Heart Health & Heart Surgery with Dr. Paul Pearsonhttp://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=119Heart disease is the leading cause of death in the United States for both men and women. And each year, over 500,000 people will have their first heart attack. Paul Pearson, MD, Cardiovascular Surgery at NorthShore, will answer all your questions on heart health. Are you a good candidate for surgery? What can you expect after surgery? What changes can you make now to prevent heart disease down the road? Submit your questions early.Copyright 2014 NorthShore University HealthSystemPost at 1:36 PMBrenna: Our chat will begin at 4 PM. You can submit questions before the chat begins or at any point during the chat. For those who are not available to watch at the chat from 4 to 5 PM, a transcript of the chat will be made available at the end.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1191:36 PMPost at 4:00 PMDr. Paul Pearson: The Division on Cardiovascular Surgery of NorthShore would like to welcome you to our webinar. We look forward to answering your questions and have a fun and informative hour.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:00 PMPost at 4:01 PMPatti: I am a 50 yo female, overweight and have sleep apnea. There is a Hx of HTN and heart disease in my family. My cholesterol & BP have been normal. I see my PCP yearly for a check up. I have mult. musculoskeletal issues( have been on NSAIDS PRN for > 20 yrs) w/ pain but sometimes I think is it angina when I have symptoms in my chest, left arm, neck, jaw. I want to ask my PCP for a cardiac work-up. What kind of testing should I ask for or expect besides an EKG.<br/><br/>Dr. Paul Pearson (NorthShore): When diagnosing Coronary Artery Disease, a good place to start is a non invasive stress test. The stress test looks at your Hearts electrical activity and bloodflow when demands are placed upon it. In most individuals the stress test is the ideal tool to answer the question "Do I have significant Coronary Artery Disease?". However, in some patients with a strong family history of coronary artery disease, a cardiologist might procede with a invasive coronary angiogram, even with an unremarkable stress test if the patients symptoms are compelling.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:01 PMPost at 4:06 PMJackie: What can you tell me about silent heart attacks? My husband had a second one sometime within the last three or four months. He is 71 years old and has been treated for high blood pressure for several years.<br/><br/>Dr. Paul Pearson (NorthShore): A silent Heart Attack is one which occurs without classic symptoms or signs that alerts the patient or those around them that there is something wrong. Typically silent heart attacks occur in individuals whose sensory nerves from the heart are compromised. Many patients with severe diabetes cannot sense if their heart is not getting enough blood supply. Interestingly, patients who have had a heart transplant also cannot sense a heart attack.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:06 PMPost at 4:11 PMBill: 1. I read a study that longterm prescribed amphetamine use (Adderall/Vyvanse) is not linked to fatal cardiovascular events. If this is true, why are some over-the-counter pre-workout supplements that contain Dimethylamylamine (an amphetamine based compound) linked to fatal CV events when used appropriately? Does this mean prescribed amphetamine medication is safer during high activity than pre-workout supplements? What is your position on the safety of prescribed amphetamines and exercise?<br/><br/>Dr. Paul Pearson (NorthShore): First one should understand that many pre-workout products sold over the counter contain high levels of stimulants such as caffeine. Also, the pre-workout supplements are sold as "food products" and not as medications (see the small print on the bottle). Thus these products are not regulated by the FDA and there can be variable quantities of stimulants in different packages of the same product. Amphetamine's such as Adderall also can increase the heart rate and blood pressure in addition to causing vasoconstriction. When used with pre-workout products, these medications can cause a dangerous increase in heart rate and blood pressure in certain individuals. If one were to find a Physician who would prescribe amphetamines to take before a workout(I suspect it would be hard to find such a Doctor), one would have to ensure that your heart rate and blood pressure were monitored during the workout.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:11 PMPost at 4:20 PMStephanie: I have a history of heart disease in my family. I'm only in my 20s now. When should I start to consider this family history as having an impact on me? Are there things I can do now to help prevent heart disease?<br/><br/>Dr. Paul Pearson (NorthShore): You should consider your strong family history of heart disease as important right now. For example, there is a strong family history of early coronary artery disease in my family. One of my sons was found to have elevated cholesterol level even as an active and athletic teenager. This was able to be controlled with diet and medication. As for preventing heart disease the greatest danger that patients in general face is obesity. Thus simple things such as maintaining a proper diet and exercise can have a monumental longterm impact on good health.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:20 PMPost at 4:26 PMRae: What is the success rate for valve replacements? For those not successful, what is the outcome?<br/><br/>Dr. Paul Pearson (NorthShore): Valve replacement, meaning inserting an artificial valve in the place of a patients own diseased valve is universally successful in this day and age. The risk of a procedure of course varies with the patients age and medical complexity. For example, a healthy 40 year old would have a different risk for surgery than a complex 90 year old patient with severe lung disease and bad kidneys. However the long term outcome following valve replacement is outstanding with our current technology.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:26 PMPost at 4:31 PMRobert: What kind of animal tissue is used to make Biologic valves and can patients choose the type used for their procedure at Northshore?<br/><br/>Dr. Paul Pearson (NorthShore): There are two types of animal tissue valves available. One type is a pig valve. This is an actual heart valve which is harvested from healthy pigs and processed for human implantation. The tissue is not living and thus it does not reject like a transplant. The other type of tissue valve is bovine pericardium. This valve is made from the fibrous sack which surrounds the cow heart. Valve leaflets are cut from this tissue and then assembled into a new heart valve. At NorthShore we have both types of tissue valves available. At NorthShore patients have the freedom to choose which type of tissue valve is implanted. Some patients for strong religous or social reasons prefer one type of tissue valve over another.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:31 PMPost at 4:41 PMDane: I am 30 years old and was born with a VSD (same area as my 60 y/o father). I am healthy, no restrictions, no meds and no symptoms. I have been followed all my life with EKG's, and echo's. This past year I saw a new MD and he wants me to consider having the VSD repaired. Why is this necessary? What does this procedure entail? Why has no one told my father to have his VSD closed? Thanks<br/><br/>Dr. Paul Pearson (NorthShore): That is a great question and very personal for me. Two of my sons were born with VSD's. Like you, they are both active, are on no medications and have no symptoms and neither have had closure of the VSD. VSD's only need to be closed if they are of a certain size and cause significant leakage from one chamber of the heart to another. Your cardiologist should be able to tell you based upon your most recent echocardiogram the size of the VSD and the amount of leakage(shunt). He or She should them be able to tell you what criteria has changed that now makes intervention necessary. Second opinions when surgery is suggested are very important. At NorthShore we are always happy to review a patients case and give our opinion as to whether an operation is indicated or not.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:41 PMPost at 4:47 PMBrenna: There are 15 minutes left in this chat. Please submit your final questions.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:47 PMPost at 4:50 PMMichael: I'm overweight and have hypertension. I'm changing my diet and trying to exercise more and on medication. I'm worried there is a chance I'm already too late and that I might be at risk for my first heart attack. Are there early signs of a heart attack I can look out for? Are there over the counter medications I should have on hand as a precaution?<br/><br/>Dr. Paul Pearson (NorthShore): First congratulations on your commitment to your health, diet, and exercise. It is never to late, even if one has already sustained a heart attack or heart damage, to making life improving changes in heart health. The most common symptom that a man would experience who is having a heart attack would be chest or arm pain, chest tightness, or shortness of breath. Women can experience any of these but also can present with very atypical symptoms such as indigestion, gall bladder pain or back pain. If someone is having a heart attack, antiplatlet medications are very important. Simply taking aspirin(an antiplatelet medication) in this situation has been shown to improve outcomes.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:50 PMPost at 4:58 PMShayna: I know that both men and women can have heart attacks but why do you think it is that more women die from heart attacks each year than men?<br/><br/>Dr. Paul Pearson (NorthShore): First, most physicians don't know that more women die from heart attacks then men. To many physicians, heart disease is erroneously thought of as a male disease. Also, women as a group present with diverse sympstoms of heart attack while men have a very typical presentation. Thus, it is possible that a delay in diagnosis contributes to the adverse outcomes of women with acute coronary syndromes.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1194:58 PMPost at 5:02 PMBrenna: Thank you everyone for your wonderful participation in our chat this afternoon. And thank you Dr. Pearson for taking our questions. This was a popular topic and, unfortunately, this will be the last question we can answer today. A transcript will be made available at the end of the chat.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1195:02 PM