The Heart Attack Risks of Shoveling Snow

woman shoveling snowI love the snow (but I don’t live in New England). It’s a great time for sledding, blog writing, reading and relaxing by the fire. Notice I didn’t say shoveling? That’s right, I don’t do it. Although I am probably in the best shape of my life, I leave the shoveling to my wife.

While you are mocking me with a “she must wear the pants” comment, let me explain why she carries the shovel. My wife just won’t let me shovel snow – for good reason. Snow shoveling has a reputation for triggering heart attacks and I have an extremely suspect cardiac profile.

Avoid Shoveling If You Are At Risk

According to an article Dr. Marc Gillinov of the Cleveland Clinic, people at risk of having a heart attack while shoveling snow, include people who have:

  • Heart attack history
  • Heart disease history
  • Heart bypass surgery
  • Peripheral arterial disease
  • 2 or more: Smoking, high blood pressure, diabetes, and high cholesterol

I have 4 out of 5 of those, so take back your snickering insults. It seems that people with these conditions may have suspect plaques in the arteries of the heart. The stress of shoveling snow can rupture these plaques, leading to blockage in your arteries. As a reminder, blocked artery = heart attack.

There are other factors at play here as well – mostly male stupidity. Nothing like eating a bunch of chicken wings, washing them down with a 6-pack and then shoveling in shorts and a t-shirt.

Play It Safe When Shoveling

The best way to protect yourself from harm while shoveling is to treat it as exercise:

  • Don’t eat a huge meal before heading out to shovel
  • Stretch
  • Warm up with a brief walk
  • Hydrate before and during shoveling
  • Layer clothing and stay warm.

Of course, if you fall into one of the categories on the high-risk list, don’t shovel. That’s what your wife or kids are for!

References:

Gillinov, Marc A., MD. “Shoveling Snow Can Kill You.” The Huffington Post. TheHuffingtonPost.com, 08 Jan. 2014. Web. 23 Nov. 2014.

Photo credit: AstridWestvang / Foter / CC BY-NC-ND

Holiday Heart – Celebrating Your Way To a Heart Attack

Drinking SantaThe holiday party season has officially kicked off. While Thanksgiving gives us a single day to demonstrate our ability to consume mass quantities of food and alcohol, the Christmas “season” gives us an entire month! No wonder it is the most magical time of the year.

Although magical, Christmas is not the healthiest time of the year. According to a study in the Circulation publication, “The number of cardiac deaths is higher on Dec. 25 than on any other day of the year, second highest on Dec. 26, and third highest on Jan. 1.”

What’s behind all this holiday doom and gloom? Say hello to Holiday Heart!

What is Holiday Heart?

I had the pleasure of learning about holiday heart several years ago from a doctor in the ER. The term first appeared in the late 1970’s when Philip Ettinger described holiday heart syndrome:

HHS (holiday heart syndrome) is the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking.

How Does Alcohol Affect the Heart?

Time for a good news/bad news answer. The good news: Alcohol can provide cardiovascular benefits when consumed in moderation. The American Heart Association (AHA) describes apparent benefits of moderate alcohol consumption due to the role of antioxidants, an increase in HDL (the good cholesterol) or anti-clotting properties.

Before you get too excited, exercise works better to increase HDL and an aspirin a day does a better job at providing anti-clotting properties. I can imagine people now planning for the best of both worlds – walk home from the Christmas party and pop an aspirin!

Now the bad news.   Alcohol can be addictive, cause liver disease, heart disease, and even cancer. Specific to HHS, excessive or binge drinking leads to dilated cardiomyopathy (heart disease), known to be a cause of not only cardiac failure, but also has been associated with atrial fibrillation and other cardiac arrhythmias.

These arrhythmias, while more common amongst heavy drinkers, can also appear in otherwise moderate drinkers going on a holiday “binge”.

How is that for a buzz kill?

What Are the Symptoms of Holiday Heart?

Holiday heart symptoms include an irregular or fast heart rate, shortness of breath, and/or dizziness. Although holiday heart is generally non-life threatening, the condition should not be ignored. If you are experiencing these symptoms, go to the ER and have yourself checked out, particularly if you have a pre-existing heart condition. The alternative is ruining everyone’s Christmas when you actually do have a heart attack!

How to Avoid a Holiday Trip to the ER

You don’t have to give yourself the gift of holiday heart this season. Take a few simple precautions:

  1. Pace Yourself – You don’t have to say yes to every invitation. Try to avoid consecutive nights of heavy drinking. When you do drink, spread the drinks out over the course of the evening. Having a glass of water every other drink is an effective pacing strategy.
  2. Drink Less – This one seems so easy, but may prove to be the most difficult. Success may have something to do with what kind of a drinker you are outside of the holidays. More moderate drinkers may be able to set a limit and stick to it. Heavy drinkers may just need to leave the party early!
  3. Drink More – Water, I’m talking about water. Alcohol is a diuretic. This means you pee a lot and could become dehydrated. Drinking a glass of water every other drink is also a part of your pacing strategy – remember?
  4. Eat Some – Food can slow the absorption of alcohol into your bloodstream. Hopefully, this will keep you more sober so you can remember steps 1-3.

It’s the holidays – relax and enjoy yourself, but don’t forget to take care of yourself.

References

“The Truth Behind More Holiday Heart Attacks.” WebMD. WebMD, n.d. Web. 30 Nov. 2014.

Tonelo, David, Rui Providência, and Lino Gonçalves. “Holiday Heart Syndrome Revisited after 34 Years.” National Center for Biotechnology Information. U.S. National Library of Medicine, 01 Aug. 2013. Web. 30 Nov. 2014.

“Alcohol and Heart Health.” Alcohol and Heart Health. N.p., n.d. Web. 27 Nov. 2014.

Photo credit: sameb / Foter / CC BY-NC-SA

Thanksgiving Day Food Orgy Leads To Heart Attack!

Thanksgiving Day Gluttony

Here is a startling fact: The average American scarfs down 4,500 calories and 229 grams of fat during Thanksgiving. Gluttonous indeed, but are you putting your life at risk? Of course you are! – A study has found that heavy meals can trigger a heart attack.

How Can Dinner Trigger a Heart Attack?

The study, conducted by Dr. Francisco Lopez-Jimenez, a cardiologist at the Mayo Clinic, found overeating QUADRUPLES a person’s risk of a heart attack for up to two hours after a meal. Think of that as you pile on the stuffing, mashed potatoes, gravy and pumpkin pie.

So what causes the increased chance of having a heart attack after a large meal? There are a number of factors in play here:

  • Blood – Your digestive system goes into overdrive when you eat a large meal. This mean your gut needs more blood than normal and the heart has to work hard to get all that blood moving around.
  • Sugar – Blood sugar and inulin levels go up. These spikes can increase blood pressure and decrease the normal relaxation of the coronary arteries.
  • Fat –Fatty meals lead to an elevation of triglycerides (fat) in the blood. Increased triglycerides cause coronary artery inflammation. Inflamed arteries are a common precursor to a heart attack.
  • Magik – the magik of alcohol. Alcohol adds more calories to your day and makes us love/hate our relatives. Can also lead to an abnormal and dangerous heart rhythm (arrhythmia/A-Fib)

Bonus if you got the Red Hot Chili Peppers reference in the bullets!

Will Thanksgiving Dinner Kill Me?

Likely not. The risk of heart attack from eating a heavy meal is about the same as the risk from sex or a heavy workout. Only benefit of that large meal – I doubt you are moving on to sex and a workout after gorging on 4,500 fatty calories and a few bottles wine!

The usual suspects should be most concerned. Moderation is important for everyone, but more so if you already meet one or more of the following conditions:

  • Heart attack history
  • Heart disease history
  • Heart bypass surgery
  • Peripheral arterial disease
  • Any combination of smoking, high blood pressure, diabetes, or high cholesterol

Personal note – I scored a 4 out of 5.

Strategies for Not Overeating

Thanksgiving is a holiday that is all about food! I think we are supposed be thankful for something also, not sure. Enjoy a few tasty treats but also try and control your portions. A few tips for not overeating:

  • Start healthy – Start the day on a positive not and get some exercise in early. Turkey Trot?
  • Eat early – Eat a healthy breakfast and lunch (depending on timing) before the feast. Proteins (eggs, poultry, etc.) help keep you full throughout the day.
  • Control portions – You should be able to carry your plate with one hand. Enough said.
  • Engage – The whole family is there, you might as well talk to them. And since you don’t talk with food in your mouth, automatic portion control.
  • Walk it off – Avoid the table to couch transition. A walk is a great family activity or a way to get some solitude!

Happy Thanksgiving

Back to the real purpose of the holiday – giving thanks. I am thankful for the opportunity to be here! I’m thankful for my health, family, and friends. And thanks to you for reading this.

References

Richwine, Lisa. “Heavy Meals May Trigger Heart Attacks.” ABC News. ABC News Network, n.d. Web. 25 Nov. 2014.

“9 Classic Thanksgiving Recipes Made-over Healthy.” Caloriecontrol.org. N.p., n.d. Web.

Photo credit: OctopusHat / Foter / CC BY-SA

AFib Symptoms, Treatment, and Management

EKG

Have you ever felt your heart skip a beat, flutter, speed up or slow down? Of course you have.   It may have happened before an interview or important meeting, while climbing a flight of stairs, or after a weekend in Vegas.

Think of the situation you are in when you experienced the symptoms. Common causes for these palpitations include:

  • Stress or strong emotions
  • Intense or endurance exercise
  • Certain prescription or over-the-counter drugs
  • Alcohol, caffeine, nicotine
  • The “other” kind of drugs.

Palpitations are harmless for most people. For others, they may be the sign of an electrical problem with the heart called arrhythmia.  According to the Heart Rhythm Society, atrial fibrillation (AFib) is the most common arrhythmia. In fact, it affects more than 2.5 million American adults.

Although common, AFib can also be very serious.   People who have AFib are 5 times more likely to have a stroke than those who don’t have the condition. So how do you know the difference between palpitations and AFib?

Know Your AFib Risk Factors

According WebMD, you could be at risk of AFib if you are over 60 or you have one of the following conditions:

  • Heart disease due to high blood pressure
  • Heart valve disease
  • Heart muscle disease (cardiomyopathy)
  • Heart defect from birth (congenital heart defect)
  • Long-term lung disease (such as COPD)
  • Heart failure
  • Past heart surgery
  • Overactive thyroid gland
  • Sleep apnea.

AFib Symptoms

The primary symptoms of AFib are the palpitations mentioned above.  In addition to racing or irregular heartbeat you may feel:

  • Chest discomfort
  • Dizziness
  • Fatigue
  • Shortness of breath

AFib Treatments

Your doctor will typically recommend medications such as beta-blockers (to slow down your heart).  You might also be put on blood thinners to reduce the chance of clotting and stroke. If you are in AFib and medication is not working, you may need a procedure such as an electrical cardioversion.

My Shocking Experience

I had the pleasure of this procedure late last year. I went into AFib one night while brushing my teeth. My doctor doubled my beta-blocker and put me on a blood thinner for a couple of days to try and get me back in rhythm.

When this didn’t work, it was on to a cardioversion. My procedure was done at the hospital. After a quick dose of propofol to knock me out, the doctor placed an adhesive pad connected to some wires on my chest. Next, an electrical current was sent through the wires to shock my heart back into rhythm. Bingo – I was all fixed.

Managing AFB

Managing AFib is similar to the steps necessary to manage any underlying heart conditions:

  • Quit smoking
  • Limit caffeine and alcohol
  • Avoid cold medications that contain pseudoephedrine
  • Stop all those illegal drugs (seriously, you should have outgrown this by now)
  • Manage your stress
  • Exercise.

In other words, be a HeartGeek!

Photo credit: Dinh Linh / Foter / CC BY-NC-SA

What Is a Cardiac Arrest?

difibrillattorI couldn’t let National Sudden Cardiac Arrest (SCA) month go by without a mention. According to the American Heart Association (AHA), over 90% of those suffering a cardiac arrest outside of a hospital died. The awareness campaign wants to improve those odds.

Did the campaign work? Do you now know the difference between a heart attack and a cardiac arrest?  Don’t worry, I have experienced both and I didn’t know the difference for quite a while afterwards.

Plumbing vs. Electrical

A heart attack is plumbing – your arteries are blocked.  A cardiac arrest is electrical – your heart stops beating (think death).  Here are the main differences:

  1. A heart attack occurs when a blocked artery prevents blood from reaching a section of the heart.
  2. Symptoms may be immediate and intense, or they may start slowly and persist for hours, days or weeks before the attack occurs.
  3. The heart usually does not stop beating during a heart attack.
  4. Cardiac arrest occurs suddenly and often without warning.   Cardiac arrest is triggered by an electrical malfunction in the heart that causes an irregular heart attack vs cardiac arrestheartbeat.

For those that are more visual, check out the Infographic on the right provided by the American Heart Association.

How To Save a Life

What should you do if you think someone might be in cardiac arrest? The AHA recommends the following:

  1. Yell for help. Tell someone to call 911 and someone else to find an automated external defibrillator (AED).
  2. Check breathing – if the person is not breathing, start CPR.
  3. Begin chest compressions. Use the AED if available.
  4. Keep up the chest compressions until help arrives.

Immediate assistance is the difference between life and death for someone in cardiac arrest. You can read more about the campaign and sudden cardiac arrest here.

Photo credit: Cliff Johnson / Foter / CC BY-SA

Symptoms of a Heart Attack, Silence Can Be Deadly

man clutching heart
We have all seen the Hollywood heart attack. It starts with a middle-aged man clutching his chest and breaking into a sweat before gasping for air and dropping to the ground. This makes good film, but the actual symptoms usually come on much more gradually – or not at all!

Know Your Risk Profile

Before diving deeper into the actual symptoms of a heart attack, it’s important to understand your cardiac risk profile. Having this understanding will help you put the symptoms into context. Risk factors include:

  1. Hereditary
  2. Smoking
  3. High Cholesterol
  4. High Blood Pressure
  5. Inactivity
  6. Obesity

The first risk factor is obviously out of your control. Your risk of a heart attack increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed before 65 years of age.

If heart disease is in your genes, managing the rest of the risk factors becomes even more critical. Doing so is not complicated, but it is hard; quit smoking, eat healthy, and exercise. The hardest part is getting started.  Set realistic goals, and start making changes.

Heart Attack Symptoms

Hopefully you are working to manage your risk profile. But let’s say you experience some pressure in your chest or pain in your arm. What should you do? Words could not provide a better explanation than the video below. Be warned that parts of it may be considered a little graphic.

Great stuff, but I could have done without the vomit.  Also, if in the U.S., be sure to dial 911.

The Silent Heart Attack

There is one other type of heart attack that you need to be aware of – the silent heart attack. Even the name is scary. As many as 25% of all heart attacks fall into this category. A silent heart attack happens when no symptoms are felt or they are misinterpreted.

This is what happened to me the day I had a heart attack and cardiac arrest. Reading a book to my daughter one minute, no pulse the next. Afterwards, my wife said I had been complaining of fatigue for a few days. Knowing my cardiac risk profile (heredity, smoker, poor diet) I should have talked to my doctor.

If you have a high cardiac risk profile, talk to your doctor about silent heart attacks.  Most importantly, don’t ignore any symptoms of chest pain, “heartburn”, shortness of breath, or fatigue.  Because silent heart attacks happen with no warning, the need for immediate response is critical to your survival.