The Cleveland Clinic Heart Advisor

Volume 13
Number 2
February 2010

Many of the charts & tables found on this site are PDFs.

February 2010

Know the 3 Main Reasons You Could Benefit from Cardiac Rehabilitation
When most people are first diagnosed with cardiovascular disease (CVD), they are confronted with major lifestyle changes: stop smoking, lose weight, eat better, take medications and exercise. "There is no doubt that lifestyle modification is difficult, because it takes time, education and support," says Mike Crawford, MS, manager of Cardiac Rehabilitation at Cleveland Clinic. "A good cardiac rehab program provides all of these things. Experts on nutrition, exercise and behavior change will help you understand the CVD process, treatment goals, identify hurdles to your success and help a person find ways to meet their health goals. The rehab staff works closely with each patient, their cardiologist or managing physician."

Understand Your Treatment Options If You Have HOCM
Hypertrophic obstructive cardiomyopathy (HOCM, pronounced "hokum") is a condition in which an enlarged muscular wall between the ventricles (septum) prevents the mitral valve from closing correctly, impeding blood flow through the heart. It carries a risk of abnormal heart rhythms, heart failure and, in rare cases, sudden cardiac death (SCD). HOCM is incurable, but new devices and surgical procedures can help preserve quality and length of life. "Patients come in very sick. We make them feel so much better by eliminating the obstruction and valve leakage. They say we have given them their lives back," says Cleveland Clinic cardiologist Harry Lever, MD, an expert in HOCM.

Know the Warning Signs of Worsening PAD
Healthy peripheral arteries are smooth and unobstructed, allowing blood to flow freely to the legs and provide oxygen, glucose, and other nutrients to the lower extremities. As people age, plaque can build up in these blood vessels, which narrows the passageway within the arteries and causes them to become stiff. Peripheral arterial disease (PAD) occurs when the peripheral arteries become too narrow or obstructed and blood flow to the legs is limited. Left untreated, PAD can cause pain and difficulty with walking (called claudication) and can lead to limb loss in its most severe form. People with PAD may also be more likely to suffer a heart attack and stroke.

Treat Fatty Liver Disease to Reduce Heart Risk
Nonalcoholic fatty liver disease (NAFLD) affects upwards of 29 million Americans, according to the Centers for Disease Control and Prevention. While it causes no symptoms or complications for many, in some the disease can inflame and scar the liver and, at its most severe, progress to liver failure. However its effects also extend to heart health: It’s associated with metabolic syndrome and diabetes, two conditions that raise the risk of cardiovascular problems.

Vitamin D May Play a Major Role in Heart Health
Low intake of vitamin D has long been associated with weak bones, aching joints, mood swings, falls and cancer. Research now implicates low vitamin D levels in the development of heart disease, and death from heart diseases and all causes. "Regardless of whether you are a man or a woman, low vitamin D is bad," says Cleveland Clinic cardiologist Leslie Cho, MD. Multiple studies have confirmed various detrimental effects of insufficient vitamin D consumption. One study found a 45 percent increased risk of coronary artery disease, 78 percent increased risk of stroke and 77 percent increased risk of death. Another found that vitamin D deficiency prior to menopause tripled the likelihood of developing hypertension in mid-life. Rates of heart disease and osteoporosis in men have been found to be much higher when levels of vitamin D and estrogen were low.

Moral Support a Key Component of Cardiac Rehabilitation
Learning how to modify your diet, exercise more and work with your doctor to reduce cardiovascular disease risk factors are the primary goals of cardiac rehabilitation, but there is another critical aspect of the program that can be just as important in your recovery. Moral support in dealing with any challenge can be helpful, but among heart patients, in whom depression and anxiety can be common conditions, addressing mental health recovery is vital, says Mike Crawford, manager of Cleveland Clinic’s Cardiac Rehabilitation Program. He explains that patients new to cardiac rehab see that they are not alone in dealing with heart disease and witness how dedication to the program can produce visible results in patients just like themselves.