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Those attending Cumberland Medical Center’s heart health luncheon Feb. 13 listen to Dr. Hunt Anderson, an interventional cardiologist, discuss causes of heart disease and ways to prevent it.

Those attending Cumberland Medical Center’s heart health luncheon Feb. 13 listen to Dr. Hunt Anderson, an interventional cardiologist, discuss causes of heart disease and ways to prevent it.

Tennessee is in a “heart attack belt” — a status that’s particularly alarming for the most common form of death in the U.S.

“It dwarfs everything else. It dwarfs cancer, it dwarfs really anything you can think of as a killer,” said Dr. Hunt Anderson. “Somebody dies in the United States every 52 seconds from heart disease.”

Anderson, an interventional cardiologist who joined Cumberland Medical Center in September, was the keynote speaker for CMC’s luncheon dedicated to learning about and discussing heart health on Feb. 13.

Tennessee, however, is not alone.

Anderson said the “heart attack belt” encompasses most of the Southeastern United States, where heart disease affects people at a particularly high rate.

Heart disease has been widely recognized as a national problem. The American Heart Association designates February as Heart Month as a national spotlight, due to heart disease being the leading cause of death in the United States.

Anderson emphasized that disease is the cause of death for approximately 24% of the country’s population, killing more than 600,000 people per year.

The cost of treating heart disease is also high — annually, coronary heart disease costs the United States $108.9 billion, with 12 million office visits, 1.9 million outpatient hospital visits and 3.7 million inpatient admissions per year.

Smoking is considered to be one of the surest ways to hurt the heart, as everything inhaled from cigarette smoke directly poisons the inner lining of the arteries, according to Anderson.

“If you quit smoking, your risk of heart attack falls substantially even just within a year,” Anderson said.

According to Anderson, there are approximately 6,300 new smokers every day, with 1,000 people every day becoming a daily smoker.

“You would think that we don’t see people smoke like they used to, but with advent of vaping, the tobacco industry has made sure they’re still going to stay in business,” he said.

Another link to heart disease is hypertension, with Anderson saying that getting blood pressure under control drops an individual’s risk for a heart attack by about one-third.

“The lower with blood pressure you go, the better you do for heart attack or stroke prevention, but if I get you too low, you get woozy, fall down and break a hip, so now we’re in a whole other category of badness,” Anderson said.

One risk factor for heart disease or strokes lies in cholesterol levels, particularly in low-density lipoproteins. This is also known as LDL, or “bad cholesterol.” A high LDL level leads to a build-up of cholesterol in the arteries. HDLs, known as the “good cholesterol,” carries cholesterol from other parts of the body to the liver, which removes the cholesterol from the body.

With LDL cholesterol, the lower the number, the better. It is optimal to have a LDL cholesterol level below 100 mg/dL. Anything above 130 mg/dL is considered to be high, with above 190 mg/dL labeled as very high-risk. Patients who have already had a heart attack or a stroke should have a goal of under 50 mg/dL, Anderson said.

“We don’t really need LDL for much of anything,” Anderson said. “I have patients with LDLs in single digits, and they’re fine.”

Ways to lower LDL levels include heart-healthy eating that limits saturated and trans fats, weight management and physical activity. Preventing obesity is directly linked to preventing heart problems, Anderson said.

“Obesity leads to diabetes, and diabetes increases your chance of heart disease by two to four times,” Anderson said.

Anderson also guided attendees through signs of a heart attack. He explained that it is often difficult for people to realize, as the heart, lungs, esophagus, stomach and intestines are all controlled by the vagus nerve.

“When that one nerve goes off, it’s very confused. The brain doesn’t know what to do with it,” Anderson said.

Typical heart attack symptoms include pain felt just below the sternum, or the left side of the chest.

“Usually it’s more dull, like a tightness or pressure than it is sharp,” Anderson explained. “It will last for more than five minutes, so a 20-second little twinge is not a heart attack.”

The pain would then most likely “radiate” to the left shoulder or arm, though not always on the left side. Neck, jaw and upper back pain can also occur. Other symptoms include shortness of breath, indigestion, nausea/vomiting, lightheadedness, cold sweat, fatigue, anxiety and heart palpitations.

Anderson noted it is often shown that women do not present the same as men in their heart attack symptoms.

“It’s actually really, really rare that women will have a heart attack with zero chest pain, but that may not be the chief complaint,” Anderson said. “They may come in and say, ‘Look, my shoulder and back’s really hurting, and I’ve got a little bit of chest pain,’ whereas the guys may be more frequent to come in and say, ‘There’s an elephant sitting on my chest.’”

CMC offers a wide range of cardiac services to treat patients with heart disease, including cardiac diagnostics, cardiac and pulmonary rehabilitation, intravascular ultrasound, invasive cardiovascular laboratory and telemetry control services.

Procedures offered at CMC include heart catheterization, pressure wire, cardioversion, intra-aortic balloon pump insertion, closure device, percutaneous transluminal coronary angioplasty and stent procedures.

Heart catheterization is performed to find out if the patient has disease of the heart muscle, valves or coronary arteries. In the procedure, a thin, hollow tube called a catheter is inserted into a large blood vessel that leads to the heart.

A pressure wire study is also a common diagnostic conducted by a cardiologist, in order to predict whether or not someone is likely to develop heart failure. A pressure wire is inserted into the artery (after a catheter), placed beyond the narrowing in the coronary artery, using x-ray imagery. The cardiologist then assesses the consequences of narrowing the patient’s arteries.

Cardioversion is a medical procedure that uses quick, low energy shocks to restore an abnormal heart rate to its normal rhythm, using electricity or medication.

Intra-aortic balloon pumps are a type of therapeutic device that helps the heart pump more blood, and is needed for those who are unable to pump enough blood for their bodies.

Closure devices treat heart conditions like atrial septal defect, which are holes in the tissue that separates the two upper chambers of the heart. The closure devices will help to close the hole in the heart, using what looks like two small mesh umbrellas. Over time, heart tissue around the hole grows into the mesh.

In the case of blocked arteries, a percutaneous transluminal coronary angioplasty is a minimally invasive procedure that opens the coronary arteries to improve the patient’s blood flow to the heart muscle. The doctor may also place a stent within the artery to keep it open permanently.

Stent procedures keep the patient’s arteries from being blocked, using a wire mesh stainless steel tube that holds the artery open. The procedure involves inserting a catheter through an artery, and moving a balloon catheter, and then the stent, to the site of the blockage. The balloon is then deflated and taken out, leaving the stent in place and the arteries permanently open to allow blood to flow smoothy.

“The stents do amazingly well. You may have heard, ‘Oh, he had to get his stents replaced.’ We don’t replace them. Nobody can get them out. A surgeon can’t get them out. Once they’re in, they’re in,” Anderson said. “I joke that this is now the strongest artery in your body, because it has rebar inside it.”

One way that people can find out if they are at increased risk for a heart attack is through calcium scoring with CT coronary, a CT scan that is performed to access coronary artery blockage. The test is a convenient and non-invasive way to evaluate one’s risk for a heart attack.

The information given from calcium scoring lets one know how much calcium buildup (plaque) is present in their coronary arteries. The exam only takes a few minutes, and only requires the patient to lie still while pictures are taken with a low-dose of radiation on a CT scanner.

CMC offers calcium scoring as a part of its cardiology service, however most insurance companies do not cover screening tests. At CMC, the screening would cost $99, which is a standard price across Covenant Health facilities. Those interested in scheduling a calcium scoring CT can call the hospital’s scheduling line at 931-459-7040 to arrange.

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