Your heart health and your lifestyle undoubtedly coincide. We are here today to discuss ways in which your lifestyle, particularly around the foods you put into your body, makes a significant impact on your heart health. We also will be sharing some tips to keep you the healthiest you can be. Making a commitment to better health will always open new doors and we want to help get you there. Let’s get started!

The Overview

They always say, an apple a day keeps the doctor away. While that may not be 100% accurate, they do have a valid point. Filling your body with nutritious food makes you feel better and physically healthier — who doesn’t want that? Keeping up with a healthy lifestyle is much easier said than done, but it is highly beneficial to make a lifestyle shift.

Consuming greasy, fatty, and processed food is a huge no-no when discussing maintaining a healthy heart. We are not saying you can’t treat yourself every once and a while, but choosing to live like that every day can prove to be catastrophic.

Healthy Heart Foods

What foods should you be emphasizing in your diet when it comes to heart health? 

According to The American Heart Association:

• A variety of both fruits and vegetables
• whole grains
• low-fat dairy products
• skinless poultry & fish
• nuts & legumes
• non-tropical vegetable oils

The American Heart Association also suggests limiting your intake of saturated fats, trans fats, sodium, red meat, sweets, and sugar-sweetened beverages.” to maintain a healthier heart and diet.

A few other key ways to maintain nutrition and heart health include living tobacco-free, burn at least the amount of calories you intake, and eat fewer non-nutrient foods. All in all, maintaining a more nutritious diet with whole foods is the way to get you on track to a healthier heart and mind.

The post Heart Health: Boosting Your Nutrition appeared first on Shinsegae Heart & Vascular Center.

Peripheral Artery Disease is a circulatory condition that typically affects arteries in the legs. It is a narrowing of the peripheral arteries serving your legs, stomach, arms, and head.

It is a pretty common disease, affecting over 3 million people in the United States each year. Risk factors that could increase your possibility of developing PAD include aging, high blood pressure & cholesterol, diabetes, and smoking.

Luckily, detecting PAD is easy and, in some cases, managing it can be easy as well. If your diagnosis is PAD, there are ways you can take control and change your lifestyle to keep your body healthy. In some cases, lifestyle change and medicine can be the answer to the successful management of PAD.

That being said, here at Shinsegae Heart & Vascular Center, we have two doctors that specialize in PAD treatment and management.

First, Osama Ibrahim, MD, FACC, is a regional and national pioneer in Peripheral Arterial Disease (PAD). Another one of our doctors that has a vast interest in PAD is Dr. Mohanned Bisarat.

If you have concerns about Peripheral Artery Disease, please give us a call at (904) 339-2335. We will be able to connect you with an excellent doctor, who will take care of you from there.

The post Peripheral Artery Disease (PAD) & Our Specialists appeared first on Shinsegae Heart & Vascular Center.

Stress is a feeling that each person experiences at some point in their life, some more than others. While the sense of stress is common, it is a feeling of emotion that should not be overlooked. Managing Stress is very important. Stress and anxiety can highly affect one’s mental, physical, and emotional health. Due to the detrimental possibilities surrounding stress (increased blood pressure, increased risk of heart attack, etc.), taking control and managing yours could make a world of difference.

Managing one’s stress does not mean changing everything in your daily life; some simple adjustments can get the job done. Likewise, one’s mindset is a key factor in striving to reduce stress levels. Here, I am going to share some tips on how to manage and cope with your stress.

Do Something You Love

As simple as it sounds, focusing on something enjoyable can break the start of a stressful moment. This method is a natural way to boost serotonin and allow your mind to focus on the task at hand. Work on a puzzle, watch your favorite movie or bake some sweets. Sometimes you just need to pause and allow yourself some downtime.

Physical Activity

I am almost positive everyone who may be reading this has been told to exercise to stay healthy. Not only is this correct, but it doesn’t mean just physically. Getting out and moving your body can play a massive role in the state of your mental health. Many people take up running, usually letting you know that it’s not always because they love sweating and getting leg cramps, but because it fully clears their minds (aka eliminating stress). Others prefer the gym setting and lifting weights, while some just enjoy a stroll around the neighborhood. All of these methods of physical activity will enhance both your physical and mental health.

Get Outside

In case you didn’t know, nature and stress relief go hand in hand. It is a well-known fact that more green space in neighborhoods, parks, etc., lowers one’s heart rate and lowers cortisol in the body, a stress hormone helping with stress management. Isn’t it amazing that something we all have access to can positively impact our bodies and overall health?

In conclusion, prioritizing your mental health and stress levels should be a lifestyle. Your physical health is just as important as your mental health. When one goes array, the other is typically affected. Take charge of managing stress in your life to live happier and healthier.

The post Managing Stress for a Healthy Heart and Mind appeared first on Shinsegae Heart & Vascular Center.

Here are five heart-healthy resolutions to add to your new year’s resolutions list that will serve you well.

1. Resolve to lose weight

Typically, the No. 1 goal for most Americans is to lose weight — and often, that resolution is one of the first they break. But think of the benefits you’d reap if you could make steady progress in that area of your life. When you’re overweight or obese, you increase your risk of:

• Heart disease.
• Stroke.
• Diabetes.
• Hypertension.
• High cholesterol and triglycerides.
• Blood clots.

If you set a goal of healthy eating and regular exercise, losing weight is often a natural byproduct. Or you can use our activity calculator to determine how much ― and what type ― of activity you need to reach your goals. There are many apps for your phone or tablet that can help you track your food intake and exercise. And it helps to understand your triggers so you can avoid them. (Do you eat more when you’re stressed, bored, or in a social setting?)

2. Resolve to get an annual physical

Schedule a check-up with your doctor. Aside from ensuring that you have no major health problems, a physical allows your doctor to keep tabs on your blood pressure and glucose levels. He or she will also likely discuss physical activity, and drinking, smoking, and eating habits — they all affect your heart health, of course. Both men and women should get annual physicals to better focus on heart-health risk modification.

3. Resolve to reduce stress in your life

Reducing stress should be a goal for the whole country. Highly anxious people tend to have more heart attacks and strokes. Make time in your day to do things that help you relax. Try meditation, talking with friends, getting outside for a walk, reading a book, or exercising. And while the internet can sometimes increase your stress levels, it also has the potential to be a tool for good. There are many websites and apps that will help you calm yourself or embrace reflection and relaxation. They can walk you through simple breathing exercises or facilitate meditation.

4. Resolve to get more sleep

Shorting yourself on sleep can lead to overeating, heart failure, hypertension, and atrial fibrillation. Having less sleep consistently can increase blood pressure and cause inflammation. That part of the brain that activates during sleep deprivation is near the region where hunger is, so we know that you eat more if you don’t sleep.

Tips for success: To get more ZZZs, we recommend:

• Put your phone away, long before bedtime.
• Cut back on caffeine.
• Sleep in a cool, dark room.

5. Reduce alcohol and caffeine intake and resolve to stop smoking

Drinking in moderation is OK. But don’t start now if you don’t drink (even though you’ve heard red wine is good for you). Drinking less alcohol and caffeinated beverages will help you sleep better and reduce stress. It may even help you lose weight by reducing the empty calories you consume. And smoking cessation is excellent for your heart — it can significantly lower your blood pressure and heart rate.

If you resolve to make yourself healthier this year, talk to your doctor about ways to trim down, be more active and relax. You know in your heart those are all new year’s resolutions you can live (longer) with.

*suggested by The Cleveland Clinic

The post 5 New Year’s Resolutions to Boost your Heart Health appeared first on Shinsegae Heart & Vascular Center.

Written by Dr. Farah Al-Khitan, Ashchi Heart & Vascular

Ischemic heart disease (IHD) is the leading cause of death in women as in men, although presentation in women is on average 7-10 years later. Recently a decrease in IHD incidents and resulting mortality among men has been noticed but not so among women due to lack of early diagnosis, prevention, and treatment. Mortality among women remains higher than in men. 

Coronary Artery Disease in Women

In women, the issue of Coronary Artery Disease (CAD) is underestimated, which results in underdiagnosis and undertreatment. Diagnosing angina pectoris is based on medical interviews. Unfortunately, clinical practice shows that there are significant differences in symptoms between men and women. The difference is particularly important because the data gathered during interviews and the degree of symptoms initiates the diagnostic process. The symptoms of angina pectoris as the first manifestation of coronary artery disease differ among men and women. Women more often report atypical anginal symptoms or uncharacteristic chest pain accompanied by increased sweating, dyspnea, nausea, and vomiting, which, in most cases, does not lead to further non-invasive CAD diagnostics.

Coronary Artery Disease

The widely known risk factors for CAD are identical in both sexes; frequency and intensity vary. Smoking is a known modifiable risk factor that increases the risk of CAD in women as much as five times compared to non-smokers. Tobacco smoking in combination with oral contraception increases the risk of CAD 13 times. It appears that tobacco smoking is one of the more substantial risk factors for coronary artery disease in women, even more so than in men, especially in individuals over 50.

Hypercholesterolemia is also a risk factor for CAD both in women and in men. Studies have shown that the concentration of total cholesterol, LDL, and lipoprotein was a more potent risk factor for developing CAD in men; in women, hypertriglyceridemia was a more decisive factor.

Diabetes mellitus (DM) is another significant risk factor for CAD. Type 2 DM is associated with higher CAD risk in women than in men. Coronary artery disease statistics have shown that mortality due to myocardial infarction is substantially higher in women with type 2 DM than in men with type 2 DM and women without this condition.

Atypical Symptoms, Men Vs. Women

Due to atypical symptoms of IHD and later presentation in women, the outcomes of both chronic and acute coronary syndromes are worse in women than in men, concerning older age and comorbidities. Recognition and quality of care of IHD are still not the same for both sexes. Non-invasive CAD diagnostics in women are less sensitive and specific than in men; this pertains to electrocardiographic stress testing. Women are more likely than men to exhibit non-specific changes in resting ECG, lower voltage of QRS complexes, high resting heart rate, which, combined with the smaller diameters of coronary vessels and lower fitness, reduces the specificity of stress testing (sensitivity and specificity of the test in women is 60–70% vs. 80% in men). Studies also found that most women won’t achieve 4.7 METs on exercise stress. In other words, they will only finish stage 1 on Bruce protocol. Therefore, referring women for echocardiographic tests using dobutamine or perfusion scintigraphy (SPECT) is ideal.  

Diagnosis

Coronary angiography remains the gold standard to diagnose CAD. Women are also less likely to undergo coronary angiography and coronary revascularization. More than 50% of women undergoing coronary angiography receive the diagnosis of insignificant changes in the coronary vessels or “clear coronary vessels.” Coronary atherosclerosis is not the only cause of myocardial ischemia; spasms, microcirculatory dysfunction, and spontaneous dissection are also causes of ischemia that happen to be more prevalent among women. Women undergoing percutaneous or surgical coronary revascularization are more likely to suffer from ischemic stroke or hemorrhagic complications. The in-hospital mortality rate after CABG is higher among women. Their potentially worse prognosis is associated with the fact that coronary artery disease in women occurs approximately 7–10 years later than in men. Furthermore, older women more often suffer from concomitant diseases such as diabetes or chronic kidney disease. Therefore the challenge remains in diagnosing and treating coronary artery disease in women.

Check out this video by Go Red for Women about a “little heart attack” by Elizabeth Banks.

The post Coronary Artery Disease: Diagnosis and Treatment in Women appeared first on Shinsegae Heart & Vascular Center.

For the longest time, heart disease has been considered a “man’s disease”. However, women in the United States die from heart disease more than from any other disease, and there are almost as many women as men who die each year from heart disease (Women and Heart Disease, 2020). Unfortunately, this fact has long gone under-recognized, especially as women do not always have the ‘typical’ symptoms of heart disease that we all have come to learn and recognize- chest pain, shortness of breath, numbness/tingling, and diaphoresis. In women, it is more common to present with what is known as ‘atypical’ symptoms- milder symptoms of discomfort in chest, abdomen, and/or back, feelings of indigestion, and sometimes, just presenting as generalized weakness, fatigue, feeling “off” as if have developed some type of systemic illness.

Heart disease mostly affects men and women starting their 50s- however, studies have shown that heart disease can develop as early as in one’s 20s depending on genetics and risk factors. This is because heart disease can actually develop during pregnancy- high blood pressure leading to preeclampsia or eclampsia, and heart failure called peripartum cardiomyopathy- a condition that is rare, but has been known to affect some women during their last month of pregnancy or up to 5-6 months post-birth. It is not a condition that is always recognized and diagnosed as symptoms of this condition is similar to those commonly recognized as part of being pregnant- shortness of breath, leg swelling, and/or fatigue. 

Most heart diseases (about 80% of all heart disease), are preventable. And to do so, we need to identify and diagnose not only the disease but also the risk factors early in order to start treatment and to prevent further development of disease burden. Therefore, it is important that we start to recognize the fact that women are just as at risk for heart disease as men, and that even atypical, milder symptom presentation should trigger concerns for possible underlying heart disease in women.

The post Heart Disease in Women appeared first on Shinsegae Heart & Vascular Center.

Symptoms

Although sleep apnea may cause you to feel tired and fatigued once awake, new research has linked the disorder to depression, high blood pressure, irregular heartbeats (atrial fibrillation), coronary artery disease, increased risk of motor vehicle accidents, heart failure, and even sudden death among other medical conditions. Recognizing this medical condition and taking corrective action can be a life-saver, in addition to improving your everyday energy level.

Causes

Sleep apnea means you often stop breathing for 10 seconds or longer, 5 to 50 times an hour. The most common cause is large tonsils, adenoids, or a large uvula, often linked to obesity. A less common type, called central sleep apnea, occurs in people who have had a stroke, heart failure, brain tumor, or infection. Certain medications or alcohol intake before bed can also contribute. Undiagnosed sleep apnea patients who are facing surgery or anesthesia may have an increased risk for the planned surgeries.

Danger to Cardiovascular Health

Thus, informing your surgeon of this disorder before any surgery is very important. While breathing tops, this causes low blood oxygen levels, which can eventually raise blood pressure and damaged blood vessels. This, in turn, can contribute to cardiovascular disease and even stroke. The main symptoms of sleep apnea are: being so sleepy during the day that you fall asleep while working or driving, feeling tired in the morning, or waking up with a headache. Your bed partner may notice that while you are asleep you stop breathing, often snore loudly, gasp, choke, or toss and turn.

The sudden drop in blood-oxygen levels can increase blood pressure, strain the cardiovascular system, and damage the heart muscle. These dangers present even more reasons to seek help for the disorder. With treatments improving, if you have sought help before, now is the time to try again. People with obstructive or central sleep apnea may also complain of memory problems, morning headaches, mood swings, feelings of depression, a need to urinate frequently at night (nocturia), and/or impotence. Gastroesophageal reflux (GERD) may be more prevalent in people with sleep apnea, as well. Children with this condition who go untreated may be hyperactive and may be diagnosed with attention-deficit/hyperactivity disorder (ADHD).

Conclusion

Treating this condition in the appropriate patients is very rewarding. At Shinsegae Heart & Vascular Center, we utilize the highest quality equipment and technologists in a safe and comfortable environment to help diagnose and treat sleep apnea. If our staff and/or physician discuss sleep issues with you, it will be clear that we are exploring this possibility. The possibility of a condition that is highly associated with general cardiovascular conditions that affect many of our patients.

Schedule an appointment with us today.

The post Sleeping Your Way to a Healthier Heart appeared first on Shinsegae Heart & Vascular Center.

Venous Insufficiency Overview

Venous Insufficiency is a condition in which the veins have difficulty sending blood from the legs back to the heart. This condition also goes by the name Varicose Veins. This problem occurs through a combination of weakened vein walls and faulty venous valves. Varicose veins are enlarged and twisted rope-like veins that appear near the surface of the skin. Any vein in the body can become varicose,however, the veins most affected are those in the legs, most notably the calved and inner thighs.

Under normal circumstances, one-way valves in the veins open and enable blood flow upward and toward the heart. If the walls are weak and the valves faulty, the blood will pool in the lower leg. This creates a pressure build that further weakens the veins causing them to become twisted (varicose), enlarged and painful. Over time, the increased pressure can cause additional valves to fail. This venous reflux, or venous insufficiency, leads to the development of varicose veins and spider veins. An example of painful varicose veins found elsewhere in the body is hemorrhoids. Hemorrhoids are simply varicose veins in the anus.

Who is Affected?

If you suffer from venous insufficiency, you are a member of a massive club with over 25 million members nationally. Half of all Americans over the age of 50 and two-thirds of women over 60 have this condition. Many factors can cause venous insufficiency, but the main factors are heredity, age, gender, pregnancy, lifestyle, and occupation.

Venous Insufficiency Signs and Symptoms

While in many cases, you can see venous disease on the skin surface, sometimes they are not visible. Varicose veins not being visible does not indicate what is happening underneath the surface. Therefore, symptoms often associated with veins include leg pain, heaviness, throbbing, swelling, itching, restlessness, fatigue, cramping, and burning. More prominent veins may cause small spider veins. Large ropey superficial varicose veins may be a symptom of something larger. In the medical world, considering varicose veins severe medical problems is not common, as bad as they may look and feel. However, large varicose veins may indicate a critical blockage in deeper veins, a potentially life-threatening condition called thrombosis. It is essential to meet with a doctor that specializes in treating venous disorders such as Shinsegae Heart & Vascular Center.

Treatment Options

Proper medical evaluation and treatment of varicose veins are essential. Because venous insufficiency is a progressive disease, symptoms will worsen if left untreated. The assessment includes a visual and physical examination of the legs and feet by a physician. The Physician will check for signs of skin breakdown. This includes but is not limited to inflammation, tender to touch areas, changes in skin color, ulcerations, etc. Your physician classifies these skin breakdowns on a scale from one to six. The criteria for this scale are clinical etiology, anatomical, and pathophysiological (CEAP). In most cases, your physician will order a particular ultrasound test called a Venous Insufficiency Duplex to determine if the valves in the veins are functioning correctly and to check for evidence of a blood clot. Based on the test findings, your physician will recommend a treatment plan to treat your venous disease in the best way.

The post Venous Disease: Understanding Venous Insufficiency appeared first on Shinsegae Heart & Vascular Center.

Hypertension represents the most common reason for healthcare office visits in the United States. It is estimated that over 50 million Americans and over one billion people worldwide have hypertension. Recently, the seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension changed the definition of hypertension to greater than 120/80mmHg. This will increase the number of Americans who are candidates for aggressive risk factor intervention and drug treatment for newly diagnosed hypertension.

What is Renovascular Hypertension?

The vast majority of patients with hypertension have primary hypertension. That is, there is no underlying medical reason for hypertension, they just have high blood pressure. Approximately, 10 percent of patients who have secondary hypertension, which is an underlying reason, and if identified and treated, would cure or lower the high blood pressure.

The Primary Cause of Hypertension

The most common causes of hypertension include chronic kidney disease and medications, for example, non-steroidal anti-inflammatory drugs (ibuprofen, etc.), sympathomimetics (decongestants, antihistamines), oral contraceptives, anabolic steroids, illicit substances (cocaine), and over the counter dietary supplements (ephedra).

The Secondary Cause of Hypertension

One important secondary cause of hypertension, which has good results from treatment, is renal artery stenosis (RAS). Stenosis means narrowing, or partial blockage of the blood vessel that carries blood to the kidney, in addition, RAS may occur in younger (commonly female) patients due to abnormal development of the artery wall known as fibromuscular dysplasia.

The Cause of Hypertension in Older Generations

The cause of Renovascular Hypertension in older patients is usually the hardening of the arteries or atherosclerosis. Atherosclerosis is the most common cause of RAS. Discovering RAS in patients with vascular disease in other areas is common(coronary, carotid, abdominal aorta, peripheral arteries).

“RAS is associate with certain clinical clues, which, if appreciated by physicians, may result in earlier diagnosis.”

Renal artery stenosis (RAS) Indicators

RAS correlates with certain clinical clues, which, if appreciated by physicians, may result in earlier diagnosis.

Some of these clues include:

• Worsening blood pressure control in someone whose blood pressure is previously under control.
• The need for >3 medications at maximal doses for blood pressure control.
• Severe high blood pressure with a symptom (heart attack, stroke, aortic dissection, rupture).
• Development of renal failure when taking certain medications: Angiotensin
• Converting Enzyme Inhibitors (captopril, enalapril, lisinopril, etc.).
• Angiotensin II Receptor Antagonists (losartan, candesartran, irbesartran, etc.).
• High blood pressure and artery disease in the coronary, carotid, lower extremity arteries, or abdominal aortic aneurysm.
• A major difference in kidney size from one side to the other.
• Repeated episodes of sudden severe heart failure, especially if the heart squeezing function is normal.
• Kidney failure without an obvious cause.
• Risk factors for Renovascular hypertension.

In patients with atherosclerosis elsewhere, the likelihood of finding significant RAS is anywhere between 30-50%. RAS is associated with several medical conditions, including increasing high blood pressure (a serious predictor of heart attack, stroke, kidney failure, and premature death), kidney failure, and recurrent heart failure.

How is Renovascular Hypertension diagnosed?

There are several excellent non-invasive tests for the diagnosis of RAS including ultrasound, nuclear imaging tests, magnetic resonance arteriography, and spiral computed tomography (CT) scanning. All of these have their advantages and disadvantages, yet all have a high degree of accuracy.

Overall, treatment of RAS generally falls into three categories:

• Medical treatment
• Open surgery
• Endovascular Therapy

Conclusion

In conclusion, making the decision regarding which option is best by consulting vascular experts who take into consideration the level of high blood pressure, the degree of kidney function problems, the overall health of the patient, the risk of the chosen procedure, and the likelihood of the improvement is ideal.

Whether fixing RAS prevents progression to kidney failure is uncertain, therefore, major clinical trials will begin shortly with the hope of answering this important question.

The post High Blood Pressure – Hypertension appeared first on Shinsegae Heart & Vascular Center.

This wonderful patient came to visit Dr. Majdi Ashchi at Shinsegae Heart & Vascular Center from a hospital for a second opinion in regards to gangrene and poor circulation in her leg. After completing the procedure on her leg, her spirits were high. However, after some time her leg was feeling cold and showing gangrenous symptoms. She was horrified as her previous specialists suddenly began offering amputation as her last resort.

The condition she was experiencing is Peripheral Arterial Disease (PAD). Dr. Ashchi and his team took her in on a Saturday morning at the Shinsegae Heart & Vascular Center’s Outpatient Cath Lab and were able to open up the arteries and restore blood flow to the leg rather than performing the suggested below-the-knee amputation. Two years later the patient is still walking. That’s a win for all of us!

Too many amputations happen and we believe in considering two or three opinions prior to amputation. These amputations are occurring without proper care at a rate of almost 40-50%.

Not all specialists can perform below-the-knee vascular work and limb salvage. Do your research first! It is easy to look at the Medicare website and see which hospital or doctors have the lowest amputation rates in your region.

—

If you are worrying about amputation and need a second opinion request an appointment with us.

The post Case of the Day – Dr. Ashchi appeared first on Shinsegae Heart & Vascular Center.