August 29, 2024 • 25 mins
We spoke with Dr. James Cardon from Hartford Healthcare and Adria Giordano, Executive Director of the American Heart Association, about the upcoming 2024 Greater Hartford Heart Walk taking place on Saturday, September 7, as well as heart disease and heart health in general.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Thank you for listening to Community Access. I'm Allison Demurz.
Today my guests our doctor James Cardon from Hartford Healthcare,
and from the American Heart Association Executive Director Adria Giordano. Welcome,
good morning, Thank you for having us, my pleasure, Thank
you for being here. So we have an event coming
(00:20):
up with the American Heart Association.
Speaker 2 (00:22):
Tell us about it, sure, thanks Allison. So we have
our Greater Harford Heartwalk happening on Saturday, September seventh at
Bushnell Park in downtown Hartford. Registration begins at nine and
the walk kicks off at ten am. And we are
thrilled this year to have Jeff Flax, the CEO of
Harford Healthcare, as our Centennial Heartwalk Chair.
Speaker 1 (00:43):
Wow Centennial Heartwork Chair. What does that mean exactly?
Speaker 2 (00:46):
So on June tenth of this year, the American Heart
Association celebrated our one hundredth anniversary, which is looking at
all of the amazing research and impact that we've had
over the past one hundred years, and as we look
to the future, we have these amazing volunteer leaders in
the community like Jeff and doctor Cardon, who are helping
us create even bigger impact here in the state in
(01:09):
the next one hundred years.
Speaker 1 (01:10):
That's amazing. As I understand, it's a five K, which
means it's three loops.
Speaker 2 (01:15):
It is three loops, but there's really no one policing that.
So we invite people to come out of all ages
and join us. It's a really fun way to celebrate
heart health, to celebrate physical activity. We have a children's
area tent, we have Harford Healthcare going to come and
do some CPR and cholesterol training. We have there's an
(01:38):
area for dogs to come, so we have like a
bark park. There's food, there's you know, water stations. It's
a fun family activity for all ages. And again we
don't really monitor how many times you're going to go
around the loop, but yes, three times.
Speaker 1 (01:53):
And you need volunteers for this.
Speaker 2 (01:55):
We always love our community volunteers to come out and
help us absolutely, and our corporate sponsors they come out
and sponsor us and volunteer as well.
Speaker 1 (02:04):
I went to your website and there were some things
on there that maybe you could talk about. Join a
million walkers, lace up with us, connect easily, hero gear,
all of those things.
Speaker 2 (02:14):
Sure, so Heartwalk is truly the signature fundraising activity for
the American Heart Association nationally since nineteen ninety four. The
Heartwalk promotes physical activity, heart, healthy living, and a fun
family environment. Each year, we have over a million people
in the country participate in more than three hundred heart
(02:35):
walks across the country, raising funds to save lives from
the number one killer.
Speaker 1 (02:41):
Is heart disease.
Speaker 2 (02:42):
Yeah, I believes really a way to mobilize everyone.
Speaker 1 (02:46):
Feel that you're.
Speaker 2 (02:47):
Joining in your neighbors, your communities, your corporate communities, your church, family,
your your school, anybody who wants to come out. We
asked you to lace up. And so it's just a
fun way to feel that you're not only promoting the
American Heart Association and helping us raise truly critical funds,
but that you are doing something to be healthy.
Speaker 1 (03:08):
What is the web address?
Speaker 2 (03:09):
If people are listening, sure, so's it's heart dot org
and then you can be directed to or you could register.
An easier way is heart Hertford Heartwalk Altogether Hartford Heart
h h e A r T walk dot org and
it'll bring you right to the Hartford Heartwalk page. You'll
see all of the sponsors, all of the all of
(03:30):
the captains and the teams that are already signed up,
and hey, sign up to be a team captain. Join
your neighbors and friends. If you want, you can support
another team. If you can't join us, you can always
make a donation online it's secure website, or you can
form your own team. Many people walk in honor of
somebody that they've loved or in memory of someone who
has passed away, and it's wonderful. People make their own shirts.
Speaker 1 (03:53):
They get very, very creative.
Speaker 2 (03:55):
We have a survivor speaker that speaks to the depth
and breath of why the American Heart Association has saved
their lives through our research dollars, through advocacy, through community impact.
And it's not a long day. You'll be out by
eleven o'clock.
Speaker 1 (04:11):
It's beautiful and as you said, it's saving lives. So
why the need for an event like this?
Speaker 2 (04:17):
Yeah, So, as I mentioned, it is the number one killer.
Cardiovascular disease, including stroke, remains the number one killer of Americans.
Over seven thousand Connecticut adults will die from cardiovascular disease
this year. So by participating in the Heart Walk or
donating to the Heartwalk, you're supporting our life saving mission.
Speaker 1 (04:36):
Wonderful. Last year my friend forty seven years old, the
epitome of perfect health, absolutely beautiful, thin. She dropped it
from a massive heart attack. Horrible and it literally changed
my life. And you think I'd put down the big Mac.
I haven't put down the big Mac yet. Doctor. I'm
not as bad as I was, but still need to
(04:57):
be better, if that makes any kind of sense. Absolutely, So,
let's talk about heart disease with women, and then we
can talk about heart disease with men.
Speaker 3 (05:05):
Sure. So first, as stated, heart disease affects so many
of us, both personally. We all know somebody have a friend,
family member who have been affected by heart disease, and
so much can really be prevented if we do a
better job of controlling our risk factors. A lot of
(05:27):
our partnership with the American Heart Association is the tremendous
work they do to raise awareness because although we acknowledge
and we always talk about number one killer, the reality
of it is it's still not as present and aware
and people are making bad choices as they go through.
So heart disease is common most killer for men and
(05:49):
women in the United States. They often present with somewhat
different symptoms, so there's importance there per your story. Oftentimes
it is a sudden event without any warning at all,
which is the always the anxiety we have around heart disease.
It can strike without necessarily giving you any heads up
(06:12):
that you have the disease underneath. So what is it.
It's a disease of the blood vessels of your heart predominantly,
is what we're talking about today. That is inevitably linked
to us getting older. So it is almost a consequence
of us as we age as first and foremost, and
that's something you can't do much about. However, there's a
(06:33):
bunch of things that impact the development and the progression
of it, and those are both lifestyle choices and some genetics.
So we know family history plays a role in this,
and that's to make sure you're aware because the more
your family history plays, and the more attentive you need
to be and start at younger ages to control what
we know contributes to it. What are those smoking an
(06:56):
enormous risk factor for corner disease promotes the disease of
developing this blockage in your arteries, and therefore avoiding smoking
is a very important thing to do. Interestingly, people say, well,
I have smoked for a lot of years, So what's
the point your cardiphask your risk factors drop off. The
risk drops off pretty quickly when you stop smoking, so
within several years you're really starting to be like you
(07:18):
hadn't smoked at all. So it's really important not to
say it's already kind of the damage is done. It's
not the case at all. Second, is we know hypertension,
we know high cholesterol, we know diabetes. All those things
increase your risk of having corner disease. So making sure
that you're monitoring those things, getting your radio check up,
(07:40):
do I have high blood pressure? Is my cholesterol where
it needs to be? And then taking the appropriate steps
to try and control those risk factors all decreasing the
chance that you will get corner disease and heart disease
and had consequences of that. Despite all of that though,
and people say, well, I'm doing all the right things
and my numbers all look good, still at risk. Unfortunately
(08:01):
you are because it is part of the aging process
for some of us, and some of that is could happen.
So we all experience somebody who seemed to be perfectly healthy,
having no identical risk factors, but still presents with an
acute episode of a heart attack or otherwise, and often
unfortunately presents as their first presentation with sudden death or
(08:25):
a cardiac arrest. And that is a major problem for
us as we go forward.
Speaker 1 (08:29):
So let's just say someone is on a statin for
the cholesterol, they're on a high blood pressure med as well.
They're overweight, they're not eating the healthiest, they have a
genetic components. What can they do every year? Go for
an EKG and get chat, have their credit artery. Listen
to what would they do?
Speaker 3 (08:47):
So a couple of things. One is do the best
you can at modifying your risk factors so it doesn't
take much activity. As Adria was talking about walking, simple
walking or risk walking on a regular basis can significantly
reduce your risk factors. One hundred and fifty minutes a
(09:08):
week we're talking about, which is a thirty minute walk
a couple times a week. You can get there. Working
on your diet. No, you're not going to be perfect,
but where you can make smart choices. Always just keep
in mind that there are things you can do that
can help mitigate those risk factors. In terms of follow up, yes,
following in your clinician, making sure your blood pressure is
(09:28):
at goal, that your cholesterol is at goal. Oftentimes people
are on blood pressure medicines but their numbers are not
in the ideal range, and so making sure that you're
really optimally controlled around those things go forward. There are
sometimes where screening tests can be helpful, but oftentimes it
really is modifying your risk factors and then if you
(09:51):
have any symptoms at all which are of concern, being
promptly evaluated around those things.
Speaker 1 (09:57):
Let's talk about those signs and symptoms different for men
and women, and sometimes they can be the same.
Speaker 3 (10:02):
Yes. The classic description of what people experience when they
start to have symptoms related to a supply and demand
imbalance between what the heart needs for blood and what
it's getting because of blocked arteries is typically described as
a chest pressure or a tightness in their chest. It
can travel up to the jaw or down the arm
(10:23):
is classically defined. It can happen suddenly and abruptly at rest,
but oftentimes people will start to experience when they're doing inactivity,
walking up a hill, climbing stairs, they'll start to get
some shortness of breath and chest pressure resolves when they rest.
Those are really tell tale signs that needs to be investigated.
It doesn't mean it's absolutely heart disease. Other things can
(10:46):
cause symptoms, but it certainly is very suspicious for that,
but it does don't stop there. For women, oftentimes it's
more shortness of breath than chest pressure or tightness. The
symptoms aren't predictable. You can go out and do something
and feel fine. In the next minute you're trying to
do something and you have symptoms, so it can be
somewhat variable. Many times I've had patients come in and say, gee,
(11:08):
I've walked three miles yesterday, I felt great. Today I'm
getting the chest pressure when I do something that doesn't
reassure me that yesterday you were fine and today you
have a problem. It can come and go a bit
like that. For women. Also, profound fatigue tends to dominate
more than for men, So this over has a sense
if I just have exhausted when I'm trying to do
things and I used to be fine, should elevate to
(11:31):
some suspicion around that. There's lots of other explanations for it,
but again, the threshold to get these things looked into
has to be pretty low, because it can be a
very subtle disease to try and detect early enough so
that you don't get into trouble with it.
Speaker 1 (11:46):
How do we know if it's anxiety or indigestion, when
to go to the hospital when not to.
Speaker 3 (11:51):
So if you have an unexplained symptom that doesn't quite
feel like something you've had before, that you know the
cause of low threshold to go get evaluated. So if
you're suddenly experiencing chess pressure that you never have. I've
had some indigestion, it never felt like this. Yeah, that's
a different that's a different animal, and so therefore that
(12:12):
needs to be evaluated. Also, an abrupt on seat of
any of those symptoms. Yes, there are alternative explanations, as
you said, can be reef locked, indigestion, other stuff. Don't
assume it's the least risky thing. Assume it's the most
receipd thing and get evaluated by your physician or if
an acute problem in the emergency apartment.
Speaker 1 (12:32):
Do you find that most people don't want to go
to the hospital because they're afraid that they're just making
more of it and it's nothing, and that's probably not
the wisest thing to do.
Speaker 3 (12:42):
See it over and over again. We all tend to
try to avoid and explain away symptoms that are concerning
us because the consequences of what it could be are frightening.
That is exactly the song of wrong approach. Better to
be reassured that it really is nothing than to miss
the opportunity because it is something you ignored it.
Speaker 1 (13:01):
For people who have sleep apnea and don't wear their
seapat machines, is that something that can affect their heart
as well?
Speaker 3 (13:06):
Yes, so sleep apne. You can have multiple effects for
your heart and have adverse consequences. So any of these
disorders that can contribute need to be dealt with and
properly treated. Sleep Apne can be a difficult thing to manage,
but some of the therapies have had many patients who
(13:28):
say that therapy I can't work with it. Keep looking,
keep working on it, finding solutions because ignoring it is
posing some risk to you.
Speaker 1 (13:37):
Doctor, When somebody shows up at the hospital thinking they
may be having a hard episode, a hard incident heart attack,
I know there's a lot that goes on, but can
you just tell me a little bit of what they
do with the hospital.
Speaker 3 (13:47):
Sure, the first thing is taken immediately in for evaluation
time is of the essence if we believe somebody is
having heart damage due to a blocked artery, and that
quickly is a rapid assessment looking at your electric cardiogram
and EKG is an electrical signature of your heart and
there's telltale signs that if there's a lack of blood
(14:09):
suppoty your heart, that EKG will demonstrate changes that are
indod given of that second thing is really getting a
good robust history of what's going on, what's the symptom
Like a lot of what can be determined is what's
the pattern of the symptoms that can elevate or reassure
that this is potentially card related or not so. Clinicians,
(14:31):
getting your story from you is important, and then a
series of blood tests that can look is there any
evidence for some heart damage, subtle heart damage that is
giving us an early indication that that's going on is
the next step. If in fact it doesn't appear on
the initial assessment that you're having acute heart attack, generally
there's an observation period and then some additional testing to
(14:53):
make sure that there isn't any evidence for a lack
of blood suppoty heart and there's various ways in imaging
modalities and stress tests the light that can be done
to evaluate that. If you are having acute heart attack,
generally the treatment is taken directly to the catheterization laboratory.
This is a procedure room where we can go in
and open that artery up, unplug that artery real time
(15:14):
to minimize any damage that black artery caused.
Speaker 1 (15:19):
I believe I just had a cardiac calcium test.
Speaker 3 (15:22):
So what a calcium score is and it's an essential
tool that can be used. It's mostly to assess what's
your risk and how aggressively should we be treating your
cornate disease. So, cornate disease is an inflammatory process of
your arteries, and all inflammatory processes in the body when
(15:43):
they occur cause calcium deposition. It's part of the inflammatory
process that happens. If you've got a lot of athorosclerosis,
the scarring of the inside of the arteries, it will
be accompanied byposists of calcium, and calcium looks like bone,
It's what bone are made up of. So when you
do this low radiation CT scan, we can count how
(16:07):
much calcium or quantitate how much calcium is in those arteries,
and if you have no calcium in the arteries, it's
very reassuring that you don't have much scarring your arteries
and therefore not much athos crosis. Still doesn't mean that
you can't have some not all athroscrosis is causing calcium deposition,
but it's a good initial test. The more calcium you
(16:28):
have in that artery, the more likely you have significant
scarring of your arteries, and aggressive treatment of that needs
to be sort of done so that oftentimes we use
the calcium scoring as another way to assess somebody's overall
risk of having carn disease, and it's been very useful
good to know.
Speaker 1 (16:48):
Should we take a baby assprin every day?
Speaker 3 (16:52):
No, that had been a long term recommendation for prevention.
Now there are certain people who should you have evidence
for athroscrosis. So if we know you have blocked arteries,
then you should be on a baby aspirin in addition
to your therapy. I've had a previous heart attack, if
you've had arteries unplugged, if you've had bypass surgery, all
(17:12):
of which you have way to deal with blocked arteries.
Those people need to be maintained on an aspirin long term,
but as primary prevention. If you have just hypertension, you
don't need to be on aspen anymore. Turns out, the
consequences of that, bleeding risks and other things outweighed the
benefit at that point. Part of that has come about
(17:33):
because if you know, we used to tell everybody you
know to get to a certain ages to start taking
a baby aspen. Our therapy controlling cholesterol, lowering blood pressure,
managing those kind of risk factors have become so good
that the aspirin is no longer having the beneficial effect,
so that it is really important that you address those
risk factors because that's what's lowering your chance of having
(17:54):
that heart attack, and the aspirin becomes less important.
Speaker 1 (17:57):
What advice would you give a caregiver of some one,
a family member of someone who's had a heart attack,
How would you encourage them to stay the course?
Speaker 3 (18:06):
So a couple of things we're going. Part of our
focus with the American Art Association is an effort to
broaden the skill set and competency of people who can
do cardiopulmonary resuscitation CPR. This is an essential skill that
we should all learn to be able to how to
(18:27):
assist somebody who has a sudden cardiac collapse their heart
stops pumping appectively to maintain the blood supply to the
vital organs until help can arrive. And learning how to
do CPR is an essential skill that unfortunately not enough
people know how to do or have the confidence to
do so. First and foremost, all family members who have
(18:48):
somebody who has underlying carn disease should make sure they're
trained to be able to respond. Cardiac disease. Unfortunately, even
though you may have it or you don't, still present
sometimes abruptly, suddenly and unpredictably, and therefore trying to be
ready to how you'll deal with the consequences that becomes important.
So that's one.
Speaker 2 (19:08):
Two.
Speaker 3 (19:10):
Maintain a high through lifestyle for your loved one family member.
The more you can make the lifestyle in the home
and in work and other places consistent to make it
easy for people to adhere to the temptations. If you will,
the better off you're going to be. So it's really
important that families maintain an active lifestyle, have the right
(19:33):
choices of foods in the house, look at what everybody's
doing around those things, eliminate smoking. If your spouse or
your family member has a corner disease and has been
trying to give up smoking, you should give up too,
because that's really really hard for one to do it
in the house and others not. So Working collaboratively around
(19:53):
this will help your own health, but importantly help support
the person who has the disease as well.
Speaker 1 (19:58):
And the last thing I want to ask you is
about the first hands only CPR mobile Kiosk at Hartford Healthcare.
Speaker 3 (20:04):
Yeah, this was part of our partnership with the American
Art Association, So they developed a kiosk, a self taught
sort of machine if you will, that will instruct you
on how to perform CPR real time, and it walks
you through the process of proper hand placement, proper pressure
(20:25):
to be put on when you're doing CPR, the probab
rhythm that you need to be doing it on, all
the things that cause people anxiety saying I don't know
how to do this, give them the confidence to know
how they're doing it and they're doing it right. The
reason we're doing it is because we know that not
enough people are trained so that if somebody were to
collapse suddenly, be it on neighbor, be it a family member,
(20:48):
be it somebody on the street who you haven't met yet.
The ability to save lives, CPR becomes an essential bridge
to getting appropriate therapy, to restart the heart into normal
function and to serve. And that skill set is what
we're trying to get more broadly and making this really
(21:08):
easy to do. You can go in, get trained, Making
this available to the public and they can practice and
get on will be two things. Gives them the skill
set to gives them the confidence to do it if
it's something were to happen. So it really brings that
all forward. We also know it's a real you know,
for us, we know there's significant opportunity of inequities that
(21:34):
go on. We know that certain cities are much less
likely for people who collapse to get CPR than if
you're out in some of the residential communities where you
are matters a lot, and so we're really trying to
bring this to all of our at risk populations where
there's population density to make sure more and more people
know what to do should this happen.
Speaker 1 (21:53):
Over the years, doing CPR changed, how do you do CPR.
Speaker 3 (21:57):
Now there and full cardipulmeter resuscitation really does involve both
assisted breathing as well as the CPR. But what we've
recognized is you can accomplish an awful lot without necessarily
adding the breathing and the other things that used to
do which would marjor your barrier, by just doing it
with your hands and using the compression. So that I'd
advise you to go to the machine. It has a
(22:19):
lovely way for you to figure out and how to
keep the right cadence and where you're going. But it
really is getting that kind of easy training that makes
it so simple. So CPR just hands only can absolutely
save lives without necessarily the more elaborate sort of way
it used to be taught.
Speaker 1 (22:37):
Is there anything else you'd like to say about heart
disease that we haven't mentioned.
Speaker 3 (22:42):
No, Again, this is where community matters a lot, and
oftentimes we sort of hold these things to ourselves and
don't share. So the more we can elevate the ubiquity
of this disorder, the potential and the power of really
(23:03):
managing this with things that you can control and being
available to respond if somebody who's in acute trouble. It's
just something that we can do a much better by
job socializing that and holding each other a little bit
more accountable to say, don't bury your head on these things.
It is a preventable disease in an awful lot of way.
(23:24):
And know we're not going to live forever, but we
can sure extend lives by everybody knowing how to do this.
Speaker 1 (23:30):
Things wonderful. Let's go back to the event that's happening.
Speaker 2 (23:34):
Absolutely so, we are having our Greater Hartford Heartwalk on Saturday,
September seventh at Butional Park. You can go to www
dot Hartford Heartwalk, that's Hartford Heartwalk Altogether dot org to
register or to support. You can make a donation online.
You can sign up online. And it truly is one
of the things that I hear a lot and our
(23:56):
team hears a lot is where does the money go
that we raise for the heart? And I think it's
important to address that that you know, as doctor Cardon mentioned,
it's the number one killer of Americans, and particularly here
in Connecticut, we do have people who don't have resources
to be able to address this. So our hands only
CPR chios. We're so grateful and so thrilled to bring
(24:17):
the first one to New England to really reach everyone
in every community and to give people the opportunity to
live their healthiest lives. So the money that we raise
it supports research, advocacy, CPR, training and other ways to
educate and promote better health within Connecticut.
Speaker 1 (24:36):
Wonderful again. That is the Greater Hartford hard Walk on Saturday,
September seventh. Check in is at nine, the walk begins
at ten. It's at Bushnell Park right in downtown Hartford.
It's a five k, but you don't have to do
the whole thing. And what is that website again, Hartford
Heart h e art Walk dot org. Wonderful. They need
(24:57):
volunteers and donations, so please please go to the walk.
I want to thank you doctor James Carden from Hartford
Healthcare and from the American Heart Association Executive director Adria Girdano.
Thank you both so much for all the amazing work
that you do. Thank you. Thanks for havingson my pleasure
Thank you for listening to Community Access. I'm Allison Demurz.
Today my guests our doctor James Cardon from Hartford Healthcare,
and from the American Heart Association Executive Director Adria Giordano. Welcome,
good morning, Thank you for having us, my pleasure, Thank
you for being here. So we have an event coming
(00:20):
up with the American Heart Association.
Speaker 2 (00:22):
Tell us about it, sure, thanks Allison. So we have
our Greater Harford Heartwalk happening on Saturday, September seventh at
Bushnell Park in downtown Hartford. Registration begins at nine and
the walk kicks off at ten am. And we are
thrilled this year to have Jeff Flax, the CEO of
Harford Healthcare, as our Centennial Heartwalk Chair.
Speaker 1 (00:43):
Wow Centennial Heartwork Chair. What does that mean exactly?
Speaker 2 (00:46):
So on June tenth of this year, the American Heart
Association celebrated our one hundredth anniversary, which is looking at
all of the amazing research and impact that we've had
over the past one hundred years, and as we look
to the future, we have these amazing volunteer leaders in
the community like Jeff and doctor Cardon, who are helping
us create even bigger impact here in the state in
(01:09):
the next one hundred years.
Speaker 1 (01:10):
That's amazing. As I understand, it's a five K, which
means it's three loops.
Speaker 2 (01:15):
It is three loops, but there's really no one policing that.
So we invite people to come out of all ages
and join us. It's a really fun way to celebrate
heart health, to celebrate physical activity. We have a children's
area tent, we have Harford Healthcare going to come and
do some CPR and cholesterol training. We have there's an
(01:38):
area for dogs to come, so we have like a
bark park. There's food, there's you know, water stations. It's
a fun family activity for all ages. And again we
don't really monitor how many times you're going to go
around the loop, but yes, three times.
Speaker 1 (01:53):
And you need volunteers for this.
Speaker 2 (01:55):
We always love our community volunteers to come out and
help us absolutely, and our corporate sponsors they come out
and sponsor us and volunteer as well.
Speaker 1 (02:04):
I went to your website and there were some things
on there that maybe you could talk about. Join a
million walkers, lace up with us, connect easily, hero gear,
all of those things.
Speaker 2 (02:14):
Sure, so Heartwalk is truly the signature fundraising activity for
the American Heart Association nationally since nineteen ninety four. The
Heartwalk promotes physical activity, heart, healthy living, and a fun
family environment. Each year, we have over a million people
in the country participate in more than three hundred heart
(02:35):
walks across the country, raising funds to save lives from
the number one killer.
Speaker 1 (02:41):
Is heart disease.
Speaker 2 (02:42):
Yeah, I believes really a way to mobilize everyone.
Speaker 1 (02:46):
Feel that you're.
Speaker 2 (02:47):
Joining in your neighbors, your communities, your corporate communities, your church, family,
your your school, anybody who wants to come out. We
asked you to lace up. And so it's just a
fun way to feel that you're not only promoting the
American Heart Association and helping us raise truly critical funds,
but that you are doing something to be healthy.
Speaker 1 (03:08):
What is the web address?
Speaker 2 (03:09):
If people are listening, sure, so's it's heart dot org
and then you can be directed to or you could register.
An easier way is heart Hertford Heartwalk Altogether Hartford Heart
h h e A r T walk dot org and
it'll bring you right to the Hartford Heartwalk page. You'll
see all of the sponsors, all of the all of
(03:30):
the captains and the teams that are already signed up,
and hey, sign up to be a team captain. Join
your neighbors and friends. If you want, you can support
another team. If you can't join us, you can always
make a donation online it's secure website, or you can
form your own team. Many people walk in honor of
somebody that they've loved or in memory of someone who
has passed away, and it's wonderful. People make their own shirts.
Speaker 1 (03:53):
They get very, very creative.
Speaker 2 (03:55):
We have a survivor speaker that speaks to the depth
and breath of why the American Heart Association has saved
their lives through our research dollars, through advocacy, through community impact.
And it's not a long day. You'll be out by
eleven o'clock.
Speaker 1 (04:11):
It's beautiful and as you said, it's saving lives. So
why the need for an event like this?
Speaker 2 (04:17):
Yeah, So, as I mentioned, it is the number one killer.
Cardiovascular disease, including stroke, remains the number one killer of Americans.
Over seven thousand Connecticut adults will die from cardiovascular disease
this year. So by participating in the Heart Walk or
donating to the Heartwalk, you're supporting our life saving mission.
Speaker 1 (04:36):
Wonderful. Last year my friend forty seven years old, the
epitome of perfect health, absolutely beautiful, thin. She dropped it
from a massive heart attack. Horrible and it literally changed
my life. And you think I'd put down the big Mac.
I haven't put down the big Mac yet. Doctor. I'm
not as bad as I was, but still need to
(04:57):
be better, if that makes any kind of sense. Absolutely, So,
let's talk about heart disease with women, and then we
can talk about heart disease with men.
Speaker 3 (05:05):
Sure. So first, as stated, heart disease affects so many
of us, both personally. We all know somebody have a friend,
family member who have been affected by heart disease, and
so much can really be prevented if we do a
better job of controlling our risk factors. A lot of
(05:27):
our partnership with the American Heart Association is the tremendous
work they do to raise awareness because although we acknowledge
and we always talk about number one killer, the reality
of it is it's still not as present and aware
and people are making bad choices as they go through.
So heart disease is common most killer for men and
(05:49):
women in the United States. They often present with somewhat
different symptoms, so there's importance there per your story. Oftentimes
it is a sudden event without any warning at all,
which is the always the anxiety we have around heart disease.
It can strike without necessarily giving you any heads up
(06:12):
that you have the disease underneath. So what is it.
It's a disease of the blood vessels of your heart predominantly,
is what we're talking about today. That is inevitably linked
to us getting older. So it is almost a consequence
of us as we age as first and foremost, and
that's something you can't do much about. However, there's a
(06:33):
bunch of things that impact the development and the progression
of it, and those are both lifestyle choices and some genetics.
So we know family history plays a role in this,
and that's to make sure you're aware because the more
your family history plays, and the more attentive you need
to be and start at younger ages to control what
we know contributes to it. What are those smoking an
(06:56):
enormous risk factor for corner disease promotes the disease of
developing this blockage in your arteries, and therefore avoiding smoking
is a very important thing to do. Interestingly, people say, well,
I have smoked for a lot of years, So what's
the point your cardiphask your risk factors drop off. The
risk drops off pretty quickly when you stop smoking, so
within several years you're really starting to be like you
(07:18):
hadn't smoked at all. So it's really important not to
say it's already kind of the damage is done. It's
not the case at all. Second, is we know hypertension,
we know high cholesterol, we know diabetes. All those things
increase your risk of having corner disease. So making sure
that you're monitoring those things, getting your radio check up,
(07:40):
do I have high blood pressure? Is my cholesterol where
it needs to be? And then taking the appropriate steps
to try and control those risk factors all decreasing the
chance that you will get corner disease and heart disease
and had consequences of that. Despite all of that though,
and people say, well, I'm doing all the right things
and my numbers all look good, still at risk. Unfortunately
(08:01):
you are because it is part of the aging process
for some of us, and some of that is could happen.
So we all experience somebody who seemed to be perfectly healthy,
having no identical risk factors, but still presents with an
acute episode of a heart attack or otherwise, and often
unfortunately presents as their first presentation with sudden death or
(08:25):
a cardiac arrest. And that is a major problem for
us as we go forward.
Speaker 1 (08:29):
So let's just say someone is on a statin for
the cholesterol, they're on a high blood pressure med as well.
They're overweight, they're not eating the healthiest, they have a
genetic components. What can they do every year? Go for
an EKG and get chat, have their credit artery. Listen
to what would they do?
Speaker 3 (08:47):
So a couple of things. One is do the best
you can at modifying your risk factors so it doesn't
take much activity. As Adria was talking about walking, simple
walking or risk walking on a regular basis can significantly
reduce your risk factors. One hundred and fifty minutes a
(09:08):
week we're talking about, which is a thirty minute walk
a couple times a week. You can get there. Working
on your diet. No, you're not going to be perfect,
but where you can make smart choices. Always just keep
in mind that there are things you can do that
can help mitigate those risk factors. In terms of follow up, yes,
following in your clinician, making sure your blood pressure is
(09:28):
at goal, that your cholesterol is at goal. Oftentimes people
are on blood pressure medicines but their numbers are not
in the ideal range, and so making sure that you're
really optimally controlled around those things go forward. There are
sometimes where screening tests can be helpful, but oftentimes it
really is modifying your risk factors and then if you
(09:51):
have any symptoms at all which are of concern, being
promptly evaluated around those things.
Speaker 1 (09:57):
Let's talk about those signs and symptoms different for men
and women, and sometimes they can be the same.
Speaker 3 (10:02):
Yes. The classic description of what people experience when they
start to have symptoms related to a supply and demand
imbalance between what the heart needs for blood and what
it's getting because of blocked arteries is typically described as
a chest pressure or a tightness in their chest. It
can travel up to the jaw or down the arm
(10:23):
is classically defined. It can happen suddenly and abruptly at rest,
but oftentimes people will start to experience when they're doing inactivity,
walking up a hill, climbing stairs, they'll start to get
some shortness of breath and chest pressure resolves when they rest.
Those are really tell tale signs that needs to be investigated.
It doesn't mean it's absolutely heart disease. Other things can
(10:46):
cause symptoms, but it certainly is very suspicious for that,
but it does don't stop there. For women, oftentimes it's
more shortness of breath than chest pressure or tightness. The
symptoms aren't predictable. You can go out and do something
and feel fine. In the next minute you're trying to
do something and you have symptoms, so it can be
somewhat variable. Many times I've had patients come in and say, gee,
(11:08):
I've walked three miles yesterday, I felt great. Today I'm
getting the chest pressure when I do something that doesn't
reassure me that yesterday you were fine and today you
have a problem. It can come and go a bit
like that. For women. Also, profound fatigue tends to dominate
more than for men, So this over has a sense
if I just have exhausted when I'm trying to do
things and I used to be fine, should elevate to
(11:31):
some suspicion around that. There's lots of other explanations for it,
but again, the threshold to get these things looked into
has to be pretty low, because it can be a
very subtle disease to try and detect early enough so
that you don't get into trouble with it.
Speaker 1 (11:46):
How do we know if it's anxiety or indigestion, when
to go to the hospital when not to.
Speaker 3 (11:51):
So if you have an unexplained symptom that doesn't quite
feel like something you've had before, that you know the
cause of low threshold to go get evaluated. So if
you're suddenly experiencing chess pressure that you never have. I've
had some indigestion, it never felt like this. Yeah, that's
a different that's a different animal, and so therefore that
(12:12):
needs to be evaluated. Also, an abrupt on seat of
any of those symptoms. Yes, there are alternative explanations, as
you said, can be reef locked, indigestion, other stuff. Don't
assume it's the least risky thing. Assume it's the most
receipd thing and get evaluated by your physician or if
an acute problem in the emergency apartment.
Speaker 1 (12:32):
Do you find that most people don't want to go
to the hospital because they're afraid that they're just making
more of it and it's nothing, and that's probably not
the wisest thing to do.
Speaker 3 (12:42):
See it over and over again. We all tend to
try to avoid and explain away symptoms that are concerning
us because the consequences of what it could be are frightening.
That is exactly the song of wrong approach. Better to
be reassured that it really is nothing than to miss
the opportunity because it is something you ignored it.
Speaker 1 (13:01):
For people who have sleep apnea and don't wear their
seapat machines, is that something that can affect their heart
as well?
Speaker 3 (13:06):
Yes, so sleep apne. You can have multiple effects for
your heart and have adverse consequences. So any of these
disorders that can contribute need to be dealt with and
properly treated. Sleep Apne can be a difficult thing to manage,
but some of the therapies have had many patients who
(13:28):
say that therapy I can't work with it. Keep looking,
keep working on it, finding solutions because ignoring it is
posing some risk to you.
Speaker 1 (13:37):
Doctor, When somebody shows up at the hospital thinking they
may be having a hard episode, a hard incident heart attack,
I know there's a lot that goes on, but can
you just tell me a little bit of what they
do with the hospital.
Speaker 3 (13:47):
Sure, the first thing is taken immediately in for evaluation
time is of the essence if we believe somebody is
having heart damage due to a blocked artery, and that
quickly is a rapid assessment looking at your electric cardiogram
and EKG is an electrical signature of your heart and
there's telltale signs that if there's a lack of blood
(14:09):
suppoty your heart, that EKG will demonstrate changes that are
indod given of that second thing is really getting a
good robust history of what's going on, what's the symptom
Like a lot of what can be determined is what's
the pattern of the symptoms that can elevate or reassure
that this is potentially card related or not so. Clinicians,
(14:31):
getting your story from you is important, and then a
series of blood tests that can look is there any
evidence for some heart damage, subtle heart damage that is
giving us an early indication that that's going on is
the next step. If in fact it doesn't appear on
the initial assessment that you're having acute heart attack, generally
there's an observation period and then some additional testing to
(14:53):
make sure that there isn't any evidence for a lack
of blood suppoty heart and there's various ways in imaging
modalities and stress tests the light that can be done
to evaluate that. If you are having acute heart attack,
generally the treatment is taken directly to the catheterization laboratory.
This is a procedure room where we can go in
and open that artery up, unplug that artery real time
(15:14):
to minimize any damage that black artery caused.
Speaker 1 (15:19):
I believe I just had a cardiac calcium test.
Speaker 3 (15:22):
So what a calcium score is and it's an essential
tool that can be used. It's mostly to assess what's
your risk and how aggressively should we be treating your
cornate disease. So, cornate disease is an inflammatory process of
your arteries, and all inflammatory processes in the body when
(15:43):
they occur cause calcium deposition. It's part of the inflammatory
process that happens. If you've got a lot of athorosclerosis,
the scarring of the inside of the arteries, it will
be accompanied byposists of calcium, and calcium looks like bone,
It's what bone are made up of. So when you
do this low radiation CT scan, we can count how
(16:07):
much calcium or quantitate how much calcium is in those arteries,
and if you have no calcium in the arteries, it's
very reassuring that you don't have much scarring your arteries
and therefore not much athos crosis. Still doesn't mean that
you can't have some not all athroscrosis is causing calcium deposition,
but it's a good initial test. The more calcium you
(16:28):
have in that artery, the more likely you have significant
scarring of your arteries, and aggressive treatment of that needs
to be sort of done so that oftentimes we use
the calcium scoring as another way to assess somebody's overall
risk of having carn disease, and it's been very useful
good to know.
Speaker 1 (16:48):
Should we take a baby assprin every day?
Speaker 3 (16:52):
No, that had been a long term recommendation for prevention.
Now there are certain people who should you have evidence
for athroscrosis. So if we know you have blocked arteries,
then you should be on a baby aspirin in addition
to your therapy. I've had a previous heart attack, if
you've had arteries unplugged, if you've had bypass surgery, all
(17:12):
of which you have way to deal with blocked arteries.
Those people need to be maintained on an aspirin long term,
but as primary prevention. If you have just hypertension, you
don't need to be on aspen anymore. Turns out, the
consequences of that, bleeding risks and other things outweighed the
benefit at that point. Part of that has come about
(17:33):
because if you know, we used to tell everybody you
know to get to a certain ages to start taking
a baby aspen. Our therapy controlling cholesterol, lowering blood pressure,
managing those kind of risk factors have become so good
that the aspirin is no longer having the beneficial effect,
so that it is really important that you address those
risk factors because that's what's lowering your chance of having
(17:54):
that heart attack, and the aspirin becomes less important.
Speaker 1 (17:57):
What advice would you give a caregiver of some one,
a family member of someone who's had a heart attack,
How would you encourage them to stay the course?
Speaker 3 (18:06):
So a couple of things we're going. Part of our
focus with the American Art Association is an effort to
broaden the skill set and competency of people who can
do cardiopulmonary resuscitation CPR. This is an essential skill that
we should all learn to be able to how to
(18:27):
assist somebody who has a sudden cardiac collapse their heart
stops pumping appectively to maintain the blood supply to the
vital organs until help can arrive. And learning how to
do CPR is an essential skill that unfortunately not enough
people know how to do or have the confidence to
do so. First and foremost, all family members who have
(18:48):
somebody who has underlying carn disease should make sure they're
trained to be able to respond. Cardiac disease. Unfortunately, even
though you may have it or you don't, still present
sometimes abruptly, suddenly and unpredictably, and therefore trying to be
ready to how you'll deal with the consequences that becomes important.
So that's one.
Speaker 2 (19:08):
Two.
Speaker 3 (19:10):
Maintain a high through lifestyle for your loved one family member.
The more you can make the lifestyle in the home
and in work and other places consistent to make it
easy for people to adhere to the temptations. If you will,
the better off you're going to be. So it's really
important that families maintain an active lifestyle, have the right
(19:33):
choices of foods in the house, look at what everybody's
doing around those things, eliminate smoking. If your spouse or
your family member has a corner disease and has been
trying to give up smoking, you should give up too,
because that's really really hard for one to do it
in the house and others not. So Working collaboratively around
(19:53):
this will help your own health, but importantly help support
the person who has the disease as well.
Speaker 1 (19:58):
And the last thing I want to ask you is
about the first hands only CPR mobile Kiosk at Hartford Healthcare.
Speaker 3 (20:04):
Yeah, this was part of our partnership with the American
Art Association, So they developed a kiosk, a self taught
sort of machine if you will, that will instruct you
on how to perform CPR real time, and it walks
you through the process of proper hand placement, proper pressure
(20:25):
to be put on when you're doing CPR, the probab
rhythm that you need to be doing it on, all
the things that cause people anxiety saying I don't know
how to do this, give them the confidence to know
how they're doing it and they're doing it right. The
reason we're doing it is because we know that not
enough people are trained so that if somebody were to
collapse suddenly, be it on neighbor, be it a family member,
(20:48):
be it somebody on the street who you haven't met yet.
The ability to save lives, CPR becomes an essential bridge
to getting appropriate therapy, to restart the heart into normal
function and to serve. And that skill set is what
we're trying to get more broadly and making this really
(21:08):
easy to do. You can go in, get trained, Making
this available to the public and they can practice and
get on will be two things. Gives them the skill
set to gives them the confidence to do it if
it's something were to happen. So it really brings that
all forward. We also know it's a real you know,
for us, we know there's significant opportunity of inequities that
(21:34):
go on. We know that certain cities are much less
likely for people who collapse to get CPR than if
you're out in some of the residential communities where you
are matters a lot, and so we're really trying to
bring this to all of our at risk populations where
there's population density to make sure more and more people
know what to do should this happen.
Speaker 1 (21:53):
Over the years, doing CPR changed, how do you do CPR.
Speaker 3 (21:57):
Now there and full cardipulmeter resuscitation really does involve both
assisted breathing as well as the CPR. But what we've
recognized is you can accomplish an awful lot without necessarily
adding the breathing and the other things that used to
do which would marjor your barrier, by just doing it
with your hands and using the compression. So that I'd
advise you to go to the machine. It has a
(22:19):
lovely way for you to figure out and how to
keep the right cadence and where you're going. But it
really is getting that kind of easy training that makes
it so simple. So CPR just hands only can absolutely
save lives without necessarily the more elaborate sort of way
it used to be taught.
Speaker 1 (22:37):
Is there anything else you'd like to say about heart
disease that we haven't mentioned.
Speaker 3 (22:42):
No, Again, this is where community matters a lot, and
oftentimes we sort of hold these things to ourselves and
don't share. So the more we can elevate the ubiquity
of this disorder, the potential and the power of really
(23:03):
managing this with things that you can control and being
available to respond if somebody who's in acute trouble. It's
just something that we can do a much better by
job socializing that and holding each other a little bit
more accountable to say, don't bury your head on these things.
It is a preventable disease in an awful lot of way.
(23:24):
And know we're not going to live forever, but we
can sure extend lives by everybody knowing how to do this.
Speaker 1 (23:30):
Things wonderful. Let's go back to the event that's happening.
Speaker 2 (23:34):
Absolutely so, we are having our Greater Hartford Heartwalk on Saturday,
September seventh at Butional Park. You can go to www
dot Hartford Heartwalk, that's Hartford Heartwalk Altogether dot org to
register or to support. You can make a donation online.
You can sign up online. And it truly is one
of the things that I hear a lot and our
(23:56):
team hears a lot is where does the money go
that we raise for the heart? And I think it's
important to address that that you know, as doctor Cardon mentioned,
it's the number one killer of Americans, and particularly here
in Connecticut, we do have people who don't have resources
to be able to address this. So our hands only
CPR chios. We're so grateful and so thrilled to bring
(24:17):
the first one to New England to really reach everyone
in every community and to give people the opportunity to
live their healthiest lives. So the money that we raise
it supports research, advocacy, CPR, training and other ways to
educate and promote better health within Connecticut.
Speaker 1 (24:36):
Wonderful again. That is the Greater Hartford hard Walk on Saturday,
September seventh. Check in is at nine, the walk begins
at ten. It's at Bushnell Park right in downtown Hartford.
It's a five k, but you don't have to do
the whole thing. And what is that website again, Hartford
Heart h e art Walk dot org. Wonderful. They need
(24:57):
volunteers and donations, so please please go to the walk.
I want to thank you doctor James Carden from Hartford
Healthcare and from the American Heart Association Executive director Adria Girdano.
Thank you both so much for all the amazing work
that you do. Thank you. Thanks for havingson my pleasure
Popular Podcasts
1. Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
2. Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations.
3. Crime Junkie
If you can never get enough true crime... Congratulations, you’ve found your people.