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Leading Medicine Magazine, Vol 7, No 1 - 2013

o one expects a healthy, active person’s heart to stop in the middle of a game or race. But it happens every year. Thousands of Americans who are otherwise perfectly healthy suffer from congenital or genetic heart conditions that may produce no symptoms at all — until a crisis occurs. N Maintaining a healthy lifestyle is essential in helping prevent cardiovascular disease, stroke, hypertension and other complications. But we also hear stories of young athletes — high school football players, marathon runners — suffering serious heart stress or even death in the midst of activity. Understanding how these unknown vulnerabilities can be discovered before it’s too late can help people at all activity levels learn the red flags associated with potential heart problems and how they can be treated or prevented. HEART BASICS Your heart is a complex muscle: think of it as a power station that powers the circulatory system throughout the body. Just like any building, the heart needs functional plumbing and electrical systems to stay in top shape. The heart’s plumbing system, a network of arteries and veins, brings vital nutrients to the heart, which is constantly contracting. The electrical impulses that work as this natural pacemaker stem from conduction tissue, a system of microscopic “cables” that carry signals to keep the heart pumping. They work in tandem with the circulatory system to keep the heart beating 70-to-80 beats per minute, every minute of every day. When something goes wrong with these basic heart systems, even the healthiest and fittest individuals can be affected. If the flow of blood through the coronary arteries is impaired, the heart will work harder to compensate; if an electrical impulse is flawed, it could lead to tachycardia (a heart rate that is higher than its normal range) or even heart attack. Many of these causes are congenital, or present from birth, but can easily go undetected, especially in young, healthy people. Even so, there are ways to be proactive about risk and screening. RISK FACTORS & SYMPTOMS “Be aware of your blood pressure, cholesterol and blood sugar numbers,” says Dr. Keith Ellis, an interventional cardiologist at Methodist Sugar Land Hospital. “Hypertension, high cholesterol and diabetes are all conditions that should lead to an evaluation by a cardiologist, but genetics also play an enormous role in screening for cardiac disease.” This sentiment is echoed by other heart specialists, who say that knowing your family history is often the most important information to have when you visit your doctor. If a close male relative died from a heart attack or heart-related illness at age 45 or younger, or a female relative at 55 or younger, you are at a much higher risk — sometimes as much as 50 percent higher than average — for developing heart problems yourself. Factors such as genetic abnormalities, a diabetic mother or even belonging to a particular ethnic group can predispose individuals to congenital heart defects they may not be aware of. Heart conditions such as cardiomyopathy or Marfan syndrome cannot be overcome with diet and exercise alone, but must be treated medically. Certain blood tests, stress tests and imaging can help diagnose existing or potential heart conditions in people who fall into a risk pool. Though many of these defects or conditions cause no symptoms, there are some warning signs to be aware of: • Chest discomfort or shortness of breath during exertion • Heart palpitations or irregular heartbeat while at rest • Passing out or losing consciousness when active • More fatigue than peers when active • Seizure activity or involuntary muscle movement If you are healthy and active and experience any of these symptoms, “stop training and get checked,” says Dr. Miguel Quiñones, chair of the Department of Cardiology at The Methodist Hospital and professor of medicine at Weill Cornell Medical College. “There are three ways to tell if further testing is needed: symptoms, family history or an abnormality.” There are numerous tests that can inform doctors and patients of heart disease risk. Leading Medicine • Volume 7, Number 1 15


Leading Medicine Magazine, Vol 7, No 1 - 2013
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