well.

Hello and welcome to HealthLine.

I'm Jennifer Bloomquist.

I'll be hosting the program this evening and I'm so glad you joined us.

I wore red because tomorrow was St. Valentine's Day of course and we are talking about hearts tonight we have a cardiologist and we have not had a cardiologist on this program in a while.

So I'm sure hoping that you'll take advantage of getting some great advice.

It's timely considering this is Heart Health Awareness Month so feel free to call at any time.

Again I'll introduce you to the physician who's been kind enough to come tonight but we keep that phone number up at the bottom of the screen throughout the program and call at any point.

So it's (969) 27 two zero.

It's a free call even if you're outside of Fort Wayne just put 866- in front of there and then I want to remind you that you have two choices when you call in to talk to the doctor and ask a question you can do it live.

So when you call in they don't throw you on the air.

You will talk to a very nice call screener and you can tell that person if you want to ask the question live or if you prefer that I ask the question for you I will say that if you ask it live the nice thing is that the doctor can interact with you live on the air maybe he would need some more information from you to better answer your questions.

So just keep that in mind and again that will stay up at the bottom of the screen throughout the program.

So let me introduce you to our guest tonight.

He's been on before but it's been a while.

It's a cardiologist, Dr. Mark O'Shaughnessy.

So thank you so much for coming on.

Thanks for having me.

>> Appreciate it.

Absolutely.

I think I can't go more than a week without hearing about somebody I a friend or a relative having a heart issue and it just seems to be very prevalent and I know the feel of cardiology just the offices are so busy just packed with people.

So we're in Heart Awareness Month.

What advice do you give to people in general you don't think about your heart until you have a problem probably right.

>> So so heart disease is the leading cause of death in both men, women and men.

So women think that cancer is their leading cause of death.

One in seven women will have a cancer.

One and two of them will have heart disease and so it's really important that we raise awareness that heart issues are significant in the majority of what I see are preventable.

And so with some very simple preventative type of things, the first thing I would say is o your numbers.

So the causes for heart disease or risk factors are cigaret smoking and I'm unabashed proponent of a cigaret ban tobacco ban because we know it causes heart disease but high blood pressure, high cholesterol, diabetes in a family history of the things that are the risk factors and so if you have a family history you need to know what your blood sugar is, what your cholesterol is and what your blood pressure is and a lot of patients will say, well, my family doctor knows that well they probably do but you can't be part of your health if you don't know what your numbers are.

So I would I would strongly encourage patients to know their numbers and make sure that we're doing everything we can to prevent this disease.

>> And I've always been under the impression a lot of the disorders you just talked about the high blood pressure, high cholesterol I mean that usually comes I feel like with people who are just sick around the middle.

So I was always told, you know, think about the middle part of your body.

Don't let it get don't let that get flabby because that is a predisposition to a lot of those.

>> So obesity is an epidemic as well and it is a risk factor for coronary disease but it is not I mean it's really you can't look at some of your body habits and say they're going to have disease and so the person's not going to have disease.

>> It's really important I've had people who are real skinny and have heart disease and so it's not not obesity certainly predisposes a person to having diabetes and high cholesterol which are risk factors for disease.

But just because somebody is obese doesn't mean they're going to destined to have heart disease.

And so it's real important that you can't look at somebody's body habits and say well, they're destined to have a problem.

>> Everybody is at risk.

And I was going to ask are there special tests you should you know I mean I know the recommendation is to see your doctor yearly for a checkup.

So would you get all those numbers you're talking about from a regular primary visit with your primary care primary care doctor is going to get those numbers for you.

>> You're going to check in, make sure you don't have diabetes If you have hypertension, you're on appropriate medications and they're not your cholesterol is and so those are the three major things you can get with your primary care doctor.

>> Of course cigar smoking if you're a cigar smoker, it's never too late to quit.

Do everything we can to get off the cigarets and in the family history you have to choose your parents and so that's one strike against you.

One screening study that would be considered is it was called a coronary calcium scan and it's a very inexpensive fifty dollars scan.

It looks it takes advantage of the stuff that plugs up our blood vessels is very complex biology.

We don't fully understand why and what it is but calcium as early component of the stuff that corrodes our pipes and so we take advantage of that x rays don't go through calcium so I can see our bones.

We get a CAT scan of your chest if you have calcium there you've got coronary disease and so it's a yes or no screening study.

It takes two minutes to do it can be done at any hospital in Fort Wayne and it basically gets a CAT scan of your chest.

>> No I.V.

sticks, no blood draws.

You don't have to disrobe for the screen.

It's a really good screening study.

Would you recommend that at a certain age or if you're having some kind of symptom if you're having symptoms?

>> I would certainly check it out with your primary care doctor first.

>> But at the age of 40, if you have risk factors we would consider doing and I wouldn't do it younger than forty and I wouldn't certainly do it if you're over 75 or 80 because when we do a screening study we're trying to mitigate risk factors.

Well, if you're eighty years old, do I want people to live to one hundred and twenty but there's not much I can do at that point in time.

So I would say if you're between 40 and maybe 60 or 70 those are the timeframe we'd want to consider doing screening.

>> OK, tell us the name again.

It was the heart scan of heart smart scan coronary calcium scan.

>> OK, we're just taking advantage of the calcium that's inside the coronary arteries.

If you have disease if your score is zero, you don't have disease.

If your score is anything but zero you have disease it's yes or no.

>> And how often would you want to do that if it came back?

Fine.

If zero I typically repeated about every five years oh OK.

I actually use it in the public safety arena.

I've been screening police, fire and EMS in this area.

>> They have the same risk factors as you right there on the job.

Stresses are weighed different than the average population and so in that population I been screening them every three years just because of risk.

But if it's a general population I think about every five years assuming a zero once it's not zero you don't need to repeat the scan.

Oh, it just it's like getting a colonoscopy if you have a polyp or not a polyp alters your screening schedule.

>> OK, right.

Good to know.

I want to just to remind everybody that we only have Dr. O'Shannassy here until a little before eight o'clock.

The time does go by quickly so take advantage of getting some wonderful advice if you have any question cardiology related mean we're talking about heart disease but do you have other things cardiology related?

Please take advantage of this guy because he can he can answer at least point you in the right direction.

Maybe it's not necessarily you that a loved one that you're concerned about or a friend and maybe you could just offer them some advice or things to think about tests to think about stuff like that.

So there's a number of nine six nine two seven two zero again outside of Fort Wayne, still a toll free call as long as you put in 866- in front of there with this being Heart Awareness Month, good time for maybe people to think about.

>> You talked about changing your habits.

I mean I think some people will roll their eyes and say yeah, yeah, I'm supposed to exercise and eat right.

>> Maybe people don't really know what that is.

It doesn't have to be running a marathon so exactly.

And so I think it's really moving, you know and I tell people there's not one form of exercise it's any better than exercise.

The one you enjoy doing will be the one that you will do so if you if you like to do an elliptical or if you like dancing or if you like swimming or whatever it is walking is a You don't have to go out and run races.

You don't have to be an elite athlete.

You have to move and it really is never too late to start that either.

You know I have patients who have severe orthopedic issues and they can still do something.

>> They can still move.

And so I think just staying active is important and I'm a firm believer in a prudent there are a lot of fad diets out there and I know you've had dietitians on this show to talk about those diets.

>> Quite honestly, we have an obesity problem in the United States.

It would be a proble worldwide.

It's really our caloric intake.

It's not the foods reading, it's how much we're eating those foods.

So I'm a firm believer in moderation decrease the amount of foods certainly moderating our fat intake is important cholesterol intakes important from cardiovascular standpoint but it's more about just moderation and exercise.

>> Is that the two things that I think can be a huge step to heart heart health ?

>> I remember you talked about salmon being so good to eat and now this is a great week to buy salmon.

It's on sale everywhere.

Tomorrow starts tomorrow.

You know some of the fish sales .

Yeah, but my kids love salmon.

You wouldn't think that kids would eat that but if you're one of these people it's like about the fishing.

Fishing is salmon.

I like I said my kids love it fresh at first you just put it on the grill.

>> It's really so when we were talking about fish we really would like to call the deep water fish so cod salmon, tuna those kind of that have a lot of omega three fatty acids, fish oils so you can supplement fish oils with fish oil capsules but actually eating the salmon is taking away something else from your plate typically a red meat.

And so it's nice to be able to have a fish instead of sort of that you don't have to be every night again, I'm a firm believer in moderation.

People can splurge every now and then if you want to try to have a steak that's fine.

Yeah.

Just don't do it every night if you want to have eggs that's fine.

Just don't do it every night.

>> So I just think moderation is the key.

I'm glad you said that because I think people I feel like when I watched other people go try and go on these diets, some of them fad diets when you are so restrictive with yourself then it doesn't last and then you just go back to bad habits, you go back to your kind of thing and so the fad diets work.

If you look at the fad diets, every one of them work by caloric restriction.

You take an entire chunk of the food chain off the diet you're going to lose weight because you're not eating as many calories and so that's really how they all work.

>> And I know that people are selling books because they show their diet does this or that.

Yeah, it should be sustainable.

>> It's literally lifelong.

I mean it's it I'd like to I like to get to kids and have them starting exercise and dietary things because it's a lifelong thing that we really want to maintain heart health and it's easier to have a lifestyle rather than trying to change your lifestyle once once you have an event you have to change your lifestyle and that's really hard and so we'd like to have it start early on and maintain throughout the rest of your life .

> I was going to say and I've seen this witnesses firsthand from friends and family but you know somebody will have, you know, go into cardiac arrest or have something horrific happen and then it's it does have a big impact on the people around them.

I'm shocked I'll see them, you know, out biking instead of driving and yeah, they'll they'll talk to me about oh nowd we're doing this.

I mean it's sad but it's scary when you have something bad happen.

>> You know, cardiac arrest is is the the worst possible outcome when it comes to heart.

When we talk about heart attacks, heart attacks are caused by a buildup of fat and cholesterol inside tubes of our heart and we close off that blood supply.

The muscle blood doesn't get the nutrients it needs.

It has a very short time to be able to get to get the muscle open heart cardiac arrest is where the heart rhythm heart quavers and stops and that's a fatal problem if you don't get resuscitated quickly.

And so it's very important if somebody is having symptoms, recurring symptoms they need to get checked out.

>> I was going to ask you about the symptoms and if they differ by age or men and women because we always think about you know I don't know in the movies you'll see the guy holding on to his chest.

But I've heard people say it's actually sometimes feels more like it's in the center or like by their stomach.

>> Right.

So classic classic heart beating is an elephant sitting on my chest or a bear hugging me going down my left arm, going to my left jaw short of breath what you sick to my stomach less than half the patients present with classic angina it's more common not to have had those women more so than men have atypical symptoms.

And so my rule of thumb is if you're having recurring symptoms from the waist up it needs to be checked out.

>> It may not be heart disease but if it is and we wait too long then it's a real problem.

So it's critically important waist up recurring symptoms get it checked out right?

>> Never never hurts to be safe than sorry.

So we have somebody who'd like to ask the question live doctor so Kevin , are you still there?

>> Yes.

Hi thanks for waiting.

Go ahead with your question.

OK, my question is about blood pressure and I've been to scans My blood pressure is getting up as high as hundred ninety over 145.

They said they could find absolutely nothing and they thought it might be attributed to traumatic brain injury I had or a spinal cord injury and I now I'm at a loss at which direction to go.

Do I see a neurologist or should I continue with a cardiologist because they just dumped me off here I am well so it's really important that we get them that blood pressure under control that is that's going to be a critically important there are a lot of things that cause high blood pressure.

The most common cause of high blood pressure is called essential hypertension.

There's not one specific cause for it.

It's just it just the blood pressur goes up.

Brain trauma certainly could but that's not necessary.

You still need to treat the blood pressure so we need to find a medication or combination of medications that are going to control your blood pressure without causing side effects because high blood pressure in general doesn't cause symptoms.

And so if I give you a pill with side effects, you really don't want to take it so very important that regardless of the cause of even if it's just essential hypertension, it needs to be aggressively treated.

So I wouldn't let them off the hook.

>> I would say just keep working to try to get that blood pressure under under good control.

Kevin , did you want to ask Dr. O'Shaughnessy anything else?

>> I think they'll do it.

OK, well best of luck.

Yes.

Direct yes.

>> Yes.

Good luck.

All right.

Thank you, sir.

Best wishes.

Yeah you sometimes you just have to be an advocate for yourself.

>> Some of these offices are swamped.

They're swamped in this busy right now.

>> I'm glad he asked about that.

That's awfully high too.

That blood pressure.

Yes.

Is somebody called wanted me to ask the question for them.

>> It was Leah and she wanted to she was talking about that heart smart.

Yes.

Tessy you're talking about like a CT of your chest.

She must know if you need to have a prescription to get that test.

>> Great question.

So in the past no we were we're doing it but unfortunately we had too many people who shouldn't have gotten the excuse to get the scan.

>> So now we do need a prescription.

But you could talk to your primary care doctor.

I'll be happy to order that scan for you.

It's it's you know, either either any hospital in Fort Wayne or you could do that.

>> So just talk you talk to the family physician and they can order that for you.

You said it was it's fifty dollars.

OK, I understand it takes two minutes to totally painless.

Yeah I've not heard of that so that's a great great thing I think about that they'd be a great gift to give it to somebody you a hundred bucks on roses they're built in a day although the women are going to get mad at me but but this would be this is something they're thinking about love you want you to be some time thoughtful gift.

>> Let's see we had another person call Tom wanted me to ask you how long will a heart bypass last?

>> Great question.

So so when we hit we talk about heart bypass basically it's do you have blocked arteries?

The highways are closed to the plumbing is closed and so they bypass that and so typically the bypass grass can last forever.

But the problem is we can have progression of disease which means that the stuff that caused the fat and cholesterol in the first place can progress and we do everything in our power to make sure that we mitigate risk factors, keep your cholesterol down your blood pressure control your sugar under control, stop smoking exercise.

But even in that some people will unfortunately have some progression of disease.

>> But with today's technology I mean I see I've seen bypass grafts that are twenty five years old.

>> They look pristine and brandao so it's in there not destined to have bypass graft just function over time and so we will get Adreno for the blood vessel at some point in.

We don't have that today but something that dissolves that stuff out of there.

And so but right now I would say that you know, bypass I wouldn't put an expiration date on them at all.

I think that you know, we'll see if you do aggressive modification of your lifestyle.

>> It can last for four decades.

Yeah, that's longer than the orthopedic hardware that we talked about and that stuff's really expensive too.

So good to know there's a long life .

Let's see.

Sarah called and wanted me to ask you this question.

She said her mother has high blood pressure, has high blood pressure over night so she's taking medication to help.

>> Is there anything else she can be doing?

I think it's most important to take the blood pressure medication and make sure the blood pressure is staying down.

It depends on the age.

OK, so yeah, we I am a little bit hesitant to optima blood pressure is less than 120 over 80 and that's the current goal.

But when we get our patients get older in their 80s and their 90s dropping their blood pressure too low and we sometimes all of us had experience when you stand up quickly you get that feel like and so if we do that to elderly patients we're going to potentially cause them to pass out.

>> Right.

So if we can if we have a decent blood pressure control, then that's that's what we're looking for .

If it's overnight like it's during the daytime hours, then you take your blood pressure medication the evening before she goes to bed if it's during the daytime you take it during the daytime try to get better but so you try to modify the schedule of the medications to control the pressures when they're having high blood pressure.

>> Yeah, I was going to ask you is that typical for people just a certain time of the day to have the issue but then the rest of the day they're fine.

>> There's a circadian rhythm to our blood pressure is normal so our blood pressure will go up and down throughout the day.

And so yeah, in some people they will.

And so what I will do with that if they see my blood pressure is always up at night then I say what I would do is is to shift their blood pressure medications to the afternoon evening so I controller because most of the pressure medications have a half life and so so it will wear off over a period of time and so we try to control their blood pressure when it's highest point.

>> And so just really talking to the primary doctor and managing that blood pressure at the time the patients are having it and you know, I want to say, you know, Sarah was talking about taking care of her mom, you know.

Yeah.

If you've got an older mom or dad is on this heart having heart issues I mean sometimes you know, you have to monitor it, you know, especially if it's somebody who might be you know, not remembering to take their medicine all the time or maybe you know, they just they just don't want to.

And so sometimes I would feel like a family like a child or close relative could help in that situation.

>> It's hard to take any medications really and quite honestly taking medications multiple times a day is very difficult.

Oh yeah.

So we try the best we can to No one use generic medications because cost becomes an issue.

>> We try to use medications that are at the most twice a day if you do three or four times a day it's just not patients can't be compliant.

>> It's just too much too often to do that.

I have patients who were literally setting alarms to try to take their medications.

They say please don't do that.

Yeah, let's make it easy on you and try to try to make it cost effective.

And and again, I want to get the pressure down.

I want to control the risk factors but I don't want to break the bank in the process of doing that.

>> Yeah, well that just decreases your quality of life to you know, when you're living round the clock thinking about when when you take your pill next.

Absolutely.

Absolutely.

We do have a few minutes left and so I just want to remind everybody we've had some great questions.

I appreciate everybody calling n tonight but you could still squeeze in a few more questions if you want to give us a call.

It's (969) 27 two zero again, anything cardiology related would be more than welcome.

So feel free to call.

We just have a few more minutes left.

One thing we've talked about this but it's been a really long time ago and I think it was either you or one of your colleagues had referred to the heart as a sympathetic muscle.

You know, we talk about having a broken heart or but I feel like there's so much stress going on in the world.

We were talking before about how you can't post anything online without making somebody mad.

Yeah, I would do that literally .

It sounds like it literally could take a toll on your heart when you have stress especially most emotional stress.

>> How do you handle that?

So so we've gone back and forth about stress as a risk factor for coronary artery disease for blockers.

But there is a there is a diagnosis called tonkatsu Bacardi myopathy and it's basically broken heart syndrome.

It's a stress induced cardiomyopathy and so what person gets a severe emotional stress loss of a loved one house fire or something like that?

>> They will actually have what appears to be a heart attack.

>> The entire front of their heart stops moving.

They have chest pain.

We do a heart catheterization.

There's no blockages at all.

>> And so it's really unusual.

When I was in training we would see talk at SuBo once or twice a year.

We see it several times a month now I don't think it's related to the fact that our lives are way more stressfl.

>> Yeah, if we were at a very fast pace and I think it really creates problems.

>> So how do we deal with it?

Much more challenging problem, right?

Trying to reduce stress is a difficult wow.

You know, having a good foundation you know, base base of friends and family supportive.

You know, it helps to pray, you know?

I mean all right.

I can't tell you how many people I bet that's that faith is then a great medicine.

So something to think about.

Let's see Bob called in and he's on the line waiting to ask you the question.

>> Go ahead, Bob.

Well, I have a defibrillator in and I was wondering if you could kind of explain it.

It did go off on me on last off.

It was like a ton of bricks hit me in the chest and so I just wanted to kind of explain that.

>> Sure.

So defibrillators are devices paced fancy pacemakers that are monitoring your heart rhythm and looking for you to have an abnormal heart rhythm, specifically a rhythm coming from the lower chambers which are life threatening called ventricular tachycardia or ventricular fibrillation.

And so the pacemaker defibrillator is a guardian angel and it's watching your heart rhythm and if you happen to have a bad rhythm it will initially try to pace you out of it if it can't patia it'll shock your heart out of it and it's like an elephant kicking in the chest.

I mean when you least expect it is there but it's a life saving device.

It has backup pacing as well.

But it's critically important to maintain that because that's it's a light when even though it's uncomfortable to get shock, it just saved yourplife t exactly what it is is basically a guardian angel watching your heart rhythm if you have a bad really will shock you back to normal rhythm.

>> Bob, did you want to ask anything else real quickly we've got to come.

Oh no, no.

He answered it for he answered it really nice.

>> OK, thank you.

Thanks for coming here and happy Valentine's Day.

Happy Valentine's.

>> When that happens should you let your doctor know?

Yes.

OK, our patients get shock.

Give us a call and then we can interrogate the device make sure that there was an appropriate shock.

Rarely these devices are very sophisticated and rarely will be an inappropriate shock if an appropriate shock happens once we say did what we wanted to do if it's a recurring theme it's uncomfortable to get shock then we adjust our medications.

>> OK, I did not realize that my mom has one of those actually but she has not had a shock that she just got last fall so my mother had one as well.

>> She got shocked in her life and and she let people know she got shocked.

>> OK, I'm glad Bob.

Thank you because now I will be more aware when right around my mom.

So we do have time just for this quick question.

Patty had called in and she said she went in for surgery and they said she might have a heart murmur.

Is that something that she's got worry about I guess getting treated just to just evaluate it?

>> So heart rumors are sounded here with my stethoscope.

I remember just sound that we hear of blood flowing across a valve and so the only thing we would do is we would we would first off you can see a cardiologist or your primary care doctor might just ordered echocardiogram an ultrasound of your heart.

Look, the valves in most murmurs that we hear are flow members.

They're just flew across abnormal valve.

Pathologic members are actually going across an abnormal valve and those are the murmurs that we would want to be aware of and see how we make sure that there's not a major problem.

>> So it echocardiogram to be very reasonable.

OK, where she is going to be like a complication for medical treatment should not you know it really if they get the echocardiogram she could easily have a surgery or even to see a heart doctor and we could tell whether it's a plumber or not.

>> All right.

Well, this is going to be our last question and it's a good one I figured somebody to call and ask how much wine could I have each night so we only have 30 seconds left but she just wants is at heart healthy to have maybe a glass of red wine if you're if you're not if you're not a drinker I wouldn't ay to do it for heart health if you eat but in moderation a glass of wine a night is very reasonable.

>> OK at my house having sparkling grape juice tomorrow night red and red and white but you know it's it's the thought that counts.

Yes.

I figured we get a question about the wine.

I sadly our show is over.

Dr. O'Shaughnessy, sure appreciate the thank you very much.

>> Hopefully have you back sooner this year compared to the last.

So thank you so much to all of you for watching and your questions were great.

Really appreciate that.

And I know people got helped a lot tonight so I want to remind you too that if you wanted to see clips from the show you can go to YouTube.

They post like three minute clips and if you want to find out more information, just go online YouTube.

Have a good night.

Have a happy Valentine's Day.

I'm Jennifer Blomqvist.

>> Take care