Caring for Your Heart with John Farquhar, M.D.

By John Farquhar
WebMD Live Events Transcript

Join John Farquhar, MD, to discuss how to maintain a healthy heart, recognize warning signs, causes of chest pains, and managing blood cholesterol.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Event_Moderator Welcome to WebMD LIVE! Our guest today is cardiologist John Farquhar, MD, and the topic is 'Caring for Your Heart.' Dr. Farquhar is the founder of the Stanford Center for Disease Prevention and Health Promotion and a professor of medicine and disease prevention at Stanford University. He is the director of the World Health Organization Collaborating Center for Chronic Disease Prevention. He is also the author of The American Way of Life Need Not be Hazardous to Your Health , The Last Puff , and Diagnosis Heart Attack, which is due out this year. He is a member of the Institute of Medicine, the World Health Organization Expert Advisory Panel on Cardiovascular Diseases, and chair of the International Advisory for the International Hearth Health Conference. Welcome, Dr. Farquhar! How are you today?

John_Farquhar_MD Just fine.

Beth8_WebMD Long story short, I'm concerned with the effects of Mitral Valve prolapse with pregnancy. I'm 10 weeks pregnant and am currently on disability. I have severe swelling in my upper abdomen and area up between my ribs. Also have shortness of breath & chest pain.

John_Farquhar_MD I am not an expert in this field. I think that it is very important that you consult both with a gynecologist and a cardiologist on this matter, and soon.

yingeleh_WebMD Both of my grandfathers died at age 55 of heart attacks. How much more at risk am I because of this?

John_Farquhar_MD Family history is important but only as a clue. It is essential that you have all of your potential risk factors studied, for example, your BP, total cholesterol, HDL, LDL, triglycerides, plasma homocysteine and Lp(a). When you have worked out your own risk factors, you may find that any genetic inheritance from your grandparents has not been passed on to you. You see, it is most important to know your own risks.

Event_Moderator What is heart disease?

John_Farquhar_MD The word heart disease in this country usually refers to coronary heart disease. There are 500,000 deaths/year from coronary disease. Congestive heart failure has about 50,000 deaths/ year. Many of these are the end result of coronary disease, but some come from cardiomyopathy or from untreated hypertension. So heart disease as a phrase usually means coronary disease. In some countries where rheumatic heart disease is more common than in the US, more people have this as the source of their heart disease. There are many fewer cases of cardiomyopathy, some of arrhythmias due to genetically determined problems in the heart's conduction system--but these are quite uncommon. Some arrhythmias, common in older individuals is in fact due to coronary disease as well. So you see that we always return to heart disease being largely coronary artery disease

brendaw1_MSN What is the difference between congestive heart failure, and coronary disease?

John_Farquhar_MD Congestive heart failure is a failure of the heart's muscle to pump efficiently. About 75% of the time this is due to past heart attacks, or myocardial infarctions. The myocardial infarctions or MI's are due to coronary artery disease, which is secondary to atherosclerotic plaques in the arteries. About one quarter of cases of congestive heart failure, also called CHF for short are due to hypertension alone. The way that hypertension causes CHF is by making the heart pump against resistance for many years. The heart muscle enlarges but finally "wears out."

jrd35_WebMD What are the best ways to find out if I am at risk for heart disease?

John_Farquhar_MD The best way is to get your blood pressure measured about 4 or five times, take the average. Of equal importance is to get your cholesterol measured about 2 or 3 times over a few weeks. If your total cholesterol is over about 175 mg/dl, then get HDK, LDL and triglycerides measured. Know that if you smoke cigarettes, you are at great risk for heart disease on that alone. Risk factors are additive and even multiplicative. A person with low levels of the standard risk factors may have about 1/30th the risk of one with high levels of one with high levels. Important to know as well is your level of exercise. Any degree of exercise becomes protective but 40 minutes of brisk walking 4 times a week is highly protective. If there is a family history of heart disease, then the new risk factors of blood levels of homocysteine and Lp(a) should be measured. Also know if you are depressed, that is a risk factor. Levels of stress, especially if you have anger and hostility, acts as a risk factor as well probably by raising levels of cortisol and catecholamines.



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