More than 22 million people suffer from heart failure worldwide with approximately one million new patients diagnosed annually. In the setting of an aging global population, heart failure is the number one reason for hospitalization. The most severely ill patients need heart transplants in order to recover. More than 8,000 people worldwide are on the list of eligible candidates for heart transplants annually, but less than 3,000 receive a transplant each year. A large number of people who suffer from severe heart failure do not qualify for transplantation due to other health issues. An alternative for these patients is access to artificial mechanical assist.
A Left Ventricular Assist Device or LVAD is a surgically implanted mechanical device that helps the heart pump blood. In other words, they are “heart pumps” or “heart assist devices.” If both your heart’s pumping chambers are failing, 2 heart pumps may be used, one for each ventricle. An LVAD either takes over or assists the pumping role of the left ventricle – the heart’s main pumping chamber. Newer LVADs are meant to be permanent in people with severe heart failure. Part of the device is implanted in your heart and abdomen, and part remains outside your body. You carry the external part of the device on a belt around your waist or on a shoulder strap. Most LVADs right now have an electric pump, an electronic controller, an energy supply (usually a battery weighing about 8 pounds) and 2 tubes. One tube carries blood from your left ventricle into the device. The other tube takes blood pumped from the device into your aorta (artery) to be circulated throughout your body.
Terumo Heart, Inc., announced this week that another patient implanted with the DuraHeart™ Left Ventricular Assist System (LVAS) has surpassed four years after receiving the mechanical circulatory support device. Helga Gieseke, 66, who lives in the south of Saxony-Anhalt, Germany is now one of the longest-living heart failure recipients of this device designed to aid the pumping action of the heart in order to circulate blood throughout her body.
Mrs. Gieseke received the DuraHeart LVAS as an investigational device in May of 2006 after suffering from heart failure for many years. She was treated by the Physicians at The Deutsches Herzzentrum Berlin as part of the DuraHeart LVAS clinical study that ultimately lead to CE Mark and commercialization in Europe.
Mrs. Gieseke has had a long history of heart problems; her first heart surgery was performed in 1994. Since then, Mrs. Gieseke had undergone several procedures including implantation of stents, pacemakers and implantable defibrillators in an attempt to manage her condition. Despite all these treatments, Mrs Gieseke’s condition continued to deteriorate until she found herself unable to walk or carry out simple activities around the house without getting chest pain. It was after admission to the local hospital in April of 2006 that Mrs. Gieseke was told by her cardiologist, also a school friend, that she required additional treatment. It was then that she was referred to The Deutsches Herzzentrum Berlin.
The DuraHeart LVAS can be used as a bridge to heart transplant in patients with end stage heart failure. Due to the scarcity of donor organs, patients can sometimes be on the waiting list for many months until a suitable donor becomes available. During that time, a patient’s condition can deteriorate dramatically until no other alternative is available to them. The left ventricular assist systems offer the patient a second chance while waiting for a suitable donor.
The DuraHeart LVAS is currently being studied in the DuraHeart Pivotal U.S. Trial for Bridge-to-Transplant (BTT), a multi-center, prospective, non-randomized study, involving 140 patients. The study, which granted unconditional approval in early 2010 by the U.S Food & Drug Administration (FDA), will evaluate the safety and efficacy of the device in helping to sustain patients awaiting heart transplant who are at risk of death due to end-stage heart failure.
For more detailed information about the DuraHeart BTT Trial, visit www.clinicaltrials.gov, and for more information about the DuraHeart LVAS, visit www.terumoheart.com.
Sleep apnea is a common disorder in which you have pauses in breathing (actually stop breathing) or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. The most common type of sleep apnea is obstructive sleep apnea. This most often means that the airway has collapsed or is blocked during sleep.
When I lecture about sleep apnea and heart disease I often ask people to take a deep breath and hold it for about 20 to 30 seconds (why not try it now)…
Okay after the 30 seconds let the breath out. That is how long many people with sleep apnea stop breathing while they sleep, often several times every hour.
Take a look at this short PSA on Sleep Apnea:
Untreated sleep apnea can:
Increase the risk for high blood pressure, heart attacks and strokes!
Increase the risk for or worsen heart failure
Lead to irregular heartbeats
Increase the chance of having work-related or driving accidents
Common symptoms of sleep apnea include:
Excessive daytime sleepiness/fatigue
Loud snoring
Observed episodes of breathing cessation during sleep
Abrupt awakenings at night sometimes accompanied by shortness of breath
Awakening with a dry mouth or sore throat
Morning headaches
Difficulty staying asleep (insomnia)
Sleep apnea can be treated once it is diagnosed. By treating your sleep apnea you can actually also protect your heart from future problems.
For more info about risk factors for heart disease, stroke and diabetes visit www.heart-strong.com
We are nurses practitioners who have spent years taking care of people with heart disease and our mission now is to help people PREVENT heart attacks and strokes. We have written two books that may help you learn about your individual risk factors and what you can do to prevent heart problems, strokes and diabetes. “Take Charge: A Woman’s Guide to a Healthier Heart” and “Take Charge: A Man’s Roadmap to a Healthy Heart – So simple you will not even have to stop and ask for directions” – our books offer realistic steps to help you develop a healthier lifestyle, all of the information in the books comes from the latest medical guidelines available and is written in an easy to follow and understand format.
During this final installment of our 3 part series about women and heart disease we will be focusing on heart problems older women are more likely to experience. Some of the things we will discuss are heart failure, diastolic dysfunction, atrial fibrillation, aortic valve disease and sudden cardiac death.
One of the most important parts of your journey to a healthier heart is deciding who will be your regular heart doctor. Heart doctors (cardiologists) can vary greatly. Even though most adhere to the standard of care, their interpretations can lead to a wide range of treatment styles. Some may be more conservative by suggesting very minimal medicines and follow-up. Others tend to be more aggressive in their treatment of heart disease by recommending more medicines and frequent follow-up. Both conservative and aggressive styles are perfectly fine but you need to find a cardiologist with the style you prefer. It should ideally be someone you trust undoubtedly. When it comes to your heart care, you do not have time to second-guess every move your doctor makes!
If you prefer a cardiologist who is proactive when it comes to national guidelines and standard of care, I would recommend you search several websites. First, go to http://www.ncqa.org which is the website for The National Committee for Quality Assurance. NCQA is a not-for-profit organization that promotes quality care for patients. You can search their physician database to obtain a list of doctors who have passed the Heart/Stroke Recognition Program requirements. The list contains both primary care physicians and cardiologists.
If you cannot find a cardiologist in the NCQA list for your area, then look up cardiologists through a search engine on the internet (Google, MSN, Yahoo, etc). You will have to type in key words like “cardiologist” and the name of your city. You can also use your local phone directory or ask a friend.
Once you have a list of possible cardiologists for your area, I recommend you check out their credentials. By internet, you can view all types of information about any licensed provider through your state’s medical board website. To find your specific medical board website you can visit the American Medical Association’s webpage (link http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml) and click on your state in their list. Physicians who have passed the cardiology board exam will generally have this listed on the Medical Board website under Specialty Board Certifications. The Medical Board website can also tell you if the doctor has had any lawsuits settled against them. If you prefer not to use the internet, you can call the American Board of Medical Specialties (1-866-ASK-ABMS) with questions about a doctor’s certification.
After checking out their credentials, the next step would be to call the cardiologist’s office for an appointment. You will have to ask if they accept your insurance and if they are taking new patients. Many offices have more than one doctor in their group. If you really want to find the perfect match, consider asking a nurse, physician assistant or nurse practitioner about the doctors. You might say to them, “I’m looking for a doctor who will see me often and treat my heart disease aggressively.” Or you could say, “I’d like to see a doctor who is personable and open to alternative treatments.” Chances are they can guide you to the right person!
This is a video I filmed discussing high blood pressure, what your blood pressure numbers mean and things you can do to control your blood pressure. Why not take 3 minutes to learn the blood pressure basics…
Have you ever investigated your roots and your family tree? Several years ago I was able to trace several of my great-grandparents back to the ship they traveled on when they arrived at Ellis Island. While you are working on your family tree, why not piece together your family health history as well?
The best place to start is with your immediate family. Your parents, brothers and sisters have the closest genetic link to you and the greatest likelihood of sharing similar conditions or diseases. Next, move on to your grandparents, aunts, uncles and as much extended family as possible. You may uncover a lot of information about your family’s health that you were never aware of.
Are there certain diseases that run in your family? Be sure to ask about the “BIG 4”- cancer, heart disease, stroke, and diabetes. You should also inquire about some other common cardiovascular risk factors such as high blood pressure, high cholesterol and other unhealthy risk factors they may have had. If a family member has had or died from a heart attack or stroke, were the overweight/obese, did they smoke or drink alcohol heavily, were they sedentary? If your grandfather died form a heart attack but was obese, never exercised, smoked 2 packs per day for 30 years and drank excessive alcohol, these factors may have contributed more to his heart attack than genetics. However, you cannot rule out a genetic influence as well. Also, if anyone in your family has died from heart disease at an early age, you may be at increased risk for premature heart disease as well. Finally, if a family member has died due to an aneurysm, either in the brain or the chest/abdomen, you should also be screened. Increased risk for aneurysms can also be inherited.
Try to find out the age at which your relatives developed certain conditions. If your grandmother developed diabetes in her 70’s, it may not be a very strong genetic risk factor. If she developed diabetes in her 20’s or 30’s, you may be at a higher risk of inheriting the gene. The general rule is that the younger a person is when they develop a disease; the more likely it is to have a genetic or hereditary component.
For women, at what age did your mother or grandmother go through menopause? Most women will become menopausal around the same age as her mother. Remember, menopause is one of our strongest risk factors for heart disease. If you have an idea as to when you may go through menopause, you can try to get all of your controllable risk factors at goal levels before this occurs.
Make sure you investigate all diseases….from A to Z….Addison’s disease, Alzheimer’s, thyroid disease, etc. (not too many diseases start with Z, but you get the point). Be thorough and put the information in a computer program or make a chart. Share this information with your healthcare provider, your children and your family. There is a lot you can learn by investigating your family’s health history and many diseases are preventable by making healthy lifestyle choices. So what are you waiting for? Get moving, learn about your family’s history and make some lifesaving changes.
When you’ve been diagnosed with heart disease, you may instantly feel completely alone. The feeling is, of course, totally illogical when you consider that heart disease is the most common health ailment among women. So while you’re hardly alone, sometimes it is hard to be completely logical when you are going through a major life change. In August 2009, a study published by the American Psychosomatic Society found that there was a direct correlation between loneliness and coronary heart disease, which can mean that women with existing heart disease could be at increased risk of future heart-related complications, along with depression and anxiety. Your world has been completely turned upside-down and you are suddenly juggling multiple prescription medications, dietary restrictions and extreme fatigue, and it may feel like there is no one out there who truly understands you anymore.
Luckily, in our networked society, there are many ways that you can connect with other women who are dealing with the same heart health issues. They may be around the corner or halfway around the world, but are really only as far away as the click of a mouse. Check out WomenHeart’s online community and support networkInspire <http://www.womenheart.org/supportForWomen/community.cfm> to connect with other women living with heart disease. Community members can share stories, post journal entries and participate in discussions with other women with similar heart conditions or who have had similar treatments.
A 2007 study in Great Britain showed that heart patients who were given access to information and communication via the Internet were more likely to participate in healthy behaviors.
Deep-vein thrombosis (DVT) is a relatively common and serious medical condition that occurs in approximately 2 million Americans each year. DVT occurs when a blood clot (which is also called a thrombus) develops in one of the large veins, usually in the legs, leading to either partially or completely blocked circulation. This may lead to complications, such as a pulmonary embolism and even death if not diagnosed and treated effectively.
Only about 50% of people experience symptoms when they have DVT. Symptoms of DVT may include:
Pain
Swelling
Tenderness
Discoloration or redness of the affected area
Skin that is warm to the touch
Who is at risk?
DVT can occur in almost anyone. Certain individuals may be at increased risk for developing a DVT. Some of the risk factors for DVT include:
Surgery
Restricted Mobility (like when on a long plane flight)
Congestive Heart Failure
Cancer
Respiratory Failure
Age > 40
Overweight/Obesity
Smoking (especially in women taking oral contraceptives)
High blood pressure or hypertension is called the silent killer because it can cause damage to your heart and blood vessels even though you may not have any symptoms. One out of three adults in the United States has high blood pressure. Many people think of high blood pressure as an older persons disease, however an alarming increase has been observed among children secondary to inactivity and obesity.
High blood pressure can lead to kidney disease, heart attacks, strokes and heart failure (an enlargement of the heart muscle). Can this be prevented? Unfortunately family history, increased age and ethnicity (African Americans are at a much higher risk) are risk factors that cannot be controlled. Postmenopausal women also have a higher risk of developing high blood pressure. But the good news is there are numerous diet and lifestyle risk factors that are modifiable: being overweight, physical inactivity, smoking, excessive alcohol consumption, emotional stress and consuming a high salt diet. Sleep apnea is an often unrecognized contributing factor to high blood pressure, when the sleep apnea is treated the blood pressure often improves.
What do your blood pressure (BP) numbers mean?
Two numbers are obtained when you get your blood pressure (BP) checked. The first number is called the systolic BP and tells you how hard your heart muscle is working in order to pump the blood out of your heart and throughout your body. If the systolic BP is high it means your heart muscle is working too hard and can lead to an enlargement and weakening of the heart muscle which leads to heart failure. When the systolic BP is too high, your risk for stroke increases. The higher the systolic BP, the higher your risk for stroke. The second number is called the diastolic BP and tells you how relaxed or constricted your blood vessels are. If the diastolic BP is too high, blood is not able to circulate effectively. So both numbers are important to control.
What is a normal blood pressure?
Below are the current guidelines for both men and women.
Normal BP Less than 120/80
Pre-hypertension 120 to 139/80 to 89
Hypertension 140/90 or greater
Some people have “white coat hypertension” which means they have a transient increase in their blood pressure when they see someone in a white coat (healthcare provider). A single elevated blood pressure reading caused by the apprehension of going to the doctor’s office usually does not require treatment. It is not uncommon to have fluctuations in your blood pressure with activity and emotional events but consistently high readings require treatment.
Can high blood pressure be cured?
Kidney disease, tumors of the adrenal glands, or coarctation (narrowing) of the aorta may lead to high blood pressure. Treating these disorders may eliminate the blood pressure problems. But the majority (95%) of people with high blood pressure have essential hypertension meaning the underlying cause cannot be determined. The most important goal is to control the blood pressure even if a specific cause for the high blood pressure cannot be found. There are a lot of things you can do to help control your blood pressure. Lifestyle changes such as regular exercise (remember walking counts as exercise); smoking cessation, weight loss if overweight, stress management, limiting alcohol consumption and sodium restriction can help to lower blood pressure. Some people are more salt sensitive, and just by cutting back on their salt intake can lower their blood pressure significantly.
Eight Tips to Lower Blood Pressure:
1) Low Sodium (salt) Diet – recommendation is less than 2,400mg per day, or less than 2,000 mg of sodium daily if you have high blood pressure
2) Increase Potassium Rich Foods – recommendation is 4,700 mg of potassium daily. Good food sources of potassium include: Bananas, Dried beans, Tomatoes, Beef, Orange juice/grapefruit juice, Milk, Coffee, Potatoes, Kidney beans, Salmon/Halibut
3) Exercise – Aim for 30 minutes 5 to 7 days every week
4) Weight loss (if overweight) or maintain a healthy weight
5) Use fresh garlic frequently (chop garlic and let sit for 15 minutes – this allows garlic to oxidize and gets converted to allicin which is the heart healthy part of garlic)
6) Develop consistent healthy stress relief strategies (exercise, get a massage, yoga, Tai Chi, meditation, deep breathing exercises, read, listen to relaxing music) whatever works best for you
7) Stop smoking
8) Limit alcoholic beverages (no more than 2 drinks per day for men and 1 drink per day for women)
Many people will require medications to help control their blood pressure readings. The majority of people with high blood pressure require two or more medications to keep their blood pressure controlled, this is why numerous combination medications are available. Routine monitoring of your blood pressure is also important. If you are taking high blood pressure medications and your blood pressure numbers are good you should not stop taking your medications without consulting with your healthcare provider. Most likely the reason your blood pressure numbers are good is because of the medications.
A recent Centers for Disease Control publication stated that only about 30% of adults with high blood pressure have their blood pressure well controlled! The only way to know if you have high blood pressure or to know if it is controlled with medications is to check your blood pressure on a regular basis. Do you know your numbers? If not what are you waiting for – get it checked today! Your heart will thank you.
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