House Calls / Keep your eye on the ball when it comes to heart disease
New York Yankee’s star pitcher C.C. Sabathia was recently diagnosed with coronary artery disease.
While it is somewhat unusual for a 38-year-old to suffer from this type of heart condition, it is less uncommon if someone has multiple risk factors for the disease. In the case of Sabathia, his extensive family history most likely played a role.
Heart disease is the most common cause of death for both men and women in the United States, claiming the lives of over 600,000 people annually. Coronary artery disease is one of the most prevalent heart ailments ultimately affecting a very high percentage of the population. With CAD, the coronary arteries, which deliver blood and oxygen to the heart, become narrowed resulting in a multitude of symptoms which may include chest pain, chest pressure, a fluttering in the heart area, shortness of breath, dizziness, lightheadedness and sweating.
Pain, also referred to as angina, may also radiate into the left shoulder, neck or jaw. Most of these symptoms tend to increase with exertion and exercise; however, this is not always the case. Furthermore, some patients may not exhibit any of these common symptoms.
Recently, a 43-year-old patient complained of a “burning sensation every time he took a deep breath while exercising.” He had no other “typical” heart related warning signs and attributed these symptoms to heartburn or a chest wall strain. However, an electrocardiogram heart test revealed an abnormality. This lead to a stress test which then lead to a heart catheterization and a stent being placed into the main artery of his heart. This patient was fortunate; had he ignored these symptoms, untreated he could have had a potentially serious heart attack.
Common risk factors for CAD include high blood pressure, elevated cholesterol, cigarette smoking, diabetes, obesity and family history. Nevertheless, even without these risk factors, patients can develop blockages in their arteries. If CAD is suspected, a diagnosis can be made via a stress test, CAT scan or cardiac catheterization.
Treatment for mild heart disease may include a statin which is a medication designed to lower cholesterol and reduce inflammation on the arterial wall. Additionally, an aspirin (or other blood thinning medications) may also be prescribed to reduce the risk of a heart attack. Lastly, there are other medications which can protect the heart muscle by reducing how hard or fast the heart pumps.
In Sabathia’s case, he developed what he thought to be heartburn. Fortunately, he visited his doctor who discovered the blockage in his coronary artery and he quickly underwent treatment which involved placing a stent (a small tube) into his artery to reopen the blood flow.
Cardiac catheterization with angioplasty and stent placement is a procedure performed in the hospital. With the patient sedated, a small catheter is inserted through an artery in the groin or arm in order to directly visualize the coronary arteries. Once in place, a small amount of dye is injected in order to determine if any blockage exists. If it is determined that there is a narrowing or occlusion, another instrument is inserted to clean out the blood vessel and place a stent into the artery thereby opening up the vessel creating better blood flow.
The entire procedure may take less than an hour and is fairly painless. Patients are then monitored and observed for several hours after the procedure to make certain there are no complications.
Despite Sabathia’s diagnosis of CAD, once successfully treated and cleared for baseball activities, the condition should not affect his ability to pitch. He will most likely be advised to follow a healthy lifestyle by losing weight, working on a low-cholesterol diet, taking medication to protect his heart and stents, and work on maintaining an exercise program to promote cardiovascular health.
Patients concerned that they might have a heart issue are encouraged to visit their physician. However, regardless of risk, it is always advised to eat properly, exercise, get plenty of rest and lead a healthy lifestyle. Despite that you may never be able to throw a 95 mph fastball, caring for your health will allow you to make a pitch for a long and healthy life.
Dr. Michael Schwartz is Board Certified in Internal Medicine and is affiliated with Soundview Medical Associates with a private practice in Darien. For comments or questions, visit his website at drmichaelbschwartz.com