Heart Month: The Latest on Heart Disease | Connecting Point | Feb. 25, 2020

Heart Month: The Latest on Heart Disease | Connecting Point | Feb. 25, 2020


>>FEBRUARY IS HEART MONTH, AND
IN THIS SEGMENT WE TAKE A LOOK AT THE NEWEST PROCEDURES TO HELP
PEOPLE WITH HEART DISEASE, AND TALK PREVENTION WITH MEDICAL
EXPERTS. CAROLEE MCGRATH SAT DOWN WITH
DR. AARON KUGELMASS, VICE
PRESIDENT AND MEDICAL DIRECTOR OF THE HEART AND VASCULAR
PROGRAM AT BAYSTATE MEDICAL CENTER AND DR. THOMAS SCHWANN,
ASSOCIATE DIRECTOR OF THE HEART AND VASCULAR PROGRAM AT
BAYSTATE, TO LEARN MORE.>>THE BIGGEST ISSUE IN THE
UNITED STATES IS AND HAS BEEN FOR A LONG TIME WHAT WE CALL
CORONARY ARTERY DISEASE THEN THE PROBLEMS THAT FOLLOW IT. WHICH REALLY REFERS TO IS A
BUILD UP OF CHOLESTEROL AND OTHER THINGS IN THE WALLS OF THE
ARTERIES THAT FEED THE HEART. THAT IS WHAT TYPICALLY CAUSES
HEART ATTACKS. ONCE HEART ATTACK OCCURS, THE
HEART MUSCLE ITSELF BASICALLY DIES, ONCE THAT HAPPENS THINGS
LINE CONGESTIVE HEART FAILURE CAN ENSUE. IF YOU CAN GET TO THE BOTTOM OF
THE CORONARY ARTERY DISEASE PROBLEM YOU CAN FEND OFF A LOT
OF DIFFERENT PROBLEMS.>>DOES CONGESTIVE HEART FAILURE
HAVE TO FOLLOW A HEART ATTACK OR CAN THAT BE SEPARATE. CAN YOU EXPLAIN IT?>>THEY ARE BASICALLY BREAK
CONGESTIVE HEART FAILURE DOWN INTO DO DIFFERENT TYPES. TYPE WHERE THE HEART MUSCLE IS
WEAKENED IT CANNOT PUMP. A DIFFERENT TYPE WHERE THE HEART
MUSS MUSCLE FAILS TO RELAX ADEQUATELY AND DRIVES PRESSURE
IN THE HEART HIGHER THEN IMPACTS THE LUNGS MAKES IT DIFFICULT TO
BREATHE. IF YOU CAN HAVE HEART FAILURE AT
TWO ENDS OF THE SPECTRUM. ONE WHERE THE HEART WON’T PUMP
AND ONE WHERE HEART WON’T RELAX.>>WHEN YOU’RE TALKING ABOUT
CORONARY DISEASE YOU’RE TALKING ABOUT — HOW CAN YOU REVERSE
THAT, PRETTY SIMPLE WAYS TO AVOID THAT OR TO REVERSE THOSE
SIGNS?>>BEST WAY TO AVOID IS TO AVOID
THINGS THAT ARE — HAVE KNOWN IMPACTS ON THE BUILD UP OF
CHOLESTEROL INSIDE. THE HEART ARTERIES, WHICH WOULD
INCLUDE HIGH CHOLESTEROL LEVELS ITSELF, SMOKING, HIGH BLOOD
PRESSURE, INACTIVITY IS EMERGING AS A RISK FACTOR AS WELL. ONCE THAT HAS OCCURRED, THE KEY
IS TO STABILIZE THAT CHOLESTEROL BUILD UP TO MAKE SURE THAT THAT
PLAQUE OR CHOLESTEROL BUILD UP DOESN’T RUPTURE AND CAUSE A
BLOOD CLOT TO FORM. THE NEW CLASSES OF DRUGS, THE
STAT TINS, REALLY HAVE BEEN SHOWN TO STABILIZE PLAQUE AS
WELL AS REVERSE SPIN CASES. THERE’S A NEW CELT OF DRUGS THAT
ARE EVEN MORE POTENT. THOSE NEED TO BE INJECTED ARE
STILL RESTRICTED TO PEOPLE WHO HAVE REALLY SERIOUS CHOLESTEROL
PROBLEMS OTHERWISE CAN’T CONTROL.>>DR. SHA JUAN, WHAT ARE SOME
OF THE LATEST ADVANCES IN HELPING PEOPLE YOU KNOW WHO
HAVE HAD A HEART ATTACK SOME OF THE NEW SURGICAL PROCEDURES?>>THERE ARTERY DISEASE NUMBER
OF APPROACHES, NUMBER ONE. IS THAT WE CAN GIVE THEM
MEDICATIONS. NUMBER TWO, IS IF THE CORONARY
DISEASE IS MILD TO MODERATE, WE CAN SUBJECT THESE PATIENTS TO A
STENT PROCEDURE WHERE WE CRUSH THE BLOCKAGE ITSELF AND REOPEN
THE BLOOD VESSEL AND REOPEN. THOSE FOLKS WHO HAVE EXTENSIVE
AND VERY ADVANCED CORONARY DISEASE, PARTICULARLY IN
DIABETICS AND PARTICULARLY IN THOSE INDIVIDUALS WHO HAVE HAD A
HEART ATTACK, WHOSE HEART FUNCTION IS DIMINISHED, ON THE
DOSE CIRCUMSTANCES, BEST LONG TERM APPROACH IS TO HAVE BYPASS
OPERATION. THE OPERATION IS EXACTLY AS ITS
NAME IMPLIES. WE TAKE BLOOD VESSELS FROM OTHER
PARTS OF THE BODY WE TRANSPOSE THOSE INTO THE HEART CIRCULATION
SO THAT BLOOD FLOW THROUGH NATIVE DISEASED BLOOD VESSELS
WILL STAY THE SAME. THEN THEY CAN COME FROM THE
LEGS, FROM INSIDE THE BREAST BONE OR ALTERNATIVELY FROM THE
UPPER EXTREMITIES. TRADITIONALLY, THE OPERATION
THAT 90% OF THE PATIENTS IN THE UNITED STATES GET TODAY IS USING
ONE ARTERY FROM UNDERNEATH THE BREAST BONE THEN SUPPLEMENTAL
VEINS FROM THE LEGS. WHAT WE HAVE PIONEERED, WHAT WE
HAVE FOUND IS THAT INCREASING THE NUMBER OF ARTERIAL BYPASSES
TO FIX THE ARTERIES IN THE HEART AS OPPOSED TO VENOUS CHANNELS
INCREASES THE PATIENT’S LIFE EXPECT TEN SEES AND IMPROVE THE
PATIENT’S OUTCOMES.>>CARDIOVASCULAR DISEASE IS
NUMBER ONE LEADING CAUSE OF DEATH FOR BOTH MEN AND WOMEN. I THINK THAT STILL SURPRISES
PEOPLE ESPECIALLY WHEN YOU ADD WOMEN INTO THE MIX ON THAT.>>I THINK WHAT WE CAN SAY IS
THAT THE NATURE OF THE DISEASE HAS CHANGED OVER THE DECADES. THE TYPES OF PATIENTS WHO
TYPICALLY WILL PRESENT WITH A HEART ATTACK IN 2020 ARE VERY
DIFFERENT THAN PROFILE OF THE 40-YEAR-OLD MAN IN 1960s. WE HAVE NOT ABOLISHED HEART
DISEASE. WE HAVE REDUCED WHAT IT
OTHERWISE WOULD HAVE BEEN AND IN MANY WAYS WE HAVE DELAYED IT
UNTIL MUCH LATER STAGE OF LIFE. AND WOMEN ARE THOUGHT OF AS
BEING PROTECTED UP THROUGH MENOPAUSE. AS THE TIMELINE OF
ATHEROCARDIOVASCULAR DISEASE. WOMEN NOW ARE JOINED BY MEN.>>HOW DO YOU KNOW WHEN TO CALL
THE DOCTOR OR EVEN 911. BECAUSE I THINK SOME PEOPLE
MIGHT BE RELUCTANT, I DON’T WANT TO CAUSE ALARM. HOW DO YOU KNOW THE RIGHT TIME
TO DO THAT?>>WOMEN TYPICALLY THINK, I
SHOULDN’T BE CAUSING ALARM, THERE ARE MORE WORRIED ABOUT
THEIR HUSBAND THAN THEY NEED TO BE WORRIED ABOUT THEMSELVES
BECAUSE IF THEY’RE NOT AROUND AFTER HEART ATTACK THERE WON’T
BE ANYBODY TO WORRY ABOUT THEIR HUSBAND. WE’RE A TIME IN MEDICAL SCIENCE
NOW WHERE WE HAVE VERY EFFECTIVE TREATMENTS FOR HEART ATTACKS. AND THE QUICKER WE CAN APPLY
THOSE, THE QUICK ARE RERESTORE BLOOD FLOW LESS OVERALL DAMAGE. IF YOU THINK BACK TO WHAT WE
TALKED ABOUT TO THE HEART MUSCLE DYING WE CAN PREVENT THAT IF WE
CAN GET THAT BLOOD CLOT REMOVED AND PUSHED OUT OF THE WAY QUICK
ENOUGH. AT THIS POINT WE’VE MADE A LOT
OF PROGRESS HOW WE DELIVER THAT CARE INSIDE THE HOSPITAL AND
EVEN HOW WE CONNECT BETWEEN EMERGENCY MEDICAL SERVICES AND
THE HOSPITAL. THE BIGGEST DELAY NOW AND
BIGGEST CHALLENGE WE FACE IS WHAT YOU JUST SAID, GETTING
PEOPLE TO CONTACT MEDICAL CONTACT. IF YOU HAVE SYMPTOMS LIKE
SQUEEZING CHEST DISCOMFORT, YOU CAN’T BREATHE SUDDENLY, YOU PASS
OUT, I THINK THAT IS CAUSE TO CALL 911. IF YOU’RE NOT FEELING RIGHT
GOING UP THE HILL ON WALKING THE DOG IS NOT WHAT IT USED TO BE
IT’S TIME TO SEE YOUR DOCTOR.>>SOMETHING THAT ALSO SURPRISES
PEOPLE, TOO, I’M SURE YOU CAN TALK ABOUT THIS. IS THAT WHEN YOU HAVE SOMEBODY
WHO IS EXTREMELY ATHLETIC, MAYBE MIDDLE AGE PERSON BUT WE HEAR
THOSE CASES WHERE, OH, MY, GOSH, THEY WERE IN PERFECT SHAPE, HOW
COULD THEY SUDDENLY HAVE A HEART ATTACK. EVEN IN THOSE SITUATIONS, YOU
HAVE TO LOOK BACK AT FAMILY HISTORY? HOW CAN YOU HELP ADVISE PEOPLE
ON WHAT TO LOOK FOR.>>THERE’S A WHOLE SPECTRUM OF
HOW PATIENTS PRESENT WITH HEART DISEASE. SOME FOLKS PRESENT WITH
PROGRESSIVE CHEST PAIN M. FOLKS PRESENT WITH CARDIAC EVENT SUCH
AS ARTERY DISEASE ATTACK SOME FOLKS UNFORTUNATELY FIRST
MANIFESTATION OF THEIR UNDERLYING HEART DISEASE IS
SUDDEN CARDIAC ARREST AND SUDDEN CARDIAC DEATH. THAT’S WHY IT’S IMPORTANT AND
LOT OF SORT OF PUBLIC HEALTH FOCUS HAS BEEN SPENT ON
DEVELOPING BYSTANDER CPR BECAUSE FASTER WE CAN RESUSCITATE THOSE
PATIENTS AT THE SITE OF THE EVENT WHICH TYPICALLY OCCURS
OUTSIDE OF THE HOSPITAL, THE BETTER THE LIKELIHOOD OF
SURVIVAL. AS AGGRESSIVE AS WE HAVE BEEN,
THE CHANCES FOR OUT OF THE HOSPITAL ARREST, PATIENT
SURVIVING LESS THAN 5%. WE HAVE STILL A LONG WAY TO GO. BUT I THINK THAT WHAT I WANTED
TO EMPHASIZE AGAIN IS THAT WE HAVE MADE DRAMATIC PROGRESS OVER
LAST YEARS, WE DEVELOPED INTERVENTIONS, MEDICATIONS, WE
HAD VERY AGGRESSIVE PUBLIC HEALTH EVENT TRYING TO MAKE
PEOPLE AWARE THAT HEALTHY LIFESTYLE IS REALLY IMPORTANT. ALSO LEARNED A LOT FROM THE
VIETNAM WAR, WHERE A LOT OF YOUNG FOLKS WERE SUBJECTED TO
CASUALTIES AND WE FOUND THAT THIS HEART DISEASE REALLY BEGINS
VERY, VERY EARLY. MUCH MORE SO THAN WE HAD
ANTICIPATED. SO, THESE — THESE FATTY STREAKS
THAT OCCUR WHICH IS THE PRECURSORS OF ATHEROSCLEROTIC
PLAQUE CAN OCCUR AS EARLY IN THE LATE TEENS AND EARLY 20s. SO, THIS IS A CHRONIC PROBLEM
THAT IS REFLECTIONS OF OUR LIFESTYLE, I THINK THAT IT’S
ABSOLUTELY ESSENTIAL THAT WE DO WHAT WE CAN POSSIBLY DO TO
CONTROL THE ENVIRONMENTAL FACTORS, BECAUSE THE GENETICS
WE’RE NOT GOING TO CHANGE IN THE FORESEEABLE FUTURE. MAYBE WITH SOME GENETIC
MANIPULATION WE CAN MODIFY THAT. BUT TODAY THE ENVIRONMENTAL
FACTORS ARE GOING TO BE THE FACTORS THAT ARE GOING TO BE
MOST IMPORTANT IN TERMS OF TRYING TO EXTEND THE LIFE
EXPECTANCY.

Comments

(3 Comments)

  • MisterTracks

    awesome content

  • Trap Drip

    Lovely content! Keep it up! Would you like to be YouTube friends? :]

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    First like !

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