Selected Podcast
Life After Having a Heart Attack
If you or a loved one experienced a heart attack and are thinking, "Now what?" listen to this podcast featuring an interventional cardiologist who will address some of the common post-heart attack questions.
Featured Speaker:
Jeff Schussler, MD, FACC, FSCAI
Dr. Schussler' is Chief Medical Officer for Baylor Scott & White Heart and Vascular Hospital Dallas. An interventional cardiologist, Dr. Schussler is board certified in cardiovascular disease and interventional cardiology. He received his medical degree from The University of Texas Medical Branch in Galveston, TX, and then completed fellowships in General Cardiology and Interventional Cardiology at Baylor University Medical Center in Dallas, TX. Dr. Schussler is a fellow of the American College of Cardiology, and the Society of Cardiac Angiography and Interventions. He has numerous published articles and has been featured on both radio as well as television shows such as Good Morning Texas discussing various cardiovascular disease topics including cardiac catheterization. He is a Professor of Medicine through Texas A&M College of Medicine and a faculty member at Baylor University Medical Center, part of Baylor Scott & White Health, where he teaches medical students, residents, and fellows. Transcription:
Scott Webb: This is HeartSpeak, the podcast from Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth. I'm Scott Webb. And joining me today is Dr. Jeffrey Schussler. He's an interventional cardiologist and Chief Medical Officer for Baylor Scott & White Heart and Vascular Hospital, Dallas.
Doctor, thanks so much for your time today. We're going to talk about heart attacks, right? What folks experience, what the steps would be if they've been told they had a heart attack or they know they're having a heart attack and so, sort of all of that bundled in here together. So, let's talk about this, just maybe have you briefly explain to our audience what happens during a heart attack, because we've seen it on TV and movies. But what really happens during a heart attack?
Dr. Jeff Schussler: What a heart attack essentially is the heart muscle is not getting enough oxygen. And since the oxygen's carried by the blood, it's usually because there's not enough blood supplied to the heart muscle. Nine times out of 10 that's because of a clot that forms in one of the arteries to the heart. So when people talk about having a blockage in "the widow maker," it's really because they've got a clot in the main artery that feeds blood to the largest portion of the heart. So when your heart doesn't get enough oxygen, it starts to hurt. And people perceive this in different ways, but the most classic way to feel this is a heaviness or a burning or an aching in the center of their chest, so you often see it described by someone clutching their chest.
Scott Webb: So, let's talk then, after a heart attack, who do we see? Is it an interventional cardiologist, a clinical cardiologist? If someone were in a less urban area, would they maybe see their primary care provider? What are those steps basically after a heart attack?
Dr. Jeff Schussler: Well, it depends on when you mean by after. So in the throes of a heart attack, the most important person to see is your ambulance driver to get you to a hospital. And then, the next most important person is the cardiologist to hopefully open up that artery so you don't die of the heart attack. And the good news is that these days with modern medicine and techniques, the majority of people, as long as they seek quick medical attention, don't end up passing away. It's usually the people that don't decide to go to the ER, don't call 911. Those are the people that we worry about because they're the ones that either die from the heart attack or have damage from the heart attack.
So, let's assume that you did the right thing, you felt the symptoms, you called 911, you got to the hospital and you saw the cardiologist. After the heart attack, there's a lot of things that go on. You know, there's aftercare in the immediate sense where you're usually in the hospital for a few days. There's usually some quick followup with your heart doctor, because if they really did take care of you for a heart attack, they want to see you back usually within a few weeks to make sure you're taking your medicines, that you're feeling okay, that they've enrolled you in things like cardiac rehab, that you've stopped smoking, if you were smoking, et cetera.
And then long-term, you're going to be following with cardiologists. You know, once you had a heart attack, you're a cardiac patient, you really need to see somebody pretty routinely for the rest of your life. Once a year is pretty routine these days for someone who's had a heart attack and doing well.
Scott Webb: Yeah. And you mentioned there cardiac rehab. Let's talk about that. I guess, whether folks have had, you know, a heart cath or not, you know, as a result of their heart attack, I'm assuming that cardiac rehab is recommended. So, let's talk about that. What does that mean exactly, cardiac rehabilitation? And why is it important?
Dr. Jeff Schussler: So, cardiac rehab encompasses several different things, but the core of it is really exercise. And it's for a lot of people who've never exercised, it's the first time they've been exposed to it. But for other people who may have been exercising and then had a heart attack, they are afraid to get back to exercising. And so, it's a controlled series of visits. It's usually over 12 weeks where they get you back into the swing of things or teach you how to become a regular exercising person. Cardiac rehab also encompasses things like dietary management, smoking cessation, medication management. So, there's a team of people, usually exercise physiologists and/or other personnel like dieticians, that help a person after their event with some of the non-specifically medical issues, it's sort of the things that are surrounding the heart issues themselves.
Scott Webb: Yeah. And doctor, I've known some folks that have had heart attacks, my dad being one of them, and he definitely experienced some depression, was anxious afterwards. I don't know if it was the worry over possibly having another heart attack or, as you say, folks who used to exercise feeling like maybe they can't get back to that or shouldn't because of the perceived risks anyway. Is it common for folks to feel depressed or anxious after a heart attack?
Dr. Jeff Schussler: It's extremely common. It's one of those things that's been known for a long time and there's obviously a situational component to it. People who've gone through a major life stressor, they often feel anxious and worried and depressed, but there's probably some chemical effects of just having the heart attack that affect your brain chemistry. There's lots of discussions about how to treat this. But if you're in a short period of time, a situation where you're having depression, medications for this is very helpful, seeing somebody from a therapy standpoint's helpful. But sometimes, it's just getting back into your normal life routine that actually really helps.
Scott Webb: You kind mentioned this, that, you know, once you've had a heart attack, you're more or less, for all intents and purposes, sort of always a heart patient after that. So, I'm wondering, related to heart and heart attacks and the medications, is that a thing, doctor? Like, basically once you've had a heart attack and you're on the medications afterwards, are you just kind of always on them?
Dr. Jeff Schussler: Well, starting from why do people have a heart attack, some of it's what they do, you know, people who smoke or overweight, et cetera. But a lot of it's genetic. So, we don't choose our parents. We don't cure things like high cholesterol for most people. It's different from a pneumonia where if you have an infection, we can treat the infection, the infection's gone, you're done with your antibiotics. If you have high cholesterol or if you have heart disease, we don't cure you of your heart disease, but we manage it. So whether that's in the context of a heart attack or in the context of just high cholesterol, the plan is to treat these things to prevent new problems from occurring or old problems from recurring again.
So, it doesn't make a lot of intrinsic sense that you'd say, "Okay, well my heart attack's over, I'm done with the therapy." It's really, "My heart attack's over. I don't want a second heart attack. What can I do to put myself in a much better, safer situation?" So, that usually revolves around lifelong medical therapy.
Scott Webb: So wondering then, if we're kind of always a heart patient, we're always on medication, we're trying to manage this, let's say, you said typically at least once a year, so whether it's more frequently than that or not, but when they do come in, what do you do? How do you check in on them? Is it blood tests? Is it inducing some level of stress to see how the heart's doing? Maybe you can take us through that.
Dr. Jeff Schussler: Sure. Well, it's usually not any of those things interestingly, it's usually a conversation. So, I have people who come in and they've had a heart attack 10 years ago, and they're taking their medicines. We do check things like cholesterol to make sure that's well-treated. We check their blood pressure. But as far as checking the heart, and this concept's a little hard for people to understand, there really is no good provocative test for people who are feeling fine, especially if they're exercising regularly, which is one of the reasons we focus so much on regular exercise after a heart attack. If you tell me, "I walk 15, 20 minutes at a moderate pace and I feel fine, I'm not having chest pain," et cetera, there's really no stress tests that's going to prove that you're doing well more than you telling me that you're doing well.
And what's more important is that things like stress tests, they have such a high false negative and false positive rate. It's up to 20%, that I have lots of people who've, over the years, they said, "Well, look, I had my stress test on a Monday and it was fine, and then I had my heart attack on a Friday. What happened?" And the answer is the stress tests are not that great. So for people who've had an event, they've had a heart attack, I really just talk to them and say, "How are you feeling?" If they say, "I feel fine. I'm doing everything I want to do. I'm exercising regularly. My, you know, medications are treating my cholesterol and high blood pressure," we're done. There's no further proof that they're doing well and, more importantly, there's no test that's going to predict what in the next six to 12 months are going to happen.
Scott Webb: Yeah, interesting, right? If somebody is, you know, if they're exercising a 100, 130, 150 minutes a week and they're feeling fine and looking fine, I mean, I can see the value of that conversation, that trying to force them to do something, to force the heart to do something that it's not being asked to do normally, what good would that be really?
Dr. Jeff Schussler: It just doesn't predict the future like people thought. You know, so it's a bit of an old thought process years ago. You know, everybody got their stress test once a year, whether they needed it or not, and there really wasn't a lot of benefit to it. There's actually, you know, guidelines these days, there's something called Choosing Wisely, which is, it's not just cardiology, but it's lots of things that we sort of took for granted and they're kind of educating the public to say, "Okay, well if you're getting these things done on a regular basis, but you don't know why, you might want to just ask your provider why we're doing this." one of those includes sort of the routine stress test, which really doesn't help in a lot of situations. If you're having symptoms and your doctor thinks it's going to help make a decision as far as next treatment steps, by all means. But the routine I-feel-fine-how-am-I-doing-doc stress test, that's kind of a thing of the past.
Scott Webb: Yeah. You go in for your, you know, yearly wellness exam or physical, whatever they're called now, whatever the proper terminology is. And yeah, you're right, like the old days of, "Well, while you're here, going to go ahead and give you the stress test." And you're like, "But I feel fine. I'm not having chest pain. Why would we do that?"
Dr. Jeff Schussler: People often wondered, "Well, what's the benefit of that?" And the reality was in a lot of cases, there really wasn't. Stress tests have their place, but it's not usually the, "I feel fine. Make sure I'm not lying to you." There's some people where they don't do any exercise and, you know, they may want to get into an exercise program and you're just not sure how well they're going to do, that's one reason to do it. And sometimes people are having symptoms where you're not sure if that's indicative of a new problem, it's another reason to do it.
But usually, honestly, for a lot of people who are stable after their heart attack, it's a good idea to maintain a relationship with somebody. So having those once a year or, for some people, a little bit more frequently cadence of a follow-up visit, just kind of keeps you established within the practice. So if and when, God forbid you have another problem, you know exactly what to do and who to talk to. So, there are some very good benefits in maintaining a regular relationship. But yeah, once you're a cardiac patient, especially with a heart attack, you're usually always going to have a relationship with a cardiologist.
Scott Webb: Yeah. And that sounds like a good plan. We touched earlier on depression and anxiety for those who've had a heart attack. Let's talk a little bit doctor about loved ones and family members trying to help a person mentally and physically who survived a heart attack.
Dr. Jeff Schussler: It's very stressful. Not to look at one group, but you know, in my younger patients who have heart attacks, I think they take it particularly hard. The youngest person I've ever seen in my practice was in their late 20s. And, you know, they were thinking that they were invincible and, all of a sudden, this happens to them. It's not the norm. But for younger patients who have cardiac issues, it's very devastating. And so, we get a lot of people who end up very fearful for, you know, any little thing that happens. If they get any pain between their eyebrows and their kneecaps, they're rushing to the emergency room because they're worried it's the next big heart attack. So, it's terrible living in fear that the next day is going to be your last. Reality is that with modern medications after a heart attack, most people do very, very well. And if you can manage the problems that brought you to that issue you, you can really avoid problems in the future.
Now, like we talked about, your genetics are something you can't really cure. You can't choose your family history. But there are absolutely things that you can change that will change the course of your future. Number one is tobacco use, whether that's smoking or otherwise. Number two is obesity. And it's easier said than done, but being overweight really puts you at higher risk because there's high blood pressure, there's diabetes, and so managing those things really helps reduce your future risk. And then, taking medications because a lot of the medications, and very few people really want to take medicines, but a lot of the medications really reduce your future risk. So, there are things you can do, but it definitely does make people very upset and anxious. And some people take it worse than others, and they need reassurance that they can go out and lead normal lives and, for the most part, do very well.
Scott Webb: Yeah, I see what you mean. It's been really educational today, doctor. And I think, as we wrap up, I want to talk a little bit about-- we hear this all the time, "You got to eat healthy. You got to exercise." Okay. So from an expert, what does that mean? What does eating healthy look like? What do we shop for at the grocery store? And just what are some tips in general for those who've had a heart attack if they weren't eating healthy and exercising before? What do you recommend now?
Dr. Jeff Schussler: So, believe it or not, there's really not a lot of eating healthy. The problem is we know what eating unhealthy is, but there's not really an eating healthy. So, what people are looking for is they're looking for the vitamin, the supplement, the vegetable or berry that's going to counteract their heart disease. The reality is, is that that's not the answer. So, eating unhealthy is too many calories, a lot of processed foods, things that are high in cholesterol and fat, and really it revolves a lot around obesity. So if you have too many calories in and not enough calories burned and you're carrying a lot of excess weight, it raises cholesterol, it raises blood pressure, it puts you at risk. So, most people, eating a reasonable diet is more fruits and vegetables, less processed foods, lean meats, not eating meat at every meal, those are the things that really help. But the difference is you're not looking at what food is the antidote to my condition, you're really looking at how can I generally eat healthy, maintain an active lifestyle, avoid those things that we know are really toxic, like tobacco, and that really helps prevent problems.
Scott Webb: Yeah, I see what you mean. Like we all sort of know when we're not eating healthy, right? We make those decisions to like, "You know, I could go home and make dinner or I could just grab some fast food." We sort of are aware that this is maybe not the healthiest option for us. But as you say, if we're addressing the risk factors, right? They got us to the heart attack in the first place and we're getting some moderate exercise and we're trying to at least, you know, limit the unhealthy diet, the bad habits that maybe led us to the heart attack again, then we're probably doing the best we can, right?
Dr. Jeff Schussler: Right. You can't go out and, you know, eat poorly and smoke and then eat a bushel of kale and expect that to be the antidote to the problems. The other thing is, and we talked about this a little bit, but knowing your family history is important because, you know, there are some people that know that every man in the family's died before age 50 of a heart attack. Well, if you're in your 40s and you know that that's looming over your head, it really behooves you to start even earlier than that, probably making healthy choices, avoiding things that are not healthy and preemptively striking before you become part of the family history.
Scott Webb: Yeah. The importance of family history, of knowing your family history and trying to gather that information early enough and maybe even make sure that it's included in your medical records, your electronic medical records, so that everybody involved can see, "Oh, I see dad, grandpa, everybody died of a heart attack before the age of 50. That's why he's here or she's here." So, really good stuff today. Really helpful, educational. Appreciate your knowledge and compassion. So, thank you so much, doctor. You stay well.
Dr. Jeff Schussler: Absolutely. You too.
Scott Webb: That's Dr. Jeffrey Schussler, interventional of cardiologist and Chief Medical Officer for Baylor Scott & White Heart and Vascular Hospital Dallas. And thanks for checking out this episode of HeartSpeak. To find a specialist on the medical staff, please call 1-844-279-3627 or visit bswhealth.com/heartdfw.
Thanks for listening to HeartSpeak, the podcast for Baylor Scott & White Heart and Vascular Hospital in Dallas and Fort Worth. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for additional topics of interest. I'm Scott Webb. Thanks for listening.
Host: Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, joint ownership with physicians.
Scott Webb: This is HeartSpeak, the podcast from Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth. I'm Scott Webb. And joining me today is Dr. Jeffrey Schussler. He's an interventional cardiologist and Chief Medical Officer for Baylor Scott & White Heart and Vascular Hospital, Dallas.
Doctor, thanks so much for your time today. We're going to talk about heart attacks, right? What folks experience, what the steps would be if they've been told they had a heart attack or they know they're having a heart attack and so, sort of all of that bundled in here together. So, let's talk about this, just maybe have you briefly explain to our audience what happens during a heart attack, because we've seen it on TV and movies. But what really happens during a heart attack?
Dr. Jeff Schussler: What a heart attack essentially is the heart muscle is not getting enough oxygen. And since the oxygen's carried by the blood, it's usually because there's not enough blood supplied to the heart muscle. Nine times out of 10 that's because of a clot that forms in one of the arteries to the heart. So when people talk about having a blockage in "the widow maker," it's really because they've got a clot in the main artery that feeds blood to the largest portion of the heart. So when your heart doesn't get enough oxygen, it starts to hurt. And people perceive this in different ways, but the most classic way to feel this is a heaviness or a burning or an aching in the center of their chest, so you often see it described by someone clutching their chest.
Scott Webb: So, let's talk then, after a heart attack, who do we see? Is it an interventional cardiologist, a clinical cardiologist? If someone were in a less urban area, would they maybe see their primary care provider? What are those steps basically after a heart attack?
Dr. Jeff Schussler: Well, it depends on when you mean by after. So in the throes of a heart attack, the most important person to see is your ambulance driver to get you to a hospital. And then, the next most important person is the cardiologist to hopefully open up that artery so you don't die of the heart attack. And the good news is that these days with modern medicine and techniques, the majority of people, as long as they seek quick medical attention, don't end up passing away. It's usually the people that don't decide to go to the ER, don't call 911. Those are the people that we worry about because they're the ones that either die from the heart attack or have damage from the heart attack.
So, let's assume that you did the right thing, you felt the symptoms, you called 911, you got to the hospital and you saw the cardiologist. After the heart attack, there's a lot of things that go on. You know, there's aftercare in the immediate sense where you're usually in the hospital for a few days. There's usually some quick followup with your heart doctor, because if they really did take care of you for a heart attack, they want to see you back usually within a few weeks to make sure you're taking your medicines, that you're feeling okay, that they've enrolled you in things like cardiac rehab, that you've stopped smoking, if you were smoking, et cetera.
And then long-term, you're going to be following with cardiologists. You know, once you had a heart attack, you're a cardiac patient, you really need to see somebody pretty routinely for the rest of your life. Once a year is pretty routine these days for someone who's had a heart attack and doing well.
Scott Webb: Yeah. And you mentioned there cardiac rehab. Let's talk about that. I guess, whether folks have had, you know, a heart cath or not, you know, as a result of their heart attack, I'm assuming that cardiac rehab is recommended. So, let's talk about that. What does that mean exactly, cardiac rehabilitation? And why is it important?
Dr. Jeff Schussler: So, cardiac rehab encompasses several different things, but the core of it is really exercise. And it's for a lot of people who've never exercised, it's the first time they've been exposed to it. But for other people who may have been exercising and then had a heart attack, they are afraid to get back to exercising. And so, it's a controlled series of visits. It's usually over 12 weeks where they get you back into the swing of things or teach you how to become a regular exercising person. Cardiac rehab also encompasses things like dietary management, smoking cessation, medication management. So, there's a team of people, usually exercise physiologists and/or other personnel like dieticians, that help a person after their event with some of the non-specifically medical issues, it's sort of the things that are surrounding the heart issues themselves.
Scott Webb: Yeah. And doctor, I've known some folks that have had heart attacks, my dad being one of them, and he definitely experienced some depression, was anxious afterwards. I don't know if it was the worry over possibly having another heart attack or, as you say, folks who used to exercise feeling like maybe they can't get back to that or shouldn't because of the perceived risks anyway. Is it common for folks to feel depressed or anxious after a heart attack?
Dr. Jeff Schussler: It's extremely common. It's one of those things that's been known for a long time and there's obviously a situational component to it. People who've gone through a major life stressor, they often feel anxious and worried and depressed, but there's probably some chemical effects of just having the heart attack that affect your brain chemistry. There's lots of discussions about how to treat this. But if you're in a short period of time, a situation where you're having depression, medications for this is very helpful, seeing somebody from a therapy standpoint's helpful. But sometimes, it's just getting back into your normal life routine that actually really helps.
Scott Webb: You kind mentioned this, that, you know, once you've had a heart attack, you're more or less, for all intents and purposes, sort of always a heart patient after that. So, I'm wondering, related to heart and heart attacks and the medications, is that a thing, doctor? Like, basically once you've had a heart attack and you're on the medications afterwards, are you just kind of always on them?
Dr. Jeff Schussler: Well, starting from why do people have a heart attack, some of it's what they do, you know, people who smoke or overweight, et cetera. But a lot of it's genetic. So, we don't choose our parents. We don't cure things like high cholesterol for most people. It's different from a pneumonia where if you have an infection, we can treat the infection, the infection's gone, you're done with your antibiotics. If you have high cholesterol or if you have heart disease, we don't cure you of your heart disease, but we manage it. So whether that's in the context of a heart attack or in the context of just high cholesterol, the plan is to treat these things to prevent new problems from occurring or old problems from recurring again.
So, it doesn't make a lot of intrinsic sense that you'd say, "Okay, well my heart attack's over, I'm done with the therapy." It's really, "My heart attack's over. I don't want a second heart attack. What can I do to put myself in a much better, safer situation?" So, that usually revolves around lifelong medical therapy.
Scott Webb: So wondering then, if we're kind of always a heart patient, we're always on medication, we're trying to manage this, let's say, you said typically at least once a year, so whether it's more frequently than that or not, but when they do come in, what do you do? How do you check in on them? Is it blood tests? Is it inducing some level of stress to see how the heart's doing? Maybe you can take us through that.
Dr. Jeff Schussler: Sure. Well, it's usually not any of those things interestingly, it's usually a conversation. So, I have people who come in and they've had a heart attack 10 years ago, and they're taking their medicines. We do check things like cholesterol to make sure that's well-treated. We check their blood pressure. But as far as checking the heart, and this concept's a little hard for people to understand, there really is no good provocative test for people who are feeling fine, especially if they're exercising regularly, which is one of the reasons we focus so much on regular exercise after a heart attack. If you tell me, "I walk 15, 20 minutes at a moderate pace and I feel fine, I'm not having chest pain," et cetera, there's really no stress tests that's going to prove that you're doing well more than you telling me that you're doing well.
And what's more important is that things like stress tests, they have such a high false negative and false positive rate. It's up to 20%, that I have lots of people who've, over the years, they said, "Well, look, I had my stress test on a Monday and it was fine, and then I had my heart attack on a Friday. What happened?" And the answer is the stress tests are not that great. So for people who've had an event, they've had a heart attack, I really just talk to them and say, "How are you feeling?" If they say, "I feel fine. I'm doing everything I want to do. I'm exercising regularly. My, you know, medications are treating my cholesterol and high blood pressure," we're done. There's no further proof that they're doing well and, more importantly, there's no test that's going to predict what in the next six to 12 months are going to happen.
Scott Webb: Yeah, interesting, right? If somebody is, you know, if they're exercising a 100, 130, 150 minutes a week and they're feeling fine and looking fine, I mean, I can see the value of that conversation, that trying to force them to do something, to force the heart to do something that it's not being asked to do normally, what good would that be really?
Dr. Jeff Schussler: It just doesn't predict the future like people thought. You know, so it's a bit of an old thought process years ago. You know, everybody got their stress test once a year, whether they needed it or not, and there really wasn't a lot of benefit to it. There's actually, you know, guidelines these days, there's something called Choosing Wisely, which is, it's not just cardiology, but it's lots of things that we sort of took for granted and they're kind of educating the public to say, "Okay, well if you're getting these things done on a regular basis, but you don't know why, you might want to just ask your provider why we're doing this." one of those includes sort of the routine stress test, which really doesn't help in a lot of situations. If you're having symptoms and your doctor thinks it's going to help make a decision as far as next treatment steps, by all means. But the routine I-feel-fine-how-am-I-doing-doc stress test, that's kind of a thing of the past.
Scott Webb: Yeah. You go in for your, you know, yearly wellness exam or physical, whatever they're called now, whatever the proper terminology is. And yeah, you're right, like the old days of, "Well, while you're here, going to go ahead and give you the stress test." And you're like, "But I feel fine. I'm not having chest pain. Why would we do that?"
Dr. Jeff Schussler: People often wondered, "Well, what's the benefit of that?" And the reality was in a lot of cases, there really wasn't. Stress tests have their place, but it's not usually the, "I feel fine. Make sure I'm not lying to you." There's some people where they don't do any exercise and, you know, they may want to get into an exercise program and you're just not sure how well they're going to do, that's one reason to do it. And sometimes people are having symptoms where you're not sure if that's indicative of a new problem, it's another reason to do it.
But usually, honestly, for a lot of people who are stable after their heart attack, it's a good idea to maintain a relationship with somebody. So having those once a year or, for some people, a little bit more frequently cadence of a follow-up visit, just kind of keeps you established within the practice. So if and when, God forbid you have another problem, you know exactly what to do and who to talk to. So, there are some very good benefits in maintaining a regular relationship. But yeah, once you're a cardiac patient, especially with a heart attack, you're usually always going to have a relationship with a cardiologist.
Scott Webb: Yeah. And that sounds like a good plan. We touched earlier on depression and anxiety for those who've had a heart attack. Let's talk a little bit doctor about loved ones and family members trying to help a person mentally and physically who survived a heart attack.
Dr. Jeff Schussler: It's very stressful. Not to look at one group, but you know, in my younger patients who have heart attacks, I think they take it particularly hard. The youngest person I've ever seen in my practice was in their late 20s. And, you know, they were thinking that they were invincible and, all of a sudden, this happens to them. It's not the norm. But for younger patients who have cardiac issues, it's very devastating. And so, we get a lot of people who end up very fearful for, you know, any little thing that happens. If they get any pain between their eyebrows and their kneecaps, they're rushing to the emergency room because they're worried it's the next big heart attack. So, it's terrible living in fear that the next day is going to be your last. Reality is that with modern medications after a heart attack, most people do very, very well. And if you can manage the problems that brought you to that issue you, you can really avoid problems in the future.
Now, like we talked about, your genetics are something you can't really cure. You can't choose your family history. But there are absolutely things that you can change that will change the course of your future. Number one is tobacco use, whether that's smoking or otherwise. Number two is obesity. And it's easier said than done, but being overweight really puts you at higher risk because there's high blood pressure, there's diabetes, and so managing those things really helps reduce your future risk. And then, taking medications because a lot of the medications, and very few people really want to take medicines, but a lot of the medications really reduce your future risk. So, there are things you can do, but it definitely does make people very upset and anxious. And some people take it worse than others, and they need reassurance that they can go out and lead normal lives and, for the most part, do very well.
Scott Webb: Yeah, I see what you mean. It's been really educational today, doctor. And I think, as we wrap up, I want to talk a little bit about-- we hear this all the time, "You got to eat healthy. You got to exercise." Okay. So from an expert, what does that mean? What does eating healthy look like? What do we shop for at the grocery store? And just what are some tips in general for those who've had a heart attack if they weren't eating healthy and exercising before? What do you recommend now?
Dr. Jeff Schussler: So, believe it or not, there's really not a lot of eating healthy. The problem is we know what eating unhealthy is, but there's not really an eating healthy. So, what people are looking for is they're looking for the vitamin, the supplement, the vegetable or berry that's going to counteract their heart disease. The reality is, is that that's not the answer. So, eating unhealthy is too many calories, a lot of processed foods, things that are high in cholesterol and fat, and really it revolves a lot around obesity. So if you have too many calories in and not enough calories burned and you're carrying a lot of excess weight, it raises cholesterol, it raises blood pressure, it puts you at risk. So, most people, eating a reasonable diet is more fruits and vegetables, less processed foods, lean meats, not eating meat at every meal, those are the things that really help. But the difference is you're not looking at what food is the antidote to my condition, you're really looking at how can I generally eat healthy, maintain an active lifestyle, avoid those things that we know are really toxic, like tobacco, and that really helps prevent problems.
Scott Webb: Yeah, I see what you mean. Like we all sort of know when we're not eating healthy, right? We make those decisions to like, "You know, I could go home and make dinner or I could just grab some fast food." We sort of are aware that this is maybe not the healthiest option for us. But as you say, if we're addressing the risk factors, right? They got us to the heart attack in the first place and we're getting some moderate exercise and we're trying to at least, you know, limit the unhealthy diet, the bad habits that maybe led us to the heart attack again, then we're probably doing the best we can, right?
Dr. Jeff Schussler: Right. You can't go out and, you know, eat poorly and smoke and then eat a bushel of kale and expect that to be the antidote to the problems. The other thing is, and we talked about this a little bit, but knowing your family history is important because, you know, there are some people that know that every man in the family's died before age 50 of a heart attack. Well, if you're in your 40s and you know that that's looming over your head, it really behooves you to start even earlier than that, probably making healthy choices, avoiding things that are not healthy and preemptively striking before you become part of the family history.
Scott Webb: Yeah. The importance of family history, of knowing your family history and trying to gather that information early enough and maybe even make sure that it's included in your medical records, your electronic medical records, so that everybody involved can see, "Oh, I see dad, grandpa, everybody died of a heart attack before the age of 50. That's why he's here or she's here." So, really good stuff today. Really helpful, educational. Appreciate your knowledge and compassion. So, thank you so much, doctor. You stay well.
Dr. Jeff Schussler: Absolutely. You too.
Scott Webb: That's Dr. Jeffrey Schussler, interventional of cardiologist and Chief Medical Officer for Baylor Scott & White Heart and Vascular Hospital Dallas. And thanks for checking out this episode of HeartSpeak. To find a specialist on the medical staff, please call 1-844-279-3627 or visit bswhealth.com/heartdfw.
Thanks for listening to HeartSpeak, the podcast for Baylor Scott & White Heart and Vascular Hospital in Dallas and Fort Worth. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for additional topics of interest. I'm Scott Webb. Thanks for listening.
Host: Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, joint ownership with physicians.