Danielle Lee: Good evening, Jacksonville, and merry Christmas. I’m Danielle Lee, and welcome to The Conversation with Dr. Ali Kasraeian. You too can join the conversation. Give us a call at 340-1045. Dr. Ali, always a pleasure to see you. Merry Christmas.
Kasraeian: Merry Christmas.
Danielle Lee: Thank you.
Kasraeian: And happy holidays.
Danielle Lee: Yes, and happy holidays.
Kasraeian: I don’t know what to say anymore, to be politically correct.
Danielle Lee: Yeah, everybody, you know … Exactly. Trying to be politically correct here, but … What’s going on today?
Kasraeian: Today, I am very fortunate, and we are very fortunate, to have Dr. Mona Shah in the studio. She’s a friend of mine, and she’s a cardiologist as well as a holistic medicine specialist, so we have a multi-faceted view on heart disease. But we’re going to look at it from a slightly different perspective, being that we’re approaching the holidays. Even though the holidays are this beautiful time of the year, family, gifts, it can also be a very stressful time of the year.
One interesting thing that people may not know, the risk of cardiac events and cardiac deaths is the highest in Christmas, December 25th, followed by December 26th and January 1st. Studies have shown, it’s actually, when you look at this … you know, sometimes they call it the holiday heart attacks. In 1999, a big study published in the American Heart Association’s journal, called Circulation, they examined more than 222 thousand death records from LA County. Again, sorry to have such a dark beginning study to quote before Christmas here, on Christmas Eve.
Danielle Lee: Right on time.
Kasraeian: I apologize to Santa Claus for darkening his voyage today, or his journey today.
Danielle Lee: As he gets ready to eat all of the cookies and drink all the milk today, right.
Kasraeian: Yeah. I’m glad he’s listening, though. They found that cardiac deaths in December and January were 33% higher. Again, in December and January, 33% higher than in the summer months. That’s a dramatic increase in cardiac deaths that started in Thanksgiving and continued through the New Year’s time and the New Year’s holiday. Another study in 2004 was an analysis of more than 53 million records over a 26-year period across the United States. This, again, a large volume of patients across the United States, so you can generalize it. It wasn’t just one area. This pinpointed in more specificity, and they found that the cardiac deaths occurred specifically on December 25th more than any other day, followed by December 26th and January 1st, and that the excess in the holiday mortality seems to be growing in proportionality through time. This continues. It wasn’t just a blip in time. It continues.
To help us discuss this and shed some light on the why, and hopefully help us figure out how to survive the holidays and be heart-healthy through the process, and make it not just through the holidays but maintain some heart health through our life, is Dr. Shah. Thank you for joining us.
Dr. Mona Shah: Thank you so much for having me.
Kasraeian: I was trying to figure out where bring this up, and I think being that one of the things you have expertise and interest in is women’s health. Over the past few days we’ve heard in the media that Carrie Fisher, known to all of us as Princess Leia from the Star Wars history that is so dear to anyone of, I guess, my age, you know-
Dr. Mona Shah: I like them too. I almost wore a Star Wars shirt today.
Kasraeian: It’s interesting. I bought some water, I was going to bring our guest and everyone water, and the one that Dr. Shah has, it has a Star Wars on it. I picked the wrong one for myself. But Carrie Fisher, who’s about 60, was flying from London to Los Angeles, and about 15 minutes before the plane landed, she went into cardiac arrest. Fortunately, there was an EMT on the plane, started performing CPR. They landed the plane safely. Paramedics were able to get on the scene, and she was transferred to UCLA medical center and transferred to the intensive care unit, where she is.
We have limited information, but it brings that place to start the discussions, before we get into the discussions of the holiday heart disease and the increased risk of cardiac events. Being that you look at women’s health and women’s heart disease, both in terms of an episode such as this, but prevention, what are some of the differences that women’s heart attack and women’s heart disease … how does it present differently, and how, especially in times of stress where women … and in Christmastime, they’re cooking, they’re taking care of all the kids, you’re worried about the presents, you’re worried about all the stress around this weekend and the week to follow. What should women and the people that love women keep in mind if someone may be having a cardiac event, and that it may present differently than what we classically believe is [inaudible 00:05:04] chest pain, elephant sitting on your chest, radiating to your arm, your jaw, things of that nature?
Dr. Mona Shah: Right. First, I want to … I love talking about women and heart disease, on top of the holistic cardiology, but-
Kasraeian: Who doesn’t?
Dr. Mona Shah: Right, exactly. First, I always try to, any time I get a chance to push the importance of women and heart disease, I do, because I think a lot of women think that they’re going to die of breast cancer. You know, it’s a one that is talked about a lot. I think more and more women are recognizing that they’re actually going to die of a heart attack more and more dying of breast cancer. Okay? I think that’s a very important fact that most of us, and most people, are getting to know that now. However, it’s really becoming an aware that women are going to die of a heart disease more.
As far as symptoms go, a lot of women have fatigue as their most common symptom. Not necessarily, like you said, the chest tightness, the going down your arm. When you’re tired, as a woman … I mean, who’s not tired, okay, whether you’re a woman or a man? But like you said, a lot of women, they’re moms, they’re wives, they’re trying to take care of jobs and kids, especially this time of year even more so with all the gifts and holidays and friends and families. And so when you’re more tired, you just chalk it up to, you know, I’m either getting older or I just have a lot on my plate.
Fatigue is a very common symptom. I’ll always ask any patient, but especially women I’ll ask besides the regular, “Do you have chest pain, do you have shortness of breath?” I’ll say, “Are you more tired than normal?” You always want to look at your baseline. What is your normal? You know, if you have chronic fatigue and you get tired at the end of the day, okay, fine. But if you’ve noticed that, “You know, I’m getting really exhausted just doing basic things. Six months ago I could run around and do things and get a little bit tired, and now I’m just getting much more exhausted,” that’s a red flag for me to start really digging in deep. Could they have heart disease causing this?
Kasraeian: What should they do if they feel that?
Dr. Mona Shah: If they start having more fatigue or any change in the symptoms, obviously go to your primary care doctor. If you already have a cardiologist, of course, go to your cardiologist. At least get a basic EKG. Let him get a good history and if they want to do further testing then they’ll order what’s appropriate.
Kasraeian: The other thing I wanted people to know about a little bit as a tangential subtopic of what we’re talking about today is that people around this weekend may be traveling a lot. One of the things that, if you’re getting on a plane, especially if you have heart disease or underlying medical issues, as you’re getting on a plane it may be a good idea for you and your family to be aware of your medical history. I’ve been in situations where I’ve had to intervene and resuscitate patients and things of that nature, and you’d be surprised how the people around the family are completely unaware of the medical history, what medications people are on, what happened that prompted this scenario.
Be aware of the medical history. Try to be aware of your medications. There are a lot of things that you can actually do on your cell phone that you can actually list all your medications. You can put your medical history. You can put your allergies on there. Be mindful of those. Be mindful of your physicians. Have all that information readily available so that if something does happen you can share that information.
The other thing that you want to be mindful if you do have a heart history is to be very, very cognizant of taking your medications and things of that nature under the respectful guise and instructions of your physician. Don’t just haphazardly stop medications because you feel like it. Because especially with heart disease, the medications that you are on, the dosing that you’re on, your blood pressure control, are very, very, very important. And so if you’re on vacation, if Christmas holidays and things of that nature are in place, just stopping things … and you’re more stressed out, you’re eating more, you’re drinking more. Those things can have significant impact, as we’ll elaborate further during the course of this show. If you’re traveling, if you’re getting on a plane, those things can become very, very, very important.
If you’re thinking about intervening in a situation where someone may be going down, or there’s a cardiac event or any kind of event where you’re looking to volunteer to help, be mindful that on the plane there are first aid kits. There is a defibrillator on the plane. On the plane, the staff and the crew are trained in CPR. Most planes, you’re not sure if there’s a physician or an EMT or anyone on the plane, there’s a chance that there is not. However, most of the American airlines have relationships with medical centers and consultants that they can communicate with so you’re not alone and responsible to do everything from that standpoint. Don’t try to be a hero if you have no medical experience. Try to let the staff do what they’re-