Heart Health Archive

Ask the doctor

Q. My brother went to the emergency room because he thought he was having a heart attack. Instead, he was diagnosed with costochondritis. What is that?

A. Costochondritis is caused by inflammation of the cartilage between the ribs and the breastbone, called the costosternal joints (see illustration). This uncommon condition can trigger a stabbing, aching pain that's often mistaken for a heart attack.

Intermittent fasting promises better health and longer life, but does it work?

The obesity epidemic has spawned a cottage industry of weight-loss schemes. Currently in vogue is intermittent fasting, which involves alternating intervals of extreme calorie reduction with periods of normal eating. Proponents of an intermittent fasting regimen claim that it helps shed pounds faster than traditional diets, as well as reduce inflammation and other heart disease risks.

What is intermittent fasting?

All diets achieve weight loss through the same equation — you take in less food energy each day than your body burns for normal activity. Intermittent fasting achieves this goal by severely limiting calories during certain days of the week or during specified hours during the day. The theory is that intermittent fasting will help decrease appetite by slowing the body's metabolism.

There's no mercury to worry about, and flaxseed oil  does contain omega-3 fats...but not the best kind.

Troll the medical literature, and you'll come up with study after study showing that fish and fish oil are good for us, especially for our hearts but maybe also for our moods and immune systems. Various epidemiologic investigations have found that people who eat fish regularly are less likely to have heart attacks, suffer strokes, or die from sudden cardiac arrest. The definition of "regularly" varies, but it usually means at least a couple of times a week, although eating fish even once a month has been shown to make a difference.

Fish, and especially fish oil, have also been the subject of dozens of randomized clinical trials, most involving people with existing heart conditions. In large amounts (several grams a day), fish oil has been shown to nudge various cardiac risk factors ("good" HDL cholesterol, triglycerides, blood pressure) in the right direction.

The DASH diet has already been shown to lower blood pressure, and a new study found that people who followed it closely had a lower risk of heart failure. Try these suggestions to incorporate the DASH diet into your daily eating pattern.

Another study is questioning the healthfulness of eggs, but whether or not you should eat fewer eggs depends on your overall diet and your risk of cardiovascular disease.

Advice about eating eggs has evolved over the years. Should you go easy on this popular protein source?

Over the years, eggs have taken a bit of a beating, starting in the late 1960s. That's when the American Heart Association advised people to cut back on cholesterol in their diets and to eat no more than three whole eggs a week.

Decades later, eggs got a break after studies suggested that for most people, an egg a day was A-OK for heart health. But a recent report cracked down on eggs once again, suggesting that we return to the yolk-rationed days of yore (see "No yolk: Eggs linked to slightly higher risk of heart disease").

Ask the doctor

Q. I'm getting a pacemaker to treat a slow heart rate and am wondering how it might affect my daily life. For instance, can I still exercise? Is it safe to go through airport security scanners and to have medical imaging tests?

A. Pacemakers are small, implanted electronic devices that monitor your heart's rhythm and, when necessary, generate a painless electrical impulse that triggers a heartbeat. The latest models not only help people stay active later in life, they're also more compatible with today's technology.

Mounting evidence suggests that all movement — even low-effort activity — counts for preventing cardiovascular disease as people age.

When exercise experts talk about physical activity, they often focus on moderate and vigorous exercise — the types that get your heart pumping. But there's a growing appreciation that any type of activity that gets you up and off the couch also may benefit your heart.

One recent study found that doing light physical activity (preparing a meal or strolling through a park, for example) may lower the risk of cardiovascular disease among women in their early 60s and older (see "Low-intensity activity and heart disease risk"). The new study directly measured how much time people spent moving, using a device that tracked body movements and could assess light-intensity activity accurately, says study coauthor Dr. I-Min Lee, professor of medicine at Harvard Medical School.

The simple version of cardiopulmonary resuscitation — pushing hard and fast on the chest — can double a person's odds of surviving cardiac arrest.

If someone suddenly collapses and stops breathing, the most likely cause is cardiac arrest. An electrical malfunction causes the heart to beat rapidly and chaotically — or to stop beating altogether. But if a bystander immediately begins chest compressions, which mimic the heart's pumping action, blood keeps flowing to the person's brain.

For more than a decade, guidelines have recommended this simpler version of cardiopulmonary resuscitation (CPR), which does not involve the mouth-to-mouth breathing used in standard CPR.