By Steven Meyer, PA-C
According to the Center for Disease Control and Prevention, more than 15 million Americans with coronary artery disease are living with the disease. The number one killer of Americans, heart disease takes various forms.

Coronary artery disease involves narrowing of the coronary arteries that supply blood to the heart. When a clot forms on plaque deposits that are narrowing the passage, the result is a heart attack.

Angina is chest pain that occurs when the heart needs more oxygen than its getting. This is usually caused by a partial blockage of a coronary artery. When the angina is stable, it can be controlled with short periods of rest and medication. When episodes of pain are more frequent, more painful and less likely to be relieved by rest and medication–a condition known as unstable angina–a heart attack may be imminent.

Congestive heart failure refers to a weakening of the heart’s pumping action, caused by injury or disease that can lead to a dangerous buildup of fluids in the lungs, ankles or elsewhere in the body.

When early manifestations such as high cholesterol and high blood pressure are included, a substantial portion of the population, young and old, is living with heart disease.

For either of these early conditions, required behavioral changes include regular exercise, a heart-healthy diet, weight control and avoidance of cigarette smoke, both first- and second-hand. Patients should also monitor both cholesterol and blood pressure carefully and take prescribed medications.

Even with normal cholesterol and blood pressure, however, some individuals suffer a heart attack or discover that they have angina. At this point, the need for dramatic lifestyle changes becomes critical.

Angina occurs because constriction of coronary arteries prevents normal blood flow to the heart. The pain can be triggered by anything that causes the heart to work harder–physical activity, emotional stress, cold weather, a big meal. To relieve angina attacks, many patients are prescribed nitroglycerin to carry with them at all times and to place under the tongue at the time of an attack. They shouldn’t limit physical activity or exercise because of fear of a heart attack, but to respect angina and rest until the symptoms subside.

Patients also can keep a diary to help them discover when their angina tend to occur—maybe after climbing more than one flight of stairs without stopping, walking faster than usual or when under a great deal of emotional stress. They should avoid combining triggers–such as hurrying to get to a car when the weather is especially cold.

When angina becomes difficult to control, many patients undergo balloon angioplasty or coronary artery bypass graft surgery to restore normal blood flow through coronary arteries. These procedures are also used as emergency treatment for a heart attack.
Either a heart attack or a heart procedure is emotionally and physically traumatic.

Nevertheless, doctors like to get patients up and moving around as soon as possible. Cardiac rehabilitation typically starts in the hospital, and most doctors recommend or prescribe it after the return home.

Regular supervised exercise strengthens the heart and reduces the risk of a future heart attack. It’s also good treatment for congestive heart failure. According to one study, heart attack patients who attended cardiac rehabilitation had a 50 percent increased chance of being alive three years later compared to those not participating.

Unfortunately, many Americans living with heart disease–whatever the form or severity–fail to heed the advice about what they should or shouldn’t do. Many even become lax about taking their prescribed medications.

In an era when treatment options were severely limited, our grandparents had heart attacks and died early. But today, if those with coronary artery disease are careful about following treatment plans, they can enjoy fairly normal lives for many years.

For more information please visit minitryhealth.org or contact Ministry Medical Group in Rhinelander at 715.361.4060.

Stephen Meyer, PA-C, is a Physician Assistant with Ministry Medical Group Internal Medicine in Rhinelander.