Heart Health Archive

How maintaining a healthy weight and other lifestyle habits can help prevent this common heart rhythm disorder.

During a bout of atrial fibrillation, your heart may beat so rapidly, it may feel as though it's going to explode out of your chest. Commonly known as afib, this heart rhythm problem can leave you breathless and lightheaded—or cause no symptoms at all. About 9% of people ages 65 and older have afib, which raises the risk of stroke and other heart-related problems. But there are ways to lower your odds of developing afib—or to reduce its impact if you already have the condition.

Lessen your load

By far, the most important step you can take is to attain and stay at a healthy weight. "We have good evidence from multiple studies showing that people who are overweight have a higher risk of afib than people who are at a healthy weight," says Harvard professor of medicine Dr. Christine Albert, former director of the Center for Arrhythmia Prevention at Brigham and Women's Hospital. And the more you weigh, the higher your risk: people who are overweight have a 20% to 25% higher risk, whereas those who are obese (a body mass index, or BMI, of 30 or higher) have a 60% higher risk.

A high pain tolerance may account for some "silent" heart attacks. But failing to recognize atypical symptoms is a more likely explanation.

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Nearly half of people who have a heart attack don't realize it at the time. These so-called silent heart attacks are only diagnosed after the event, when a recording of the heart's electrical activity (an electrocardiogram, or ECG) or another test reveals evidence of damage to the heart.

What's behind this surprising phenomenon? One explanation may be a higher-than-average tolerance for pain, as a recent study suggests (see "Does a high pain tolerance mask heart attack symptoms?"). Other people mistake their symptoms as indigestion or muscle pain. Still others may feel pain, but in parts of their upper body other than the center of the chest.

Q. After several episodes where my heart suddenly started racing, I was diagnosed with supraventricular tachycardia. My doctor said I could try gagging or coughing to help slow down my heart when these episodes occur. Why would those things help?

A. Supraventricular tachycardia (SVT) is caused by an electric problem in the area above the heart's lower chambers, or ventricles. This uncommon disorder can cause the heart to beat more than twice as fast as normal—even up to 300 times a minute. It is more common in younger people than in older folks.

Sometimes it's hard to tell the difference between a heart attack, heartburn, and lung problems.

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Many kinds of health problems can cause chest discomfort, with symptoms so intense that you rush to the hospital. "I see older adults with chest pain or something related to it every time I work in the emergency department," says Dr. Kei Ouchi, an emergency medicine physician at Harvard-affiliated Brigham and Women's Hospital.

The big fear

You may worry that chest pain is due to a heart attack, which occurs when blood flow to the heart is blocked, typically by a blood clot and narrowed arteries. Classic symptoms include pressure or squeezing in the chest, lightheadedness, and pain in the shoulder, arm, neck, jaw, or back.

Ask the doctor

Q. A friend recently had what his doctor called a "3D echocardiogram." How is that different from a standard echocardiogram?

A. All echocardiograms use high-frequency sound waves (ultrasound) to create still and video images of your heart. But there are two different procedures for getting the images and several variations of this common test, which doctors often refer to simply as an echo.

Stressful experiences are hard to avoid and impossible to predict. But taking steps to bolster your resilience may help.

The palpable stress stemming from the COVID-19 pandemic has made things once considered stressful — such as deadlines or traffic jams — seem pretty trivial in comparison. But while you may not be able to avoid the stressful situations that come your way, there are ways to mitigate your body's response to those events.

So far, the evidence that stress management strategies can protect your heart is limited but growing. Yet there's no doubt that stress contributes to heart problems. "The link between stress and cardiovascular disease is well established," says cardiologist Dr. Ahmed Tawakol, an associate professor of medicine at Harvard Medical School.

The novel coronavirus is especially risky for people who have or are at risk for cardiovascular disease.

Editor's note: Research and news about COVID-19 change rapidly. For updated information about the pandemic, see www.health.harvard.edu/cvrc.

When cases of COVID-19 began to surge across the globe earlier this year, doctors quickly realized the infection was particularly dangerous for people with heart disease and related conditions, especially high blood pressure. These health problems become more prevalent with age, so could that explain why COVID-19 is more deadly in older people?

Every year, hundreds of people in the United States die waiting for a heart transplant. A new procedure may make more donated hearts available.

In this country, more than 7,300 people are on the waiting list for a new heart during the course of a year. The majority are in their 50s and early 60s, and most have severe, debilitating heart failure. But because of a shortage of suitable donor hearts, fewer than half will receive a heart transplant. However, an emerging technique known as donation after circulatory death may help address that gap in coming years.

For decades, all heart transplants done in the United States have used hearts donated after brain death, which is defined as the irreversible loss of all brain function. Organs other than the heart — including lungs, kidneys, and livers — are donated after either brain death or after circulatory death, a circumstance known as donation after circulatory death, or DCD (see "What is donation after circulatory death?"). But in recent years, researchers in Australia and England began pioneering heart transplants following circulatory death.