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Health Matters: Providence St. Joseph Hospital | 5 Dr. Thomas Kim E very 40 seconds, someone in the United States has a heart attack. Men face a greater risk of heart disease at a younger age than women. On average, a first heart attack—the most common manifestation of this prevalent disease— strikes men at age 65. For women, the average age is 72. In fact, says Providence St. Joseph cardiologist Brian Kolski, MD, "50% of men who reach the age of 55 or 60 will develop heart disease. The most important thing any man can do is to be aware, plain and simple," adds Dr. Kolski, who specializes in interventional cardiology and cardiovascular diseases. "Often men delay seeking treatment because they ignore some of the basic warning signs," says Aidan Raney, MD, who also specializes in interventional cardiology and cardiovascular diseases at Providence St. Joseph Hospital. For men, according to interventional cardiologist Jeffrey Tyler, MD, "the most common warning sign is chest discomfort. I say 'discomfort' because people unfortunately anchor on the word 'pain,' but many times it's a feeling of squeezing or pressure or just a fullness in the chest." "While chest discomfort is the most common warning sign, there are other symptoms to be aware of. Some people may feel indigestion or heartburn, pain that spreads to the arm, jaw or throat pain that radiates from the chest, and dizziness/light-headedness, shortness of breath or even a general feeling of being unwell," says Dr. Raney. "Not all heart problems come with clear warning signs, so if you're not sure, get it checked out." Dr. Tyler adds, "Generally, heart attack pain will last three or four minutes. And it's worse when you are asking more of the heart— exercising, walking, exerting yourself in any way—although when you stop, it generally subsides." Another sign that's especially important, he says, "is feeling winded when you wouldn't expect it. Maybe you used to be able to run a 10-minute mile and now you can barely make it half a mile. Even chores around the house can exhaust you." Dr. Kolski agrees: "In men, while abdominal symptoms can be a sign of angina—a lack of blood to the heart, which is what a heart attack basically is—most of the symptoms are above the waist and related to activity; they should always be followed up on." In the follow-up, he explains, "we will look at any change in exercise tolerance or activity level. Have you noticed a decline in how many sets of stairs you can do, or are you exercising less? I think an underappreciated sign is that people start to limit their activity based on symptoms." Interestingly, heart disease is not necessarily a precursor. "In about a third of people who have coronary artery disease (CAD)," Dr. Tyler says, "their first clue is a heart attack and the diagnosis that follows. Another third will have the kind of chest discomfort that gets worse with exertion and better with rest. And then a third, unfortunately, experience sudden cardiac arrest with no warning at all." Prevention is the number one way to avoid a heart attack, according to Thomas Kim, MD, a cardiologist and non-invasive medical director at Providence St. Joseph. "Quit smoking, choose a healthy diet, be physically active every day and aim for a healthy weight." But we can't control our genes, Dr. Kolski stresses. "So even people who do all the right things might be at high risk and need to get regular screenings." Those include people with high blood pressure, high cholesterol, diabetes and pre-diabetes, and any autoimmune condition, which increases inflammation—and, of course, family history, especially if the family member 's event was before age 65, according to Dr. Kim. GENTLER TREATMENTS Providence St. Joseph takes pride in offering several minimally invasive procedures to repair blocked arteries, damaged heart valves and holes in the heart that cause CAD and has a team of cardiologists who specialize in these, which include TAVR (transcatheter aortic valve replacement), MitraClip, Watchman and the PFO closure. "In the past 15 years," says Dr. Tyler, "we have seen a renaissance, a revolution The Heart of the Matter Providence St. Joseph doctors on what you need to know about symptoms of heart attack and innovative new treatments. Dr. Brian Kolski Dr. Aidan Raney Dr. Jeffrey Tyler

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