the heart affected if you have Lyme disease? Dr. Keating: Often, it's not affected but it can affect the control mechanism of the heart beats, creating a slow heartbeat. Crazyvil: Can you give me some info on cardiomyopathy? Dr. Keating: Cardiomyopathy is a weak heart muscle, which has many causes. Crazyvil: Is prednisone a possible cause.? Dr. Keating: Probably not by itself. Crazyvil: Thank you. Skyler: THANK YOU! Dr. Keating: Thank you very much. If anybody is interested, I would be happy to see anyone about heart problems in my East Greenwich office: 401-886-7590. Moderator: Thank you Dr. Keating. That concludes today's Lifespan Better Health for Life Doc Chat. Find out more: |
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