Heart Health Archive

Ask the doctor

Q. A friend was just diagnosed with cardiomyopathy. What causes this problem, and what is the prognosis?

A. In simple terms, cardiomyopathy refers to abnormal heart muscle. Some cases are mild and require no treatment. But in other cases, the condition causes severe symptoms (such as breathing difficulty and leg swelling) and leads to serious complications. Cardiomyopathy is one of many possible causes of heart failure, which happens when the heart is unable to pump well enough to meet the body's need for oxygen-carrying blood.

Experts recommend one or two servings of fish per week. But healthy vegetarian meals are a good alternative.

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Eating fatty fish such as salmon, tuna, or mackerel at least once a week may help prevent heart attacks and other serious cardiovascular problems. That's according to a recent scientific advisory from the American Heart Association, which reaffirms a long-held observation about the health benefits of seafood.

You'll potentially reel in the biggest benefit if you replace less healthy foods — such as red meat or processed meats — with seafood entrees. For example, choose salmon over steak, and swap the ham on your sandwich for tuna.

High blood levels of a fatty particle called lipoprotein(a) may explain some unexpected premature heart attacks.

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Have you ever heard of a middle-aged man who was in great shape, never smoked, had a normal cholesterol level, but still had a heart attack? Many people either know someone who fits that profile or have read about Bob Harper, the celebrity fitness trainer from the TV show The Biggest Loser, who had a heart attack last year at age 52.

For Harper, the culprit apparently was an abnormally high level of lipoprotein(a). Also known as Lp(a), it's a variant of the familiar "bad" LDL cholesterol (see "Cholesterol 101: Lipoprotein basics"). Lp(a) particles are LDL with an extra protein attached.

Several sex-specific issues may foretell a higher risk of cardiovascular problems in women and men.

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You probably know the key health indicators that pose a danger to your heart, such as high cholesterol and elevated blood pressure. But many people are not aware of the sex-specific conditions that may serve as early warning signals for heart disease.

For women, these include problems that sometimes occur during pregnancy, as well as other diseases that are more prevalent in females (see "Female-focused cardiac risks"). For men, it's a relatively common problem that's less commonly discussed: erectile dysfunction.

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A salad is a great way to meet your daily vegetable requirement — just toss a few of your favorite veggies together with lettuce or other greens. Most grocery stores sell a variety of salad greens (separate or mixed), prewashed and bagged for convenience. Arugula and watercress are peppery, dandelion and escarole are bitter, mâche and iceberg are sweet, and a green called tatsoi has a mustard flavor. Baby spinach is another popular option.

The USDA recommends two to three cups of vegetables per day for adults. But because greens aren't very dense, it actually takes about two cups of raw greens to make the nutritional equivalent of a one-cup serving of vegetables.

Research we're watching

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Depression and heart disease often overlap. As many as one in five people with heart disease has depression. This common mood disorder is also linked to a higher risk of dying of heart disease.

Now, new research lends further support for the protective role of exercise for both conditions. The study, published online June 27 by JAMA Psychiatry, included nearly 18,000 people (mostly male) and used records dating back to the early 1970s. Researchers found that people who were fit during middle age were 16% less likely to develop depression after age 65.

This newer way to perform CPR is easier than the traditional method, and it's saving lives.

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Every year, more than 350,000 Americans experience sudden cardiac arrest, when the heart stops beating without any warning. In the agonizing moments before paramedics arrive, there's no blood circulating in the body to deliver oxygen to the brain and other organs; death is just minutes away.

"When the cardiac arrest occurs outside of a hospital setting, the survival rate ranges from 2% to 15%," says Dr. Kei Ouchi, an emergency physician at Harvard-affiliated Brigham and Women's Hospital.

Learn the most common sources of sodium in your diet and some easy substitutions you can make.

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If you think steering clear of potato chips, pretzels, and other savory snacks is the best way to trim salt from your diet, think again. Yes, those foods are salty — but they only rank no. 7 on the top 10 sources of sodium (a major component of salt) in the average American's diet.

The category of bread and rolls tops the list, which is based both on sodium content and how often people eat the foods. Bread is not especially salty, but we eat a lot of it, as well as similar foods such as hamburger and hot dog buns, bagels, and English muffins.

Ask the doctor

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Q. I was recently diagnosed with aortic stenosis after my doctor heard a slight heart murmur and referred me for an echocardiogram. I don't have any symptoms, so the cardio­logist recommended that I get periodic echocardiograms to monitor the condition. Is there anything else I can — or should — do?

A. Aortic stenosis — also called aortic valve stenosis — occurs when the one-way valve inside the heart's largest vessel, the aorta, stiffens and becomes clogged with calcium deposits. As a result, the valve doesn't open as easily. During a heartbeat, as the heart's main pumping chamber (the left ventricle) contracts, pressure builds up behind the aortic valve. This creates the turbulent blood flow that a doctor can hear through a stethoscope.

These drugs help prevent potentially life-threatening events. Make sure you're taking them correctly.

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Recently, a Heart Letter subscriber emailed us this query: "Does taking your blood pressure medication at night protect the heart more than if you take it in the morning? If so, why?"

Maybe you've wondered the same thing, or have other questions about the drugs you take to prevent or treat heart disease. In addition to blood pressure pills, these include drugs to lower cholesterol and to prevent blood clots.