Knowledge

The Heart Center

If you have been diagnosed with heart disease, you can reduce your risk by taking control of the factors in your life that increase your risk of progression of disease.

Identify the factors that apply to you and take action!

  • 1. If you smoke, you must stop. Ask your doctor about counseling, nicotine replacement methods and formal ces­sation programs to help you quit. The California Smokers’ Help line is a free telephone program, funded by the California Department of Health, that can help you quit smoking.

Call 1-800-NO-BUTTS!

  • 2. Ask what your ideal weight should be; if you exceed it by more than 20 percent, ask your doctor to prescribe a diet and exercise program. You may find that a referral for nutritional counseling by a dietician who specializes in diet instructions for heart patients will be helpful.
  • 3. Find out what your cholesterol level is by having a fasting lipid blood test. Your LDL should be below 100mg/dl.
  • Medication may be prescribed to achieve this value. In addition you should be consuming less than 30 percent of calories as fat and no more than 7 percent of calories as saturated fat to optimize your lipid levels.
  • 4. Talk to your doctor about taking an aspirin daily.
  • 5. If you are sedentary, exercising aero-bically 30-60 minutes 3-4 times a week will improve many of the above risks.
  • 6. Have your blood pressure checked regularly. If your blood pressure is consistently above 130-139/85-89, you should discuss with your doctor the need for medication in addition to adopting healthy lifestyle habits such as exercising regularly, losing weight, and eating a low-fat, high-fiber, low-salt diet.
  • 7. If you are diabetic, it is important that you keep your blood sugars con­trolled.
  • These values may vary depending on              If your current program falls short of
    your age and other conditions. Ask                     these goals, discuss how you can
    your doctor what your goals should                         improve with your doctor,
    be to achieve the most benefit.

Proper diet, regular exercise, weight                 For more information: Check out the
control and proper use of medica-                               American Heart Association
tions all play a part in good diabetes                             www.americanheart.org.
management.

Relaxation techniques can be used to help prevent stress or help
you cope with it.
Three examples of relaxation techniques are deep breathing,
fantasy  meditation   and       general     muscle       relaxation.
Practice them whenever you have free time, since the more you practice,
the more effective they are when you need them. These techniques can
work just about anywhere and at any time.

Deep Breathing

  • 1. Get into a comfortable position, either sitting upright with your head sup­ported or lying on your back. Loosen tight, constricting clothing, especially at your neck and waist.
  • 2. Close your eyes and place your left hand on your abdomen and your right hand on your chest. Breathing nor­mally, notice which hand moves as you breathe.
  • 3. Mentally, slowly count from one to four as you inhale through your nose. Pause for two counts. Then open your mouth and mentally count from one to six (or one to eight if comfortable) as you exhale through your mouth.
  • 4. As you continue breathing this way, try to shift most of the movement toward your lower hand, which is at the level of your diaphragm. Consciously let your abdomen push your hand out as you inhale and pull your abdomen in, letting your hand fall or move in as you exhale.
  • 5. After several minutes of slow, rhyth­mic breathing, let your hands slowly
  • move to your sides as your abdomen continues to move freely in and out with each breath.
  • 6. After several more minutes, slowly open your eyes and sit quietly.
  • This technique is especially helpful for emotional calming.

Fantasy Meditation Exercise

This method requires you to use your imagination. Begin by closing your eyes, and creating in your mind a comforting, relaxing place. You can picture yourself relaxing in the sunshine on an island beach, walking through a quiet, fragrant pine forest, or floating on a billowy cloud. It doesn’t matter where you place yourself as long as you allow the won­derful, comfortable feeling to relax your entire body. You may want to write your fantasy down on paper or create a new one in your mind each time that you use this technique.

As you “wake up” from your fantasy, notice how relaxed you feel. Take time to enjoy this experience, and try to carry it with you throughout the day.

This technique is especially helpful for quieting the mind when there is a lot of “internal clutter.”

Progressive Muscle Relaxation Technique

The third and final technique is one in which you alternately tense and relax all of the muscles in your body, a few at a time. When you practice, find a quiet room away from all interruptions. You may either sit in a chair or lie down, tak­ing a few minutes to close your eyes and relax before beginning.

Get into a comfortable position with your head and neck supported. Close your eyes and tense each muscle group listed on the right to about 25-50 percent of maximum capacity. Hold the tension for a few seconds as you continue to breathe, then slowly release the tension as you focus on the pleasant contrast between tight and relaxed muscles.

  • 1. Hands and arms—tense, hold, slowly release, pause and focus
  • 2. Face—tense, hold, slowly release, pause and focus
  • 3. Neck and shoulders—tense, hold, slowly release, pause and focus
  • 4. Stomach and abdomen—tense, hold, slowly release, pause and focus
  • 5. Buttocks and thighs—tense, hold, slowly release, pause and focus
  • 6. Calves—tense, hold, slowly release, pause and focus
  • 7. Feet—tense, hold, slowly release, pause and focus

Sit quietly for several minutes and enjoy the feeling of a relaxed body before you slowly open your eyes.

Angina

Angina is chest discomfort that occurs when the heart muscle is not getting enough blood and oxygen. This is due to a decrease in blood flow through one or more of the coronary arteries, which carry blood to the heart. The decrease in blood flow is usually due to narrowing of the artery. Think of a clogged sink—only a small amount of water can get past the clog. The portion of the heart muscle beyond the narrowing gets less blood and oxygen. The result of this is angina.

What Causes Narrowing of the Artery?

One of the causes is atherosclerosis. Atherosclerosis is a complex process. It includes the deposit of fatty substances (such as cholesterol) on the artery walls, resulting in narrowing of the arteries. When the narrowing involves one or more of the coronary arteries, it is called coronary artery disease. If the narrowing becomes severe enough that the blood supply to the heart is decreased, angina may result.

When is Angina Most Likely to Occur?

Narrowing of the Artery


Often angina occurs during exercise, emotional stress, after a large meal or in very hot and/or cold weather. Your heart works harder at these times and there­fore requires more oxygen to do its work. Rarely, people can experience angina at rest.

What Does It Feel Like to Have Angina?

Some people describe it as a heaviness, tightness, burning, pressure and/or squeezing sensation that is usually felt in the chest, and may or may not spread to the arms, neck, or jaw. Others say they have feelings of indigestion or a choking feeling. Angina pain can also be felt in the upper back between the shoulder blades. Angina can also cause numbness in the shoulders, arms, or wrists,

Treatment

If you have angina, your doctor may prescribe nitroglycerin (NTG)to relieve discomfort. NTG is a very effective drug that rapidly relieves most angina attacks.

3X5 Rule

The NTG tablet is rapidly dissolved when placed under the tongue. It begins working in about 30 seconds. NTG may be repeated every 3-5 minutes for a total of three tablets if discomfort persists. You should not take more than three tablets for an episode of angina. If your discomfort is not relieved by the NTG, call 911.

Nutrition and Your Heart

  • Aim for Fitness
  • Aim for a healthy weight
  • Be physically active each day

Build a Healthy Base

  • Let the Food Guide Pyramid guide your food choices
  • Choose a variety of grains, especially whole grains
  • Choose a variety of fruits and vegetables daily

Choose Sensibly

  • Choose a diet that is low in saturated fat and cholesterol and     moderate in total fat
  • Choose beverages and foods to moderate your intake of sugars
  • Choose and prepare foods with less salt
  • If you drink alcoholic beverages, do so in moderation

Types of Dietary Fat

Saturated Fat

May increase your total cholesterol and LDL levels (bad cholesterol) and have a negative effect on HDL levels (good cholesterol)

Examples:

  • butter
  • cheese
  • whole
  • milk & ice cream
  • fatty meats
  • palm & coconut oil

Polyunsaturated Fat

May decrease total cholesterol and LDL levels (bad cholesterol), but may also decrease HDL levels (good cholesterol)

Examples:

  • soybean oil
  • corn oil
  • sun­flower oil
  • safflower oil

Monounsaturated Fat

May decrease your total blood cho­lesterol levels and LDL levels (bad cholesterol) without decreasing HDL levels (good cholesterol)

Examples:

  • olive oil
  • canola oil
  • nut oil

-The American Heart Association rec­ommends using polyunsaturated or monounsaturated fat in place of satu­rated fat. All types of fat are high in calories so limit intake.

Cholesterol

  • - Found only in animal products (meats, egg yolks, dairy, etc)
  • - The saturated fat in foods affects your cholesterol levels more than the cholesterol in foods.
  • - Recommend consuming less than 300mg of cholesterol per day.

Trans Fatty Acids (Trans fats) Hydrogenated Oils

  • -Type of fat formed when liquid oils are made by hydrogenation into solid fats like shortening and margarine. Small amounts are found in some ani­mal products.
  • -Found in vegetable shortening, some margarines, crackers, candies, cookies, snack foods, fried and baked goods.
  • -May increase risk of heart disease by lowering HDL cholesterol (good choles­terol) and raising LDL (bad cholesterol)
  • - The American Heart Association rec­ommends choosing a tub or liquid margarine with liquid vegetable oil as the first listed ingredient and no more than 2 grams of saturated fat per tablespoon. Margarines containing no trans fatty acids are also available. Read labels carefully.

Omega-3 fatty acids

  • - Good fats that affect heart health in positive ways.
  • - Fatty fish like blue fish, halibut, mack­erel, lake trout, herring, sardines, albacore tuna, Chinook salmon and pink salmon are high in two kinds of omega-3 fatty acids, eicosapen-taenoic acid (EPA) and decosa-hexaenoic acid (DMA).
  • - Decrease triglyceride levels and growth rate of atherosclerotic plaque and help lower blood pressure to a certain extent.
  • - Tofu and other forms of soybeans, canola, walnut, fiaxseed , and their oils contain alpha-linolenic acid (LNA), which can become omega-3 fatty acid in the body, so these are highly recommended as well.

TIPS

Meats

  • - Limit meat, poultry, fish and cheese to no more than 6 ounces per day (about the size of two decks of cards).
  • - Limit red meat intake to no more than 6 ounces per week.
  • - Buy leaner meats (loin and round are leaner cuts) and trim fat well before cooking.
  • - Remove the skin from poultry before cooking (quickly spray with cooking spray to prevent it from drying out).
  • - Use more white meat than dark meat and eat more fish.
  • - Use cooking methods that will drain fat off (broiling, grilling, stir frying, etc).

Eggs

  • - Egg yolks (yellow part of the egg) are high in fat and cholesterol so limit to two to three egg yolks per week.
  • - Use egg substitutes (such as Egg Beaters) or use more egg whites in place of using a whole egg.

Milk

Use 1% or skim milk that are lower in fat content

  • -Whole milk……..8 grams of fat per cup
  • - 2 percent milk ..5 grams of fat per cup
  • - 1 percent milk ..3 grams of fat per cup
  • -Skim milk ……….0 grams of fat per cup

Cheese

-Use light cheeses like grated parme-san, part-skim mozzarella cheese, low fat cheddar or other low fat or non-fat cheeses.

Butter and Margarine

  • - The softer the better (choose soft tub margarine instead of stick margarine) Examples are Benecol, Take Control, Smart Balance etc.
  • - Margarine spray is a good choice, but the label is misleading (zero calories and fat per label because the serving size is very small. Margarine spray   does contain fat and calories).

Fat-Free Products

  • - Check the label, they may be higher in calories and/or sodium than a regular product (light products may be a bet­ter choice).
  • -Doesn’t mean you can eat more— watch your servings (calories add up).

Sodium

  • - Recommend no more than 2300mg (or 1 teaspoon) per day
  • -Use fresh or plain frozen vegetables (without sauces or seasonings)
  • - If using canned vegetables: rinse well with water to remove some of the sodium or buy vegetables canned without sodium
  • - Avoid processed foods like cold cuts, bacon, hot dogs and some canned soups

Look at the Food Label

  • -A low-sodium product: less than 140mg sodium per serving
  • - A moderate sodium product: 140-300mg sodium per serving
  • - A high sodium product: 300mg sodium per serving
  • - Watch for words like soda on food labels. They refer to sodium bicarbon­ate or baking soda.

Try Herbs and Spices

- Use a variety of herbs and spices instead of salt for seasoning your food. They add good flavor without compensating on taste.

Some examples are:

Mrs. Dash season­ings and marinades, other individual herbs and spices like bay leaf, dry mustard, green pepper, sage, mush­rooms, nutmeg, onion, pepper, thyme, garlic, lemon juice, paprika, parsley, thyme, dill, rosemary, curry powder, tomatoes, basil, chives, mint, caraway, oregano, vinegar and cinnamon.

New Pyramid Guidelines

The New 2005 Food Guide Pyramid (MyPyramid) provides dietary guidelines for Americans. It recommends food choic­es that will improve the quality of an aver­age American diet. It encourages variety, proportionality, moderation and activity. Recommendations include eating:

  • - whole grain cereal, bread, pasta, rice
  • - variety of fruits and vegetables
  • - low-fat or fat-free milk and milk products
  • - low-fat or lean meats and poultry that are grilled, baked or broiled

For more information and to obtain a customized food guide pyramid visit www.mypyramid.gov.

Choose More Often Pepper, herbs, spices, sodium-free seasonings, hot sauce, cocoa powder; salt substitute as allowed by your physician; alcoholic beverages as allowed by your physician.

Choose Less Often Salt, seasoning salts, meat tenderizer, monosodium glutamate (MSG), soy sauce, teriyaki sauce, Worcestershire sauce, steak sauce, gravy mixes, bouillon, olives, pickles, coconut; commercially prepared or convenience foods containing greater than 10 grams of fat and greater than 300 mg sodium per serving.

For more information please contact the American Heart Association.

www.americanheart.org,

Other websites for your reference:

www.scrippshealth.org

www.mayoclinic.com

www.nhlbi.nih.gov

www.healthywomen.org

www.heart.uci.edu

www.womenheart.org

www.eatright.org

Causes for Congestive heart Failure

High Blood Pressure

In a person with high blood pressure, the heart has to work harder to pump blood out to the narrowed arteries. If the blood pressure remains high for long periods of time, the heart may become enlarged and weakened; heart failure can follow. Therefore, if you have high blood pressure, it is important to take your blood pressure medication as directed by your doctor, and get your blood pressure checked regularly.

Problems with Heart Valves

If a valve does not open or close as it should, the heart muscle has to do more work. If the strain on the heart is too much, heart failure can result. Sometimes surgery can correct the problem with the valve by replacing or repairing it. Your doctor will talk to you about this if surgery is an option for you.

Heart Attack (Myocardial Infarction)

When someone has a heart attack, this means a portion of the heart muscle has been damaged. If the damaged area is large enough, it may affect the heart’s ability to pump blood. This can lead to heart failure.

Lung Disease

If the pressure in the blood vessels in the lungs is high, then the right ventricle must pump harder to send blood to the lungs. This extra workload on the heart can lead to heart failure.

In people who have lung disease, it is more difficult for the exchange of oxygen between the air sacs of the lungs and the blood to take place. The result is that less oxygen gets into the bloodstream. Since there is less oxygen available in the blood, the heart must pump more blood in order to get enough oxygen to the cells of the body. This extra workload on the heart can cause heart failure.

Cardiomyopathy

This is a disease of the heart muscle itself. The muscle becomes weak and/or ineffective in its pumping action and this can lead to heart failure. Cardiomyopathy can be caused by infections, coronary artery disease, disease of the immune system or exposure to toxic agents such as alco­hol, heavy metals and certain drugs. Ask your doctor if you have further questions about Cardiomyopathy.

Heart Attack

When your coronary artery(s) become severely clogged and blood flow is cut off for any period of time, damage to the heart muscle will occur. This damage is known as a heart attack or myocardial infarction (M.I.).


Signs and symptoms of heart attack

  • - Chest discomfort (heaviness, tight­ness, squeezing, or a burning sensa­tion).
  • - Shortness of breath
  • - Tightness or pain in other areas of the upper body
  • -Nausea
  • -Sweating
  • -Dizziness
  • -Heart palpitations
  • -Loss of consciousness

The symptoms of a heart attack vary for each person. Some people may have a heart attack without ever having symptoms. Angina is the most common symptom of a heart attack.

Your doctor will evaluate your signs and symptoms, risk factors, an electrocar­diogram (EKG), and blood tests, to deter­mine if you have had a heart attack. Medications and special procedures may be used right after your heart attack to help heal your arteries and help restore blood flow.

Healing

After a heart attack, scar tissue forms where the heart muscle was damaged. This damaged area will not work as well as the rest of your heart.

Over time, new vessels will grow to feed your heart blood and oxygen. This process is called collateral circulation. Collateral circulation takes many months, possibly years for good circulation to rebuild. Exercise and medications can speed up the collateral growth process.

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