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Community DC Jenni Chase & Heart Month · Community D.C.

0:06
Speaker 1: Hi, good morning. I hope you're doing well this weekend.
0:08
Speaker 1: I am my Heart Radio's Jenny Chase. Really appreciate you listening.
0:12
Speaker 2: Of course.
0:12
Speaker 1: Lots of hearts and flowers everywhere this weekend for Valentine's Day,
0:15
Speaker 1: and the heart is what we're going to focus on
0:17
Speaker 1: this morning with our friends from Johns Hopkins. Lots of
0:20
Speaker 1: attention right now on heart health because February is heart month,
0:24
Speaker 1: and I am so thrilled to be joined by Johns
0:26
Speaker 1: Hopkins doctor Steven Sue.
0:28
Speaker 2: Hello, sir, thank you for being here.
0:30
Speaker 3: Awesome, Well, thank you so much, Jenny for having me.
0:32
Speaker 3: It's a pleasure to be here.
0:33
Speaker 2: Oh, of course, and we have a lot to get to.
0:36
Speaker 1: Let's start with if you don't mind you yourself sharing
0:38
Speaker 1: a little bit about your background. I've got your resume
0:41
Speaker 1: in front of me, but tell us a little bit
0:43
Speaker 1: about yourself. How you got started in cardiology?
0:46
Speaker 3: Yeah, great, so for the most part, I grew up
0:49
Speaker 3: in New York City, but I've been down in Maryland
0:51
Speaker 3: now for twenty years.
0:53
Speaker 2: Okay.
0:53
Speaker 3: Went to Hopkins for medical school and then stuck around
0:58
Speaker 3: for all of my training, which included a cheap residency
1:02
Speaker 3: year cardiology training and then I gravitated towards taking care
1:06
Speaker 3: of patients with congestive heart failure. Wow, you might need
1:10
Speaker 3: more advanced things like heart pumps or heart transplants. Okay,
1:15
Speaker 3: So I did my training there and I've been faculty
1:18
Speaker 3: at Johns Hopkins since twenty seventeen minutes.
1:21
Speaker 1: Okay, I want to start with the super super basics
1:24
Speaker 1: for those of us who maybe have forgotten a lot
1:26
Speaker 1: of what we learned in anatomy back in school in
1:28
Speaker 1: the day, can you just give us a real quick
1:30
Speaker 1: overview of the heart, the different chambers, the different aspects
1:34
Speaker 1: of the heart.
1:35
Speaker 3: Absolutely, so, the heart is a pump that pump's blook.
1:39
Speaker 3: And fundamentally speaking, there are actually two sides to the heart,
1:43
Speaker 3: the right side and the left side, And the heart
1:46
Speaker 3: when it pumps, actually is pumping to two places at
1:48
Speaker 3: the same time. The right side receives blood from the
1:52
Speaker 3: body and pumps that blood into the lungs so that
1:56
Speaker 3: it can go pick up more oxygen. For another truth,
1:59
Speaker 3: that blood then gets to the left ventricle, and while
2:02
Speaker 3: the heart is squeezing the left ventricle, then the left
2:06
Speaker 3: side of the heart basically pumps blood out to the boy.
2:09
Speaker 3: But I like to think about this as if I
2:11
Speaker 3: were sitting on the belwet, because of course there's never
2:14
Speaker 3: traffic on the beltwet.
2:15
Speaker 2: Bringing to interesting do share? Please love?
2:18
Speaker 3: Yeah? My idea, my metaphor for this, this follows the
2:22
Speaker 3: right heart, the lungs, and the left heart, or basically
2:26
Speaker 3: like three exits. So picture yourself passing by a silver spring,
2:30
Speaker 3: and when blood is done going through the city or
2:33
Speaker 3: going around the city, it's got to get back to
2:36
Speaker 3: the hearts, and then the right heart has to squeeze
2:39
Speaker 3: blood into the lungs, and then after it's done picking
2:41
Speaker 3: up oxygen there, it gets to the left heart, and
2:44
Speaker 3: then the left heart has to squeeze that blood back
2:46
Speaker 3: out to the body, and then you make another trip
2:48
Speaker 3: around the belfet.
2:49
Speaker 1: Gotcha, gotcha? So it's just one big loop. What exactly
2:53
Speaker 1: is heart failure and why is it so important that
2:55
Speaker 1: we treat that as soon as possible?
2:58
Speaker 3: Heart failure is a condition and where the heart is
3:02
Speaker 3: not a pumping blood as well as it should. So
3:04
Speaker 3: to kind of continue on that traffic metaphor, you imagine
3:09
Speaker 3: you have a traffic jam at exit somewhere up at
3:13
Speaker 3: software spring. You have a chronic traffic jam. Then you'll
3:16
Speaker 3: have a couple of problems. You won't get as much
3:18
Speaker 3: traffic all the parts of your body that need book flight,
3:22
Speaker 3: and so you'll be a little more tired. You'll be
3:24
Speaker 3: a little more winded. You just won't to have as
3:27
Speaker 3: much energy as you would like as you build up
3:30
Speaker 3: traffic or blood flow at various exits, and you might
3:33
Speaker 3: get some of the other symptoms. If you're building up
3:36
Speaker 3: traffic or blood flowed inside your lungs, then you'll get
3:39
Speaker 3: a little shorter breath. If the traffic's really wrapping around
3:42
Speaker 3: the Beltway and now you're building up food in your belly,
3:45
Speaker 3: then you might have trouble with your appetite where you
3:49
Speaker 3: might be full of the time traffic's really wrapping all
3:52
Speaker 3: the way down the Fort Washington. Then now you have
3:55
Speaker 3: swelling in your legs. And this basically sums up how
3:59
Speaker 3: hard failure can affect them. Buy. Yeah, not only do
4:02
Speaker 3: you get let's flood flow to where it's got to
4:04
Speaker 3: go exactly, but you also have blood flow of blood
4:07
Speaker 3: building up where it doesn't want to be.
4:09
Speaker 2: That is a very clear layman's explanation.
4:12
Speaker 1: Thank you from all of us who are not doctors
4:14
Speaker 1: or scientists or know much about this stuff, doctor Sue.
4:18
Speaker 1: I'm curious if there's there was something specific that inspired
4:21
Speaker 1: you to specialize in caring for patients with heart failure
4:25
Speaker 1: and you know, the advanced heart therapies, like a certain
4:28
Speaker 1: point in your life where you went, that's what I
4:30
Speaker 1: want to do. And here's why.
4:31
Speaker 3: That's a great question. I think there have been lots
4:34
Speaker 3: of events over the years that have shaped my career.
4:37
Speaker 3: First off, I've been sick.
4:38
Speaker 4: Myself is a patient, and I've had the experience of
4:42
Speaker 4: being an hospital dead and dealing with medical issues that
4:47
Speaker 4: had the possibility of really threatening my mind.
4:49
Speaker 1: I don't mean to prive were these cardiac related issues.
4:52
Speaker 3: They were not a card Okay, they were kind of
4:55
Speaker 3: more in the neurologic category. Gotcha, I got a condition
5:00
Speaker 3: that kind of left me paralyzed bytown.
5:02
Speaker 2: Oh my god.
5:03
Speaker 3: It was thine that the doctors at Hopping and said,
5:06
Speaker 3: they really just they diagnosed things quickly and saved my life.
5:09
Speaker 3: I mean, in my future now, I barely have any
5:12
Speaker 3: deficits from kind of what happened. Having been in those shoes.
5:16
Speaker 3: I just kind of really developed a part for you know,
5:21
Speaker 3: patients who are going through any medical I think for
5:24
Speaker 3: all of us, we take our health for granted, but
5:27
Speaker 3: when something that pops up, it just can really derail
5:30
Speaker 3: our entire lives and the lives of those who love
5:33
Speaker 3: us and care for us. Absolutely, And so I've always
5:37
Speaker 3: been drawn to people who are in a tough spot
5:40
Speaker 3: because I feel compelled to try to help them.
5:42
Speaker 2: Yeah.
5:43
Speaker 3: That kind of just strengthened my resolve to be a doctor.
5:47
Speaker 3: And it happened during medical school, so it didn't really
5:50
Speaker 3: change my path at that point. I think a gear
5:52
Speaker 3: it probably pushed me towards some of the more critical
5:56
Speaker 3: things out there that could be afflicting patients.
5:59
Speaker 1: Cardiac gives you are so there are so many, It's
6:03
Speaker 1: so widespread amongst such a large section of our population.
6:06
Speaker 3: Yeah, and I think, you know, some people would consider
6:10
Speaker 3: heart failure almost like big cancer cardiology. And so you know,
6:14
Speaker 3: when we meet people who are in a tough spot
6:17
Speaker 3: for heart failure, they can feel very worried about their future,
6:21
Speaker 3: and I just have always been drawn to trying to
6:24
Speaker 3: help them make that better.
6:26
Speaker 2: Thank you for your dodication, Thank you so much.
6:28
Speaker 3: Oh, no problem. I think why I got drawn to
6:31
Speaker 3: cardiology specifically is because it makes a lot of sense
6:34
Speaker 3: to me. There's a lot of physiology and science behind
6:38
Speaker 3: it that kind of makes sense as I understand it,
6:41
Speaker 3: and I try to take care of people in a
6:44
Speaker 3: way that helps them understand their problems as well so
6:47
Speaker 3: that they are empowered.
6:48
Speaker 1: Yeah, the easier you make it for us to understand,
6:51
Speaker 1: I think sometimes just the very easiest of terms you
6:55
Speaker 1: know that it's put in, really can grab our attention.
6:57
Speaker 1: And it definitely helps to have a caring, trusted specialist
7:03
Speaker 1: that we can go talk to. And I'm gathering that
7:06
Speaker 1: that is exactly why your patients come to you in
7:09
Speaker 1: this time of fear and worry and need for treatment.
7:14
Speaker 1: We talk about this all the time, but I don't
7:17
Speaker 1: think it gets said enough. Can you share with us
7:20
Speaker 1: the most common signs and symptoms that people should pay
7:23
Speaker 1: attention to when it comes to their heart health.
7:26
Speaker 3: If you take a step back, our hearts need to
7:29
Speaker 3: deliver a blots our bodies so that we stay healthy.
7:32
Speaker 3: But our hearts also need to be able to crank
7:36
Speaker 3: up hired so that we can do all the things
7:39
Speaker 3: that we want to do, like exercise, spend time with
7:44
Speaker 3: friends and family. Our hearts need to be able to
7:46
Speaker 3: crank it up a notch, so one of the earliest
7:49
Speaker 3: symptoms that people can notice if you have more and
7:51
Speaker 3: more tiredness or shortens of breath right with the higher
7:55
Speaker 3: levels of activity and exertion. To borrow from that traffic metaphor,
8:00
Speaker 3: you might have a situation where the problem is mild.
8:03
Speaker 3: You only notice it when the carflow is hired. So
8:07
Speaker 3: just like during rush hour, traffic gets worse, but the
8:10
Speaker 3: traffic may look better when the traffic is later. Hart
8:13
Speaker 3: issues can manifest the same way. Part issues will often
8:16
Speaker 3: manifest first when you're trying to exercise or push your
8:20
Speaker 3: body to higher levels.
8:22
Speaker 1: For this particular timeframe. You know people who have been
8:24
Speaker 1: shoveling after the snowstorm. I know that's a big concern.
8:27
Speaker 3: You're exactly right. Yeah, So shoveling snow ends up being
8:31
Speaker 3: sometimes an event that people notice their heart want because
8:35
Speaker 3: if they're having heart issues, unbeknownst to them, they may
8:38
Speaker 3: be limiting their activity to accommodate. Then you get a
8:41
Speaker 3: horrible snow and ice lither coming along, and all of
8:43
Speaker 3: a sudden, people are being asked to exert themselves beyond
8:46
Speaker 3: what they're comfortable with. Yeah, sometimes that can unmask heart
8:50
Speaker 3: problems or short.
8:51
Speaker 1: The common things, the common symptoms outside of shoveling snow,
8:55
Speaker 1: like chest pain.
8:56
Speaker 2: Can we talk a little bit more about that.
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Speaker 3: Some of the things that can be more specific to
9:00
Speaker 3: the heart part. You're having chest pain or chest pressure,
9:04
Speaker 3: that could be a sign that the heart is having trouble.
9:06
Speaker 3: Those symptoms are more related to artery blocking juice of
9:10
Speaker 3: the heart, which are not necessarily related to just apart
9:14
Speaker 3: from it, okay, for heartlier specifically, my mind goes back
9:18
Speaker 3: to that traffic analogy. So if you have fluid built
9:22
Speaker 3: up in your body somewhere, then the symptoms come from that.
9:25
Speaker 3: If you have extra fluid built up in your lungs,
9:28
Speaker 3: you might get more shorter breath when you lay down
9:30
Speaker 3: at night to sleep, okay, or you may wake up
9:34
Speaker 3: from sleep for unclear reasons because you're frankly shorter breath.
9:37
Speaker 3: In that scenario, basically, you have extra fluid in your
9:41
Speaker 3: body just piles up in your lungs when you may
9:44
Speaker 3: slat because gravity brings it back on to the chest.
9:46
Speaker 2: Yeah, scary, those are.
9:48
Speaker 3: That's one group of symptoms. Another group of symptoms is
9:51
Speaker 3: if you are having belly in sheet, So if you're
9:54
Speaker 3: having fullness in your belly, or you find that if
9:57
Speaker 3: you have an appetite but you just can't eat as
9:59
Speaker 3: much you use. Yeah, those can be signs that you're
10:02
Speaker 3: holding on and extra food in your belt. And then
10:04
Speaker 3: if you have swelling in your feet, especially both of you,
10:07
Speaker 3: then that can be a big sign of heart failure
10:09
Speaker 3: because the fluid is basically kind of not getting back
10:12
Speaker 3: up to the heart and fooling in your legs.
10:15
Speaker 2: I know you had mentioned those before.
10:17
Speaker 1: I'm just wondering about you know, you hear like job
10:19
Speaker 1: pain or pain in your back.
10:22
Speaker 3: Those So another thing that is out there means just
10:26
Speaker 3: what we call cornary artery disease. We in this situation,
10:30
Speaker 3: people can have cholesterol build up in the arteries that
10:35
Speaker 3: give flood to plug themself. And if you're having cholesterol
10:39
Speaker 3: build up, when your heart demands more blood flow, parts
10:42
Speaker 3: of the heart and clocked arteries might feel beam quite
10:47
Speaker 3: literally because they can't get enough blood flow to do
10:50
Speaker 3: what you resting thought to do. When parts of your
10:53
Speaker 3: heart get that blood flow, then you can get pain
10:56
Speaker 3: because the heart is hurting because it's not getting enough fund.
10:59
Speaker 3: So that pain cammand best as chest pressure under your
11:02
Speaker 3: sturnum or just like under the front of your page.
11:05
Speaker 3: We do not have good pain receptors in heart, so
11:09
Speaker 3: sometimes that pain goes to funny places in our body
11:12
Speaker 3: and it's hard for our moins to interpret that it's
11:16
Speaker 3: coming from hard So when you hear about draw pain
11:18
Speaker 3: or left arm pain, it just can be what we
11:21
Speaker 3: call referred pain. Okay, the pain is coming from the heart,
11:24
Speaker 3: but the brain is having trouble of localizing.
11:27
Speaker 2: That makes sense. I had never known about that before.
11:30
Speaker 2: Thank you for that explanation.
11:31
Speaker 1: All right, So when is it to the point where
11:35
Speaker 1: you feel something and you're like, I really need to
11:37
Speaker 1: go not just see a doctor, and that's the first step,
11:40
Speaker 1: but then, like, if it's gotten to an emergent situation,
11:44
Speaker 1: at what point do we need to reach out for
11:47
Speaker 1: some help?
11:47
Speaker 3: Great question. I tell my patients to really trust their bodies.
11:51
Speaker 3: People have a really great sub sense of whether change
11:55
Speaker 3: in symptoms warrants the doctor's visit or a What I
12:00
Speaker 3: would say is we all know our bodies quite well.
12:03
Speaker 3: You know what we're used to. If you ever noticed
12:06
Speaker 3: a change slowly over weeks to months, I would say
12:11
Speaker 3: that that calls for our doctors.
12:12
Speaker 2: Isn't okay?
12:13
Speaker 3: An offer too, And if you ever noticed a change
12:16
Speaker 3: in your body we're well being that's occurring over the
12:20
Speaker 3: course of minutes to hours or just over the last
12:23
Speaker 3: two days. Okay, that's probably safer evaluated in an emergency.
12:27
Speaker 1: Now, are there certain groups of people in our society
12:30
Speaker 1: who are at higher risk for developing heart failure?
12:33
Speaker 3: You know, we've talked about two different conditions part of
12:35
Speaker 3: the heart failure and then also in the clench building
12:38
Speaker 3: as colerosis. It turns out that athos colerosis or heart
12:42
Speaker 3: attacks in general are the number one consparture country. Approximately
12:47
Speaker 3: fifty percent of people, if they survive their heart attack,
12:52
Speaker 3: may go on to have weakening up their heart must
12:55
Speaker 3: that then needs a heart filing. So if you ever
12:57
Speaker 3: have a heart attack, it's really important to stay in
13:00
Speaker 3: the care of cardiology and watch out for In science,
13:05
Speaker 3: so fifty percent artery cholesterol blockages, but another fifty percent
13:10
Speaker 3: is kind of a grab bag of lots of different things.
13:12
Speaker 3: So sometimes part failure ones and families. Sometimes there are
13:16
Speaker 3: colds or cold viruses that can attack the heart and
13:19
Speaker 3: cost far failure. Anyone who's ever gotten a chemo theraphy
13:22
Speaker 3: in their past, Wow, me bee sured of they're cancer
13:27
Speaker 3: should probably periodically check in with a primary care doctor
13:31
Speaker 3: or cardiologist to make sure that that chemo doesn't have
13:34
Speaker 3: an effect on the heartwork.
13:35
Speaker 1: I wanted to ask you mentioned like if you're susceptible
13:38
Speaker 1: to colds, Like what if you have a weekend immune system.
13:40
Speaker 3: That's a great question. Basic colds, the common cold, those
13:44
Speaker 3: types of things do not cause do not have mutinely
13:47
Speaker 3: cause part problems. Okay, there are very specific rare viruses
13:53
Speaker 3: that can.
13:53
Speaker 1: Sometimes attain Let's talk about prevention and early detection. Biggest
13:57
Speaker 1: steps that we can do starting today this moment to
14:01
Speaker 1: lower our risk of heart failure.
14:03
Speaker 3: So some of the biggest risks for heartier you know,
14:06
Speaker 3: making sure cluster student yes, so that we don't have
14:08
Speaker 3: cholesterol block views. Another major thing to prevent heart failure
14:12
Speaker 3: is to make sure our blood pressure is block control.
14:15
Speaker 3: Absolutely so sometimes if people have high blood pressures as
14:19
Speaker 3: high blood culture, we can actually be a very silent problem. Yes,
14:24
Speaker 3: that can be there for decades before it shows up.
14:26
Speaker 3: If you have high blood pressure, we will eventually stress
14:30
Speaker 3: out the heart and make the arry and then avoiding
14:35
Speaker 3: other medical problems. So I would kind of cluster this together.
14:38
Speaker 3: But booking city diabetes and activity. Those things can all
14:42
Speaker 3: combine to affect the heart and put you at risk
14:45
Speaker 3: of heartgood. So making sure that we exercise and stay
14:49
Speaker 3: out good weight, those are all. You know, that list
14:51
Speaker 3: of things right there would prevent the vast majority.
14:54
Speaker 1: Let me touch on something that I hear a lot
14:56
Speaker 1: about as well as smoking and alcohol usage.
14:58
Speaker 3: Oh yes, thank you. Smoking can certainly affect the heart
15:02
Speaker 3: because it can increase your chance of heart attack. So
15:05
Speaker 3: staying away from tobacco is very important. Alcohol can affect
15:09
Speaker 3: the heart. There is a condition out there called alcohol
15:12
Speaker 3: and cardiomyopathy.
15:13
Speaker 2: Oh wow.
15:13
Speaker 3: Okay, Statistically speaking, alcohol affects more people's lyrics, but there
15:19
Speaker 3: are definitely a lot of people out there who with
15:23
Speaker 3: enough heavy drinking, and it might not even be a lot,
15:25
Speaker 3: you know. So we usually say for men, you know,
15:28
Speaker 3: something on your four to six drinks for more owarded
15:32
Speaker 3: trump of the wine model could quickly add up to
15:34
Speaker 3: four to six drink or portbal teps or women plus
15:37
Speaker 3: I'm sharing two or four for the absolutely you can
15:40
Speaker 3: put your heart at risk. Let's talk about just heart
15:42
Speaker 3: failure treatment. It has come such a long way, so
15:45
Speaker 3: many new options. What are you specifically excited for right
15:49
Speaker 3: now being in the field of cardiology. So over the years,
15:52
Speaker 3: a lot of great medicines have been developed that can
15:56
Speaker 3: actually slow down, stop, even reverse justin one time. Amen,
16:03
Speaker 3: So we're very grateful to these medications. You know, about
16:06
Speaker 3: thirty years ago we barely had any minutes. Over the
16:09
Speaker 3: last three decades, four medicines have been developed. A lot
16:13
Speaker 3: of them are now generic. And these four medicines each
16:16
Speaker 3: work in different ways, and the four of them together
16:18
Speaker 3: worked very well to either stop or reverse the progression.
16:24
Speaker 3: So it's important to try to get on all four medicines.
16:27
Speaker 3: But once all four medicines are there and dialed up
16:30
Speaker 3: to the rpdosis, then they can kind of really push back.
16:33
Speaker 2: Do you mind naming those four?
16:34
Speaker 1: Not that I'm a pharmacist or anything, but just just
16:37
Speaker 1: the folks have that in their brain.
16:39
Speaker 3: Absolutely. So. One of them is in medicine called Q
16:43
Speaker 3: control valsartine. The trade name for it is Entrusted, and
16:47
Speaker 3: they're good commercials of it over the years. Okay, So,
16:50
Speaker 3: and trust tho is kind of one of the main pillars.
16:52
Speaker 3: The second pillar is a class of medicines called BATA blockers.
16:57
Speaker 3: Took them data law or mental pro law. Those fallen category.
17:00
Speaker 3: A third category us on the medicine is called scorn,
17:04
Speaker 3: a lactome or a flow or none. And then the
17:07
Speaker 3: fourth pillar is actually a group of diabetes and so
17:11
Speaker 3: impatal closing or jardins charting both. Yes, interestingly they all
17:16
Speaker 3: work in very different ways. Yeah, well selectively, they all
17:20
Speaker 3: block all the bad stuff going on in Hopefully, with
17:23
Speaker 3: the right medicines we can get people feeling a whole
17:26
Speaker 3: heck of a lot better, get them back to their
17:29
Speaker 3: regular life whenever possible, reverse everything that's going on.
17:32
Speaker 1: Well, thank you so much, doctor Steven Sue with Johns
17:35
Speaker 1: Hopkins Hard and Vascular Institute. Now I'm joined by another
17:39
Speaker 1: amazing doctor who takes care of our tickers, Zshaan a
17:42
Speaker 1: mad with Johns Hopkins.
17:44
Speaker 2: Nice to have you here as well.
17:45
Speaker 5: Thank you for having me. I appreciate it.
17:47
Speaker 1: Would you also mind telling us about your background and
17:49
Speaker 1: how you got to this point in your medical career.
17:52
Speaker 3: Sure? So.
17:52
Speaker 6: Originally I'm from Seattle, but I did my training in
17:55
Speaker 6: the University of Toledo and Ohio, and then went out
17:57
Speaker 6: to training in Arizona and Texas before I ended up
18:00
Speaker 6: in the Greater Washington area working for Johns Hopkins and
18:05
Speaker 6: specifically in cardiology. It's just I kind of always had
18:08
Speaker 6: an affinity for the heart and it kind of made
18:10
Speaker 6: my way into cardiology that way. And then the specific
18:14
Speaker 6: field that I'm in, which is called electrophysiology, which is
18:17
Speaker 6: the study of heart rhythm, that's because of my father essentially.
18:22
Speaker 6: So my father has a heart rhythm disorder called the
18:25
Speaker 6: atrial fibrillation, and so you know, that's near to my heart.
18:28
Speaker 6: So that's kind of how I was introduced to the field.
18:32
Speaker 2: I completely understand what you're saying.
18:34
Speaker 1: My dad passed away from congestive heart failures.
18:38
Speaker 2: So I'm so.
18:41
Speaker 1: Grateful to you and cardiologists everywhere for the work that
18:44
Speaker 1: you do.
18:45
Speaker 6: We appreciate that, but we love what we do and
18:47
Speaker 6: I'm helping people, especially in the regional.
18:49
Speaker 1: Area, so very much. All right, Well, let's talk about
18:52
Speaker 1: your field. For those of us who really aren't knowledgeable
18:56
Speaker 1: about it, talk to us please about electrophysiology.
19:00
Speaker 5: So it's the.
19:00
Speaker 6: Study of the electrical conduction within the heart. Essentially, what
19:04
Speaker 6: we're doing is looking at whether or not if the
19:08
Speaker 6: heart is having an abnormal rhythm and whether that rhythm
19:11
Speaker 6: could be fast or slow, and you know, does it
19:15
Speaker 6: need to be treated, you know, do you need medications potentially,
19:17
Speaker 6: do we need to do some lifestyle modifications for you
19:20
Speaker 6: to help you reduce those issues, or if it's an
19:23
Speaker 6: invasive procedure such a pacemaker or a defibrillator, or a
19:26
Speaker 6: procedure called an oblation to kind of help treat the
19:29
Speaker 6: heart rhythm disorders.
19:31
Speaker 1: Okay, so we have a lot to unpack here. A
19:34
Speaker 1: FIB A lot of people know that by the abbreviation.
19:38
Speaker 1: Do you happen to have a ballpark for the number
19:40
Speaker 1: of people affected with atrial fibrillation?
19:42
Speaker 6: Well, well, rough numbers, you know, I would say roughly
19:45
Speaker 6: forty million people are so easily have it, but there's
19:48
Speaker 6: probably increased prevalence, and we're finding more and more patients
19:52
Speaker 6: are having or detecting the fact that they have atrial
19:55
Speaker 6: fibrillation or other heart rhythm disorders because of wearable devices.
19:59
Speaker 5: Such as an eyewatch or you know, the ORR ring
20:01
Speaker 5: things like that.
20:01
Speaker 6: Not that I'm promoting those things, that I'm just saying
20:04
Speaker 6: because of that, we're finding younger and younger patients having
20:08
Speaker 6: these rhythm disorders as well to incoming to our clinic
20:11
Speaker 6: at a much younger age than previously.
20:13
Speaker 1: It seems like every time you turn around, there's there's
20:16
Speaker 1: more and more worry about cardiac issues. Can you describe
20:20
Speaker 1: exactly what a what a fib is, what atrial fibrillation is.
20:23
Speaker 6: Of course, so h real food relation is the most
20:25
Speaker 6: common sustained heart rhythm disorder in the world, actually, and
20:29
Speaker 6: it's an irregular rhythm that can cause patient symptoms such
20:33
Speaker 6: as talpitations, sometimes some dizziness or you know, near passing
20:36
Speaker 6: out symptoms, and sometimes some chests comfort as well with
20:40
Speaker 6: shortness of breath and fatigue. Other patients don't have any
20:43
Speaker 6: symptoms at all, and that's kind.
20:44
Speaker 7: Of the The issue with undiagnosed hil FID relation is
20:48
Speaker 7: those patients can actually present with things like a stroke
20:52
Speaker 7: or congestive heart failure, and so it's becoming more and
20:55
Speaker 7: more pressing issue with regards.
20:57
Speaker 6: To the medical system, especially in the United States, to
20:59
Speaker 6: be able to recognize these patients and get their treatments sooner.
21:03
Speaker 1: Are there signs that people often get and they ignore them,
21:06
Speaker 1: but they shouldn't because then maybe they think it's just
21:08
Speaker 1: not a big deal.
21:09
Speaker 6: Yeah, great question. So some people might just feel a
21:12
Speaker 6: little bit more fatigued than usual, and you know, they
21:15
Speaker 6: chop it up to maybe just getting slightly old or
21:17
Speaker 6: things like that, and so you really have to be
21:20
Speaker 6: you know, if you see a noticeable change and even
21:23
Speaker 6: your activity level, your exercise tolerance to be able to
21:26
Speaker 6: used to be able to go work out and walk
21:28
Speaker 6: this far, you know, a couple of miles and now
21:31
Speaker 6: you can barely kind of get up and you just
21:32
Speaker 6: feel tired and fatigue. That could be a sign that
21:35
Speaker 6: you might have, you know, some heart rhythm disorder as
21:37
Speaker 6: well too, and so evaluation with the medical professional is
21:41
Speaker 6: kind of vital at that at that point.
21:43
Speaker 1: Right, doctor Amott, Is there anything we can do at
21:45
Speaker 1: home to try and prevent these issues so we don't
21:49
Speaker 1: have to come see you?
21:50
Speaker 5: And that's also a great question.
21:51
Speaker 6: So with regards to rhythm disorders and specifically atrophib relations,
21:55
Speaker 6: since it's the most common issue that we see, really
21:59
Speaker 6: lifestyle and management. The biggest thing, and I think that
22:01
Speaker 6: goes across any cardiac disorders is making sure that we're
22:06
Speaker 6: eating healthy, exercising. You know, if we if we need
22:09
Speaker 6: to losing a few pounds, that's for all of us essentially,
22:13
Speaker 6: and if you have other issues such as sleep apnea,
22:16
Speaker 6: making sure that we're getting tested forward and treated for
22:18
Speaker 6: it as well too, So those are kind of things
22:20
Speaker 6: that we can do as patients to kind of help
22:23
Speaker 6: prevent these issues. They're kind of the usual things that
22:25
Speaker 6: all physicians talk about, but on this side, we kind
22:29
Speaker 6: of really see that if we can make those changes,
22:31
Speaker 6: if we can help patients lose a little bit weight,
22:33
Speaker 6: there the amount of a fit they have can actually
22:35
Speaker 6: be reduced as well to and the symptoms that they
22:37
Speaker 6: have decrease.
22:38
Speaker 2: You mentioned the aura ring earlier.
22:41
Speaker 1: There's all these new technologies, you know, the smart watches.
22:45
Speaker 1: I'm guessing based on what you said earlier that you know,
22:48
Speaker 1: you have some doubts about these types of devices, So
22:52
Speaker 1: I think it's you.
22:53
Speaker 6: Know, the fact that they're out there is great, you know,
22:55
Speaker 6: in the sense that they can help us catch something
22:58
Speaker 6: that might be concerning. There are you know, times where
23:02
Speaker 6: it might overread a situation. It might catch you know,
23:06
Speaker 6: muscle movement or things like that, some things that we
23:09
Speaker 6: call artifact which can be confused as a heart rhythm
23:12
Speaker 6: disorder by the device. Remember it's just a machine and
23:15
Speaker 6: it's only been programmed to monitor these things. So it's
23:17
Speaker 6: really if you have and you know, these devices, and
23:20
Speaker 6: it's telling you that there might be some issue. Seeking
23:23
Speaker 6: expert medical care is really the main way to go.
23:26
Speaker 6: So overall, the numbers you see are usually around eighty
23:29
Speaker 6: to ninety percent sensitivity race with regards to catching heart
23:33
Speaker 6: rhythm disorders like a trial fibrillation.
23:35
Speaker 5: Still better than nothing exactly, but you know, you do
23:39
Speaker 5: have to take them with a.
23:40
Speaker 6: Little bit of precaution in the overall sense of what
23:44
Speaker 6: they may be scanning for. Essentially, So I think there
23:48
Speaker 6: are great in certain instances and inserted patients, and they
23:52
Speaker 6: can help kind of, you know, detect early onset of
23:57
Speaker 6: these heart rhythm disorders.
23:59
Speaker 1: Better to be safe, I'm sorry, but don't don't rely
24:02
Speaker 1: on them completely for your medical diagnoses.
24:05
Speaker 6: Yeah, until these wearable devices have to go to medical school,
24:08
Speaker 6: I would still say you need to go see a physician.
24:13
Speaker 2: That's great. We could go into the whole thing about
24:16
Speaker 2: about AI and technology, but we won't. We won't do
24:19
Speaker 2: that on your time. Today.
24:20
Speaker 1: I'm hearing about something and new treatment, and I'm and
24:23
Speaker 1: I think I know a lot about cardiac stuff because
24:25
Speaker 1: again of you know my family history. But what is
24:28
Speaker 1: pulsed field ablation. I have never heard this term before.
24:32
Speaker 6: So it's a new way of performing a procedure called
24:35
Speaker 6: an ablation. And what it is is, you know, taking
24:39
Speaker 6: an existing technology and applying it to the heart essentially.
24:43
Speaker 6: And so what we do is we're able to go
24:45
Speaker 6: in with catheters through a minimally invasive procedure and a
24:50
Speaker 6: blate meaning kind of scar over certain areas of the
24:53
Speaker 6: heart where these rhythm issues occur, such as in a
24:57
Speaker 6: fib They come from mainly these structures called the pulmonary veins.
25:00
Speaker 6: And so by using these newer technology, not only are
25:04
Speaker 6: we able to do a procedure like in elation more efficiently,
25:07
Speaker 6: but also with a better safety profile than ever before.
25:10
Speaker 5: And that's the nice thing about this newer technology. It's
25:12
Speaker 5: quicker and it's safer.
25:13
Speaker 6: Not a lot of things in medicine where you get
25:15
Speaker 6: in both quicker and safer procedures. So this is great
25:18
Speaker 6: and exciting time to be in our field and to
25:20
Speaker 6: be able to treat our patients with these new technologies.
25:23
Speaker 1: Absolutely, that is an amazing advance in cardiac care.
25:26
Speaker 2: Thanks for sharing.
25:27
Speaker 1: Can you tell us some of the benefits of this
25:29
Speaker 1: treatment for cardiac patients?
25:31
Speaker 5: So, I think the biggest thing.
25:32
Speaker 6: Is the safety profile So the one thing we were
25:35
Speaker 6: concerned about with the existing kind of ablation systems, which
25:39
Speaker 6: were either a freezing cathor burning cather called radio frequency,
25:43
Speaker 6: was causing kind of collateral damage to the heart or
25:46
Speaker 6: the surrounding structures. And with this newer technology, we kind
25:49
Speaker 6: of decrease that risk by quite a bit.
25:52
Speaker 5: And that's the biggest reason for the kind of the.
25:58
Speaker 6: Spread of pulse elevation throughout the country in the last
26:02
Speaker 6: two or three years or so. And that's been kind
26:04
Speaker 6: of the exciting part about this newer technologies. We're still
26:07
Speaker 6: finding out, you know, the subtle nuances of this technology,
26:10
Speaker 6: but it's an exciting time to be in our field.
26:12
Speaker 1: Is this currently available to most patients or is it
26:15
Speaker 1: still kind of you know, like, is it kind of
26:18
Speaker 1: just ramping up and not everybody is up to speed
26:21
Speaker 1: just yet on it.
26:22
Speaker 6: Well, definitely in certain areas, certain major you know, city centers,
26:26
Speaker 6: it's probably a lot more available to patients. But even
26:29
Speaker 6: in a place like Beaus at Suburban Hospital, we have
26:33
Speaker 6: it available. So community hospital like Suburban has this technology
26:37
Speaker 6: and we're able to do these treatments for our local
26:39
Speaker 6: patient population, which is great.
26:41
Speaker 2: Doctor.
26:41
Speaker 1: One more thing i'd like to pick your brain about.
26:43
Speaker 1: We've all heard of pacemakers, but this is new. What
26:45
Speaker 1: is a leadless pacemaker?
26:48
Speaker 6: So what a leadless pacemaker is is a peacemaker device
26:51
Speaker 6: that's kind of been miniaturized to be able to fit
26:53
Speaker 6: totally within the heart.
26:55
Speaker 5: You know.
26:56
Speaker 6: Usual traditional pacemakers are implanted through blood vessels around the
27:00
Speaker 6: shoulder area and then the wires kind of go into
27:02
Speaker 6: and they're tunneled into the heart. With this newer technology,
27:06
Speaker 6: we're able to kind of put the entire pacemaker in,
27:08
Speaker 6: including the battery and everything directly within the heart without
27:11
Speaker 6: any wires or battery kind of being.
27:15
Speaker 5: Outside of the heart or underneath the skin.
27:18
Speaker 6: And so this allows us to be able to take
27:20
Speaker 6: care of our patients who especially are higher risk for
27:24
Speaker 6: things like infections, such as patients who are in dialysis
27:29
Speaker 6: or have had recent infections as well too, or had.
27:31
Speaker 5: A risk for other issues.
27:33
Speaker 6: We're able to kind of pace their heart without having
27:35
Speaker 6: to put those traditional wires in, which then they and
27:38
Speaker 6: themselves can.
27:39
Speaker 5: Have some risk factors associated with them. So it's an
27:41
Speaker 5: exciting time.
27:42
Speaker 6: Like I said, our field of electrophysiology with you know,
27:45
Speaker 6: with the changes in technology.
27:47
Speaker 5: You know, the things that you see in your hands,
27:49
Speaker 5: like the iPhones.
27:49
Speaker 6: Or whatever or or sorry, you can repeat that, our
27:54
Speaker 6: cell phones, you know, in our hands. That technology is
27:57
Speaker 6: kind of transferring to our field, and we're able to
27:59
Speaker 6: do procedures that you know, we're just you know, more
28:03
Speaker 6: like science fiction than anything in the.
28:05
Speaker 5: Past, and we're able to do them these days. So
28:07
Speaker 5: it's really, like I said, an exciting time to be
28:08
Speaker 5: in the field.
28:09
Speaker 1: I got to tell you, I am floored by all
28:11
Speaker 1: this information about the new technologies. It's just incredible, Doctor Amaud.
28:16
Speaker 1: We are, of course talking about Heart month. If you
28:18
Speaker 1: had to sum it up, what is one thing you
28:20
Speaker 1: would like our listeners to remember about protecting their heart health?
28:25
Speaker 1: It is so important we can't stress it enough. What's
28:28
Speaker 1: what's one main thing you want to impart.
28:31
Speaker 6: I think the biggest thing is, you know, preventive strategies.
28:34
Speaker 6: You know, lifestyle modifications are always going to be the
28:37
Speaker 6: mainstay in the base of treatment for any cardiac issue,
28:40
Speaker 6: and so making sure that you're eating healthy exercising is
28:43
Speaker 6: just going for a walk thirty to forty minutes, and
28:46
Speaker 6: I think not only does it help promote physical health,
28:49
Speaker 6: but also helps promote emotional and mental health as well too,
28:52
Speaker 6: which I think are all interconnected and important.
28:55
Speaker 1: I'm with you on that, Doctor Zishan Ahmad, thank you
28:58
Speaker 1: so much for your time today.
28:59
Speaker 2: It's been very informative.
29:01
Speaker 5: I appreciate you taking the time.
29:03
Speaker 6: And you know, if any patients are out there that
29:05
Speaker 6: would like to come and see our care, you know
29:08
Speaker 6: we're more than happy to see them at Johns Hopkins.
29:10
Speaker 5: So I appreciate the time that you've taken.
29:12
Speaker 6: To let us talk about an important issue to my heart.
29:16
Speaker 5: Especially.
29:16
Speaker 1: Yes, absolutely, that was doctor z shaunah Mad with Johns Hopkins, which,
29:21
Speaker 1: if you don't know, does have locations here in the
29:24
Speaker 1: DC area. You can find Johns Hopkins cardiac doctors at
29:26
Speaker 1: Sibley and Suburban hospitals, also community physician locations in Bethesda, Arlington,
29:32
Speaker 1: and Rockville. Again, February is Heart month. Let's all take
29:36
Speaker 1: care of ours. It is one of the most important
29:39
Speaker 1: things we can do for our health and our body,
29:41
Speaker 1: and you can find out a whole lot more at
29:43
Speaker 1: Hopkins HEARTDC dot org.
29:49
Speaker 4: Kick clean the oceans and make the world a better place.
29:56
Speaker 2: Learn more at she Can Stamps. A message roped you
29:59
Speaker 2: by the ad Council