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A short course of lectures
«Heart health: answers at your fingertips»

I had a heart attack over a month ago and I now feel completely better. I am frustrated that my doctor wants me to vegetate at home! When will I be allowed to lead a normal life again after my heart attack?So how much salt do we actually need in our diet?I have felt well since being on HRT but I am worried about its effect on my heart and the risk of breast cancer - what should I do?I should like to go walking but I'm afraid to walk alone - I'm always reading in the local paper of women being attacked. Isn't it rather dangerous to walk on my own?SELF-HELPEMOTIONAL PROBLEMS AFTER A HEART ATTACKHow often should my blood pressure be checked?Why are doctors so sceptical about alternative medicine?The article that I read also mentioned vitamin E as being beneficial. Why is it important?My doctor has told me that I have will have to undergo some tests to check to see whether I have atrial fibrillation. What will this involve?FOOD TYPES AND EATING HEALTHILYIf I'm fit why should I quit smoking as well?I have heard the nurse talk about a waist/hip ratio. What is this? Does it apply to my husband as well as me?Since I came back from hospital following a heart attack, I've had no interest in making love. It upsets my partner and frustrates him. What should I say to him?Can my husband's chest pain be from causes other than heart disease?Does the effect of Viagra wear off the more you use it?StressIf you can balloon a narrow valve without heart surgery, can you replace valves also?I am on treatment for high blood pressure. I know that some medications cause side effects. What should I look for?I thought that people supplementing their diet with extra beta carotene from the health food shops had a lower chance of developing heart disease or cancer. You say that there may be risk of developing these conditions - which view is right?OTHER ABNORMAL HEARTBEATSI have been asked to go for tests to see if I have valve disease. What will these involve?I always thought that having a heart attack was the end of the story. Now you give me the good news that nearly everyone recovers nowadays. Is this true?My friend has taken so-called diet tablets. Do these work?SAFETYAngiogramI've been very worried when I had two attacks of rapid heartbeats recently. Are there any types of palpitations that are dangerous?My doctor tells me that I need digoxin to help my heart. Why?I have diabetes and have now been told that I have insulin resistance and am at risk of heart disease - what is insulin resistance?Valve diseaseI do find the advice on HRT confusing - can you clarify it for me?HEART ATTACK - THE EVENTI have an appointment at the hospital for a nuclear scan. This sounds rather dangerous to me. Is it harmful and how is a nuclear scan done?Taking your medicationI had a valve replacement some months ago. How will I know if I have developed an infection?TESTSMy doctor placed me on eplerenone because I developed heart failure after a heart attack. How does it work?Are there any other types of surgery for valve disease? I have been told there is something called 'balloon surgery'. What is this?I thought alternative medicine practitioners were all trained. Isn't this so?I have been feeling tired and lethargic lately. Do you think my tablets are causing the problem?What exactly is a 'portion'?TESTSThe doctor often recommends that I should eat more fibre. Is fibre important in my diet?I have read that garlic is very good for high blood pressure. Is this true?I have tried Viagra but it only partly works - how can I improve things?I have been diagnosed with angina. Will heart disease affect my sex drive?I have been told that I have heart failure. Is heart failure dangerous?I'm really depressed after my heart attack, which is unusual for me as I am usually 'bubbly'. My doctor tells me that this is normal after a heart attack. How will I know if I am 'medically' depressed rather than just 'down'?How your heart worksShould I discuss the diagnosis of heart failure with my family?Is the angiogram procedure dangerous?I'm going to have a complete check-up next month. When I have my cholesterol profile checked, what levels should all these different fats be?TESTSI have been prescribed cholesterol-lowering medication, although I am only 50. Will I always need medication?I am in my twenties and am getting rapid heartbeats every so often. I work in the type of job where results are all important. My husband has just lost his job as well, so sometimes I feel really stressed. Should I go to the doctor?WHAT CAN GO WRONG WITH MY HEART?Am I likely to get more chest pain after I have recovered from my heart attack?MedicationI have angina, but I want to live an active life. Is there any activity that is likely to bring my angina on?I have been taking the pill on and off since I was 18. I have just been through the menopause. Am I at any greater risk of heart disease because I have been using oral contraceptives?I had a heart attack a year ago when I was 61. Is it too late to stop smoking?I have had a heart attack and even though my cholesterol was only 4.51 have been put on a statin - why is this?I'm 62 and my doctor is making me cut down on salt as she says that I am getting more sensitive to salt. What does this mean?I've read that poor dental health can cause coronary heart disease - is this true?I am the one who has had a heart attack, but I now feel fine, perhaps a bit low sometimes; but my children really blame themselves over what happened. Why do they feel guilty?Drugs are much cheaper on the Internet - is it safe to buy them?My husband has lost all interest in sex even though he has made a good recovery from his small heart attack. Is it my fault?RECOVERY PERIODSugarCan you give some simple guidelines regarding calories? How many should I need on a daily basis?QUESTIONS YOU MAY FIND DIFFICULT TO ASK YOUR DOCTORWhen should I dial 999 rather than just call a doctor?Beta-blockersGarlicMy husband has got angina. He is obviously in pain but cannot describe it easily. What does it feel like?How is blood pressure measured in the clinic?Besides fruit can you suggest some healthy snacks?SurgeryMy husband has just been told that he has atrial fibrillation. Is this dangerous and can anything be done to help him?What is a smoking cessation clinic - is it worth a try?NitratesI've read about a new medication called Physiotens which was called a breakthrough for blood pressure treatment in my newspaper. Should I get my doctor to put me on it?How quickly should I lose weight?The hospital has written to me and told me that I need a test called a SPECT. What is this?What are the valves?Are herbal cigarettes or dummy cigarettes worth trying?What sort of HRT therapy is available?What is the difference between soluble and insoluble fibre? Should I eat both?Can pacemakers be troublesome?SYMPTOMSThe use of aspirin as a preventative drug has been discussed a lot in the media recently. What does aspirin do?I have changed to a low-tar brand of cigarettes, with a filter. Why will smoking be so harmful to me now?Can I mix medications?Should I know my cholesterol and other test level numbers? Will it do any good?I have been prescribed diuretics. What are these?Can lowering cholesterol levels be harmful, as I have read that lowering cholesterol increases the chances of suffering a violent death or suicide?I was told that all cholesterol is bad for you. Now I read that there is a 'good' cholesterol and 'bad' cholesterol. What's the difference?I feel that I am stressed at the end of the day. What can I do?Potassium channel activatorsI am told that I have high blood pressure and need treatment, but I don't seem to have any symptoms. If I do not feel unwell, why should I need it?I am 46 and sometimes feel odd sensations in my chest. Are these to do with my heart? How will I know if I have a heart problem?My mother has been told that she is 'at high risk' of a heart attack. I am her carer and am worried about her. What should I do if I think she is having a heart attack?TreatmentWhat are artificial heart valves like?DietAre there better ways of cooking I could try?TYPES OF PALPITATIONSWOMEN AND CORONARY HEART DISEASEWhat medication will I be offered to treat my atrial fibrillation?I drink quite a few cups of coffee a day. Is coffee bad for the heart?What is the heart?CAUSESAre Chinese herbs the same as our herbal medicines and can they help?What is there, apart from medication, to treat angina?I have heard a lot about the benefits of wine. Is wine better than beer or spirits?What medications are there to treat high cholesterol levels and are there any side effects?An appointment has been made for me to go to hospital for electrophysiological (EPS) tests. What are these?How many calories are there in alcohol?I am told I need an angiogram but I saw on TV a new kind of angiogram using CT scanning. What's this?Can I help monitor my heart failure at home?My cardiologist has mentioned cardiac ablation. What will this involve? Is it safe?I've tried walking 1 mile a day and I find that I get bored after a month. What else can I do besides walking?There are times when I really fancy a steak. Should I never eat this?My partner has recently had heart surgery but has been given the all clear. Are some positions during lovemaking dangerous?My wife has heart failure and gets very breathless. She was prescribed nitrates at her last visit to the doctor. What are these for?I have read about a new cholesterol drug called Ezetrol - when is this used?What types of exercise are good for the heart? I have been doing weight lifting for years - is it of any help to my heart?The nurse at our practice runs a clinic to test blood pressures. What is blood pressure exactly and why is it so important?All I hear about is men's problems - do women get sexual difficulties and can they be helped, with Viagra for example?I have a very stressful job and find that I get really nervous. My heart seems to miss a beat when I am stressed or anxious. Is there anything that can help me?What is the pericardium?How do I know if the fish is fresh? I would hate to get food poisoning.I am not too sure what the 'placebo factor' means. Can you explain this to me?How does a faint differ from a blackout?Why do I feel so angry about what has happened to me?What sort of treatment is there available for me now that I have been diagnosed with atrial fibrillation? Can I just be treated with medication?I have heart failure - can you tell me which drugs I should be taking and why?What drugs should a heart attack patient be taking on leaving hospital?Self-helpIf tablets don't work do I have any other choices?I had a heart attack recently. My cardiologist tells me that my heart has weakened and that I have now got heart failure. Will the symptoms be noticeable?ECGI have been told to go to the hospital for an angiogram. What is this and what does it involve?While I am taking my tablets, can I lead a normal life or is there anything I should avoid doing?I had heart surgery 3 weeks ago. My husband is keen to make love again. Can I resume lovemaking safely?Why do we have to say 'heart attack' when calling an ambulance?I've read about exercise and there is often a mention of METs -what are they?What happens to my heart when I am making love?I know I should eat more vegetables and fruit in my diet to lose weight. Which ones have the least calories?ExerciseCalcium antagonistsMy daughter has been diagnosed as having cardiomyopathy -what is this condition?A friend of mine had a heart attack after taking Viagra: it seems dangerous to me. What do media reports say?I have heart failure and find that sex is too much effort. What can I do?According to the TV ads, some margarines seems to be a good way of lowering cholesterol - do they really work?Both my husband and I smoke one pack of cigarettes a day. I have recently read that women are as much at risk as men. Is this true?I have had test after test until I feel that I could not be tested further. I now have been summoned for a nuclear scan. When is nuclear scanning specifically helpful?Going to hospitalSYMPTOMSTo be honest, our love life wasn't up to much before the heart attack. Will it get worse?Why is so much emphasis placed on stress in the media?I have a very stressful job. Am I more likely to get heart problems?Should I be taking beta-blockers?How will I know that the palpitations are due to atrial fibrillation?I have been diagnosed with valve disease. What do you think is likely to have caused it?I am in my early fifties and have had a heart attack. Am I too old for sex?Could alternative medicine with acupuncture, homeopathy or herbal therapy just be a placebo effect?My blood pressure seems to be resistant to many drugs and I have now been put on spironalactone. How is this different?I have been on cholesterol-lowering medication for some time now. When I go for a check-up, my doctor checks my liver. Why?Is there any way I can reduce my stress levels?I am now 51 and made a resolution on my 50th birthday to take exercise regularly. I found that my good intentions fell away after 3 months when I was ill for a week with flu. What do you suggest might help now?Are there any side effects to the nicotine preparations?Does oral or anal sex stress the heart?I've heard about an operation to reduce the size of the heart by cutting out a piece of heart muscle. It is claimed to help heart failure. Should I consider this before a transplant?When I am in the supermarket, I get confused as to which foods are best for fibre content. Can you tell me more about which contain more fibre?When I was in hospital for a valve replacement, one of the patients there had developed an infection. Is infection common? Is it likely that I shall develop an infection too?I want to be healthy and not overweight - can you summarise for me the most important ways of achieving this?Do you think there is place then for alternative medicine or should I ignore it?How long do these different types of valve last?I have been trying to find a support group - can they help me?DrinksI have had an unpleasant jolt, having a heart attack. I suppose that I ignored the advice and warnings. Now I am determined not to lose control again. My doctor says it's heart failure. What can I do to help myself with my heart problem?My friend in America is taking nicotinic acid (niacin) for her cholesterol - is it available here?What should my intake of fats be?I cannot stop smoking. Would it help if I just cut down on my smoking?RISKS OF HIGH CHOLESTEROL LEVELSA friend of mine has a defibrillator for atrial fibrillation - is this a new treatment?I have seen two different charts for an ideal weight. What should my target weight be?I have heard of newer Viagra-like drugs - are they any different?If I could stop smoking, would this do any real good?TREATMENTWill I be able to recognize the symptoms of dangerous levels of stress?I find the whole business of BMI confusing - can it be made simpler?Why will exercise do me good?I am a mother aged 53. I am concerned to read that coronary heart disease is a major risk for me. Isn't this a man's disease?How will I know if the diuretics are working?I know of people taking beta carotene supplements and our health food shop is always marketing it. What is beta carotene, and should I be taking it?I am absolutely miserable when I go on a slimming diet - it never works anyway. What is so wrong with being fat?I have seen cholesterol self-testing kits in the chemists. Are these any good?My wife has been ignoring these blackouts because they don't happen too often. Should I get her to go to the doctor and have them investigated?Should I be doing anything about what I eat?What drugs should I be on to help stop my angina problems coming back?I have read about type A' and 'B' personalities having an effect on the heart. What is the difference between them?I have just had three attacks of palpitations in a week, which made me very worried. By the time I got to see my doctor, they had gone away. What should I do if I get another attack?I have heard that some echocardiograms are done by the patient swallowing a tube. Is this true and, if so, what is happening here?ExerciseIs an artificial heart another option for me?I have been told that I have heart failure but was also informed that I will not need treatment for some time; why not? And, if I have to have treatment in the future, what might it consist of?How much do these products cost?I have tried all sorts of self-help methods but I keep getting palpitation attacks; when should I see the doctor?Measurement of blood pressureForewordI have rather a sweet tooth. Is sugar really that bad for you?How do I read food labels and what do the figures mean for me?HOW MUCH?My husband has heart failure but the doctor says his heart is OK, he's just anaemic. How can this be?What happens after I have had my angiogram?My doctor has mentioned cardiomyoplasty but was not very enthusiastic about it. What is this operation?I have always believed taking vitamin supplements would protect me - are you saying this is not true?I know I have to lose some weight. Have you any general tips?I've given up smoking but I am afraid that I might begin again. Will it put me back to square one if I start again?I have been on a slimming diet and managed to lose some weight. How can I keep the weight off now?My cholesterol was checked 2 weeks after my heart attack. It had gone right down, but my hospital doctor did not seem as pleased as I was. Why not?I have been diagnosed as having unstable angina. What is this?I have read in the paper about a new drug called raloxifene -what advantage does this have?My wife was told that she is going to have a PET scan. How is PET different from SPECT?I have heart failure. Am I right to be worried that I will not be able to lead an active life?What happens when things go wrong with the coronary arteries?I have an appointment for an exercise ECG. How should I prepare for it?Facts and figuresHow I should begin my exercises?I read in the newspaper and saw a report on TV that calcium antagonists can be dangerous - is this true?How often do sports players collapse and die?I have read a lot about what I should do, now that I am home after my heart attack, but there seems to be too much to do at once.Medication Is there any difference between an angiogram from the arm or the leg?I'm over 60 and have never really taken exercise properly, though I live an outdoor life. Am I too old to exercise now?OTHER RISK FACTORS FOR CORONARY HEART DISEASEMy doctor wants a special echocardiogram to see if I might benefit from a pacemaker. What is this about?I have heard a lot about Zyban. Does it help stop smoking and how does it work?INFECTIONA friend of mine had a heart attack recently and is still in hospital. She rang me to say that she was coming out soon. Will she be completely dependent and unable to look after herself? What can she do for herself after leaving hospital?What sort of foods should I eat to cut down on my fat intake?Can I take other medicines while I am on any of these heart failure tablets?What should I do to help my recovery after my heart attack?I am in my sixties and have developed rapid heartbeats in the last few weeks. I like to drink with friends most evenings. Do you think I am drinking too much?I still feel very moody at times after my heart attack. Why is this?I have been to the doctor because I was so worried about these rapid heartbeats that occurred. He has given me a little machine to record any attacks that I get in future. Can you tell me more about this please?You hear horror stories about the dangers of exercise, from slipping a disk to straining muscles, or even dropping dead! Are there any 'commandments' that I should be following?I can honestly say that I have never taken any exercise, but my doctor tells me that I need to do so if I do not want more heart problems. For how long should I exercise?My doctor has taken me off water tablets and put me on ACE inhibitors, which don't agree with me at all - they just make me cough all the time. Why?I have been prescribed warfarin. I thought this was rat poison! Why am I taking it?My ECG last week was absolutely normal. However, because the doctor still thinks that I have angina, I have got to go for more tests. Why?Can complementary therapies do any harm?What is the aorta?My doctor says I have a hibernating myocardium. What does he mean?CAUSESYou have not mentioned Aldomet. I am pregnant and my doctor prescribed this medication for my blood pressure. Why did she choose this rather than the others that you have talked about?Can you give me some advice in preparing for sex since my heart attack?Do I need to starve for the blood test?The doctor at the hospital told me that I have heart failure. For some reason, he told me to report back for a chest X-ray. Why do I need a chest X-ray for heart failure?I am rather nervous about having a pacemaker fitted. What will it involve?Sometimes when I drive, for instance in the rush hour, I get angina symptoms - am I wise to carry on?How long after my angiogram will I get my results?What are the symptoms of a heart attack?Can I become addicted to the nicotine patches?Can you tell me more about blood pressure? Why is it serious if it becomes high?I have tried again and again to give up smoking. Are there any 'safe' cigarettes?When I went to the clinic to have my blood pressure checked, I was told that I had white coat hypertension. What is this?What relieves the pain of angina? Do I have to take medication?It sounds like a big operation. What are my chances of pulling through?Being overweight - obesityI know that I eat too much salt and my blood pressure is on the high side. What foods should I try to limit?I have heard that herbs can be helpful in heart disease and angina. Can you give me some advice?I don't do much exercise. Would exercise help me to give up smoking?MRI does not involve X-rays so can I have an MRI instead of an angiogram?I quite like fish but it can be expensive. How much is it recommended that I eat each week?I sometimes get a pain after eating. The doctor told me this was 'post-prandial angina'. What exactly is this?HELPING YOURSELFI drink rather a lot of coffee. I have heard that caffeine is bad for the heart and I must admit that sometimes I feel that my heart has missed a beat. Am I about to have a heart attack?When should I have a repeat cholesterol level test?What types of food have low or high levels of fat and cholesterol in them?Which is more important - to avoid foods high in cholesterol or saturated fats?RISKS OF SMOKINGI have been advised to go on HRT but I am resisting as I have read that it doubles your chances of getting blood clots in the legs - is this true?OTHER TREATMENTS FOR ANGINAWhat happens if my second cholesterol level test is still raised?TREATMENTMy wife and I have always had a vigorous and adventurous love life. Now I am worried that I may get angina while I am making love. Is this likely?AnginaMy brother has had a heart attack - according to the hospital. He says that he did not feel it happening. I thought a heart attack was painful.What causes high blood pressure?My partner is very stubborn and simply refuses to go to hospital. He is getting on now and not strong. He has been a life-long smoker. I do not want to upset him by making him go to hospital if he had a heart attack. Would he be able to stay at home?My father had heart disease and I am concerned that my daughter might develop heart disease also. I know that she smokes. How can I help her avoid heart disease?We have a full social life and I am often out during the week at business lunches. How can I avoid fatty foods when I am out?Can you tell me what causes a heart attack?TREATMENTI have had diabetes for 30 years. What is the effect of diabetes on heart disease?I have heard that bananas are very good for you. Why is this?I have recently heard that heart attacks can be caused by exhaust pollution. Is this true?I worry that my teenage daughter might have access to drugs. Do illegal drugs affect young people's chances of heart problems?Can pacemakers be used to treat heart failure?You have talked about vitamin E. What about vitamin C - isn't this an antioxidant as well?Nitrates help my angina but I would like to try Viagra - what should I do?My girlfriend has suggested that I change to a pipe as she is convinced that pipes and cigars are safer than cigarettes. Is this true?SYMPTOMSTwo or three of my friends now have a pacemaker. Although I have 'funny' heartbeats, I have not been offered one. When are they used?RISKS OF HIGH BLOOD PRESSUREAre there any specific risk factors for high blood pressure that might apply to me?What happens if I get angina during sex after taking Viagra?A friend of mine went to an acupuncturist to help her stop smoking and she has not smoked now for some months. I have also read that hypnosis can help. Do you think that any of these methods is any good?I am taking medication for my heart problem. Can medication affect my sex life?My local recreation centre offers 40 different sports from judo to meditation. What is the best form of exercise to do?Bypass surgeryWhat types of alternative therapy are available for people with heart problems?SurgeryI'm not keen on fish - can I have fish oil capsules instead?Would it help if I saw a dietitian?I am 58 and have been smoking for many years. Is it ever too late to stop?My doctor tells me that my systolic pressure is very high, although the diastolic pressure is normal. Does this matter?My husband has gone into a Coronary Care Unit. What will happen when he returns to the general ward?If I eat fish twice a week, will it allow me to eat what I like for the rest of the week?Are you in favour or against alternative methods of treatment?TESTSSaltAre there any risk factors that I can't change?FibreI lead a very busy life and just do not have time to exercise. Is there anything I can do?I think the machine that I am to be given is called an event recorder. Is this different to the 'Walkman'-type recorder?Have you any tips for cutting down on sugar?Illegal drugsWhat are the symptoms of heart failure?If my wife feels faint, what should I do to help?I'm worried that I might overdo things. Should I take any special precautions before exercising?I know that vegetables are good for me because they contain fibre and vitamins. I have heard that boiling vegetables loses the vitamins. How should I prepare fruit and vegetables to get the maximum benefits from them?Last time I tried jogging, I tore a calf muscle and was off work for 2 weeks. How can I avoid this happening again?What should I get my cholesterol levels down to in order to see a benefit to my heart?Should I be taking aspirin? I have heard a lot about it in the media recently.Coronary heart diseaseWhy do I need blood tests for heart failure?Self-helpI'm on HRT at the moment. Do I need regular check-ups?WHY BOTHER?I am in my forties and have always hated competitive sport but enjoy walking. Is there a simple walking programme I could start?My doctor has only measured my total cholesterol level. Is this enough, or should I ask for all the different levels to be measured?I have read of footballers and other sports people dropping dead from HOCM - what is this?I always thought that angina was a man's problem. Do women get angina?I've not yet tried quitting as I am frankly unable to cope with going 'cold turkey'. What can I expect as withdrawal symptoms when I stop smoking?A friend of mine was told to judge his exercise by the talking test. What is this?Are the causes of heart failure known?TREATMENTI am on the mend after a heart attack - a nasty shock! How will I feel in myself when I return home?Is it really necessary to know my heart rate?How will I recognise valvular disease?LOSING WEIGHTI don't feel overweight but the doctor says I am. Have I got more chance of developing heart disease because of this?The government gives us dire warnings about smoking but I know many people who smoke who are in their seventies or eighties. Are the statistics regarding the harmful effects of smoking really as bad as the press makes out?I have reduced my cholesterol level so that the tests are now normal. Can I go back to smoking?What is 'exercise with a purpose'?One of my friends is taking Champix - does it work?I have a busy life and am not sure that I can set aside half an hour every day for exercising. Is my effort wasted if I do not take exercise every day?BLACKOUTSTreatment of atrial fibrillationWhen I asked my doctor how my heart works, he said that it would take too long to explain! Can you tell me simply how the normal heart works?My doctor is sending me for an ECG next week. I am not sure what this involves - will it mean time in hospital for an operation?I have just had a test for irregular heartbeats and been told that I have atrial fibrillation. What is this?I have been diagnosed as having heart failure. Will I be able to have a heart transplant?Everyone has heard about Viagra. My husband has a poor erection: will it help him?I am recuperating from a severe heart attack. How can I tell when I am overdoing things?Will I be able to avoid a heart attack?My husband has been told that he has a high blood pressure. The doctor gave him a diet sheet. How can a better diet help him?When I had a lipid profile done on my blood, the doctor told me I had hypercholesterolemia. What does this mean?Would it be better if I used a filter?What does a heart transplant involve?Does HRT have any side effects?CHOOSING YOUR EXERCISESince being on blood pressure pills, my husband is having a problem getting an erection. Is there a connection?I am going to start an exercise routine. How will I be able to work out how many calories I use up?You keep emphasizing the importance of going to reputable shops to buy herbal medicine. Isn't all the information we need on the label?I have been on oral HRT for some months and my doctor has arranged for me to have a lipid test. Why?Isn't it possible to keep fresh fish in the fridge for a week?If I miss a meal because I am travelling or I am on business, what can you suggest as an alternative?What are the dangers if I can't get my high blood pressure down?I'm fit and active with no risk factors for heart disease - will I benefit from HRT?AngioplastyWhat should I do if I forget to take my tablets?Are there any warning signs that might point to an impending heart attack?I've tried all sorts of slimming diets and nothing seems to work -what can I do now?I have heard that meditation can help people to stop smoking. Do you think it works and is it worth the effort?My wife and I went to the doctor's to get our blood pressures checked. Hers was different to mine. Why?I know there is a good deal of fibre in breads and cereals. What about their calorie value?I have read that fish oil is very good for you. Can you tell me about this?I am not too sure what the adrenal glands are for. Can you explain their purpose?I have raised blood pressure and my doctor tells me that I must cut down on my salt. Why is this?How would I know if my blood pressure was raised?ANATOMY OF THE HEARTThere is a lot of talk these days about lipids and cholesterol and now I've seen something about triglycerides! I am rather muddled about it all. Can you tell me what all these words mean?I am put off exercising because, in my exercise class, everyone else seems much fitter than me. Why is this?How well will a healthy diet lower my cholesterol?I'm taking aspirin every day - do I need to stop this for the angiogram?I have had my angiogram and my arteries are clear, but I still have angina. My doctor says that I have Syndrome X - what does this mean?Do different emotions affect the heart adversely?I am going for tests at the hospital next week for palpitations. Will I be offered any medication to treat irregular heartbeats?I am going to have a pacemaker fitted next month - are there different types?I have often seen home blood pressure monitoring machines in high street chemists, but they are pricey. Are they any good?Is there an alternative to 'clot buster' drugs for heart attacks?You have mentioned before that Asians have a higher incidence of coronary disease and diabetes - what dietary changes can they make?TreatmentHow is an echocardiogram performed?FatsMy father had a high cholesterol level and died aged 55. My wife is concerned that I may be like him -1 am now 52. Can this be inherited?I have always hated exercise. Now that I have had a heart attack, and presumably should take things easy, my doctor tells me that I need to take more exercise. What exercise should I be doing?What tests might I have to undergo for angina?I have had tests for valve disease and have been put on a waiting list for a new valve. It all sounds rather frightening -what will this involve?I occasionally get palpitations. Now that I am approaching 50 are they going to get worse?I am home from hospital after having had a heart attack. Will I need surgery or angioplasty in the future?When I was 16, my blood pressure was lower than it is now that I am 45. Is this OK?I have been on warfarin tablets for some time now, to prevent blood clots. Do I need to stop or reduce my warfarin before the angiogram?PalpitationsSYMPTOMSYou mention talking to my doctor before I start exercising. Do I really need a medical check first?Facts and figuresHOW YOUR HEART WORKSWhat tests can I expect to have if my blood pressure is found to be raised?I have heart disease and am finding that I occasionally get attacks of palpitations. Is this serious?Does the fact that I have valve disease mean that there is a greater strain on my heart?I recently read about spironolactone. Will this be given to me?I often feel that my heart has missed a beat. Is this serious?There was something in the media about a problem with grapefruit juice interacting in some way with medications. Should I avoid the fruit or juice completely?I had a heart attack recently. How soon can I start making love again?We were so grateful that my brother did not die from his heart attack. Why do some but not others die from a heart attack?Will I be able to resume a normal sex life after a heart attack?Does regular exercise help prevent me from getting a heart attack during sex?The media has also talked about the harmful effects of trans fatty acids. How can I avoid them?There is so much advice about fat intake that I really don't know what to believe. How much fat should we eat a day?TREATMENTIs casual sex more stressful to the heart than with a partner in a long-term relationship?I have smoked since my teens just as my father and grandfather did. My father is still alive and my grandfather lived until he was 65. What are my risks of heart disease?I know that the heart beats automatically, but what, if anything, keeps it going?I know people who have given up smoking, but then put on weight. How can I avoid this?Now that I have been prescribed tablets, how long will my treatment last?There is a heart testing machine at my local gym, but frankly I do not understand what the figures mean. What should my maximum heart rate be?When I went to see the cardiologist, he was very frank with me and said that the type of heart rhythm that I had was rather dangerous. He wants to insert an implantable defibrillator. Is this a type of pacemaker?There seem to be a lot of different methods of helping abnormal heartbeats. Why was I offered electric shock treatment and not a pacemaker?ATRIAL FIBRILLATIONWhat is the difference between angina and a heart attack?Before my heart started to play up, I was very active. Will I be able to go back to that sort of activity when I have had my pacemaker inserted?I am told that I have a high cholesterol level. If I manage to lower this level, will this really prevent heart disease?I get indigestion on aspirin - is there an alternative?My sister is very concerned that she has been given an appointment to have an echocardiogram. What is this?I am about to undergo valve surgery. Are there any problems associated with valve replacement?SnacksI have breast cancer which is now controlled, and I have also had a heart attack - will HRT help me?I have read about the rule of halves, but did not understand it. Could you explain?What makes the exercise test abnormal?What keeps the right and left heart apart?Why do some people smoke like chimneys but live a long life all the same?My wife has suffered from blackouts recently. Can you tell me what these are and what causes them?Is it safe for heart patients to try the Atkins diet?When I look at a food label, there are different types of fats listed, such as saturated and unsaturated fats. Can you explain more about the differences between the types of fats?I have been diagnosed as having atrial fibrillation. What could have caused this?What does an exercise ECG involve?I'm concerned that my wife is at risk of heart disease and I want her to take it seriously; she smokes and is rather well padded! However, her doctor does not seem to be bothering either. What should I tell her?DiabetesI have read that women's natural hormones protect us from heart disease. Is this true?I don't mind taking one tablet a day, but one of my friends has so many that she rattles. Will these tablets be all that I need to take?Sex and the heartDo all diseased valves need an operation?You sometimes hear horror stories of people dying while they are making love. Are these stories true?When I was at work the other day, I suddenly felt my heart was working overtime -1 hadn't even been rushing up the stairs! What was happening?When I have finally got my cholesterol level under control, how often should I have it checked?We have a local Weightwatchers group in our area. Are slimming groups any good?My husband has angina and I am worried that he may not survive a heart attack. What can I do if he has one suddenly -and what should I tell his friends to do?I have read in the paper about laser surgery. This sounds exciting - is it being used everywhere?AcknowledgementsWhat treatment will I be given when I leave hospital following my heart attack?Someone told me that nuts were good for reducing coronary disease - should I eat them regularly?Someone told me that one particular medication for blood pressure makes your hair grow - is this true?My doctor says the exercise test is equivocal, so he can't be sure if there is or isn't a problem, and is sending me for a nuclear scan. Will I be radioactive?DietFrom the point of view of heart health, who will benefit most from taking HRT? I have been taking HRT for 7 years and I think that it is wonderful -1 now feel a new woman! However, my doctor says that I should stop it soon. How long should I continue taking HRT?Tests for atrial fibrillationI've got a tracksuit and trainers. Do I need any other special clothing to exercise in?Does HRT raise blood pressure?What is the commonest heart problem for me to watch out for?If the heart valves are to blame for weakened muscle, can they be replaced?Are there other heart drugs that may react with Viagra?What is the difference between white fish and oily fish?There is a lot of talk about the harmful effects of passive smoking. Can other people's smoke really harm me?What happens if something goes wrong later? Can valve operations be repeated?I have resumed sex after my bypass and there are no problems, but I'm afraid that it might do some damage to the operation site. Is this possible?I know that I get angina and have learnt to recognise the symptoms. How will I recognise the difference between the pain of angina and that of a heart attack?GlossaryThere seem to be a lot of different medications on the market for raised blood pressure. Why have I been given one and not another?Heart attacksMy husband has heart problems and I am told that he is 'at risk'. If he had a heart attack, what actually happens after hospital admission?I am on medicine for angina and I still often get pains. If I get an attack of angina, it is difficult to know when I should bother the doctor. What should I do?My mother had high blood pressure and she suffered a stroke when she was 65. Can I avoid having hypertension myself?My partner has been diagnosed with heart failure but no one would guess on meeting her. However, she does get breathless at night. Why is this?My husband went straight for an angioplasty even in his outdoor clothes - why did they rush?When I went to see my doctor, he measured my blood pressure and put me on tablets straight away. Why was this?If the heart rate is increasing, is sex stressful to the heart?What happens after I have been discharged from hospital, following the angiogram?Preface to the fourth editionHow will exercise help me?I have heard that K-Y jelly can be useful if lovemaking is a problem or painful. How safe is it to use?I have heard that blood pressure pills can affect your sex life - is this true?Is the angiogram at all painful?I read in the newspaper that ED could be a marker for silent coronary disease. Is this true?My cardiologist has advised a defibrillator as well as a pacemaker. Why both?I have seen adverts for nicotine gum and patches. I smoke about 20 a day. Would nicotine replacement help me?Can you tell me what the coronary arteries are?I have been told that I am going to have shock treatment for atrial fibrillation. What will this involve and is it dangerous?I like to have a drink now and again. How does alcohol affect my heart?We live in the country and fortunately have a very good local hospital. However, it does not have a coronary care unit like the general hospital 40 minutes away. Our doctor has advised us to go to the coronary care unit in the event of my husband having a heart attack. Why?I am bitterly disappointed because I have lost weight and reduced my salt intake, but I have been told that my blood pressure is still raised. What should I do?Heart failureI have tried to stop smoking but always lapse. What can I do to quit smoking and avoid the temptations?
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