DEAR DOCTOR K: I have a heart arrhythmia. My doctor wants me to get an ICD. What do I need to know before agreeing to get one?
DEAR READER: ICD stands for “implantable cardioverter-defibrillator.” It is a small device that is surgically placed in your body. An ICD can save your life — but it can also complicate your life.
DEAR DOCTOR K: I recently had a heart attack. Now my doctor wants me to start cardiac rehabilitation. Is it dangerous for me to start exercising so soon?
DEAR READER: I understand your concern. Not that long ago, rest was exactly what the doctor ordered after a heart attack. Taking it easy, the thinking went, would help the heart heal more quickly. Now, doctors know that inactivity doesn’t help your heart or the rest of your body. Exercise actually strengthens your heart, if you do it correctly. And it helps your muscles use oxygen more efficiently, easing the heart’s workload.
DEAR DOCTOR K: My 61-year-old mother plans to take a long plane trip. Her legs usually become swollen when she flies a long distance. Should she wear elastic stockings or take any other precautions so she doesn’t develop a blood clot in her legs?
DEAR READER: Long flights increase anyone’s risk of developing mild swelling in the feet, ankles and lower legs — and of getting blood clots in the legs. Swelling is common; blood clots are uncommon. On a long flight, unless you’re in a fully reclining first-class or business-class seat, you are not lying flat. Gravity is pulling blood down into the veins of your lower legs. Also, your legs are bent at the knees. This makes it harder for blood to travel through your leg veins and back to your heart. As a result, the veins swell up.
DEAR DOCTOR K: For years I thought I was at lower risk for heart disease than men because I was a woman. Now I know better. I’d like to take steps to reduce my chances of developing it. What can I do?
DEAR READER: Heart disease has carried a reputation as a “man’s disease” for years. But it is not now — nor was it ever — a disease that mainly targets men. In fact, these days more women die each year of cardiovascular disease than men. (Cardiovascular disease refers to heart disease, stroke and related blood vessel conditions.) Like you, a lot of my patients don’t think of heart disease as a problem for women. Here’s a pop quiz: Are women more likely to die of breast cancer or heart disease? The answer: More women die of heart disease each year in the United States than from all types of cancer combined. That includes breast, ovarian and cervical cancer, plus lung, stomach and colon cancer, plus leukemias, lymphomas and melanoma — all types of cancer.
DEAR DOCTOR K: Although some members of my family have heart disease, I haven’t been diagnosed with it. I know people with current cardiovascular problems should take aspirin, but should I be taking it to prevent future problems?
DEAR READER: Your question seems simple enough. I wish I had a simple answer. The problem is that aspirin, like virtually all medical treatments, has benefits and risks. The main risk of aspirin is bleeding. But for people who have heart disease, regularly taking low-dose aspirin definitely reduces the risk of heart attacks in the future. The benefits and risks are different for one person than for another.
DEAR DOCTOR K: I recently had some mild chest pains, so my doctor scheduled an exercise stress test. What will happen during this test?
DEAR READER: An exercise stress test is also known as an exercise tolerance test. As in your case, stress tests are often given to people with chest pain or other symptoms that could indicate coronary artery disease.
DEAR DOCTOR K: I have healthy cholesterol levels, but my triglyceride level is high. What are triglycerides? And how dangerous is it to have high levels of them?
DEAR READER: Triglycerides are a type of fat. They are important because they provide energy the body needs. Our bodies convert food we eat into triglycerides. They get bundled together into small packages and travel in the blood.
DEAR DOCTOR K: Until recently, I had never noticed coconut oil in the grocery store. Now it seems I can’t avoid it. Is it true that it’s better for you than other cooking oils?
DEAR READER: Most plant oils are full of “good” fats — monounsaturated and polyunsaturated fats — and contain relatively few “bad” fats, particularly saturated fats. Plant oils such as olive oil, canola oil, peanut oil and safflower oil are all definitely better for you than other sources of fat, such as butter, hard margarine and lard.
DEAR DOCTOR K: I’m an 80-year-old man who spends summers on the coast of Maine. I love to swim in the ocean for 20 or 30 minutes each day. The water is cold (55 degrees F), but it doesn’t bother me. My real question is whether doing this is bad for my heart, because my heart rate is sometimes irregular. Are my cold-water swims OK?
DEAR READER: First of all, congratulations! Anyone who is 80 years old and is up to the challenge of a daily swim in the ocean deserves our admiration. You obviously have both courage and a zest for life.
DEAR DOCTOR K: I enjoy an alcoholic beverage from time to time. Now I hear it may actually be good for my heart health. How can I enjoy regular drinking without it becoming a harmful habit?
DEAR READER: What you’ve heard is true. Study after study has shown that moderate alcohol consumption is associated with good health. But — and it’s an important “but” — alcohol is healthful only if you drink moderately and don’t go overboard. A little may be better than none, and also better than more.
Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. Learn more »
Harvard Health Publications is the publishing division of Harvard Medical School, providing the general public with authoritative, trustworthy, and accessible health information. Learn more »
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