Über die Autorin bzw. den Autor

Harlan M. Krumholz, M.D., is a professor of cardiology, epidemiology, and public health at the Yale University School of Medicine and director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation. Author of more than 250 journal articles, Dr. Krumholz serves on numerous cardiovascular care committees for national organizations, including the American Heart Association and the American College of Cardiology.

Von der hinteren Coverseite

What Do the Best-Trained Doctors Do to Beat Heart Disease?

In today's avalanche of medical information, how can you distinguish between proven evidence and unfounded claims? This is the first book to translate key medical data into clear guidelines capturing the highest treatment standards for heart disease. Renowned cardiovascular expert Dr. Harlan Krumholz presents seven strategies for reducing cardiac risk—what professionals agree really works. In this indispensable handbook, he also profiles care alternatives from supplements to stress reduction as well as treatments on the horizon. A "Tools for Success" section helps you track blood pressure, cholesterol, exercise, and weight.

Auszug. © Genehmigter Nachdruck. Alle Rechte vorbehalten.

The Expert Guide to Beating Heart Disease

HarperResource

Chapter One

Understanding Heart Disease

The human heart is an astonishing organ. A muscle only about thesize of your fist, it sits just to the left of the center of your chestcontracting and relaxing to pump blood -- roughly five liters of it aminute -- throughout your body. It is an involuntary muscle. Unlike,for example, the muscles in your arm that you flex voluntarilywhen you lift something, your heart needs no instruction. It operatesindependently and continuously, day and night, week in, weekout, year after year. When it stops, life stops.

What Is Heart Disease?

The heart is tough, but it's not invulnerable and it can be afflictedby a variety of diseases. But what's commonly called heart disease(though, more accurately known as "coronary artery disease") is, interestinglyenough, not a disease of the heart at all. At least not directly.It's a disease of the large arteries outside the heart thatsupply the smaller vessels that feed the heart muscle with bloodrich in nutrients and oxygen that the heart needs to keep working.Other vessels carry away the waste products produced by the heartin the course of its work. Coronary arteries, the large arteries carryingblood to the heart muscle, are like the huge pipes that carry waterfrom a reservoir to a big city, to be distributed to streets,individual houses, and then specific faucets before being carriedaway again through drains. If something happens to those big pipesthat blocks the flow of vital water to the city, the city shuts down in no time at all. Your heart needs an open system of pipes to maintainan unabated flow of blood all the time.

When the heart works harder, such as during exertion or stress,it needs even more blood flow. It gets this greater flow because, unlikewater pipes, the blood vessels can dilate, or open larger, whenthe need arises. When something impedes that flow, it causes immediateproblems for the heart muscle, which becomes starved ofoxygen and nutrients.

With heart disease, the "something" that restricts the flow is anaccumulation of fatty deposits -- including cholesterol -- that formthick "plaques" on the interior walls of the coronary arteries, a processthat can slow the flow of blood to the heart. This condition,called atherosclerosis, occurs gradually and may go unnoticed foryears.

What Are the Symptoms of Heart Disease?

When atherosclerosis is advanced, the flow of blood can be reducedenough that when the heart is asked to work harder than usual -- forexample, when you're exercising or climbing stairs, or simply digestinga heavy meal -- it can't get the blood flow that it needs.

Typically, the heart signals that it's struggling by producing afeeling of chest discomfort, a condition that doctors call angina.Angina can take many forms; the sensations can include weakness,heaviness, pressure, tightness, and even pain in the middle of thechest. People with angina may also feel this discomfort at some distancefrom the heart -- in the arms, abdomen, back, neck, andlower jaw, for example. Angina is simply the heart's way of sayingthere is a mismatch between the oxygen-rich blood flow it needsand what is actually arriving for its use. Usually, if you have thissymptom, the discomfort goes away when you stop whatever activityis causing your heart to work harder than usual (or, if you've alreadybeen diagnosed with angina, when you take medication, suchas nitroglycerin tablets or spray). You should also know that noteveryone has this feeling when there is a problem with blood flowto the heart, but it usually is an important signal when it occurs.

If you experience any symptoms in the checklist below, youshould let your doctor know because they could be indications ofheart disease. These symptoms are not always caused by heart disease;they may be harmless or due to other medical conditions. Butif you already have heart disease, these symptoms are enough to indicatea potential heart problem and reason enough for you tocheck with your doctor, especially if these symptoms are new.

• DISCOMFORT IN YOUR CHEST that comes on during physical exertionor emotional stress; it may spread to your arms, neck, lowerjaw, face, back, or stomach. If this discomfort is from yourheart, it is called angina.


• UNUSUAL BREATHLESSNESS when doing light activity or whenyou are at rest can be a symptom of heart disease. Breathlessnessthat comes on suddenly may be an important warning sign.


• PALPITATION is the term used to describe the condition in whichyou feel your heart beat faster or more forcefully than usual, orin an irregular pattern. Palpitations may be a symptom of heartdisease, especially if they last for a few hours, if they come andgo over several days, or if they cause chest pain, breathlessness,or dizziness.


• FAINTING (or the sensation that you are about to faint) can becaused by inadequate oxygen reaching the brain, which may bedue to heart disease.


• SWELLING or fluid retention (also known as edema) is fluidbuildup in your tissues. This usually happens around the ankles,legs, lungs, and abdomen. Swelling of the legs can be perfectlynormal for some people after working many hours on theirfeet. However, it can also be a sign that the heart is not pumpingefficiently.


• FATIGUE has many causes, but it's worth seeing the doctor if youfeel unusually tired, especially if it is combined with other suspicioussymptoms noted above.

Sometimes, however, the danger signal from the heart is moredramatic. Atherosclerosis causes plaques to accumulate in thecoronary arteries. These plaques are lumps and bumps within thecoronary arteries that can contain cholesterol, white blood cells,and other substances. Sometimes they grow to block the arteriesand sometimes they are small and do not affect the blood flow ...

Excerpted from The Expert Guide to Beating Heart Diseaseby Krumholz, Harlan M. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.