Some of the reasons that people get heart disease are not in their control, such as family history, age and race. However, there are many ways you can control the development and seriousness of heart disease. Because the disease is so common (it is the number one cause of death of men and women over 85) many older adults may already have heart disease and not even know it. It is also common not to have any signs while heart disease is developing, so it is extremely important to know your risk factors and ways to manage them. Lifestyle issues such as smoking, obesity (being overweight), high cholesterol, lack of exercise, high blood pressure and uncontrolled diabetes can all lead to problems with your heart. We know that making changes in your lifestyle is not an easy task, but no matter what your age, by making changes you can improve your health and reduce the chance that heart disease occurs or becomes more problematic.
There are many ways you can improve the health of your heart. The first change you will need to make is to quit smoking. Because people who smoke have more than twice the risk for heart attack, this is a powerful way to slow heart disease and reduce symptoms of existing heart disease. Secondly, you may need to improve your cholesterol levels and lower your blood pressure. Because the fat from cholesterol and damage from high blood pressure can lead to heart problems such as coronary artery disease and congestive heart failure, eating a diet low in fat and exercising is extremely important. To lose weight and improve your health you will need to eat foods such as fish, vegetables, fruits and whole grains. You can lower your chances of getting heart disease by carefully choosing the foods you eat. Be sure to speak with your health care professional before beginning any diet program. For a healthy heart eat:
Less Fat
Some fats (saturated) are more likely to cause heart disease.
Eat less of foods containing:
• Animal fats such as meat, milk, cheese and butter
• Palm and coconut oils
Eat more of foods containing polyunsaturated & monounsaturated fats:
• Olive, canola, safflower and corn oil
• Seafood
Less Sodium
This can help to lower some people’s blood pressure as well as reduce the risk of heart disease. Avoid adding salt to foods at the table; many already contain sodium, which was added during preparation.
Fewer Calories
If we eat more calories than our body needs then we gain weight. Being overweight can cause heart disease. In order to lose weight, eat fewer calories.
More Fiber
To lower your chances of getting heart disease eat more foods containing fiber such as:
• Fruits
• Vegetables
Grain
Exercise not only helps you lose weight but also strengthens the heart and improves blood flow. It is safe for most adults over the age of 65 to exercise. Even people with chronic conditions such as heart disease, high blood pressure, diabetes and arthritis can exercise safely; in fact, many of these conditions are improved with exercise. Even leisure-time activities such as gardening, walking and dancing are good for our hearts. If you are not sure if exercise is safe for you, please ask your health care provider. Exercise can be fun and helps to reduce stress, which can be a common problem for people with heart disease. Managing stress can help to reduce heart disease symptoms as well as help prevent feelings of depression, another common complication for those diagnosed with heart disease. Be sure to speak with your healthcare provider if you are experiencing signs of depression such as feeling sad, trouble sleeping, wanting to be alone, or feeling worthless or helpless.
Normally blood flows freely inside your heart’s arteries, which are like hollow tubes. As you grow older, fat and other substances build up along the walls of these tubes, causing narrowing and hardening; this build up is called plaque. Coronary artery disease is the clogging or narrowing of the blood vessels that bring blood to our hearts; if the heart doesn’t get enough blood it becomes starved for oxygen and cannot work properly. Lack of oxygen causes the heart to cramp during activities such as exercise, eating and excitement, when your heart needs extra oxygen. The most common symptom of coronary artery disease and lack of oxygen is angina, which most people say feels like bad heartburn. Angina causes the sensation of pressure in your chest, but it is also common to feel aching, burning, fullness and pain. Angina discomforts may also be felt in the left shoulder, arm, throat and jaw or in your back. If you have angina pain for the first time or if you are already taking medication for angina and it does not relieve your pain, you should seek help immediately.
Another serious condition that can affect your heart is called congestive heart failure. Heart failure is when your heart can no longer pump enough blood to your body, or, when the heart cannot stop blood from “backing up” in your lungs. In most cases heart failure occurs over time and can have many different causes. One of the most common causes of heart failure is an abnormal heartbeat called an arrhythmia. Patients sometimes describe an arrhythmia as their heart beating too fast, fluttering or skipping a beat. Although it is important to see your doctor if you have had any of these symptoms, it is common as you age to have arrhythmias. Other causes of heart failure include: high blood pressure, abnormal heart valves, alcohol or drug abuse, damaged heart muscle or damage to the lungs. Symptoms of heart failure include feeling tired, an irregular heartbeat, loss of appetite, confusion, nausea, coughing or wheezing that doesn’t go away, shortness of breath and swelling of the feet, legs or stomach. Again, it is very important to see your doctor if you experience any of these problems. With congestive heart failure your doctor may recommend limiting your fluid intake in order to reduce the stress on your heart. Weighing yourself daily will also be an important tool in managing congestive heart failure.
One more complication we would like to mention is vascular disease or disease of the blood vessels. Vascular disease is included in the discussion on heart disease because it can eventually lead to heart failure or even a heart attack. There are many different types of vascular disease, each with separate causes and symptoms, but what is important to remember is that any condition that affects your arteries, veins, lymph vessels or blood can affect your heart. Blockage of arteries in your body, abnormal bulges in your vessel walls (aneurysm), certain diseases, varicose veins and blood clots or clotting disorders all place you at a higher risk for heart disease.
After studying the results of your tests your doctor may prescribe medications to help treat or prevent heart disease. There are many different kinds of medications, some are used to lower blood pressure and cholesterol while others rid your body of excess fluids, which put stress on your heart. Each person is unique as is the treatment of his or her heart disease. Although we cannot possibly describe every medication and how it works, we do have some simple suggestions to help you safely use the medications prescribed to you. Keep a list of your medications and how much you are taking with you at all times, this is important in case you experience complications or illness and need to go to the hospital. It is also important to tell your health care team about additional medications you are taking, such as: vitamins, herbals and dietary supplements. If you have allergies to any medications or have had a problem when taking a particular medication in the past, this is also important information to share. If cost is a concern, there may be another medication that costs less, yet works the same. Ask questions about every new prescription medication and be sure to get the answers you need before taking the medication. Know what your edication is for. It is also important that you take your medication when scheduled and at the same time every day. Some medications are more effective when taken at a certain time of day, so scheduling is key. Also, some medications may work better if taken with food and others may react with certain types of foods or with other medications so be sure you follow instructions. Do not skip doses or stop taking your medication unless you speak with your doctor first. Filling a pillbox is a great way to keep medications organized and help you to remember times and dosages. It is also not safe to take over-the-counter or herbal remedies unless approved by your doctor. Before having surgery be sure to let the doctor or dentist know what medications you are taking, because some heart medications may cause excess bleeding. Also, some medications may cause dizziness, so be sure to stand up slowly, especially when getting out of bed. In sharing these tips we hope to help you prevent complications from medication errors, and live a healthier life.
The prevention of infection is of utmost importance to people who have heart disease. By getting vaccinations that protect against flu and pneumonia you can lower your risk of infection related complications that could further damage your heart. Protecting yourself against infections such as the common cold is as simple as washing your hands. Be sure to use soap and warm water and lather up for at least 15 seconds and a great tip for anyone during cold and flu season is to avoid others who appear sick. Knowing the symptoms of the common cold and the flu will allow you to know when there is a problem and when it is time to notify your doctor. A high fever, accompanied by a headache, body aches and pains, fatigue and chest discomfort such as coughing may be the flu. The flu can produce many severe complications, such as pneumonia, so be sure to call your doctor if you experience these symptoms.
The final topic is cardiac emergencies. There are different types of emergencies, but we are going to focus on heart attack. A heart attack occurs when the heart does not get enough oxygen due to blocked arteries; remember that plaque that caused narrowing? Due to the lack of oxygen some of the heart muscle dies, and if too much of the heart is damaged, it can cause sudden death. A heart attack requires immediate attention! For most people symptoms of a heart attack include severe chest pain that may also be felt in the back, jaw, throat or arm. Other symptoms include heartburn-like sensation, sweating, nausea and vomiting, problems with breathing, feeling dizzy, weak or anxious. If you are having chest pain and have been diagnosed with angina, it is important to take your nitroglycerin as prescribed. If you think you are having a heart attack call 911 or emergency services right away. If your heart stops beating, or is quivering instead of beating, you will need to receive defibrillation. Defibrillation assesses your heart rhythm and delivers an electric shock in order to correct it. If a defibrillator or AED device is not available, CPR is another method to help someone whose heart has stopped. CPR does not “restart” the heart, but it helps to deliver oxygen and circulate blood until help arrives. Once you arrive at the emergency room doctors will perform an ECG and do several blood and other tests. Quick treatment is important to save the heart from permanent damage. Treatment may include any of the various medications, procedures, surgeries and/or devices that we have mentioned throughout our discussion and there are also many more options available that we didn’t discuss. If you have already had a heart attack you may be able to prevent having another one; this is where the lifestyle changes we discussed are so important. We at Interim HealthCare are available.
References
Allender, J., & Spradley, B. (2005). Community Health Nursing (6th ed.). Philadelphia:
Lippincott Williams & Wilkins.
American Heart Association. (2005). Diseases and Conditions. Retrieved November 3,
2005, from http://www.americanheart.org
Black, J., Hawks, J., & Keene, A. (2001). Medical-Surgical Nursing (6th ed.).
Philadelphia: W.B. Saunders Company. Allender and Spradley.
Cardiology Channel. Congestive Heart Failure. Retrieved November 8, 2005, from
http://www.cardiologychannel.com
Cass, P., Luckmann, J., Nigro, C., Schlapman, N., & Timby, B. (2002). Content Mastery
Series Registered Nurse Medical-Surgical Review Module (4.1 ed.). United States:
Assessment Technologies, LLC.
Cleveland Clinic. (2005, July). Recovery after heart surgery. Retrieved November 10,
2005, from http://www.clevelandcling.org/heartcenter
Jarvis, C. (2000). Physical Examination and Health Assessment (3rd ed.). Philadelphia:
W.B. Saunders Company.
Porth, C. (2002). Pathophysiology Concepts of Altered Health States (6th ed.).
Philadelphia: Lippincott Williams & Wilkins.
WebMD. (2005, October). Heart Disease: Your Guide to Heart Disease. Retrieved
October 27, 2005, from http://mywebmd.com
MedlinePlus. (2004, February 1). Nitroglycerin Tablets, Capsules, and Sprays. Retrieved
November 10, 2005, from National Institutes of Health Web Site:
http://nlm.nih.gov
Additional resources include JCAHO.org and FDA.gov
Allender, J., & Spradley, B. (2005). Community Health Nursing (6th ed.). Philadelphia:
Lippincott Williams & Wilkins.
American Heart Association. (2005). Diseases and Conditions. Retrieved November 3,
2005, from http://www.americanheart.org
Black, J., Hawks, J., & Keene, A. (2001). Medical-Surgical Nursing (6th ed.).
Philadelphia: W.B. Saunders Company. Allender and Spradley.
Cardiology Channel. Congestive Heart Failure. Retrieved November 8, 2005, from
http://www.cardiologychannel.com
Cass, P., Luckmann, J., Nigro, C., Schlapman, N., & Timby, B. (2002). Content Mastery
Series Registered Nurse Medical-Surgical Review Module (4.1 ed.). United States:
Assessment Technologies, LLC.
Cleveland Clinic. (2005, July). Recovery after heart surgery. Retrieved November 10,
2005, from http://www.clevelandcling.org/heartcenter
Jarvis, C. (2000). Physical Examination and Health Assessment (3rd ed.). Philadelphia:
W.B. Saunders Company.
Porth, C. (2002). Pathophysiology Concepts of Altered Health States (6th ed.).
Philadelphia: Lippincott Williams & Wilkins.
WebMD. (2005, October). Heart Disease: Your Guide to Heart Disease. Retrieved
October 27, 2005, from http://mywebmd.com
MedlinePlus. (2004, February 1). Nitroglycerin Tablets, Capsules, and Sprays. Retrieved
November 10, 2005, from National Institutes of Health Web Site:
http://nlm.nih.gov
Additional resources include JCAHO.org and FDA.gov
