September 17, 2025 • 36 mins
Host Jenn Seay from iHeartRadio and Valley girls Jess Staples & Melanie Adkins talk to Dr. Mehrette Maru about heart health and what you can expect to find at Valley Health's Heart and Vascular Center.
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Speaker 1 (00:00):
The content shared on this podcast is for informational and
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This podcast is not a substitute for professional medical advice, diagnosis,
(00:21):
or treatment. Always seek the advice of your physician or
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Speaker 2 (00:40):
This is TMI Talking Medical Information with Value Health.
Speaker 3 (00:45):
Hello everybody, we are back with another episode of TMI
Talking Medical Information with Value Health. And I've got my
Value girls alongside me once again. Just Staple Hey, Happy Friday. Hey,
and we've gotten Melanie ad kids yep here and ready
to go. Okay, and so something really exciting is happening
(01:06):
at Valley Health right now. The Cardiology department. Hello, y'all
have just opened this.
Speaker 2 (01:11):
We've got three cardiologists and three mid levels, twenty two
exam rooms, and all kinds of wonderful things to take
care of whatever your need is cardiovascular wise. We are
ready to see anyone in town, Valley patient or not,
so come on over and let us take care of you.
Speaker 4 (01:26):
One of the coolest things that we have going on
is we are going to be offering all kinds of
advanced cardiac testing and imaging in house, so our patients
don't have to go and sit at a hospital or
another facility. They get to come right here have that
testing done on site. See that's perfect, that's what you want.
And Valley Health offers all of this here.
Speaker 3 (01:46):
And we're also talking to doctor Maru today, who is
a cardiologist.
Speaker 2 (01:50):
Hello, doctor Maru.
Speaker 3 (01:52):
Hi, So tell us a little bit about your background, Sir.
Speaker 5 (01:55):
I was born in Brooklyn, New York, but I did
my medical school in Ethiopia. Since my family moved back
to practice medicine. My dad as a cardiologist, so he
wanted to set up a medical school back home, so
he moved while I was a kid. So I finished
med school in Ethiopia and then joined Marshall to do residency.
(02:19):
So after the residency, I joined again Marshall Cardiology to
do the cardiovascular training and interventions. Since then I have
worked with HIMG and Saint Mary's and now Valley Hills,
which we are very excited about.
Speaker 3 (02:37):
Well, that is an extensive background as well. So I
think we know that you can absolutely answer all of
our questions today.
Speaker 5 (02:44):
Right, We'll try my best.
Speaker 2 (02:47):
He'll give us the lowdown, tell us what to watch
for for sure.
Speaker 3 (02:49):
Absolutely, And actually I was looking over some of these
questions and I got to tell you just a few
years ago, I had an incident where I pulled a
back muscle. But it was such a bad pull that
it was like radiating through my chest. So when I
went to the hospital and I told them my symptoms,
I was like, yeah, I have some chest pain. Like
four nurses came out to get me and take me back.
I was like, oh my gosh, am I having a
heart attack. So I was freaking out. So I'm glad
(03:11):
that you're here today so we could talk to you
about this.
Speaker 4 (03:14):
This one hits home for me. I start my day
off with at least a pot of coffee, and sometimes
I find that my heart likes to raise or beat
really really, I mean like beating out of my chest.
Is that normal and why does.
Speaker 5 (03:28):
It do that? Caffeine consumption has good value for the
heart as long as it's done in moderation. So the
idea is the FDA recommends like four to five cups
a day, assuming that your cap has closed to seventy
five too one hundred milligrams caffeine in them. So the
maximum consumption healthier is around four hundred miligrams. But it
(03:52):
depends on individuals. So some people will have one cup
of coffee they are fine. Some people can have four
the whole four hundred melegrams and then they are okay,
they can sleep. They can have two cups and then
they will experience palpitations, jittery, anxiety, tremors. So if you
are sensitive to caffeine, then you should have lesser amount.
(04:15):
If you can tolerate, then it's ideal. So it does
give palpitations heart issues for older people who have heart
rhythm problems will recom in lesser consumption. For a younger
person than They can consume up to four to five
cups without any issues. So it depends on how sensitive
you are. So if you are sensitive to caffeine, then
(04:35):
you need to cut down.
Speaker 2 (04:36):
So if she's shaking and sweating, she might want to
walk back a little bit. That would be a little
sensitive too, okasive, not as much coffee before I get here?
Speaker 4 (04:44):
Just all they want?
Speaker 5 (04:45):
Got it?
Speaker 1 (04:45):
Does?
Speaker 2 (04:46):
Actually? Maybe just switch to green tea. Okay, that's good
for you. Yeah, chill out, shell out. I have a
question too. Sometimes I will just be in the course
of my normal day and this sounds crazy, but I
feel like my heart flips almost and like I have
to cough to get it back in rhythm. Oh wow, melanies, stop,
it's fine, I mean fine, Okay? Is that normal? Is
(05:08):
that a sign of like, so sister's got a problem.
Speaker 5 (05:11):
So that that's non normal. If you have that, then
the are This is one of the part of advanced
cardiac testing we do here, so in those instances it
can be rhythm issues like that are what we call
paroxysmal supraven to cloud taki cardias, where the upper chamber
of the heart goes faster than the lower. Usually they
(05:34):
are benign, but they can be treated with better blockers.
And then sometimes if they have some symptoms, like people
will feel dizziness, lightheadedness, or they get short winded. If
they have symptoms with that, then it needs to be investigated.
But if it's short lasting, no symptoms, then usually we
(05:57):
recommend cutting down the caffeine and some stop I should
take care of.
Speaker 2 (06:03):
I'm kidding. It's been happening since college though you know
in college was there, which was only a couple of
years ago. Whatever, So I mean, I just I had
a lot of caffeine consumption obviously through college and being
a mom. We rack caffeine pretty hard. So I'll out
of mind. But I don't have any symptoms, so but
that is good.
Speaker 3 (06:21):
I've always have any symptoms. Except you do have a
heart that feels like it flips. I mean, that's that's
all I can.
Speaker 2 (06:26):
Yeah, but if I cough it kind of it just
automatically it goes away.
Speaker 5 (06:31):
Yeah, for the most part, you should have dizy spells
or light headedness, shortness of press done. Those needs to
be investigated. And also we do blood work, so some
people who have low blood count anemia can have that
if their tyroid function is abnormal, so the TSH level
has to be checked, so there are preliminary blood works
(06:52):
we do. In some people we even do monitoring like
Halter or event monitor. They will wear a monitor to
see what exactly is going on, and then in few
people also we do echo cardiogram to make sure the
heart has no structural abnormalities. But for the most part,
it's benigh as long as there is no symptom.
Speaker 2 (07:11):
Thanks doctor Marue.
Speaker 3 (07:12):
Do you love how women usually wait like a good
ten to twenty years before they have all right, yeah,
they're like, oh, yeah, it's been going for a while,
it's not a big deal. But though, so I do
have a question. Then they talk about a silent heart
attack where you don't actually even know that you're having
a heart attack. Sometimes you just feel like a fullness
or like a weight, like maybe in your chest or
even in your stomach, and you're like, Eh, it's no
(07:34):
big deal, I'll be fine, But how serious can that be?
Speaker 5 (07:38):
So if you really closely investigate, they have symptoms that
are not typical of a heart attack. They might have
felt like a heartburn and then they will say it's
a heartburnd. They will ignore it, but they are having
a heart attack, so at a later date you find
out that they have a heart attack, so we call
them silent heart attack. But truly, especially in women, they
(08:02):
ignore the symptoms and some of the symptoms they have
is a little bit different than in guys, so they
have a tendency to tolerate pain more ignore symptoms more
so the disease gets diagnosed later. And then in diabetes
patients with diabetic abnormalities, they can truly have a symptomatic
(08:23):
heart attack because like the nerves are different, like they
will have neuroperty symptoms, they don't have the typical chest
beIN but most of them, if you look at it
in detail, they will let you know that they have
been short winded easily whenever they do stuff or they
associated to age, like they slow down because they are
(08:44):
getting older, rather than assuming they had pluckage in the
heart that's slowing them down. So it is a well
known fact and people should take their symptoms seriously, see
their primary care provider, get checked to avoid having the
heart muscle damage because we call it like time wasted
(09:04):
is muscle infarcted and heart muscle doesn't regenerate. So if
you have a liver damage, people can give a portion
of their liver for transplant and then within three six
months the liver regenerate in the heart. If your muscle
is damaged, then you're going to end up having heart
failure cardiomyopathy. So you have to act faster to recover
(09:25):
and not sustain heart muscle damage in the long term.
So when you are not sure, it's always better to
see a physician primary care. And if it's nothing, you
don't need anything done.
Speaker 1 (09:36):
Sure.
Speaker 5 (09:37):
If it's something, then you get investigated and addressed.
Speaker 3 (09:40):
The issue, and you're right you need I mean, your
heart is obviously a very important muscle in your body.
Speaker 4 (09:46):
Don't ignore it like the check engine light in the car.
Speaker 5 (09:48):
You got it exactly.
Speaker 2 (09:50):
Don't ignore it. Don't ignore it.
Speaker 4 (09:52):
One question that we had sent into us is is
it okay to have intercourse after a heart attack?
Speaker 5 (09:58):
Again, it depends on the type of heart attack you have.
So there are minor heart attacks which people can resume
sexual activity within two weeks after they have the heart attack.
There are bigger heart attacks, major heart attacks that have
major muscle damage, they have sustained significant carreomioperty, and then
(10:18):
they will have heart failure. Then those people it might
take them longer time to resume sexual activity. So all
depends on the extent of the heart attack, and we
judge also by enrolling them in cardiac rehab. Once you
have a heart attack, your cardiologist before hospitalist judge should
arrange for you to have a cardiac rehab and then
(10:40):
how you perform those few days in cardiac rehab guides
when you can resume sexual activity. But definitely for most
people after two weeks it's safe. But people who have
had complicated course after their heart attack, they might have
to wait for a few more weeks. And I think,
(11:00):
I know it's like almost a taboo, like people don't
want to discuss when they come to the follow ups,
but that's the one question. Also they should discuss is
when to resume sexual activity, when to resume driving, for instance,
and then depending on the work type, when they can
go back safely to work. Also, there are certain people
(11:20):
who just do office work, not a whole lot, sit
in the computer. Then we let them go back to
work early sure, And then there are some who we
might be operating school buses or cranes, things like that,
then we want them to complete rehab, make sure they
are fit before they can return to work for their
(11:41):
safety as well as the safety of the public. So
it depends on the type of heart attack. So it's
a very difficult question to answer. There's no blanket answer.
It depends on the type of heart attack.
Speaker 3 (11:54):
Good though the rehab what all would be entailed in
a cardiak rehab.
Speaker 5 (11:58):
So in a cardiac rehabually patients are monitored by trained
nurses and then they exercise. They start exercising on a treadmill,
so they monitor their heart rate, blood pressure and then
the more they perform, then the exercise level keeps on
increasing and then if they have issues. This cardiac rehabs
(12:19):
are located in the hospital so the cardiologist gets informed
so medications can be tightrated. Cardiacry have is very important
after you have an heart attack and then you have
also teachings. They will teach you like what to avoid,
what to do, So we encourage people to enroll cardiacry
have at least do a portion of it and then
you will get some idea. And also it's better to
(12:41):
have trained person monitoring you so you can exercise rather
than you go by yourself on a treadmill. After you
have a heart attack. The problem is people ignore their symptoms.
First after they have a stint or open heart surgery,
everything they feel is they think it's heart attack. Again.
Speaker 2 (12:58):
Sure, well it's scary.
Speaker 5 (13:00):
Exactly, so doing cardiacre having controlled environment will make it
easier for them to adapt and increase their activity level.
Speaker 3 (13:10):
Okay, Our fitness trackers and smart watches pretty reliable at
spotting heart troubles.
Speaker 2 (13:16):
Sometimes they feel seem so so wonky, like when do
I need to pay attention to that? And when am
I like? Ah, that's not right?
Speaker 5 (13:23):
Right, So it's again. Some will give you ideas, but
they're not as accurate as having a monitor put in.
But let's say if your monitor is telling you your
heart rate is irregular, you should get it checked by
a physician and have EKG done to make sure you
don't have atrial fibrillation. So it does identify certain rhythms,
(13:47):
like if you have a slow heart rate. It does
identify if you have abnormal rhythm. It will tell you,
for instance, like Apple Watch will tell you if you
have sinus, tacky cardia, Brady cardia, or A three alphibrillation.
Speaker 2 (14:01):
Those are all bad.
Speaker 5 (14:01):
I guess well, depending on against symptoms. So like some
people will come asking us to chake. For instance, their
heart rate is low at night. Low heart rate at
night is normal as long as you don't have symptoms.
But if you feel fatigue, tired, feel easy on and off,
(14:21):
then that might be the symptom of the low heart rate,
so we have to investigate. You can have sleep up now,
and then sleep up now will make you have slower
heart rates, specially at night when you sleep. That's assuming
you have a normal schedule, or when you are taking
a nap, same thing. Sleep up now will make your
heart rate drop. So heart rate less than forty, it's
(14:44):
not normal. But if you are also fit, if you
are an athlete exercise all the time, you tend to
have a resting lower heart rate than the average person,
so that is not abnormal. So that's exactly.
Speaker 3 (15:01):
Yeah, honey, But it is a very personal, case by
case basis.
Speaker 2 (15:05):
That's why.
Speaker 5 (15:06):
Exactly case by case and depending on whether you have symptoms.
So anything with symptoms always should be investigated. If you
don't have symptoms, then usually it's benine. You don't have
to worry about it.
Speaker 2 (15:18):
Let's talk about family history. I know heart disease is
a pervasive in our area and in fact across most
of the country. So if your family, if your mom,
your dad, your grandfather has had heart problems, does that
automatically mean you need to be on watch.
Speaker 5 (15:37):
So again you have to see everything into context. Yes,
family history contributes to heart disease. At the same time,
also you have to look at what your siblings had before,
like so somebody if they were smoking, and then if
you have diabetes and their A and C level is
like twelve thirteen, never controlled it, they are not eating right,
(16:01):
so that also contributes to their desast and just truly
family history, but it's one part of the history we
depend on. And then if you have really really strong,
multiple generations family history, then yes, then you have to
we do that on a younger person like we do
heart screening especially these day. Is now the letters technology
(16:24):
is coronary calcium score, which is cheaper, you get it done,
and then if you have calcium on the coronaries, now
you are at a higher risk. So you should be
treated aggressively like you will need statin treatment. You need
to change your diet, you need to exercise, so you
try to change the risk factors, modify them. Before a
(16:45):
major disaster, happens. But for anybody though, you should consider
as if, like you have a strong family history so
you can take care of yourself. Again, depending on the person,
like if the person has already a high blood pressure,
diabetes and they smoke, there is no point screening. These
are all the risk factors they have. So the family
(17:06):
history will be one part of it. But it helps
on a person who doesn't take any medications, never told
to have any problems, then if their family history suggests
that people are having major heart attack in the age
forties fifties, then they should have the screening. So now
it changes. Having seen looking at calcium on the coronaries,
(17:29):
then they will be taking statin regardless of what their
cholesterol level is.
Speaker 2 (17:34):
So the calcium test is that a blood test, is
that a blood drawer, that's.
Speaker 5 (17:38):
A city scan. So what you do is you do
city scan of the chest. You don't use any dye,
and that city scan looks for any calcium, any plaques
in the coronaries in the heart, and it doesn't tell
you whether you have a blockage or not. It just
tells whether it's any plaque in the arteries. The plaque
(17:58):
can be outside the wall, it can be inside the
wall or it might be obstructing the lumen. It's just
a screening taste and it's not invasive. You don't have
to have any IVY line, nothing, no die exposure. It's
just a little bit minimal radiation. And then you get
chest X ray same thing like chest X ray, this
(18:21):
one would be CT scan and it gives you more information.
And if the calcium score is zero, then the chances
that you will have a plaque is minimal, so you
don't have to do just lifestyle modification. But if you
have positive calcium score, then you need status. If the
calcium score is very high, then we do stress test.
Now we risk stratify the person whether they had the
(18:43):
blockage or not. So there are guidelines we follow, but
mainly it tells you how aggressive you need to be
to treat that young person who has family history of
heart problems.
Speaker 2 (18:53):
I've seen people who eat right, okay, exercise all the time,
but they have that family treat and you I've always
heard you can't outrun your genetics. You can't. So they
just need to be hyper vigilant. Oh yes, and the
rest of us need to change our diet and exercise.
Speaker 4 (19:09):
That is for sure. I think we all need to
One thing I think we have a lot of in life,
just generally speaking, is stress and anxiety. Can that cause
issues with your heart long term?
Speaker 5 (19:20):
Yes, so stress Like people who do stressful stuff, they
have a higher state of catecholambin levels. And then stress
itself causes inflammation and all these things will lead to
you to develop atrosclerotic disease. So you can have a
heart attack, you can have stroke. Ideally you should lower
(19:43):
the stress level.
Speaker 4 (19:45):
I think he just told us to go on vacation more.
Speaker 2 (19:47):
Too, maybe more yoga.
Speaker 5 (19:49):
Yes, so yoga is one part of exercising. So anything
that can reduce your stress level is better for the heart.
Stress we sp we call it stress induced heart attack
or stress induced carrio app or in other term the
Japanese called takasubu. We call it stress related heart attack.
(20:11):
So or broken heart syndrome is one part of it.
Like people will have a griefing like certain family days,
and they come up with a heart attack and we
take them do a heartcat and they don't have any blockages,
but the heart muscle is weak. There is a specific
type of movement we look at and we see the
classical one. Likely, it's good you treat them, the stress
(20:32):
reduces within a week, two, a month, the heart completely recovers.
Oh good, But it can recur if they have another
stressful event in life.
Speaker 2 (20:42):
So broken heart syndrome, it's.
Speaker 5 (20:43):
More common in females. And then we see it now
and then so to that extent, you cannot have a
heart attack.
Speaker 3 (20:50):
Oh my goodness.
Speaker 2 (20:51):
I mean I've heard of it before a bit I
have too, but did I think it was real? It's
interesting that your heart can recover from that when.
Speaker 5 (20:58):
Yeah, because the thing is it's mediated from a higher
catecholamine level. It's not from a blockage, so their arteries
are normal, but it's due to chemical changes that goes
through your body that results in the broken heart syndrome.
Speaker 2 (21:13):
That's very interesting.
Speaker 5 (21:13):
And you suppress that and then it completely recovers.
Speaker 2 (21:17):
That's amazing.
Speaker 3 (21:18):
That is amazing. Our bodies are so amazing. We just
need to give them what they need to recover. Yes,
and vacation, vacation time, rest, coffee. Failing both things, let's.
Speaker 2 (21:28):
Talk about aphib I know a lot of people have
questions about that. What exactly is that? How serious is it?
What do you do if you have it.
Speaker 5 (21:36):
Aphib is essentially the upper part of the heart chamber
is moving faster than the lower chamber. The diagnosis by
itself is associated with higher risk of stroke because since
the heart is beating not in a coordinated manner, blood
tends to stay more in the upper chamber. So that blood,
(21:56):
the more stagnant it is, the higher chance that it
came from a blood cloth. And then now that blood cloth,
if you throw it up into the brain, it causes stroke.
If it goes to the leg, it can cause leg schemia,
If it goes to the spleen, it can cause splinic
in farnctions. So a FIB should be treated. There are
different ways to treat the aphib The first thing is
(22:18):
every patient with a FIB, unless they have contraindication, they
should be on blood tener. That is mainly to prevent
the risk of the blood clot The second part of
it is to treat the heart rate. Most FI people,
they tend to have a faster heart rate and that
will give them to feel the heart fluttering or they
call it palpitations, like the heart going faster. So we
(22:42):
give medications to block the heart rate from going too fast,
and then The third part we address is after obtaining
eco cardiogram, we decide whether this person needs a trial
to be on normal rhythm or leave them in a FIB.
So most people, the first time they get diagnosed, we
try to restore normal rhythm by shocking the heart. That's
(23:05):
essentially rebooting the electrical system with the anestheesia. We shock
them and try to keep them in normal rhythm, and
we give them medications to try to keep them in
normal rhythm. If you think you are having a PHIB,
you should address it quickly because you can develop stroke,
and the stroke that's associated with FHIB with a bigger
stroke because it comes blocking bigger arteries. Yes, so the
(23:28):
neurological deficit would be bigger, so it's better to treat
it quick It's common in older people, especially after the
age of eighty, and then people who have long standing
high blood pressure, and then people who have untreated and
undiagnosed sleep up no obstructive sleep apnea are associated with that,
and then every FIV patient we see them, we do
(23:49):
stressed as to make sure they don't have blockages in
the heart artery as well, because some of the medications
they get for a fib treatment are contraindicated in a
person who had problem, so you have to make sure
there's no heart disease before like coronary artery disease, before
you give certain medications. There are rhythm medications which are contraindicated,
(24:10):
so those are also a little bit safer. So we
tend to use those medications when we see initially those
patients and then we have to do stress us to
rule out. And how you prevent it is treat the
underlying disease that predispose. Control your blood pressure well, if
you have sleep APNA, you need to wear your c PAP,
(24:30):
get diagnos, use the treatment. Exercise like like any other thing,
lose weight, eat right.
Speaker 2 (24:37):
Man, exercise and eat right.
Speaker 3 (24:38):
They just said, is exactly what you should do, isn't
it everything?
Speaker 2 (24:42):
That's the answer to everything, and we just don't do it.
Speaker 3 (24:44):
I swear We've got all that we need to succeed
in this world.
Speaker 4 (24:48):
We just need to do it.
Speaker 2 (24:49):
It seems to be the answer to almost everything that's anxiety.
Speaker 3 (24:53):
You know the same thing.
Speaker 4 (24:56):
Since we're talking about eating, can spicy or hot food
trigger pow.
Speaker 5 (25:01):
Yes? The simple answer is yes. There are chemicals from
the spicy like cap sasin is included in most of
spicy foods and it tends to cause faster heart rate.
The other thing is if you eat spicy foods, most
people tend to have acid reflex. So that's like if
you look at the anatomy of the chest, like the
(25:23):
esophagus lies behind the heart, the right atrium gets close
to that, so irritation of the esophagus will also irritate
the heart and you tend to have more palpitations. Actually,
most people who come with palpitations, if you treat the
acid reflex this is they feel better also, so it
(25:44):
has some associations and then if you are sensitive to it,
you shouldn't eat it or you have to take proton
pump inhibitors or H two blockers to reduce the reflex symptoms.
But just without having reflex. Also, the cap sussing can
make you have faster heart rate.
Speaker 4 (26:01):
So no more coffee and no more Mexican That's what
I just heard, well in motivation, But I will ask
so then how can you tell if you've got severe
heartburn or it's happening like.
Speaker 2 (26:14):
A heart attack.
Speaker 5 (26:15):
Sometimes you can't, Oh man, sometimes it's heart So that's
why we say okay. If you have a heart problem,
usually there are associated symptoms, like if you get a
heart burn. Chest pain can also present as a heartburn,
but usually you will get short winded. With the heart problem.
(26:35):
You can break into sweats and then the pain usually
goes to the jaw and arm. Like the pain you
have it can READI it up into the jaw and
in the arm, and then you will get short winded.
You can feel clammy sweaty. That one definitely it's not
acid reflex. It is. The acid reflex is just the
heart burn. And then sometimes you can if it's bad enough,
(26:57):
you can feel the taste of the acid. So that
one is and then it gets relieved. If you take
antiacid medications, it gets better quick The heart doesn't. But
it's harder for the let alone, for the average person.
Sometimes it's hard for physicians in the emergency room when
we are not sure, we observe the person for twenty
four hours, We admit them, do heart enzymes and then
(27:20):
serial EKG and if everything is fine, then you know
its reflects. You treat that and send them home. So
for the general community, I think you should see if
you have those associated symptoms. I think you should go
to the er. It's safer to get evaluated faster if
it's just a heartburn only, then you take your antiacid
(27:40):
medications and see how you do in fifteen twenty minutes.
It gets better than you are okay, But if you
continue to have symptoms, sometimes it's better to get checked
because it's not clear cat to identify. But mostly heart
problems will have other symptoms.
Speaker 2 (27:55):
Okay.
Speaker 4 (27:55):
So are you seeing more patients in the er presenting
with symptoms after like Thanksgiving and Christmas when they're eating
all these big heavy meals.
Speaker 3 (28:04):
It's yes, it's common, I figured, I mean absolutely yeah.
Speaker 5 (28:09):
Yes, even though nobody wants to come to a hospital.
Speaker 2 (28:14):
They've got first all on family, why would you want
to leave the table too? That's right, Well, we've talked
about food. What about dehydration. Does that play a part
into whether you have palpitations or how your heart can
be healthy?
Speaker 5 (28:27):
So? Yes, like if you get dehydrated, you can have palpitations. Essentially,
the simple way of explaining it is the heart is
trying to compensate, because if you are dehydrated, it's almost
like having if you are bleeding, you are losing blood.
Now the heart has to compensate. So the way it
increases the oxygen consumption to the oxygen consumption demand is
(28:51):
it increases its heart rate. How blood has to travel
faster to replenish the oxygen. So if you are dehydrated,
your volume is deplay. The heart has to compens it.
One way of increasing your cardiac output is by increasing
the heart rate. It does cause palpitation, and the treatment
is easy. Avoiding dehydration is depending on the situation awareness.
(29:13):
If you are out in the doing yard work anything
hot weather specially which we had for the last few weeks,
then you need to keep drinking hydrate yourself. The other
way it affixes if you are dehydrated, you can have
also electrolyte abnormalities. With the electrolyte abnormalities, you can have palpitations.
Your potassium can be low, your magnesium can be low,
(29:36):
and then those can lead you to have ski pits
and palpitation. So be aware of the situation what you
are doing, and you need to keep hydrating yourself and
it's easy fix.
Speaker 2 (29:46):
So we've talked about food, we've talked about water, but
we had somebody write in and ask about constipation and
could that put a strain on your heart as you
I guess.
Speaker 4 (30:00):
Have you seen heart attacks when people are having a
problem using the restroom.
Speaker 5 (30:04):
Yes, anything that puts a stress, especially not for a
young person or a healthy person. But if the person
has already heart disease. Let's say you have a weaker heart.
Now you are straining, so that maneuver puts a stress
on the heart and then you can have a heart attack.
(30:26):
So it's the same as like people they complain. Let's
say if they bend, they get short winded or they
will have discomfort. The same thing like when you bend,
you affect your dad from movement. Plus you increase your
intratastic pressure by bending, and if you have heart problem
(30:50):
to begin with, then you can have symptoms of heart failure.
Bending is common. Like when they bend like tying a
shoe or something, they would have showness of prose. So
we tell them lose weight and then we check first
make sure they don't have heart failure. They can have
pulmonary hypertension like people with obstructive sleep apnea, so we
(31:10):
tell them use your seapop religiously everything so you have
to look at it. Is it a major cause of
heart attack? Obviously not. But anything you put strained, especially
on already stressed heart, then it can have a heart attack,
but not on young person it doesn't.
Speaker 2 (31:31):
Yes, somebody young and healthy is okay. If there was
one message you wanted to get to people who are listening,
what would you want to tell them about taking care
of their heart? What habits do they need?
Speaker 5 (31:42):
You can't change your family history, so there isn't much
you can do, but there is a lot you can
do by yourself, even without seeing a physician. So like,
if you quit smoking, you reduce your risk of heart
attack and stroke close to thirty percent. That is like
(32:03):
the articles say for a patient which has CAD we
work on we give them assprien it reduces risk of
heart attack by twenty five percent. So most medications we give,
if you look at the number needed to treat to
get a benefit, it doesn't get close to just quitting smoking.
(32:23):
So if you quit smoking, you prevent heart attack and stroke.
And the other thing is if you try to increase
your activity level most days of the week, four to
five days of a week, if you walk, you don't
have to run, just walking, increasing activity, then you prevent
(32:44):
a lot of disease. Lang dise is heart disease. And
then if you watch your diet, it's simple. You try
to avoid high fat, high cholesterol diet and then avoid
frying foods as much as possible, use grilled baked stuff,
try to pick healthier choices fish, chicken, turkey instead of
(33:05):
eating all the time like burgers, burgers and misteaks.
Speaker 2 (33:11):
Wow, we have just taken away so much from Jess today. Coffee,
you know, steak, well, the joy, all the joy is left.
Speaker 5 (33:18):
Well. Coffee is okay as long as you are not
sensitive to the caffeine. So that's what. Actually, people who
drink coffee than people who didn't drink coffee. The people
who drink coffee lived longer.
Speaker 4 (33:30):
See I'm good, but.
Speaker 5 (33:32):
But it all depends on how much you consume. You
shouldn't consume more than four hundred milligrams. That's like I
think more than four caps. It's crazy, Like some people
drink a whole part and then they complain they have
having palpitations. So that's the answer, or come on, you
have to you have to account also not just simple coffee.
You have to be careful. Certain teas have also caffeine,
(33:54):
like coffee might have hundred certain teas have seventy five miligrams,
so you have to account if you drink Mountain do it.
There's also a lot of caffeine.
Speaker 6 (34:05):
Or if you do drink energy drinks like they keep
you awake, but they have some Some energy drinks can
have up to three hundred milligram caffeine, so you have
to look at that.
Speaker 5 (34:17):
So coffeine moderation is good. Anything in moderation is good,
but there are easier things and the other thing you
should do is at least you should see a family
physician once a year and have a wellness check, check
your cholesterol level and then that will guide you. If
you are going in the wrong direction, then you can
(34:38):
change your lifestyle before taking medication. If you have family history,
then get the screening tastes to see what you have,
depending on how much you can afford. City coronary cit
is very good. Like calcium scoring. You can have ultrasound
of the carotids, which we do that if we see
a plaque, we give patients to prevent risk of stroke.
(35:02):
So people who don't want to have any radiation exposure,
we can do screening taste with the vascular studies we
do ABIs we do alta sound of the cartage and
some patients even we screen them for abdomin all articandurism
if they have plaque. If they have anurism, then treatment
changes now it would be more of aggressive prevention. Overall
(35:23):
is do everything you can and then see how you
perform in the long term.
Speaker 2 (35:29):
Basically your part, Yeah, do your part. Don't just rely
on the meds. Well an exercise.
Speaker 3 (35:34):
This is real. I mean, you know, you know you
hear from your doctors, but I gotta tell you it's
really the truth.
Speaker 2 (35:39):
You gotta eat right and exercise.
Speaker 4 (35:42):
Doctor mur We are so excited to invite you in
the entire hard and vascular team next door the Peerage
Medical Complex because I think it's really really going to
be awesome for all of us and all of the community.
Speaker 2 (35:53):
Community and the amount of experience that has headed our
way one hundred and sixty eight years of experience taking
care of people. We're thrilled to have you on board.
Speaker 5 (36:02):
Yes, and we thank you having us.
Speaker 3 (36:04):
Yes, thank you so much for talking with us today too.
To give us a little bit of a background. I mean,
these are questions that people need to know about. We've
got Sadly, we have a lot of heart disease in
the area, so it's much needed. So I think that
wraps up our talk with doctor Maru. Thank you so much,
sir and Jess Melanie. I have a few other providers
(36:26):
lined up for the next TMI and we will be
back with you in about a month, so stay tuned
and we'll talk to you this see soon by
The content shared on this podcast is for informational and
educational purposes only and should not be gets strewed as
medical advice. While we strive to provide accurate and up
to date information, the host and producers make no representations
or warranties regarding the accuracy, reliability, or completeness of the
information presented. Medical information this constantly evolving, and what is
discussed may not reflect the most current research or guidelines.
This podcast is not a substitute for professional medical advice, diagnosis,
(00:21):
or treatment. Always seek the advice of your physician or
other qualified healthcare provider with any questions you may have
regarding a medical condition or treatment. If you are experiencing
a medical emergency, please call emergency services immediately. By listening
to this podcast, you acknowledge and agree that the host
and producers are not liable for any decisions or actions
taken based on the information provided.
Speaker 2 (00:40):
This is TMI Talking Medical Information with Value Health.
Speaker 3 (00:45):
Hello everybody, we are back with another episode of TMI
Talking Medical Information with Value Health. And I've got my
Value girls alongside me once again. Just Staple Hey, Happy Friday. Hey,
and we've gotten Melanie ad kids yep here and ready
to go. Okay, and so something really exciting is happening
(01:06):
at Valley Health right now. The Cardiology department. Hello, y'all
have just opened this.
Speaker 2 (01:11):
We've got three cardiologists and three mid levels, twenty two
exam rooms, and all kinds of wonderful things to take
care of whatever your need is cardiovascular wise. We are
ready to see anyone in town, Valley patient or not,
so come on over and let us take care of you.
Speaker 4 (01:26):
One of the coolest things that we have going on
is we are going to be offering all kinds of
advanced cardiac testing and imaging in house, so our patients
don't have to go and sit at a hospital or
another facility. They get to come right here have that
testing done on site. See that's perfect, that's what you want.
And Valley Health offers all of this here.
Speaker 3 (01:46):
And we're also talking to doctor Maru today, who is
a cardiologist.
Speaker 2 (01:50):
Hello, doctor Maru.
Speaker 3 (01:52):
Hi, So tell us a little bit about your background, Sir.
Speaker 5 (01:55):
I was born in Brooklyn, New York, but I did
my medical school in Ethiopia. Since my family moved back
to practice medicine. My dad as a cardiologist, so he
wanted to set up a medical school back home, so
he moved while I was a kid. So I finished
med school in Ethiopia and then joined Marshall to do residency.
(02:19):
So after the residency, I joined again Marshall Cardiology to
do the cardiovascular training and interventions. Since then I have
worked with HIMG and Saint Mary's and now Valley Hills,
which we are very excited about.
Speaker 3 (02:37):
Well, that is an extensive background as well. So I
think we know that you can absolutely answer all of
our questions today.
Speaker 5 (02:44):
Right, We'll try my best.
Speaker 2 (02:47):
He'll give us the lowdown, tell us what to watch
for for sure.
Speaker 3 (02:49):
Absolutely, And actually I was looking over some of these
questions and I got to tell you just a few
years ago, I had an incident where I pulled a
back muscle. But it was such a bad pull that
it was like radiating through my chest. So when I
went to the hospital and I told them my symptoms,
I was like, yeah, I have some chest pain. Like
four nurses came out to get me and take me back.
I was like, oh my gosh, am I having a
heart attack. So I was freaking out. So I'm glad
(03:11):
that you're here today so we could talk to you
about this.
Speaker 4 (03:14):
This one hits home for me. I start my day
off with at least a pot of coffee, and sometimes
I find that my heart likes to raise or beat
really really, I mean like beating out of my chest.
Is that normal and why does.
Speaker 5 (03:28):
It do that? Caffeine consumption has good value for the
heart as long as it's done in moderation. So the
idea is the FDA recommends like four to five cups
a day, assuming that your cap has closed to seventy
five too one hundred milligrams caffeine in them. So the
maximum consumption healthier is around four hundred miligrams. But it
(03:52):
depends on individuals. So some people will have one cup
of coffee they are fine. Some people can have four
the whole four hundred melegrams and then they are okay,
they can sleep. They can have two cups and then
they will experience palpitations, jittery, anxiety, tremors. So if you
are sensitive to caffeine, then you should have lesser amount.
(04:15):
If you can tolerate, then it's ideal. So it does
give palpitations heart issues for older people who have heart
rhythm problems will recom in lesser consumption. For a younger
person than They can consume up to four to five
cups without any issues. So it depends on how sensitive
you are. So if you are sensitive to caffeine, then
(04:35):
you need to cut down.
Speaker 2 (04:36):
So if she's shaking and sweating, she might want to
walk back a little bit. That would be a little
sensitive too, okasive, not as much coffee before I get here?
Speaker 4 (04:44):
Just all they want?
Speaker 5 (04:45):
Got it?
Speaker 1 (04:45):
Does?
Speaker 2 (04:46):
Actually? Maybe just switch to green tea. Okay, that's good
for you. Yeah, chill out, shell out. I have a
question too. Sometimes I will just be in the course
of my normal day and this sounds crazy, but I
feel like my heart flips almost and like I have
to cough to get it back in rhythm. Oh wow, melanies, stop,
it's fine, I mean fine, Okay? Is that normal? Is
(05:08):
that a sign of like, so sister's got a problem.
Speaker 5 (05:11):
So that that's non normal. If you have that, then
the are This is one of the part of advanced
cardiac testing we do here, so in those instances it
can be rhythm issues like that are what we call
paroxysmal supraven to cloud taki cardias, where the upper chamber
of the heart goes faster than the lower. Usually they
(05:34):
are benign, but they can be treated with better blockers.
And then sometimes if they have some symptoms, like people
will feel dizziness, lightheadedness, or they get short winded. If
they have symptoms with that, then it needs to be investigated.
But if it's short lasting, no symptoms, then usually we
(05:57):
recommend cutting down the caffeine and some stop I should
take care of.
Speaker 2 (06:03):
I'm kidding. It's been happening since college though you know
in college was there, which was only a couple of
years ago. Whatever, So I mean, I just I had
a lot of caffeine consumption obviously through college and being
a mom. We rack caffeine pretty hard. So I'll out
of mind. But I don't have any symptoms, so but
that is good.
Speaker 3 (06:21):
I've always have any symptoms. Except you do have a
heart that feels like it flips. I mean, that's that's
all I can.
Speaker 2 (06:26):
Yeah, but if I cough it kind of it just
automatically it goes away.
Speaker 5 (06:31):
Yeah, for the most part, you should have dizy spells
or light headedness, shortness of press done. Those needs to
be investigated. And also we do blood work, so some
people who have low blood count anemia can have that
if their tyroid function is abnormal, so the TSH level
has to be checked, so there are preliminary blood works
(06:52):
we do. In some people we even do monitoring like
Halter or event monitor. They will wear a monitor to
see what exactly is going on, and then in few
people also we do echo cardiogram to make sure the
heart has no structural abnormalities. But for the most part,
it's benigh as long as there is no symptom.
Speaker 2 (07:11):
Thanks doctor Marue.
Speaker 3 (07:12):
Do you love how women usually wait like a good
ten to twenty years before they have all right, yeah,
they're like, oh, yeah, it's been going for a while,
it's not a big deal. But though, so I do
have a question. Then they talk about a silent heart
attack where you don't actually even know that you're having
a heart attack. Sometimes you just feel like a fullness
or like a weight, like maybe in your chest or
even in your stomach, and you're like, Eh, it's no
(07:34):
big deal, I'll be fine, But how serious can that be?
Speaker 5 (07:38):
So if you really closely investigate, they have symptoms that
are not typical of a heart attack. They might have
felt like a heartburn and then they will say it's
a heartburnd. They will ignore it, but they are having
a heart attack, so at a later date you find
out that they have a heart attack, so we call
them silent heart attack. But truly, especially in women, they
(08:02):
ignore the symptoms and some of the symptoms they have
is a little bit different than in guys, so they
have a tendency to tolerate pain more ignore symptoms more
so the disease gets diagnosed later. And then in diabetes
patients with diabetic abnormalities, they can truly have a symptomatic
(08:23):
heart attack because like the nerves are different, like they
will have neuroperty symptoms, they don't have the typical chest
beIN but most of them, if you look at it
in detail, they will let you know that they have
been short winded easily whenever they do stuff or they
associated to age, like they slow down because they are
(08:44):
getting older, rather than assuming they had pluckage in the
heart that's slowing them down. So it is a well
known fact and people should take their symptoms seriously, see
their primary care provider, get checked to avoid having the
heart muscle damage because we call it like time wasted
(09:04):
is muscle infarcted and heart muscle doesn't regenerate. So if
you have a liver damage, people can give a portion
of their liver for transplant and then within three six
months the liver regenerate in the heart. If your muscle
is damaged, then you're going to end up having heart
failure cardiomyopathy. So you have to act faster to recover
(09:25):
and not sustain heart muscle damage in the long term.
So when you are not sure, it's always better to
see a physician primary care. And if it's nothing, you
don't need anything done.
Speaker 1 (09:36):
Sure.
Speaker 5 (09:37):
If it's something, then you get investigated and addressed.
Speaker 3 (09:40):
The issue, and you're right you need I mean, your
heart is obviously a very important muscle in your body.
Speaker 4 (09:46):
Don't ignore it like the check engine light in the car.
Speaker 5 (09:48):
You got it exactly.
Speaker 2 (09:50):
Don't ignore it. Don't ignore it.
Speaker 4 (09:52):
One question that we had sent into us is is
it okay to have intercourse after a heart attack?
Speaker 5 (09:58):
Again, it depends on the type of heart attack you have.
So there are minor heart attacks which people can resume
sexual activity within two weeks after they have the heart attack.
There are bigger heart attacks, major heart attacks that have
major muscle damage, they have sustained significant carreomioperty, and then
(10:18):
they will have heart failure. Then those people it might
take them longer time to resume sexual activity. So all
depends on the extent of the heart attack, and we
judge also by enrolling them in cardiac rehab. Once you
have a heart attack, your cardiologist before hospitalist judge should
arrange for you to have a cardiac rehab and then
(10:40):
how you perform those few days in cardiac rehab guides
when you can resume sexual activity. But definitely for most
people after two weeks it's safe. But people who have
had complicated course after their heart attack, they might have
to wait for a few more weeks. And I think,
(11:00):
I know it's like almost a taboo, like people don't
want to discuss when they come to the follow ups,
but that's the one question. Also they should discuss is
when to resume sexual activity, when to resume driving, for instance,
and then depending on the work type, when they can
go back safely to work. Also, there are certain people
(11:20):
who just do office work, not a whole lot, sit
in the computer. Then we let them go back to
work early sure, And then there are some who we
might be operating school buses or cranes, things like that,
then we want them to complete rehab, make sure they
are fit before they can return to work for their
(11:41):
safety as well as the safety of the public. So
it depends on the type of heart attack. So it's
a very difficult question to answer. There's no blanket answer.
It depends on the type of heart attack.
Speaker 3 (11:54):
Good though the rehab what all would be entailed in
a cardiak rehab.
Speaker 5 (11:58):
So in a cardiac rehabually patients are monitored by trained
nurses and then they exercise. They start exercising on a treadmill,
so they monitor their heart rate, blood pressure and then
the more they perform, then the exercise level keeps on
increasing and then if they have issues. This cardiac rehabs
(12:19):
are located in the hospital so the cardiologist gets informed
so medications can be tightrated. Cardiacry have is very important
after you have an heart attack and then you have
also teachings. They will teach you like what to avoid,
what to do, So we encourage people to enroll cardiacry
have at least do a portion of it and then
you will get some idea. And also it's better to
(12:41):
have trained person monitoring you so you can exercise rather
than you go by yourself on a treadmill. After you
have a heart attack. The problem is people ignore their symptoms.
First after they have a stint or open heart surgery,
everything they feel is they think it's heart attack. Again.
Speaker 2 (12:58):
Sure, well it's scary.
Speaker 5 (13:00):
Exactly, so doing cardiacre having controlled environment will make it
easier for them to adapt and increase their activity level.
Speaker 3 (13:10):
Okay, Our fitness trackers and smart watches pretty reliable at
spotting heart troubles.
Speaker 2 (13:16):
Sometimes they feel seem so so wonky, like when do
I need to pay attention to that? And when am
I like? Ah, that's not right?
Speaker 5 (13:23):
Right, So it's again. Some will give you ideas, but
they're not as accurate as having a monitor put in.
But let's say if your monitor is telling you your
heart rate is irregular, you should get it checked by
a physician and have EKG done to make sure you
don't have atrial fibrillation. So it does identify certain rhythms,
(13:47):
like if you have a slow heart rate. It does
identify if you have abnormal rhythm. It will tell you,
for instance, like Apple Watch will tell you if you
have sinus, tacky cardia, Brady cardia, or A three alphibrillation.
Speaker 2 (14:01):
Those are all bad.
Speaker 5 (14:01):
I guess well, depending on against symptoms. So like some
people will come asking us to chake. For instance, their
heart rate is low at night. Low heart rate at
night is normal as long as you don't have symptoms.
But if you feel fatigue, tired, feel easy on and off,
(14:21):
then that might be the symptom of the low heart rate,
so we have to investigate. You can have sleep up now,
and then sleep up now will make you have slower
heart rates, specially at night when you sleep. That's assuming
you have a normal schedule, or when you are taking
a nap, same thing. Sleep up now will make your
heart rate drop. So heart rate less than forty, it's
(14:44):
not normal. But if you are also fit, if you
are an athlete exercise all the time, you tend to
have a resting lower heart rate than the average person,
so that is not abnormal. So that's exactly.
Speaker 3 (15:01):
Yeah, honey, But it is a very personal, case by
case basis.
Speaker 2 (15:05):
That's why.
Speaker 5 (15:06):
Exactly case by case and depending on whether you have symptoms.
So anything with symptoms always should be investigated. If you
don't have symptoms, then usually it's benine. You don't have
to worry about it.
Speaker 2 (15:18):
Let's talk about family history. I know heart disease is
a pervasive in our area and in fact across most
of the country. So if your family, if your mom,
your dad, your grandfather has had heart problems, does that
automatically mean you need to be on watch.
Speaker 5 (15:37):
So again you have to see everything into context. Yes,
family history contributes to heart disease. At the same time,
also you have to look at what your siblings had before,
like so somebody if they were smoking, and then if
you have diabetes and their A and C level is
like twelve thirteen, never controlled it, they are not eating right,
(16:01):
so that also contributes to their desast and just truly
family history, but it's one part of the history we
depend on. And then if you have really really strong,
multiple generations family history, then yes, then you have to
we do that on a younger person like we do
heart screening especially these day. Is now the letters technology
(16:24):
is coronary calcium score, which is cheaper, you get it done,
and then if you have calcium on the coronaries, now
you are at a higher risk. So you should be
treated aggressively like you will need statin treatment. You need
to change your diet, you need to exercise, so you
try to change the risk factors, modify them. Before a
(16:45):
major disaster, happens. But for anybody though, you should consider
as if, like you have a strong family history so
you can take care of yourself. Again, depending on the person,
like if the person has already a high blood pressure,
diabetes and they smoke, there is no point screening. These
are all the risk factors they have. So the family
(17:06):
history will be one part of it. But it helps
on a person who doesn't take any medications, never told
to have any problems, then if their family history suggests
that people are having major heart attack in the age
forties fifties, then they should have the screening. So now
it changes. Having seen looking at calcium on the coronaries,
(17:29):
then they will be taking statin regardless of what their
cholesterol level is.
Speaker 2 (17:34):
So the calcium test is that a blood test, is
that a blood drawer, that's.
Speaker 5 (17:38):
A city scan. So what you do is you do
city scan of the chest. You don't use any dye,
and that city scan looks for any calcium, any plaques
in the coronaries in the heart, and it doesn't tell
you whether you have a blockage or not. It just
tells whether it's any plaque in the arteries. The plaque
(17:58):
can be outside the wall, it can be inside the
wall or it might be obstructing the lumen. It's just
a screening taste and it's not invasive. You don't have
to have any IVY line, nothing, no die exposure. It's
just a little bit minimal radiation. And then you get
chest X ray same thing like chest X ray, this
(18:21):
one would be CT scan and it gives you more information.
And if the calcium score is zero, then the chances
that you will have a plaque is minimal, so you
don't have to do just lifestyle modification. But if you
have positive calcium score, then you need status. If the
calcium score is very high, then we do stress test.
Now we risk stratify the person whether they had the
(18:43):
blockage or not. So there are guidelines we follow, but
mainly it tells you how aggressive you need to be
to treat that young person who has family history of
heart problems.
Speaker 2 (18:53):
I've seen people who eat right, okay, exercise all the time,
but they have that family treat and you I've always
heard you can't outrun your genetics. You can't. So they
just need to be hyper vigilant. Oh yes, and the
rest of us need to change our diet and exercise.
Speaker 4 (19:09):
That is for sure. I think we all need to
One thing I think we have a lot of in life,
just generally speaking, is stress and anxiety. Can that cause
issues with your heart long term?
Speaker 5 (19:20):
Yes, so stress Like people who do stressful stuff, they
have a higher state of catecholambin levels. And then stress
itself causes inflammation and all these things will lead to
you to develop atrosclerotic disease. So you can have a
heart attack, you can have stroke. Ideally you should lower
(19:43):
the stress level.
Speaker 4 (19:45):
I think he just told us to go on vacation more.
Speaker 2 (19:47):
Too, maybe more yoga.
Speaker 5 (19:49):
Yes, so yoga is one part of exercising. So anything
that can reduce your stress level is better for the heart.
Stress we sp we call it stress induced heart attack
or stress induced carrio app or in other term the
Japanese called takasubu. We call it stress related heart attack.
(20:11):
So or broken heart syndrome is one part of it.
Like people will have a griefing like certain family days,
and they come up with a heart attack and we
take them do a heartcat and they don't have any blockages,
but the heart muscle is weak. There is a specific
type of movement we look at and we see the
classical one. Likely, it's good you treat them, the stress
(20:32):
reduces within a week, two, a month, the heart completely recovers.
Oh good, But it can recur if they have another
stressful event in life.
Speaker 2 (20:42):
So broken heart syndrome, it's.
Speaker 5 (20:43):
More common in females. And then we see it now
and then so to that extent, you cannot have a
heart attack.
Speaker 3 (20:50):
Oh my goodness.
Speaker 2 (20:51):
I mean I've heard of it before a bit I
have too, but did I think it was real? It's
interesting that your heart can recover from that when.
Speaker 5 (20:58):
Yeah, because the thing is it's mediated from a higher
catecholamine level. It's not from a blockage, so their arteries
are normal, but it's due to chemical changes that goes
through your body that results in the broken heart syndrome.
Speaker 2 (21:13):
That's very interesting.
Speaker 5 (21:13):
And you suppress that and then it completely recovers.
Speaker 2 (21:17):
That's amazing.
Speaker 3 (21:18):
That is amazing. Our bodies are so amazing. We just
need to give them what they need to recover. Yes,
and vacation, vacation time, rest, coffee. Failing both things, let's.
Speaker 2 (21:28):
Talk about aphib I know a lot of people have
questions about that. What exactly is that? How serious is it?
What do you do if you have it.
Speaker 5 (21:36):
Aphib is essentially the upper part of the heart chamber
is moving faster than the lower chamber. The diagnosis by
itself is associated with higher risk of stroke because since
the heart is beating not in a coordinated manner, blood
tends to stay more in the upper chamber. So that blood,
(21:56):
the more stagnant it is, the higher chance that it
came from a blood cloth. And then now that blood cloth,
if you throw it up into the brain, it causes stroke.
If it goes to the leg, it can cause leg schemia,
If it goes to the spleen, it can cause splinic
in farnctions. So a FIB should be treated. There are
different ways to treat the aphib The first thing is
(22:18):
every patient with a FIB, unless they have contraindication, they
should be on blood tener. That is mainly to prevent
the risk of the blood clot The second part of
it is to treat the heart rate. Most FI people,
they tend to have a faster heart rate and that
will give them to feel the heart fluttering or they
call it palpitations, like the heart going faster. So we
(22:42):
give medications to block the heart rate from going too fast,
and then The third part we address is after obtaining
eco cardiogram, we decide whether this person needs a trial
to be on normal rhythm or leave them in a FIB.
So most people, the first time they get diagnosed, we
try to restore normal rhythm by shocking the heart. That's
(23:05):
essentially rebooting the electrical system with the anestheesia. We shock
them and try to keep them in normal rhythm, and
we give them medications to try to keep them in
normal rhythm. If you think you are having a PHIB,
you should address it quickly because you can develop stroke,
and the stroke that's associated with FHIB with a bigger
stroke because it comes blocking bigger arteries. Yes, so the
(23:28):
neurological deficit would be bigger, so it's better to treat
it quick It's common in older people, especially after the
age of eighty, and then people who have long standing
high blood pressure, and then people who have untreated and
undiagnosed sleep up no obstructive sleep apnea are associated with that,
and then every FIV patient we see them, we do
(23:49):
stressed as to make sure they don't have blockages in
the heart artery as well, because some of the medications
they get for a fib treatment are contraindicated in a
person who had problem, so you have to make sure
there's no heart disease before like coronary artery disease, before
you give certain medications. There are rhythm medications which are contraindicated,
(24:10):
so those are also a little bit safer. So we
tend to use those medications when we see initially those
patients and then we have to do stress us to
rule out. And how you prevent it is treat the
underlying disease that predispose. Control your blood pressure well, if
you have sleep APNA, you need to wear your c PAP,
(24:30):
get diagnos, use the treatment. Exercise like like any other thing,
lose weight, eat right.
Speaker 2 (24:37):
Man, exercise and eat right.
Speaker 3 (24:38):
They just said, is exactly what you should do, isn't
it everything?
Speaker 2 (24:42):
That's the answer to everything, and we just don't do it.
Speaker 3 (24:44):
I swear We've got all that we need to succeed
in this world.
Speaker 4 (24:48):
We just need to do it.
Speaker 2 (24:49):
It seems to be the answer to almost everything that's anxiety.
Speaker 3 (24:53):
You know the same thing.
Speaker 4 (24:56):
Since we're talking about eating, can spicy or hot food
trigger pow.
Speaker 5 (25:01):
Yes? The simple answer is yes. There are chemicals from
the spicy like cap sasin is included in most of
spicy foods and it tends to cause faster heart rate.
The other thing is if you eat spicy foods, most
people tend to have acid reflex. So that's like if
you look at the anatomy of the chest, like the
(25:23):
esophagus lies behind the heart, the right atrium gets close
to that, so irritation of the esophagus will also irritate
the heart and you tend to have more palpitations. Actually,
most people who come with palpitations, if you treat the
acid reflex this is they feel better also, so it
(25:44):
has some associations and then if you are sensitive to it,
you shouldn't eat it or you have to take proton
pump inhibitors or H two blockers to reduce the reflex symptoms.
But just without having reflex. Also, the cap sussing can
make you have faster heart rate.
Speaker 4 (26:01):
So no more coffee and no more Mexican That's what
I just heard, well in motivation, But I will ask
so then how can you tell if you've got severe
heartburn or it's happening like.
Speaker 2 (26:14):
A heart attack.
Speaker 5 (26:15):
Sometimes you can't, Oh man, sometimes it's heart So that's
why we say okay. If you have a heart problem,
usually there are associated symptoms, like if you get a
heart burn. Chest pain can also present as a heartburn,
but usually you will get short winded. With the heart problem.
(26:35):
You can break into sweats and then the pain usually
goes to the jaw and arm. Like the pain you
have it can READI it up into the jaw and
in the arm, and then you will get short winded.
You can feel clammy sweaty. That one definitely it's not
acid reflex. It is. The acid reflex is just the
heart burn. And then sometimes you can if it's bad enough,
(26:57):
you can feel the taste of the acid. So that
one is and then it gets relieved. If you take
antiacid medications, it gets better quick The heart doesn't. But
it's harder for the let alone, for the average person.
Sometimes it's hard for physicians in the emergency room when
we are not sure, we observe the person for twenty
four hours, We admit them, do heart enzymes and then
(27:20):
serial EKG and if everything is fine, then you know
its reflects. You treat that and send them home. So
for the general community, I think you should see if
you have those associated symptoms. I think you should go
to the er. It's safer to get evaluated faster if
it's just a heartburn only, then you take your antiacid
(27:40):
medications and see how you do in fifteen twenty minutes.
It gets better than you are okay, But if you
continue to have symptoms, sometimes it's better to get checked
because it's not clear cat to identify. But mostly heart
problems will have other symptoms.
Speaker 2 (27:55):
Okay.
Speaker 4 (27:55):
So are you seeing more patients in the er presenting
with symptoms after like Thanksgiving and Christmas when they're eating
all these big heavy meals.
Speaker 3 (28:04):
It's yes, it's common, I figured, I mean absolutely yeah.
Speaker 5 (28:09):
Yes, even though nobody wants to come to a hospital.
Speaker 2 (28:14):
They've got first all on family, why would you want
to leave the table too? That's right, Well, we've talked
about food. What about dehydration. Does that play a part
into whether you have palpitations or how your heart can
be healthy?
Speaker 5 (28:27):
So? Yes, like if you get dehydrated, you can have palpitations. Essentially,
the simple way of explaining it is the heart is
trying to compensate, because if you are dehydrated, it's almost
like having if you are bleeding, you are losing blood.
Now the heart has to compensate. So the way it
increases the oxygen consumption to the oxygen consumption demand is
(28:51):
it increases its heart rate. How blood has to travel
faster to replenish the oxygen. So if you are dehydrated,
your volume is deplay. The heart has to compens it.
One way of increasing your cardiac output is by increasing
the heart rate. It does cause palpitation, and the treatment
is easy. Avoiding dehydration is depending on the situation awareness.
(29:13):
If you are out in the doing yard work anything
hot weather specially which we had for the last few weeks,
then you need to keep drinking hydrate yourself. The other
way it affixes if you are dehydrated, you can have
also electrolyte abnormalities. With the electrolyte abnormalities, you can have palpitations.
Your potassium can be low, your magnesium can be low,
(29:36):
and then those can lead you to have ski pits
and palpitation. So be aware of the situation what you
are doing, and you need to keep hydrating yourself and
it's easy fix.
Speaker 2 (29:46):
So we've talked about food, we've talked about water, but
we had somebody write in and ask about constipation and
could that put a strain on your heart as you
I guess.
Speaker 4 (30:00):
Have you seen heart attacks when people are having a
problem using the restroom.
Speaker 5 (30:04):
Yes, anything that puts a stress, especially not for a
young person or a healthy person. But if the person
has already heart disease. Let's say you have a weaker heart.
Now you are straining, so that maneuver puts a stress
on the heart and then you can have a heart attack.
(30:26):
So it's the same as like people they complain. Let's
say if they bend, they get short winded or they
will have discomfort. The same thing like when you bend,
you affect your dad from movement. Plus you increase your
intratastic pressure by bending, and if you have heart problem
(30:50):
to begin with, then you can have symptoms of heart failure.
Bending is common. Like when they bend like tying a
shoe or something, they would have showness of prose. So
we tell them lose weight and then we check first
make sure they don't have heart failure. They can have
pulmonary hypertension like people with obstructive sleep apnea, so we
(31:10):
tell them use your seapop religiously everything so you have
to look at it. Is it a major cause of
heart attack? Obviously not. But anything you put strained, especially
on already stressed heart, then it can have a heart attack,
but not on young person it doesn't.
Speaker 2 (31:31):
Yes, somebody young and healthy is okay. If there was
one message you wanted to get to people who are listening,
what would you want to tell them about taking care
of their heart? What habits do they need?
Speaker 5 (31:42):
You can't change your family history, so there isn't much
you can do, but there is a lot you can
do by yourself, even without seeing a physician. So like,
if you quit smoking, you reduce your risk of heart
attack and stroke close to thirty percent. That is like
(32:03):
the articles say for a patient which has CAD we
work on we give them assprien it reduces risk of
heart attack by twenty five percent. So most medications we give,
if you look at the number needed to treat to
get a benefit, it doesn't get close to just quitting smoking.
(32:23):
So if you quit smoking, you prevent heart attack and stroke.
And the other thing is if you try to increase
your activity level most days of the week, four to
five days of a week, if you walk, you don't
have to run, just walking, increasing activity, then you prevent
(32:44):
a lot of disease. Lang dise is heart disease. And
then if you watch your diet, it's simple. You try
to avoid high fat, high cholesterol diet and then avoid
frying foods as much as possible, use grilled baked stuff,
try to pick healthier choices fish, chicken, turkey instead of
(33:05):
eating all the time like burgers, burgers and misteaks.
Speaker 2 (33:11):
Wow, we have just taken away so much from Jess today. Coffee,
you know, steak, well, the joy, all the joy is left.
Speaker 5 (33:18):
Well. Coffee is okay as long as you are not
sensitive to the caffeine. So that's what. Actually, people who
drink coffee than people who didn't drink coffee. The people
who drink coffee lived longer.
Speaker 4 (33:30):
See I'm good, but.
Speaker 5 (33:32):
But it all depends on how much you consume. You
shouldn't consume more than four hundred milligrams. That's like I
think more than four caps. It's crazy, Like some people
drink a whole part and then they complain they have
having palpitations. So that's the answer, or come on, you
have to you have to account also not just simple coffee.
You have to be careful. Certain teas have also caffeine,
(33:54):
like coffee might have hundred certain teas have seventy five miligrams,
so you have to account if you drink Mountain do it.
There's also a lot of caffeine.
Speaker 6 (34:05):
Or if you do drink energy drinks like they keep
you awake, but they have some Some energy drinks can
have up to three hundred milligram caffeine, so you have
to look at that.
Speaker 5 (34:17):
So coffeine moderation is good. Anything in moderation is good,
but there are easier things and the other thing you
should do is at least you should see a family
physician once a year and have a wellness check, check
your cholesterol level and then that will guide you. If
you are going in the wrong direction, then you can
(34:38):
change your lifestyle before taking medication. If you have family history,
then get the screening tastes to see what you have,
depending on how much you can afford. City coronary cit
is very good. Like calcium scoring. You can have ultrasound
of the carotids, which we do that if we see
a plaque, we give patients to prevent risk of stroke.
(35:02):
So people who don't want to have any radiation exposure,
we can do screening taste with the vascular studies we
do ABIs we do alta sound of the cartage and
some patients even we screen them for abdomin all articandurism
if they have plaque. If they have anurism, then treatment
changes now it would be more of aggressive prevention. Overall
(35:23):
is do everything you can and then see how you
perform in the long term.
Speaker 2 (35:29):
Basically your part, Yeah, do your part. Don't just rely
on the meds. Well an exercise.
Speaker 3 (35:34):
This is real. I mean, you know, you know you
hear from your doctors, but I gotta tell you it's
really the truth.
Speaker 2 (35:39):
You gotta eat right and exercise.
Speaker 4 (35:42):
Doctor mur We are so excited to invite you in
the entire hard and vascular team next door the Peerage
Medical Complex because I think it's really really going to
be awesome for all of us and all of the community.
Speaker 2 (35:53):
Community and the amount of experience that has headed our
way one hundred and sixty eight years of experience taking
care of people. We're thrilled to have you on board.
Speaker 5 (36:02):
Yes, and we thank you having us.
Speaker 3 (36:04):
Yes, thank you so much for talking with us today too.
To give us a little bit of a background. I mean,
these are questions that people need to know about. We've
got Sadly, we have a lot of heart disease in
the area, so it's much needed. So I think that
wraps up our talk with doctor Maru. Thank you so much,
sir and Jess Melanie. I have a few other providers
(36:26):
lined up for the next TMI and we will be
back with you in about a month, so stay tuned
and we'll talk to you this see soon by
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