Controlling risk factors key to reducing heart attacks

The sudden passing of actor James Gandolfini’s this week serves as a poignant reminder that heart disease can be indiscriminate in its victims.

The actor, popularized by his role as fictional mobster Tony Soprano, was only 51 when he was found dead of a suspected heart attack.

At Oakwood, we’ve been stressing the importance of Men’s Health this month, given that as many as 25 percent of adult males don’t even have a primary care physician. Those that do are often reluctant to go—and even then, they are sometimes hesitant to share all of the information that may save their lives.

“They minimize their symptoms; that’s a big no-no,” said Peter Mancini, MD, FACC, an Oakwood-affiliated cardiologist.
Mancini said proper communication with your doctor is a key component to avoiding major health issues and solving problems at early stages. Walid Harb, MD, FACP, an Oakwood-affiliated internal medicine specialist, agreed.

“Tell me everything,” he said. “Let me worry about what it means.”

There is no guaranteed way to eliminate the risk of heart attack or heart disease, but there are plenty of things you can do to reduce your risk factors. The first is to quit smoking, Harb said.

“It is the single biggest risk factor associated with heart disease,” he said.

Maintaining a healthy cholesterol level is also important. The body needs cholesterol—it is one of the building blocks of our hormones—but too much is a bad thing.

“Then we make too much of it, it has to go somewhere,” said Harb. That somewhere is usually our arteries, which leads to the blockages that cause heart difficulties.

Ideally, you want your total cholesterol levels to be lower than 200, according to the Mayo Clinic. Your Low Density Lipoproteins (LDL) should be lower than 70 if you are at a very high risk of a heart attack (anything above 160 is considered high). High Density Lipoprotein (HDL) is considered the ‘good cholesterol’ because it can help protect against heart attacks. The Mayo Clinic recommends those numbers be above 60.

Exercise is also an important way to reduce your risk factors. The American Heart Association recommends about 150 minutes of cardio exercise every week—that could be as simple as taking a brisk walk daily—to help keep things pumping normally.

Heart attack symptoms can be difficult to recognize, too. Many may expect a sudden, searing pain near the center of their chest or numbness in their left arm, but signs of trouble can be much more subtle. They could include anything from shortness of breath to a feeling of indigestion—and the term ‘chest pain’ is not a literal one, according to Mancini.

“Doctors characterize ‘chest pain’ as any abnormal feeling between the earlobe and the belly button,” he said. “Chest pain isn’t always painful.”
Kevin Donaldson knows that. In his mid-50s, Donaldson said he just felt a little off one day after work last year.

“I’m usually go-go-go all the time, but I was restless. I couldn’t take a nap, but I felt like I wanted to take a nap,” he said. “I went in [to get checked] with the most vague symptoms. I just felt ‘icky.’ I didn’t feel nauseous, but I felt like I could become nauseous.”

Subsequent tests revealed that Donaldson has 90 percent blockage in two arteries. He credits Oakwood-affiliated cardiologist Chaman Sohal, MD, with saving his life. Six months later, he has taken a mountain biking trip on the Porcupine Rim Trail in Utah. He still rides his bike daily.

“I’m very fortunate to be here,” he said.

Donaldson’s example is just as important—and a bit more optimistic—than Gandolfini’s. It shows that virtually any medical condition can be treated and controlled today, if you communicate well with your doctor.

“We need to partner with each other do lower all your risk factors,” said Harb.