Frequently Asked Questions (FAQs) about Heart Disease

As the number of health calamities associated with heart disease and problems sour on a global and national scene, here are some FAQs about heart problems to look into that can help prevent you from a health disaster.

How do I know if I have a heart problem?

Even though not all heart problems have the same signs and symptoms as depicted in movies, some indications are worth noticing and scheduling a visit to your doctor.

1. Heart problems due to complications in the blood vessels

• Chest pain, discomfort or tightness (angina)
• Shortness of breath
• Pain, numbness, weakness, or coldness in legs, arms, neck, or upper abdomen
• Arrhythmic heart (fast or slow)
• Lightheadedness, dizziness, or fainting

2. Heart problems due to complications in the heart rhythm

3. Heart problems due to birth defects in the heart and its muscles

• Change of skin color to pale, grey, or blue
• Swelling in areas around arms, legs, and eyes
• Shortness of breath, dizziness, lightheadedness, or fatigue

I have shortness of breath, what do I do?

Shortness of breath can indicate various complications, such as congestion, fever, asthma, and sometimes heart problems.

Breathing problems should not be taken lightly, whatever the reason for them. Thus, visiting a doctor is advised, especially when the breathing problems are acute (sudden) and severe.

Birth defects with an abnormal heart, especially those associated with arrhythmic heartbeats, namely SVT (Supraventricular Tachycardia) are usually linked with shortness of breath. This is a condition where heartbeats are abnormally fast.

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How does my family history affect my heart health?

Having a history of heart disease or stroke in family lineage increases the likelihood of the same according to Dr. Kraus, (M.D. Cardiologist and Research Scientist at Duke University).

Thus, sharing one’s family history about the heart problem with their doctor is highly advised. 

This is because the roots of heart problems can be traced back to either genetics or the environment of the person.

Even though the environment of the person, such as lifestyle choices and food, can be altered at will, genetics cannot be manipulated because it is inherited from the parents or the family lineage.

For example, African American people have higher chances of having high blood pressure, diabetes, and stroke. Thus, if someone has a predisposition to heart disease in their family lineage, they should be aware that they have the likelihood to have heart problems in the future and therefore adopt healthy lifestyle choices.

Healthy lifestyle choices are not limited to but include regular exercise, healthy food and drinks, and avoiding smoking.

Is my blood pressure reading normal?

There are altogether 5 different categories of blood pressure as differentiated by the American Heart Association which are listed on the table below.

Blood Pressure Category	Systolic mm Hg(upper number)		Diastolic mm Hg(lower number)
Normal	Less than 120	And	Less than 80
Elevated	120-129	And	Less than 80
High Blood Pressure (Hypertension Stage 1)	130-139	Or	80-89
High Blood Pressure (Hypertension Stage 2)	140 or higher	Or	90 or higher
Hypertensive Crisis	Higher than 180	And/Or	Higher than 120

Having your blood pressure tested is the only way to get to know your blood pressure category.

Blood pressures are measured in mm Hg. Different blood pressure categories as represented above with different color codes are elaborated below.

1. Normal Blood Pressure
   If the upper margin of blood pressure (systolic) and lower margin of blood pressure (diastolic) ranges between (80-120) mm Hg, it’s considered to be normal blood pressure. 

2. Elevated Blood Pressure
   If the blood pressure ranges between (120-129) systolic and less than 80 mm Hg, diastolic, it’s considered to be elevated blood pressure. People with elevated blood pressure should adopt healthy lifestyle choices and failing to do so can make them prone to develop high blood pressure in the future.

3. Hypertension Stage 1
   This is the condition when blood pressure consistently ranges between (130-139) systolic or (80-89) diastolic. At this stage, the doctor may recommend some lifestyle changes and also some blood pressure medication after the assessment of any future risk of cardiovascular disease.

4. Hypertension Stage 2
   This is a condition when blood pressure (diastolic-systolic) readings are consistently (90-140) or higher. Immediate lifestyle changes and blood pressure medication is advised for peoples at this condition.

5. Hypertensive crisis
   This is a condition where (diastolic-systolic) ratio of the blood pressure readings suddenly exceeds (120-180). Often hypertensive crisis is associated with organ damage, for example, chest pain, shortness of breath, back pain, numbness or weakness, change in vision, or difficulty speaking therefore immediate medical attention is highly advised. 
   

What is my cholesterol level and how does it affect my heart?

Cholesterol is essential to our body as it helps build new cells, insulates nerves, and produces hormones.

These are generally produced inside our bodies in the liver but we can get cholesterol from the animal-based foods we eat such as eggs, milk, meat, etc. 

While it is useful for our body in optimal quantity, too much cholesterol can be harmful to us. This is because it can build up into the walls of our arteries, narrowing the vessels, and causing a heart disease namely atherosclerosis.

This disease is characterized by limiting the flow of blood into the heart muscles and eventually blocking them leading to fatal consequences.

Types of cholesterol

1. Low-density lipoprotein (LDL) Cholesterol / Bad Cholesterol: The primary form of cholesterol that builds up in the arteries and blocks the vessels.
   
2. High-density lipoprotein (HDL) Cholesterol / Good Cholesterol: It helps remove bad cholesterol from our arteries.
   
3. Total Cholesterol (TC): It is the sum of good and bad cholesterol in our blood (LDL+HDL).
   
4. Non-HDL: This represents the number after deducting HDL from our total cholesterol and hence is equivalent to total bad cholesterol LDL+VLDL (Very low-density lipoprotein).
   
5. Triglycerides: A form of fat in our blood that elevates the risk of heart disease.

Thus the amount of cholesterol must be regularly monitored and evaluated.

Below is the table representing a healthy level of cholesterol based on their age and gender. Cholesterol levels are measured in milligrams per deciliter mg/dL.

Table 1: For anyone aged 19 or younger

Type of Cholesterol	Healthy level
Total Cholesterol (TC)	Less than 170 mg/dL
Non-HDL	Less than 120 mg/dL
LDL	Less than 100 mg/dL
HDL	More than 45 mg/dL

Table 2: For any men aged 20 or older

Type of Cholesterol	Healthy Level
Total Cholesterol (TC)	125-200 mg/dL
Non-HDL	Less than 130 mg/dL
LDL	Less than 100 mg/dL
HDL	More than 40 mg/dL

Table 3: For any women aged 20 or older

Type of Cholesterol	Healthy level
Total Cholesterol (TC)	125-200 mg/dL
Non-HDL	Less than 130 mg/dL
LDL	Less than 100 mg/dL
HDL	More than 50 mg/dL

The table above clearly represents the healthy level of cholesterol in our blood which surely aids us in discriminating our blood reports on our own and thereby taking necessary steps. 

Am I experiencing heart-related symptoms because of age, sex, or weight?

Contrary to the popular belief that assumes heart problem is exclusively related to men, research has proven it wrong.

Given the likelihood of risk factors including family history and lifestyle, anyone regardless of their gender can have heart problems.

Moreover, the almost same number of men and women die of heart problems each year. Nevertheless, fewer women survive their heart-first heart attack than compared to men and women are more likely to have a stroke.

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But definitely, the likelihood of having heart problems increases with age, especially for people 65 years or older. This is because the structure of the heart and vessels changes with age hindering the proper functioning of our heart.

Hence it cannot beat faster at times of stress as compared you your younger age. Moreover, fatty deposits narrow our vessels, blocking the normal flow of blood leading to various heart diseases, stroke, and heart attacks.

Similarly, being overweight is directly correlated to an increased likelihood of heart disease.

According to Dr. Nieca Goldberg, being overweight increases the body fats that are linked to high blood pressure, blood sugar, and increased triglycerides, all of which are the major risk factors for heart disease.

I have chest pain, Is it a symptom of a heart attack?

Yes, chest pain is undoubtedly the most common symptom of a heart attack. Chest pain or pressure which is medically termed Angina is primarily caused by the lack of flow of blood to the heart.

Even though some people have signs and symptoms of heart attacks, sometimes a week ahead other people don’t and can have a sudden cardiac arrest.

Nevertheless, recurrent chest pain is the earliest sign to be aware that you are likely to have a heart attack.

Hence, if you have a history of heart problems in your family, chest pain should not be taken lightly and medical attention must be sought.

Do all heart attacks have the same symptoms?

No, not all heart attacks have the same symptoms. These symptoms vary according to people, their family history, health conditions, and risk factors they are exposed to.

Hence, some people may experience a severely sudden (acute) heart attack without any symptoms, while others may experience the signs and symptoms beforehand.

Similarly, some people may experience, mild pain while others may experience severe pain.

Nevertheless, the more signs and symptoms you can experience, the greater the chances of getting a heart attack.

Can exercise and diet help me in a way that I no longer need my cholesterol and blood pressure medications?

The answer is yes, but it depends on what level of cholesterol and blood pressure you are diagnosed with.

If the condition is severe, that is to say, if you already have above normal or unhealthy levels of blood pressure and cholesterol in your blood then you may be advised to take the medication in addition to sticking up with healthy lifestyle habits such as regular exercise and healthy food. 

For example, if your blood pressure is above normal levels which is medically termed as “Hypertension Stage 1 and above” you may be advised by your physician, to get some medication in addition to the healthy lifestyle changes. Similar is the case with a high cholesterol level.

 But sure, sticking with a good and heart-healthy diet and having regular and ample exercise may in the long run reduce your blood pressure and cholesterol level such that you can reduce, avoid or delay the use of medication.

These are healthy lifestyle choices that can reduce your need for medication

• Trimming down your extra-weight
• Regular exercise- Increasing physical activity
• Heart-healthy food- Reduction in saturated and trans fats, intake of soluble fibers, whey protein and omega-3 in your diet
• Reduction of sodium in the diet
• Decreasing alcohol consumption (drinking in moderation)
• No smoking
• Reducing caffeine consumption
• Reducing stress at home and work
• Monitoring blood and cholesterol levels regularly at home

I don’t think I am at risk. Should I still talk to my doctor?

As the fact suggests, about half of the people that die of heart attack, die within an hour of their first symptoms and before arriving at the hospital.

And not all heart attacks and strokes have warning signs ahead of time. So why take chances?

Therefore, it is a wise decision to talk to your doctor about your heart health especially when you have risk factors such as smoking, drinking, unhealthy diet, overweight, high blood pressure, diabetes, or cholesterol.

References

American Heart Association (2015) Family history and heart disease, stroke

American Heart Association (2015) Understanding Blood Pressure Readings

Janie McQueen, WebMD, Your waistline and heart disease: What’s the link?

Linda Lee (M.D, Cardiologist) (2016), Women and heart disease: Frequently asked questions, University of Iowa, Article

MedlinePlus (2017), Cholesterol Levels, what you need to know, U.S National Library of Medicine

National Institute of Health (NIH) (2018), Heart health and aging

National Institute of Health (NIH) (2011), Heart Attack-Know the symptoms Take action, NIH Publication No. 11-7791

Mayo Clinic, Heart Disease, Heart attack symptoms vary, Article

Mayo Clinic (2019), 10 ways to control blood pressure without medication

Mayo Clinic (2018), Top 5 lifestyle changes to improve your cholesterol 

Nayana Ambardekar (2020) Heart Problems that affect your breathing

National Health Services (NHS) (2018) Supraventricular Tachycardia (SVT)

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