Heart Health

Is coffee bad for your heart health?

DEAR DOCTOR K: I've heard that coffee is good for your health -- but I've also heard that it increases your blood pressure and heart rate. What's true?

DEAR READER: Right now, the evidence I'm aware of points to health benefits for most people from regularly drinking coffee. I'm talking about straight coffee -- minus the cream and sugar. Straight coffee is a nearly calorie-free beverage brimming with antioxidants. There's evidence that drinking coffee might help prevent Type 2 diabetes and reduce the risk of heart disease and stroke. And studies show lower rates of gout and liver disease among regular coffee drinkers.

Is an endarterectomy the best treatment option for a clogged carotid artery?

DEAR DOCTOR K: I have a clogged carotid artery. My doctor wants me to have an endarterectomy. Is this the best treatment option for my condition?

DEAR READER: It's impossible to answer your question without a lot more information. What I can do is describe what a clogged artery is, and what some of your treatment options are. The carotid arteries of the neck carry oxygen- and nutrient-rich blood from the heart to the brain. Deposits of fat and cholesterol -- plaque -- on the walls of the carotid arteries increase the risk of a stroke. Plaque can block blood flow to part of the brain. Or, a piece of it can break loose and completely block a smaller vessel in the brain.

I take low-dose aspirin to prevent a heart attack. Do I need to worry about bleeding risks?

DEAR DOCTOR K: I had a heart attack several years ago. I have been taking low-dose aspirin ever since to prevent a second one. Do I need to worry about bleeding risks?

DEAR READER: Every medicine contains risks as well as benefits. The question with any medicine is: Do the benefits outweigh the risks? Aspirin helps prevent repeat heart attacks in two ways. A heart attack occurs when the flow of blood through one of the heart's arteries is blocked.

What is a pulmonary embolism?

DEAR DOCTOR K: What is a pulmonary embolism?

DEAR READER: A pulmonary embolism occurs when a blood clot (called an embolus) suddenly blocks a blood vessel in the lung. A small pulmonary embolus can happen without causing any symptoms, but a large pulmonary embolus can suddenly threaten your life. To explain pulmonary embolism, let's begin with a refresher on the circulation of blood in our bodies. Blood carries nutrients (like oxygen and sugar) to the cells of our body and removes waste material from the cells. The blood circulates because of the pumping action of the heart.

Should I be concerned about my heart while shoveling snow?

DEAR DOCTOR K: Every winter my wife worries that I am going to have a heart attack while shoveling snow. Does she have cause for concern?

DEAR READER: She does. Each winter, more than 1,200 heart-related deaths occur during or after snowstorms. Shoveling snow is risky for many reasons: Shoveling is similar to weight lifting. Resistance exercise raises both heart rate and blood pressure, stressing the heart. Cold weather affects the heart. To conserve body heat in the cold, blood vessels narrow. This raises blood pressure and puts stress on the heart.

Could my anger trigger a heart attack?

DEAR DOCTOR K: I have a bad temper. Could my anger trigger a heart attack?

DEAR READER: You've seen it in movies: A character shouts in anger -- then drops to the floor clutching his chest. But this isn't just a movie scenario. Research shows that in the two hours after an angry outburst, a person has a slightly higher risk of having heart trouble. By heart trouble, I mean chest pain (angina), a heart attack, or a dangerous heart rhythm that can lead to sudden death. The person also is at higher risk for having a stroke.

What is a heart murmur?

DEAR DOCTOR K: What is a heart murmur? How is it treated?

DEAR READER: A heart murmur is a sound made by turbulent blood flow within the heart. (Think whitewater rapids as opposed to a gently flowing river.) Your doctor hears this sound with a stethoscope. Most often, a murmur occurs in a healthy heart. Sometimes, people have murmurs just with a normal flow of blood through their hearts.

Is it important to know your heart rate when you’re exercising?

DEAR DOCTOR K: I've seen fitness monitors that track heart rate. Is it important to know your heart rate when you're exercising?

DEAR READER: Whether you're just getting started with an exercise routine or are a committed fitness enthusiast, tracking your heart rate can be helpful. Heart rate monitors -- which instantly tell you how fast your heart is beating -- can help you exercise at the right intensity.

Is Pradraxa as safe as previously thought?

DEAR DOCTOR K: I have atrial fibrillation. For years I took warfarin. Last year I switched to Pradaxa. Now I hear Pradaxa may not be as safe as my doctor said. What can you tell me about this?

DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. It increases the risk of stroke. For decades, the best way to prevent stroke from atrial fibrillation was by taking a blood thinner called warfarin (Coumadin).

How does an LVAD work?

DEAR DOCTOR K: I have severe heart failure. My doctor wants me to consider an LVAD. What do I need to know?

DEAR READER: Heart failure is a condition in which the heart cannot pump efficiently enough to meet the body's need for blood. It needs help; it's too weak to do the job. Medicines can strengthen the heart, but only to some degree. Ultimately, the only solution may be a heart transplant.