This space is dedicated to all the information that cardiology patients might find themselves in need of; this data is backed, as always, by the expertise of our team of physicians.



Love yourself! A healthy diet that takes care of your heart

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 03-02-2020

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The National Institute of Statistics indicates that the most frequent causes of death in Spain are ischemic heart disease or heart failure. Good prevention is key to avoiding such casualties. Prevention starts with the food we eat daily. Taking care of what we eat, combined with series of good habits such as walking 20 minutes a day, sleeping for 8 hours and avoiding toxic substances such as alcohol or smoking are the key to taking care of our heart.

So, ready to start your heart-healthy diet?

Dr Gómez Doblas, Head of the Cardiology Department at Vithas Xanit International Hospital, offers us today a series of advice to get started.

First, we should know who are the groups with the high risk of cardiovascular diseases: we are talking about people with a family history of premature cardiovascular disease or family dyslipidaemia, or patients with a significant risk factor — smokers, people with diabetes, high blood pressure or cholesterol. In patients with cardiovascular risk factors mentioned above, a health check is recommended every 5 years, and in general men from the age of 40 and women from the age of 50.

Back to the pieces of advice related to diet, we should mention that it is remarkable that consuming raw foods always generates a more beneficial effect on health than when cooking them. Mainly due to eliminating or lowering vitamins in contact with heat. Examples? Cooking tomatoes for just two minutes decreases their vitamin C content by 10%. On the contrary, some vegetables offer greater health benefits when cooked. In this group are carrots, asparagus and even tomatoes. Its cooking makes our bodies benefit more easily from some of their protective antioxidants, although in some case we lose some of their vitamins.

 

Mediterranean diet: now and always

Now we are talking about the worldwide known fact, although it is not always put into practice. Who has not heard of the Mediterranean diet? An adequate proportion of olive oil, legumes, unsalted nuts, fruit and bluefish is synonymous with good cardiovascular health.

In contrast, the abuse of animal fats, especially trans fats, and quick-release sugars, increases the incidence of coronary heart disease by up to 23%.

 

The list of the non-purchase

If we choose a practical approach, it is not difficult to list those foods that harm your cardiovascular health. The best known is salt, although more important are those that contain trans fatty acids, which we can define as fats with a special conformation derived from the realization of some processes, such as the refining of vegetable or fish oils or the heating of oils at high temperatures, as occurs during frying.

The natural source of trans fats comes from ruminant animals, such as cow, sheep or goat, as the rumen bacteria of these animals perform partial hydrogenation of part of the fatty acids, which are found in the leaves, stems and roots they eat, as well as feed content.

These trans fatty acids are absorbed and incorporated into the muscles and milk of animals and, for this reason, are found in beef, lamb and kid meat, as well as whole milk. In any case, the foods that contain trans fats in greater quantity are those baked such as biscuits, industrial pastries, precooked foods, snacks and fried foods such as chips, corn, and other snacks, along with ice cream, creams and smoothies.

The first effect of trans fatty acids is to increase total cholesterol levels, especially LDL cholesterol (bad cholesterol), while lowering HDL cholesterol (good cholesterol) and increasing triglycerides. Besides, its consumption generates inflammation at the level of the cells of the endothelium, which is the innermost layer of the arteries and which is in close contact with the circulating blood. Inflammatory factors play an important role in the development of diabetes, atherosclerosis, plaque rupture and sudden cardiac death.

And the chocolate?

As a curious fact, it is noteworthy that theine or caffeine are not harmful at low doses and that certain studies have shown that dark chocolate is beneficial at cardiovascular level. Spices can also be consumed without problem, as long as they do not incorporate salt.

Treatment of coronary artery disease: bypass surgery and angioplasty

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 17-12-2019

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Today in our blog we will talk about two of the most frequent types of surgeries in Spain, bypass surgery and angioplasty, which serve to treat coronary artery disease, the most common type of heart disease. For more information on these surgical interventions, we spoke with the Head of our Heart Department, Dr Gómez Doblas. In our hospital, we have a long experience in performing these interventions, with more than 500 aortocoronary bypass surgeries and more than 3,000 angioplasty performed.

 

Coronary artery disease, what exactly is it?

People with coronary artery disease form cholesterol and fat deposits, called plaques (lesions), in the coronary arteries. This process is called atherosclerosis (hardening of the arteries) and is progressive. If material continues to be deposited in the plaque, the coronary arteries may become partially or completely obstructed, and, therefore, the heart may not receive enough oxygen carried by the blood. If this happens, it can lead to angina pectoris or even myocardial infarction.

The good news is that, at present, this pathology can be treated through aortocoronary bypass or angioplasty, two of the most common surgical interventions in Spain.

 

Aortocoronary bypass and angioplasty

Aortocoronary bypass diverts blood flow by implanting grafts between the aorta and the distal part of the coronary arteries in order to save coronary lesions.

Angioplasty also restores blood flow by widening the artery with a catheter that grafts into the coronary veins and carries a balloon and a stent device that unfolds over the lesion that obstructs the artery, which allows restoring the passage of blood through the previously obstructed artery.

Every year around 5,000 aortocoronary bypass surgeries are performed in our country and more than

70,000 angioplasties. The progressive development of percutaneous or non-surgical techniques causes the number of the aortocoronary bypass to decrease and increase that of

angioplasty.

 

Care to take into account after the surgery

Patients intervened by coronary bypass technique may present over the subsequent years progression of atherosclerotic disease in the native arteries and the appearance of vascular disease in the grafts; to prevent this situation, the most important thing after a cardiac bypass surgery is to have a strict control of cardiovascular risk factors (no smoking, taking care of cholesterol, blood pressure, diabetes…).

Regarding patients undergoing angioplasty, the recommendations to take into account are: follow heart-healthy nutrition based on the Mediterranean diet, exercise, do not smoke and carry out strict control of risk factors. It is also very important to maintain the use of anticoagulation such as aspirin and clopidogrel for at least 6 months or a year.

CPR, all we need to know

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 05-09-2019

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CPR stands for cardiopulmonary resuscitation. It consists of a series of universal and standardised manoeuvres implemented in the face of a cardiorespiratory arrest and included in what is known as the survival chain.

The cardiorespiratory arrest is defined as a sudden, unexpected and potentially reversible loss of consciousness, accompanied by a cessation of breathing and signs of life.

It is estimated that there are about 65 cardiorespiratory arrests per 100,000 inhabitants per year, resulting in arrest every 20 minutes. The leading cause of cardiorespiratory arrest is cardiac aetiology, 75% occur at home, and a high percentage are witnessed. For this reason, it is of huge importance to raise awareness among the population on CPR manoeuvres that will allow us to intervene in the face of a cardiac arrest.

Today Dr Pablo De Rojas, Head of the Intensive Medicine Department at our hospital, offers us some guidelines for action should we be a witness of a cardiorespiratory arrest.

In the event of a suspected cardiac arrest, the first thing to do is to stay in a safe, danger-free place (move the victim from the road, the water in case of drowning, etc.). Next, we should check the absence of consciousness by vigorously moving the victim and even causing pain with energetic stimuli. If the patient does not respond to stimuli and we are not dealing with a case of severe trauma, we should perform the face-chin manoeuvre pulling the head and raising the jaw, in this way we will open the patient’s airway. We should then check if the victim breathes by bringing our ear to his mouth and also examining whether the chest rises, HEAR if air comes out and FEEL the exhalation of the air.

If we check that the victim is not breathing, we determine the cardiac arrest situation and begin CPR manoeuvres.

How are the CPR manoeuvres performed?

To carry out CPR manoeuvre we must take off the victim’s clothes and perform chest compressions: with the palm of our hand and in the centre of the victim’s chest with our hands crossed, over the patient’s sternum and with a force that depresses the victim’s chest about 5 — 6 cm and at a rate of 100-120 compressions per minute. In this way, we will “squeeze” the heart temporarily replacing its pump function.

The chest compressions are then accompanied by mouth-to-mouth breathing. To do this we should seal the lips of the patient with our lips and pinch his nose, blowing into his mouth twice and making sure that the chest rises (only this way the manoeuvre is effective). It should be performed at a rate of 30 compressions alternating with 2 air blows.

It has been widely demonstrated that many lives can be saved with the chin manoeuvre and with early and correct chest compressions.

The third link in the survival chain is early defibrillation. The first cause of out-of-hospital cardiac arrest is cardiac aetiology secondary to infarction and is caused by an arrhythmia. Such arrhythmia responds in a high percentage to early defibrillation. That is why the use of defibrillation is recommended as soon as possible.

With regard to cardiac arrest of paediatric origin, its most frequent cause is by airway obstruction secondary to the intake of a foreign body, therefore prevention and knowledge of airway removal techniques are essential. As for performing cardiopulmonary resuscitation manoeuvres for the paediatric population, they are similar to those for adults, considering that chest compressions, obviously, in this case will be performed with a pair of fingers or with the palm of the hand, depending on the size of the child.

The usefulness of these simple manoeuvres, monitored and recommended by associations that advocate and standardise their use, is now widely demonstrated, recommending their knowledge to the general population and early and universal access to defibrillators.

There are multiple options to access relevant courses, where on mannequins we can learn basic life-saving techniques.

In our Vithas centres, we have a standardised training plan that ensures that all workers are trained to act in this type of incidents.

What should we do if we witness a cardiorespiratory arrest?

In case of suspected cardiorespiratory arrest, it is important to know the chain of survival, which consists of 4 steps:

  1. Notify the universal emergency phone number 112 and follow their recommendations.
  2. Remember the time of the suspected cardiac arrest, later you’ll be asked so.
  3. Start with cardiopulmonary resuscitation manoeuvres
  4. Request, if possible, an automatic external defibrillator.
  5. Expect the arrival of advanced medical services, while continuing to perform chest compressions.

Technology: Learn about calcium score

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 24-05-2019

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The Cardiology Department at Vithas Xanit Hospital incorporates all the diagnostic and therapeutic procedures available today. It allows us to offer personalised care for any cardiovascular disease using the latest technology.

Within this framework, the Score Calcium technique is used to detect the presence, location and extent of calcium in the coronary arteries. Accumulation of calcium in the arteries can lead to atherosclerosis (buildup of fat in the arteries) and exposes the patient to an increased risk of a heart attack.

With this technology, we obtain markers that allow us to evaluate the cardiovascular risk of the patient and subsequently determine the most appropriate treatment plan according to the results.

What does Calcium Score consist of?

It is a technique used to determine whether coronary arteries are blocked or narrowed by the accumulation of plaque. It is performed by cardiac computed tomography (CT) using special X-ray equipment to create photographs of arteries that allow quantification of coronary calcium.

What do we diagnose with Calcium Score?

Information obtained through this system can help assess whether the patient is at risk of a heart attack. It is an exploratory study that may be recommended to patients who have risk factors for coronary artery disease but who have no clinical symptoms.

How is it carried out?

Once the patient is laid on the examination table, electrodes (small “sticky” discs) are placed on the patient’s chest and connected to an electrocardiograph (ECG) machine that records the electrical activity of the heart.

The table moves quickly through the scanning device to determine the correct starting position for scanning, and then the table moves slowly through the machine while scanning is performed.

Patients are asked to hold their breath for a time of 10-20 seconds while the images are recorded.

What benefits does it have?

This technology is a practical, non-invasive way to assess whether the patient is at increased risk of a heart attack. The examination is performed in a short time, does not cause pain and does not require the injection of contrast. It also does not leave traces of radiation in the body, nor does it usually have side effects.

Cardiac surgery, from its beginning until today: how has it evolved?

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 09-05-2019

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The heart has been one of the most mysterious organs throughout the history of medicine.

It took us 2,000 years to walk the 3 centimetres that separate the skin from the pericardium. Here is a brief review of the history of cardiac surgery.

The first cardiac intervention was performed in 1815 by the Spaniard Francisco Romero, who successfully performed the first thoracotomy followed by pericardiectomy.

Despite the lack of support from the scientific community of the time, cardiac surgery continued to advance and in 1896, Dr L. Rehn, a surgeon from Frankfurt, performed the first direct suture of the heart. In America, Dr L. Hill was the first to report the surgical repair of a heart wound in a 13-year-old male. In 1923, E. Cutler performed the first mitral valvulotomy in Boston.

The first major achievements of cardiac surgery took place in the 40s. Among all the surgeons who contributed to the advancement of cardiac interventions, outstanding was the role of Dr D. Harken, a surgeon of the U.S. Navy who, during World War II, extracted 134 projectiles from the mediastinum, 55 from the pericardium and 13 from the heart cavities, without any patient dying.

Until now, only interventions to correct external lesions of the heart had been possible. It was necessary to obtain devices that would allow the blood to be pumped and oxygenated out of the body so that the heart could be temporarily stopped.

During the 40’s and early ’50s, all interventions in this field had not yielded good results. In 1953, Dr J. Gibbon was the first surgeon to perform an “open heart” surgery successfully and we started to see an emergence of other devices that replaced the function of the heart, but they were still very rudimentary and their use entailed high mortality.

Appeared techniques such as cross circulation, for which it was necessary the participation of a relative or volunteer, whose heart and lungs were connected in parallel through femoral arteries exercising as an aid during the intervention.

Also emerged the heart-lung machines, a system thanks to which it was possible to perform the first valve replacements and be able to open the heart, obtaining a direct view of the mitral valve.

At the end of the 60s, a new device emerged that allowed correcting electrical defects of the heart. It was the heart pacemaker, invented by J. Reynolds. Undoubtedly, one of the most revolutionary techniques of the twentieth century was heart transplantation and the development of an artificial heart.

Cardiac surgery is still a science in development. We have been able to see how for thousands of years the heart was an unknown and untouchable organ, and how in just 50 years cardiac surgery developed at a rapid speed. It is sensible to think that in the coming decades’ cardiac surgery will continue to evolve and provide new techniques to deal with other types of heart disease that even today continue to shorten life expectancy.

Cardiovascular diseases are the leading cause of death in Spain

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 04-10-2018

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Did you know that cardiovascular diseases are the leading cause of death in Spain? Today, Dr Gomez Doblas talks to us about these pathologies and their risk factors, offering us some advice on taking care of our heart.

Cardiovascular diseases represent 29.66% of the total number of deaths in our country, which places them above cancer (27.86%) and pathologies of the respiratory system (11.08%). Fortunately, they are also one of the illnesses that can be prevented the most, mainly by adopting healthy lifestyle habits.

Many risk factors can trigger cardiovascular related pathologies, such as obesity, arterial hypertension, cholesterol, diabetes, smoking, inadequate nutrition or sedentary lifestyle. Their prevention with multi-factorial strategies has shown that the development of cardiovascular illnesses we can avoid in 30% of cases. With that in mind, we would like to take the opportunity of the fact that World Heart Day has recently been celebrated to make particular emphasis on the importance of prevention since by following a few simple tips we can keep our heart healthy and prevent cardiovascular pathologies.

 

Some advice on taking care of our heart:

  • Doing sport regularly:Sport is one of the best methods to prevent health problems. Exercising reduces the risk of heart diseases and all types of cardiovascular illnesses. The practice of moderate exercise or sports activity along with the monitoring of other health habits has immediate consequences in the reduction of risk factors such as diabetes, arterial hypertension, arteriosclerosis, obesity and hypercholesterolemia. Sport lowers cholesterol levels in general and raises HDL (good cholesterol). It also benefits patients with type II diabetes by increasing the sensitivity of cells to insulin.

Besides, physical exercise improves the organic capacity of the heart, reducing our need for oxygen and lowering our blood pressure, so that we require the medication less and, at the same time, we improve the quality of our life.

Aerobic exercise is recommended between three and five times a week in sessions of no less than 30 minutes, controlling the heart rate to keep it within levels of moderate intensity. The most recommended physical activities are brisk walking or running at a gentle pace, bicycling, and swimming. We recommend that the intensity of these exercises should be moderate, involving and moving large muscle groups for the maximum benefits.

  • Following a healthy diet: A low consumption of dairy products is recommended (between 2-4 portions a day of skimmed or semi-skimmed products), using more olive oil as the primary source of fat, eating meat and meat products in small quantities, increasing, on the contrary, the consumption of fish and legumes as the main source of protein. It is also recommended to eat plenty of cereals (4-6 servings a day in the form of bread, rice, pasta – ), as well as fruits and vegetables. The consumption of salt and products rich in sugars must also be limited and, of course, we must not forget to drink at least 2 litres of water a day.

Performing sports will also help us in this task, allowing better control of caloric intake, which translates into a decrease in being overweight, producing a significant improvement in the quality of life.

Resolution on healthy lifestyle habits: Quitting negative habits such as smoking and reducing alcohol intake can also help us take care of our heart. Only by quitting smoking, for example, we can significantly reduce the risk of heart attacks and strokes.

  • Monitoring our heart regularly with medical check-ups:There is no specific “optimal” age to start caring for our heart. Even if we do not present any symptoms of cardiovascular diseases, we are still recommended to have a medical check-up of the heart from the age of 45-50. Furthermore, it is advisable to repeat the test every five years. Also, if we practice sports on a regular basis, we should perform the check-up a few years earlier, at the age of 40-45, and repeat it with the same frequency: a check-up every five years even if there are no symptoms. Professional athletes and people who regularly engage in high-intensity exercise should have a sports cardiovascular check-up.

Sport and sudden death

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart, Xanit salud | Posted on 26-04-2018

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Exercise is one of the most potent medicines out there, but unfortunately, in very few instances, people can experience a very catastrophic event while exercising: sudden death. Many are the cases of young boys and girls, top sportsman, highly prepared athletes, who become victims of sudden cardiac death while practising sport or undergoing a high or moderate physical exertion. However,what does sudden cardiac death implies? Why does it happen and how can we avoid it?

Dr Juan Jose Gomez Doblas, a cardiologistat Vithas Xanit International Hospital,explains in this post what sudden death is.

By sudden death we mean death that occurs unexpectedly, naturally, non-traumatically, non-violently, and in a short period. It is consideredto be related to a sports activity when the symptoms appear during the exercise or one-hourpost-exercise.

There are also cases of Sudden Infant Death Syndrome, but this should be considered as a separate condition because it includes different causes, not always well identified and not entirely of cardiological origin.

Sudden death is not more common in athletes,but it does have a high media impact when it occurs among athletes who have a healthy lifestyleand get regular exercise. However, exercise acts as a trigger in some cardiac pathologies which in result may induce sudden death.

In some types of cardiopathy, there may be symptomssuch as chest pain or asphyxia on light physical exertion, or repeated syncopes.

The prevention of sudden deathassociated with the sportwe can base on two fundamental pillars:

1) Medical examinationbefore engaging in sports activity.

(2) The establishmentof the necessary mechanisms for appropriate cardiopulmonary resuscitation and defibrillation.

With regard towhen to undergo a medical check-up, we recommend it to those people who are over 40 years of age and who are going to engagein a particular sporting activity. Also, a full medical check-up is recommendedfor people under 40 looking to improve their exercising performance, people who present any of the related symptoms or those with a family history of sudden death.

Only in a small percentage of patients, sudden death can be hereditary.

The familyhistory of heart disease can also be related to sudden death syndrome, as well as in the caseof patients with acquired advanced cardiopathy.

We should not confuse a heart attack with sudden death, even though the most common cause of sudden death after the of age 40 is precisely heart attack. What happens is, that after an acute heart attack, an arrhythmia may be triggered, leading to sudden death.

Ideally we should all have adequate training in basic Cardiopulmonary Resuscitation so we could help those who might be suffering from the condition.It is something that we should teach the majority of the population, even at schools.

Pacemakers: Technology to take care of our heart

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 23-01-2018

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An artificial pacemaker is an electronic device designed to produce electrical impulses to stimulate the heart when there is a failure of normal or physiological stimulation. These impulses, once generated, require a conduction lead from the device to the heart to achieve its goal. Thus, a cardiac stimulation system consists of an electrical impulse generator and a lead.

After many years improving this technique, pacemakers have become safe and reliable systems. A modern pacemaker has an estimated, average life of between 9 and 10 years. After implantation it requires maintenance, in the same way as any other electronic device.

Dr Gomez Doblas, Head of the Heart Centre at Vithas Xanit, answers some of the most frequently asked questions on implantation and life span and provides information on this technology, which has managed to lengthen, and save, the life of millions since its invention.

Pacemakers are generally implanted in patients who have a very low heart rate due to an abnormal electrical system in the heart. Especially when this heart rate is related to symptoms which are not attributable to other causes and where there is no capacity to increase the heart rate with exercise.

 

How is a pacemaker implanted?

Surgery for pacemaker implantation is very straight forward. A lead is implanted which is taken right up to the heart from the chest wall through a small puncture, a small-sized battery is left inserted underneath the pectoral skin. It is performed under local anaesthetic, the procedure only takes a short time and has a low complication rate.

It is a simple procedure to perform. As it is carried out under local anaesthetic, and is not a prolonged operation, it is a low risk procedure. A pacemaker can be implanted in very elderly patients, in fact the majority of patients are elderly, as the electrical system of the heart degenerates at an advanced age and as a result this is when these problems most commonly occur.

 

Once the pacemaker is in place, how is the patient’s life affected? 

The effect of pacemaker implantation on the patient’s life is minimal. With a pacemaker in situ care should be taken not to pass through the magnetic security scanners such as those found in airports, the second inconvenience is that people with a pacemaker in situ are unable to have an MRI scan. Although we do now have some pacemaker models which are compatible with this diagnostic test.

There are no risks or restrictions with the magnetic devices in shops or with mobile phones or microwaves, to name but a few of the devices that patients often ask about.

 

Pacemaker maintenance and review

As discussed at the start, the first pacemakers had a limited life but current technology allows pacemaker batteries to last an average of 9 to 10 years. When the battery runs out, we only have to remove the pacemaker generator or battery, it is not necessary to replace the lead which is inside the heart. In reality it is the same as changing any battery.

Pacemaker reviews are performed annually except at the start, when an early review is recommended to ensure that all is functioning well. However when the pacemaker battery starts to run out, checks will take place every 6 months until replacement.

Pacemaker reviews are performed using a computer, with an extension which is positioned over the skin where the pacemaker is. With this simple procedure we can check its programming, function, battery life, etc… This process can also now be carried out from home, if the pacemaker has this function available. The majority of pacemakers now possess this technology. The patient has a device which is placed next to their phone. The pacemaker connects through this device to the computer where we can check all the parameters of the pacemaker’s function.

Why is a heart attack more likely at Christmas?

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 09-01-2018

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Some of the most important dates of the year are coming up. Christmas involves days full of preparation and celebration with some of us having to travel to meet up with our loved ones. At this special time of year, Christmas excess is common, bringing with it risks that we should bear in mind. The facts are overwhelming, there are more heart attacks on the 24th December than on any other day of the year. Why is this?

Dr Gomez Doblas, Head of The Heart Centre at Vithas Xanit International Hospital, explains to us what the reasons are and how to avoid them.

  • DOES EXCESS FOOD ON CHRISTMAS EVE AND CHRISTMAS DAY INCREASE THE LIKELIHOOD OF A HEART ATTACK?

Yes, there is no doubt that dietary transgressions are dangerous, especially when they involve fat, alcohol and excess sugar, all of which are common at Christmas time. It is especially dangerous for patients with hypertension, diabetes and heart failure, where lack of compliance with diet leads to poor control of these health problems.

  • IS COLD A FACTOR WHEN CONSIDERING HOW TO PREVENT CORONARY PROBLEMS AT THIS TIME OF YEAR?

Classically exertion in cold spells is related to a higher rate of angina in patients who already have coronary disease. On the other hand, it is common after summer, with the change in season, for blood pressure to rise in hypertensive patients. In summer, due to heat and perspiration, blood pressure lowers, it rises again with the cold typical in the months of December and January.

  • WHAT ROUTINE DO YOU RECOMMEND FOR ALL THOSE SUSCEPTIBLE TO SUFFERING A HEART ATTACK AT THIS TIME?

The recommended routine for these dates is exactly the same as for the rest of the year. In other words, follow the usual recommendations of not smoking, taking regular exercise, eating a healthy diet, not consuming excessive amounts of alcohol, watching your weight and avoiding stressful situations. The only thing which changes at Christmas is that there is the opportunity, over 2 to 3 days, to deviate from all the above at the same time.

  • INCREASED ALCOHOL INTAKE AND CONSUMPTION OF DESSERTS AT CHRISTMAS. DOES THIS AFFECT THE HEART MORE AT THIS TIME?

The effect is not greater because it is Christmas, but excessive consumption of food and alcohol does affect us, and this particularly tends to happen on these dates. It is a great time to have fun, whilst also keeping to moderate consumption.

  • OFTEN WE NEED TO TRAVEL TO A FAMILY REUNION OR WE TAKE THE OPPORTUNITY TO ENJOY TIME AWAY FROM HOME. DOES THIS HUSTLE AND BUSTLE DO US MUCH HARM?

Not too much, but we must avoid drinking alcohol if driving, and not eat to excess if we have long car journeys to make. In general they are gatherings which are eagerly anticipated, and should not be particularly stressful.

  • FROM WHAT AGE SHOULD WE START TO TAKE CARE OF OUR HEART?

In truth for our whole life, from birth. In essence our cardiovascular health should be looked after from infancy. It is vital to avoid being overweight and to enjoy regular physical exercise, particularly after the age of 40. At this age the risk is higher and we should at least check our cardiovascular risk factors regularly with our doctor.

As we have seen, risk factors affect all of us, regardless of age and much less the time of year. The unusual circumstances of Christmas encourage overindulgence which we should avoid. Care should be taken not to indulge in excess and enjoy Christmas whilst still being as careful as we are during the rest of the year.

From Vithas Xanit International Hospital, we wish you happy holidays and a prosperous new year.

Disease and treatment of the Aortic Valve

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 16-02-2017

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Today we are entering the world of Cardiology. We are speaking to Dr. Gómez Doblas, Head of the Heart Unit at Vithas Xanit International Hospital, who will be discussing the aortic valve.  One of 4 heart valves, the aortic valve communicates between the left ventricle and the aorta and is responsible for one of the most commonly occurring cardiovascular problems amongst the general population.

According to the specialist, the problems which can occur in this valve are:

  • Stenosis (poor opening)
  • Regurgitation (poor closing)

Aortic stenosis is currently the most common valve disease in our country due to a process of valve calcification, especially in the elderly.

How is an Aortic Valve problem identified?

Mainly on auscultation by a Cardiology Specialist and by having an echocardiogram for assessment of any significant abnormality, such as aortic stenosis.

What are the symptoms?

Severe aortic stenosis manifests itself with three symptoms:

  1. Heart failure, generally with dyspnoea on exertion
  2. Loss of consciousness with exertion
  3. Chest pain on exertion.

When these symptoms appear they are indicative that there is a valve problem.

 

What is the cause of this disease? Is it genetic?

The cause in the majority of cases is degenerative, that is to say, due to age. But when we find it in younger patients it is often because the aortic valve has been deficient since birth. Instead of being a valve with three leaflets it only has two, this is known as a Bicuspid Aortic Valve. With these congenital valve abnormalities the valve becomes damaged earlier and gives symptoms at an earlier age.

 

 

Can it be treated?

Treatment will depend on age and other concomitant diseases (diseases which occur during the same period of time). As a general rule it is treated by “valve replacement.” But in patients who have a high surgical risk, or who are very elderly, it can be treated with percutaneous, transcatheter prosthesis implantation, with no need for surgery (a procedure known as TAVI).

 

What is the permanent solution?

Normally treatment with medication only achieves a temporary improvement in symptoms. Definitive treatment is always surgical or with transcatheter prosthesis implantation (TAVI).

If the prosthesis implanted is mechanical it can last a lifetime with appropriate anticoagulation. In the case of a bioprosthesis, the prosthesis can last from 10 to 12 years.

Lifestyle modification

As with any valve disease it is important to avoid salt consumption, lose weight and perform moderate exercise as well as to avoid smoking and follow a healthy diet.

What survival rates can be achieved?

Both surgery and TAVI have low perioperative mortality, except when there is significant concomitant disease affecting the patient’s life.

Is post-operative monitoring required?

Yes, any type of prosthesis requires at least yearly monitoring with an echocardiogram.

Is exercise beneficial?

Always, it just has to be adapted to the patient’s ability and condition. It is especially beneficial after Aortic Valve Replacement to maintain good postural tone and adequate functional capacity.