Advice for heart conditions

Interview

Cardiovascular diseases account for about 50-60 percent of all deaths in Hungary, with most caused by atherosclerosis. If the coronary artery becomes calcified, it can lead to a heart attack; if the cerebral vessels calcify, a cerebral infarction, or stroke, can occur. Of course, our heart can be attacked by other diseases, but just like atherosclerosis, most cardiovascular diseases can be prevented, the risk of developing them can be reduced, and more and more advanced therapies can prevent a serious condition once the problem has occurred. Dr. Éva Junger, head of outpatient care at Dr. Rose Private Hospital, internist, cardiologist, and occupational health specialist, outlines the details.

Perhaps most of us can name them in our sleep, but it is not harmful to repeat the risk factors for cardiovascular diseases and atherosclerosis. So: high blood pressure, smoking, high cholesterol, diabetes, obesity, a sedentary lifestyle, stress, unhealthy eating, excessive alcohol consumption, as well as genetic factors and an inherited predisposition.

Blood pressure

Among the risk factors that cause atherosclerosis, it is perhaps worth talking in more detail about high blood pressure, as it is a disease that many people ignore, even though it is called a silent killer. It does not cause any symptoms for a long time, but by the time the complaints appear, by then the blood vessels have been significantly damaged. The background of high blood pressure is 95 percent genetic, so it is hereditary, but it is also influenced by our lifestyle. If we eat healthy, pay attention to our weight, exercise regularly, and refrain from smoking and drinking too much alcohol, then the tendency to high blood pressure can be controlled.

The ideal blood pressure is usually said to be 140/90, but in fact 130/80 mmHg is best. For some diseases, such as diabetes, even lower levels are optimal to avoid complications. The upper, higher value is the systolic value, which shows the amount of blood pressure after the heart has contracted and then pushed the blood into the body. The lower value is the measure of blood pressure maintained after the heart valves close. None of the values ​​are good if they are higher than ideal. “Experience has shown that if the upper value deviates significantly from the optimal, it is more likely to damage the cerebral vessels, and if the lower is higher, it is more likely to burden the heart,” says Dr. Junger.

Cholesterol levels

Nor can we talk enough about the danger of high cholesterol because this risk factor also contributes significantly to the coronary, cerebral, and limb blood vessels’ calcification, and thus even to death. For this reason, those with high cholesterol levels have multiple risk factors, or if early atherosclerosis can already be detected, taking cholesterol-lowering drugs is definitely recommended as these medications can even reverse the onset of calcification.

According to Dr. Junger, many people have unfounded fears about the side effects of cholesterol-lowering drugs. In addition, there are already new types of drugs that can be used on a monthly basis. Moreover, the latest development is a cholesterol-lowering injection that only needs to be administered once every six months in more severe illness and keeps cholesterol levels persistently low. This product is already available in Hungary and is also available to patients at Dr. Rose Private Hospital.

Other diseases of the heart

Myocardial infarction also affects a relatively large number of people. The heart muscle can weaken due to a heart attack, but a virus can also cause inflammation, which can cause the heart to contract less. COVID-19 is associated with myocarditis too, says Dr. Junger, who adds that the disease can be caused by other toxic substances, such as heavy alcohol consumption.

Arrhythmias also play a significant role in heart disease, affecting hundreds of thousands of people. In the case of arrhythmia, the patient experiences more beats, extra beats, setbacks, and bigger beats, but the heart function can also slow down a lot. In this case, too, the arrhythmia should be examined to see if there is any more serious heart disease in the background.

It is known that atrial fibrillation, or irregular heartbeat, may become more common with advancing age. Patients, for a short or longer period of time, feel their hearts beating back and forth and are much weaker than usual. Such an irregular rhythm can also have a more serious consequence, as disorder of the atria can cause clot formation in the heart cavity, which can lead to embolism in the brain or limbs. Anticoagulants should be used to prevent clot formation. There are new types of medications that no longer require a monthly check-up or a strict diet.

Pacemaker implantation may be required for certain arrhythmias and more severe cases.

Sudden cardiac death is often mentioned in the news, although it fortunately does not count for too many cases, but of course it should be taken seriously. Sudden cardiac death can be caused by several things, often due to the aforementioned coronary calcification. As surprising as it may be, it causes the sudden death of many young people. The highly intense lifestyle and the disregard for risk factors are leading to the development of coronary stenosis. Vascular developmental abnormalities can also be the cause of sudden cardiac death and is usually found in the youngest victims. In athletes, extreme stress and sometimes the use of doping agents can lead to sudden cardiac death.

Screening

Those with more than one risk factor should have their blood pressure measured regularly, and it is recommended that you keep a blood pressure log to keep track of any fluctuations. Dr. Junger points out that it is important that the blood pressure always rises a little in winter, so those who take medication may need a slightly higher dose.

Those who have high blood pressure or heart disease among their ancestors and are asymptomatic but want to make sure they have not inherited the disease, are also advised to get themselves examined. For example, a complete risk assessment, a cardiological examination, cardiac ultrasound, exercise ECG, and a cervical vascular status are all recommended, as this is the easiest way to screen for atherosclerosis.

But not only does the cardiologist recommend regular blood pressure measurements to people who are more at risk, it is also advisable for patients over the age of 30-35 to consult a doctor each year, have a lab test, or have an ECG performed. An occupational health examination can also be a perfect opportunity for this, but a more complex screening test will of course give more detailed results.

More sophisticated targeted tests, such as a CAT scan or a cardiac catheterization, are used by doctors only when there are clear signs of a problem such as coronary calcification and stenosis. A symptom of this may be, for example, chest tightness due to exertion.

A cardiac MRI examination is prescribed by doctors for cardiomyopathy and heart valve abnormalities, as this diagnostic procedure can better reveal the tissue composition and strength of the heart muscle. For example, after a heart attack, this procedure can be used to assess very accurately if the heart muscle has died and how large an area has been affected.

The condition of the heart of unborn children can be screened with fetal ultrasound to shed light on major developmental abnormalities of the heart.

COVID-19

Currently, during the pandemic, there has been a lot of talk about the lungs and lung diseases, as COVID-19 primarily attacks this organ. However, the virus can cause a great deal of damage to both the heart muscle and the brain, and because it damages the walls of blood vessels, there is a high risk of thrombosis. Cardiac complications, myocardial infarction and arrhythmias may occur in more severe infections, but also in patients with mild COVID-19 disease. So, if you still feel weak or arrhythmic 4-6 weeks after the onset of the disease, you may want to visit a cardiologist or Post-COVID outpatient clinic, where patients can receive a full examination and treatment, says Dr. Junger, who reassures: fortunately, Post-COVID’s cardiological symptoms are not permanent in most cases. They often subside over time and even go away spontaneously. It is not common for the damage to be permanent.

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