Questions & Answers

Frequently, chest pain or pressure that is associated with heart disease occurs with physical exertion or with other types of stress, such as emotional stress. It can also occur after meals and can sometimes be confused with a bad case of indigestion. The chest pain or pressure that relates to heart disease can also occur with other symptoms, such as shortness of breath, sweatiness or even nausea. If you are experiencing these symptoms and they are different from what you have experienced in the past, it is important that you seek help from your physician.

2. Of the six major controllable risk factors for heart disease — diabetes, high cholesterol, high blood pressure, obesity, inactivity, and cigarette smoking — is there one factor principally responsible for most of the associated risk?

Although each risk factor is important, if you have diabetes, your risk of developing heart disease is very high. In fact, if you are diabetic you will be treated as if you have heart disease, using medications to lower your cholesterol and blood pressure, as well as aspirin. It is also important for you to know that if you have more than one risk factor, your risk of heart disease increases significantly. Each of the other risk factors is equally important and each of them should be addressed aggressively.

3. At what age should people begin screening for heart disease?

It is never too early to screen for the risk factors for heart disease, especially if you have a family history of heart disease or stroke. Unfortunately, greater numbers of children are developing Type II diabetes, and therefore it is important for pediatricians to look for risk factors at a young age.

4. Some heart attacks are silent, that is, a person experiences no symptoms. What should a person do to determine whether or not he or she has had an attack?

It is important to have a routine electrocardiogram (EKG) when you have your yearly physical examination. Although the EKG is not a perfect test, it can be an indicator that something has gone wrong. People with diabetes are more likely to have silent heart attacks. If you have diabetes, you should talk with your physician about having a stress test, even if you aren’t having symptoms.

5. How does cigarette smoking damage the heart?

The toxins in cigarette smoke can promote the development of plaque in the arteries. In addition, the nicotine in the cigarette smoke causes the blood vessels to constrict, increasing blood pressure. Cigarette smoking also will decrease your ability to exercise, therefore increasing your risk. Your HDL, the “good” cholesterol, will decrease if you smoke. Women who take birth control pills and smoke are at much higher risk of heart disease and stroke.

Cigarette smoke not only damages the blood vessels going to the heart but it damages blood vessels going to all of your major organs. Smokers are two to three times more likely to die of heart disease, and smoking is the leading cause of premature death in the United States.

6. Why is diabetes considered a risk factor for heart disease?

Type II Diabetes, especially when blood sugar is not well controlled, can damage the blood vessels going to the heart and to the rest of the major organs. People with diabetes are far more likely to suffer heart attacks, heart failure, and strokes. In addition, people with diabetes are more likely to have other risk factors for heart disease, such as obesity, abnormal cholesterol levels and high blood pressure, and are more likely to not exercise. The good news is that many of these risks are in your control. If you have diabetes, it is critically important that you work with your physician to control your blood sugar levels.

7. What is the maximum amount of time a person should wait before calling 911 if symptoms of a heart attack occur?

If you think you are having a heart attack, it is important to call 911 as soon as possible. Every minute counts and each minute that you do not receive care, the more likely it is that heart muscle is dying.