think with your heartdoc.mediaplanet.com/all_projects/8209.pdf · to find a doctor, call...

An Independent supplement by medIAplAnet to chIcAgo trIbune

Finding support empowering women in their fight against heart disease

Anginathe pain in your chest has a name

don’t skip a beat detecting Atrial Fibrillation

Changing the way you think about heart diseaseChanging the way you think about heart diseaseThink wiTh your hearT

Women’s heart healthSeptember 2011

Women’s heart healthWomen’s heart health

About HeArt DiSeASe in

Women

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ResuRRection Medical centeRto find a doctor, call 877-rES-info (877-737-4636) or visit rmc.reshealth.org

We are proud to have been presented with the 2011 Women’s Health Excellence award™ from HealthGrades®. this ranks us among the top 5 percent of all hospitals nationwide for care in Women’s Medicine, Women’s cardiovascular Procedures and Women’s Bone and Joint Health.

to find a doctor,

We are proud to have been presented with the 2011 Women’s Health Excellence HealthGradesWomen’s Medicine, Women’s

working hard for your heart.

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“Women continue to be misdiagnosed when present-ing with signs of heart attack.”

ChallenGes though more and more women understand heart disease currently outweighs cancer as their top health concern, many are still unaware, thus continuously overlooking risk factors and symptoms.

start with your heart

Gr e e t i n g s women of Chi-cago. We need to talk. Did you know that your leading health threat

is heart disease? Yes, your heart is more at risk than you might be aware, and chances are that your health care provider may not be talking to you about it. In fact, one in three deaths in women is from heart disease and more women die from heart disease than all cancers combined!

Do you have high blood pressure or high cholesterol? Do you smoke? Do you have a family history of heart disease? If your answer is yes to any of these, you may be at increased risk for developing heart disease. And, if you are an African-American or Hispanic woman, research says that you are also at higher risk. So, we do have a lot to talk about, and that is why I am so pleased that this special report is being published.

Since 1984 more women than

men have died from heart disease every year. Women in Illinois die at a rate of 364/100,000—that is 13 more than the national average! Women continue to be misdiag-nosed when presenting with signs of heart attack, don’t receive guide-lines based care as often as men, and have worse health outcomes after heart attack. We also know that women don’t call 911 as readily when experiencing signs of a heart attack because “this couldn’t be happening to me.” Think again. It could be happening to you, and you need to be prepared to help prevent it, advocate for your heart health when you need to, and know how to live a heart healthy life. In the following pages you will learn how.

finding supportLeading health experts and Wom-enHeart: The National Coalition for Women with Heart Disease are working tirelessly to ensure that every woman has informa-tion about how to prevent heart disease, and have access to early and accurate diagnosis and proper

treatment should they develop heart disease. WomenHeart also provides the only peer led patient support groups in the country to support women living with heart disease. In fact, you have several right here in Chicago.

one heart at a timeAlso in this issue, learn about the signs and symptoms of heart dis-ease and heart attack; heart con-ditions such as atrial fibrillation; the correlation between obesity and heart disease; and how to talk to your doctor about your heart health.Ladies, starting today, make a promise to yourself to take care of your heart and become an empow-ered patient! Together, one heart at a time, we can eradicate heart dis-ease as the leading cause of death in women. And, when you need that extra bit of encouragement or support to do so, visit www.womenheart.org.

Carol allred

[email protected]

Carol Allredheart disease survivor, chair of the board of directors, Womenheart: the national coalition for Women with heart disease

Heart Sisterslocal cVd survivors offer support to newly diagnosed women

We recommend

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mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality editorial content that motivates them to act.

Take charge of your hearT healTh! Visit www.womenheart.orgFor information about WomenHeart Support Networks for women living with heart disease in Chicago email: [email protected]

Women’s heArt heAlth, First edition, sePtember 2011

Publisher: Paul stover [email protected] Developer: terence [email protected] Designer: Ariela [email protected] Director: Geraldine delacuesta [email protected]

Contributors: carol Allred, American heart Association, Kathy berra, Petra canan, marla cowen, debbie dunn, Anne Gillis, Fiorenzo Gaita, marla Kalish, U.s. department of hearlth and human services, Womenheart

Distributed within: chicago tribune, september 2011this section was created by mediaplanet and did not involve the chicago tribune or its editorial departments.

FolloW Us on FAcebooK & tWitter! facebook.com/mediaplanetuSAtwitter.com/mediaplanetuSA


neWs

Following a low sodium diet to a healthy heartthe average daily intake of sodium in the u.S. is a whopping 3,500 milligrams, much of it from processed and packaged foods. that’s more than twice the amount recommended by the Health Department, which says your daily intake should be no more than 1,500 milligrams.

The correlation between high blood pressure and sodium intake is well documented and the fact is simple; the lower your sodium intake, the lower your blood pres-sure and the better the outlook is on your personal heart health.

One of the keys to successfully reducing salt intake is making wise food choices. A very small amount of sodium comes naturally from food, and an even smaller amount comes from salt we add at the table. This means that the pro-cessed foods most Americans eat are accountable for the majority of

our sodium intake. Fresh foods, and moreover,

freshly prepared foods are the best way to ensure you are adhering to a salt reduced diet. While making your food choices, the label can be your best friend. Most foods and condiments that people use every single day have low sodium coun-terparts. A regular can of diced tomatoes can have as much as 15 times more sodium than the low sodium option.

fruits and vegetablesAnother way to help lower your daily sodium intake is by inject-

ing more fruits and vegetables into your diet because they are naturally low in sodium and have the added benefit of being high in potassium. Start gradually. No one goes from a lifestyle in which meat and processed foods are the main course to a diet heavy on fruits and vegetables.

If you’re currently only eating one or two servings of vegetables per day, add an extra serving dur-ing lunch and another for din-ner. Add fruit as a healthy snack in between meals. Try treating meat as only part of your meal, and not necessarily the main focus.

Increasing vegetable servings and whole grains not only help reduce the amount of sodium you take in, but they also help you eat less by making you feel full.

Seasoning and condimentsWhile it’s normal for processed foods to be a person’s main source of sodium, food preparation can sometimes be a factor as well. Seasonings, spices and condi-ments used during your meal prep can unknowingly increase your sodium intake during any meal. Finding reduced sodium and sodium free options such as sea-sonings allow for a healthier meal without giving up on taste.

“most foods and condiments that people use every single day have low sodium counterparts.”

NatioNal iNstitute of HealtH

[email protected]

Avocado Lime Cream bitesserves: 4Prep time: 10 mincook time: 10 minready in: 10 min

Directions1. Peel, pit, dice, and mash avoca-do, add mrs. dash Garlic & herb, and all remaining ingredients, mix well.2. cover mixture and chill until ready to serve.3. serve mixture on small round corn chips.4. slice cherry tomatoes and place on top.

recIpes

ingredients1 tbsp. (15ml) mrs. dash Garlic & herb seasoning blend2 medium ripe avocados2 tbsp. (30ml) fresh lime juice1/2 tsp (2.5ml) tabasco sauce20 small round tortilla chips10 cherry tomatoes

All American burgerserves: 4Prep time: 10 mincook time: 10 minready in: 20 min

Directions1. heat a grill or cast iron grill plate to medium. spray with cooking spray. 2. toss all ingredients in bowl. 3. Form into 6 oz. patties. 4. Grill to desired degree of done-ness.

ingredients2 tbsp. mrs. dash original blend 1 lb. lean ground beef 1/4 onion, diced finely 2 garlic cloves, chopped fine cooking spray

reciPes PAid For by Advertiser

obesityThere are 71.3 million over-weight and obese adult

women, representing 62.3 per-cent of the women in the U.S.

40.1 million women are obese, representing 35.2

percent of women with a BMI equal or greater than 30.

26.5 percent of Caucasian women are overweight and

32.8 percent are obese.

26.7 percent of African-American women are over-

weight and 51 percent are obese.

31.7 percent of Mexican-American women are over-

weight and 43.4 percent are obese.

Within 30 years, the percent of obese adult women has

more than doubled: 1976-1980; 17.1 percent obese 2003-2006; 35.2 percent obese

Heart disease 42.7 million women are cur-rently living with some

form of cardiovascular disease. More than 8 million women have a history of heart attack and/or angina.

Seven and a half million women will suffer angina.

Heart disease is the leading cause of death of American

women, killing more than a third of them.

More women than men die of heart disease each year.

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InsPIratIon

heart sisters share their strengthDebbie Dunn, Marla Kalish and Marla Cowan are just three of the 42.7 million women living with congenital heart disease, accord-ing to the American Heart Associa-tion. But coming together through WomenHeart: The National Coali-tion for Women with Heart Disease gave these women an unbelievable power—the power to heal.

Patient advocacyFounded in 1999 by three heart attack survivors, WomenHeart pro-vides national support, education and a loving nudge. “Most women, because they are caretakers, we tend to deny what is happening in our bodies,” Cowan said. “We tend to soldier on, ignore early warning signs.” WomenHeart has grown

into a system of 73 patient support groups, meeting in local hospitals in 27 states. More than 500 heart disease survivors have completed the WomenHeart Science & Lead-ership Symposium, created in col-laboration with Mayo Clinic, to become educators.

three hearts, one missionWhile Cowan’s, Dunn’s and Kalish’s journeys to physical health have been different, their mental and emotional recoveries are uniquely intertwined. Dunn sought to better educate herself after her 2002 heart attack and found WomenHeart in 2004. She started support groups at Glen-brook Hospital, Advocate Condell Medical Center and Northwestern Lake Forest Hospital. “I decided right then and there that I needed

to take this public, that I needed to share my story,” Dunn said. A f t e r having three stents inserted in February 2006, Kalish was shocked when hospital staff could not refer her to a support group. ”I needed to connect with other women,” she said. “I was having a difficult time adjusting to all these medi-cations and how I was feeling.” Cowan, a breast cancer survivor, underwent a triple bypass to repair damaged arteries and attended her first WomenHeart meeting three years ago. “I realized not only that I was not alone, I was beginning the process of regaining control over my life,” she said.

reaching their communitySince meeting through local sup-port groups, all three women have competed the symposium. They

attend speaking engagements and distribute information to women and physicians.

WomenHeart now holds sym-posiums at Chicago-area hospitals including Rush University Medi-cal Center as well as health fairs, bringing translators and physi-cians to answer questions.

Dunn, Kalish and Cowan want WomenHeart to be an automatic response for women diagnosed with heart disease and to make sure no woman feels alone when it comes to her heart health.

Dunn summed up their bond: “Do not mess with a heart sister.”

petra CaNaN

[email protected]

insPirAtion

marla Cowan

“most women, because they are caretakers, we tend to deny what is happening in our bodies.”


InsIGht

atrial fibrillation impacting more americanseach year, approximately 160,000 new cases are diagnosed, including eight out of every 100 people over the age of 65. Although it usually occurs in adults older than 60, younger adults can develop Afib too.

What is AfibFor an adult, a normal resting heart rate ranges from 60 to 100 beats per minute. However, when the heart is in Afib, it is characterized by a rapid and irregular heartbeat where the top chambers of the heart (the atria) quiver (fibril-late) rapidly and erratically. Afib itself is not life-threatening, but if left untreated, the side effects can severely depreciate a person’s quality of life and can lead to heart failure or stroke. Afib increases the risk of stroke fivefold and is esti-mated to be responsible for 88,000 deaths and $16 billion in additional costs to the U.S. healthcare system each year. As the population of the U.S. and other countries ages, the prevalence of Afib is projected to increase — projections are that more than 5.6 million adults will be diagnosed with the disorder by 2050.

It is important to know the symptoms of Afib, which can be different for each person. Some people feel no symptoms at all and do not know that there is a prob-lem, while others can tell some-thing is wrong immediately. This is because the symptoms depend on age, the cause (heart problems, other diseases, etc.) and on how

much Afib affects the pumping of the heart. Generally, symptoms of Afib include:

■■ Feeling over-tired or a lack of energy (the most common symp-tom)

■■ Pulse that is faster than normal or changing between fast and slow

■■ Shortness of breath■■ Heart palpitations (feeling like

your heart is racing, pounding or fluttering)

■■ Trouble with everyday exercises or activities

■■ Pain, pressure, tightness or dis-comfort in your chest

■■ Dizziness, lightheadedness or fainting

increased risk in womenAlthough both men and women can develop Afib, some studies have shown that women with Afib are more likely to experience a stroke and, thus, are at an increased risk of death and other cardiovascular health events. There are several theories as to why this may occur, including research that suggests a difference from men in the way women perceive and, ultimately, downplay their discomfort to phy-sicians. Without a full description of symptoms, a physician would

not be able to diagnose a poten-tially dangerous heart rhythm irregularity.

A diagnosis of Afib can set a patient on the right course to obtain treatment(s) to manage it. There have been several advance-ments in the treatment of heart rhythm disorders, which have helped to improve the quality of life of people with the condition. Each situation is different, so it is important that a person with Afib talk with their physician to deter-mine the best treatment option for them. A physician may recom-mend medication, surgery, or an implantable heart device to help stabilize the heart rate and rhythm. Overall, greater awareness of Afib is needed. The Heart Rhythm Soci-ety is calling attention to the need for more public education of Afib through our national awareness campaign, “Afib Feels Like.” The campaign makes available several resources to health care profes-sionals in order to foster better dialogue with patients. Further-more, we recently released a public service announcement (PSA) to help people identify and articulate symptoms that may be indicators of Afib, including racing, pound-

ing and fluttering of the heart. We believe that greater communica-tion between doctors and patients will help those with Afib improve their quality of life through early diagnosis and treatment.

The U.S. Senate has also taken steps to ensure that Americans have greater knowledge of Afib. In 2009, the Senate approved a resolution designating the month of September as National Atrial Fibrillation Awareness Month. On July 29, 2011, the U.S. Senate passed by unanimous consent Senate Resolution 243, which promotes increased awareness, diagnosis, and treatment of Afib in order to address high morbidity and mor-tality rates and to prevent avoid-able hospitalizations associated with the disease. Both resolutions underscore the need for greater attentiveness to Afib.

Remember, Afib is treatable. If you experience any symptoms of the condition (or others), docu-ment them and talk to your doctor. Do not minimalize or downplay any part of your health – the sooner a person is diagnosed with Afib, the sooner he/she can begin the right treatment options and improve their well-being and quality of life.

To learn more about Afib and to view the Heart Rhythm Society’s PSA, “Afib Feels Like,” visit www.MyAfib.org.

aNNe Gillis

[email protected]

nearly 2.5 million Americans live with the most common type of heart rhythm disorder, Atrial Fibrillation (Afib).

“A diagnosis of Afib can set a patient on the right course to obtain treatment.”

Anne Gillis md, Fhrs; president-elect of the heart rhythm society

QUestion & AnsWer

What is an electrophysiologist?

! An Electrophysiologist is a “heart electrician” special-

ized in the treatment of heart rhythm problems (“arrhyth-mias”), such as for instance atrial fibrillation. The heart is a muscle pump built like a house: it has a plumbing system—the arteries and veins that carry blood and oxygen to and from the heart. It also has an electrical system that keeps the heart beating in a coordinated and regular fashion. A heart attack is a plumbing problem: a clogged artery that leads to damage of a part of the heart muscle. Arrhythmias are problems with the electrical system. The heart beat can be too fast or too slow, and an abnormal heart beat can be life-threatening or fairly harmless. The damage to the electrical system can occur dur-ing or after a heart attack, or it may be independent of any other heart problem. The symptoms of arrhythmias can sometimes be the same as those during a heart attack—chest pain, shortness of breath, dizziness, but the treat-ment is very different. Fixing the plumbing does not usually take care of the electrical system.

Dr. eriCA enGeLStein

[email protected]

Dr. erica engelsteindirector, cardiac electrophysiology at resurrection medical center

Afib mAy LASt A SHort time

AnD enD SPontAneouSLy

or it mAy Continue

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CHICAGO TRIBUNE

Pradaxa® is a registered trademark of Boehringer Ingelheim Pharma GmbH & Co. KG and used under license. Copyright © 2011 Boehringer Ingelheim Pharmaceuticals, Inc. All Rights Reserved. (8/11) Issued March 2011

Read this Medication Guide before you start taking PRADAXA and each time you get a refi ll. There may be new information. This Medication Guide does not take the place of talking with your doctor about your medical condition or your treatment.

What is the most important information I should know about PRADAXA?

sometimes lead to death. This is because PRADAXA is a blood thinner medicine that lowers the chance of blood clots forming in your body.

You may have a higher risk of bleeding if you take PRADAXA and:

including:

Tell your doctor if you take any of these medicines. Ask your doctor or pharmacist if you are not sure if your medicine is

lessens the ability of your blood to clot. While you take PRADAXA:

Call your doctor or get medical help right away if you have any of these signs or symptoms of bleeding:

such as:

Take PRADAXA exactly as prescribed. Do not stop taking PRADAXA without fi rst talking to the doctor who prescribes it for you. Stopping PRADAXA may increase your risk of a stroke.

more any reason

doctor who prescribed PRADAXA for you to fi nd out when you

taking PRADAXA again after your surgery or procedure. See “What are the possible side effects of PRADAXA?” for more information about side effects.

What is PRADAXA?PRADAXA is a prescription medicine used to reduce the risk of

not beat the way it should. This can lead to blood clots forming and increase your risk of a stroke. PRADAXA is a blood thinner medicine that lowers the chance of blood clots forming in your body.

Who should not take PRADAXA?

Do not take PRADAXA if you:

unusual bleeding.

your doctor if you are not sure.

What should I tell my doctor before taking PRADAXA?

if PRADAXA will harm your unborn baby.

PRADAXA passes into your breast milk. Tell all of your doctors and dentists that you are taking PRADAXA.

any

Tell your doctor about all the medicines you take, including

What is the most important information I should know about PRADAXA

Know the medicines you take. Keep a list of them and show it to your doctor and pharmacist when you get a new medicine.

How should I take PRADAXA? Take PRADAXA exactly as prescribed by your doctor.

or empty the pellets from the capsule.

skip the missed dose. Do not take two doses of PRADAXA at the same time.

Do not stop taking PRADAXA without fi rst talking with your doctor. Stopping PRADAXA may increase your risk of stroke.

MEDICATION GUIDEPRADAXA (pra dax’ a)

(dabigatran etexilate mesylate) capsules

What are the possible side effects of PRADAXA?PRADAXA can cause serious side effects.

and itching. Tell your doctor or get medical help right away if you get any of the following symptoms of a serious allergic reaction with PRADAXA:

that does not go away. These are not all of the possible side effects of PRADAXA. For

How should I store PRADAXA?

Keep the bottle tightly closed.

Keep PRADAXA and all medicines out of the reach of children.

General information about PRADAXAMedicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use PRADAXA for

for information about PRADAXA that is written for health professionals.

What are the ingredients in PRADAXA?

Distributed by:

the Administration.

Dr. Minerva Santo-TomasCardiologistMiami, FL

Dr. David MontgomeryCardiologistChicago, IL

Dr. Howard CohenPrimary CareLaguna Hills, CA

Doctors compensated

If you have an irregular heartbeat called atrial fi brillationnot caused by a heart valve problem

ask your doctor about PRADAXA.

In a clinical trial, PRADAXA 150mg reduced stroke risk 35% more than warfarin.

Risk reduction was greatest when compared to patients on warfarin whose blood tests showed lower levels of control.

No regular blood tests

C A P S U L E SIf you need help paying for your medication can help,

and for more information about PRADAXA call 1-855-PRADAXA or visit pradaxa.com.

PRADAXA is a prescription blood-thinning medicine used to reduce the risk of stroke and blood clots in people with atrial fi brillation not caused by a heart valve problem. With atrial fi brillation, part of the heart does not beat the way it should. This can cause blood clots to form, increasing your risk of a stroke. PRADAXA lowers the chance of blood clots forming in your body.

PRADAXA can cause bleeding which can be serious and sometimes lead to death. Don’t take PRADAXA if you currently have abnormal bleeding or if you have ever had an allergic reaction to it. Your risk of bleeding with PRADAXA may be higher if you: are 75 years old or older, have kidney problems, have stomach or intestine bleeding that is recent or keeps coming back or you have a stomach ulcer, take other medicines that increase your risk of bleeding, like aspirin products, non-steroidal anti-infl ammatory drugs (NSAIDs) and blood thinners.

Call your doctor or seek immediate medical care if you have any of the following signs or symptoms of bleeding: any unexpected, severe, or uncontrollable bleeding; or bleeding that lasts a long time, unusual or unexpected bruising, coughing up or vomiting blood; or vomit that looks like coffee grounds, pink or brown urine; red or black stools (looks like tar), unexpected pain, swelling, or joint pain, headaches and feeling dizzy or weak.

It is important to tell your doctor about all medicines, vitamins and supplements you take. Some of your other medicines may affect the way PRADAXA works.

Take PRADAXA exactly as prescribed by your doctor. Don’t stop taking PRADAXA without talking to your doctor as your risk of stroke may increase.

Tell your doctor if you are planning to have any surgery, or medical or dental procedure, because you may have to stop taking PRADAXA for a short time. PRADAXA can cause indigestion, stomach upset or burning, and stomach pain.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see detailed Medication Guide on adjacent page.

IMPORTANT SAFETY INFORMATION ABOUT PRADAXA

Reduce your risk of a stroke caused by a clot that starts in the heart.

“FINALLY after 50 years our patients have a choice.”

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12831_CHICAGO_TRIBUNE 1 8/19/11 1:32:02 PM


www.SpeakFromTheHeart.com Tips, information,and more from real angina patients including Ralph and Donnette.

Ralph, angina patient

Donnette, angina patient

Speak From the Heart is a trademark, and the Speak From the Heart logo is a registered trademark, of Gilead Sciences, Inc. © 2011 Gilead Sciences, Inc. All rights reserved. UN10335 8/11

F17932_1a_Chi_Lv0608/17/1185LSTW

A17401x01G_240ucr.tifA17932x02B_240ucr.tif

InsIGht

the evolution of aF ablation therapies

the last 10 years have seen an amazing evolu-tion in catheter ablation of atrial fibrillation (AF). It has gone from

being an experimental technique to the most common ablation pro-cedure performed worldwideCur-rently, there is wide consensus that the best strategy in parox-ysmal AF is pulmonary vein iso-lation (PVI) while for persistent and long-standing persistent AF, a more aggressive approach includ-ing left atrium linear lesions and/or CFAEs ablation is necessary. Hand in hand with the growth of AF ablation, the industry has pro-gressively provided new ablation tools and imaging techniques with the aim of facilitating AF ablation, improving success and reducing complications. The main imaging techniques that have been used over time, first included fluoroscopy, followed by intracardiac echocardiography (ICE) and virtual 3D electro-ana-tomic mapping, with or without magnetic resonance/computed tomography (MRI/CT) imag-ing integration. Considering the

growing number of procedures performed, the increasing num-ber of patients affected by AF suit-able for ablation and the consider-able costs of these new technolo-gies, it is fundamental to know the real impact of these tools in terms of outcomes.

Fluoroscopy in AF ablation was the first imaging technique applied in clinical practice. Stud-ies of pulmonary vein isolation and fluoroscopy reported aver-ages for short-term success of 70 percent, complication rate of 4 percent, procedural time of 188 minutes, and fluoroscopy time of 61 minutes. The main advantages are the availability in every elec-trophysiology lab, simultaneous visualization of all catheters and real time acquisition. The disad-vantages are mainly represented by 2D imaging, which may be challenging for inexperienced operators, and the long X-ray exposure required to visualize the movement of the catheters.

ICE was also a technique quickly applied to AF catheter procedures, due to its potential to easily solve the main problem with AF ablation: transseptal puncture. The main advantages of ICE are

the detailed real-time imaging acquisition and the possibility to continuously monitor thrombus formation. Disadvantages are extra venous sheath and catheter insertion, visualization of ultra-sonographic-centred catheter only, higher costs and no X-ray exposure reduction and success improvement. Virtual 3D electro-anatomic mapping, including the Carto system from Biosense Webster, with or without mag-netic MRI/CT imaging integra-

tion, helped AF ablation to reach popularity and diffusion. In fact, performing AF ablation is techni-cally challenging because lesions are based on a point-by-point approach that needs great preci-sion; and the three-dimensional structure of left atrium is very complex and difficult to visual-ize with fluoroscopic guidance alone. Non-fluoroscopic mapping techniques were introduced to allow a 3D reconstruction of the left atrium with real-time visu-alization of all catheters in order to achieve better success rate, reduced incidence of side effects and X-ray exposure. Studies with pulmonary vein isolation with this approach reported a mean success rate of 75 percent, compli-cation rate of 2 percent, procedural time of 175 minutes and fluoros-copy time of 36 minutes. Given the increase in ablation procedures along with the higher success rate and lower complication rate, we are headed in the right direction. The exciting part is that we still have more advancements to make in ablation treatment.

fioreNzo Gaita, CardioloGist

[email protected]

insiGht

“the main advantages of Ice are the detailed real-time imaging acquisition and the possibility to continuously monitor thrombus formation.”

QUestion & AnsWer

What can you tell women about quality of life related to their angina?

! Women often don’t realize how a symptomatic problem

like chronic angina can affect their quality of life. All that said, I think it is important that to have this dis-cussion - but it is a two way street. Health care providers need to ask women and men about how they are feeling, are they enjoying their life, are there things that they wish they could be doing that they are not doing now. The answers to these questions can help guide medical therapies or other inter-ventions to reduce the symptom burden – hopefully resulting in an improved quality of life. So, under-standing that your health care pro-vider is there for more than just treating and correcting disease, they really are interested in your life in general and how you are feel-ing in terms of quality of life, depression, sleep. All of this knowl-edge will help guide their care.

kathy berracardiovascular nurse practitioner

http://www.speakfromtheheart.com

GPS for the Heart.

Catheter ablation for a heart arrhythmia may not be an option for you if you have any of the following conditions: certain recent heart surgery; prosthetic valves; active systemic infection; certain cancers; intracardiac thrombus, or an interatrial baffle or patch. Consult your physician to find out if catheter ablation is right for you. Known complications of catheter ablation include the following: bleeding, swelling or bruising at the catheter insertion site, and infection. More serious complications are rare, which can include damage to the heart or blood vessels; blood clots (which may lead to stroke); heart attack, or death. For further information, consult your physician. Caution: Federal law limits this device to sale by or on the order of a physician. *THERMOCOOL® Navigation Catheters are approved for drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used with CARTO® Systems (excluding NAVISTAR® RMT THERMOCOOL® Catheter). ©Biosense Webster, Inc. 2011 All rights reserved.

The CARTO® 3 System from Biosense Webster offers the

New Vision in AF* Ablation and helps your doctor diagnose and treat arrhythmias of the heart with cutting-edge 3D mapping and navigation technology.


angina occurs when your heart does not get enough oxygen, which results in a tightness, pres-sure, burning or

pain in the chest and/or the neck, jaw, back, shoulders, or arms. Some-times it’s a sense of unusual fatigue or shortness of breath. The discom-fort or pain from angina is often con-fused for indigestion. Angina is not actually a disease; it is a symptom of coronary artery disease (CAD- block-ages in the bigger arteries in the heart) and coronary microvascu-lar disease (MVD- blockages in the smaller arteries in the heart). This means that the underlying causes of angina are a result of blockages in the arteries of the heart; both the bigger arteries and the smaller arter-ies. Research suggest that smoking, high amounts of fat and cholesterol in your blood, high blood pressure and a high amount of sugar in the blood due to diabetes or insulin resis-tance are all factors that contribute to blockages in your heart arteries and symptoms of angina.

types of AnginaThere are two major, more common types of angina; stable and unstable. Each type has different symptoms and will require a different type of treatment. Stable angina is the most common form. It occurs when your heart is not getting enough oxy-gen. Stable angina can occurs with regularity, almost in a pattern, giving

you the ability to predict when the discomfort or pain will occur, how severe it will be and what factors will trigger it. The discomfort or pain will usually go away within a few minutes after you’ve rested or taken medication prescribed to you. Stable angina symptoms do not mean that you are having a heart attack, but it does let you know that your heart is not getting enough oxygen and that you need to stop what you are doing, rest and take medication that your doctor prescribed. Unstable angina is very different than this. Unstable angina is usually much more severe, can occur at any time, and can last for a longer time. It usually does not fol-low a specific pattern –such as with exercise or eating a large meal and then resolving in 5 minutes with rest or medication. It is a much more dangerous form of angina. Unstable angina could be a sign that you are having a heart attack.

Helping your doctor help youDoctors can’t predict the future, and they certainly cannot feel discom-fort or pain for you. In order to com-pletely understand how to diagnose and treat your angina it’s important

for you to track when you have feel-ings of pain, discomfort, or other feel-ings that you know are your angina symptoms. If you are exercising and begin to feel a shortness of breath or discomfort in your chest, make a note of it. Determine exactly what activity you are doing that brings on the pain or discomfort, as well as what relieves it. Tell your doctor what it feels like. Is it heaviness, or tightness in your chest? Does it occur on a regular basis? If so, how often? Where are you feeling the discom-fort, how long does it generally last, and how severe is it? Some of the answers to these questions will help your doctor determine what type of angina you have and how to treat it.

Living with the conditionWe know that stable angina is not a heart attack, but it does increase your risk of having a heart attack. No one can say that living with angina is “easy” but it is possible. After a few episodes of angina you’ll have a better idea of the pattern, and a bet-ter idea of how to control it but it doesn’t mean your work is done. It’s important to continue monitoring any changes that may occur. If your

angina symptoms start to occur more often, lasts longer, becomes more severe or don’t go away with rest or medicine then your angina may be getting worse, or becoming unstable. Have your angina medi-cines readily available and know how to take them. Make sure that you are aware of your limits for phys-ical activity, and don’t go over those limits. Eliminate stress. Of course, that is easier said than done, but stresses like anger and severe emo-tional upset can trigger your angina as well. Always let your doctor or nurse know if your usual angina symptoms are changing in any way. Your doctor may want to give you new medications for angina or you may need some tests to better evalu-ate your heart.

Sit down with your doctor and come up with an emergency plan. Because angina can increase your risk for a heart attack it’s important that you, your family and your friends know when and how to seek medical attention. Help them understand the signs and symptoms of a heart attack and how to use the medications your doctor has approved. Ensure that you are aware of the nearest hospital that has 24 hour emergency heart care. The most important thing is to never underestimate your heart condi-tion. Whether you are having a heart attack or experiencing unstable angina is difficult to tell. If you have any doubt, call 911 immediately.

kAtHy berrA

[email protected]

“sit down with your doctor and come up with an emergency plan.”kathy berracardiovascular nurse practitioner

You are not alone

InsPIratIon

QUestionnAire

if an angina patient is going to discuss quality of life with their doctor, what advice could you give?

■ Women who have anginal symptoms from heart disease need to look at it from two perspectives. One, what is going on when I am having my angina? Is there some-thing I can do or my health care provider can help me figure out to do differently to avoid anginal episodes? Am I taking my medications regu-larly? Are there additional stressors in my life that are causing increased anginal episodes? Am I exercising too much or not enough? Am I getting enough sleep? How’s my weight? Do I have enough support from family and friends. How am I feel-ing emotionally? This is an important discussion to have with all patients who have symptomatic diseases such as chronic stable angina so they understand that living with a chronic illness, espe-cially one that is symptom-atic, is difficult.

■■ We are there to help them understand and live a better quality of life through medi-cal therapies and lifestyle management, getting ade-quate rest, avoiding stress, taking medications on a regu-lar basis and helping their family and friends under-stand what having angina is like.

KatHy Berra

[email protected]

tHere Are tWo tyPeS of

AnGinA: StAbLe AnD unStAbLe

3fACt

nearly 10 million people in America have a heart condition called Angina, and around 500,000 more will develop angina each year.

http://www.pcna.net/clinical/patients/tough/index.php

Speak fromthe heart

about yourangina

“My doctor has worked with me to manage my angina by managing my medications.”

If you have been limiting your work or your activities because of your chronic angina, be sure to talk about it with your cardiologist.

For tips on how to talk with your cardiologist, information about living better with angina, and support and stories from real angina patients—

including Claudia—visit www.SpeakFromTheHeart.com.

Speak From the Heart is a trademark, and the Speak From the Heart logo is a registered trademark, of Gilead Sciences, Inc. © 2011 Gilead Sciences, Inc. All rights reserved. UN10327 8/11

Claudia, angina patient

Your cardiologist is listening

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