After Heart Attack, a Second Chance

Every day clinicians and patients at Rush face moments of great challenge and great inspiration. During this time of giving thanks, they’re sharing what they are thankful for and how their experiences at Rush have inspired them. 

Gary Schaer, MD

By Gary Schaer, MD

Heart disease is not a death sentence. Even if you’ve survived a heart attack, proper medical therapy and lifestyle modifications can allow you to have an excellent quality of life — and a long life. Surviving a heart attack can be a second chance.

Recently, I cared for a previously healthy, 42-year-old firefighter who came in after having a cardiac arrest in the field. His fellow firefighters brought him to Rush University Medical Center, and he arrested again upon his arrival. He was having a heart attack and we took him directly to the cardiac catheterization lab to fix a severely blocked artery.

When I came out of the cath lab to tell his wife that he was going to be fine, there were at least 20 firefighters and police officers waiting outside. I’d never seen anything like it. I walked through the parting huddle of police officers and firefighters all looking very grim, and they pointed me to his wife, who was stricken and expecting the worst. When I said he would be fine, she hugged me and the firefighters introduced me to his young son. It was wonderful to be able to deliver good news about a young guy with so much potential, so much life ahead of him and so many people caring and depending on him. I was pretty choked up by the whole thing.

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Patient Takes Heart in Supporting Rush

By Tami McQuown

My first personal encounter with Rush University Medical Center was about 11 years ago. I was having chest pains, my heart was fluttering strangely, and though I had been diagnosed with mitral valve in college, I assumed it was only panic attacks. After several of these occasions, I was referred to cardiology at Rush and was given an immediate appointment.

Following blood and stress tests and a series of other diagnostic procedures, I was told by a cardiology intern that while my current condition was stress-related, there was a bigger issue: sometime in the past I had suffered a mild heart attack or cardiac event that had, in fact, caused damage to my heart. I was so unprepared for the news that I really didn’t know what questions to ask. I felt very confused, unsure about what to do and what my condition would mean. My father had died at 39 of a heart attack, and upon learning that I, too, had sustained damage to my heart, I was suddenly terribly scared and alone.

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Where to Draw the Line on Cholesterol

Eggs are high in cholesterol but contain important nutrients.

By Heather Rasmussen

As a registered dietitian in a cardiology clinic, one of the most common questions I get asked relates to dietary cholesterol. Patients either state that they are avoiding dietary cholesterol as they know that it is “bad” for their heart, or they ask if the rumors that has been circulating about the dangers of cholesterol consumption are really true. As a researcher in the field of heart disease, I know the ins and out of cholesterol, and have a variety of responses in my arsenal.

First, it is true that in some people (approximately one-third), dietary cholesterol does increase your own circulating cholesterol. However, it raises both your good (HDL) and bad (LDL) cholesterol, so the ratio of the two does not change. Thus, it is thought that because of this simultaneous increase in both HDL and LDL cholesterol, dietary cholesterol does not greatly impact heart disease risk. However, there are a few caveats.  One, some research shows that eggs (containing dietary cholesterol) increase risk of heart disease in diabetics. In addition, there is some concern that if we measure our own circulating cholesterol after eating (not fasting as most of how cholesterol is measured), that dietary cholesterol may have a negative impact.

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The ❤ in Heart Month

This is the first in a series of posts recognizing American Heart Month.

By Megan Marz

Don’t have plans yet for this Feb. 14? The Centers for Disease Control and Prevention (CDC) offers the following suggestion: “Make a date with your heart! February is American Heart Month, and Valentine’s Day is a great time to start taking steps to be heart-healthy.” As employees of an institution focused on improving people’s health, we can’t argue with this advice. But it made us wonder: Why does Valentine’s Day, that candy-filled, Cupid-kissed holiday, seem particularly heart-friendly to the CDC? Put another way, why does the organ that pumps our blood bring to mind love and romance?

The Heart as a Symbol

Exploring the origins of such symbolism, the cultural historian Ole M. Høystad points out that love is only one of many emotions the heart represents:

“We talk about being light-hearted, being sick at heart, not having the heart to do something, of losing our heart,” he writes. “… We can find something heartbreaking and have our heart in our mouths; the heart can be squeezed, broken or crushed because we have been struck to the heart. And that the heart has something to do with the intellect can be seen from the expression ‘to learn by heart.’”

According to Høystad’s A History of the Heart, the organ has had such powerful associations since the beginning of recorded history: At a crucial point in the 4,000-year-old Epic of Gilgamesh, the eponymous hero offers a heart to the gods. Among all the internal organs, ancient Egyptians replaced only the heart before sealing back up an embalmed corpse and wrapping it in linen. Aristotle saw the heart as the origin of the other organs and the seat of the soul. Continue reading

High-Tech Heart Care, With a Personal Touch

Kousik Krishnan, MDBy Kousik Krishnan, MD

The practice of cardiac electrophysiology is far removed from the type of medicine my grandfather practiced in India. My interest in medicine, however, was not dominated by the wonders of medical technology, but the one-on-one patient contact that defined my grandfather’s practice.

Some of my earliest memories were visiting India and witnessing my grandfather see patients in his home and the trust that patients placed in him in their time of pain and suffering. It is that type of patient contact that I strive to provide my patients despite the high-technology nature of cardiology.

Despite my earliest thoughts that I wanted to be a physician, I also had a love for engineering and physics. This drove my decision to major in electrical and biomedical engineering. Even at this point I did not know how relevant my undergraduate major would be to my professional future. After a short time as an engineer for Frito Lay, I moved on to medical school.

It was only in my final year of medical school that I chose internal medicine as my specialty (I originally thought I would be a plastic surgeon!). I enjoyed the long-term patient contact that is common in internal medicine, but also felt that internal medicine’s subspecialties offered the opportunity to satisfy my need to work with my hands as well. Continue reading

Can Stress Cause a Heart Attack?

Can stress cause a heart attack?By Jill Waite Goldberg

Stress can trigger insomnia, exacerbate digestive problems and cause muscle tension that leads to body aches. But can stress cause a heart attack? Or is it just a dire, unsubstantiated warning offered by concerned family and friends along the lines of “You’ll catch pneumonia if you go outside with your hair wet”?

When faced with a stressful situation (known as acute stress) — such as rush-hour traffic or babysitting an ornery grandchild — our bodies release hormones, including cortisol and adrenaline, which help us react to the situation. These hormones increase heart rate and blood pressure, supplying the body with a burst of energy and strength. This creates a “fight or flight” reaction that, when you’re in actual danger, helps you defend yourself or flee. When the “danger” or stressful scenario passes, the body’s relaxation response kicks in and hormone levels return to normal.

Stress and Heart Health

“In a person with a healthy cardiovascular system, this surge shouldn’t be a problem,” says Rami Doukky, MD, a cardiologist at Rush. However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack. The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat.

“There is no solid evidence that stress can directly cause a heart attack,” says Doukky. “However, chronic stress — the kind of stress that’s due to ongoing situations like a bad relationship or difficult job — can lead to risk factors that affect heart health.”

Chronic stress has been linked to overeating (which can result in obesity), poor sleep habits and tobacco and alcohol use — practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes. For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says. Continue reading