 Dr. Brett, February is heart month. What's the importance of that? February is heart month and it's an important month in that we recognize the importance of heart disease as a major cause of death in our country, both for men and women. It's the number one killer. And it's a time where we can make sure our patients are educated as to things that they need to know about to prevent their risk of developing heart disease. And also educating our patients so that they know what to do if they develop symptoms of heart disease. And what are some of the risk factors for developing heart disease? There are some risk factors that are not in our control. So unfortunately genetics does play a role. As does age. Those things are not really under our control. So we don't spend too much time worrying about those things. But there are several risk factors that are within our control. So patients that have high cholesterol, high blood pressure, diabetes, cigarette smokers who are inactive or who are obese, all those are risk factors that are theoretically preventable or can be modified to prevent the risk of heart disease. Among those risk factors are some more important to reduce on your own than others. I think smoking is always just such a huge risk factor for developing vascular disease. We really emphasize that as much as we can. Smoking cessation is just so important. And then the others are right underneath that. And so one of the important things is for people to understand what their numbers are. A lot of people we see had no idea they had high cholesterol for years, had no idea that their blood pressure ran high, and might not have had some of these routine screening tests before. So it's very important for people to know what their numbers are so that they can begin the process of addressing those risk factors. When you say people should know their numbers, what numbers are we talking about? The numbers that they should know are the numbers that really define what their risk is. They should know what their cholesterol profile is. That's a measurement of their total cholesterol as well as the different levels of good cholesterol, bad cholesterol. These numbers are critical to understand what their risk of developing heart disease is. So that's one set of numbers they should know. They should also know whether their blood pressure runs high. They should know whether they have that entity of hypertension or high blood pressure that is a risk factor for developing heart disease. And they should also have a blood sugar measurement at some point so that they know whether or not they have diabetes, which is a very potent risk factor for developing heart disease. Heart attacks, it's about 17 million people a year will die of heart attacks around this time. And that's expected to rise over the years. Do you know the reasons for that projected increase? Well we have an aging population and we have an obesity epidemic. And with obesity comes some other metabolic abnormalities including lipid or cholesterol abnormalities that all contribute to this increase in the prevalence of vascular disease. And what are some of the symptoms of heart disease or heart problems? Symptoms can be variable, but there are some symptoms that are common. The classic symptoms of people who have developed the most common type of heart problem, which is coronary disease, is chest pain or chest pressure or tightness, particularly when the heart is being asked to do more. So with exertion or sometimes just with emotional stress. A lot of times other symptoms go along with that chest discomfort. So, sweatingness, nausea, shortness of breath, all can be seen along with those chest symptoms. Not everybody presents with those classic symptoms. Those are the easy ones to recognize. But some people and particularly women seem to have a higher instance of this will have symptoms that are less classic. And they might just feel poorly. They might just feel very weak and nauseated and think it may be something not related to their heart. So you don't have to have all of those symptoms to think you're having a heart attack? That's absolutely right. And particularly in people who have several cardiac risk factors, if they do develop some of these symptoms, they should be thinking that this might be something related to my heart. And how does someone distinguish let's say indigestion from chest pain from a heart attack? Gastrointestinal problems like heart burn and reflux are notoriously difficult to differentiate from more serious types of heart problems. And there's been countless examples of people who come in with their heart attack and say, I thought it was just heartburn. So again, I think people that have risk factors for developing the problem who develop heartburn where maybe they haven't really had it before or there's something about it that feels different or it's more severe, they should think maybe I'd better get checked out and make sure this isn't my heart. What goes into an evaluation? If a patient comes in and they haven't had a heart attack but they think there might be something wrong, what sort of goes into that evaluation process? We have very good testing for heart problems here at Mercy. If a patient were to come in with chest discomfort, a combination of an electrocardiogram, which is an EKG, a very easy test to do, along with some simple blood tests, often make it clear right off the bat whether their symptoms are related to their heart or not. And if somebody has the symptoms, what should they do? Well, time is of the essence if people are having symptoms that reflect a heart attack. A heart attack means a coronary vessel, a blood vessel feeding the heart is obstructed or clotted off and the heart's not getting good blood flow. And the longer that happens, the more heart damage there is and the deadlier the heart attack can be. So time is of the essence and if patients have symptoms that they're suspicious maybe related to the heart and are lasting for more than just a few minutes, that's the time to call 911 and come into the hospital to get checked out. And if somebody does have a heart attack, what sort of the post attack treatment and lifestyle changes that they need to go through? Lots of different treatments for a heart attack. The treatment of heart attack has evolved fantastically so over the last several years and decades. But so it's very variable depending on what type of heart attack somebody has. After somebody is treated acutely for their heart attack, then there's lots of things that they need to do in terms of lifestyle interventions, so correcting risk factors. Sometimes that can be just with modification of their lifestyle. Sometimes it's with medications, usually it's with both, become paramount. And what's the trend in survival rates for people who have had heart attacks? We've done really well treating people with heart attack and the survival rate has just gotten better every year. Partly because of educational programs like this, people being quicker to understand the symptoms of heart attack and coming in to get help. And partly because our treatments have gotten better and partly because this emphasis on prevention has become so strong. February is heart month but people need to be cognizant of these things all the time. That's exactly right. It's not the only month we see problems obviously but that's right. But it's a good time for public awareness and I think there's no question that if patients know what their risk factors are, know what their numbers are, the goal is to actually have them come in and see us before their heart attack so that we can prevent that from happening. Here at Mercy Cardiology, we see patients like that quite a bit. They'll come in concerned that they might have some of these risk factors or concerned that somebody in their family had early heart problems. And there's lots of testing and therapies that can really change the course of them having a heart problem. If people want more information about Mercy Cardiology Program, where can they go for that information? Well, I'd recommend our website or to call our department and we'd be happy to see them. They can also talk to their primary care physician about setting up a referral to see one of the Mercy Cardiologists to help them with these prevention efforts.