Heart Health

What is sick sinus syndrome?

DEAR DOCTOR K: My doctor says I have "sick sinus syndrome." What is it?

DEAR READER:Your question reminded me of something that happened many years ago. A new patient came to my office. She told me that a colleague of mine had been her doctor, but she had stopped seeing him because "he didn't know what he was talking about." When I asked her to explain, she said that she had been weak and had almost fainted several times. At other times, her heart suddenly seemed to be beating too fast.

When is it safe to have sex after a heart attack?

DEAR DOCTOR K: I'm a man in my 60s. I had a heart attack a few months ago, and now I'm afraid to have sex. Is it too strenuous for my heart?

DEAR READER: Your question is a common one. Many of my patients who've had a heart attack wonder if and when it will be safe to resume sexual activity. I can understand why. Physical exertion causes the heart to work harder, and if you've had a heart attack, your heart has been injured.

Does my high HDL cancel out concerns about my high LDL cholesterol?

DEAR DOCTOR K: I am 71 years old. My LDL cholesterol is 160, but my HDL is 122. Does my high HDL cancel out concerns about my high LDL cholesterol?

DEAR READER: I can't give you a definite answer for a simple reason: There are very few people like you. Therefore, there are few studies of people like you. Here's what we know. For the vast majority of people, the higher your LDL ("bad") cholesterol, the greater your risk of heart disease. In contrast, the higher your HDL ("good") cholesterol, the lower your risk.

What’s the link between diabetes and heart disease?

DEAR DOCTOR K: When I was diagnosed with diabetes, my doctor said I am now also at increased risk for heart disease. What's the connection?

DEAR READER: The link between diabetes and cardiovascular disease is stronger than many people realize: About two-thirds of people with diabetes die of heart disease or stroke. I spoke to my colleague Dr. Benjamin Scirica, a cardiologist at Harvard-affiliated Brigham and Women's Hospital, about the link between the two conditions. He explained that diabetes harms the heart in several ways.

Are treatments for peripheral artery disease and coronary artery disease similar?

DEAR DOCTOR K: I have PAD. It sounds like coronary artery disease of the legs. Is the treatment similar too?

DEAR READER: You're right: It's the same disease -- atherosclerosis -- in different arteries. In atherosclerosis, cholesterol-filled growths, called plaques, grow inside the artery. They block the flow of blood through blood vessels. In coronary artery disease (CAD), atherosclerosis blocks blood flow to the heart. In peripheral artery disease (PAD), plaque builds up in the arteries of the legs and feet, restricting blood flow to those areas.

Do I really need to be on statins?

DEAR DOCTOR K: I had bypass surgery last year, and I've been on two different statins. But I had severe muscle and joint pain. Do I really need to be on a statin? The side effects are awful for me.

DEAR READER: Statins are the most widely prescribed cholesterol-lowering drugs. They significantly lower levels of harmful LDL cholesterol in the body. And they've been shown to reduce death, heart attack and stroke risk by up to 30 percent in people at high risk.

How is a pacemaker inserted?

DEAR DOCTOR K: I'm scheduled to have a pacemaker inserted in a couple of weeks. Can you tell me what will happen during the procedure?

DEAR READER: A pacemaker is a little box that is placed beneath the skin of your chest. It has wires that run into your heart, attaching to its inner surface. A pacemaker regulates your heartbeat electronically.

What is a list superfoods that support heart health?

DEAR DOCTOR K: You've written about "superfoods" that deliver a lot of nutritional bang for their buck. Do you have a list of superfoods for heart health?

DEAR READER: Many foods -- from the everyday to the exotic -- are rich in nutrients that help keep heart disease at bay. That's good news, and it's been documented in many scientific studies. My colleagues in nutrition science at the Harvard School of Public Health and Harvard Medical School have published the following list of heart-healthy superfoods. They and I use the word "superfoods" advisedly. Obviously, no food offers anything like perfect protection against any illness.

Does a diet rich in saturated fats still increase heart disease risk?

DEAR DOCTOR K: Here we go again. After years of hearing that diets rich in saturated fats increase the risk for heart disease, I hear a new study says that's not so. What gives?

DEAR READER: I don't blame you for being frustrated. So let me start with the bottom line: Take this new study with several grains of salt. (Incidentally, it still is true that too much salt is bad for your health, so just a few grains, please.) Back in the 1970s and 1980s, you heard a lot about how fat was bad for you.

Does chelation therapy help with heart disease?

DEAR DOCTOR K: I have heart disease, and I keep hearing that chelation therapy can help. It sounds like snake oil to me. What is it, and can it help?

DEAR READER: Ever since I graduated from medical school, I've thought, like you, that chelation therapy for heart disease sounded like snake oil. Many of my patients have asked about it, and I've told them not to consider it. About a year and a half ago, a reader asked me the same question, and I was pretty negative in my column.