Dr. Rajesh Maharaj, a Board-certified Cardiologist with AdventHealth Medical Group, joined Good Day Orlando on Monday morning at 8 a.m. He answered your questions on cardiology below.
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QUESTIONS ANSWERED
Q: Is my mother more common to develop heart disease than my father?
A: Not necessarily. Men tend to develop heart disease at a younger age than women.
Q: At what age should I start worrying about my heart? I live a stressed life but I am young.
A: Heart disease can happen at any age. However, most tend to develop heart disease, including cholesterol buildup in the coronary arteries in their 50's to 60's, although this is very variable!
Q: What eating / exercise habits do you recommend to keep my heart in good shape?
A: A healthy diet should include less fatty foods and fried foods, and lowering caloric intake as well. I don't believe in fad diets however. I think that changes should be something that you can sustain long term.
Q: I'm an Asian woman in my 60s. I tend to have high blood pressure and work constantly. I take medicine to help keep my blood pressure low, but how do I know if I am developing heart disease?
A: Good heart health starts with a healthy diet and regular exercise. In your case, close attention to your blood pressure control as well. The onset of heart disease can be seen with different symptoms. In some cases, there are different cardiac tests that can be done to determine if someone is starting to develop heart disease before having symptoms.
Q: At what age should one start getting cardiology appointments? How often?
A: At any age if you are having symptoms of heart disease. If not, then you should start with your primary care doctor. If he/she feels that you may be at a higher risk of developing heart disease, then you can be referred for further supplemental cardiac testing.
Q: Does drinking affect the heart severely? I'm an older man, just got a pacemaker put in. I like to drink, but not sure what my limits should be?
A: It's well known that "moderate" alcohol intake is actually protective. From the American Heart Association, this means up to two drinks daily. More than this could be detrimental to your heart in the long term.
Q: Can children develop heart issues?
A: Absolutely. Although much less common, children can develop different types of heart disease from adults.
Q: What can I do now, while I'm in my 20s, to prevent heart disease?
A: In your 20's, good preventive action would include engaging in a healthy diet- cut back on carbs, less fatty/fried foods, and regular exercise- at least 30 minutes of exercise daily.
Q: How common is heart disease? Who is it most common among?
A: Heart disease is extremely common. The persons at most risk are those with high blood pressure, diabetes mellitus, high cholesterol, tobacco use, and those with a family history of heart disease.
Q: Can heart disease be cured after getting it?
A: There are some cardiac conditions that can be cured. In the majority of cases though, it's a matter of improving and maintaining your cardiac condition to prevent things from getting worse.
Q: What tests are done to test for heart disease?
A: Depending on your symptoms, common tests include an EKG, echocardiogram, stress test. In some cases, when a patient is felt to be having a heart attack or at risk of one, a test called cardiac catheterization is performed.
Q: What's an ideal weight or BMI for avoiding heart disease?
A: Ideally a BMI <25-30.
Q: Does smoking increase my chance for heart disease?
A: Absolutely. Smoking significantly increases the risk of developing clogged arteries in your heart and increases the risk of having a heart attack.
Q: I drink quite a bit of coffee. Does caffeine really increase my chance for heart disease? Or is that just a myth?
A: The evidence for this has evolved over the last 10 years. Moderate coffee intake- up to 3 cups a day is ok. In fact, this has been shown to be MORE protective of heart disease than those who do not drink coffee. Higher consumption of coffee more than this does increase risk though.
Q: Does bad cholesterol affect my heart greatly? What level should I have?
A: Yes. Bad cholesterol, or LDL increases the risk of cholesterol buildup in the arteries in your heart. Ideally a "bad" cholesterol level of less than 100 is what you should aim for.
Q: Does baby aspirin really help the heart?
A: Yes and No. All medicines have risks, even a baby aspirin. In someone who is not at high risk, no aspirin. In someone who is at a high risk of developing heart disease, a baby aspirin is protective of not only having a heart attack and in some cases a stroke as well.
Q: Are there certain activities I should avoid as I get older so that I do not get heart disease?
A: In terms of exercise activities, no- you should continue to be as active as you can. In terms of lifestyle habits, no smoking and a healthy low fat diet is recommended.
Q: Do genetics weigh heavy on developing heart disease?
A: Definitely. Genetics play a major part, and increases the risk of heart disease, especially in persons who have other risk factors for heart disease, like high blood pressure, diabetes, high cholesterol and a history of smoking.
Q: I have diabetes -- will this play a great effect on my heart?
A: Yes. Diabetes is probably the one disease that singularly increases the risk of heart disease more than any other.
Q: Tips for maintaining good blood pressure?
A: Regular exercise and a low salt diet are good starting points.
Q: I take medication for my blood pressure, but I lived a very stressful lifestyle. Lately, I have been noticing I am dizzy often and can barely walk some days. It feels somewhat like vertigo. Could this be related to my heart given my history of high blood pressure and lifestyle?
A: Yes this can be related to your high blood pressure, or even to the medications that you take for high blood pressure as well. There are many other things that can cause dizziness, so you should have this evaluated by your doctor.
Q: I am currently doing the KETO diet but I've heard it is not very good for my heart, considering all the fats and meats. What do you think?
A: This is controversial. The keto diet has not been studied long term to determine its effects on the heart. Most cardiologists frown on it because of the high fat content, which goes against what we presently recommend. I personally discourage my patients from it, because I don't know the long term effect just yet.
Q: What are the warning signs of a heart attack?
A: Most commonly, severe chest pain or difficulty breathing. Sometimes palpitations, dizziness or even loss of consciousness can be symptoms of a heart attack as well.
Q: Does heart disease affect libido at all?
A: It can, indirectly. The same process that causes cholesterol buildup in the heart can cause it to happen in other organs as well. There are also some cardiac medications which can affect libido.
Q: I am epileptic. Does this pose a risk to my heart at all. I have probably at least one seizure every other month.
A: No there is no proven correlation between epilepsy and heart disease. Of course if your oxygen level decreases during a seizure, that can place stress on your heart.
Q: How can I determine the health of my heart outside of blood pressure readings?
A: In general, we refrain from excessive cardiac testing. However, in some patients who may be at increased risk, there is a role for a special heart scan called a calcium score, which can help determine if you are starting to develop heart disease.
Q: I take anti-depressants. Specifically celexa. Does this endanger my heart at all?
A: No there is connection between anti-depressant medications and developing heart disease. Some anti-depressants can interact with cardiac medications, so you should talk to your doctor if you also take cardiac medications.