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Find answers to frequently asked questions about a variety of health conditions, like heart attack, high blood pressure and atrial fibrillation.

  • What are congenital heart defects?
  • “Congenital” means present from birth. So, congenital heart defects refers to a number of different conditions that can occur when a baby’s heart is forming or at birth. As a result, the heart—or the major vessels in and around the heart—may not develop or work the way they should.

    Congenital heart defects are the most common type of birth defect. Roughly 8 of every 1,000 babies are born with some sort of structural defect in their hearts. These problems cause more deaths in the first year of life than any other birth defects. Some examples are atrial septal defect, coarctation of the aorta, and aortic stenosis.

    But, there is good news. More babies are surviving than ever before thanks to advances in treating and correcting many of these problems. Although most defects are found during pregnancy by ultrasound or in early childhood, some defects aren’t discovered until adulthood. About 1 million adults are living with congenital heart disease.

  • What are the symptoms of aortic stenosis?
  • Aortic valve stenosis is a slow process. For many years, even decades, you will not feel any symptoms. But at some point, the valve will likely become so narrow (often one-fourth of its normal size) that you start having problems. Symptoms are often brought on by exercise, when the heart has to work harder.

    As aortic valve stenosis gets worse, you may have symptoms such as:

    • Chest pain or pressure (angina). You may have a heavy, tight feeling in your chest.
    • Feeling dizzy or faint.
    • Feeling tired and being short of breath.
    • A feeling that your heart is pounding, racing, or beating unevenly (palpitations).

    If you start to notice any of these symptoms, let your doctor know right away. If you have symptoms, you need treatment. By the time you have symptoms, your condition probably is serious. If you have symptoms, you also have a high risk of sudden death.

  • What is sleep-disordered breathing?
  • Sleep-disordered breathing describes a group of disorders characterized by involuntary breathing cessation during sleep. Obstructive sleep apnea is the most common type of disorder and can increase risk for conditions such as high blood pressureheart disease and stroke.
  • What is pulmonary arterial hypertension?
  • Pulmonary arterial hypertension (PAH) is a form of pulmonary hypertension in which the arteries in the lungs constrict abnormally. PAH causes the heart to work faster and increases blood pressure within the lungs. PAH typically worsens over time and can be life-threatening, as it puts added strain on the heart.
  • What is Tetralogy of Fallot?
  • Tetralogy of Fallot is a rare type of congenital heart defect that affects roughly one in 3,500 births a year in the United States. This type of defect keeps the body from getting the oxygen-rich blood it needs and can cause infants and children to have blue-tinged skin. Tetralogy of Fallot is usually diagnosed during infancy or soon after, but sometimes it’s not detected until later in life.
  • How many people have congenital heart disease?
  • Every year, 35,000 babies are born with congenital heart disease in the United States. It’s estimated that 90% of children who are born with a heart defect now survive well into adulthood and there are currently more than 1 million U.S. adults living with congenital heart disease.
  • How is Tetralogy of Fallot treated?
  • Babies diagnosed with Tetralogy of Fallot are typically treated with corrective surgery. However, patients with this condition require ongoing monitoring to prevent complications later in life.
  • What are the risk factors for heart disease?
  • The most common risk factors for heart disease include increased age, tobacco use, diabetes, high blood pressure, high cholesterol, obesity, stress, illegal drug use, lack of physical activity and family history of heart disease.
  • How can I reduce my risk for heart disease?
  • You can reduce your risk for heart disease by maintaining a healthy weight, eating a heart-healthy diet and staying physically active. Any additional risk factors, such as high blood pressurecholesterol and diabetes, should be properly addressed and controlled through lifestyle changes and working with your healthcare provider.
  • What is diabetes?
  • Diabetes refers to a group of diseases that cause high blood sugar, either because the body can’t produce enough insulin or the body doesn’t respond to insulin properly (or both). There are three main types of diabetes: type 1 diabetes (occurs when the pancreas stops making insulin), type 2 diabetes (occurs when the body doesn’t use or make insulin the way it should) and gestational diabetes (diabetes that occurs during pregnancy). Also, prediabetes is a condition in which blood sugar levels are higher than normal, but not high enough to be diagnosed with diabetes.
  • How can I prevent diabetes?
  • You can prevent or delay the onset of type 2 diabetes through healthy lifestyle choices, such as eating healthy and staying physically active. Achieving a healthy weight and managing cholesterol and blood pressure levels can also help reduce risk for diabetes and heart disease.
  • How is inflammation linked to heart health?
  • Inflammation is the body’s response to injury or infection. Although it’s not proven that inflammation actually causes heart disease, research shows that many heart disease patients have heightened markers of inflammation. It’s possible that inflammation may be a sign of heart disease or a response to it, and further research is needed to better understand the role of inflammation on cardiovascular risk.
  • Why do some women take estrogen during menopause?
  • The estrogen in hormone therapy is used by some postmenopausal women to increase estrogen levels. This helps prevent osteoporosis and perimenopausal symptoms, such as hot flashes and sleep problems.
  • What is acute coronary syndrome?
  • Acute coronary syndrome is an umbrella term used to describe situations where there is sudden, reduced blood flow to the heart. Acute coronary syndrome encompasses chest pain and heart attack, both of which can be serious and life-threatening.
  • What is heart valve disease?
  • Heart valve disease, also referred to as valvular heart disease, occurs when any of the heart’s four valves fail to work properly. Heart valve disease happens when the heart’s valves can’t open far enough to let blood through (stenosis) or can’t close enough to prevent blood from flowing back into the heart (regurgitation).
  • Why is blood sugar control important for patients with diabetes?
  • Keeping blood glucose levels as close to normal as possible can help prevent or slow the progress of many complications of diabetes. To get tight control, you should pay attention to diet and exercise, keep close track of blood glucose levels, and if you take insulin, closely manage your injection schedule.

  • What is kidney disease?
  • Chronic kidney disease (CKD) occurs when kidneys become damaged and unable to do their jobs properly. CKD can slowly develop over a long period of time, and is often caused by diabeteshigh blood pressure and other health conditions. Early detection and treatment can help slow disease progression and keep CKD from getting worse.
  • How are diabetes and chronic kidney disease related?
  • Diabetes is the leading cause of kidney disease, accounting for roughly 44% of kidney failure cases in the United States each year. Patients with diabetes should work closely with their doctor to monitor their kidney function and take steps to help reduce risk for developing chronic kidney disease, like by eating healthy and controlling blood sugar levels.
  • I have been told that I have LAFB, what exactly is it? What happens now? What does this lead to?
  • The left bundle branch is the conduction system of the main pumping chambers of the heart (right and left ventricles) and is composed of the left posterior and left anterior fascicles or divisions. Left anterior fascicular block (LAFB) forces all the electrical conduction down the left posterior fascicle. Historically, the presence of LAFB was considered a benign finding but recent research in patients greater than 65 years old revealed that LAFB may slightly increase a patient’s risk of atrial fibrillation, heart attack, and death. [1] Follow-up in this study was over 15 years and only 2 of 1,664 patients in this series required a pacemaker.   

    The presence of LAFB merits a thorough clinical evaluation for any underlying heart disease.  Once this evaluation is completed, an asymptomatic patient should undergo routine clinical evaluations to ensure there has been no development or progression of underlying heart disease.   

    Best regards,

    Jeffrey L. Williams, MD, MS, FACC, FHRS 

    1. Mandyam MC, Soliman EZ, Heckbert SR, Vittinghoff E, Marcus GM, “Long-term Outcomes of Left Anterior Fascicular Block in the Absence of Overt Cardiovascular Disease,” JAMA, V. 309, No. 15 (April 2013), pp. 1587-1588.
  • I am 21 years old and have been feeling shortness of breath while doing little physical activity. I also have been feeling heart palpitations a few times a week. Is there anything I need to be doing? Do I need to see a doctor?
  • Do you have a doctor? If you do not, I would recommend you establish a new patient visit with an internal medicine or a family medicine physician for physical examination and evaluation. Sometimes this can take several visits, as he or she may order lab work, EKG and other diagnostic testing depending on your history and physical exam. In the meantime, I would recommend that you avoid strenuous physical activity, scuba diving, caffeine, and energy drinks. 

    Best regards,

    Puja Mehta, MD, FACC

  • What is metabolic syndrome?
  • Metabolic syndrome is a cluster of risk factors that can greatly increase risk for heart disease and type 2 diabetes. These risk factors include a large waistline, high triglyceride level, a low HDL or “good” cholesterol, high blood pressure and high blood sugar. Individuals with three or more of these risk factors are considered to have metabolic syndrome, and the more risk factors one has, the greater their risk for heart disease and diabetes.
  • How is metabolic syndrome treated?
  • Healthy lifestyle changes, like losing weight, getting active, eating healthy and quitting smoking, are some of the best ways to help treat metabolic syndrome. Medicine may also help address certain risk factors, such as high blood pressure and high triglycerides. Addressing risk factors that contribute to metabolic syndrome can help greatly reduce risk for both heart disease and type 2 diabetes.
  • What is cardiac syndrome X?
  • Cardiac syndrome X occurs when a patient with healthy arteries experiences unexplained chest pain, called angina. Most patients with angina have coronary artery disease, or a buildup of plaque in the arteries, which can restrict or block blood flow. Patients with cardiac syndrome X, however, experience chest pain but have no blockage in their arteries.
  • What is the best exercise for heart attack patients?
  • In general, aerobic exercise and strength training are recommended for heart attack patients. Aerobic exercise includes activities like walking or jogging, and strength training can include lifting weights or using resistance bands to build muscle. However, it’s important that heart attack patients work closely with their providers to create a workout program that’s right for them.
  • Is it safe to exercise after a heart attack?
  • Although many patients are nervous to exercise after a heart attack, research shows that regular exercise is one of the best ways to strengthen the heart and reduce risk of a recurrent heart attack. It’s important that heart attack patients work closely with their healthcare providers to create an exercise program that is safe for them.

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