How can a person with good cholesterol levels have severely blocked arteries?
Plaque build-up in your arteries can be from high cholesterol (fatty protein) levels in your blood OR inflammation of the artery walls caused by insulin-resistance and too much sugar.
Only 54% of heart disease patients have high cholesterol levels (Heart Foundation NZ).
What are the side effects of statins?
Statins are very effective at reducing cholesterol. They also help stabilise plaque so that it doesn’t rupture and form a clot, which might travel to the heart or brain and cause a heart attack or a stroke.
However, side effects, can include ‘hazy thinking’ or irrational, emotional outbursts and at the worst, destruction of muscle tissue.
If you are getting severe muscle pain and highly discoloured urine, after two weeks of taking statins, you must consult with your doctor. It can be life threatening.
Are some heart medications more essential and important than others?
The medicines prescribed by your doctor are all equally important, in that they help your heart in different ways.
Drugs may help blood flow more freely, prevent build-up of plaque, relax the heart so that it doesn’t have to work as hard, or help stabilize the electrical signals across the heart.
They all reduce your risk of having another heart event. Each one is like an insurance policy.
How long can I safely go without heart medications and what might influence that?
Your doctor or cardiologist will prescribe appropriate drugs for your condition, and when you should take them.
In their own way, each drug reduces the risk of having another heart event, or your heart condition getting worse. If you stop one, or more, drugs it makes the possibility of another heart attack more likely.
It’s a bit like a ‘lottery’. The more drugs you take (tickets you buy), the higher the probability of success (you won’t have another heart event).
You could ‘win’ with just one ticket, but the odds of success are much lower.
What sort of weight can I lift after surgery, and how much exercise can I safely do?
It is generally recommended to lift not more than 2kg in each arm, within the first 6-8 weeks after surgery (including stents). In the first 12 weeks it is advisable to do more aerobic exercise (brisk walking, treadmill, exercise cycle, light rowing machine) rather than weightlifting, which can strain your upper body. Stop immediately if you develop chest pain or become breathless.
You can build your weight-bearing exercises gradually from 3-6 months. Always consult with your doctor or physiotherapist before you start lifting weights that require effort.
I’ve felt big swings in my emotions. Is this related to my heart attack?
Anxiety is very common after a heart attack, especially if your heart event has ‘come out of nowhere’ and you have had to make big changes in lifestyle.
Depression occurs in 31% of all heart event survivors (American Heart Foundation).
Some medications, such as beta blockers, can be associated with depression.
A twinge of pain may spark fear of another heart attack or death, and you may feel anxiety. This is very understandable. Discuss mood changes with your doctor and family and don’t be afraid to seek professional assistance to help you cope.
Can I get rid of some of the drugs I take and eat foods that will have the same effect?
You should always consult with your doctor when considering different foods or supplements that might claim to help your condition.
Some natural foods have the same effect as drugs e.g. turmeric is known to reduce blood pressure, broccoli is helpful in controlling cholesterol, as is salmon (which is high in Omega-3 oils).
However, you would have to eat large amounts of ‘helpful’ foods and many supplements are too low dose of the active ingredient to be effective.
Your pharmacist can provide information on side effects of certain drugs and interactions of supplements with the drugs you are taking.
Always consult with your doctor when you are thinking about stopping or reducing any prescribed medicine.
Can you be ‘cured’ of heart disease? I’ve been told that if I become vegan, I can reverse the plaque in my arteries. I had a stent put in two years ago, my friend said that I am cured.
No, you cannot cure heart disease or ‘reverse’ atherosclerosis (build-up of plaque in the arteries).
A stent prevents further blockage in that part of the artery, but plaque can develop in the rest of your coronary arteries.
Eating a more plant-based diet, with less saturated fats or processed foods and lower sugar will certainly help in stopping or slowing further plaque build-up.
I would like to attend a Heartbeats group. Do you have a group in my area and when do they meet?
Heartbeats has groups operating across North, Central and West Auckland. All groups are run at local Community Centres. See our group directory at ‘Get Support’. Group meetings, dates and times can be found under ‘Events’. If there is sufficient interest we can set up a Heartbeats group in your area in less than a month.
What is ‘brain fog’ and how did I get it?
Post operative cognitive decline (POCD), following surgery, known as ‘brain fog’, is a complicated and multifactorial issue. You could break down the contributors and risk factors for POCD into:
- procedure related
- general risks.
Patient related risks for POCD include age, previous cognitive or neurological issues (including trans ischemic attack (TIA) or stroke), high blood pressure, diabetes, vascular disease and renal disease.
Procedure related risks for POCD are quite complex, but often associate with surgery of the aorta and aortic valve. General anaesthetics are thought to cause some cognitive dysfunction, the older we are.
It is extremely difficult in cardiac surgery to separate the factors that may cause ‘brain fog’ but anaesthesia likely contributes a bit.
Another factor is if a patient needs a lot of medications to support the heart and blood pressure during and after surgery (so-called vasopressors and inotropes). This may be the case with people who are sicker going into surgery.
The non-pulsing flow of blood through a heart-lung machine as well as certain unavoidable surgical issues also contribute.
What is a heart attack?
There are two general events that are generally known as a heart attack.
One is when a blood clot is released from the rupture of plaque build up in your arteries, which is carried to either the heart or the brain where it blocks a blood vessel in either of these organs, which starves them of blood and oxygen. This can cause damage to that area and results in severe pain and/or breathlessness (if in the heart) or stroke (if in the brain). In this event, you are usually conscious.
The second is where the electrical pulses that cause the heart to beat rhythmically, are interrupted or stopped and this leads to unconsciousness and what is known as cardiac arrest.
How does exercise help my heart?
Research has shown that regular, daily brisk walking (where you are breathing moderately but not breathless) is very beneficial for your heart and has as much positive impact on avoiding another heart attack as many of the drugs that you have to take.
Your heart is a big muscle, which has to pump over 1.1 billion times in your lifetime, and like any muscle, it needs to be exercised to keep it strong.
Also, brisk walking and other exercise, pumps more oxygen around your body and burns fat, which is then removed from your bloodstream, and cannot build up as plaque on the walls of your arteries.
Exercise keeps you fit, creates healthy cells (including heart cells), helps keep your blood pressure stable, and lowers stress. Stress has been shown to be a major factor in heart disease.
Are certain drugs that my doctor has prescribed, more important than others and does it matter if I miss some of the ones that are not important?
All drugs that you are prescribed by your doctor are important in that they each treat different aspects of your heart condition.
For example, for cardiovascular disease (build- up of plaque on the walls of your arteries) your doctor will usually prescribe:
- A blood thinner – your blood flows more easily which reduces the strain on your heart and arterial walls. This is usually aspirin
a statin – which reduces your cholesterol levels (particularly your bad cholesterol or LDL) so that you are less likely to build more plaque and makes the plaque that you have, less likely to rupture and send a clot to your heart or your brain
- A drug that ‘relaxes’ the heart so that it doesn’t have to work so hard: these are what are called beta-blockers and calcium-blockers, but they all reduce the workload on the heart