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Series Code: UP
Program Code: UP190119A
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00:01 The following program presents principles
00:02 designed to promote good health 00:04 and is not intended to take the place 00:05 of personalized professional care. 00:07 The opinions and ideas expressed 00:09 are those of the speaker. 00:10 Viewers are encouraged to draw their own conclusions 00:13 about the information presented. 00:15 Did you know that coronary artery disease 00:17 is the most common type of heart disease 00:19 found in the United States? 00:21 Unfortunately for some people, 00:22 the first sign of this disease could be a heart attack. 00:25 On today's program, 00:26 you'll learn how you can reduce your risk 00:28 of coronary artery disease, 00:30 and thank you for joining us, 00:31 the Ultimate Prescription starts now. 00:54 Welcome and thank you for joining us today 00:56 on the Ultimate Prescription. 00:57 I'm your host Nick Evenson here with Dr. James Marcum, 01:00 speaker and director of Heartwise Ministries, 01:02 and also a practicing physician. 01:04 Yeah, Nick, I see patients every day 01:06 in the office at the Chattanooga Heart Institute, 01:09 and I've had now quit a few years of experience. 01:13 And you know there's a place for modern medicine, 01:17 can't fix everything, you know? 01:18 Right, yeah. 01:20 And there's a place for lifestyle, 01:21 that can't fix everything. 01:22 But I've learned the key in health 01:24 is to walk with our Lord through worship 01:27 and that helps us understand where to go. 01:29 And today we've got an exciting topic. 01:31 That's right. That's right. 01:33 For viewers who've watched this program for a long time, 01:35 you'll know that we talked 01:36 about a lot of different health topics, 01:38 not just related to your specialty, 01:40 but today we're talking about 01:41 one of your specialties which is... 01:42 Coronary artery disease. That's right. 01:44 And we think about the cardiovascular system. 01:47 You know the heart and all the blood vessels, 01:49 but today we're just gonna focus 01:51 on one aspect of that. 01:53 And that's the coronary arteries. 01:56 You know, arteries supply the heart 01:58 with blood, nutrients, oxygen. 02:02 When something happens to this artery 02:04 or any of the arteries that supply the heart, 02:07 the heart malfunctions. 02:08 When the heart malfunctions, guess what? 02:10 The organs suffer. 02:12 Right. 02:13 Blood pressure goes down. 02:15 When it doesn't get the oxygen and the nutrients, 02:17 bad things happen very quickly. 02:20 So our listeners today are gonna learn things 02:22 about what to do about heart attack, 02:25 what to do in emergency situation, 02:27 what are the modern medical things we have, 02:30 how to prevent it from happening, 02:32 all these good things that people want to know 02:34 and, you know, everyone wants 02:36 to prevent a heart attack, right, Nick? 02:37 Absolutely, that's right. 02:39 You know, heart attacks are scary things. 02:41 Yeah, absolutely. 02:42 You know, and I'm surprised the youngest heart attack 02:45 I've ever seen was a person in their early 20s, okay? 02:50 And the oldest one was a guy, was 101 years old. 02:54 So you can have a heart attack any time, 02:57 and that's a problem with the arteries of the heart. 02:59 So what a heart attack means is the artery doesn't get blood 03:02 to that part of the heart, the heart dies, 03:05 sorts of die and it malfunctions. 03:08 Often time it ends up in a funny heart rhythm 03:11 because the heart doesn't get enough blood 03:12 as electrical instability. 03:15 Those are the type of situation we'll have a heart attack, 03:17 the heart goes crazy, 03:19 and you see people running to shock the heart. 03:20 Right, yeah. 03:22 Other times it's just chest pain. 03:23 There's no funny rhythms 03:25 and then bad things happen from that as well. 03:27 So that's all the different things 03:28 we're gonna talk about today. 03:30 Yeah, well, let's go and get into it. 03:31 We've got a short video 03:32 that'll like us to take a look at 03:34 and you can kind of comment 03:35 on what's happening here in this, 03:36 regarding to what happens... 03:38 Well, here is our cardiovascular system, Nick, 03:41 and there's the heart right in the center, 03:43 pumping blood everywhere. 03:45 Pumping blood throughout the arteries, 03:47 through legs, to every aspect, 03:48 then it goes to the capillaries, 03:50 then it comes back to the heart. 03:53 The right side of the heart pumps 03:55 through lungs which gets oxygen. 03:57 The veins bring it back to the heart, 03:58 we're seeing that right now. 04:00 And if you notice, 04:01 all the blood vessels on the heart, 04:03 those are the coronaries. 04:05 That's what we're going to talk about today. 04:07 Those red streaks on the heart 04:09 and inside all sorts of things are going on. 04:12 And this is a picture of an artery 04:14 that supplies the heart 04:16 and in it we're going to notice it's getting bigger 04:19 and it's picking up different things, 04:20 it's getting bigger 04:22 because it's becoming fatty, fat filled. 04:23 Okay. 04:25 That's probably the most common cause 04:27 of a coronary problem 04:28 that is stored in the artery, more and more it gets stored, 04:32 so the blood can't flow, 04:34 then a symptom develops, that's one type of problem. 04:37 But sometimes that plaque becomes unstable. 04:41 And when that plaque becomes unstable, 04:43 it can explode or rupture like a volcano. 04:47 And when something ruptures inside an artery, 04:49 the body says, "Oh, no, I've a problem." 04:53 So the body wants to clot it off. 04:55 Even if you just have a small plaque, 04:57 a small amount of fat that ruptures, 05:00 you don't even know, it doesn't, 05:02 and then one day it gets unstable, it ruptures, 05:04 the body wants to clot it off, it clots it off, 05:07 no blood makes it down that pathway, 05:09 and the heart has a malfunction. 05:11 Yeah. 05:12 Now the way I like to think of it is, 05:14 is these are plaques, or fatty streaks in our heart, 05:17 and it becomes... 05:18 We heard this term called oxidation. 05:20 Have you ever heard that? Yep. 05:21 Oxidation, things are rusting, getting old, getting unstable. 05:26 So the thing, sort of helps that 05:28 is things called antioxidants. 05:31 So when these things start happening, 05:33 the heart can get filled up 05:34 so the blood doesn't make it downstream. 05:37 Don't get nutrients, you have a heart attack, 05:38 and that's one type of heart attack, okay, 05:41 or one type of coronary problem, 05:43 but there's other one's that's happened too. 05:45 Lot of people don't realize that sometimes these tubes 05:48 that feed the heart, the nourishment 05:50 can spasm like that. 05:53 You know, we talked about the little plaques 05:54 that get inside that disrupt flow, 05:56 but sometimes artery itself can do like that. 05:58 Now what is it that it causes the artery 06:00 to kind of contract and retreat blood? 06:01 Yeah, many different things, some of the more common causes, 06:04 extreme cold can cause constriction. 06:07 Okay. 06:08 Now people are usually 06:10 genetically predisposed to that. 06:12 Other things that can cause it is drugs. 06:15 We've seen it quite a bit in people that take cocaine, 06:18 sometimes med and vitamins 06:20 causes the arteries to constrict. 06:22 There's powerful medicines that we use 06:24 to raise the blood pressure 06:26 that can sometimes 06:27 cause the arteries to constrict. 06:30 So, many different things can cause these arteries 06:33 to do constrict suddenly. 06:36 Too much caffeine can cause it to constrict a little bit, 06:39 but it's usually multiple factors. 06:42 So I have one patient that came at one time, 06:45 that he was skiing way up at a high altitude. 06:49 So he had the cold, 06:51 but he had low oxygen levels which can cause it constrict. 06:54 And he's drinking a lot of energy drinks in caffeine. 06:57 That mixture on predisposed genetics 07:01 caused his artery to constrict. 07:03 So he had constricted, he had a heart attack, 07:06 then when we looked at the arteries diagnostically 07:08 we found out there was no blockage, 07:10 there was no fat. 07:11 It was a constriction of the artery. 07:13 So we sort of make that diagnosis 07:15 based on diagnostic testing. 07:18 So the different types of heart attacks 07:20 are one the plaque, 07:22 the pimple ruptures suddenly. 07:25 One it gradually gets clogged up over time, 07:28 the third it spasms 07:30 and then the fourth type of coronary heart attack 07:32 is sometimes a clot can float down 07:35 into those arteries and clog them up. 07:37 Just cause a blockage? Yeah, from somewhere else. 07:39 That's a little bit rare. 07:40 For instance, 07:41 sometimes the heart muscle is very weak, 07:44 and you get a lot of blood clot in there. 07:46 Well, that blood clot could be pumped out 07:48 and it could actually flow down in artery 07:50 and cause a heart attack. 07:52 That is probably the most rare type of heart attack. 07:55 The most common one 07:56 unfortunately is one that we can't really predict. 08:00 'Cause everyone is walking around 08:01 with disease based on their genetics, 08:04 some people experience the symptoms, 08:06 some people don't. 08:07 So everyone that I see, 08:09 I assume that they have some element 08:12 of coronary artery disease. 08:15 Okay, so that means damage to the arteries, 08:18 a little plaque, a little fat 08:20 that's stored damaging that inside lining 08:23 which is called the endothelium. 08:25 Now let's take a look here. 08:27 We're, kind of, gonna get into the diagnosis 08:29 of how this is discovered. 08:31 But let's take a little video here 08:32 and talk to us, Dr. Marcum, 08:34 about how coronary artery disease is diagnosed? 08:36 Okay, we'll do that. 08:38 We hear it sometimes, 08:39 if a person doesn't know he's having symptoms, 08:41 he can walk on a treadmill. 08:42 And when you're walking on a treadmill, 08:44 we can hook you up to EKG's 08:46 and different monitoring and we can do that, 08:50 see if you have a symptom. 08:52 This is a picture of a nuclear stress test 08:54 where we can actually measure the blood flow 08:57 in your heart after exercise. 08:59 We can see if the heart's getting enough blood. 09:01 We can check on the symptoms to see. 09:04 So this gentleman walked on a treadmill, 09:05 we're looking at the blood flow in the heart 09:07 to see if the blood is going everywhere it should. 09:10 Sometimes we can look 09:11 and see a part of the heart doesn't squeeze good. 09:14 And if it doesn't squeeze good, it's getting not enough blood. 09:17 We know that they do have the diagnosis of coronaries. 09:20 And here is a diagnostic angiogram 09:22 where we actually put dye into the arteries 09:24 looking for obstruction. 09:26 Once we find out that they have this 09:28 and we can talk about the best way to treat 09:30 both the symptoms, 09:32 and we could make a diagnosis 09:33 so we can talk about what are the things 09:35 that we can do to reverse the disease. 09:38 Now these are just a few 09:39 of the many diagnostic tests we have. 09:41 I mean other test that's popular to see 09:44 if the arteries are aging now 09:46 is called a CAT scan of the heart 09:48 where we look for coronary calcifications. 09:51 Where we can look at the arteries from outside 09:54 with a CAT scan 09:55 and we can see if the arteries are aging, 09:57 it doesn't necessary look at the inside. 10:00 So the tests like the stress test 10:02 where we exercise and do things, 10:04 that's trying to provoke the symptoms. 10:06 And we measure the blood flow and indirectly we can assume 10:10 that the arteries not getting enough blood flow. 10:12 So we know we have a problem. 10:14 Then we have to diagnose, well, what type of problem it is. 10:17 And usually it's fat in the arteries 10:19 that developed over a long period of time. 10:21 And that is a way we sort of diagnose this. 10:24 Now in the original video that we looked at, 10:26 it looked like there was a lot of different arteries 10:29 going to different parts of the heart. 10:30 The heart looks very complex. 10:31 Is there a reason like these arteries 10:33 are particularly susceptible to disease? 10:36 Well, the arteries of the heart feed the heart what it needs. 10:40 And it's based a lot on our genetic tendencies 10:44 to store fat. 10:45 You know we can store fat in many other organs 10:47 and we have other supplies, it's not that important. 10:50 But when the heart which pumps everything 10:52 to every part of the body, 10:54 when it gets disease we've problems. 10:56 Now we mentioned heart attacks of the arteries, 10:59 we mentioned spasms, 11:00 but sometimes you can have genetic problems as well. 11:03 Right. 11:04 And sometimes, the arteries are going 11:06 in the wrong directions and things squeeze the artery, 11:09 that can be a fatal thing that can cause artery problems. 11:13 Sometimes we can have a condition 11:14 called a bridging situation 11:16 where the muscle squeezes the artery, 11:18 so it doesn't get enough symptoms. 11:20 And these basically are made 11:21 based on a person having a symptom. 11:24 Us doing a diagnostic test finding out, 11:26 well, what the cause is. 11:28 And then we look back and say, 11:29 well, do we need to treat an emergency, 11:32 or do we need to do something lifestyle 11:34 or some other aspect 11:36 to help the artery to not progress 11:38 to the point where it needs it. 11:40 And sometimes we can use medicines 11:41 to treat the arteries, 11:43 sometimes we can give nitrates 11:44 which makes the arteries bigger, 11:46 sometimes blood thinners, 11:48 sometimes we can stabilize plaques 11:50 with different types of medications called statins. 11:54 Sometimes if the blood pressure 11:55 is too high damaging the arteries, 11:57 we can lower the blood pressure. 11:59 So there's lots of things we can do 12:01 to slow down the disease in the arteries of the heart. 12:04 So let's talk a little about some of the symptoms 12:06 that you've mentioned, 12:07 you talked about a heart attack. 12:09 Obviously lot of people knows the symptoms of that, 12:10 but what are the symptoms people need to be aware of? 12:12 Any spot of the body above the waist 12:15 that won't go away, that could be a heart attack. 12:17 Any kind of pain above, above the waist? 12:19 Yes, and pain that won't go away, Nick, 12:21 it means it that you could have a blockage in an artery. 12:24 The fact that it's not going away means 12:26 that artery is completely blocked. 12:28 And if we don't do something right away 12:30 the heart could have a dangerous malfunction, 12:33 the heart muscle could die, it could go into heart failure. 12:36 When the muscle doesn't work well, 12:38 you can't generate blood pressure 12:40 and all of the organs suffer. 12:42 So any symptom that won't go away 12:44 needs the care right now and get to the emergency room. 12:46 Yeah. 12:48 And then what if it does go away? 12:49 You feel the pain, but it does go away, 12:51 is that something to get checked out 12:52 or you need to complain on right away? 12:53 Yes, yes, well you know if it's a dramatic symptom 12:55 I would get help right away, 12:57 but let's say you're walking every day, 12:59 you can't make that walk 'cause of a funny feeling. 13:01 Well, that would be a call to your doctor 13:03 and he would might wanna confirm 13:04 that it is the arteries with one of these tests 13:07 we talked about, 13:08 and talk about all of the different treatment options 13:10 as well as ways we can reverse coronary artery disease. 13:14 So remember, coronary artery disease 13:16 is disease that affects the arteries 13:18 that feed the heart. 13:20 When the heart doesn't get enough oxygen and blood, 13:22 it malfunctions. 13:23 That can lead to a dangerous rhythm 13:25 or low blood pressure 13:27 and unfortunately that can kill someone 13:29 right away with little warning. 13:30 Some people never had a problem in their life 13:32 till they have their heart attack. 13:33 Yeah. 13:35 Well, I think I understand, I think I get the picture now, 13:36 thank you for making that clear for me. 13:38 Okay. 13:39 We're gonna talk more about the diagnosis 13:40 and also the treatment of coronary artery disease 13:42 when the Ultimate Prescription returns. |
Revised 2020-01-30