Fit Louisville


Greater Louisville Health Guide is a directory and resource guide to health providers and services in Louisville, Kentucky. Includes listings of area doctors and dentists, hospitals, nursing homes and emergency care.

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F I T 2 0 1 8 - 2 0 1 9 5 What are some of the new research and findings in cardiovascular health? "There are new pacemakers for certain cardiac patients that do not have any leads attaching them to the heart. They remind the heart to beat without actually being attached to the heart by wires. They are smaller than most pacemakers (the size of a vitamin pill) and are implanted directly into the right ventricle through a catheter inserted into a large vein of the leg. No chest incision and no wires. Many complications of pacemakers are related to malfunction, dislodgement or infection of leads, so this is an important advance. It is not for all pacemaker patients, but is an exciting innovation. "There is a relatively new device that can be implanted under the skin to monitor a patient's heart rhythm. It is particularly useful in patients who have had a stroke and are thought to possibly have an irregular rhythm that occurs intermittently. When we can't find a reason for a stroke, this device (called an implantable loop recorder, or ILR) is very helpful. It is the size of a paper clip and monitors a patient's heart rhythm for up to 18 months, often leading to the diagnosis of atrial fibrillation as the cause of the stroke. "The aortic valve can now be replaced in many patients by placing the valve in through an artery in the groin instead of opening an incision in the chest. A leaky mitral valve can be treated through the groin as well, by placing a clip on it to decrease the leaking. "For patients who have atrial fibrillation and are at risk of having a stroke, anticoagulation (blood- thinning) therapy is recommended, but some patients cannot tolerate this treatment because of bleeding tendencies or recurrent falls or inability to reliably take blood thinners. There is a new procedure to close off the Dr. Janet Smith Norton Heart Specialists CARDIOLOGIST important to move. That movement may be just getting up and walking for five minutes every hour or so during the day, if you are not able to walk stairs or long distances. Some people find that they can do more exercise in the water than on land if they have orthopedic problems. I encourage them to be involved in water aerobics. If you have not been active previously, a gradual increase in activity is better than starting out with a heavy exercise regimen from the beginning." When should someone seek treatment? "Know your body. If you notice significant changes in how you feel, you should seek medical attention. Chest pain, shortness of breath, swelling, palpitations, excessive fatigue and dizziness can all be symptoms of heart disease. But don't wait until you develop symptoms to see your doctor. The routine physical exam is very important in order to learn what your health threats may be and what you can do to prevent development of heart disease. "The most important message is that cardiovascular disease can be prevented by a healthy lifestyle. It is recognized that how long a person lives is about 20 percent dependent on inheritance and 80 percent on lifestyle. Even among people at the highest risk of heart disease because of their genetic make- up, a favorable lifestyle is associated with approximately a 50 percent lower chance of developing heart disease than if poor lifestyle choices are made." left atrial appendage, which is the area in the left atrium where clots often form. This is like a little irregular cave off the main left atrial chamber. A 'plug' is placed over the opening of the appendage. It is called a 'Watchman Device' and is also placed through the groin." What are some habits people should be practicing to maintain their heart health? "Don't smoke. If you do, stop. Walk every day. Try to get 10,000 steps per day, (which is the) American Heart Association's recommendation for minimal cardiovascular fitness. Try to do some sort of aerobic cardiovascular exercise at least three times a week for 40 minutes — a brisk walk, tennis, swim, bike, treadmill, stationary bike. Eat a plant-based diet — lots of fresh veggies, whole grains, healthy fats, small amounts of meat. "Things that can help you attain these goals: Walk the stairs instead of riding the elevator. Park your car as far away from the door to the store or office as possible rather than looking for that closest parking spot. Eat until you are 80 percent full rather than stuffing yourself. Your stomach sends a message to the brain about being "full" somewhat after it really happens. Plate your food on smaller plates so that it looks like more and you are not tempted to over-fill your plate. Put healthy snacks out in view instead of high-fat or high-sugar snacks. Pack your lunch for work or school so that you have more control of what you eat. Get a pedometer and challenge friends to walk with you." Should these habits change for different age groups? "Certainly as we age we often develop other medical issues that may decrease the ability to be involved in certain physical activity. In general, it is most

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