Heart Health

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.

Is psoriasis linked to arthritis and heart disease?

DEAR DOCTOR K: My doctor thinks my arthritis and heart disease are connected to my psoriasis. Is this possible? I thought psoriasis was a skin condition.

DEAR READER: Psoriasis (pronounced so-RYE-uh-sis) is named for an ancient Greek word meaning an itchy or scaly condition. It is classified as a skin disease, but psoriasis is the result of an immune system abnormality that can cause problems throughout the body. With psoriasis, white blood cells of the immune system become overactive.

Is there a new way to perform CPR?

DEAR DOCTOR K: I thought CPR involved chest compressions, breathing into a person's mouth and checking their pulse. But my daughter told me that the "new" CPR involves only chest compressions. Is this correct?

DEAR READER: That's right. Since 2008, the American Heart Association has recommended "hands only" cardiopulmonary resuscitation (CPR) if an adult suddenly collapses. Cardiac arrest is usually to blame when someone collapses and stops breathing. It occurs when the heart's electrical system malfunctions. The heart beats rapidly and chaotically -- or stops beating altogether. The person stops breathing and becomes unresponsive.

Should I switch my atrial fibrillation medication?

DEAR DOCTOR K: I've been taking warfarin without any problems for years to treat atrial fibrillation. Now my doctor wants me to switch to a different medicine. Should I?

DEAR READER: Atrial fibrillation (aFib) is a rapid quivering in your heart's upper chambers, or atria. Instead of vigorously pumping blood down into the lower chambers (the ventricles), the quivering upper chambers let blood pool inside them. As blood sits, it can form clots. If a clot gets into the bloodstream and blocks a vessel supplying your brain, it can cause a stroke. Therefore, a person with aFib needs anticoagulant (anti-clotting) drugs.

What happens when someone having a heart attack gets to the hospital?

DEAR DOCTOR K: Can you tell me what happens when someone having a heart attack gets to the hospital?

DEAR READER: You're going about your day when you suddenly start to sweat and become short of breath. You feel a crushing pressure in your chest. You think: "This is it. I'm having a heart attack." A heart attack occurs when one of the coronary arteries, blood vessels that supply the heart, becomes fully or partially blocked.