Russert’s death prompts questions from patients on heart disease

The high-profile heart attack death of NBC newsman Tim Russert has triggered a flood of questions from patients, internists and cardiologists say.

“They don’t want to be the person that stayed at home with minor symptoms when it could have been a heart attack,” said Greg Kumkumian, medical director of the coronary care unit at the National Institutes of Health Heart Center at Suburban Hospital in Bethesda, Md.

Experts say they welcome the interest – and the opportunity to educate the public about heart disease prevention.

Basically, the message is still this: Eat a low-calorie, high-fiber diet; exercise; get regular checkups; take medication if you need it; learn the early warning signs; and seek help early if you experience any symptoms. Although experts concede some heart attack deaths occur without warning, they say it pays for people to know their risks and reduce those they can control, such as high cholesterol and high blood pressure.

Heart disease is the country’s leading cause of death for men and women, killing more than 700,000 people a year, according to the Centers for Disease Control and Prevention. Although it’s often considered a disease that affects mostly men, women account for more than half of heart disease deaths.

The most common form of heart disease, coronary artery disease, develops when the arteries that nourish the heart become narrowed by the buildup of a fatty substance known as plaque. A continued buildup, called atherosclerosis, can limit blood flow and create clots that can block narrowed arteries, causing a heart attack, the blockage of flow to a section of heart muscle.

Because plaque buildup can start early, Philip Corcoran, a cardiothoracic surgeon at Suburban Hospital, advises starting heart disease prevention in your 20s. Knowing your family medical history, he says, is crucial. Other factors that can promote plaque buildup include high blood pressure, high cholesterol, obesity and diabetes. Age also increases the risk of heart disease.

Another common concern is stress. Douglas Zipes, emeritus director of the cardiology division at Indiana University School of Medicine, said traumatic events such as terrorist attacks, natural disasters or a spouse’s death can prompt a rise in sudden cardiac death, the abrupt stoppage of the heart. But he said there was no way to characterize the hustle and bustle of lifestyles as good or bad. “One man’s stress,” he said, “is another man’s pleasure.”

To assess heart attack risk, doctors sometimes monitor the heart’s rhythms and electrical activity as it responds to physical stress. Some stress tests also use imaging to show blood flow through the heart.

But because tests cannot prevent sudden cardiac death and people cannot control such risk factors as age, sex and genetic makeup, Corcoran recommends everyone take these steps for a healthier heart:

•Eat a diet low in calories, saturated fat and cholesterol.

•Exercise three to five times per week for at least 30 minutes.

•Avoid smoking.

•Lose weight if you’re overweight.

•See your doctor regularly to measure blood pressure and cholesterol.