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Recovering after heart attack and heart failure

During last week’s Annual Cardiac Rehab Seminar, four experts from disciplines throughout Weiss spoke about the latest advances in heart health care. Read about the first two speakers—emergency department medical director Dr. Khalid Malik and vascular surgeon Dr. Darwin Eton—in our previous post.

 

The third speaker, cardiologist Amjad Sheikh, M.D., (pictured at left) answered audience questions about post-heart-attack care.

“What about scar tissue from the stent and the plaque that occurs around it?” one man asked, wondering if this would cause the artery to become clogged once again.

Dr. Sheikh explained that some stents are coated in medication that was originally used as an anti-cancer drug. The medication stops the over-production of cells, which results in less scar tissue. “The purpose of having a drug-coated stent is to keep that stent open for longer period of time,” he said.

He went on to discuss other drugs that doctors often prescribe to patients who have had a heart attack. The regimen typically starts with anti-coagulants, drugs that keep the blood from clotting. “The moment I’m called to the ER with a heart attack, the first thing we use is Heparin,” Dr. Sheikh said, referring to the injectable drug used to stop blood from clotting. He added that aspirin “for every kind of heart condition is a definite.”

In the months following a heart attack, beta blockers are crucial. “By and large, beta blockers have the best track record of all the drugs. They limit the heart rate, take away stress on the heart and limit blood pressure.”

Statins play a role too, driving down cholesterol levels. “Statins are the big gorilla that get your LDL down from 200 to 100 right away within a few doses.”

These drugs are far from a cure-all. Diet and exercise complete the recovery package.

“Gradually increase your exercise in its intensity; don’t go to a point where you hurt your joints,” Dr. Sheikh cautioned. “The benefits will be incremental with an increase in intensity—a solid regimen of 40 to 45 minutes at a good clip four days a week.”

“But can we cure heart disease?” one audience member wanted to know.

“If we can arrest the process, that’ll make a huge difference. And can we regress it a little bit? Maybe. But it’s not going to go away.”

Cardiologist Sorin Danciu, M.D., followed Dr. Sheikh’s presentation, providing the audience with an update on heart failure.

Worldwide, more than 22 million people live with heart failure, 5 million of whom reside in the U.S. Two million new cases come up every year, and 50 percent die within five years. 78 percent are hospitalized more than once a year.

Causes include heart disease, hypertension and idiopathic cardiomyopathy. In these situations, monitoring can make all the difference. Physicians often recommend EKGs, chest X-rays, blood work, echocardiography, stress tests or MRIs.

To keep heart failure in check or to prevent it altogether, Dr. Danciu encouraged “lifestyle modifications. Cardiac rehab is one of the things that can help with these issues.”

On your own, he added, you can lose weight, stop smoking, avoid alcohol and start exercising. Physicians can help treat hypertension, high cholesterol, diabetes, arrhythmias and more.

“Exercise, too, in moderation. Everything has to be in moderation,” Dr. Danciu said.

The Cardiac Rehabilitation Department at Weiss hosted this event.

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