eHealth Connection | Cooper University Hospital

By Warren R. Heymann, MD
Head, Division of Dermatology, Cooper University Hospital

It has been almost half a century since the world was introduced to the advertising campaign for Tegrin to treat “the heartbreak of psoriasis.” Who could have imagined at that time that patients would need to be vigilant about the health of their heart when dealing with the red, scaly lesions of psoriasis?

Psoriasis is a common skin disease that affects approximately 2 percent of the population. The characteristic feature is the presence of raised plaques with redness and scaling. Lesions usually affect the scalp, elbows and knees, although any part of the body may be affected. In severe cases, practically the whole body surface area may be involved. While patients are usually well, many often have associated arthritic complaints. The effect on a patient’s quality of life may be profound, indeed resulting in “heartbreak” for many affected individuals.

Much has been learned about the cause of psoriasis, although the precise mechanism that leads to the disease remains to be defined. It is now considered to be due to abnormalities of the immune system in genetically predisposed patients. The disease may be triggered by stress, certain medications, or following infections such as a streptococcal sore throat.

Psoriasis has been in the news because of what have been called “co-morbidities” – other conditions that may be associated in patients with psoriasis. Severe psoriasis has been linked with obesity, smoking, diabetes, hypertension (high blood pressure), hyperlipidemia (high concentration of fats [lipids] in the blood), coronary artery disease, and stroke.

The basis of risk for cardiovascular events is presumably due to the effect of chronic, ongoing inflammation. Any such inflammatory process may be a predisposing factor for what is called a “hypercoagulable” state, which leads to an increased chance of clotting.

Are patients with psoriasis really at risk for cardiovascular events such as a stroke or heart attack? A sense of perspective is necessary. First, most of these studies only demonstrate a risk for those patients with severe psoriasis (those patients with disease involving a large portion of the body surface area who require systemic treatments to get the disease under control). The latest studies suggest about a 6 percent chance of these events. It must be emphasized that a relative risk is that alone–a risk, not an inevitable event. Patients with psoriasis should not stress about these risks, as stress itself may aggravate psoriasis.

The most important recommendation for patients with psoriasis is to try to live a healthy lifestyle by discontinuing smoking, maintaining a normal weight, and exercising. Patients should speak with their primary doctor about being screened for diabetes, hypertension, and hyperlipidemia.

It remains to be determined whether treating psoriasis will have any effect on decreasing the risk of a cardiovascular event. What is clear, however, is that by controlling as many known cardiovascular risk factors as possible, the chance of developing a life-threatening heart attack or stroke will be much less likely.

Visit Dr. Heymann’s Profile HERE.

Visit the Divison of Dermatology HERE.

This article first appeared in the Courier-Post. 

A heart attack is a frightening event that you probably don’t like to think about. But, if you learn the signs of a heart attack and what steps to take, you can save a life – maybe your own.

Recognize the Signs

Many people think a heart attack is sudden and intense, like a “movie” heart attack, where a person clutches his or her chest and falls over. The truth is that many heart attacks start slowly, as a mild pain or discomfort. Your symptoms can even come and go.

“If you feel such a symptom, you might not be sure what’s wrong. Even people who have had a previous heart attack sometimes don’t recognize it if it happens again, because the next attack can have entirely different symptoms,” said Cooper University Hospital cardiologist Elias A. Iliadis, MD, Medical Director of Noninvasive Vascular Intervention at the Cooper Heart Institute.

Also, if you’re a woman, you may not believe you’re as vulnerable to a heart attack as men, but you are. Women account for nearly half of all heart attack deaths. Heart disease is the number one killer of both women and men.

It’s vital that everyone learn the warning signs of a heart attack. They are:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
• Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
• Shortness of breath. Often comes along with chest discomfort. But it also can occur before chest discomfort.
• Other symptoms. May include breaking out in a cold sweat, nausea, or light-headedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Act Fast

If you or a family member feels heart attack symptoms, call 9-1-1 immediately. Do not delay. Seek fast treatment. Minutes matter. “Heart attack deaths and heart damage can often be avoided when treatment begins within an hour of when the symptoms started. Most studies show a large reduction in death rates and in heart damage in patients treated within 1 hour of the start of symptoms,” said Dr. Iliadis.

There are differences in how women and men respond to a heart attack. “Women are less likely than men to believe they’re having a heart attack and more likely to delay seeking emergency treatment,” Dr. Iliadis said.

Further, women are more likely to have other conditions, such as diabetes, high blood pressure, and congestive heart failure–making it all the more vital that they get proper treatment fast.

Heart disease is the number one killer of American women, and nearly half of all heart attack deaths each year happen to women. Furthermore, women are less likely to survive a heart attack than men.

Be Safe, Not Sorry

Some people who are experiencing the symptoms of a heart attack might wait hours or even days before seeking needed medical care because they do not recognize their symptoms as life-threatening. That’s why it’s important to know the signs and take action quickly.

“Even if you’re not sure it’s a heart attack, you should still have it checked out. It’s better to be safe than sorry, and sometimes chest pain — even mild chest pain — is the only indicator of the beginning of a heart attack,” Dr. Iliadis said.

Emergency medical personnel, or mobile EMS teams, can diagnose a heart attack and begin treatment on the spot. They can even revive a heart that has stopped or is beating erratically.

“Emergency medical personnel want you to call to get your symptoms checked out. Even if the call turns out to be a false alarm, running the risk of feeling a little embarrassed is better than running the risk of dying or having a permanently damaged heart,” Dr. Iliadis said.

Help Yourself and Others

The time it takes for an individual to decide to ask for help is the most significant portion of time delay in getting needed medical treatment for heart attack. Sometimes heart attack sufferers dismiss the seriousness of their symptoms or they fail to recognize their symptoms as life-threatening.

Studies show that family members should expect lack of awareness or denial of the seriousness of the symptoms from those suffering a heart attack, and resistance to calling for help. Many heart attack sufferers will reject calling 9-1-1, thus delaying the arrival of help. That’s why it’s best to enlist family, friends, and co-workers now. Discuss the symptoms. Talk to your doctors about risk for a heart attack. Make a survival plan, before you need one. And remember, while most heart attacks occur in people over 65 years of age, 45 percent, or nearly half, of all heart attacks occur in people under age 65, and five percent occur in people under age 40.

“Whenever a heart attack is suspected, everyone should know to call 9-1-1 immediately. Don’t wait for the person having symptoms to agree. Take charge to make sure the person gets checked out sooner rather than later,” Dr. Iliadis said.

When You’re Having a Heart Attack, Every Minute Counts.

Cooper cardiologists open blocked arteries without surgery, using angioplasty, which restores blood flow and saves vital heart muscle. On average, Cooper doctors perform emergency angioplasty 32 minutes faster than the national average of 90 minutes, saving lives and reducing complications. Many hospitals in the community provide heart care, but few can mobilize a team available 24/7 to provide the skilled emergency care to open blocked coronary arteries. The Cooper Cardiac Catheterization Lab has the physicians, staff, and technology to provide the best heart-attack care in the region.

Related Links

• Cooper Heart Institute
• 46 Minutes to Save a Life (Video)

The more sugar you eat, the wider your girth may be, the results of a recent study suggest.

Reported last month at the American Heart Association’s Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions, the study analyzed data on food intake and body weight collected on residents in Minneapolis-St. Paul over 27 years. Although the original data focused on heart health, the new study looked at what impact added sugar had on participants’ weight during that period.

Added sugar is sugar that is added to processed foods, as well as sweeteners added in home cooking and at the table.

“When it comes to cardiovascular disease and dietary controls, most of the focus has been on fats, but carbohydrates – sugars – are a big component of weight gain and the cardiovascular risk that results,” said Cooper University Hospital cardiologist Kathleen M. Heintz, DO, FACC, a specialist in women and heart disease at the Cooper Heart Institute.

Read the full story

There is no escaping the message. You can’t turn on the TV, listen to the radio, surf the web or read a newspaper without hearing about it.

Heart Disease — Who has it? How do you get it? How do you prevent it? New research and findings are being published nearly every day.

The reason for the unprecedented attention is easy to explain, reports Kathleen M. Heintz, DO, clinical cardiologist at the Cooper Heart Institute. “Heart disease gets so much attention for two key reasons. First and foremost, heart disease kills more Americans each year than the next six illnesses combined. And, secondly, because so much of the illness and damage is preventable.”

Heart disease prevention begins with modifying the risk factors. Factors that put you at higher risk for developing cardiac problems include:

• Smoking.
• High blood pressure.
• High cholesterol.
• Diabetes.
• Family history of early development of heart disease.

“Every adult knows that smoking is bad for your heart and lungs, even if they don’t acknowledge it,” says Dr. Heintz. “However, diabetes is a risk factor that surprises many people. People don’t realize that diabetes is a disease that damages blood vessels in the body, including those in the heart. The more poorly controlled the diabetes, the worse the damage.”

Prevention is only part of the equation in treating heart disease, especially in women. For women, the issue is also acknowledging that heart disease is a potential problem, and recognizing the sometimes subtler signs and symptoms. Most women are unaware that:

• Heart and vascular disease kills nearly a half a million women each year.
• Women are six times more likely to die from heart disease than cancer. One in three women will die of heart disease or stroke, compared with one in nine from breast cancer.
• 64 percent of women who die suddenly of heart disease had no previous symptoms.

However, the most striking number in these statistics is 13. Only 13 percent of women view heart disease as a health threat, even though it is the number one killer of women.

“These numbers show that we have not done a very good job educating women,” says Dr. Heintz. “Obviously, we still have a lot of work to do.”

Research shows that the lack of understanding related to women and heart disease is a potential danger for women because the symptoms they have are often not associated with heart attacks. Although the most common presentation in women is chest pain, many women also experience extreme fatigue; indigestion; chest tightness; shortness of breath; or pain referred to the jaw, arm, or shoulder. These non-traditional symptoms are often initially dismissed, putting the woman at further risk for heart damage. And, these symptoms may develop over a period of time.

“Ideally, we would like to assist women in preventing heart disease, or at least slow the progression of disease”, says Dr. Heintz. “The earlier we can intervene, the better the outcome.”

The good news for both men and women is that much can be done to prevent or slow the progression of heart disease, reports Dr. Heintz. “You can’t change your family history, but you can benefit greatly by modifying other risks, like managing high blood pressure and diabetes, getting exercise, not smoking and eating a healthier diet.”

Related Links:

• Kathleen M. Heintz, DO
• Cooper Heart Institute

It’s not your father’s heart surgery anymore.

Only a few short years ago, anyone requiring heart surgery was facing several certainties: a 12 inch scar, having their heart temporarily stopped while being attached to a heart lung machine, spending weeks in the hospital after surgery, and enduring months of recovery and pain from the surgical saw used to cut through the sternum (breast bone) to “crack the chest”. Read the full story

Heart disease remains the #1 killer of both men and women, but your actions can make a difference. Save lives by standing up and speaking out against heart disease.

All across the country, people have been wearing red to show their support for the Go Red for Women campaign to help raise awareness of heart disease. Join Cooper in celebrating this year’s National Go Red day on Friday, February 4, 2011. Wear red and ask the men in your life to also support the cause. Read the full story