Dr. Icilma Fergus is a cardiologist at The Mount Sinai Hospital in New York City, known as Dr. Icy. She and Debora Grandison share the importance of February American Heart Health Month and what you can do to keep your heart healthy.
HEART DISEASE IS THE NUMBER ONE KILLER OF WOMEN. WHAT DOES IT MEAN WHEN SOMEONE HAS CARDIOVASCULAR DISEASE?
DR. ICY: No matter what you call it – heart disease, cardiovascular disease, or coronary heart disease – cardiovascular disease means there is a plaque buildup in the walls of your arteries.
When arteries narrow, it becomes more difficult for blood to flow and creates a risk for heart attack or stroke.
Irregular heartbeat or heart valve problems can also cause a heart disease diagnosis.
WHAT’S IT LIKE TO LIVE WITH CARDIOVASCULAR DISEASE?
DEBORA: I am actually living with several cardiovascular issues, including atrial fibrillation, or aFib, which basically means I have an irregular heart beat. I was just 27 when all of this started for me and ended up in intensive care because my heart rate tripled.
It took 20 years before I got an accurate diagnosis, and today, I have an insulin pump and a pacemaker to help me live with cardiovascular disease.
I’ve been able to take what I’m dealing with and turn into positive. I make sure to exercise daily and educate myself on the proper ways to eat.
WHAT CAUSES IT AND WHY DOES HEART DISEASE IMPACT WOMEN OF COLOR, AND BLACK WOMEN IN PARTICULAR, DISPROPORTIONATELY?
DR. ICY: Debora is not alone: about half of Black women have some form of cardiovascular disease.
Black women tend to have higher rates of being overweight and diabetes, which puts them at greater risk for high blood pressure and heart disease.
Among all women, Black women are less likely to engage in physical activity. Other risk factors include cholesterol management, smoking and being cognizant of a family history of heart disease for early action. These are among the prevalent risk factors for Black women and may result in heart disease and stroke but can be helped with appropriate lifestyle changes.
CAN IT BE PREVENTED?
DR. ICY: The good news is that yes, about 80 percent of cardiovascular diseases can be prevented with education and lifestyle changes. Some risk factors, like age, gender and family history are, unfortunately, out of our control, but others we can treat or manage, like physical activity and eating habits.
WHAT ABOUT CHOLESTEROL??
DR. ICY: The American Heart Association recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease.
TELL US ABOUT THE AMERICAN HEART ASSOCIATION’S INITIATIVE “GO RED FOR WOMEN”:
DEBORA: The American Heart Association’s Go Red for Women® movement is the trusted, passionate, relevant force for change to end heart disease and stroke in women all over the world. While nearly 80 percent of cardiac events can be prevented, cardiovascular disease is the leading cause of death in women, claiming the lives of 1 in 3 women.
For 15 years, Go Red for Women has provided a platform for women to come together, raise awareness, fund lifesaving research, advocate for change and improve the lives of all women everywhere. The American Heart Association’s Go Red for Women movement is nationally sponsored by CVS Health, with additional support from national cause supporters. Connect with us on GoRedforWomen.org, Facebook, Twitter or by calling 1-888-MY-HEART (1- 888-694-3278).
FRIDAY, FEBRUARY 1ST IS A SPECIAL DAY. WHAT ARE YOU ASKING PEOPLE TO DO AS AMERICAN HEART MONTH KICKS OFF?
DEBORA: Yes, indeed! Friday, February 1st is National Wear Red Day. We encourage everyone to WEAR RED for awareness. GIVE for the mothers, sisters and friends that you can’t bear to live without. SHARE #WearRedAndGive on social media.
THE AMERICAN HEART ASSOCIATION HAS ITS OWN SUPPORT GROUP MADE UP OF HEART DISEASE AND STROKE SURVIVORS. WHERE CAN THEY GET MORE INFORMATION?
DEBORA: We certainly do – we have an amazing community for support, sharing and inspiration to be active and fit, called #GoRedGetFit.
The Facebook group is made possible by our national supporter Macy’s and helps women stay on track with fitness and nutrition goals through quarterly challenges and educational tools.
Join the 20K women who are taking charge of their heart health. It’s easy to join. Just open Facebook and search #GoRedGetFit. Select the public group and click “Join.”
HOW CAN WOMEN GET THEIR HEART CHECKED?
DEBORA: Go Red for Women’s national sponsor CVS Health is offering heart health screenings at no cost every Thursday in February at MinuteClinics nationwide to help women better understand their risk for heart disease.
WHAT ARE SOME OF THE SYMPTOMS OF HEART DISEASE?
DR. ICY: Symptoms can vary between men and women.
For example, women having a heart attack may experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, feeling lightheaded or fainting, pain in the lower chest or upper abdomen and extreme fatigue.
IS HEART DISEASE HEREDIATRY?
DR. ICY: Women with a family history of heart disease are at higher risk, but women should not get comfortable in thinking that there is no one else in their family with heart disease – given the novel risk factors and lifestyles, heart disease is still possible but there’s plenty one can do to dramatically reduce it like getting regular exercise and eating healthy.
Dr. Icilma V. Fergus, MD is Associate Professor of Medicine and Director of Cardiovascular Disparities at Mount Sinai Medical Center. Prior to that she served as Chief of the Division of Cardiology at Harlem Hospital Center. Her undergraduate and graduate education were at Barnard College, Columbia University and SUNY Downstate. She completed her residency and chief residency at Albert Einstein Medical Center.
Dr. Fergus is also Mrs. Rowe, wife to Robert Rowe and mother to three lovely children Orion, Arianne and RJ. She has been featured in several magazines newspapers and shows including Girl Friends Magazine, Heart and Soul, New York Daily News and “Being Black in America: CNN series Part 1”. You can find her on twitter @icilmafergusrow, Linkedin, instagram or Facebook and visit the website http://www.healthyheartseries.org
Debora Grandison is a 30-year survivor of both heart disease and diabetes and is living life to the fullest with an insulin pump and a pacemaker.
Grandison is very passionate about sharing her journey to educate and advocate others, to save lives and feels privileged to have been selected for the American Heart Associations’ Go Red for Women Nation “Real Women” class of 2019.
Debora serves as a volunteer speaker for the American Heart Association’s Volunteer Committee, The AHA Speaker’s Bureau and The AHA You’re The Cure Advocacy Team.
Dr. Fergus answers your ‘Text Tom’ questions on the next page.
TEXT TOM QUESTIONS
Q: What are the symptoms for men?
A: The symptoms for men tend to be more typical –chest pressure, heaviness on the chest ( as if an elephant sitting on the chest, pain radiating down the left arm. This may or may not be accompanied by palpitations and sob. Men may also present with vague symptoms, especially if they have diabetes.
Q: What are steps can be taken for prevention?
A: Prevention is most effectively achieved by managing risk factors – healthy lifestyle intervention is first and foremost. Also it is very important to control blood pressure, weight, diabetes and nutrition. It is important to stay physically active and not smoke. It is important to follow up with health care providers early on especially if there is a family history. The American Heart Association states that heart disease is 80% preventable.
Q: What is considered an elevated heart rate? Should I be concerned with a resting rate 80 that spikes to 125?
A: A normal heart rate or normal sinus rhythm is a heart rate between 60 and 100. Anything above this is considered sinus tachycardia.
Q: Dr., with all these recalls on blood pressure medicine, do you recommend adding apple cider vinegar to keep blood pressure in check?
A: I would say consult with your healthcare provider and pharmacy. The recall has to do with contaminants in the production of the medication and not the medicine itself. There are many alternatives. The apple cider vinegar is great for many things but may have side effects as well such as heart burn or acid reflux.
Q: Dr. Fergus, I was 22 (Black female) when I was diagnosed with a fast heart rate called SVT (Superventrical Tachycardia) but doctors are still all over the place trying to really figure it out. Could this heart condition eventually turn into a cardiovascular disease? I have all the symptoms that were mentioned even while on 2 different beta blockers.
A: SVT has several forms and it depends on which kind you have. You should see a sub-specialist cardiologist called an electrophysiologist who can diagnose and treat. Options may be a beta blocker, calcium channel blocker, an anti-arrhythmic or ablation.
Q: I now have what’s called a heart block. I’m 52. It’s where the electricity in my heart is not getting to the bottom of my heart in a normal manner. My doctor has no idea why I have if. So we’re in the learning discovery phase. The worst case scenario after all testing Is done is I may have to get a small pacer maker. But I passed the stress test on the treadmill.. I blew that out the water. He told me to continue to work out and eat properly. Is this common in African-American women?
A: Heart block can be congenital (born with it) or from various factors ( an infiltrative condition such as sarcoid, amyloid or an infection such as Lyme disease or chagas). Certain medications or certain anatomy of the heart could also be causative. A sub-specialist cardiologist called an electrophysiologist can diagnose and treat.
I am glad that you did great on the stress test which means your “plumbing” or coronaries are fine. It is the electrical system of your heart that has to be evaluated. This condition is not unique to African-American women.
Q: I had so much pain in my right shoulder that after an MRI I was diagnosed with arthritis. But I also have HBP and constantly feel an upset stomach. Do I need to be concerned about my heart?
A: Anyone who has blood pressure elevations should be checked out to ensure that the heart is stable. An echocardiogram and an EKG would be helpful to start with.
Q: If I wanted to get a cardiological checkup where do I start in order to do preventative work?
A: You can have your primary perform an EKG, you may be referred to a cardiologist to decide which further testing if any is needed. Deciding on what testing depends on your risk factors and symptoms.
Q: I have AFIB and taking carvedilol 6.25mg, Entresto and Eliqis. Sometimes I get pain in my left arm – elbow to shoulder. It feels like arthritis cause it only happens when it’s about to rain or get cold. I’ve lost 45 pounds and watch what I eat. Is this normal? I’m taking my meds twice a day.
A: If you are taking Entresto, it seems that you may have congestive heart failure as well. You should have had a diagnosis of ischemia ruled out already ( with a stress test, CT angiogram or cardiac cath). If these tests are negative, then you may indeed have arthritis as a cause of your left arm symptoms.
Q: Dr. Icy, I have all symptoms except the back pain. I know I have asthma, allergies, acid reflux, and I am classified as obese (ht 5”8″; wt 273). Diabetes is in family but fortunately, I don’t have it. I am going to a pulmonary doctor in February to see if I have sleep apnea.
I have had a stress test and came back fine. Should I go and see any other specialist to make sure they are looking at everything? How do I know if I don’t have heart issues? Sometimes I have squeezing in my chest then when I take deep breath in it pops loose. Doesn’t happen frequently.
A: Have you been evaluated by a cardiologist? A cardiac CT ( CTA) may be helpful out coronary artery disease
Q: Why is heart disease only in African-American women & what percentage of Black do you have to be in order to be a statistic or to get heart disease?
A: Cardiovascular disease affects all women, it is the #1 killer of women. Unfortunately, many women who are African-American may not recognize the symptoms, or may not have early diagnosis. This may contribute to more advanced conditions when the person is finally seen and evaluated.
Q: How can you tell if the numbness in your left hand and arm is an indication of heart disease or just carpal tunnel?
A: You should have an evaluation by your primary doctor and then be referred to a cardiologist if necessary. If you have cardiovascular risk factors, heart disease should be excluded as it is life-threatening and carpal tunnel syndrome is not.
Q: Dr. Icy, I’ve been having muscle pain and spasms in my upper left arm and shoulder. Is this a concern?
A: While it may simply be musculoskeletal, please have an evaluation to ensure that there are no other underlying concerns that are missed. This is especially important if you have a family history of heart disease or any of the cardiovascular risk factors.
Q: My wife was diagnosed with enlarged heart what can we do?
A: Was the diagnosis made by an EKG, or echo, if so, I suggest making an appointment for a heart specialist to decide on whether treatment or observation.
Q: I was diagnosed 10 years ago with A-Fib. I do not take a blood thinner. I am a vegan and I exercise 30 minutes a day a minimum of 5 days a week. Lately I found myself to be very tired. What can I take to increase my energy level or not feel so tired?
A: Atrial fibrillation predisposes to clot formation, hence the recommendation for blood thinners. There is a score (CHADS VASC score) which predicts the risk of getting a stroke or similar condition. I would suggest go in for a check up (blood tests and assessment to see if you are still in afib or have sequela from clot formation).
Q: Please ask the Dr. why when I take my BP meds my head hurts when I wake from a dream.
A: Perhaps you could be tried on different blood pressure medications. Some may have the side effect of headache for you, or it could be other medications that you are on. Have all of your medication bottles with you when you go in for a visit with your doctor.
Q: Doc what about tingling of the right arm starting with the fingers straight up to the elbow is that a concern?. I went to my doctor he told me to get a brace
A: Get a second opinion if you are still symptomatic, tingling could be the result of other conditions ( spinal compression, other neurological condition etc).
PHOTO: Jules Thomas/Courtesy (Dr. Fergus)
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