Dr. Justin Levisay (NorthShore)
Hi Abby, thanks for the question. Most of the time, there are warning signs - but not always. Things to watch out for: Any type of chest discomfort (particularly when active), and shortness of breath with activity is another big warning sign. Symptoms can start gradually and worsen over time. Also, woman (more than men) often has very atypical or no symptoms

Dr. Justin Levisay (NorthShore)
YES! It is really important and has been shown to save lives. Dr. Tim McDonough and his partners at St. Francis in Evanston have actually started a program in Evanston to teach people how to perform hands-only CPR. It is very easy to do (and does not require mouth to mouth), and has been shown to save lives! There will be events where people can receive fast and free training.

Dr. Justin Levisay (NorthShore)
Sure. It is a newer way of replacing an aortic valve. The difference between this and traditional surgery is a much smaller incision. In addition, with conventional surgery, the heart is stopped in order to replace the valve, and a machine is used to pump blood during the procedure. With trans-aortic TAVR, the heart does not need to be stopped. It is faster, and the recovery is easier. We having been performing TAVR for many years, and NorthShore was one of the first institutions in the country to do so. It is still heart surgery, but if I personally had a choice between the two (all things being equal), I would have the TAVR.

Dr. Justin Levisay (NorthShore)
Yes. Erectile dysfunction is often caused by blockages in small arteries. It has been shown to be associated with a higher risk for heart attack. Sleep apnea is also associated with heart disease. Apnea can cause high blood pressure and cause abnormal heart rhythms. Good news is that apnea is easily diagnosed and treated. I personally screen a lot of people for apnea, and it is often overlooked as a possible cause of problems!

Dr. Justin Levisay (NorthShore)
Actually, there is a recent trial (SPRINT), which compared controlling blood pressure to a goal of 140 versus a goal of 120. The people who were controlled to a goal of 120 did much better. So much more that the trial was actually stopped early. I suspect the new guidelines will recommend a target goal of 120 for all people being treated for high blood pressure

Dr. Justin Levisay (NorthShore)
Thanks Marie. Blood clots commonly occur in the veins of the legs. Sometimes, there are underlying disorders that lead to this, but often not. An easy way to help prevent clots is to be active, as prolonged sitting without moving can lead to clots. If one has a predisposition to forming clots, blood thinners are recommended. The most common risk factors for heart disease include: Diabetes, high blood pressure, physical inactivity, smoking, a strong family history of heart disease - particularly at an early age

Dr. Justin Levisay (NorthShore)
I would recommend a complete evaluation of your lungs and heart if it has not already been done. It can sometimes be difficult to determine if shortness of breath is caused by the heart, lungs, or the sac around the heart called the pericardium.

Dr. Justin Levisay (NorthShore)
A heart attack is a sudden event that occurs from a blood clot closing the flow to a certain area in the heart muscle, leading to damage. Usually, the clot develops over an area of pre-existing plaque from cholesterol build up. A stroke is the same kind of interruption in blood flow, but to an area in the brain. A stroke can also occur from different issues with brain circulation, such as bleeding, not just clotting. Wherever the area of damage is in the brain will lead to loss of some function, such as ability to move an arm or leg. In the heart, a heart attack can reduce the strength of the heart.

Dr. Justin Levisay (NorthShore)
The risk factors for strokes and heart attacks are similar. They include high blood pressure, high cholesterol, diabetes, smoking and also family history. You cannot modify your genetic composition (as of today, but may change in the future), but at least you can modify your blood pressure and the other risk factors. Also, get checked regularly with your primary doctor or cardiologist, and do not ignore symptoms if they develop.

Dr. Justin Levisay (NorthShore)
It should come without saying that any interventional procedure will carry a greater procedural risk that a non-procedural approach. Having noted that, one has to ask what is the risk of NOT doing the procedure. In addition, are the alternatives an effective treatment? I understand your question about the whole food plant based diet. It may not be the solution to someone that sustained a heart attack that has coronary atherosclerosis and has angina. An interventional procedural would be warranted in that case, and not doing it may lead to worsened symptoms and complications. But it does not mean that one cannot follow a healthy diet in addition. As for the DASH-type diet versus the other diet you referred to, I am not aware of a head-to-head comparison.

Dr. Justin Levisay (NorthShore)
Very unlikely for a teenager to have a heart attack-but it is possible. More commonly, younger people with heart problems usually have other types of problems. One of the most common is called hypertrophic obstructive cardiomyopathy quite a mouthful :)). It is caused by a heart muscle which impedes on the flow of blood out of the heart. When you hear about young, healthy, athletes who die suddenly, this is the most common cause. It is easy to diagnose

Dr. Justin Levisay (NorthShore)
Hi Gail. YES! Cold weather causes an abrupt rise in blood pressure (as the body tries to shunt warm blood away from the cold). This increase can cause people to have angina (chest pain) or even heart attacks. This is part of the reason that shoveling snow can be so dangerous for people with heart disease

Dr. Justin Levisay (NorthShore)
Hey Jenah. Easy answer is yes - we usually try everything possible before considering a transplant. Usually, you would start with medications, which sometimes can improve pumping function, so a transplant is not necessary. At other times, when a patient is very sick and cannot wait for a heart to become available, we can implant a VAD (ventricular assist device), which is an artificial pump which can help a failing heart. This is also an option for people who are considered too old for a transplant

Dr. Justin Levisay (NorthShore)
First I would say that exercise of any type is beneficial. It's best to find a form of exercise that you actually enjoy, which makes it much more likely that you will stick with it over the long term. Moderate aerobic exercise (walking, stairmaster, swimming, etc) are great ways to lose weight and stay fit. Mixing it up a little bit can help improve CV function and maintain muscle mass. Exercise, even with only modest weight loss, is still good, though keeping a healthy weight is important as well. Hope that helped.

Dr. Justin Levisay (NorthShore)
Firstly, it can be very hard to distinguish stomach problems from heart disease. I can't tell you how many people I have treated for heart attacks who thought they just had "indigestion". I hope you have had your heart evaluated to be sure. Usually, "heartburn (GERD)" does not lead to heart disease. Other things like inflammatory bowel disease can predispose people to developing heart disease.

Dr. Justin Levisay (NorthShore)
Great question. Kinda depends on what type of heart disease. Coronary artery disease (which leads to heart attacks) can be tricky. Sometimes, people have blockages that are not severe enough to cause symptoms, or even be detected on a stress test. These blockages can then become unstable and rapidly progress (within minutes) to a complete obstruction. While we are not perfect, a thorough evaluation will usually reveal a problem if it exists