How's Your Ticker?

How's Your Ticker?

Bill Clinton did the right thing by losing weight and sticking to an exercise program, so how did he wind up having quadruple bypass surgery?

The former president chalked up his heart problem to genetics and years of poor eating habits. He assumed his chest pains and shortness of breath was the result of a challenging fitness program. That is, until the symptoms became more frequent. When he sought medical attention, an angiogram showed significant blockage in all four arteries. A bypass is aptly named–it patches the arteries to bypass blockages and allow smooth blood flow.

The risk factors for heart disease are well known and include family history of heart disease, high cholesterol, high blood pressure, diabetes, smoking, obesity and physical inactivity. What are less clear-cut are the warning signs. Many patients can experience discomfort from indigestion, heartburn or acid reflux. They may assume a weak, nauseous feeling is just a bug that's going around.

On the other hand, "there were reports that emergency rooms saw a 25% increase in visits from people who thought they were having heart attacks after Clinton was diagnosed," says Paul Maher, M.D. a cardiologist with the Pasadena office of Southern California Heart Specialists.

When coronary problems strike a public figure—or your next-door neighbor—it makes you think about your own heart health. Rather than give in to vague worry, take the time to understand the big picture.

PLAQUE

We all know arterial plaque is bad, but why exactly? "The artery walls expand to accommodate the plaque as it forms," says Dr. Maher. "The block occurs went the plaque breaks apart allowing chunks of matter to stop blood flow." Medical illustrations showing a plaque rupture look a lot like the "before" picture in an industrial-strength drain cleaner advertisement.

TESTS

If you haven't been through a gauntlet of tests, the procedures can be hard to figure out. Here are three most common tests:

An electrocardiogram (EKG) shows the heart's electrical activity (including abnormal rhythms) and detects heart muscle damage.
A stress test usually combines an EKG with controlled exercise (like walking on a treadmill) to see how your heart performs during activity.
An angiogram involves injecting dye into your heart's blood vessels, then x-raying its dispersal. If you have don't have symptoms, the risks of an angiogram outweigh the benefits.
Grabbing headlines is a relatively new test called electron beam tomography (EBT). This test measures the amount of calcium deposits in your arteries. "Approximately 20% of plaque is calcium, says Dr. Maher, "so an EBT can sometimes help diagnose a problem." It's fast and noninvasive and requires no needles and no preparation by the patient. However, many insurance companies have yet to agree to pay for this test. (An EBT is often called a heart scan, but don't confuse this test with those full body scans that were all the rage a few years ago.)

A doctor may order an EBT if the condition warrants it, but remember: "Patients need to realize that more screening does not equal better screening–especially for people without risk factors or symptoms," says Ben England, M.D.

SYMPTOMS

So...what about symptoms? In the movies, characters have heart attacks after receiving shocking news. They clutch at their chests, then tumble to the ground. At least one person always yells, "He's having a heart attack!"

As Clinton discovered, the warning signs may be more annoying or puzzling than dramatic. According to the American Heart Association, any of these symptoms could signal a heart attack:

Discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort or pain in other areas of the upper body, such as one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.

In addition, "women often have atypical symptoms like a cold sweat or dizziness," says Dr. England. Research by the National Institutes of Health indicate that women often have no chest pain at all, but can experience other symptoms up to a month before a heart attack.

Pay attention to your body. Control the risk factors you can (smoking, diet, exercise) and let your doctor help you manage the others. By the time the next celebrity-with-a-heart-problem hits the six o'clock news, you'll be a lot healthier.