Releases from January 29, 2008

American Heart Month:
A special focus on peripheral vascular disease

By Kansas Senior Press Service

February is American Heart Month, but how many people think about the condition of their legs when they think about their risk for heart disease?

According to the National Institutes of Health, plaque that builds on the walls of arteries that supply blood to the arms and legs can lead to a reduced amount of blood flow to legs and arms. This kind of blockage can cause pain or numbness and is typically diagnosed as peripheral vascular disease, or PVD. Cardiologists are trained to diagnosis and treat patients suffering from PVD.

The symptoms of PVD vary and become more severe as the arteries become more blocked. Patients typically complain of intermittent pain, cramping, or weakness in the legs, buttocks, or arms that occurs with activity, such as walking, and disappears when resting.

Some patients with carotid artery disease may go on without noticeable symptoms, while others may experience transient ischemic attacks, or TIAs. These “brain attacks,” or “mini-strokes,” involve numbness or weakness in an arm or leg, slurred speech, or blindness in one eye.

As PVD becomes more severe, the symptoms may increase. They include:

• Limping or abnormal gait while walking
• Aching pain in the feet or toes when resting
• A sore on the leg, foot or arm that won’t heal or becomes infected (a vascular ulcer)
• Loss of hair on the legs or arms
• Change of color, paleness or blueness of the skin on the legs or arms
• In severe cases, blackened tissue on the toes, feet, or fingers, indicating that the tissue has died (become gangrenous) and may require amputation

PVD risk factors
Being aware of the risk factors associated with PVD may help you control the
development of this uncomfortable and potentially devastating disease. Risk factors include:

• Positive family history of premature heart attacks or strokes
• Being older than 50 years
• Being overweight
• Inactive lifestyle
• Smoking
• Diabetes
• High blood pressure
• High levels of “bad” cholesterol (LDL), plus high triglycerides and low levels of “good” cholesterol (HDL)

Diagnosis of PVD
Cardiologists find these tests and examinations most useful:

Physical examination and laboratory tests, in which a detailed medical history will include an assessment of risk factors for PVD, heart disease and stroke. The physician’s questions will help identify symptoms of leg pain with walking and other related medical conditions.

Checking of your blood pressure, as well as pulses in your arms and legs. Your cardiologist will look for indications of whooshing sounds within your body. This may indicate restricted blood flow caused by narrowed arteries.

Lab tests, which may include cholesterol levels, homocystine levels, tests for diabetes, and other tests that may indicate a higher risk for hardening of the arteries.

Angiography, which can include several types of medical tests that help cardiologists diagnose and treat heart or vascular disease. Angiography can be accomplished with computer tomography or X-ray scans or with magnetic resonance imaging, both of which produce pictures of major blood vessels throughout the body.

Ultrasound, a painless, noninvasive procedure that sends high-frequency sound waves into the arteries. As the sound waves bounce back, the technologist and physician analyze the images and assess the degree of circulatory impairment.

Treatment of PVD
When PVD is diagnosed, cardiologists have several treatment options. The
goals of treatment include helping the patient walk without pain and avoiding
further complications like loss of limbs or stroke.

“The number-one request from physicians to their patients who smoke is to stop smoking as quickly as possible,” says Jack Jones, MD, cardiologist and medical director of the Cardiac Cath Lab at the Cotton-O’Neil Heart Center in Topeka. “It is estimated that the risk of peripheral vascular disease may be as much as 16 times higher in smokers than in nonsmokers.”

Daily exercise helps by encouraging the development of a collateral circulation system — smaller, new blood vessels that grow to try to provide the muscles with the blood supply they need.

A low-fat diet that contains antioxidant vitamins C and E should be adopted, and eating five portions of fruits and vegetables each day is also helpful. Diet is an important part of managing problems such as high cholesterol, high blood pressure or diabetes.

Doctors may also recommend aspirin, because it helps thin the blood and prevent further clot formation. Other medicines may be prescribed to help improve circulation.

In some situations, it is possible to widen the narrowed part of the artery.

“Opening a blockage, or a plaque, in an artery typically involves the use of an angioplasty balloon,” says Jones. “When the blockage is calcified, or so dense that a balloon cannot be placed, other devices may be used. Often a stent is implanted after angioplasty to keep the artery open.”

When the narrowing is more extensive and involves more than one part of the artery, it may need to be bypassed. A bypass can be constructed using a vein from the patient’s leg or with a synthetic material designed especially for this purpose.

Peripheral vascular disease can be effectively treated. Contact your physician if you notice symptoms associated with PVD.

Source: “Healthy Times,” Stormont-Vail HealthCare, Winter 2007-2008; Author: Tami Motley

---

Skip to the beat of a healthier heart
Say goodbye to atrial fibrillation

By Kansas Senior Press Service

Atrial fibrillation, or “a-fib,” is a common heart rhythm disorder found in more than 2.2 million Americans. A-fib becomes more common as people grow older. During a-fib, the heart’s two small upper chambers (the atria) quiver irregularly instead of beating effectively. Blood isn’t pumped completely out of the chambers, so it may pool and clot.

If part of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with a-fib. In addition, a-fib significantly reduces the overall ability of the heart to pump blood through the body.

A-fib is not considered to be life-threatening. However, it can lead to additional complications such as heart failure or stroke. It is best to see your physician if you experience any symptoms of a-fib.

The following is a brief interview with Sanjay P. Tripathi, MD, a cardiothoracic surgeon at the Cotton-O’Neil Heart Center in Topeka.

What causes atrial fibrillation?
Arrhythmia associated with a-fib is often caused by the development of cardiovascular disease or high blood pressure. Episodes of a-fib can occur sporadically, or the disorder could be diagnosed as chronic.

What are the symptoms of atrial fibrillation?
Some people with a-fib experience no symptoms. Others typically complain of irregular heartbeat, confusion, weakness, chest pain, lightheadedness or shortness of breath.

How is atrial fibrillation diagnosed?
Your cardiologist may perform the following tests to diagnose a-fib:

Electrocardiogram – patches with wires and electrodes are attached to your skin to measure the electrical impulses given off by your heart. These impulses appear as waves on a monitor.

Echocardiogram – a video image of your heart is produced through the use of sound waves.

Blood tests – these tests rule out thyroid problems or blood chemistry abnormalities that could cause a-fib.

Who is at risk for developing atrial fibrillation?
Risk factors that can lead to a-fib include:

Age – the older you are, the greater your chances for developing a-fib.
Heart disease – anyone with heart disease, a history of heart attack or heart surgery is at greater risk of a-fib.
Other chronic illnesses – thyroid problems, high blood pressure and sleep apnea are a few of the conditions that can elevate your risk for
abnormal heart rhythm.
Family history – an abnormal heartbeat may be an inherited condition.
Alcohol – increased consumption or binge drinking can trigger an irregular heartbeat.

How is atrial fibrillation treated?
An abnormal heartbeat can be treated with medication. However, there is now a more curative and minimally invasive approach to minimizing a-fib. Through the use of a “surgical maze” procedure, a pattern, or maze, of scar tissue can be created. Scar tissue does not carry electricity and tends to interfere with the irregular electrical impulses that cause atrial fibrillation.

If you would like more information about atrial fibrillation, talk to your physician.

Source: “Healthy Times,” Stormont-Vail HealthCare, Winter 2007-2008; Author: Tami Motley

---

ONE MAN’S WORLD

10 little pieces of advice

By Dave Farson
Kansas Senior Press Service

Those of us who are in the last third of our lives have not offered enough advice to the younger generations. We thought they didn’t want to hear it, but, in fact, they did. What will happen to what we have learned if we don’t pass it on?

Maybe we are not always right, but our advice, our truth, will start a conversation that will be good for both sides of the chronological line. Here are my bits of advice to the young:

1. Bet on the United States of America. I know we don’t manufacture much anymore, but our existence and success is important to the world. Where else can other people come to realize their dreams? In what other country is the individual still important? When you hear the “experts” predicting the demise of the American dream, close your ears. They don’t know what they are talking about. Bet on Americans. As you believe in Americans, you can believe in yourself.
2. Attend religious services. Once upon a time, I thought I was strong enough to protect my family from the bad guys of the world. I thought I was strong enough to overcome disease and dis-ease. I was wrong. None of us are tough enough to go it alone. None of us are the end of the line. There is a spirit, a force, whatever you call it, that is stronger and tougher than us all. In a religious service, you will find others who are not strong enough to go it alone. Everyone is made stronger by worshipping together.
3. Be hard of hearing when people tell you the world is going to hell in a hand-basket. I always wondered what those people who predicted the end of world did the day after their prediction did not come true. Did they just come down from the mountain and get on with their lives? Your great-great-great-grandchildren will appreciate the fact that once upon a time, you were hard of hearing and did not listen to the doomsayers.
4. Have the courage to discipline your children and grandchildren. Young people do want discipline. Everyone needs limits. If you love children, you will say “no” once in awhile. Any child who only hears “yes” will wonder whether he or she is really loved.
5. Move! Move your body out of the chair at least three times a week. Take a walk. Exercise. Chances are good that you are not going to be an Olympic champion, but chances are also good that if you move a little, you will live a longer and healthier life.
6. Laugh as often as you can. Folks don’t tell jokes anymore. In my time, a lot of ethnic jokes were told and laughed at, but now we are more considerate. We need a group to laugh at. How about Martians? I am the son of a hillbilly, so I volunteer hillbillies as a group to be joked about. It can be our contribution. If we can join in the laughter, we shall live longer and better lives.
7. Cry a little. Some people live very difficult lives. Pain is their constant companion. Some folks don’t make enough money to sustain life. Some people worry, worry, and worry. If you are not one of these people, you should shed a tear of happiness and then cry for others. Cry for all of us.
8. Try not to neglect your friends. Who will visit you in the hospital? Who will come when there is need? If you have a few friends, or even acquaintances, cherish them, honor them, and tell them you love them. If your friends are your family members, you are lucky indeed.
9. Be a messenger of hope. Encourage people in their dreams. Stay positive. Try not to walk on peoples’ dreams. Say “yes” to your own life. Live in hope.
10. Remember the blood. I have wondered what a racist would do if he needed a blood transfusion and a person with differently colored skin offered a pint. Would he turn it down? All of our blood is the same color. Only our skins differ. All parents want similar things for their children. Human dreams are human dreams. Look for the similarities between people and ignore the differences.

We who have lived some years have an obligation to pass on what we think is true. We don’t always have to be right. But when we share our truths with those who are coming behind us, we are expressing our love. What better gift can we give? If the next generations believe we loved and valued them, they have a better chance to be better people. Share who you are.

Dave Farson, of Overland Park, taught at Shawnee Mission North High School for 33 years. He is now a freelance writer.

---

These articles are also available electronically at the Center on Aging Website: http://www2.kumc.edu/coa/Senior_Press_Article/Topic_Index.htm