Valley cardiologist Kenneth Igbalode, MD, talks about the reasons patients visit him for care, the latest advancements in diagnosing heart conditions and treatments, including wearable devices and a medicine that effectively lowers cholesterol. Plus Dr. Igbalode shares his top healthy heart tips. Watch video or see transcript below.
0:14 | What do cardiologists do and what type of patients do they care for?
Cardiologists are physicians who are specially trained in the prevention, diagnosis, evaluation, and treatment of cardiovascular conditions. These are all diseases which involve both the heart and the blood vessels that give blood to the heart and away from the heart. They treat a wide range of patients from the very young to the very old.
0:43 | What are the common reasons a primary care provider would refer someone to a cardiologist?
Some of the most common reasons for a primary care physician to refer a patient to a cardiologist would include chest pain, palpitations, or even a family history of cardiac disease. These conditions and symptoms need special evaluation and sometimes special tests to exactly figure out what’s going on. These symptoms can also be quite vague and it is worthwhile to see a specialist to ask the right questions and to order the correct studies to figure out exactly what is going on.
1:25 | What are some diagnostic tests or tools to assess a patient for a heart condition?
Some of the diagnostic tests and tools used to assess a patient for a cardiac condition can be broken down into where they are performed. There are many tests that can be performed in the clinic and there are some that can only be performed in the hospital setting. Some of the most basic tests, which are quite informative, include an EKG or an electrocardiogram. This is a tracing which records the electrical rhythm of your heart. It allows us to learn a lot about the rhythm of your heart and also if there is an underlying cardiac disease.
Some other tests that can be performed in an office setting include an ultrasound or an echocardiogram. This is a study which uses ultrasound technology to visualize your heart. We’re able to see the size of your heart, all the chambers within the heart, and all the valves inside of the heart. This test gives us enough information to make a diagnosis and to rule in or rule out a lot of major conditions.
Within the hospital setting, we have more invasive techniques and tools to make a diagnosis of a heart condition. These include a coronary angiogram, or also known as a cardiac catheterization, in which a catheter or a plastic tube is passed up to the heart and contrast dye is injected to visualize, in real time, the flow of blood through the heart arteries. With this tool, we’re able to determine and look for any evidence of blockages or obstructions both in an acute setting, for example a patient who has an acute onset of chest pain, or in a chronic setting where a patient has had chest pain for a while. This is part of a diagnostic workup.
Some additional tools that we have in the office include cardiac rhythm monitors. These monitors are helpful in diagnosing any electrical issues or arrhythmias that patients may have. These are small, wearable devices which go on the chest and patients can wear them, from anywhere from a day to up to 14 days, in order to make a diagnosis.
3:34 | What are some recent advances in cardiovascular treatments that you’re excited about as a heart doctor?
Cardiology has a rich history of advances both within technology and procedural care. Over the past two to three decades, some of the more recent advances that I think are very amazing include some of our medical therapy, for example PCSK9 inhibitors. These are newer medicines which are designed to help reduce the circulating levels of cholesterol in the blood. Prior to the invention of these medicines, patients relied heavily on statin medicines which are pills to help reduce cholesterol numbers. With these newer agents, we are able to reduce cholesterol numbers far lower than we could have with just statins alone. The population of patients that benefits most from this are actually those who already have established disease, meaning they’ve had a heart attack or they’ve had a stroke, or patients who are at very high risk for having one of these events, meaning they have a genetic predisposition or a familial inheritance pattern which drives their cholesterol numbers very high.
Another advancement within the field is the CT coronary calcium scan. This is a non-invasive way to assess a person’s risk of developing issues with their heart in the future. This scan is a CT which looks at the heart arteries and looks for evidence of calcification. Calcification is abnormal in the heart arteries and indicates a high-risk state. Once this state is identified, then your cardiologist is able to maximize medical therapy in order to reduce your long-term risk of having any potential heart issues. I think this has been a real game changer in terms of the prevention aspect of cardiology, and it has actually brought to light a lot of patients’ underlying issues which may have never otherwise been discovered.
5:43 | If a special cardiac procedure is needed what does Valley offer?
In terms of cardiac procedures, here at Valley we pride ourselves on technological advancements and doing what we can to modernize procedural therapies. For more complex coronary conditions, we now have a couple of devices which allow us to better treat complex disease. Before having these devices, here at Valley, patients would have to go downtown for their care. We now have the devices here to help us to deal with calcification within coronary arteries which makes standard interventions more difficult. These devices work to break up the calcium within the blood vessel so that balloons and stents can expand more easily within the blood vessels. Before this year, we did not have this technology at Valley. But now that we have it, we’re able to deal with more complex cases.
Additionally, we have devices which are able to support a heart that is weak. When a patient has very low blood pressure and they’re unstable, we have devices which are able to relieve the workflow of the heart and allow the patient to be stabilized so that we can deliver the care that they need.
7:05 | What are some cardiac signs or symptoms that people should not ignore? How may symptoms differ between men and women?
I would say any symptom which is associated with strain or effort always raises suspicion for a cardiac issue. The symptoms that may arise during strain can include chest pain, chest tightness, or chest pressure, also as well as shortness of breath. Anytime you have these symptoms with hard work you should talk with your primary care doctor, and potentially based on your risk factors or family history, be referred to a cardiologist for further evaluation.
Between men and women, it is known that symptoms definitely differ. Men typically will have more classic symptoms of chest pain or angina, which typically is a heavy weight or a crushing pressure sensation on the chest. Women have more atypical features, which may be anything from shortness of breath to indigestion, abdominal pain, neck pain, or jaw pain. In fact, there is no difference between men and women in terms of rates of heart attack, but unfortunately women are more likely to die from a heart attack just because they are not diagnosed quickly.
8:19 | What are some healthy habits people can do to try to prevent the need for a visit to the cardiologist?
Some healthy habits that people can do to avoid a trip to a cardiologist include making sure you get plenty of exercise. When I talk to my patients, I like to counsel them on what is exercise. Exercise is something that gets your heart rate up and gets you sweating. In fact, there was a recent study that showed that if you were able to do at least 150 minutes of moderate intensity exercise or 75 minutes of vigorous intensity exercise over the course of a week, you were able to reduce all causes of death by at least 20%. Moderate intensity exercise includes things like walking or even weightlifting. Vigorous intensity exercise is things more in line with jogging, swimming, biking or running. Doing these things daily helps to keep you in a habit and to improve your overall cardiovascular health and fitness.
Another healthy habit is to improve your daily diet. We know that diets that are high in cholesterol, saturated fats, animal proteins, and sodium (salt) all lend themselves to a higher risk of cardiovascular disease in the future. Working to decrease eating red meat, for example, will go a very long way in improving your cardiovascular risk. Another important topic is sodium. There’s a lot of sodium in the daily diet, especially in processed foods. Sodium also lends itself to water retention which can also increase blood pressure which puts stress on the heart. By eliminating or reducing sodium in your diet, you can go a long way in relieving the stress on your heart and improve long-term outcomes.
For more information go to valleymed.org/heart.