Heart Felt Class for Heart Health

Dr. Michael McCloud chats with students before
launching Week 4 of Mini Med School

There is no wonder that UC Davis School of Medicine has a world class reputation. Last weekend’s presentations at the 2012 Mini-Medical School clearly demonstrated the university at the cutting edge of medical science and education through communication.  Cardiologist Dr. Jeffrey A. Southard taught in one short hour what many people wait a lifetime to learn – the essentials about heart health and disease, and how to smartly manage our own fate as we age. And, as a real bonus, a prelude of what the UCD Med Center team will deliver in  groundbreaking procedures this week.

Hard Working Heart

Think, for a moment, about the job done by the heart. It beats every second of every day throughout our lives. It doesn’t take time off, or rest up after an injury or heal a broken valve before going back to work.  It just keeps on beating and pumping and making life possible.  Dr. Southard suggested we think about the heart as if it is a house – with plumbing (flow and pipes and valves that open and shut), an electrical system that fires impulses to keep the beat steady and rooms, or chambers, where constant work is happening in concert with the whole-house system.

Considering the vital and continuous demand on the human heart it’s not surprising that it breaks, fails and fibrillates. Think heart attack, coronary disease, atrial fibrillation, congestive heart failure, etc.  But, Dr. Southard says his aim is to keep the heart healthy and avoid acceleration of diseases that can, and often do, land people on a surgeon’s table and, in the extreme, a morgue.  

Some of the common causes of heart disease?  Chief among them are smoking, high blood pressure, high cholesterol, diabetes and genetics.  First line of defense? Exercise, thoughtful eating and drinking, and quitting smoking – very logical preventions but apparently a daunting prescription for Americans. Heart disease is the nation’s number one killer – accounting for more deaths than all cancers combined.

The Aging Heart

The most prevalent heart conditions include Coronary Heart Disease  – a narrowing or blocking in the plumbing that leads to the heart. Plaque, frequently formed because of high cholesterol intake, builds up on the walls of the arteries to the heart. This constricts blood flow and the heart may no longer be pumping adequate blood through the narrowed channels of the arteries.  The preventative or prescription? Diet and exercise. According to Dr. Southard, these two practices are fundamental and necessary. “It is the mainstay of therapy for your entire health,” he told the class.

We don’t want to hear this, but the prevalence of heart disease rises significantly as we age. Therefore, it’s logical that attention to diet and exercise should receive equal increased attention in the second-half of life. Unfortunately, we’ve come to equate “retirement” and later years as a period of well earned inactivity, while people a third of our age are sweating at the gym. Heart disease can and does affect longevity. The Doc reports that most people who make it past the age of 80 or so have not had heart failure along the way.

Remedies and Repairs

Conditions to be aware of include Coronary Artery Disease (mentioned above), Congestive Heart Failure (the heart doesn’t pump enough blood to the body and brain), Atrial Fibrillation (irregular heartbeat that ranges from mild to dangerous) and Valvular Heart Disease (traced to damage of one of the four heart valves). Heart disease, particularly Atrial Fibrillation, can also prompt a stroke.

How we handle any of these conditions varies according to the severity of damage and disease. When a heart ailment has taken hold, repairs can range from the placement of stents – tiny devices that are implanted in heart arteries to keep them open – to open heart surgery. There was an audible groan in the class when Dr. Southard said 60 percent of heart attacks happen in the population over the age of 65. Then, a measure of relief when he added that the best outcomes are also in this same demographic.

New Procedures Hold Promise for Older Patients

In some cases, heart patients are not good candidates for tried and true surgeries. In this arena, UC Davis is a national leader in using the Edwards Sapien TranscatheterHeart Valve to repair damage and increase longevity for qualified candidates. This procedure has been used in more than 60,000 cases worldwide and shown to reduce mortality by half. It is fast, does not require surgery or long recovery. The procedure was only recently approved in the U.S., but fully implemented in Canada and elsewhere. Our lagging behind is due to the political nature of FDA approvals and America’s litigious penchant. Dr. Southard said other countries have eliminated these objections by capping ‘damages’ and cutting political red tape.

Physicians are also leveraging the power of stem cell therapy. Stem cells taken from adult bone marrow (and other parts of the body) can regenerate in targeted organs. Dr. Southard and his colleagues are focused on the potential of such stem cells to treat heart disease without surgery. Patients receiving this cutting edge treatment will be followed for two years and assessed along the way. UC Davis has a state of the art facility at its Institute for Regenerative Cures in Sacramento.

After arming students with information and warnings, Dr. Southard offered his heart healthy rules. “If it tastes good, leave it alone,” he joked (I think). “Eat healthy, exercise, have portion limitation, control your blood pressure, don’t smoke, visit your primary care doctor and avoid seeing me.”

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