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The Messenger-Inquirer Tuesday, Feb. 1, 2022
TABLE OF
CONTENTS 3
Area cardiology specialists
4
Owensboro Health performing TAVR procedure
6
Healing after quitting smoking
8
Heart attack symptoms in women
9
Support groups for heart disease patients
9
Atrial fibrillation
10
4 common heart conditions
11
What heart patients need to know about COVID-19
Tuesday, Feb. 1, 2022 The Messenger-Inquirer
AREA CARDIOLOGY SPECIALISTS Advanced Cardiology of Owensboro
Roshan K. Mathew, MD, PSC 3110 Fair view Drive Owensboro, KY 42303 Phone: (270) 240-2129 Phone: (844) 940-2129 Fax: (270) 240-1227 www.advancedcardiologyofowensboro.com
The Muhlenberg Clinic
Kishor Vora, MD, FACC, FSCAI, CCDS 1100 West Everly Brothers Blvd. Central City, KY 42330 Phone: (270) 757-9991 Fax: (270) 757-9943 www.OwensboroMedical.com
Owensboro Health Medical Group — Cardiology (Owensboro)
1301 Pleasant Valley Road, Suite 202 Owensboro, KY 42303 Phone: (270) 417-7500 Fax: (270) 417-7509 www.owensborohealth.org
Owensboro Health Medical Group — Cardiology (Greenville) 440 Hopkinsville St. Greenville, KY 42345 Phone: (270) 377-2384 Fax: (270) 377-2387 www.owensborohealth.org
Owensboro Health Medical Group — Cardiothoracic Surgery 1301 Pleasant Valley Road, Suite 201 Owensboro, KY 42303 Phone: (270) 417-7510 Fax: (270) 417-7529 www.owensborohealth.org
Owensboro Heart & Vascular Clinic
Kishor Vora, MD, FACC, FSCAI, CCDS Lior Shamai, DO, MPH, FACC, FSCAI 1200 Breckenridge St., Suite 101 Owensboro, KY 42303 Phone: (270) 683-8672 Fax: (270) 685-8223 www.OwensboroMedical.com
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4 LOVE YOUR HEART
The Messenger-Inquirer Tuesday, Feb. 1, 2022
TAVR PROCEDURE
OH doctor performing procedure that once required open-heart surgery
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BY CHRISTIE NETHERTON MESSENGER-INQUIRER
s part of its efforts to place an emphasis on cardiology and heart-related procedures and treatment, Owensboro Health Regional Hospital recently began its structural heart program. Through the program, under the direction of Dr. Ashish Rastogi, the hospital has performed 15 transcatheter aortic valve replacement (TAVR) procedures to treat patients suffering from aortic stenosis. Several more are scheduled for the coming months. Rastogi, an inter ventional cardiologist with specialized training in performing TAVRs and other heart procedures, said bringing the procedure to Owensboro allows patients in need to receive the ser vices close to home rather than traveling to another state or city. “I was looking for a place to do these procedures in a community that would benefit from it and Owensboro seemed to be the perfect situation because they wanted to start a program,” he said. “They have a hospital that has high-end facilities and can really provide these ser vices to the community; they just needed a physician to do it.” Rastogi began performing TAVRs in August this year, having performed nine so far with 15 patients scheduled throughout the next month or two. Since the program started up, he said he has received about two or three referrals per week. TAVR, he said, is a minimally invasive procedure used to treat aortic stenosis, which is blockage of the main valve. A TAVR replaces a narrowed aortic valve that fails to open properly — an aortic valve stenosis. In this procedure, doctors insert a catheter into the leg or chest and guide it to the heart through the old heart valve, using the natural heart
valve to hold it in place. According to Rastogi, the procedure began to become more widely used about five years ago. Prior to that, he said aortic stenosis was treated with open-heart surger y, which is much more invasive and requires a longer recover y time. Additionally, he said, open-heart surger y is not as ideal for patients who might have underlying medical conditions that might make them more at-risk for an invasive procedure with a difficult recover y process. Such underlying conditions might include lung disease, COPD, individuals who have has strokes in the past, are debilitated or have multiple underlying medical conditions. “Before 10 years ago, the only way to treat aortic stenosis was with surger y,” he said. “Now, the standard of care is to have TAVR for aortic stenosis for the majority of patients instead of having surger y.” TAVRs, he said, are not only more minimally invasive than open-heart
get seen by a doctor and get it figured out,” he said. “We know that when someone has severe aortic stenosis blockage to that degree and have symptoms of it, they don’t do ver y well long-term.” About one-in-five individuals with the disease who do not receive treatment, he said, do not live past five years and 50% might pass away after two years of experiencing symptoms. “Recognizing it and treating it is really important,” he said. Bringing the procedure, along with other heart-focused treatments, to Owensboro, Rastogi said, creates better access for individuals to seek out care and consultation locally if they are experiencing symptoms or have concerns, rather than living with a disease that is treatable. surger y, but have a shorter recover y “Bringing this to the community time. Whereas open-heart surger y here, I think, is really important might require a week or longer of because it’s a procedure … and not recover y in the hospital, the TAVR having to leave their community procedure is typically about an in Owensboro and having to go to hour-long procedure with a day-long Nashville or Louisville or somewhere recover y process before the patient a few hours away,” he said. being can be discharged. able to get this … procedure more Rastogi said aortic stenosis is locally and have follow up here is actually quite common with about much better for them.” one-in-eight individuals ages 75 and TAVR is the latest in a series older experiencing some level of the of innovations within OH’s heart disease. program during the past year. Dr. “It’s ver y common,” he said. Rastogi has also began implanting “When it is severe, it can limit blood the MitraClip device, which is flow to the whole body.” an alternative to open heart However, he said, many of these surger y for patients with a leaky individuals who feel symptoms mitral valve, and the Watchman of the disease might not even get device, which is an alternative to it checked out as the symptoms blood thinners for patients with commonly get confused with regular atrial fibrillation. OHRH has also signs of aging. expanded its cardiac imaging and Symptoms of aortic stenosis might electrophysiology capabilities, include fatigue, lightheadedness, renovated the catheterization lab dizziness, chest pain and fainting and partnered with Cincinnati spells. Children’s to provide pediatric “They don’t recognize that they cardiology ser vices. actually have a valve issue, so a lot Christie Netherton, cnetherton@ of it goes unrecognized and the majority of patients actually never messenger-inquirer.com, 270-691-7360
Tuesday, Feb. 1, 2022 The Messenger-Inquirer
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DR. ASHISH RASTOGI
“Medicine, for me, has always been a calling, as well as a privilege.”
Dr. Ashish Rastogi is a board-certified interventional cardiologist specializing in the invasive and non-invasive diagnosis and treatment of complex coronary artery, peripheral vascular, valvular and structural heart diseases with minimally invasive procedures. He attended the highly competitive accelerated Physician Scientist program at Rensselaer Polytechnic Institute and Albany Medical College. There he was inducted into the Alpha Omega Alpha honor society and graduated at the top of his class. He then completed his Internal Medicine residency at Washington University in St. Louis, followed by Cardiology fellowship at New York Presbyterian Hospital / Weill Cornell Medical Center where he was selected to be the Chief Cardiology Fellow. He pursued advanced training in Interventional Cardiology under the world-renowned Dr. Paul Teirstein at the Scripps Clinic. This fellowship included a dedicated year of training in Advanced Peripheral and Structural Heart interventions. He is currently the medical director of the Structural Heart Disease program at Owensboro Health. — From Owensboro Health
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6 LOVE YOUR HEART
The Messenger-Inquirer Tuesday, Feb. 1, 2022
HOW DOES THE BODY HEAL AFTER QUITTING SMOKING? Few habits are as harmful to the human body as smoking tobacco products, especially cigarettes. The American Heart Association states that smoking is the most preventable cause of death in the United States. It’s linked to heart disease and stroke, and it can increase the risk for cancers of the bladder, throat,
RISK OF HEART ATTACK DECREASES
After day one of quitting smokers’ risk of heart attack begins to decrease.
RATE OF COPD DECLINE IMPROVES
Research published in the journal Respiratory Medicine found that people with mild to moderate COPD can expect to experience normalization of lung function decline within a year of quitting. This means that the rate of decline considered normal with age is the same as someone who had never smoked before.
REDUCED LUNG CANCER RISK
The risk of getting lung cancer reduces by 50 percent after 10 years of being smoke-free, according to the Centers for Disease Control & Prevention.
cervix, pancreas and mouth. Smoking is linked to roughly 90 percent of lung cancer cases in the United States as well. Even though smoking can ravage the body and cause significant damage to the lungs, which worsens the longer one smokes, people who quit may be able to restore a good portion of their lung health.
CARBON MONOXIDE LEVELS GO DOWN
The Lung Health Institute says there are a number of ways the lungs can heal once a person stops smoking. While it may not be possible to undo the structural damage to the lungs, lung function can be significantly restored when people quit smoking. Here’s a look at some ways the lungs and other parts of the body may recover.
Orlando Health says carbon monoxide gradually leaves the bloodstream after people quit smoking, which helps reduce the severity of symptoms like shortness of breath. Similarly, chemicals in cigarette smoke can inflame the lining of the airways.
REACTIVATION OF CILIA
Cilia are the small hair-like structures that move mucus and bacteria to the back of the throat. They fail to work properly when a person smokes, but can resume function after quitting.
IMPROVED CIRCULATION
When lung function improves, oxygen can more effectively reach cells through the body and circulation improves. Within 24 hours of quitting, constriction of blood vessels also will occur, resulting in lower blood pressure and improved pulse rate. Body temperature will start to normalize within 24 hours as well.
IMPROVED TASTE AND SMELL
Within 48 hours of quitting, taste and smell receptors start to heal, and damaged nerve cells also will begin to self-repair.
— Information from metrocreativeconnection.com
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The Messenger-Inquirer Tuesday, Feb. 1, 2022
IF YOU HAVE ANY OF THESE SIGNS, CALL 911 AND GET TO A HOSPITAL RIGHT AWAY
1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back. 2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach. 3. Shortness of breath with or without chest discomfort. 4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness. 5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
HEART ATTACK SYMPTOMS IN WOMEN
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e’ve all seen the movie scenes where a man gasps, clutches his chest and falls to the ground. In reality, a heart attack victim could easily be a woman, and the scene may not be that dramatic. “Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure,” said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center and an American Heart Association volunteer. “Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.” Even when the signs are
slowly narrow from a buildup of fat, cholesterol and other substances (plaque). Many women think the signs of a heart attack are ‘I THOUGHT I HAD THE FLU’ unmistakable — the image of the elephant comes to mind — but Even though heart disease is in fact they can be subtler and the No. 1 killer of women in the United States, women often chalk sometimes confusing. You could feel so short of up the symptoms to less lifebreath, “as though you ran a threatening conditions like acid marathon, but you haven’t made reflux, the flu or normal aging. a move,” Goldberg said. “They do this because they Some women experiencing a are scared and because they put heart attack describe upper back their families first,” Goldberg pressure that feels like squeezing said. “There are still many or a rope being tied around women who are shocked that them, Goldberg said. Dizziness, they could be having a heart lightheadedness or actually attack.” fainting are other symptoms to A heart attack strikes look for. someone about every 43 “Many women I see take an seconds. It occurs when aspirin if they think they are the blood flow that brings having a heart attack and never oxygen to the heart muscle call 911,” Goldberg said. “But is severely reduced or cut if they think about taking an off completely. This happens aspirin for their heart attack, because the arteries that they should also call 911.” supply the heart with blood can subtle, the consequences can be deadly, especially if the victim doesn’t get help right away.
TAKE CARE OF YOURSELF
Heart disease is preventable. Here are Goldberg’s top tips: • Schedule an appointment with your healthcare provider to learn your personal risk for heart disease. • Quit smoking. Did you know that just one year after you quit, you’ll cut your risk of coronary heart disease by 50 percent? • Start an exercise program. Just walking 30 minutes a day can lower your risk for heart attack and stroke. • Modify your family’s diet if needed. Check out these healthy cooking tips. You’ll learn smart substitutions, healthy snacking ideas and better prep methods. For example, with poultry, use the leaner light meat (breasts) instead of the fattier dark meat (legs and thighs), and be sure to remove the skin. — from the American Heart Association
Tuesday, Feb. 1, 2022 The Messenger-Inquirer
LOVE YOUR HEART
SUPPORT GROUPS FOR HEART DISEASE PATIENTS AND SURVIVORS AMERICAN HEART ASSOCIATION The American Heart Association offers online support networks for anyone who has experienced cardiac arrest, cardiac arrhythmia, cardiomyopathy, heart attack, heart failure, heart transplant, heart value disease, peripheral artery disease (PAD) and venous thromboembolism. www. heart.org WOMENHEART HEARTSISTERS ONLINE HeartSisters is a support program led by WomenHeart Champions, women heart disease survivors who have committed to becoming leaders in their communities and providers of support for other women with heart disease. Online support meetings are conducted using web-conferencing instead of chat rooms or forums. Two monthly online meetings are offered: heart disease and women; and heart disease, AFib and women. hwww.womenheart.org/page/ virtualsupportsgc HEART SUPPORT GROUP AT NORTON HEALTHCARE Norton Healthcare also offers monthly WomenHeart support group meetings on the first Wednesday of every month. Each session is free and covers a different topic to help women better their heart health. nortonhealthcare.com/services- andconditions/heart-and-vascular- care/ patient-resources/heart-support- group
BE MINDFUL OF ATRIAL FIBRILLATION Atrial fibrillation, commonly known as AFib, is a heart condition characterized by a quivering or irregular heartbeat, called arrhythmia. Millions of people across the globe currently live with AFib. When a person has AFib, the heart’s two upper chambers, known as the atria, beat chaotically and do not coordinate with the two lower chambers. AFib can cause heart palpitations, shortness of breath and weakness. AFib is not often life-threatening, and symptoms may come and go. However, side effects of the condition can be dangerous. AFib often results in poor blood fl ow, which can cause pooling of blood in the atria. The American Heart Association notes that the risks of clotting increase as blood pool. If a clots forms in the atria, it can be pumped out of the heart and reach the brain, potentially blocking off the blood supply to an arter y in the brain. This is known as an embolic stroke. AFib also can reduce the heart’s pumping capacity. An other wise healthy heart may be able to compensate for this reduction in efficiency. But those with damaged heart muscle or valves cannot. AFib can trigger breathlessness and exercise intolerance and potentially coronar y arter y disease, offers Har vard Medical School. Other problems from poor pumping can cause blood to back
up into the pulmonar y veins, the vessels that return oxygen-rich blood from the lungs to the heart. This can cause fl uid in the lungs. Fluid also can build up in the feet, ankles and legs. There are various potential causes for AFib, such as: • high blood pressure • abnormal heart valves • previous heart attack • congenital heart defects • overactive thyroid • exposure to stimulants • previous heart surger y • lung disease Some people with AFib do not have any heart defects or damage, and the cause is unclear. The Mayo Clinic says treatment goals for AFib include resetting the rhythm or controlling the rate of the atrial valves, known as cardioversion. This can be done electrically or through the use of drugs. Sometimes, other therapies to control atrial fibrillation do not work. In these cases, a doctor may recommend a procedure to destroy the area of heart tissue that’s causing the erratic electrical signals and restore the heart to a normal rhythm. Medication to prevent blood clots and reduce the risk for stroke often are prescribed.
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10 LOVE YOUR HEART
The Messenger-Inquirer Tuesday, Feb. 1, 2022
4 COMMON HEART CONDITIONS
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CAD causes damage or disease to major blood vessels that supply blood, oxygen and nutrients to the heart. Certain risk factors for CAD, such as age, are beyond individuals’ control. However, many risk factors are within a person’s control. Individuals can speak to their physicians about how to maintain a healthy blood pressure and a healthy weight, limit stress, and reduce their cholesterol, all of which can lower risk for CAD.
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the brain can cause stroke. 3. CARDIOMYOPATHY: The Centers for Disease Control and Prevention notes that cardiomyopathy often goes undiagnosed, making it hard to determine just how common the condition is. But the CDC estimates that as many as one in 500 adults have cardiomyopathy. Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump oxygen-rich blood to the body at optimal capacity. Heart & Stroke notes that cardiomyopathy can lead to heart failure. Early stages of cardiomyopathy may not produce any symptoms, but as the disease gets worse individuals may experience fainting, irregular or rapid heartbeats, light-headedness, and swelling of the hands and feet, among other things. 4. CORONARY ARTERY DISEASE: Heart & Stroke notes that coronary artery disease (CAD) is the most common form of heart disease. CAD occurs when one or more of the coronary arteries narrows or becomes blocked.
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suffocating or burning, is caused by a temporary disruption in the flow of blood and oxygen to the heart. Though angina symptoms typically do not last long, they are considered warning signs for heart attack and should be discussed with a physician immediately after they appear. 2. ATHEROSCLEROSIS: Atherosclerosis is characterized by the buildup of plaque on the interior wall of an artery. That buildup makes the walls of the artery thick and hard, thus restricting the flow of blood, and can potentially contribute to a blockage. The experts at Johns Hopkins Medicine note that risk factors for atherosclerosis include high cholesterol, high blood pressure, obesity, and a poor diet that includes lots of saturated fats. Atherosclerosis can cause angina, though many individuals with the condition experience no symptoms until it has reached an advanced stage. Blockages in the leg may cause cramping when exercising or walking, while those in the arteries of the heart can cause heart attack. Blockages that develop in
M ME E
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ardiovascular disease is the leading cause of death across the globe. According to the World Health Organization, an estimated 17.9 million people die each year from cardiovascular diseases, which are a group of disorders of the heart and blood vessels. The sheer volume of deaths caused by heart disease each year suggest there’s little people can do to avoid it. However, the Canadian organization Heart & Stroke notes that healthy behaviors like eating a heart-healthy diet and exercising regularly can help individuals delay the onset of heart disease by as much as 14 years. Education is another valuable asset in the fight against heart disease. Individuals who are aware of common heart illnesses can discuss them with their physicians and take measures to reduce their risk. 1. ANGINA: Heart & Stroke notes that angina is another word for chest pain. The discomfort associated with angina, which can feel like squeezing,
Tuesday, Feb. 1, 2022 The Messenger-Inquirer
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What heart and stroke patients need to know about COVID-19 T
BY MICHAEL MERSCHEL
AMERICAN HEART ASSOCIATION NEWS UNDEFINED
wo years into the pandemic, researchers have learned a lot about how COVID-19 affects people with heart disease and stroke survivors. But like the coronavirus itself, what everyone needs to know keeps evolving. “You can’t assume that what was true three months ago is true now,” said Dr. James de Lemos, a cardiologist at UT Southwestern Medical Center in Dallas. Thanks to the omicron variant, “it’s a fundamentally different pandemic than it was at Thanksgiving.” Early data suggests omicron causes less severe illness but spreads more easily than its predecessors. So heart and stroke patients need to protect themselves, starting with understanding that COVID-19 still is a threat to their health. “Early on, we recognized that the risk was higher for those with pre-existing cardiovascular disease,” said Dr. Biykem Bozkurt, a cardiologist at Baylor College of Medicine in Houston. According to the Centers for Disease Control and Prevention, people with conditions such as heart failure, coronary artery disease and possibly high blood pressure may be more likely to get severely ill from COVID-19. So can people who have diabetes, are overweight or are recovering from a stroke. SARS-CoV-2, the virus that causes COVID-19, also has been linked to increased risk of several cardiovascular conditions. According to a September 2021 report from the CDC, people with COVID-19 are nearly 16 times more likely to have heart inflammation, or myocarditis, than uninfected people. The report found about 150 cases per 100,000 people with COVID-19 versus about nine cases per 100,000 people without the virus. In addition, an August 2021 study in the New England Journal of Medicine showed people with the coronavirus may have a significantly higher, albeit rare, risk of intracranial hemorrhage, or brain bleeding; heart attack; and having an arrhythmia, or abnormal heartbeat.
Researchers don’t have full data on long-term implications for the heart look omicron’s effects yet, Bozkurt said, favorable. but it’s still affecting people who are “The vast majority of people who have vulnerable. “And that’s why the hospitals mild COVID infections really appear to right now are full.” have nothing to worry about with their The risks of any one person having hearts,” he said. “That’s good news, a severe problem from the new variant I think, and doesn’t get emphasized are relatively small, de Lemos said. enough.” “But the flipside is, given how many People with existing heart conditions people are getting infected right now, or a history of stroke still need to protect the cumulative number of people with themselves, and have many ways of COVID-19 complications is still very doing so. large.” “Number one: Get vaccinated,” said De Lemos, who helped create the Bozkurt, who has studied COVID-19 American Heart Association’s COVID-19 vaccine side effects. “And please, Cardiovascular Disease do get a booster.” Registry, said omicron Reports of rare cases “is obviously wildly more of vaccine-related “The vast infectious and able to myocarditis, majority of evade the vaccine to particularly in some extent, although people who have younger males, it does appear that the should not dissuade mild COVID vaccine seems to prevent anybody with an infections really severe infections and existing condition. hospitalizations.” Most people appear to have And overall, “we with pre-existing nothing to worry don’t know a ton cardiovascular disease about with their about specifically why are not young adult certain patients with males, she noted. And hearts.” heart disease do less regardless of age, the — Dr. James de Lemos benefits from vaccines well,” he said, although understanding has outweigh the risks. cardiologist at UT evolved over time. Given how the Southwestern Medical In the beginning, vaccines don’t seem Center in Dallas de Lemos said, doctors to be as protective feared the virus directly against the spread infected the heart muscle. “That doesn’t of omicron, de Lemos said if you’re really appear to be the case,” he said. a heart disease or stroke patient, Instead, it appears that in severe hunker down for the next several cases, the virus is inflaming the lining of weeks until this wave passes, “and blood vessels of the heart and increasing then you’ll be able to re-emerge.” the likelihood of clotting in the smallest Patients should avoid indoor vessels, he said. crowds, he said, and use a KN95 COVID-19 also can overwhelm the mask or, when possible, an N95 mask heart by making it work harder to pump instead of cloth masks when being in oxygenated blood through the body as a crowd is necessary. the lungs are overwhelmed. Bozkurt said heart and stroke But as they’ve learned more about the patients should keep in contact with coronavirus, doctors have gotten better their health care team and continue at fighting it. For example, de Lemos taking medications as prescribed. said, they now work proactively to treat Anybody with symptoms that could blood-clotting disorders in hospitalized be heart-related should seek care patients. And although researchers are immediately. “Do not delay,” she said. working to understand lingering effects Both doctors said it was important known as “long COVID,” it appears to get information from reliable
sources. Some false remedies promoted on social media can actually damage the heart, Bozkurt said. De Lemos acknowledged that even from reliable sources, advice can shift. “I would say that the information is written in pencil, not in pen, because things are changing so fast.” It can be frustrating for him, even as a scientist, when experts disagree or alter their recommendations, but “that’s the way science goes.” And even as COVID-19 “remains a bizarrely arbitrary virus in terms of who gets sick and who doesn’t,” he’s optimistic. “Think about all the progress we’ve made in a year or two, and the remarkable effect of the vaccines, the fact that we have drugs” that should help keep people out of hospitals. Heart and stroke patients need to be extra careful right now, but “as frustrating as it is, we will not be in this situation forever. We really won’t.” Editor’s note: Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. Visit Heart.org for the latest coverage, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance. If you have questions or comments about this story, please email editor@heart. org. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News. Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.
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