HEART. put your heart in our hands. HEART keep your heart happy, visit BaylorHealth.com/heart. HELP FOR YOUR

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SUMMER 2009 put your heart in our hands back to life Baylor helped solve Susan Herbert s heart rhythm problems PAGE 2 GET A LEG UP Sometimes leg pain can signal a more serious health problem called PVD PAGE 3 IN THE BEAT Understanding the irregular rhythms of atrial fibrillation PAGE 3 HEART CHECKLIST HELP FOR YOUR Do you know what steps to take to care for your heart? Check out our heart-healthy checklist on page 4. For other ways to HEART keep your heart happy, visit BaylorHealth.com/heart.

true love One family put their loved one s cardiac care in Baylor s hands and they re grateful they did Other than a sinus infection, there was nothing wrong with Susan Herbert on the day her heart just stopped beating. The healthy 51-year-old mother of two, who has been married to her high school sweetheart for 31 years, took the antibiotic her doctor prescribed for the sinus infection and that s where her journey began. Within just a few hours, Herbert had a rare reaction to the antibiotic that caused abnormal electrical activity in her heart. She collapsed and experienced sudden cardiac death. I don t remember any of it, but my husband and son were performing CPR on me while my son was on the phone with 911, Herbert says. I guess I started turning purple and actually died in their arms. Paramedics used a defibrillator to shock her heart into beating again and took her to a nearby hospital. There, Herbert was hooked up to life support and the doctors told her family there was nothing more they could do. But her family refused to accept that decision. The hospital was ready to call the funeral home and my family said, No, we re going to Baylor, Herbert says. She was airlifted to Baylor University Medical Center atdallas. Physicians surgically implanted a defibrillator/pacemaker to protect Herbert in the event of any future episodes of irregular heart rhythms. It s standard to put a defibrillator in all survivors of sudden cardiac death, explains Paul A. Grayburn, M.D., medical director of cardiology research and education at Baylor Dallas and a cardiologist on the medical staff at Baylor Hamilton Heart and Vascular Hospital. Herbert remained in cardiac intensive care at Baylor Dallas for about a week, and began cardiac rehabilitation to ease her back into normal activities. Two days after her discharge, Herbert felt strong enough for a stroll around her local mall. Here I am today, back with my family and back at work, almost like nothing ever happened, she says. Another hospital was ready to give up on me, but Baylor didn t. Susan Herbert Because Baylor Dallas is a large tertiary care hospital, the physicians on the medical staff are used to taking care of very sick patients, Dr. Grayburn says. In particular, Baylor excels in regard to people with cardiac rhythm problems, he explains. So it s good for people to be aware there are specialists here who can help them. help for your heart If you re at risk for or have symptoms of heart disease, talk to your doctor. For a referral to a cardiologist on the medical staff at Baylor Dallas, call 1-800-4BAYLOR or visit BaylorHeartHospital.com/physicianfinder or BaylorHealth.com/ KNOW YOUR numbers 120/80 200 35 100 Blood pressure levels are best kept below 120/80 mmhg. Higher levels can increa se your risk of a heart attack or heart failure. Total cholesterol levels should be less than this. Keep LDL ( bad ) levels below 70 mg /dl and HDL ( good ) levels above 50 mg /dl. The maximum number of inches your waist should mea sure. Any higher is a sign of obesit y, a significant risk f ac tor for heart disease. Fasting blood glucose should be below this. Higher levels can signal diabetes, which can increa se your risk of heart disease. 2 HeartSmart / Summer 2009 Visit BaylorHeartHospital.com

Take control of PVD If you re experiencing discomfort and fatigue in your legs, talk to your doctor. For a referral to a vascular surgeon on the medical staf f at Baylor Hamilton Hear t and Vascular Hospital or Baylor Dallas, call 1-800-4BAYLOR or visit BaylorHeartHospital. com/physicianfinder or BaylorHealth.com/ don t let PVD break your stride Like many women, you re probably on the run most of the time. But if you don t take time to take care of yourself, you could wind up sidelined by peripheral vascular disease (PVD). PVD is the narrowing of the blood vessels in the legs, abdomen, pelvis and neck caused by the buildup of plaque, or fatty deposits. This buildup can lead to blockages that restrict blood circulation. A telltale sign of PVD is discomfort and fatigue in the legs when walking, which is relieved when you stop and rest, says Gregory Pearl, M.D., a vascular surgeon on the medical staffs at Baylor Hamilton Heart and Vascular Hospital and Baylor University Medical Center at Dallas. People with PVD of the neck arteries may experience transient ischemic attacks, or TIAs, which are warning signs of stroke. In fact, most people with PVD have a higher risk of death from heart attack and stroke, according to the American Heart Association. PVD usually develops gradually, and symptoms typically don t appear until middle age or later, says Bradley Grimsley, M.D., a vascular surgeon Baylor Hamilton Heart and Vascular Hospital and Baylor Dallas. High blood pressure, high cholesterol, smoking and family history can all contribute to PVD, as can diabetes and being overweight. Postmenopausal women are also at increased risk of developing PVD. Surgical and minimally invasive techniques such as angioplasty and stents can be used to relieve blockages. But many people with PVD can be treated with healthy lifestyle modifications. The two most influential risk factors are high cholesterol and smoking, Dr. Grimsley says, both of which can be controlled to prevent PVD. skipping a beat Sometimes, the best things in life like falling in love or a pleasant surprise can make your heart beat a little faster. But for people with atrial fibrillation, a racing heart isn t such a good thing. Atrial fibrillation is an irregular, often rapid, heartbeat. It can decrease blood flow to the body and cause heart palpitations, shortness of breath, fatigue and worst of all potentially damage the heart muscle or even cause a stroke. Some people with atrial fibrillation have noticeable symptoms while others don t feel anything at all. Atrial fibrillation is more common in older people, and other risk factors include high blood pressure, coronary artery disease, heart disease and thyroid disorders. According to Robert Kowal, M.D., Ph.D., an electrophysiologist Baylor Hamilton Heart and Vascular Hospital and Baylor University Medical Center at Dallas, people are often diagnosed with atrial fibrillation during a routine physical exam followed by an electrocardiogram (EKG). Atrial fibrillation can be managed with medications to regulate the heart rate, or blood thinners to reduce the risk of stroke. There s also a new minimally invasive procedure available that can help reduce symptoms and the risk of stroke, along with the need for medication. We go inside the heart with a tiny catheter and spot weld, or freeze, abnormal areas that can be triggering the atrial fibrillation, explains Kevin Wheelan, M.D., medical director of the Baylor Hamilton Heart and Vascular Hospital and medical director of the Cardiovascular Fellowship Program at Baylor Dallas. It s very exciting to be able to offer a potential cure that can improve the quality of people s lives. To find a physician on the medical staff at Baylor Dallas or Baylor Hamilton Heart and Vascular Hospital, call 1-800-4BAYLOR. Or call 214-820-0015 for a free consultation with a licensed professional to discuss your treatment options for atrial fibrillation or visit BaylorHeartHospital.com/ atrialfibrillation. Visit us at BaylorHealth.com HeartSmart / Summer 2009 3

Take control of PVD If you re experiencing discomfort and fatigue in your legs, talk to your doctor. For a referral to a vascular surgeon on the medical staf f at Baylor Hamilton Hear t and Vascular Hospital or Baylor Dallas, call 1-800-4BAYLOR or visit BaylorHeartHospital. com/physicianfinder or BaylorHealth.com/ get a leg up on pvd If you ve developed varicose veins, you re probably not too happy about it. But appearances aside, those veins could be a sign of peripheral vascular disease (PVD), a condition with many risk factors, including being postmenopausal. PVD is the narrowing of the blood vessels in the legs, abdomen, pelvis and neck caused by the buildup of plaque, or fatty deposits. This buildup can lead to blockages that restrict blood circulation. A telltale sign of PVD is discomfort and fatigue in the legs when walking, which is relieved when you stop and rest, says Gregory Pearl, M.D., a vascular surgeon on the medical staffs at Baylor Hamilton Heart and Vascular Hospital and Baylor University Medical Center at Dallas. People with PVD of the neck arteries may experience transient ischemic attacks, or TIAs, which are warning signs of stroke. In fact, most people with PVD have a higher risk of death from heart attack and stroke, according to the American Heart Association. Risk factors for PVD include high blood pressure, high cholesterol, diabetes, obesity, a family history and cigarette smoking. If you have any of these risk factors or experience symptoms, your doctor can make a diagnosis during a physical exam. Surgical and minimally invasive techniques such as angioplasty and stents can be used to relieve blockages if necessary. And many people with PVD can be treated with healthy lifestyle modifications including diet and exercise. The most influential risk factors are high cholesterol and smoking, says Bradley Grimsley, M.D., a vascular surgeon Baylor Hamilton Heart and Vascular Hospital and Baylor Dallas. Both of these factors can be controlled to prevent PVD. Listen to your heart Women have a reputation for following their hearts. But that s not so easy if you have atrial fibrillation, which can cause an irregular and often rapid heartbeat. You could be at risk for atrial fibrillation if you have high blood pressure, coronary artery disease, heart disease or a thyroid disorder. Other risk factors include increasing age, sleep apnea, or exposure to stimulants such as caffeine and alcohol. Managing controllable causes like high blood pressure or caffeine consumption can reduce your risk, says Kevin Wheelan, M.D., co-medical director of the division of cardiology at Baylor Hamilton Heart and Vascular Hospital and medical director of the Cardiovascular Fellowship Program at Baylor Dallas. Some people don t have symptoms, but atrial fibrillation can cause heart palpitations, shortness of breath and fatigue. It can decrease blood flow to the body and potentially damage the heart muscle or cause a stroke. If you experience symptoms or have risk factors, talk to your doctor. Atrial fibrillation can be managed with medications to regulate the heart rate, or blood thinners to reduce the risk of stroke. There s also a new minimally invasive procedure available that freezes abnormal areas of the heart that may be responsible for the atrial fibrillation. The procedure can reduce symptoms, the risk of stroke and the need for medication. We insert a tiny wire into the heart and target the sites that are causing the atrial fibrillation, explains Robert Kowal, M.D., Ph.D., an electrophysiologist on the medical staffs at Baylor Hamilton Heart and Vascular Hospital and Baylor Dallas. For a large percentage of people, this is a cure for atrial fibrillation that can prevent it from recurring. To find a physician on the medical staff at Baylor Dallas or Baylor Hamilton Heart and Vascular Hospital, call 1-800-4BAYLOR or call 214-820-0015 for a free consultation with a licensed professional to discuss your treatment options for atrial fibrillation or visit BaylorHeartHospital.com/ atrialfibrillation. Visit us at BaylorHealth.com HeartSmart / Summer 2009 3

Baylor Health Care System 2001 Bryan Street, Suite 750 Marketing Department Dallas, TX 75201 NON-PROFIT ORG. US POSTAGE PAID PERMIT 2422 DALLAS TX heart-health checklist What women need to know to take care of their tickers Take these six steps for a healthier heart: 1. Kick the habit. According to the National Heart, Lung and Blood Institute, women who smoke are two to six times more likely to suffer a heart attack than nonsmoking women. Even secondhand smoke can raise your risk. 2. Check your cholesterol. The National Institutes of Health reports that for every 10 percent reduction in cholesterol, your risk for heart disease is reduced by about 20 percent. If you re over age 45, have it checked annually. 3. Reduce the pressure. All women ages 18 and older should have their blood pressure checked annually. 4. Get moving. A half hour of exercise most days can help you maintain a healthy weight, reduce stress and keep your heart healthier. Vigorous, aerobic exercise may help lower cholesterol and blood pressure. Always check with your physician before beginning an exercise program. 5. Lose weight. Being overweight or obese increases your blood pressure and cholesterol and places you at greater risk for diabetes, heart disease and stroke. Even a modest weight loss of 10 pounds can lower your risk. 6. Start young. Given that cardiovascular disease is the number-one cause of death for women, it s never too early to start making healthier lifestyle choices. schedule a checkup Annual checkups are one way to keep your heart healthy. For a referral to a physician Baylor Hamilton Heart and Vascular Hospital or Baylor Dallas, call 1-800-4BAYLOR or visit BaylorHeartHospital. com/physicianfinder or BaylorHealth.com/ The material in HeartSmart is not intended for diagnosing or prescribing. Consult your physician before under taking any form of medical treatment. Physicians are members of the medical staff at one of Baylor Health Care System s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Hamilton Heart and Vascular Hospital, Baylor University Medical Center at Dallas or Baylor Health Care System. Photographs may include models or actors and may not represent actual patients. GENERAL WHAT S YOUR risk? You want to live a longer, healthier life, right? Did you know that heart disease kills more women each year than any other illness? While healthy habits, such as eating a well-balanced diet and getting regular exercise, can help prevent hear t disease, there are other risk factors that you can t control. Since you won t necessarily know if you have hear t disease until it has progressed a fair amount, taking preventive steps and getting regular screenings are key. To find out your risk for hear t disease, take the heart risk assessment at BaylorHealth.com/ heartassessment, then discuss the results with your doctor.