Episode Transcript
Courtney Collen (Host):Hello and welcome. You’re listening to the Health and Wellness Podcast brought to you by2022世界杯巴西阵容. I’m your host, Courtney Collen with Sanford Health News. This series begins new conversations and continues the important ones, all designed to keep you well, physically and mentally. In this episode, we are focusing on heart health, specifically heart and vascular screenings and everything you need to know.Ahmed Abuzaanona, M.D., is a cardiologist at Sanford Health in Fargo and joins us now for this conversation.
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Dr. Abuzaanona, welcome. Good to have you.
Dr. Ahmed Abuzaanona:Yeah, thank you for having me.
Host:As we talk about heart and vascular screenings, why are these so important?
Dr. Abuzaanona:Screening, by nature, means that we are getting a patient or an individual who doesn’t really have any symptoms or known disease, and we’re trying to find out if they’re at risk of having a particular heart problem or vascular problem in the upcoming few years. That means if we discover it early in the process, we can do a lot more about it to curb the problem and make sure we don’t progress into a real event, because a heart attack for instance, can be a very dramatic event that can lead to a lot of complications.
Host:Talk about some of the common signs or symptoms that might lead to heart health concerns, heart disease, or may eventually result in a heart attack.
Dr. Abuzaanona:It can be different for different people. We know any discomfort in the chest area or even the upper abdominal area, the upper part of the belly, can be a sign of heart attack. Women can have additional symptoms like maybe nausea, a little bit of vomiting or shortness of breath, rather than the typical heaviness of chest that we were taught as a sign of a heart attack. So, heart attack can have a lot of symptoms. Now, outside of that, heart disease in general can have different symptoms that can be bad lightheadedness, bad palpitations, which means like fluttering sensation and fast heartbeat sensation. It could be shortness of breath, doing things that you are capable of doing weeks before, or swelling in the ankles, or it can be chest pain that maybe not as dramatic, but tends to happen frequently, when an individual is doing things that are their daily activities or exercising. So there are multiple things that the heart disease can present with.
Host:So when we talk about a heart or vascular screening, what’s the difference and how would I know which one I need?
Dr. Abuzaanona:That’s an excellent question. So, the heart screening focuses on the arteries of the heart. Essentially there’s one question we’re trying to answer: What is the likelihood that the person would have a heart attack or a similar event in the next few years? So the way the heart screening answered that question is by checking a few things. That includes an EKG, blood pressure, body weight, and cholesterol levels along with some information about the individual. If the risk is thought to be high enough, we do additional testing that’s called calcium scoring. Now we can expand on this later, but I’ll leave that for the heart part. Now for the vascular part, so vascular, that means blood vessels, and those are the things that run from the heart into the body.
我们想要确定的是:这些动脉堵塞的风险高吗?其中一些动脉会到达大脑，我们称之为颈动脉它们位于颈部，如果它们有问题，它们会增加中风的风险。有一条大动脉向下延伸到我们的腹部，叫做主动脉，它会扩张，导致动脉瘤，这是拉丁语中扩张的意思。这也是我们想要发现的。最后一件事是通往腿部的动脉，它会导致腿部问题，包括疼痛，有时最严重的形式会导致溃疡、截肢和感染。所以这些动脉也可以被研究。现在，如果我们谈论血管筛查，我们关注的是颈部的动脉，腹部的大动脉和腿部的动脉和静脉，大多数时候我们只是用超声波来研究它们。我们还可以通过测量腿部的血压来了解腿部动脉的健康状况。所以它们有点不同，但正如你所想象的，影响心脏的疾病过程很可能也会涉及这些动脉。所以，我想说的是，大多数人都能从这两种检查中受益如果他们有症状的话。 So if you have high risk to heart problems, you would benefit from heart screening, and also you would benefit from vascular screening.
Host:Now, if I wanted to move forward with one or both screenings, how does that process work? Where do I start?
Dr. Abuzaanona:有两种方法。通过初级保健医生或提供者，他们总是能很好地评估心脏和血管风险。当人们认为风险已经足够高的时候，我们就会讨论各种选择。这可以是直接治疗，给一些药物，如胆固醇药物，可以帮助降低风险，或者如果我们不是100%确定我们可以做额外的测试。另一种方式是通过社区，这也是桑福德正在做的，试图通过我们的筛查项目向社区开放。在筛选过程中你会遇到筛选中心的技术人员。
They evaluate the risk based on multiple things, include the age, the gender assigned at birth, the blood pressure. They check an EKG, they also check a cholesterol level, and they put all of this information together and identify the risk in the next 10 years. If the risk is considered to be high and for us here at Sanford, we define as more than 6%, then they would recommend the calcium score test. So there’s multiple different ways to do it. If you are in the community and you want to directly get that evaluated, it can be through the screening center or you can just do it through the primary care physician, the primary care provider.
Host:那么，在筛查期间我能期待什么呢?告诉我整个过程。
Dr. Abuzaanona:Part of that screening is identifying the risk. So after the blood pressure, the cholesterol, the EKG, and the brief conversation to ask about family history, etc., the next big thing that is done – if a patient is eligible – is called calcium scoring. And we’ll talk a little bit about this. Calcium score is essentially a CAT scan and it’s considered a low dose CAT scan. We do it without injecting dye, without even needing IV access. So we don’t use an IV line for this, and it’s a quick process where the patient would go into the CAT scanner. It typically takes seconds to take the picture itself. The whole process might take few minutes. What we do is we look at calcium depositions. So how much calcium there is on those arteries that supply the heart and what that tells us, if someone has some calcium on their arteries, that tells us they have higher risk for coronary problems or, like a heart attack or heart attack-like conditions in the future, and that allows us to start treating them to prevent them from happening.
Now, if someone does not have any calcium, we call that a calcium score of zero. The risk is extremely low and this actually adds up to be less than 1% in the next 10 years. So it would be quite reassuring if someone is concerned about a high-risk, maybe due to family history or due to higher cholesterol or anything else, having a negative or a zero calcium score is very, very reassuring. And even having a positive test where we uncover some early process will allow us to treat effectively and prevent future heart attacks.
Host:Do you recommend these screenings every year? So what about those of us who are not at high risk, assuming a low risk score like zero can be associated with good health?
Dr. Abuzaanona:Yeah, I really like the way you describe it: it’s good health. Even though it’s initially designed to comment on the heart and the risk for heart attacks, it turns out if someone has a low, or like a zero score, which is normal, they actually have lower risk for a lot of other things. So lower risk for cancer, lower risk for chronic kidney disease, lower risk for a lung obstructive disease and even lower risk for hip fractures. There is a comment that we sometimes use is: someone who has, even if they’re in their sixties or their seventies or eighties, if they have a calcium score of zero, we call them healthy agers in general. So, you are aging in a very healthy way, and it’s not just a testament to how healthy your heart and your vascular system is, it is just a reflection of how healthy the entire body is.
你需要多久重复一次?如果它是零，我会说，不早于五年。如果是的话，可能是3到5年。我们不确定，但我们最早会在三年后进行，也许会推迟到五年，我认为这是合适的。如果结果是阳性的，那么我们就发现了异常，我们真的不需要再重复了，因为一旦我们确定谁的风险更高，我们就会治疗[他们]，我们基本上会做很多事情来预防心脏病发作。我们关注生活方式，饮食，运动，减肥，控制血压。所以我们要确保血压得到很好的控制。我们会控制胆固醇，通常会让病人服用降低胆固醇的药物确保胆固醇处于一个良好的水平，一个令人满意的水平。
Host:When it’s time to look at the results of the screening, where does that information go? Who reviews it? What comes next?
Dr. Abuzaanona:在我们的筛查项目中，病人会被告知他们的结果，如果他们的结果是阳性的，这意味着他们有冠状动脉钙化，他们会被转诊到初级医生那里，我们最终会看到大多数病人。所以大多数的病人，尤其是钙评分很高的病人，我想说超过100，我们最终在心脏病学上看到大多数这样的病人。在这一点上的目标是看看是否需要额外的测试，是否有任何堵塞和我们需要修复的动脉。Otherwise, we just make sure that we’ve corrected all the risk factors and we’re maintaining a good blood pressure, maintaining good cholesterol and treating appropriately.
Host:For our listeners now who might be ready to get their screening, how can they make an appointment?
Dr. Abuzaanona:The heart and vascular screening is essentially a service. So if you’ll go intoour website at Sanford查一下位置-因为我们有多个位置-查一下离你最近的位置，有一个号码。你只要打电话预约就行了。你不需要在此之前去看医生，因为这是一个结构良好的过程。所以只有那些被认为是必要的事情才会被做，就看医生而言，你可以事先看医生讨论你是否需要这样做，如果你想要一个量身定制的答案，这取决于你的风险状况。但如果你对测试结果有任何担心，任何问题，你会被推荐去看医生。
Host:So as a cardiologist, Dr. Abuzaanona, I imagine you’ve seen a variety of patients with varying heart health. If we want to take better control of our heart health, you mentioned lifestyle changes a little bit ago. What are some simple recommendations that you have to get us started?
Dr. Abuzaanona:Yeah, I would say introduce some changes because we all can. If we look in into our diet, there is always something that we can do to improve the quality of our diet. And we can always move a little bit more. So that’s different for different people. What we would recommend in general, like general outlines or general guidelines: in terms of diet, try to introduce more vegetables, fruits and grains. Try to replace some of the unhealthy fat with healthier fat. We don’t say stay away from fat. We don’t say that anymore. We try to replace with healthier fats. Healthier fats are found in fatty fish and extra virgin olive oil and in nuts – unsalted nuts, obviously. The unhealthy fat, as you all know, is probably in the red meat and you know the lard, the butter, etc. And stay away from highly processed food. The more processed the food is, if you look at a package that has 20 ingredients, that’s probably no matter what food product that is, it’s probably not the good choice for you.
In terms of exercise, we recommend about 30 minutes of intermediate intensity. So something that gets your heart rate up, but it doesn’t get it up really high. So you can still talk while you do this. You won’t feel very tired. Walking can be a very good exercise for most people and do that for 30 minutes, about 3-to-5 times a week, and that should be good enough.
The biggest advice I try to give is introduce small changes because small changes are usually the ones you can sustain and over time you’ll find yourself, if you introduce enough small changes over a course of a year, that it becomes easy. If you start trying to adapt a lot of things at the same time, it becomes overwhelming and difficult.
就个人而言，如果我想在饮食或锻炼方案上做出两三个以上的改变，我通常发现这种改变不会持续太久。所以要保持简单。给自己很多时间。也许是一两年，然后说，‘我想在年底之前完成’，然后做一些小小的增加，小小的改变，到年底的时候你就会发现自己在那里了。你会有一个更好的饮食，你会有一个更好的锻炼方案。另一件事是，如果你有任何健康状况，健康问题，一定要解决它们，坚持服药。所以如果你有高血压，要确保治疗得当血压得到控制。如果你有睡眠呼吸暂停，确保你坚持使用CPAP机，并遵循你的医生的建议，确保你按时预约。This is how you take good care of your heart and overall good care of yourself.
Host:I love that. Thanks. So much of our overall health aligns with having a healthy heart as well. So, this is such great information, doctor, is there anything else that you want our listeners to know today?
Dr. Abuzaanona:我想说，在桑福德，我们有一个强大的预防心脏病学项目。我们想尽早发现心脏病。我们为我们阻止手术而不只是做手术而感到自豪。在未来，我们将致力于帮助人们远离医院，控制自己的健康。因此，我们将在未来扩大预防心脏病学项目，这是我的目标，也是我的热情所在。所以希望在接下来的几年里，我们会继续为我们的病人提供优质的服务。
Host:Wonderful. Heart disease prevention is key all year long. Dr. Abuzaanona, thank you so much for your expertise and all that you do for Sanford Health.
Dr. Abuzaanona:Yeah. Thank you for having me. Appreciate it.
Host:For Sanford Health News. I’m Courtney Collen.
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Posted InFamily Medicine,Fargo,General,Genetics,Healthy Living,Heart,Internal Medicine,Physicians and APPs,Specialty Care,Vascular
