Entries in Cardiac Care (4)


Adrenaline-Fueled Sprint Makes Some Marathons Deadly

Hemera/Thinkstock(PHILADELPHIA) -- Those exhilarating moments when marathoners sprint to the finish line on pure adrenaline can prove fatal to vulnerable hearts, a veteran marathon medical director said Monday.

Taking an 81-milligram baby aspirin and avoiding caffeine on race day -- especially super-caffeinated energy drinks -- are simple ways that marathon runners can reduce the chances their hearts will give out at race's end, like those of two men who collapsed Sunday at the 8th Philadelphia Marathon, said Dr. Lewis G. Maharam, board chairman of the International Medical Directors Association. Last year, the organization issued recommendations for preventing sudden death among runners and walkers.

"Runners are not bullet-proof," said Maharam. No matter how young or outwardly healthy they feel, runners should undergo an annual physical where a doctor can screen for hidden heart ailments and advise them on ways to reduce the odds of dying.

Both Philadelphia victims were initially said to have suffered apparent heart attacks, although they might have succumbed to sudden death from other cardiac causes, such as fatal heart rhythms. Jeffrey Lee, a 21-year-old University of Pennsylvania senior from Cerritos, Calif., collapsed at the finish line of the Philadelphia Marathon and died at Hahnemann University Hospital, The Daily Pennsylvanian reported Monday. Lee, who was studying both nursing and business, had finished the course in one hour and 58 minutes.

The other victim, a 40-year-old man, also died at Hahnemann after collapsing a quarter-mile from the finish line. His name has not been released.

The course for the Philadelphia Marathon, whose website uses the slogan "Best: Time of Your Life," runs past some of the most famous historic landmarks in the City of Brotherly Love, including the Liberty Bell and the home of Betsy Ross, who stitched the first American flag.

More people may seem to be losing their lives while competing in marathons, although the absolute risk of dying has remained stable at one out of every 50,000 entrants, explained Maharam, past medical director of the New York Road Runners Club and the New York City Marathon. We are just hearing about more deaths because more people are participating in an increasing number of marathons and half-marathons. "There's a marathon or half-marathon every week, where 20,000 to 30,000 people are running, but the statistic hasn't changed," he said.

Some runners' hearts are particularly vulnerable to an adrenaline surge that occurs when they first spot the finish line, a location Maharam called "The X Spot," which he said "comes from the excitement of knowing you're going to finish."

Maharam, medical director of the Leukemia & Lymphoma Society's Team in Training Program and for Competitor Group's Rock 'N' Roll Marathon Series, said he makes sure that paramedics are placed at that spot in each of the races in which he's involved. "I've had 10 successful resuscitations at my events this year at the X-spot because it goes down right in front of the paramedics."

He explained that excessive caffeine can make the heart muscle susceptible to ill effects of the adrenaline rush. So, too can the impact of running a half-marathon, which can dislodge small amounts of artery-blocking plaque, cutting off blood flow to a microscopic area of the heart muscle and leaving it more vulnerable to an erratic and ultimately fatal heart rhythm triggered by the adrenaline.

When this happens, "the heart stops and they go unconscious," he said.

Endurance athletes should be aware that intense bouts of exercise can lead the muscles to release enzymes that promote blood clotting and reduce the blood supply to the heart muscle. They should be properly hydrated, consume sufficient salt and avoid nonsteroidal anti-inflammatory medications commonly taken for pain, muscle sprains and other sports injuries.

Some studies suggest that caffeine consumption becomes risky at about 200 milligrams, the amount contained in two "diner-size" cups of coffee. A cup at Starbucks contains 320 milligrams, "which is too much," he said.

Women marathon runners have less plaque in their arteries than male runners, or than sedentary women, researchers from the Minneapolis Heart Institute reported Nov. 14 at the American Heart Association annual meeting. That finding followed a report in 2010 that marathon-running men had more plaque than sedentary men, although those men were older than the women in this year's study, the Minnesota researchers said. Researchers could not account for the gender-based differences.

Copyright 2011 ABC News Radio


Study Reveals the Importance of Cardiac Rehabilitation

Comstock/Thinkstock(ROCHESTER, Minn.) -- Patients with heart disease and especially those who survive a heart attack can reduce their risk of death by undergoing cardiac rehabilitation.

Now a study in the journal Circulation says this also applies to those who have had an angioplasty, a procedure that restores blood flow by widening blood vessels that have become narrowed or blocked.

The Mayo Clinic study looked at more than 2,000 patients who underwent angioplasties over a 15-year period.  It found that those who participated in cardiac rehabilitation were almost 50 percent less likely to die within six years than those who did not have the rehab.

Rehab programs include patient education, supervised exercise training, nutrition counseling and help to quit smoking.

Medicare and most health insurance plans cover cardiac rehabilitation, yet it's estimated that only one in four eligible patients actually get it.

The authors say that if all eligible patients had cardiac rehabilitation, the gains in long-term survival would be substantial.

Copyright 2011 ABC News Radio


Heart Attack Risk: Does Having Sex Really Tax the Ol' Ticker?

Jupiterimages/Thinkstock(BOSTON) -- It has become a Hollywood cliché -- the older man who clutches his chest and keels over midway through having sex -- but is it as real as people think? New research from Tufts Medical Center suggests that sex does increase the risk of a heart attack, but the risk is still small and only rises during and soon after doing the deed.

Researchers analyzed past studies in which heart attack victims, mostly men in their 50s and 60s, were questioned about their activities just preceding and during their coronaries to see if sex served as a trigger for their cardiac events.

While they found that sexual activity caused a 2.7 percent increased risk of heart attack, this overall risk was quite small and should not dissuade those with heart disease from indulging in a little bedroom action. They say that's important, especially since several other studies show that regular sexual activity (usually defined as two or more times a week) actually decreases one's risk of heart attack over time.

Lead author Dr. Issa Dahabreh says people shouldn't take the new report to mean the sex is harmful for those with heart disease "because the absolute risk is really small."

What's more, patients could battle this increased risk by being physically active on a regular basis. Regular exercise made sex and other types of physical exertion less likely to be a trigger for heart attack, the study found.

"We saw a 45 percent reduction in the relative risk of heart attack with every additional weekly exercise session," says co-author Jessica Paulus, an epidemiologist at the Harvard School of Public Health.

"The main take-home [is that] regular exercise training, which we should be promoting anyway as a means to improve cardio respiratory fitness…will markedly reduce the risk associated with both acute exercise/exertion as well as sexual activity," says Dr. Chip Lavie, medical director of Cardiac Rehabilitation and Prevention at John Ochsner Heart and Vascular Institute.

What's more, the emotional and physical benefits of sexual satisfaction have also been linked in several studies to overall health and specifically cardiac health.

In a 2010 study published in the American Journal of Cardiology, men between the ages of 50 and 70 were followed for 16 years and quizzed about sexual activity. Researchers found that sex twice a week reduced the risk of heart disease in these men by up to 45 percent, compared to their peers who had sex once a month or less.

Dr. Mehmet Oz, heart surgeon and host of the Dr. Oz Show, is also famous for recommending frequent sex (three times a week) as a way for men decrease their risk of heart attack and stroke by 50 percent.

So the exertion of a romp in the bedroom may briefly increase the risk of heart attack, but the cardiovascular and emotional benefits of regular sexual satisfaction far outweigh the downside, especially in those who are regularly active in other ways as well.

"The bottom line is that people should not fear sexual activity, but should fear sedentary lifestyle and physical inactivity," says Lavie.

Copyright 2011 ABC News Radio ´╗┐


Heart Patients Recover Equally Well with Bypass Surgery, Stents 

Jupiterimages/Thinkstock(KANSAS CITY, Mo.) -- Findings from a new study suggest that whether one has heart bypass surgery or undergoes a less-invasive procedure in which medicated stents are used to open clogged arteries, cardiac patients may manage their recovery similarly.

"The degree of symptom relief is very comparable," said study author Dr. David Cohen, director of cardiovascular research at Saint Luke's Mid America Heart Institute in Kansas City, Mo. 

Patients can feel comfortable with whatever option they choose. However HealthDay News notes that the most severe cases fare better with bypass surgery, despite the quick recovery time of the stent procedure.

Dr. Kirk N. Garratt of the Lenox Hill Heart and Vascular Institute in New York City commented that most patients, about 90 percent, "do just fine" taking medication for arterial blockage, but surgery is necessary for other cardiac care patients.

Garratt said that with bypass surgery, the body may try to heal itself, thereby causing post-op scar tissue to form, which can be harmful.  This is one reason the stent procedure has become the preferable option -- the stents are coated with a drug that can help to prevent this scar tissue from forming.

The study, which followed up with 1,800 heart patients who underwent bypass surgery or the stent prodecure, showed that 76 percent of bypass patients had no chest pain within a year after the operation, while 72 percent of stent patients said the same.

While neither procedure can guarantee a longer life for heart patients, Garratt said both do improve quality of life.

Copyright 2011 ABC News Radio´╗┐

ABC News Radio