Angela (Moderator) - 11:45 AM:
Welcome! Today’s chat: Heart of the Matter – Know the Signs, Symptoms and Treatment of Heart Disease will begin shortly. Please start submitting your questions and Brian Shortal, MD, cardiologist will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit our
Cardiovascular pages on our website.
We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.
Angela (Moderator) - 12:03 PM:
Our chat will begin momentarily. Please start submitting your questions.
Dr. Brian Shortal (NorthShore) - 12:11 PM:
Welcome. Lets get started.
sheila castillo (east alton) - 12:12 PM:
I have pain in my right chest, back and right arm. It has been going on for some time now. I try to blow it off, but the pain is becoming too much. I have a long family history of cancer. It didn't hurt all the until this past week. I'm only 44. What could this be?
Dr. Brian Shortal (NorthShore)
The differential diagnosis for your pain is long and extensive. Concerning factors for cardiac chest pain include associated shortness of breath, palpitations, passing out, a decrease in functional capacity, or an exertional component. See your doctor for further evaluation.
Samuel (Chicago, IL) - 12:14 PM:
Aside from having a family history of heart disease, what else can increase my risks?
Dr. Brian Shortal (NorthShore)
The major risk factors for coronary artery disease include: Hypertension, high cholesterol, diabetes, smoking, obesity, and sedentary lifestyle. Family history, as you mentioned, is one of the more important risk factors.
Heidi (Evanston, IL) - 12:17 PM:
How can I tell the different between a heart attack and heart burn? Do the symptoms differ?
Dr. Brian Shortal (NorthShore)
The difference is oftentimes very difficult to tell even by doctors. Typically, heart burn or GERD, is associated with eating and improves with antiacids or drinking cold beverages. It can also worsen with alcohol or caffeine intake or lying in the supine position (sleeping). Cardiac chest pain typically is associated with shortness of breath and exertion. You should consult your doctor for further evaluation.
Mary (Evanston, IL) - 12:22 PM:
I’ve heard that heart disease differs between men and women. What are the key differences?
Dr. Brian Shortal (NorthShore)
Men typically present with more classical cardiac symptoms: chest pain across the chest with radiations into the arms/back/jaw and shortness of breath. Women, in addition to diabetics and the elderly, can oftentimes present with less classic chest pains and symptoms such as nausea/vomiting and dizziness. In fact the most common presenting symptom in women over 80 years of age is not chest pain but rather shortness of breath.
Marjorie St James toledo ohio - 12:27 PM:
I had a heart attack over a year ago and suffered damage of 60per cent according to my doctor --I am now at 43% and I have no symptoms now. What does this say about my future life span . I am 76 yrs old and still very active.
Dr. Brian Shortal (NorthShore)
The percentages you are referring to are describing your ejection fraction (EF) or the ability of your heart to pump blood. A normal EF is 50-65%, so your EF of 43% represents mild cardiac dysfunction and puts you at low risk for future arrhythmias or heart failure seen at EF's <35%. With the proper medications, diet, and exercise, you should enjoy many years to come.
Georgia (Chicago, IL) - 12:30 PM:
My husband suffered from a heart attack earlier this year. We’ve made changes to our diet, but are wondering when he can start being more active again. When is it best to exercise and travel again?
Dr. Brian Shortal (NorthShore)
I typically tell patients after a heart attack to begin light aerobic exercise after 1 week with gradual progession over the first month. Cardiovascular rehab can oftentimes serve as a guide to increasing functional capacity. After 3 months I typically tell patients that they have no physical restrictions. Travel restrictions varies from patient to patient and depends on access to health care (being admitted to a hospital in a third world country may be something to think about).
Janice (Chicago, IL) - 12:35 PM:
I work in a retirement home and am afraid that if someone was having a heart attack I wouldn’t know the signs. What do I need to know if someone is having a heart attack?
Dr. Brian Shortal (NorthShore)
Heart attacks in the elderly can oftentimes present atypically. Look for chest pain, shortness of breath, altered mental status, decreased functional capacity, nausea/vomiting, and/or decreased appetite. I realize this probably describes more than half of your patient population but you must have a high index of suspicion.
Jordan (Skokie, IL) - 12:39 PM:
How closely do my eating, drinking and exercise habits impact my chances for getting heart disease?
Dr. Brian Shortal (NorthShore)
Life style, which includes diet, exercise, and smoking status, is roughly responsible for 70% of cardiovascular disease.
Henry (Chicago, IL) - 12:41 PM:
How does high blood pressure and cholesterol affect my likelihood of getting heart disease?
Dr. Brian Shortal (NorthShore)
High blood pressure and high cholesterol are two of the strongest risk factors for heart disease. High blood pressure places stress on the arteries in the body making them more susceptible to plaque formation and rupture. The major contributor of vascular plaque is cholesterol. The excess cholesterol floating around in your system deposits in vessel walls increasing your risk of stroke and heart attack.
Anonymous - 12:47 PM:
Ok, i have been having occasional pain in about a 1x1" area to my left upper chest. I have had a heart attack in the past (per EKG reading) I did see a cardiologist and had a stress test last year, which came back fine. She told me it MIGHT be costocondritis. My question is this:IF there is something going on with the SA node and it is having some issue with how it is "firing" signals, could that cause pain to that area as well as radiating down left arm into last 2 fingers, dizziness & others
Dr. Brian Shortal (NorthShore)
Sino-atrial (SA) nodal function/dysfunction does not manifest as chest pain. If there is SA nodal dysfunction this is evaluated further with a monitor to ensure normal function to rule out pauses or arrhythmias.
Theresa (Evanston, IL) - 12:50 PM:
I had a heart attack nearly six months ago. I’ve been a fan of taking medication. What are the risks if I don’t take my medicine?
Dr. Brian Shortal (NorthShore)
The typical medications prescribed following a heart attack reduce your risk of a future cardiovascular event (heart attack, stroke) 70%. There are few medical therapies in all of medicine that make such a dramatic impact on future survival.
Marjorie St James toledo ohio - 12:53 PM:
Thanks for your previous answer.I am active at a senior center and I sing with the senior centers' band even though I have chronic copd. I find that the more I sing the better my lungs. Will this also help my heart improve?
Dr. Brian Shortal (NorthShore)
While there is no specific data linking singing and a decrease of cardiovascular events, the enjoyment you gain from singing most likely has some benefit.
Angela (Moderator) - 12:55 PM:
Thank you everyone for your great participation. The chat will be ending in approximately 10 minutes. Please submit your final questions.
Sophie (Highland Park, IL) - 12:56 PM:
I have an extremely stressful job. I often worry that this increased stress will start to negatively impact my health. Am I at a great risk for heart disease if I am constantly stressed out? What are some things I can do now to avoid this?
Dr. Brian Shortal (NorthShore)
Stress has been identified as an independant risk factor for cardiovascular disease although pales in comparison with hypertension, high cholesterol, smoking, family history, and diabetes. I hear this complaint from patients daily and think the most important way to combat stress is exercise. Channeling social stress into physical activity is the most effective non-pharmacological way to manage this common problem. The reason I run marathons is largely based on the stress of raising 3 "active" children.
Val (Chicago, IL) - 1:03 PM:
My dad suffered a heart attack last month. What does the recovery period typically look like? How can I be of assistance to help speed this up?
Dr. Brian Shortal (NorthShore)
Recovery varies from patient to patient. Light aerobic activity begins after 1 week with gradual increase in activity over the first month. Cardiac rehab can oftentimes help serve as a guide if the patient is unfamiliar with exercise. At 3 months, I tell most patients they have no physical restrictions.
Pete (Evanston, IL) - 1:07 PM:
I’ve heard that most heart attacks take place in the morning. Is this true? If it is, why?
Dr. Brian Shortal (NorthShore)
Great question. For some reason the risk of heart attack increases slightly between the hours of 6-8 am. We think this is due to the symptothetic surge associated with arousing from sleep. Heart attacks are also most common in the month of January (nothing to due to snow as this is nationwide).
Angela (Moderator) - 1:10 PM:
Thank you for participating in our online chat today. An online transcript will be available shortly. To learn more about NorthShore’s Cardiovascular services, visit our
website.