Heart Health in Uncertain Times

By Dr. Ian Riddock, SMGOR Cardiology

This month is devoted to men’s health and focusing on encouraging boys and men to practice and implement healthy lifestyle decisions. Living in Central Oregon, we may have a more active and health conscious male population than other communities, but I’m not infrequently reminded that there’s a reason heart disease remains the #1 killer. Yes, heart disease can and does strike even our fittest, most outdoorsy and dietary-conscious men.

Perhaps one silver lining of the COVID-19 pandemic is that it’s allowed us time to reflect on our own health. I’ve had many patients ask me if I feel they are at increased risk for complications from COVID-19 given their cardiac risk. While there are few sure answers surrounding this virus, we are learning a little more each day and can say it has been observed to target the heart in a few different ways.

COVID-19 is not unique to other viral respiratory infections. For instance, cardiologists advocate for annual flu vaccines not only to prevent actual influenza infection but also to protect against heart attack. When plaque (cholesterol) builds up in the coronary arteries of individuals ns and those individuals become infected with influenza, there is a much higher rate of plaque rupture, which triggers a heart attack. COVID-19 appears to behave similar to flu, but more aggressively. In some cases, it appears that the heart muscle is being bathed in inflammatory toxins (cytokine storm), causing global inflammation (myocarditis) and weakening of the heart muscle (cardiomyopathy). Having pre-existing heart conditions may make someone’s heart more of a target for the virus or may negatively contribute to how the body reacts to inflammation caused by the virus. This has been noted in our sickest patients with COVID-19 but may also occur in patients with mild or no significant symptoms.

While we battle the many restrictions the virus has put on our lives, it’s never too late to take control of our cardiac risk which can be broken down into modifiable factors such as healthy lifestyle behaviors and non-modifiable risk factors, or things we typically cannot control, such as our genes or family history. Eating healthy, exercising, maintaining an appropriate weight, and choosing not to smoke can help ward off many forms of heart disease. But even with strict adherence to such measures, heart disease can manifest silently and suddenly. In this regard, some individuals who feel they are protected by their healthy choices may ironically fail to give proper weight to non-modifiable risk factors. I often hear “My dad had heart problems fairly young, but he smoked and never exercised. I’ve never smoked, and I exercise regularly”. Another frequent comment is “My blood pressure has always been high; it runs in my family. That’s just how we are.” Or similarly, “Everybody in my family has high cholesterol. That’s normal for us”.

The weather is getting warmer. The trails are alive, and the gyms are opening again. Soon, the pickle ball courts. Many are chomping at the bit to resume prior routines. Others have found new inspiration to become fitter. Take this time of transition to evaluate your health. If you have concerns or would like more information, schedule a visit with your provider, perhaps virtually, to discuss your cardiovascular risk. It may be as simple as a conversation. Or, it may require a few laboratory tests such as a cholesterol or diabetes panel. For men over 40 with at least one risk factor, an inexpensive coronary artery calcium CT scan of the heart to screen for the presence of underlying plaque is perhaps the best tool for assessing risk of future heart attack or stroke. If you’ve been inactive and have multiple risk factors, a stress test is sometimes recommended before embarking on a new vigorous exercise routine.

Finally, if you or a loved one have established heart disease or may have recently experienced heart-related symptoms but are reluctant to engage with the health care community now is time to schedule an appointment with a cardiologist. Let’s emerge from this together in a thoughtful and healthy way!

Ian Riddock, MD, FACC

Cardiologist and Lipidologist

Summit Medical Group Oregon