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June 8, 2017

By Michael Almaleh, MD

Take a sip of coffee. Too hot? Let it cool for half a minute, then try it.

Done? Ok. In that time someone in the United States died from cardiovascular disease.  Every 33 seconds, heart disease takes a life in the United States – about 600,000 people annually – making it the leading cause of death among men and women in this country.

Yet many people also survive and manage heart disease. Nearly 1 million people annually have a heart attack, so chances are good that you are impacted directly or indirectly by heart disease. If you’re caring for someone like a parent who has had a heart attack, there are some things you can do to help them have a successful recovery and learn to better manage their heart condition.

First, from now on when your mom or dad goes to the doctor, they need to bring all their prescription medications – sometimes called bringing the “brown bag.” This should happen when they see the cardiologist, family doctor or any specialist. It’s critical after a heart attack that the patient’s provider of primary care or specialty care reconciles the prescribed medications he or she is taking.

Often, we find a patient is still taking medicine they were supposed to have stopped taking. Or, more likely, a prescription that they need to take isn’t in the bag because the patient hasn’t filled it out. And sometimes, medicines prescribed by different doctors may have an adverse effect when taken together.

However, there’s no doubt a heart attack survivor is going to be on a lot of medications. After a heart attack, most patients need to take at least five new medications, some of which need to be taken twice a day. It’s very important that mom or dad take these prescriptions without questions, without fail. But mom or dad may rebel against this regimen. They may claim there are too many pills to remember to take or that they simply get “tired” of doing it.

A pill box can help them keep track of what pills they need to take daily.  A frank talk with their cardiologist or PCP about the consequences of not taking the medications – a return trip to the hospital, for example, or worse – hopefully can motivate them to stay on their heart medication regimen.

The other major area of concern for mom or dad is weight. We need to monitor it daily or every other day at least to make sure mom or dad are not gaining weight because that is a sign of heart failure.

Why? A heart attack is essentially caused by a lack of blood flow to the heart muscle. When that happens, it can create scar tissue on the muscle, which does not contract.

After a heart attack, that muscle in the chest cavity is probably going to be less effective at pumping not only blood, but also other fluids that need to move throughout the body. When the pump becomes less effective, fluid can build up in the lungs, legs or other areas, causing weight gain. More importantly, it can make it harder to breathe, which isn’t good for the heart, leading to a possible return visit to the hospital.

Mom or dad’s diet also has to change. Sodium in high doses, like the amounts found in a lot of pre-packaged foods, cause blood pressure to rise.  Salt substitutes also may not be wise since they tend to have high amounts of potassium, which doesn’t interact well with prescribed heart medications.

Successfully managing heart disease certainly means changes in lifestyle. An informed patient and caregiver make the chances for success much greater.  Talk with the heart patient’s healthcare provider about how you can meaningfully contribute to that success.

Michael Almaleh, MD, FACC is the Chief of Cardiology for WellMed Medical Group. He completed his Bachelor degree at the University of California at Irvine and his Master’s degree at Boston University. He earned his medical degree and graduated Summa Cum Laude from Boston University School of Medicine. After earning his medical degree, he completed both his Internship and Residency in Internal Medicine at the University of Washington in Seattle, Washington. He then completed his Fellowship in Cardiology at Wilford Hall Medical Center at Lackland Air Force Base. Dr. Almaleh is board certified in cardiovascular disease, nuclear cardiology, cardiac computed tomography and internal medicine. He is a former service member of the United States Air Force.

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