WHAT DO I DO IF I AM HAVING CHEST PAIN?If you are having chest pain and it is accompanied with shortness of breath, it is recommended that you get to the hospital right away. Either call 911 or have someone drive you. If you are a patient and your physician has prescribed you Nitroglycerin, you can take that as directed. If the chest pain does not subside, you should go to the ER as soon as possible. If you are unsure of you symptoms, please contact your cardiologist.
WHAT ARE THE COMMON SIGNS OF CORONARY ARTERY DISEASE (CAD)?One of the most common signs of Coronary Artery Disease is chest pain, but often times in women can be silent. It is also described as chest discomfort, heaviness, tightness, pressure, aching, burning, numbness, fullness or squeezing. It can be mistaken for indigestion or heartburn. Chest pain is usually felt in the chest,and may radiate or travel to the left shoulder, arms, neck, back or jaw. Some other signs of Coronary Artery Disease are pain or discomfort in other areas of the upper body including the stomach, difficulty breathing or shortness of breath, sweating or “cold sweat”. If you have any of the above symptoms, please contact your cardiologist.
WHAT IS THE DIFFERENCE IN MEN AND WOMEN?Studies show that woman’s symptoms are less likely to be identified as heart disease. The symptoms of CAD and heart attack can be different for women than they are in men. Because of the atypical symptoms, women are less likely to recognize symptoms of a heart attack. By learning and recognizing symptoms, women can become assertive in their treatment.
The most common symptoms of heart disease in women are pain or pressure over their chest that travels to the arm or jaw, a burning sensation in the chest or upper abdomen, or shortness of breath, irregular heartbeat, dizziness, sweating, fatigue and nausea. For men, some signs/symptoms are often described as “the typical” type of chest pain that feels like squeezing or pressure. The pain is usually more sever and does not go away with rest.
WHAT SHOULD I DO IF I AM HAVING A DENTAL PROCEDURE?If you are having dental work and you are currently taking Plavix, Aspirin or Coumadin for heart problems, please inform your dentist. Have them call your Cardiologist with any questions or concerns regarding your medications. DO NOT stop any of your medications without speaking to your cardiologist first.
WHEN CAN I STOP TAKING PLAVIX, ASPIRIN OR COUMADIN FOR ANY PROCEDURE?Regardless of the type of procedure you are having, you should always contact your cardiologist to verify if you can discontinue your medication. This is especially important for people with a history of heart disease who take such medications as aspirin, Plavix, or Coumadin.
CAN I TAKE ERECTILE DYSFUNCTION (ED) MEDICATION IF I HAVE CAD?Prior to taking any type of ED medication, it is highly recommended to consult with your cardiologist. Medications used for ED are contraindicated with certain medications, such as nitrate therapy, as this can cause an unsafe drop in blood pressure.
IS ASPIRIN A MEDICATION?Aspirin is a medication even though you can purchase it over the counter without a prescription.
CAN I DONATE BLOOD AFTER I HAVE A STENT PUT IN?You are able to donate whole blood on aspirin therapy. There are, however, limitations if you take Plavix, Effient, or Coumadin. If you are on any of these medications and you wish to donate, please contact your cardiologist prior to stopping.
CAN I GO THROUGHT THE AIRPORT SECURITY SCANNER IF I HAVE A PACEMEAKER/DEVICE OR STENTS?Airport security systems are not likely to affect the operation of the pacemaker or implantable defibrillator. However, airport security systems (both walk through and hand held wands) are metal detectors. If you walk through at a normal walking pace, it will detect the metal of your pacemaker or defibrillator. The machine cannot determine if you have a weapon, so you may be asked to undergo additional screening. If you have a pacemaker, you may want to carry your identification card with you and ask to under go a hand-held screening wand held away from the pacemaker or hand search. If you have a cardiac defibrillator device, ask to be hand searched because the hand wand screening has potential to cause shock therapy.
I AM HAVING DENTAL WORK. DO I NEED ANTIBIOTICS BEFORE DENTAL CLEANING?In the past, patients with nearly every type of congenital heart defect needed to receive antibiotics one hour before dental procedures or operations on the mouth, throat, gastrointestinal genital, or urinary tract. However, in 2007 the American Heart Association simplified its recommendations. Today, antibiotics before dental procedures are only recommended for patients with the highest risk of Infective Endocarditis, those who have:
- An artificial heart valve or who have had a heart valve repaired with artificial material.
- A history of endocarditis.
- A heart transplant with abnormal heart valve function
- Certain congenital heart defects including:
1)Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had surgical shunts and conduits.
2)A congenital heart defect that’s been completely repaired with artificial material or a device for the first six months after the repair procedure.
3)Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.(American Heart Association, 2009)
CAN I HAVE AN MRI EVEN THOUGH I HAVE A PACEMAKER?The current guidelines from the American Heart Association and the Food and Drug Administration (FDA) do not support MRI in pacemaker patients, nor do any of the device manufacturers’ guidelines (except for new MRI-conditional devices).“In recent years, several centers have begun offering MRI to patients with cardiac pacemakers. MRI in pacemaker patients is never routine and should be conducted only when the case is properly triaged and deemed medically necessary and when alternative radiologic methods have not been diagnostic,” according to Robert E. Watson Jr., M.D., Ph.D., a radiologist at Mayo Clinic in Rochester, Minn. “Also, it is stipulated that there is cardiology pacemaker support and careful pacemaker and physiologic monitoring during the MRI, as well as MRI physicist support during imaging.”
Points to remember
- MRI in patients with non-MRI-conditional devices should be considered only if the patient is not pacemaker dependent.
- MRI should not be performed if there is evidence of generator or lead malfunction.
- MRI in selected patients with ICD’s is currently under investigation.(http://www.mayoclinic.org/medical-professionals/clinical-updates/cardiovascular/new-protocols-allow-mri-selected-pacemaker-patients)
WHAT ARE THE COMMON LIFESTYLE CHANGES I CAN MAKE TO REDUCE MY RISK OF CAD?Don’t smoke. Nicotine raises your blood pressure because it causes your body to release adrenaline, which makes your blood vessels constrict and your heart to beat faster. If you smoke, ask your doctor to help you make a plan to quit. After 15 years of not smoking, your risk of Coronary Heart Disease will be almost as low as a person who never smoked.
Control your blood pressure. If you have high blood pressure, your doctor can suggest ways to lower it. If you’re taking medicine for high blood pressure, be sure to take it just the way your doctor tells you to.
Exercise. Regular exercise can make your heart stronger and reduce your risk for heart disease. Exercise can also help if you have high blood pressure. Before you start, talk to your doctor about the right kind of exercise for you. Try to exercise at least 5-7 days a week for at least 30-60 minutes per day.
Ask your doctor about taking a low dose of aspirin each day. Aspirin helps prevent Coronary Heart Disease, but taking it also has potential risks. Before taking, discuss this with your doctor.