Heart Disease – Family History Indicators

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Yea, right cause it’s kind of the positive insult of doing such a thing, right. Alright, no I totally believe you but he is just trying to drill the effect into you head, the fact that you are very strong. And that’s a great thing and that’s good. Do that stress test if you have an uncertain a family history and the reasons don’t add up. Don’t you sit there and say, “Oh nobody has ever told me anything before. They just shut up.” So what? Who cares if your insurance likes it or doesn’t like it? As you reach a certain age, you should have an EKG that is read and clear to understand.

If you have a history of heart disease you should have an echo, of some sort depending on your history, that’s a reasonable thing. It’s also very reasonable to get a cardiac stress test, exercise stress and then you’ll know what you can control and not.

Yes, of course everyone is hurt as a person that is like me and I’ll say you were reading the paper they were riding a bike or climbing a mountain or skiing a hill and then they have a sudden heart attack. That’s very scary to us. Usually, there is some hidden factor that we didn’t know; that very narrow congenitally smaller narrow coronary vessels, coronary feeds the heart itself. You can real fit but those can be unusually small for a very strong person and that’s that relative heart attack we are talked about. You don’t quite get everything to the heart you need.

Sometimes you can be very fit that you have just high blood pressure. The way your neural endocrine system works, the hormones in your body and the way your vessels respond make your hypertensive and you didn’t know it. And that’s more often the case or you have profound hereditary high cholesterol. And so your vessels were irritated, inflamed and they got calcified or got plaques and then they broke off and you had heart attack or stroke.
A stroke is basically a heart attack to the brain, right. And so they can very much kindred spirits, the stroke and heart attack and you have to try to determine that. Go ahead.

Right and this is the thing that’s tricky because there are guidelines. There are recommendations that the American Heart Association has laid out for you and a lot of those are stratified, listed and prioritized based on your family risk. So I don’t have your family history. I want you to ask the question of your doctor and they may give you the right one, maybe not, I don’t know.

The reasonable question is I heard echoes can tell you a lot but you don’t just do an echo for any reason. Usually it’s for symptom but if you have a family history that is significant and you are on medication and you’ve never had one, just judge how your heart is doing. I like you was diagnosed for the heart murmur when I was little kid and they didn’t clear me. It was a little bit significant and everybody was walking around and acting like I was going to keel over and I was a kid and I didn’t understand it but it was likely physiologic. So I had an echo? I had my friend do it when I was in medical school. I wanted to be clear and I ended up being fine right.

So that was somebody listening to my heart not really knowing and I’m okay. But I still did it so a stress test is probably more rational if you’ve never had one and you are over 50, that would be my goal. Do a stress test. Get one it run and make sure you don’t have changes that show electrically and your doctor knows that.

And there are different types of stress test. We do them on people that can’t walk and run, that are very sick. We do it with chemicals, called the chemical stress test so we give them a little injection to make their heart do things and then we read it.

So, two things are true. I don’t want people over medicated, I don’t want you to go out there and say I have a medicine that’s going to work for everything but I also don’t want people to get under medicated. So if you are on heart medicines and this goes to my next concept of medicine errors.

If you feel worse on your heart medicine, the number one thing your cardiac doctor is going to say to anyone because they blow people off cause they want you to be disease ridden … if you exercise and you are living okay, you heart works okay. That’s kinda true. How do you live your life? Do you feel okay? And in most cases you are okay and that’s of course if you are on medicines. It depends on how you feel because you get kicked out and say what the doctors do to me today. Nothing.

But sometimes they don’t know if you don’t tell them that you feel worse with your heart medicine. Your heart rate could be too slow and they are treating one may be too low and they are pumping enough. You have to tell them if your swelling is not better. You have to tell them if you feel dizzy, if you’ve passed out, if you feel like you’re going to pass out when you’re having a restroom break or in to shower or postural change.

If you have those things, maybe that’s something that’s an acceptable side effect but I would talk to your doctor about it.

Do not stop your medicine because you think it’s bad for you. Sudden stopping of cardiac medications can be life threatening, so can taking the wrong thing, so can be misdiagnosed and taking the wrong medicine, that’s why you go to your doctor. But profoundly, the greatest risk is you are playing a doctor with the medication that you don’t understand. I want you to understand the medications you are on. If you are on three cardiac meds, you have to have a general concept of why you are on those three. This one’s a water pill, but this one is a rate pill, it controls my rate. This one is a pill that lowers my blood pressure by increasing the diameter of those tubes out of the heart to a lower pressure.

Those all tell you things. If you think about it physiologically, you’ll see what those symptoms show, what meds tolerated and which one’s not. And over time you’ll get to know yourself and you’ll get to know that medicine. Check it out, do your family history, take meds as prescribed, exercise and if you feel bad and that’s very silly, go get checked out and we don’t because we are so resilient and we are so compensated that we live with disease we don’t even know we have it because our body compensates. And once we decompensate, the disease is already set and it changes our structure, increasing the thickness of our muscle or vessel for example.

So cholesterol meds? Do you have questions or you did you just have an itch … Alright! Alright, so that’s a fake question alright! Now yes, you have one.

It is.

Right, good question. Those are the tubes, vessels, arteries, veins that I talked about a little bit when I talked about the pump; what’s coming in and what’s going out. What’s going to the heart are veins, right. Arteries have a thick wall to them when they leave the heart. Arteries have a pulse. They actually squeeze the blood where they need to go because they are full of that nutrient and oxygen source that needs to be circulated to the body. Then there us the return path back to the body to be pumped out again.

The return paths are veins and there are some differences between right left side lung circulation body, we won’t get into that but in general, this is the facts. Arteries go away A-A, Arteries away and veins go to.
So there are ways to get that. Doctors check pulses. They make sure you don’t have too much swelling which could be veins not bringing out the blood back, right; and that’s a big deal and you have to have it checked out.

Now our veins have a little saggy when we get older so sometimes at the end of the day you are a little swollen, but that doesn’t mean that your heart is necessarily weak; but it could mean that you are a little deconditioned. So another thing is helps veins squeeze blood back to your heart is muscle, because it runs through muscle, they talk about planes I’m pumping your calves so you don’t get those DVT, clots, pump your calves, muscles have to squeeze the blood back out. Our legs swell when we stand in line at Disneyland or when we stand at some social. We are not moving generally. We can be. So we check circulation by function those most often.. Do you have cold, swollen baggy extremities? Are they blue, are they red, those are important things. Those tell you why you are out here at little bit more. Talk to your doctor and he’ll check you.

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