Heart Health

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.

When can I go back to work after a heart attack?

DEAR DOCTOR K: I am 59 years old. I recently came home after being hospitalized for five days for a mild heart attack. I feel great -- but my doctor says he doesn't want me to go back to work for another six weeks, even though my job mostly involves sitting at my desk. I like to stay busy and feel ready to return to the office. Please advise.

DEAR READER: The treatment of heart attacks has come a long way in the past 30 years. Doctors can now open blocked coronary arteries with angioplasty balloons and stents or "clot-busting" drugs. We can use stress tests and echocardiograms to classify patients as low-, intermediate- or high-risk when they are discharged from the hospital. And patients go home with medications that reduce the likelihood of another heart attack.

What does snoring have to do with heart disease?

DEAR DOCTOR K: At my last checkup, my doctor asked if I snore. When I told the doctor that my husband says I snore a lot, the doctor said snoring can be a sign of heart disease, particularly in postmenopausal women. What does snoring have to do with heart disease?

DEAR READER: Snoring is not a sign of heart disease, but it can be a sign of sleep apnea. And people with sleep apnea are at greater risk for heart disease. Sleep apnea is a condition that causes brief, repeated pauses in breathing throughout the night.

What is a left bundle branch block?

DEAR DOCTOR K: I recently had an ECG that showed that I have a "left bundle branch block." What does this mean?

DEAR READER: When your heart beats, it does so in response to electrical signals. Your heart muscle is crisscrossed by a network of electrical pathways. A bundle branch block is caused by an abnormality in one of those pathways. The electrical signals that orchestrate each heartbeat work this way.

Does estrogen therapy increase the risk for heart problems?

DEAR DOCTOR K: I'm 68 years old and have been on low-dose estrogen therapy since I had a hysterectomy (and started menopause) at age 50. My doctor won't prescribe it anymore because he says it increases my risk of heart problems. Is that true?

DEAR READER: The effect of hormone therapy on the heart is a controversial area. Hormone therapy usually involves "combination therapy," with both estrogens (the main female hormones) and progestins (other important female hormones). Estrogen helps reduce symptoms of menopause, such as hot flashes. Progestin reduces the risk of cancer of the uterus.

During an angioplasty, why is the catheter inserted through the wrist?

DEAR DOCTOR K: I am scheduled to have an angioplasty next week. The doctor plans to insert the catheter through my wrist. Is there some advantage to doing it through the wrist rather than the thigh?

DEAR READER: Angioplasty is a procedure used to open a narrowed or blocked artery. Angioplasties are usually done to open up blocked coronary arteries -- the blood vessels that provide blood to the heart muscle. The blocked coronary arteries lie deep within the chest.

Should I stop taking niacin to raise my HDL cholesterol?

DEAR DOCTOR K: For years I've taken niacin to raise my HDL cholesterol. Now my doctor wants me to stop. Why?

DEAR READER: When we talk about cholesterol, we're generally referring to low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL is also known as "bad" cholesterol. When there is more LDL than necessary in the bloodstream, the LDL cholesterol burrows inside blood vessel walls. It slowly forms plaques of atherosclerosis. When those plaques rupture and block blood flow, they cause heart attacks and strokes.

How do I check my blood pressure at home?

DEAR DOCTOR K: My doctor told me to check my blood pressure at home, but he didn't give me many details. Could you provide some guidance?

DEAR READER: Keeping your blood pressure in check is vital to maintaining heart health and preventing stroke. But the way most of us monitor our pressure -- by trekking to the doctor's office for occasional blood pressure checks -- is far from ideal. For one thing, it provides isolated snapshots, rather than a complete picture.