Carotid Artery Screening: Serious Test or Serious Scam?

I received a flyer in the mail last week about a stroke/carotid artery screening (plus several other heart tests) for the low price of $139. I didn’t pay too much attention to it until two patients brought in the same exact flyer wanting to know if they should do it and get the screening.

Your carotid arteries are the main blood supplier to your brain, head, and neck and are therefore very important to your well-being! Most people recognize the carotid arteries as the place you take your pulse on your neck – just under the curve in your jaw. Over time, these arteries can develop atherosclerosis where they become narrowed by plaques of cholesterol, calcium, and fibrous tissue. This causes a decreased blood supply and oxygen up into your brain.

If the artery becomes completely blocked, or if a piece of the plaque breaks off and floats up into your brain, you are at serious risk for a stroke.

According to the National Stroke Association, stroke is the third leading cause of death in Americans and the leading cause of adult disability. They also report that up to 80% of strokes are preventable!

A stroke occurs when an artery or vessel is blocked (ie. from plaque) which stops blood supply to an area of the brain. This causes brain cell death and brain damage. The damage outcome depends on which area of the brain is affected such as the area for speech or for walking.

There may be earlier signs that your carotid arteries are narrowing before having a stroke. For example, you may lose vision in one eye, not be able to control the movement in one arm or leg, not be able to control speech, or feel weak/numb/tingling on one side of your body. If any of these symptoms occur, contact your healthcare provider immediately.

The test to check your carotid arteries involves the use of an ultrasound in order to assess blood flow through the vessels. It is a quick, painless, non-invasive test where a technician holds the ultrasound probe to your neck and watches your blood movement on a screen. If things are flowing freely and smoothly, you are at little risk. If the blood appears constricted and not able to flow easily, you are at a high risk and additional tests may be necessary.

I told both patients to spend the money and get the work-up as they both had several other cardiovascular markers such as abdominal fat, high blood pressure, and elevated cholesterol that we were trying to correct. This screening test will assess their stroke risk and help us continue on the prevention path.


References:
www.vascularweb.org
www.stroke.org

5 Heart Healthy Reasons for Fish Oil

More and more Americans are taking their fish oil and eating cold-water fish as part of a healthy diet. Fish oil is made up of fatty acids called EPA (eiosapentaenoic acid) and DHA (docosahexaenoic acid) that are part of the polyunsaturated omega 3 anti-inflammatory pathways in your body. These two fatty acids are important to cell membranes which ultimately help heart electrical conduction and tone.

According the American Heart Association, cardiovascular disease is the number one cause of death followed by cancer and accidents. It is also highly preventable and recent research shows that taking fish oil or eating fish such as salmon, mackerel, herring, or anchovies can help fight heart disease by reducing the risk of:

1) atherosclerosis (hardening of the arteries)
2) arrhythmia (irregular heartbeat)
3) heart attack (myocardial infarction or MI)
4) sudden cardiac death
5) heart failure

Omega 3 fatty acids are made by microalgae in the ocean which are then eaten by cold-water fish. The oil is deposited into their organs and stored in their fat tissue. When choosing your fish oil, make sure it is free of heavy metals, pesticides, and herbicides and that the manufacturer tests every batch for freshness. There are two forms of fish oil – the triglyceride form and the ester form. Studies lean towards the natural triglyceride form as being more digestible however the ester form is cheaper to produce.

If you puncture your fish oil pill and it smells rancid, then you have a bad batch. It should smell naturally like clean fish.

For the best heart benefits, take enough fish oil such that you are receiving at least 500mg of EPA and DHA. Your total “Omega 3” may read 1000mg or more, however it’s the actual EPA/DHA numbers you add up. When choosing to eat fish as part of your healthy diet, go for wild caught or farmed free of dyes and chemicals.

References:
1. Lavie, C. Journal of the American College of Cardiology, Aug. 11, 2009; 54:585-594.
2. Lawson, L.D.; Hughes, B.G. (October 1988). "Absorption of eicosapentaenoic acid and docosahexaenoic acid from fish oil triacylglycerols or fish oil ethyl esters co-ingested with a high-fat meal". Biochemical and Biophysical Research Communications 156 (2): 960–963.
3. Beckermann, B.; Beneke, M.; Seitz, I. (June 1990). "Comparative bioavailability of eicosapentaenoic acid and docasahexaenoic acid from triglycerides, free fatty acids and ethyl esters in volunteers". Arzneimittel-Forschung 40 (6): 700–704.
4. www.americanheart.org

Heart Palpitations - more than a flutter?

Ever have that quick flutter feeling in your chest that lasted for a couple seconds and disappears? Maybe yours lasts a little longer, a little stronger, and causes you to cough? These are called heart palpitations and are very common in women. There are many reasons your heart chooses to beat strangely, and a lot of it is normal.

The heart is a fist-sized muscle in the left side of your chest that is responsible for pumping fresh blood out to your entire body and receiving blood to be put back through the lungs. Just before each heart beat, your heart chambers fill with blood until it is squeezed out in rhythm. You have four chambers with valves separating the two on the left and the two on the right.

When your heart contracts, it sends an electrical impulse from the SA node in your right atrium down to your AV node. The SA node is your built-in pacemaker and sets the tone of your heartbeats. Sometimes it can be sped up or slowed down which causes you to take notice.

Some common reasons you may experience palpitations are with exercise and overexertion, caffeine, alcohol, smoking, drugs, thyroid problems, anemia, valve problems, stress, panic and anxiety, and adrenaline rushes. If you experience palpitations, pay attention to the time of day, what you are doing, and what you just ate or drank. Many patients report heart symptoms with stress or anxious feelings. Others feel changes after a glass or two of wine or coffee.

Palpitations should not be ignored in case they are due to a bigger process such as thyroid or anemia problems or heart valve changes. Your doctor will listen to your heart and may recommend an ECG to monitor your heart rate. Sometimes you might wear a holter monitor for 24-hours. This nifty little device keeps track of your palpitations all day long. How often have we gone to the doctor with a symptom that happens all the time and suddenly it disappears? Using a monitor can help diagnose the reason.

If for any reason you experience abnormal heart beats along with chest pain, dizziness, light-headed, pain in your arm or jaw, the sensation of blacking out – please call 911. Do not wait to see if it passes.

Treatment, of course, depends on the reason. If you are amping yourself up on caffeine or stress, then it’s a lifestyle change. Review all of your medications and supplements with your doctor to see if any could be causing palpitations. Have your blood checked for anemia and thyroid disease. More severe problems could require surgery.