Heart health chat with Beverly Barnes

Tags: angina , heart , obesity , smoking

In the UK, over 300,000 people suffer from heart attacks and over 100,000 from strokes each year. Despite being a common health concern, the good news is that a lot can be done to help prevent and manage heart conditions.
With National Heart Month just around the corner, we held a live chat on heart health on Friday 25 January to give you the chance to ask our expert questions ranging from heart murmurs to hereditary conditions.
Senior case nurse Beverley Barnes, part of our Dedicated Nurse Service, was on hand to answer all your questions. Here is what she had to say:

AXA PPP healthcare: we have had a question on our blog about whether there are any symptoms of high cholesterol.  

Beverley Barnes: The problem with high cholesterol is that it does not present itself with symptoms and is usually picked up incidentally at screening or after a medical event as an associated cause. 

Ruth asked: Hi Beverley, my boyfriend was recently told he has a heart murmur. What does this mean, and does it raise his risk of having a heart attack? 

Beverley Barnes: Hi Ruth. A heart murmur (an unusual sound) is picked up when a doctor listens to your heart. A murmur does not always mean that there is a problem with your heart as people with normal hearts may also have murmurs. A large number of murmurs are entirely innocent. If your boyfriend is concerned he should discuss this with his doctor who may suggest that he have further tests to see how well his heart is working. The most common test is an echocardiogram which uses sounds waves to look at the structure of your heart. A heart murmur is not associated with a heart attack; this is caused by blockages in the small vessels called coronary arteries which provide the blood supply to the heart muscle.

CD asked: My friend recently experienced symptoms of angina; what are the main symptoms to look out for and what are the health risks associated with angina? 

Beverley Barnes: Angina often feels like a heaviness or tightness in your chest, but this may spread to your arms, neck, jaw, back or stomach as well. Some people describe the feeling of severe tightness, while others say it’s more of a dull ache. Symptoms of experiencing shortness of breath have been reported too. Angina is often brought on by physical activity, an emotional upset, cold weather or after a meal. Symptoms usually subside after a few minutes. If your symptom pattern changes, you should speak to your doctor immediately. There is medication available, too, that can help control your symptoms, whereas some people require treatments such as angioplasty or heart bypass surgery. Living a healthy lifestyle is a very important part of your treatment, too. Many people with angina have a good quality of life and continue with their normal daily activities. Your doctor or nurse will be able to advise you on your daily activity and any lifestyle changes you may need to make.

Barry A asked: Two members of my extended family have congenital heart defects (not sure of the name, involves enlarged heart) and I was wondering; if you have blood relations with this type of condition, is there a test you can get to identify your chances of passing it on to any children you may have in future?

Beverley Barnes: Congenital conditions of the heart that causes the heart to enlarge sounds like you may have a family history associated with a condition caused cardiomyopathy. This can be hereditary, there are many different types, and the best way forward is to find out the type from your family members who have already had heart disease and then you can discuss with your GP about genetic screening and tests. Despite a family history, not everyone is always affected.

AXA PPP healthcare: We have also had a question from a blogger asking: "My baby nephew has been diagnosed with a heart murmur; is this something he may grow out of, and will it have any impact on his life e.g. taking part in sports?"

Beverley Barnes: Although a heart murmur is an important presenting feature of a cardiac disorder in infancy and childhood, innocent murmurs are very common, occurring in up to 80% of children at some time or other. These murmurs are frequently detected during a febrile/fever illness, and are also exacerbated by nervousness or exercise. It is important to distinguish between innocent and pathological murmurs and to arrange more detailed evaluation of the child if there is any doubt. Children should be routinely screened for heart murmurs and other evidence of cardiac disorder at about six weeks and nine months of age, and at any subsequent examinations during childhood. Serious cardiac pathology may exist without symptoms. Taking part in sport would only affect your nephew if something underlying the murmur was detected. It will be checked routinely as he grows - he won’t grow out of it. However, the majority of murmurs do not cause any additional problems and are just part of that person’s anatomy.

Craig asked: My cardiologist tells me my snoring may be increasing my risk of heart disease and wants me to see a sleep specialist. How does snoring affect your heart?

Beverley Barnes: Without knowing too much, sounds like he is thinking of sleep apnoea and I would suggest you have a chat to your GP.

Ian McC asked: I have started running again after a couple of years' break; 15 minutes per run, four times a week. However, I'm slightly concerned that bursts of exertion could be bad for my heart - can you advise?

Beverley Barnes: All exercise is good for you. Was the reason for your break in running related to a cardiac event? Any exercise should start with a warm up and warm down; you will not cause any cardiac problems by bursts of exertion. During vigorous exercise your heart rate will increase rapidly because of the necessity for more oxygen and nutrients to get to you muscle cells. So the harder you run, the greater the demand for gas exchange in the muscle cells. Your heart will pump faster to provide gas exchange, but will slow accordingly as soon as you slowdown. If you are concerned about it, check your resting heart pulse and your pulse at high activity. If you check the web there are charts that will give you an idea what your heart rate should be pre and during exercise for your age.

Rach asked: My resting pulse rate is about 140 beats per min. This has only ever been checked by doctors in hospital so not sure if due to nerves. I had an ECG and they said the flow was normal. Should I be worried?

Beverley Barnes: Sometimes there is something called the "white coat syndrome" which can cause your heart rate and in fact your blood pressure to rise due to a subconscious response to the test. Your ECG was found to be normal, which is good. The "normal" textbook pulse rate is around 72 beats per minute (BPM), so yours is a little high. I don’t know if you have any other health issues, but without alarming you that’s quite fast at 140 BPM. If you are otherwise in good health, I would make a routine appointment to see your GP to discuss and check.

Chelsea asked: I am confused about heart disease and the benefits of aspirin. I read in the newspaper that an aspirin a day may help prevent stroke. Is that true?

Beverley Barnes: There are lots of different cells in our circulating blood, each with a different function. Platelets help with clotting when you sustain any form of cut or graze and respond by forming a clot. Aspirin is a mild anti-platelet, which means it inhibits their function. Many people take aspirin every day, especially after they have had a medical event such as a heart attack or a stroke, as a mild preventative against further clot formation. Other blood thinning drugs are used. Taking an aspirin a day can slightly reduce a clot formation, but strokes do have other causes, too, not just blood clots.

Fiona asked: Hi there. I recently felt a fluttering around my chest and tightness at the top of my left arm. At the same time I felt dizzy and my jaw hurt (didn't realise the jaw has any significance at the time but after looking at NHS website I found out it could be heart related). It's got me really worried as I'm 24 years old plus I exercise regularly and eat well. Do you know what this might be? I have booked in to see my GP next week.

Beverley Barnes: In view of your age and the symptoms you are describing please give NHS direct a call to get some additional guidance, I am sure there is no cause for concern, but it is prudent to get these things checked out for your own peace of mind.

AXA PPP healthcare: One of our followers on Facebook asked: "My grandfather had a heart attack and stroke, and my uncle (his son) has recently had a heart by-pass - although a fit healthy man he has high cholesterol. Is this genetic, and what tests should I have if any"?

Beverley Barnes: A predisposition to heart conditions can be hereditary; high cholesterol is not obvious as it does not have any symptoms and can only be picked up on screening or after a cardiac event. A family history suggests that other family members should get their GP to check their cholesterol regularly. Even people who eat a healthy diet and exercise can be prone to high cholesterol. There are dietary changes you can make to reduce intake of fats from the unhealthy type (saturated) to the healthy type as we need fat in proportion in our diet. The best thing to do is sketch out a family tree and take this to your GP, detailing who has had what type of heart disease and ask whether that makes you a candidate for genetic testing. There are lots of really effective drugs that can drive cholesterol down to even lower safe levels called ‘statins’, so if you do have a high level you can start reducing your risk against future possible problems straight away.

Ruth asked: Some of my family members have had heart problems, but they were also smokers and heavy drinkers. Am I still at risk of getting heart problems in the future (I don’t smoke and rarely drink)?

Beverley Barnes: Smoking and heavy drinking are huge factors in disease, especially the blood vessels, so the fact that you don’t smoke and rarely drink is good. Heart disease in the UK affects approximately one in six people; the best thing you can do to reduce your risk is eat a really good, balanced diet, take plenty of exercise and keep within a healthy BMI. Treat your body well and it will look after you.

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