Take Control, Live Better Coronary Artery Disease What is coronary artery You may not feel sick at all until disease? your heart disease gets a lot worse. Some people have coronary artery Coronary artery disease means that disease for years without having the blood vessels that bring blood chest pain or any other symptoms. to the heart (coronary arteries) have This may make it hard to feel like become narrow. They get narrowed you need to pay attention to the by plaque, which is a buildup of fat problem. and other substances. When you have this type of heart disease, your arteries cannot bring as much blood and oxygen to your Narrowed heart. Poor blood flow can cause artery chest pain or other symptoms when your heart has to work harder. If the Plaque blood flow gets completely blocked, a heart attack happens.
With poor blood flow over time, your Coronary arteries heart may get weaker and not pump Plaque is a buildup of fat and other as well as it should. This can lead to substances in your arteries. dangerous heartbeat problems and heart failure.
2 But try not to ignore the fact that When to call the doctor Knowing how you have heart disease, even if Call 911 if: high your you feel fine right now. The goal XX You have symptoms of a heart heart attack is to keep feeling good for a long attack. These may include: risk is can help you time. You have a better chance and your doctor make of doing that if you start living o Chest pain or pressure, or a better decisions about healthier today. What you do can strange feeling in your chest. your treatment. To find make a big difference. o Sweating. out your risk for having How to avoid a heart o Shortness of breath. a heart attack in the attack o Nausea or vomiting. next 10 years, go to www.healthwise.net/ o Pain, pressure, or a strange For many people with heart patiented and enter feeling in your back, neck, disease, their biggest fear is a J965 into the search jaw, or upper belly, or in one heart attack. To avoid a heart attack box. and live longer and better, you will or both shoulders or arms. need to take steps to improve your o Lightheadedness or health. The good news is that you sudden weakness. are in control. o A fast or irregular heartbeat. Here are things you can do now After you call 911, the operator to get healthy and stay that way: may tell you to chew 1 adult- XX If you smoke, quit. strength aspirin or 2 to 4 XX Eat healthy food. Eat more low-dose aspirin. Wait for fiber, and cut down on an ambulance. Do not drive cholesterol, saturated and yourself.
trans fats, and salt. XX You typically use nitroglycerin to XX Try to get some exercise relieve angina and if one dose of throughout the week. Start nitroglycerin has not relieved your with short walks or any other symptoms within 5 minutes. Do activity you enjoy. not wait to call for help.
XX Take any medicines your doctor Call a doctor if: prescribes, such as medicines XX You have angina more often to control high blood pressure than usual, or it is worse or or high cholesterol. different than usual. XX You have any problems with your medicines.
3 Symptoms Dealing with angina Watch for changes in your angina. If your angina is worse or lasts Many people with coronary artery longer than usual, or if you start disease have no symptoms. But getting it more often, it could mean others may feel chest pain or that your heart disease is getting pressure or other symptoms when worse. Call your doctor right away. their hearts have to work harder. You may need a checkup or tests, These symptoms are called angina. or your doctor may need to Angina is a signal that your heart change your treatment. is not getting enough oxygen. The pain or pressure usually is mild at Tips for reducing angina first and gets worse over several XX If an activity causes angina, minutes. You may feel it in your stop and rest. Avoid doing heavy chest, back, neck, jaw, upper belly, activity that causes symptoms. shoulders, or arms. XX Ease into your day. Warm up If you have had angina for a while, slowly before activity. you may be able to predict almost XX Give yourself time to rest and exactly how much activity will cause digest right after meals. your symptoms. You know what things cause your angina, and you XX Change the way you eat. know what to expect and what to do Eat smaller meals more often when it happens. This is called during the day instead of two stable angina. or three large meals.
4 XX See if family members If you take nitroglycerin To learn or hired help can assist Nitroglycerin is a medicine that more about with heavy chores such opens blood vessels to improve when and as shoveling snow or blood flow. This relieves angina how to mowing lawns. and reduces how hard the heart use nitroglycerin, go XX If your job involves heavy has to work. to www.healthwise. labor, think about changing Your doctor will tell you when net/patiented and the kind of work you do. to use your nitroglycerin. You enter R390 into the X X If you are not taking may need to take it: search box. nitroglycerin for angina, XX To relieve sudden angina. ask your doctor if it could help you. XX Before stressful activities that can cause angina, such as What to do when you exercise. have angina Do not take erection-producing medicines such as Cialis, XX Stop what you are doing. Levitra, or Viagra if you are Sit down and rest. taking nitroglycerin. Taking any X X If your doctor has prescribed of them with nitroglycerin can be a medicine like nitroglycerin, very dangerous. If you get angina take one dose. and have taken one of these XX If you are not feeling better erection-producing medicines, within 5 minutes, call 911. tell your doctor so that you are Stay on the phone. The not given nitroglycerin or a similar emergency operator will medicine. tell you what to do next.
Watch for Drug Interactions
Always tell your doctor about all the medicines you’re taking, including over-the-counter medicines and supplements. This will help reduce the risk of drug interactions and side effects.
5 Treatment Treatment for coronary artery often prescribed for people with disease focuses on taking steps coronary artery disease include: Did You Know? to manage your symptoms and ffStatins to help lower No matter what reduce your risk for heart attack cholesterol. treatment you receive, and stroke. Some risk factors you’ll still need to make ffBeta-blockers or ACE you can’t control, such as your changes in the way inhibitors to lower blood age and family history. Other you eat and how much pressure. risk factors you can control, you exercise. These such as high blood pressure, ffAspirin or other medicines to changes, along with high cholesterol, and smoking. reduce the risk of blood clots. not smoking, will give Lifestyle changes are the first ffNitrates to relieve angina. you the best chance step and can help lower your risks. of living a longer, But you may also need to take If you take medicines, take them healthier life. medicines or have a procedure to on a schedule and take the improve blood flow to your heart. correct dose. Taking medicines properly can help you prevent a Medicines heart attack or stroke. Medicines can help control your symptoms and can lower your Angioplasty and bypass risk for heart attack and stroke. surgery Some of the medicines that are If your chest pain or other symptoms keep getting worse even though you are taking
6 medicines, you may need Cardiac rehabilitation procedures to improve blood Your doctor Your doctor may want you to take flow to your heart. They are also may talk to part in a cardiac rehabilitation done when the coronary arteries you about (rehab) program after you have are blocked during a heart having an angiogram. had angioplasty or bypass attack. These procedures include This can be a very surgery. But even if you haven’t angioplasty with or without useful test to show how had one of these procedures, stenting and coronary artery serious your coronary you can still benefit from the bypass graft surgery. artery disease is and program. how best to treat it. But Angioplasty is used to open A cardiac rehab program can there are also reasons narrowed arteries. It isn’t major help you make lifestyle changes. why you may not need surgery. During angioplasty, In cardiac rehab, a team of or want an angiogram. the doctor guides a thin tube health professionals provides For help deciding, go (called a catheter) into the education and support to help to www.healthwise. narrowed artery and inflates a you make new, healthy habits. net/patiented and small balloon. This widens the enter J525 into the In cardiac rehab, you will learn artery to help restore blood flow. search box. how to: Often a small, expandable tube called a stent is placed to keep ffManage your heart disease Ask your the artery open. A drug-eluting and other problems such as doctor about stent slowly releases a medicine high blood pressure and high joining a that prevents the growth of new cholesterol. cardiac rehabilitation (rehab) program. Many tissue. This helps keep the artery ffExercise safely. open. people who have heart ffEat a heart-healthy diet. disease find this type Bypass surgery, which is major ffQuit smoking. of program helpful. surgery, may also be used if To learn more about ffReduce stress and arteries are narrowed. It uses cardiac rehab, go to depression. healthy blood vessels to create www.healthwise.net/ detours around the narrowed ffGet back to work sooner patiented and enter arteries. and safely. F634 into the search box. Taking part in a cardiac rehab program can help lower your chance of having a heart attack or stroke. It may also reduce your need for medicine and improve your overall health.
7 Heart-Healthy Eating A heart-healthy diet can help you in saturated and trans fats keep your heart disease from and cholesterol. To learn other easy getting worse. A heart-healthy ff Stay at a healthy weight by diet means that you: ways to add balancing the calories you eat heart-healthy foods f f Eat more fruits, vegetables, with how much physical activity to your diet, go to whole grains, and other you get. www.healthwise. high-fiber foods. ff Eat more foods that are high net/patiented and ff Try to limit salt (sodium). in omega-3 fatty acids, such enter F869 into the ff Choose foods that are low as fish. search box.
Heart-Healthy Tips for Your Diet Instead of: Try this: Frying your food Bake, broil, steam, poach, or grill your food.
Eating convenience foods (canned soups, Eat fresh fish, skinless chicken, fruits, and TV dinners, frozen pizza) vegetables.
Using butter, shortening, or oil high Use products low in saturated and trans fats, such as in saturated or trans fats olive oil, vegetable oil, canola oil, or chicken broth.
Using salt, soy sauce, or BBQ sauce Use salt-free spices. Eating all of the meat product Trim fat from meat and skin from chicken.
Eating egg yolks Eat egg whites or egg substitutes. 8 Easy ways to add fruits Get more whole grains and veggies You can add whole grains to your ff Add fresh or frozen berries or a diet by choosing: sliced banana to breakfast cereal or ff Whole wheat bread instead yogurt. Put apple slices in oatmeal. of white bread. f f Have a glass of juice with breakfast. ff Whole-grain crackers and cereals. One 6-ounce glass is a serving. f (Don’t depend on juice for all of your f Oatmeal. fruit servings, though. Most juices ff Brown rice instead of white rice. have a lot more sugar and calories ff Whole wheat pasta. than plain fruits.) Don’t be afraid to try other whole ff Add lettuce, tomato, cucumber, and grains like bulgur, barley, and quinoa. bell peppers to sandwiches. Get pizza with veggies—try mushrooms, peppers, spinach, or broccoli. Choose healthy fats ff Add vegetables to soups, stews, There are healthy “good” fats and and stir-fries. Puree them in a unhealthy “bad”ones. For many blender or food processor first if it people, the least healthy types of makes them easier to use. fats—saturated and trans fats—make up too much of their diet. ff Keep carrots, celery, and other veggies handy for snacks. Buy them So it’s best to choose foods and oils already sliced and ready to eat if it that have healthy fats, such as: makes you more likely to eat them. ff Fish (salmon, mackerel). ff Have a salad with dinner every ff Nuts and seeds, and soybeans. night. Make sure it’s mostly ff Vegetable oils (canola, olive, vegetables, rather than mostly peanut, corn, safflower, sunflower, cheese, croutons, and salad walnut, flaxseed). dressing. ff Avocados and olives. ff Have fruit for dessert. If a piece of fruit doesn’t seem like dessert to It’s best to avoid unhealthy saturated you, try baked apples or pears with and trans fats as much as you can. cinnamon, or have fresh berries or These fats can be found in whole melon with some vanilla yogurt. milk, whole-milk cheese, whole-milk yogurt, butter, margarine, red meat, ff Make a fruit smoothie. Blend and processed and packaged foods bananas, berries, or oranges with like cookies, crackers, and chips. fat-free or low-fat yogurt or milk.
9 Stop Smoking Quitting smoking is one of the Smoking and heart disease best things you can do if you don’t Smokers Smoking is bad for everyone, but want to die of heart disease. Your have a it is even worse for people with risk of dying from a heart attack higher risk coronary artery disease. or stroke will start to go down very of heart soon after you quit. In time, your ffIt makes your blood cells more attack compared risk will be about the same as likely to form clots. This can to nonsmokers. To that of someone who has never cause a heart attack or stroke. see the difference smoked. based on your age ffIt can cause a sudden narrowing and gender, go to If you have had angioplasty or in your coronary arteries, which www.healthwise. bypass surgery to improve blood can reduce the blood flow to your net/patiented and flow to your coronary arteries, heart. enter X395 into the those arteries will be less likely search box. The ffIt can make your heart beat in to get narrowed again if you quit good news is that an odd rhythm. smoking. stopping smoking can You will also feel better after you ffIt lowers “good” (HDL) cholesterol lower your risk, even quit smoking. Your angina may and lets “bad” (LDL) cholesterol if you’ve smoked for get better. You will have more build up in your arteries more a long time. energy and breathe easier. And easily. you may feel more hopeful about your future and have less fear of ffIt reduces how much oxygen your getting cancer or dying suddenly blood can carry to your heart and from heart disease. the rest of your body.
10 Quitting smoking is not easy. used to less nicotine until you Many people have to try several do not need it at all. You can Did You Know? times before they quit for good. buy these products without a Smokers who quit cut But the point is that they do finally prescription. their risk of heart attack succeed. And with the right help, in half within 2 years. In ffMedicines that don’t have so can you. time, their risk of death nicotine but can help you cope from a heart attack is with cravings and mood Thinking about quitting? the same as if they had swings. Your doctor can If you’re thinking about quitting, never smoked at all. prescribe them for you. it may help to know that you don’t have to quit smoking through It’s not just the nicotine willpower alone. Using nicotine If you are like many smokers, replacement There are: smoking is part of your daily (gums, routine. You enjoy it. It’s relaxing. ffTreatments that can help with patches, inhalers, When you quit smoking, you the physical effects of giving sprays, lozenges) and have to give all that up (or at up smoking and nicotine. medicines makes it least find something to replace it). much more likely that ffResources that can help with The good news is that you you will quit for good. the emotional side of quitting. don’t have to do it alone. Lots For help in deciding Nicotine replacement of ex-smokers have found whether to try them, go and medicines support in: to www.healthwise.net/ patiented and enter When you try to stop smoking, ffStop-smoking programs O231 into the search you may have trouble sleeping, (call your health plan, box. strongly crave nicotine, or feel your local hospital, or the grumpy, depressed, or restless. American Lung Association). These symptoms of withdrawal ffTelephone “quitlines,” such are at their worst during the as 1-800-QUIT-NOW first week or so after you quit, (1-800-784-8669). but they may last up to a few weeks. ffOnline quit groups. Treatment can reduce withdrawal ffSupport groups, such as symptoms and help you quit. You Nicotine Anonymous. can try: ffNicotine replacement products, ffCounseling from doctors, such as gums, patches, nurses, or therapists. inhalers, sprays, and lozenges. They help your body slowly get
11 Get Active If you are not active right now, If you don’t enjoy walking, you Need help starting to exercise may seem might try swimming, biking, or getting hard. But it’s worth it. You don’t water aerobics. Your doctor can active? have to do a lot to make a help you make a plan. Use the For some difference. form on the next page to record ideas that might your goals and other details. Being more active can: work for you, go to ffHelp you control your weight The important thing is to try to www.healthwise. and blood pressure. get some exercise throughout net/patiented and the week. Even a little bit of enter V167 into the ffMake your heart stronger and exercise can help if you have search box. reduce symptoms like chest not been active at all. pain. ffHelp you avoid a heart attack or stroke and live longer. Be Safe When You Exercise ffReduce stress and give you See your doctor before you start exercising. more energy. He or she may want to do a test to see how much activity your heart can handle. Walking is a great, easy way to If your doctor has prescribed nitroglycerin for you, get exercise. If your doctor says be sure to have it with you whenever you exercise. it’s safe, start out with some short Stop what you’re doing right away if you have any walks, then gradually make the chest pain or start to feel bad. walks a little bit longer.
12 Exercise Planning Form Special tests I need before I begin an exercise program (if any):
Exercises to help with my chronic health conditions:
Exercises I should not do:
Should I change the time I take my medicines?
Should I take my pulse when I exercise? If so, what range (target heart rate) is best for me?
Warning signs I need to watch for:
Personal supports (like family members or exercise partners) who might help me:
Other questions I have about starting an exercise program:
Physical activities I enjoy or would like to try:
In the beginning, my exercise program will be (what, how often, and how long):
Long-term goals: In the next 6 months I will: 1. 2. 3. Short-term goals: In the next few weeks I will: 1. 2. 3. As you reach your short-term goals, add new ones.
13 Coping and Support Dealing with depression you think you have symptoms of depression, do not wait to ask for There is a link between depression help. Your doctor can help find out and coronary artery disease. People if you are depressed and talk to with heart disease are more likely you about your options for treatment. to get depression. And if they have The sooner you know if you are both depression and heart disease, depressed, the sooner you can get they may not stay as healthy as treatment and start feeling better. possible. They are less likely to take their medicines and get regular Support can help exercise. And this may raise their Whether you are recovering from risk of having a heart attack. a heart attack or changing your life- Depression causes you to feel sad style so you can avoid one, emotional and hopeless much of the time. support from friends and family is It’s different from normal feelings important. Think about joining a heart of sadness, grief, or low energy. disease support group. Ask your Depression is a medical problem doctor about the types of support that that needs treatment. are available where you live. Meeting other people with the same problems Your doctor can help can help you know you’re not alone. If you have heart disease, your doctor will probably ask you some simple questions to check for any symptoms of depression. But if
14 John’s Story
For inspiration to exercise, John hasn’t had to with another doctor who told him that regular look far. His father rides his bike daily to prevent exercise would help with stress, sleep, and another heart attack. John’s grandparents and weight gain.
others in his family also had heart disease. “You hear the mantra of losing weight, eating John’s doctor told him that his steady weight better, getting regular exercise, and it finally gain over the years was putting him in danger of sank in,” John says.
heart problems as well. “He said, ‘You want to He joined a bike club. Having others to ride live a long and happy life, right?’” John recalls. with motivated him physically and socially. “‘You’ve seen what your dad went through?’” “I’ve made a lot of friends who have the same John, a commercial pilot, got that advice as he priorities,” he says. No matter what the activity, watched his dad recover from heart surgery doing it with a group makes it easier and much in the 1990s. He started riding his bike too. “I more fun, he believes.
followed my father’s good example,” he says. He also joined a weight-loss group, which He just didn’t follow it regularly. helped him slim down. By watching how he eats and getting daily exercise, he’s lost 25 “Over the years, my weight was starting to creep pounds. “I have another 10 to 15 to go. Even up. I was fooling myself—I was in total denial my wife says I look good now,” he jokes. about how much weight I was carrying,” he says. He’s so keen on the benefits of fitness, he encourages his coworkers and friends. “My About 3 years ago, John, now 54, says he mantra is ‘Find a way to exercise.’ It has made realized he had to do more. He was stressed at all the difference in my life.” work. He didn’t get enough sleep because his flight schedules changed constantly. He talked
John’s story reflects his experiences as told in an interview. The photograph is not of John, to protect his privacy.
15 Action Plan Work with your doctor to fill out the information below.
Name: Doctor’s Phone Number:
Doctor’s Name: Other Emergency Contact Numbers:
When should I call my doctor? Next doctor visit date:
Call 911 if:
List of my medicines: When to take my medicines:
Does my doctor recommend any changes to my medicines?
What do I need to check or keep track of? (healthy eating, physical activity, weight)
Do I need to change my diet or activities?
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