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Heart disease questions and answers

Everyone living with heart disease has questions - send us yours!

Click on the question to take you to the answer:

Q. Can I alternate between the hot tub or a sauna and cold water safely?

A. If you take a blood thinner (such as Plavix) or blood pressure meds, the heat of a hot tub can combine with the medications to cause you to become dizzy, nauseated or even faint. When you go in a hot tub, the heated water causes your blood vessels to dilate. In turn, blood pressure drops. If it falls too low, you can pass out.

It may be okay for short periods. If you are able to carry out moderate exercise without symptoms such as chest pain or shortness of breath, you should be able to tolerate a sauna or soak in the hot tub.

When you get into cold water blood vessels constrict. Any sudden change in temperature leads to a considerable increase in the heart's workload so moving back and forth between cold water baths and saunas or hot tubs is not a good idea.

Check with your doctor or health clinic to be on the safe side.

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Q. My husband takes metoprolol. Should he wear a medical alert bracelet?

A. Metoprolol is used in the treatment of several diseases of the cardiovascular system, especially high blood pressure. If your husband is on metoprolol, he obviously has high blood pressure and/or other heart disease.

Experts advise wearing a medical alert bracelet if you

  • have an ongoing medical condition
  • have a severe drug or food allergy
  • take medication regularly
  • have an implant such as a pacemaker or coronary stent
  • have any other medical condition that could impact your treatment in an emergency

A medical alert bracelet can give you and your family peace of mind that medical personnel will be aware of your husband's condition in the event of an emergency. Proper diagnoses in the first few minutes can be critical for appropriate treatment in an emergency situation.

The American Heart Association and the Heart & Stroke Foundation support the use of medical alert bracelets. Personally, I think it would be a good idea.

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Q. Could you please tell me which is the best to use, treadmill or elliptical?

A. I spoke to a director of an exercise program at at a cardiac rehab program and he advised me that from an exercise standpoint, it makes no difference whether you exercise on a treadmill or an elliptical trainer - both will give your heart a good work out.

From an orthopedic perspective, the elliptical is easier on your body than the treadmill.

Finally, you will want to consider how much space the apparatus takes (or how much room you have available). Some treadmills fold up so if space is a concern, that might be the way to go. You will also want to see which better fits your budget. And then from there, it's a matter of preference. From personal experience, we have a treadmill and enjoy the range of exertion levels it offers. In the past year and a half we got a dog, so now we walk outside year-round too!

Ask your cardiac care team if they have any recommendations specific to you.

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Q. Will an EKG affect a patient with a stent?

A. Speaking from personal experience, I have had two stents in place for the past four years and I've had numerous EKGs over that period of time without any problems. The stent is essentially a little piece of wire mesh that holds the artery open. The EKG simply measures the electrical activity of the heart. It provides the health professionals with an indication of your heart's performance and possible issues. There are no risks to the patient with this procedure, and the stent won't affect the EKG or the reverse.

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Q. Can I exercise after bypass surgery?

A. Yes, in fact as part of your rehab and your ongoing heart healthy lifestyle you will need to exercise. In the first three months you can walk or ride a bike but there are some activities you will need to avoid before you heal completely. These include carrying anything heavier than a gallon of milk, golf, basketball, tennis, or vigorous swimming.After three months (and with your doctor’s okay) you may engage in activities such as

  • Heavy housework such as scrubbing floors
  • Heavy gardening
  • Football/Soccer
  • Softball/Baseball
  • Tennis
  • Bowling
  • Hunting
  • Jogging
  • Bicycling
  • Golfing
  • Weight lifting
  • Motorcycle riding
  • Push-ups
  • Swimming
  • Water skiing
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Q. What are the heart health benefits of hugs?

A. Hugs lower blood pressure and reduce stress, which are both factors in the risk of heart disease. Hugs have also been shown to improve overall mood, increase nerve activity, and a host of other beneficial effects. Positive physical touch has an immediate anti-stress effect, slowing breathing and heart rate. Hugs don’t cost anything – so why not enjoy their benefits!Back to top.

Q. I’m having a bypass operation. How long will the bypass last?

A. Typically a bypass will last for 10 to 15 years but it’s also possible for grafts to become diseased and re-block in the months or years after bypass surgery. Younger patients with no other complicating diseases will have a greater probability of long lasting, clear grafts. On the other hand, older people have a higher probability of suffering further blockage of the arteries.Back to top.

Q. How soon can I fly on an airplane after having an angiogram?

A. You should be good to fly 3 - 5 days after your angiogram or angioplasty provided you have your doctor’s clearance. Usually there are no travel restrictions after an angiogram or angioplasty if you are not experiencing chest pain or any complications. If you had a coronary artery stent inserted you should not fly for at least two weeks – again you’ll need your doctor’s okay.Back to top.

Q. Is high blood pressure a symptom of heart disease?

A. High blood pressure (also known as hypertension) is usually referred to as a risk factor for heart disease. Uncontrolled hypertension can lead to these serious conditions:

  • Hardening and thickening of arteries
  • Increased risk of heart attack due to blocked arteries
  • Weakening and enlarging of the heart - possibly leading to congestive heart failure
  • Increased risk of stroke - pressure is too great for weakened blood vessels
  • Strain on kidneys - leading to damage to, or failure of, your kidneys
This is why your doctor will want to control your blood pressure and get it to a healthy range (120/80 or less) and why, if you have high blood pressure, your doctor will want to watch your heart health.See the blood pressure page for more information.
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Q. I recently underwent heart surgery. I'm now experiencing anxiety and depression. What's wrong?

A. It's normal to experience a wide range of emotions following any type of surgery. Feelings that your body let you down, changes to your self-image, fear of future problems, questions about resumption of former activities, etc. can all weigh heavily on your mind. The recovery page addresses these questions and provides links for additional information.
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Q. Is is OK to drink coffee if I have high blood pressure?

A. This is a question that you must ask your doctor, since every one is different. Generally speaking, a moderate amount of coffee is acceptable and may offer some health benefits; however, caffeine is a mild, addictive stimulant, so too much can cause nervousness, the jitters, or trembling in some people. It can also increase the heart rate and blood pressure in some people. Visit the coffee page for more information.
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Q. I feel good and am thinking about stopping my blood pressure and cholesterol medications. What are the risks?

A. Some studies estimate that up to 50% of people do not take their medications as prescribed. This is a huge problem! Because high blood pressure or elevated cholesterol have no symptoms that you can feel, you may think you no longer need them. That said, the drugs you take to control your blood pressure and cholesterol could be contributing to why you are feeling good. Stopping your medication could have a serious impact on your health. Discuss your feelings with your doctor. If you've made lifestyle changes to try to control various risk factors, you doctor may change or reduce your prescription, BUT until you've had that discussion, it's very important to continue taking your medications as prescribed!
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Q. How often should I take my blood pressure?

A. If you are just starting to monitor your blood pressure you might begin by taking it twice a day for a week or two, then cut back to a couple of times a week. Details about how to take your readings and a handy downloadable free blood pressure log can be found on the blood pressure page. Be sure to follow the instructions so that your body is in a state of calm when you take a reading.
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Q. I'm confused. What's the difference between an EKG and ECG?

A. It is confusing - but there is no difference. Both are abbreviations for an electrocardiogram, which is a recording of the electrical activity in your heart that doctors use to look at heart rate, heart rhythm, to see if a heart attack has occurred, or if there is inadequate blood or oxygen getting to the heart.
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Q. What happens if you get a cut when you are taking blood thinners?

A. Normally, if you get a cut your body stops the bleeding by creating a blood clot. When you are on blood thinners, this doesn’t happen as quickly.

If you cut yourself and the cut is relatively small, apply constant pressure over the cut until the bleeding stops (this may take up to 10 minutes). If it doesn’t stop bleeding, continue to apply pressure and go to emergency at the nearest hospital.

If the cut is large, apply constant pressure and get help immediately either by calling 9-1-1 or by going to the nearest hospital.
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Q. Is it possible to tell if your blood pressure is high by the way you feel?

A.There are generally no symptoms associated with high blood pressure. That's why 30 - 40% of people with high blood pressure aren't even aware they have it. The only way to know if your blood pressure is high is to have it checked - preferably by a doctor or health care professional, or at least on a home monitor, or at a pharmacy.
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Q. I'm getting a pacemaker. Will people be able to see or tell that I have a pacemaker?

A. There really is nothing to see - so people will be unaware that you have a pacemaker unless you choose to tell them. The pacemaker sits under your skin near the collar bone. Depending on the pacemaker and the person, a very faint outline of the pacemaker may be visible under the skin or you might have a small scar where the incision was made.
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Q. What does hypertension mean?

A. It's simply the medical term for high blood pressure. It doesn't mean that you are tense, uptight, or anxious. Blood pressure is not necessarily higher in "uptight" people.
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Q. What's the link between gum disease and heart disease?

A. Gum disease has been identified as a factor that can complicate cardiovascular disease. Research suggests that a mouth with periodontal disease has bacteria that can enter the bloodstream. According to the Heart and Stroke Foundation of Canada, a number of studies indicate that people with gum disease have up to three times the risk of heart attack and stroke.

In addition, some of the bacteria commonly associated with infections in the mouth are also associated with some types of heart disease. That doesn't necessarily mean the gum disease caused the heart disease - it could be that the same bacteria is affecting different parts of the body.
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Q. I know I should exercise, but frankly I find it hard to get motivated - doing the same repetitive exercises gets so boring. Help!

A. Almost all of us can find excuses and reasons not to

exercise. Despite our best intentions, it's easy to put it off until tomorrow, or the next day. Getting to it is hard - but you'll feel so good after you exercise. One strategy is to make a "date" to exercise with a friend or family member. Another is to find things that you really enjoy that provide exercise - riding a bike, ballroom dancing, or swimming. Vary your activities to keep it interesting. For example I do yoga twice a week, walk several days a week, ballroom dance once a week, and do a bodylastics circuit resistance training once a week. Keep an exercise log and reward yourself at certain milestones.
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Q. I thought I was pretty fit and I led a heart healthy lifestyle. Why did I get heart disease?

A. While you may not have the most obvious risk factors - smoking, inactivity, and excess weight - you may have had high blood pressure or high cholesterol that was not diagnosed until the damage was done. Stress is another possibility. It is now being recognized as a more serious risk factor than previously thought. If you were under stress for a prolonged period of time, that could have had a detrimental effect on your heart and cardiovascular system. Finally, we don't get to choose our parents and we can't halt the clock. Our genes and our age are risk factors we can't control. But don't get discouraged. By leading a heart healthy lifestyle, we can sometimes postpone the onset of cardiovascular disease, and we can increase our chances of surviving a heart event when it does occur.
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Q. Can air pollution trigger heart attacks and other cardiac problems?

A. According to Take a Load off Your Heart by Joseph Piscatella and Barry Franklin, the particles found in air pollution can cause constriction of blood vessels, elevated blood pressure, trigger heart rhythm irregularities, and even increase the likelihood of blood clotting. The risk is modest but can be more serious in diseased or damaged hearts.
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Q. How much do I need to exercise to halt or even reverse my coronary disease?

A. The American Heart Association suggests that the maximum benefits of exercise can be achieved with five to six hours of physical activity per week.
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Q. Now that I have a heart condition, is it safe for me to travel by air?

A. If your condition is under control and your doctor has not placed any restrictions regarding travel, you should be fine to travel by airplane. If you have any concerns, check with your doctor.
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Q. My only vice is smoking - and I really enjoy it. Do I have to quit - what if I cut back?

A. Smoking is the leading cause of preventable illness and death. It's true that the risk increases with the amount you smoke each day, but smoking in any quantity is unsafe. It's not easy to quit smoking, but you must!
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Q. Can I continue to enjoy a sauna or a soak in the hot tub after getting heart disease?

A. The relaxing of the blood vessels associated with the heat in a hot tub or sauna is about the same as from a brisk walk. If you are able to carry out moderate exercise without symptoms such as chest pain or shortness of breath, you should be able to tolerate a sauna or soak in the hot tub.

Don't drink alcohol while in a sauna or hot tub.

Any sudden change in temperature leads to a considerable increase in the heart's workload so moving back and forth between cold water baths and saunas or hot tubs is not a good idea. If you have any concerns, check with your doctor.
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