Heart Health Archive

Not all heart attacks result from a blocked artery — and even small ones can have serious outcomes.

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Perhaps you've heard heart attacks described in various ways, from "mild" to "massive," or even the ominous-sounding "widow maker." But these terms may sow confusion and anxiety.

The good news: Most people who have a heart attack survive. The bad news? "Any heart attack can be fatal, no matter how big, how small, or where it occurs in the heart," says Dr. James Januzzi, a cardiologist at Harvard-affiliated -Massachusetts -General Hospital. There's a lot of mis-understanding among the general public about what a heart attack actually is, he adds.

Riding a bike — either outdoors or inside — can be a good way to exercise at different levels of intensity.

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Spring's milder temperatures often encourage people to exercise outside. Riding a bike can offer a nice break from walking, the exercise that doctors recommend most often. If you're bored of your walking route and looking for bit of a challenge, consider cycling. Biking enables you to travel faster and farther than jogging or running but puts far less stress on your joints.

"I have many patients who bike, and they find it's a great way to get some exercise, especially when the weather's favorable," says Dr. Brendan Everett, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. Cycling may not burn as many calories as jogging over a given period of time, but jogging is difficult for many people, he notes. Also, you can choose a route that suits your fitness level — from a short, flat loop to a longer ride with gently rolling hills.

Treating a borderline low thyroid hormone level may be unnecessary — perhaps even undesirable — in older people.

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Your thyroid, a butterfly-shaped gland at the base of your throat, releases hormones that affect your entire body, including your heart. An underactive thyroid, or hypothyroidism, can trigger a range of symptoms, including fatigue, feeling cold, and unexplained weight gain. If left untreated, hypothyroidism can slow the heart rate and make the arteries less elastic, causing blood pressure to rise. Elevated cholesterol -levels are another possible consequence.

True hypothyroidism is not common; it affects between 1% and 2% of people, mostly women. These people clearly need replacement thyroid hormone, which should alleviate their symptoms and protect their hearts.

Catheter ablation, a procedure that destroys faulty electrical pathways in the heart, is gaining ground.

Atrial fibrillation — called afib for short — is a rapid, irregular heartbeat caused by errant electrical signals in the heart's upper chambers (atria). This heart rhythm disorder becomes more prevalent with age, affecting about one in 11 people ages 65 and older.

The chaotic heartbeat that characterizes afib usually comes and goes and may last anywhere from a few seconds to many hours — or much longer (see "Atrial fibrillation: Defined by its duration"). Although about 20% of people with afib don't notice any symptoms, it can trigger a range of unsettling problems. These include a fluttering or thumping sensation in the chest, breathlessness, dizziness, anxiety, weakness, fainting, confusion, and fatigue.

Asparagus is often available year-round. But spring is the peak season for this popular vegetable, with April being the prime month. In the market, look for bright green stalks with firm, tight tips (which may have a purplish cast).

If you notice that your urine smells a bit unpleasant after you eat asparagus, you're definitely not alone. The odor comes from sulfur-containing chemicals that form when your body metabolizes asparagusic acid, a compound found in the vegetable. Not everyone notices this phenomenon, however, either because they metabolize the chemical differently or because of an inherited inability to perceive the smell.

Research we're watching

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Decades of sedentary behavior (for example, sitting during most of your waking hours) can cause your heart muscle to shrink and stiffen. But for longtime couch potatoes, a mash-up of different types of aerobic exercise may help restore heart health, a new study suggests.

For the study, 53 healthy but sedentary middle-aged adults were divided into two groups. One (the exercise group) did high- and moderate-intensity aerobic training four or more days a week for two years. The other (the control group) engaged in regular yoga, balance training, and weight training three times a week for two years.

Research we're watching

Smoking just one cigarette a day appears to raise the risk of heart disease and stroke by between 48% and 74%, according to a study in the Jan. 24, 2018, issue of The BMJ.

Researchers pooled data from 141 studies done in 21 countries and regions, together involving millions of people. They analyzed the risks associated with smoking one, five, or 20 cigarettes per day, taking into account age, sex, and other possible confounding factors. Just one cigarette per day accounted for half of the risk seen with smoking 20 cigarettes a day in men, and for one-third of the risk in women, they discovered.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

Q. There has been a lot of talk about the severity of this flu season, and I recently heard that influenza also can trigger a heart attack. Should I worry?

A. Influenza is responsible for about 10,000 to 20,000 annual deaths, mostly from pneumonia or internal organ failure. In other situations, influenza infection strains a person's health, which can worsen underlying conditions, such as heart disease.

In the journals

Taking a daily omega-3 fatty acid supplement might not reduce your chance of heart attacks or strokes if you already have heart disease or are at high risk for it, suggests a meta-analysis published online Jan. 31, 2018, by JAMA Cardiology.

The researchers compared 10 trials that included almost 78,000 people, approximately 47,000 of whom were men, with an average age of 64. Each trial involved at least 500 people who took daily doses of either an omega-3 fatty acid supplement or a placebo for at least a year. All participants had heart disease, had experienced a stroke, or were at high risk for these conditions.