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Heart health

Most Americans assume their heart is in pretty good shape until something happens to tell them otherwise. But it's best to know about your heart health before there's a problem.

Heart disease is the No. 1 killer of both men and women in this country, often striking without prior warning.

We know that heart disease often develops at a young age, silently laying the groundwork for a disabling or fatal heart attack several decades later.

How healthy is your heart?

Most Americans assume their heart is in pretty good shape until something happens to tell them otherwise — severe pain in the chest, inability to exercise without shortness of breath, or a heart attack.

The ideal, of course, is to know what’s happening inside the heart and blood vessels so that problems can be headed off early and there are numerous, simple tests that can do just that.

Tests and screenings

One of the easiest and most effective is one that your doctor or nurse probably performs every time you visit your primary care doctor, a reading of your blood pressure. High blood pressure is anything greater than 130 and above (top number) or 80 and above (lower number) can be a sign of early developing heart disease. And, if left uncontrolled, hypertension causes irreversible damage to both the heart and blood vessels. Fortunately, blood pressure is easily controlled with diet, exercise and medications.

High cholesterol may be an even more important risk factor, and cholesterol testing is recommended at least once every five years for adults age 20 and older and more frequently after age 50. A complete lipid profile — measuring total cholesterol including LDL, HDL and triglycerides — can be accomplished with a simple fasting blood test. When cholesterol is mildly elevated, a change in diet and exercise may be recommended. When it’s significantly elevated, or if other risk factors exist, a doctor may prescribe cholesterol-lowering medications.

What your doctor listens for when checking your heart

Whether it’s for a checkup or an illness-specific appointment, your provider usually will pull out his or her stethoscope, and as he or she listens to different areas of your chest you may also be asked to take several deep breaths. Have you ever wondered exactly what your provider is listening for?

The sounds our hearts make can warn of several different issues. Typically, your heart should be sounding out a regular, steady rhythm with a strong beat of about 60 to 100 times per minute. A heart sound is produced by the closing of your heart valve, a sound that is described as a “lub” noise as the valves between the atria and ventricles close and a “dub” noise as valves between the ventricles and large blood vessels close. If your provider hears a rapid or irregular heartbeat, a heart murmur or additional heart sounds, further testing could be needed to rule out the following potential issues.

Heart murmur

A heart murmur is essentially a noise, not a specific disease. Murmurs are generated by the turbulent flow of blood inside or outside the heart. They can be innocent or abnormal. An innocent heart murmur is one that is not indicative of any underlying health problems, and may disappear over time.

Abnormal heart murmurs are often caused by valve or blood flow abnormalities. Your provider will try to determine whether a murmur is innocent or abnormal and a sign of a health issue by listening to your heartbeat and assessing how long the murmur lasts, when it happens, what activities prompt it and where it is the loudest. An echocardiogram (ultrasound of the heart) may be needed for further clarification.

Rapid and irregular heartbeats

If your heart is beating rapidly or at irregular intervals, you might have an arrhythmia (abnormal heart rhythm). Your provider will determine if you require additional testing like an electrocardiogram (EKG) or a cardiac monitor.

Additional heart sounds

Other heart sounds may suggest heart failure. The signs and symptoms of heart failure could include shortness of breath, a persistent coughing or wheezing, shortness of breath and swelling in the legs, ankles and feet. If you are experiencing any of these, your provider will run further tests to determine what the specific problem is.

What to do if your heart rhythm is abnormal

If you feel that your heart rhythm is abnormal, it’s important to schedule a visit with your provider. Even if it ends up being a normal finding, such as simple extra heartbeats, you, and your heart, will benefit from the peace of mind.

Heart health is important. Making heart-healthy food and fitness choices as well as careful monitoring of chronic medical conditions and seeing your doctor regularly can help save lives from this often silent killer.

Dr. Richard Clark is a board-certified, family medicine physician with Wheaton Franciscan Medical Group, part of Ascension, seeing patients at 2408 Four Mile Road in Racine.


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