Heart Health

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.

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.