Mind & Body
Heart Talk
2/1/2020 1:00:00 PM
Heart Talk

Cardiovascular disease (CVD) remains the leading cause of death in the United States, responsible for 840,768 deaths in 2016, according to the American Heart Association. But there is encouraging news. From 2006 to 2016, the US death rate from CVD decreased by 18.6% and from coronary heart disease by 31.8%. This decline in heart disease could be a result of public education and people’s desire to eat healthier, lose weight, and exercise. It could also be attributed to better heart health technology and treatment options. And there’s no need to go out of town to receive high quality cardiac care! Southwest Louisiana hospitals offer a wide variety of state-of-the-art treatment modalities. In this special section, area health facilities detail various cardiac issues and how they can be treated right here at home.



Lake Charles Memorial Receives Nation’s First TAVR Certification 


Lake Charles Memorial’s Heart & Vascular team leads the nation once again by becoming the first, out of 645 programs nationwide, to receive the prestigious certification by the American College of Cardiology (ACC) for Transcatheter Aortic Valve Replacement (TAVR). The TAVR procedure is a less invasive option to replace diseased aortic valves without open heart surgery. Memorial’s TAVR team – led by Cardiovascular/Thoracic Surgeon J. Gregory Lugo MD, Interventional Cardiologists Edward Bergen DO, and Christopher Thompson MD – received the certification by implementing best practices and achieving quality outcomes.


Aortic stenosis occurs when calcium builds up within the aortic valve, limiting the valve’s ability to open and close. As the condition progresses, the valve opening narrows, obstructing blood flow and forcing the heart to pump harder. The progression of aortic stenosis cannot be reversed or stopped but requires surgical intervention to treat. Studies show that the survival rate of aortic stenosis without intervention is as low as 50 percent at two years after the onset of symptoms.


TAVR is a minimally invasive procedure in which the bioprosthetic valve is crimped onto a catheter over a balloon. The catheter (a long, thin, flexible tube) is then inserted through the femoral artery in the groin and advanced to the heart for implantation. When the valve is positioned inside the existing aortic valve, the balloon is inflated, and the new valve is immediately operable. This procedure doesn’t require removal of the existing valve, as the valve leaflets act as an anchor for the new valve. 


"TAVR greatly benefits those who are suffering from heart failure due to their valve and offers them hope for a better quality of life,” says Misty Theriot, Registered Nurse and Valve Clinic Coordinator. "Our heart team takes a truly patient-centered approach when developing treatment plans for these patients, ensuring that they are involved in each step of the process.”


The ACC validated that Memorial meets set standards for multidisciplinary teams, formalized training, shared decision-making and registry performance. Hospitals that achieve Transcatheter Valve Certification will have access to best practices to support decision-making in the care of individual patients and to track data to identify opportunities for improvement.


"We are proud to recognize Lake Charles Memorial Hospital as the first recipient of ACC Transcatheter Valve Certification,” said Phillip Levy, MD, FACC, chair of the ACC Accreditation Management Board. "Lake Charles achieved this distinction by developing processes to standardize patient care and increase quality measurement, thereby demonstrating their commitment to providing evidence-based, patient-centered care to patients undergoing transcatheter valve therapies in Southwest Louisiana.”


While being the first certified program in the nation was not the goal, achieving the best patient outcomes is, and will continue to be, the Heart & Vascular team’s priority. 


For more information about the TAVR procedure, please call the Memorial Medical Group Valve Clinic at 337-494-4759 or go to www.lcmh.com/heart.



West Calcasieu Cameron Hospital Dishes Up Nutrition Advice for Good Heart Health  


One of the best things about living in Southwest Louisiana is the food. From crawfish etouffee, gumbo and a shrimp po-boy to king cakes, beignets and pralines, we focus on taste, not necessarily health. And it shows.


Nearly one out of four adults in Louisiana is considered obese. Louisiana ranks among the top ten states in the U.S. for both adult and childhood obesity, according to the Louisiana Department of Health. The American Heart Association reports that Louisiana has the 5th highest death rate from heart disease in the country and heart disease is the leading cause of death in Louisiana. 


But, laissez le bon temps rouler, right? Absolutely! Vanessa Hardy, dietitian with West Calcasieu Cameron Hospital, says we can have our gumbo and healthy hearts, too. "The challenge is to make meals heart-healthy while keeping the flavor we enjoy. In the case of gumbo, choose or make an oil-less roux, and use low-fat meats with plenty of herbs and spices to enhance flavor. Eating healthy in Southwest Louisiana can be done, and it’s in our best interest to pay attention to what we’re feeding our bodies so that we remain active and engaged in life well into our golden years,” Hardy explains. 


Keeping your heart healthy involves a lifestyle approach, including exercising regularly, not smoking, getting an annual checkup and reducing stress, as well as being mindful to choose nutritious foods. "Making the choice to select nutrient-dense foods can reap a lifetime of health,” Hardy says. 


Whether you have years of unhealthy eating under your belt or you simply want to fine-tune your diet, here are six heart-healthy nutrition tips. 


Limit unhealthy fats. 

Saturated and trans fats can raise your cholesterol and risk of heart disease. Choose lean cuts of meat and trim fat off your meat before cooking. Some types of fat are better than others. "Choose monounsaturated fats, such as olive oil or avocado oil. Polyunsaturated fats, found in certain fish, avocados, nuts and seeds, are good choices for a heart-healthy diet. Keep in mind, though, moderation is essential. All types of fats are high in calories,” Hardy advises.


Reduce sodium. 

Frozen meals, as well as canned and processed foods often contain a high amount of salt. "Chances are, if it’s a convenient food, it’s high in sodium,” she says. Eating fresh foods and making your own soups and stews can greatly reduce the amount of salt you eat, rather than choosing pre-made foods. 

Condiments can be a secret stash of salt. 

Soy sauce and ketchup are both high in sodium. Choose herbs and spices as well as low-salt seasoning blends to boost flavor.


Fruits and vegetables are the go-to foods. 

Filled with vitamins, fiber and minerals, and low on calories and sodium, fruits and vegetables are the unsung heroes in the nutrition world. "They’re great for meals and for snacking. Pick tomatoes or carrots to go with cheese, reach for snap peas instead of chips, and have mixed berries for dessert instead of pie. These are the choices that really make a difference in your weight and overall health,” Hardy says.


Select whole grains. 

Whole-grain bread, high-fiber cereal and al dente whole-grain pasta are better choices than white bread, sugar-filled cereal and egg noodles. Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. 


Choose low-fat protein sources.

 Lean meat, poultry and fish, beans and eggs are some of the best sources of protein. Many of these are also rich in omega-3 fatty acids, which can lower blood fats known as triglycerides. Salmon, mackerel and herring, along with soybeans and olive oil have good amounts of omega-3 fatty acids. 


Control your portion size. 

How much you eat is just as important as what you eat. Overloading your plate, taking seconds and eating until you feel stuffed can lead to taking in more calories than you should. 

When it comes to restaurants, their portions are almost always oversized. "You can often get two, maybe three meals out of one meal served at a restaurant. A good rule of thumb is to take at least half of your order home,” she says. The amount of food served on a plate influences how much we eat. It’s easy to continue to eat until most of the food is gone, instead of stopping when we feel full.  


With every meal, a fresh start can be made for a healthier heart. Eat fresh, nutrient dense foods that help boost overall health, immunity, and energy. "The link between good nutrition and good health is too important to ignore. By taking steps to eat healthy, you’ll be on your way to getting the nutrients your body needs to stay healthy, active and strong,” Hardy says. 



CHRISTUS Ochsner St. Patrick Hospital:

On the Leading Edge of Heart Care in SWLA

 

In 2019, more than one million Americans experienced a coronary complication, according to the American College of Cardiology. The John and Sylvia Stelly Regional Heart Center at CHRISTUS Ochsner St. Patrick Hospital is the only chest pain accredited facility and cardiac center of excellence in Southwest Louisiana offering effective, technologically advanced treatment.

 

Chest pain is one of the most common clues that you may have a cardiac condition. However, it may also signal a nonemergent event, such as heartburn or a pulled muscle in the chest. Cardiac CT Angiography is an efficient and effective way to determine the cause of your discomfort, and CHRISTUS Ochsner St. Patrick Hospital is one of only two hospitals in the South offering this diagnostic method to triage patients with chest pain. Should heart blockage be detected, Fractional Flow Reserve–Computed Tomography (FFR-CT) can precisely determine the best treatment option.


"If someone presents in my office with chest pain with no prior history of cardiac disease, I believe the best first test to perform is a cardiac CT angiogram, which categorizes chest pain into distinct categories,” says Michael C. Turner, M.D., FACC, director of cardiac CT at Imperial Health and CHRISTUS Ochsner St. Patrick Hospital. "If the test results come back normal, no further treatment or testing is needed, and the patient does not have heart disease. If it’s abnormal, I can decide from that abnormality whether it is low risk or high risk and what treatments or additional testing need to be done.” FFR-CT works by using X-ray technology to capture detailed images of the heart and blood vessels. The scan can calculate the amount of blood pumping through the coronary arteries and help doctors see if blood flow is being restricted.


If plaque in a coronary artery interrupts the flow, the necessary treatment may be to proceed with bypass surgery or stents. FFR-CT can also help doctors determine whether procedures are required to open the artery or medication alone may be the appropriate treatment or a patient may simply be cleared to go home. "The images you see on the scanner are just breathtaking. It looks like you are holding the heart in your hand,” Dr. Turner says. "Cardiac CT Angiogram along with FFR-CT is by far the most accurate and least expensive type of testing we can offer to diagnose chest pain and determine the risk level of abnormalities. No other test does that, and we are proud to offer it to our community.”




Atrial Fibrillation: What it is, what to watch for, and procedures to control it.


Atrial fibrillation is the most common abnormal heart rhythm, affecting over two million people in the United States alone. The incidence of "a-fib” is rising annually with increasing awareness, better detection methods, and an overall aging population.


In patients who have a-fib, the top two chambers of the heart, known as the atria, are in a chaotic electrical rhythm. Whereas the regular atria beat around sixty times a minute in a normal rhythm while at rest, in a-fib the atria beat upwards of 400 times per minute! This creates numerous problems. First, the atria fire so quickly they are unable to squeeze blood forward into the lower chambers of the heart, significantly affecting the heart’s overall output. It is often why patients with a-fib experience profound fatigue and decreased energy in addition to palpitations and "skipped beats.” Second, with the top chambers of the heart firing so quickly, the lower chambers of the heart are also activated more quickly than normal. Long standing inappropriately fast heart rates can eventually cause heart failure. Often, the first symptoms are leg swelling, weight gain and shortness of breath. Finally, the slowing of blood flow through the quivering top chambers can lead to clot formation. A piece of the clot can break off, enter the circulation, and clog a downstream vessel. If this happens in the brain, it can cause stroke and permanent brain damage. For this reason, most patients with a-fib are on a blood thinner to reduce the risk of a stroke.

Several factors can increase risk for atrial fibrillation – age, uncontrolled blood pressure, diabetes, obesity, sleep apnea and binge drinking – though some patients develop a-fib without any of these risk factors due to genetic predisposition. Overall, you can reduce your chances of developing atrial fibrillation by controlling blood pressure, limiting alcohol (one to two drinks per day), losing weight, exercising regularly, and treating sleep apnea if present. However, in many individuals, lifestyle modifications alone cannot prevent a-fib.


The treatment of atrial fibrillation has progressed remarkably over the years through better understanding of the triggers of a-fib alongside the development of advanced technology. Catheter ablation has emerged as the most effective strategy for treating atrial fibrillation uncontrolled by medications. The procedure is performed by passing a catheter from the large leg veins up to the heart and burning or freezing small areas of the heart responsible for triggering or sustaining the abnormal rhythm. These are most effective when performed early in the course of disease and can even be curative in many patients.


For individuals unable to remain on blood thinners, often due to bleeding issues, there are procedural means of permanently reducing stroke risk without medications by "occluding” a structure in the heart where clots generally form. This can be accomplished with a WatchmanTM device through an approach from the veins (similar to an ablation procedure) or through a surgical approach. 


Previously, patients would have to go to Houston or New Orleans for ablations or Watchman procedures. Now, these procedures are offered locally at the John and Sylvia Stelly Regional Heart Center at CHRISTUS Ochsner St. Patrick Hospital and by physicians at Imperial Health.

Given its prevalence, adults should be aware of the signs and symptoms of a-fib, along with lifestyle modifications to reduce the risk of developing it. A-fib is not a life-threatening rhythm, but it can cause serious health problems. Treatment of atrial fibrillation has progressed dramatically over recent years, and most individuals can live normal lives with appropriate therapy. If you suspect you may have a-fib, see a physician promptly.  


Authored by Dr. David Burkland MD, an electrophysiologist at Texas Cardiac Arrhythmia, in partnership with the John and Sylvia Stelly Regional Heart Center at CHRISTUS Ochsner St. Patrick Hospital.



Pediatric Heart Health & Wellness


According to Dr. Mudar Kattash at Pediatric Cardiology of SWLA, heart disease in children is more common than people realize. It can affect all ages, starting with premature infants up to teens. "The presentation of symptoms is different in each group,” says Kattash. "Babies may show feeding difficulties, fast breathing and take a long time to eat. In older children, they may report fainting, having shortness of breath, chest pain, dizziness, or extreme tiredness.”


Intervention can be managed through diet, medication and/or surgery depending on each case. Kattash says energy drinks are not advised for cardiac patients as they can make the condition worse. Certain conditions are common in specific age groups. Some can affect the structure of the heart and others may impact the electricity in the heart. "For example, in premature babies, the patent ductus arteriosus (PDA), a fetal connection in the heart that usually closes on its own, stays open and causes complications. In the teenage years, a thickened heart and an enlarged aorta (the vessel that pumps blood from the heart to the rest of the body) can cause sudden cardiac death if not detected early.” Kattash encourages parents to monitor what their children eat and drink and report any unusual symptoms to their pediatrician.  


Clara’s Story

My daughter Clara was born prematurely. Heart defects are common with premature infants and at three weeks old, we discovered she had extra pathways in her heart. We were rushed immediately from the pediatrician’s office to pediatric cardiologist, Dr. Mudar Kattash with Pediatric Cardiology of SWLA. Her heart was stuck out of rhythm (arrythmia), beating dangerously fast. Clara was admitted to the Pediatric ICU at Lake Charles Memorial Hospital. That was a scary few weeks, but I’m so thankful to have had excellent local care during that crisis. We learned to do a daily EKG at home—her readings were faxed over the phone and monitored by Dr. Kattash. She also took heart medicine daily. Symptoms were managed for several years with outpatient care by Dr. Kattash and his partner Dr. Gugol.


With a growth spurt in third grade, Clara displayed excessive fatigue, dizziness, headaches and extremely rapid heart rates. She wore a holter monitor (small, wearable device to track heartbeats) for several weeks which detected multiple episodes of tachycardia both at rest and with exercise. Instead of one electrical impulse getting through to cue the heartbeat, extra impulses fired (due to the extra pathways). 

Her heart was in arrythmia and beating rapidly, requiring surgical intervention. If left untreated, people with this type of heartbeat can suffer from congestive heart failure or die from cardiac arrest. 


So, Clara’s birthday present in the third grade was an improved heart. She had exploratory heart surgery during which her surgery team identified and closed off the extra pathways. They also closed another hole in her heart during the eight-hour procedure at Texas Children’s Hospital. Her classmates and teachers sent her encouraging videos, artwork and heart-shaped messages to show their support while she recovered in Houston. As a teen, Clara is now singing, dancing and playing basketball like a champ. Eating a heart-healthy diet, exercising regularly and limiting caffeine intake are life-long commitments to preserving heart health into adulthood. 


Stephanie is a local speech-language pathologist, feeding therapist and wellness coach.  She enjoys helping families become healthy, happy and thriving in life.

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