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Heart Disease – Introduction

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I know that for some of you, or most of you from around the community, the topic of heart disease is, I think relevant to all people because we all know someone that has some significant heart disease, even if there are no symptoms. So, it’s difficult for me just to give you a PowerPoint and say these are the early signs, these are the symptoms you will have because it’s extraordinarily diverse and very physiologically complicated. One person’s heart disease is not the next person’s heart disease. One person’s risk factors are not your risk factors.

So when I give examples today and we just talk together try to keep in mind that the examples I give may not be your example, and may not correlate exactly to your story, but overall, that’s why we have two parts. In the end of this dialogue we have together, that I hope you we have a dialogue truly where you ask me a question relevant to something that affects your life but at the end of a complex decision process and discussion you can figure out where you fit in this realm risk of cardiac disease, prevention of cardiac disease, how to manage cardiac disease and just giving you a health plan.

The bottom line is most heart disease is preventable, excuse me, if you know me, I have voice changing all the time, I don’t know why I’m in my 40s but it still happens, so excuse me. Anyway, I’m going to do a quick kind of review. I thought about doing a PowerPoint, I thought about all sorts of things, but you know there’s been many PowerPoint commas induced and I don’t want to do that, so I’m going to try to just be more thoughtful about it.

So, what I would like you to start thinking about now, is what question, what’s the main question that brought you to your seat and you may not have one and, it may be very global a very broad, but if you want to think about it even raising your hand in the middle of something that doesn’t even seem relevant, because you don’t want to forget it, tell me and we will jot it down on our memory or we will answer it right then, or a little later because I want your specific questions to be answered. One thing about this form that I appreciate is, there is twenty to forty people to even fifty to a hundred, it’s small enough to meet the need to the individual and nothing lost in a crowd. This is a small group conversation and the value that is that you can speak, and it’s not just me speaking because your question is most likely very similar to somebody else’s.

So quickly and I was thinking about some kind of notes so instead of a PowerPoint I wrote down how to kind of keep this organized and I won’t follow this at all but I wrote down non the lest it’s Part 1 really not because I can start at a Part 1 it’s probably more how do we recognize a problem and how do we get support for what we don’t know so this is more about lets learn some things beginning of knowledge we’ll call it early knowledge part one such figure out a little bit. I know that all you know people with either heart disease hypertension heart attacks coronary artery disease cholesterol problems all these things you hear about so what does it really mean? Some of that has to do with family history; some of it has to do with human congenital issues. I will summarize a little bit.
Congenital issues. some of you may know about if you have a congenital issue or know of a person that has one or yourself. That’s a unique category that’s a structural or a genetic physical manifestation that is very unique, probably to your issue. That’s going to be harder to talk about as a group, so talk to me separately, if I don’t address that for you, so that one is congenital and oftentimes we deal with that when we’re very young. Not always, but often, not talking hereditary things like cholesterol and high blood pressure, I’m talking congenital defects that might affect your parents with their child. So if that’s you, talk to me, but we’re going to kind of go briefly, that’s one category of heart disease. Many categories fit together, the most common however is hypertension or hypertensive heart disease; and how that progresses can progress to heart failure and early death.

Cardiac disease is the number one cause of death in our country and that’s a complex statement because it’s not the same type of heart disease, so we have to kind of figure out where you fit in this stratification of risk, because some of it is reversible, some of it isn’t. The other is dovetailed in all of this, is vessel disease, whether you have hyper-cholesterol, you have coronary artery disease you know plaques atherosclerotic disease, some words you might know about, or inflammation of the vessels caused by other diseases like diabetes or some other auto-immune issues, and that can give you vessels of problems.

If your vessels have a problem, generally hearts are going to have. At one point or another and we’ll discuss why that is, and why high blood pressure is really going to be one of our main discussion points today. I’m talking a lot now but that’s going to stop pretty soon, because I want your questions.

The other are you probably heard of arrhythmias, where you don’t quite beat normally, and all of us feel some of these especially more towards middle age, women more towards menopause and you might feel these extra little beats, well that’s not necessarily a bad thing. Sometimes that’s really physiologically normal, other times it is not. Sometimes those arrhythmias are really a big deal.

So when do you kind of say, mmm, I’m not sure and when do you worry, and when do you blow it off. Well that’s pretty significant things, so we’ll go through arrhythmias a little bit, and again to arrhythmias, are linked often to these other things vessel disease, hypertension and sometimes genetics, and sometimes structure. So they’re all dovetailed in. So you can’t always isolate one out.

The other would be micro-vascular disease. We talked a little bit about not the larger vessels but the real small ones in your kidney, in your brain, in your liver and all these very small blood vessels are given a lot of attention these days, because micro-vascular not macro-vascular, the big vessels really can give you some problems with kidney function and renal insufficiency, We are going to talk about those.

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