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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
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    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • February 16, 2018

    By MedStar Health

    So you want to lose weight. But what if your method for shedding the pounds could also lower your risk for certain diseases, help you sleep, and improve your overall heart health? While there are plenty of weight loss programs and options, running is one that can also help improve your fitness and overall health.

    The idea of becoming a runner can be a little daunting, but there are a lot of advantages to taking up this healthy pastime just by running 75 to150 minutes per week.

    Why Should I Run?

    With running comes increased fitness. From a cardiovascular standpoint, the more fit you are, the longer you tend to live.

    In addition to overall increased fitness, though, comes a long list of other cardiovascular health benefits, like lower blood pressure and cholesterol, decreased risk of diabetes, and decreased risk of cardiovascular disease, including heart attacks and strokes, to name a few.

    Running can also change the physical shape of your heart. Exercise-induced cardiac remodeling, also known as “athlete’s heart,” is a healthy adaptation to a lot of endurance exercise. This adaptation can be seen in athletes who are running more than 5 hours a week.

    People who commit to a running regimen may also experience other health benefits that include improved sleep, decreased rates of depression, healthier bones and muscles, and decreased risk of colon and breast cancer.

    While running can benefit your overall health in a number of ways, it’s important to keep in mind that other factors also affect your health, like lifestyle habits and family history.

    Running doesn’t make you immune to coronary heart disease. Despite your new running routine, you can’t outrun genetics, high blood pressure, and the effects of unhealthy habits, like smoking, poor diet, or alcohol use. If any of these factors play a role, you’ll likely need to make some other life changes in order to see overall improvement.

    In terms of weight loss, running has a proven success rate. Why? In comparison to other forms of more low-intensity exercise, running burns more calories in a given amount of time.

    It’s all about net energy balance; what you expend minus what you put in. So, to lose weight, you need to expend more than you take in.

    To #loseweight, you need to expend more than you take in. via @MedStarHealth

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    Getting Started

    So what kind of a running routine should you stick to? Well, it depends on your goals, but in general, the keys are exercise duration, frequency, and intensity.

    The current recommendation for overall heart health is 150 minutes of low-intensity exercise a week, or 75 minutes of moderate-intensity exercise a week. But, most research shows that double that amount of exercise is necessary for effective weight loss. On top of that, 1 to 2 days of weight training and stretching are also recommended for improved bone health and muscle mass.

    I Started Running. Why Am I Not Losing Weight?

    There could be a couple of reasons that running hasn’t proven to be as effective as you thought. The first may be that you simply have not given it enough time. You should expect to achieve significant weight loss over months and not over days or weeks.

    The second reason may be that you are not running as much as you need to. The more you run, the more weight you will lose.

    The third reason requires taking a close look at your caloric intake. A common mistake many people make once they start exercising regularly is overestimating how much food and calories they really need. Remember, weight loss requires a net negative energy balance.

    You may be expending more energy by running but, if your food intake also increases, you won’t see the results you’re looking for.

    In simpler terms, you just might not be doing enough running or you may be eating too much.

    Be mindful of the food you’re eating, portion sizes, and calorie consumption. Focus on including fruits, vegetables, and lean meats in your diet. Avoid processed carbohydrates or sugars and red meat as much as possible.

    Don’t discount lifestyle variations, either.

    If you’re sitting at a desk job for eight hours a day, and start doing 300 minutes of low-intensity exercise a week, you will likely start to lose weight. But, if your daily routine already consists of more movement or physical work, your results may not be as noticeable, or as immediate.

    While running can bring a number of benefits to someone who is looking to lose weight and improve overall health, it’s important to remember that no exercise or weight loss regimen comes with one-size-fits-all results.

    Don’t be afraid to change up your routine, and make tweaks as you go. Another benefit to running is that it can be a social activity. Finding a running buddy or joining a running club in your area can actually help you develop and improve your routine. Check out these local running clubs:

    So, lace up your shoes, hit the pavement, and get started on the path to better health.

    Want to learn more about how MedStar Health can help you live a healthy and active life?
    Click the button below to view the list of our services.

    Learn More

  • February 16, 2018

    By Tonya Elliott, RN

    When patients find out they need a left ventricular assist device (LVAD) to treat their advanced heart failure, they go through a wide range of emotions. Some people who may have been sick for a long time are grateful and eager to regain a higher quality of life. Others who may have gotten sick quickly over a couple of weeks or months may be shocked that they need an LVAD. Sometimes they’re angry and disappointed, saying, “Why me?”

    Patients and families understandably can have a tough time adjusting. That’s a normal reaction, and we’re ready for that. After the initial shock, most patients understand that the device can save their life and make them feel a lot better, but it takes some time to come to that. Our LVAD team recognizes and helps support patients and families with a new LVAD when they go home.

    How a new LVAD can affect the emotions of caregivers and families

    When LVAD therapy was new, it was strictly an inpatient treatment for patients waiting for a heart transplant. As LVAD therapy became more innovative, patients could leave the hospital and manage their devices on their own or with the help of family members and caregivers.

    While it’s fantastic that patients can go home with an LVAD, it can be stressful at first for families. Sometimes, family members have to take on chores and duties the patient used to handle, such as caring for the children or paying the bills. They may feel burdened by the added responsibility. Sometimes, they’re scared or unsure of their role in caring for a loved one’s LVAD. They might be worried they’ll harm their loved one if they make a mistake.

    These family members might struggle with “what-if” worries:

    • What if I make a mistake?
    • What if I don’t do the dressing right?
    • What if I don’t hear a device alert?

    The more this stress piles up, the more likely caregivers are to develop burnout, which causes people to feel extremely overwhelmed, making it challenging to continue to care for their loved one.

    Our social work team counsels caregivers one-on-one through these intense feelings. We also have online community forums and in-person caregiver support groups. It’s good for them to hear from others who feel the same way, and it validates that what they’re feeling is normal.

    How we help patients and families prepare for a new LVAD

    We created a pre-LVAD class for patients and families to learn about the device and what to expect. If patients are too sick to come to the class, we come to their bedside. The class is offered twice a month and includes information about:

    • Advanced heart failure
    • LVAD management and how it works
    • Our team
    • What to expect, including that LVAD patients won’t have a pulse

    We also provide a welcome packet, resource materials and videos from the device manufacturer. We have a 50-person team that is dedicated to every aspect of LVAD patient and caregiver care before, during and after surgery. As part of that care, we’ve created a website, MyLVAD.com which offers information, resources and support for LVAD families. In preparing our patients and their caregivers, we offer hospital tours, informative videos and pre-procedure education.

    Remember, every patient and family will go through a unique process as they get used to living with an LVAD. Preparation is key, and we’re here to help make the process as smooth as possible for the whole family.

    To request an appointment with a heart specialist, call 202-877-3627 or click below.

    Request an Appointment

  • February 16, 2018

    By MedStar Health

    Like so many other physicians, Konstantinos Loupasakis, MD, has never outgrown his childhood fascination with the many complexities of the human body and how it works. But what has interested him more are cases when the body doesn’t work so well—when autoimmune diseases or similar disorders cause built-in defense mechanisms to turn against bones, joints and muscles—and what can be done to treat patients deal with the resulting pain, fatigue and other potentially debilitating symptoms.

    After medical school in his native Crete and a residency at St. Elizabeth’s Medical Center at the Tufts University School of Medicine, Dr. Loupasakis chose the rheumatology fellowship program at Weill Cornell Medical College’s Hospital for Special Surgery, for its emphasis on research.

    “My lab time was truly instrumental in broadening my horizons, and allowing me to better understand these diseases,” Dr. Loupasakis says. “My hope was that I could find a job that would combine patient care with an opportunity to teach.”

    Joining the MedStar Team

    Dr. Loupasakis found that ideal combination at MedStar Washington Hospital Center. In addition to serving as an attending physician in rheumatology, he oversees the immunology curriculum for the Hospital Center’s rheumatology fellowship program. He also supervises training fellows in the lupus and arthritis clinics.

    In both roles, Dr. Loupasakis says, communication is as important as medical knowledge and technical skill. But conveying the mechanisms of complex immunological diseases to patients is understandably more challenging, particularly when the cause and progression of some conditions are not yet fully understood.

    “Many diseases of the immune system are chronic, even if symptoms ease to some extent,” Dr. Loupasakis explains. “Patients need to understand what specific medications do for their condition, and why it’s important for them to stick with them, as well as follow up with lab work and other treatment.”

    Approach to Patient Care and Research

    Developing relationships that may well last for several years is perhaps one of the most rewarding aspects of his work.

    “I get to know my patients very well, and contribute to improving their quality of life over the long term,” Dr. Loupasakis adds. “Not all specialties have that.”

    Dr. Loupasakis remains actively engaged in research. He recently was co-investigator for a study of a new medication for lupus, and hopes to pursue future work on lupus and rheumatoid arthritis research projects.

  • February 14, 2018

    By Allen J. Taylor, MD

    The U.S. population is trending older, and as we age, our risk for heart disease increases. We’re on the verge of a serious health dilemma: While the average 65-year-old person can expect to live 20 more years or longer, the prevalence of heart disease cases in the U.S. is expected to increase more than 40 percent by 2030. How do we slow down this rising tide of risk?

    To me, the answer is clear: Every adult who is 50 or older with at least one risk factor for heart disease should be on a statin medication.

    Statins are the gold standard of treatment for coronary heart disease, especially when paired with healthy lifestyle choices. They’re also approved by the Food and Drug Administration (FDA) as a preventative therapy to slow the liver’s production of cholesterol, thereby reducing cholesterol levels in the blood. Statins are safe and effective, and I firmly believe adults should start taking them well before their senior years, when the risk for heart disease steadily increases.

    LISTEN: Dr. Taylor discusses preventative statin therapy in the Medical Intel podcast.

    What’s age got to do with it?

    The risk for heart disease increases with age, regardless of how well your blood pressure and cholesterol are controlled. It’s an unfortunate truth of the aging process.

    Numerous studies, such as the 2009 JUPITER trial and the 2016 HOPE-3 trial, have shown that older patients with at least one risk factor for heart disease (such as high blood pressure or family history of the disease) can benefit from statin therapy. The FDA has approved statins for lowering cholesterol and reducing the risk for heart attack, heart failure and stroke, even in people without a history of heart disease.

    Statins are effective for younger adults to seniors, to prevent heart disease risk. And it’s important to note that heart disease can occur in individuals who, on the surface, seem like the picture of health but despite this are slowly developing plaques in their arteries that lead to heart disease.

    3 types of patients who benefit most from statins

    If you fall into one of these three key categories, talk to your doctor and seek out treatment with a statin:

    1. Adults of any age with genetic or family risk factors

    The first type of candidate for use of statins would be somebody who has a very high inherited level of cholesterol, over 190 points. This can happen even if a person is fit and active. I’ve had patients come to me who were healthy but concerned about familial risk. High blood pressure and high cholesterol can run in the family regardless of personal wellness efforts.

    Sometimes, we find that their hunches are correct. We’ve prescribed preventative statins to many patients in their 40s or early 50s who might have been oblivious to their risk if they hadn’t been proactive. When this happens, it’s a wonderful feeling for the patient and the provider. We work together to conserve their health and keep them active.

    2. Adults of any age with a personal history of heart or blood vessel disease

    Every patient in this group should be on a statin. Once a patient has a cardiac event, such as a heart attack or blocked artery, they’re at increased risk for future events. Statins have proven time and again, especially when paired with healthy lifestyle choices, to reduce the risk of heart disease.

    3. Adults age 50 or older who have traditional risk factors

    Some of the traditional risk factors for heart disease include:

    • Family history of heart disease
    • Unhealthy lifestyle choices, such as poor nutrition, lack of exercise and smoking
    • Having diabetes
    • Having high blood pressure or high cholesterol that is not inherited

    If you’re unsure whether you’d benefit, you can use an online calculator to estimate your future heart disease risk. If your risk is over 7.5 percent over the next 10 years, you likely would benefit from a statin medication. And even if you have no heart disease history and feel healthy, it’s a good idea to see a cardiologist just to be sure. The cardiologists at MedStar Heart and Vascular Institute diagnose, treat and manage general heart-health issues and complex cardiovascular conditions. We have a large heart team, which gives us the opportunity to collaborate and improve the breadth and depth of each patient’s care. Request an appointment: Call 202-877-3627.

    How patients can reduce their risk every day

    An optimal lifestyle is far more powerful than any medicine we can prescribe and should be everyone’s primary therapy against heart disease. Statins can reduce the risk of heart disease by nearly 30 percent, but an optimal lifestyle can lower that risk by up to 50 percent. When I say “optimal lifestyle,” I mean patients should:

    • Avoid tobacco and excess alcohol
    • Eat a healthy diet that is low in saturated fats, low in concentrated sugars, and high in fresh fruits and vegetables
    • Exercise 30 to 60 minutes most days of the week
    • Know their blood pressure and cholesterol numbers

    The risks related to statins are rare and mostly include muscle aches. Some effects have been overblown online and in some public media, such as liver or memory effects. Any muscle aches can quickly and easily be improved by adjusting the drug or the dosage. Statins are extremely safe for the liver. In fact, after initial testing, there’s no medical reason to monitor liver enzymes long-term in most patients who take statins. And when it comes to memory, some research suggests that statins don’t cause memory problems but do reduce the risk of stroke.

    #Statins are the safest treatment for #heart disease. So safe, in fact, that @TaylorMHVIcard wants to see them available over the counter. via @MedStarWHC #HeartMonth

    Click to Tweet

    Statins are our safest treatment for heart disease—so safe, in fact, that I’ve advocated for statins to become available over the counter. The benefits outweigh the risks, almost without exception. And if a patient can’t tolerate one type of statin, there are multiple variations they can try to find one that works.

    A shift in mindset about statins

    Recently, more powerful cholesterol-lowering medications have been introduced that have helped change doctors’ general mindset about preventative care. As such, statins are starting to be seen as a broader level of treatment instead of being reserved only for patients with very high cholesterol.

    In the future, we’ll see more attention to intensive, proactive cholesterol lowering to decrease the risk of heart disease in the U.S., with statins as the centerpiece. As our population ages, the overall risk in this country will continue to increase. We must be attentive and proactive to prescribe statins to the right patients at the right time.

    To request an appointment with one of our cardiologists, call 202-877-3627 or click below.

    Request an Appointment

  • February 12, 2018

    By Harjit K. Chahal, MD

    Most heart attacks occur when cholesterol buildup, or plaque, blocks an artery and restricts blood flow. But a certain type of heart attack can occur with little blockage, and sometimes none at all.

    Myocardial infarction with nonobstructive coronary arteries (MINOCA) heart attacks can occur when blood flow is reduced because an artery is:

    • Constricted by a spasm
    • Damaged
    • Partially blocked (50 percent or less)

    MINOCA often strikes young females. It can cause mild chest discomfort, severe chest pain or a general feeling of unease, similar to silent myocardial infarction. The cause of MINOCA often isn’t visible on imaging, and we have to do special tests to diagnose patients. Unfortunately, too many women across the country fall through the cracks and don’t get the specialized care our heart team provides.

    To request an appointment with one of our cardiologists, call 202-877-3627 or click below.

    Request an Appointment

    One woman’s MINOCA story

    During my cardiology fellowship in New York, an anxious woman in her late 20s came into the emergency department. She had experienced chest pain while getting ready for work, but she had no risk factors for heart attack.  We reviewed her EKG, (electrocardiogram), which showed what looked like a heart attack. The patient was still shaken up, but her pain was nearly gone. We did another EKG, and her results were normal.

    When I showed the young woman’s images to my attending physician, he asked if I was sure I had the correct patient’s results. They were correct, even though the results seemed unlikely! We decided to perform a catheter procedure to get to the root of the problem. We inserted a thin, flexible tube into an artery in the woman’s groin and threaded it through her blood vessels to examine her arteries.

    We were glad we did the procedure—we discovered that she’d suffered a spasm in one of her arteries. It had reduced blood flow to her heart, causing a MINOCA heart attack.

    4 types of MINOCA

    MINOCA is an umbrella term for a group of a heart conditions that can cause a heart attack, even if an artery isn’t totally blocked by plaque. MINOCA can happen without explanation. However, it also shares the same risk factors as traditional heart attacks, including family history, high blood pressure and smoking.

    MINOCA heart attacks often are caused by major or microvascular artery dysfunctions, such as the four conditions below.

    1. Coronary vasospasm

    Like the muscles in your arms or legs, the muscles in your blood vessels can suddenly spasm and constrict blood flow—often without explanation, and often overnight.

    Coronary vasospasms can be associated with magnesium deficiencies and Raynaud’s disease, which involves vascular constriction of the fingers and hands. Women who have vascular migraines also are at increased risk. In fact, some migraine treatments can cause spasms. Use of cocaine, marijuana, excess alcohol and amphetamines can cause coronary spasms as well.

    2. Microerosion of eccentric plaque

    This type of MINOCA can occur when plaque deposits are disproportionate within an artery and tiny pieces of one breaks off. This can cause certain areas of the artery to narrow, restricting blood flow.

    3. Microvascular disease

    Damage to the walls of the small arteries in the heart can cause problems with blood flow, which can result in a heart attack.

    4. Stress cardiomyopathy

    Intense physical or emotional stress can cause heart muscle weakness. This condition can occur suddenly and can be severe.

    How we detect and treat MINOCA

    Unlike larger artery spasms, MINOCA spasms often cannot be detected on regular imaging. We can diagnose microvascular disease in our cardiac catheterization lab. Patients are given medication that causes controlled spasms, so our vascular specialists can watch to see which arteries narrow. Microerosions of plaque can dissolve quickly, often before patients can get to the lab. We can use intravascular ultrasound and optical coherence tomography to detect microerosions of plaque.

    Treatment for microvascular dysfunction depends on the underlying cause. The Swedeheart Register study followed patients with MINOCA to find out which treatments have been most beneficial in the long term. Data suggest that statins are the most beneficial in preventing future events. The study also suggests that patients should quit smoking, take nitrates and take calcium channel blockers to reduce their risk for MINOCA.  

    If you experience chest pain, go to the emergency room. MINOCA can be severe and life-threatening, even if the pain isn’t intense. Particularly for women, if you feel like something is wrong—even if your initial testing is normal—ask the doctor if more advanced heart imaging, either inpatient or outpatient is appropriate. You are your own best advocate, and you should feel empowered to get answers to your heart-health questions.  

  • February 07, 2018

    By Allen J. Taylor, MD

    It’s hard to imagine that something as serious as a heart attack could go unnoticed. But as many as 1 in 4 heart attacks are “silent,” meaning the symptoms go unnoticed or are mistaken for less serious conditions such as heartburn, muscle pain or simply not feeling like yourself.

    Research has found that silent myocardial infarction (silent MI) without a history of traditional heart attack increases a patient’s risk of heart failure, heart tissue damage and subsequent heart attacks. Because these events cause no symptoms, regular and proactive heart care is vital to avoid permanent heart damage or even death.

    LISTEN: Dr. Taylor discusses silent MI in the Medical Intel podcast.

    Who’s at risk for silent MI?

    Anyone can suffer a silent MI. The risk factors are the same as for a traditional heart attack: high cholesterol, high blood pressure, family history, lack of exercise and tobacco use, just to name a few. But a few patient populations are at increased risk:

    • Patients with diabetes: Diabetes affects many body processes, which can change the way these patients experience the vague symptoms of silent MI. Sometimes the only hint is a loss of blood sugar control.
    • Older patients, particularly women: Silent MI often leaves these patients feeling fatigued or generally unwell, or it might cause back pain. We emphasize women because, in general, they tend to brush off cardiovascular symptoms more often than men.

    A silent heart attack can cause serious, long-term heart damage. While medications such as statins are effective to prevent future heart events, leading an optimal lifestyle is the best way to preserve your heart health. Avoid smoking, eat a nutritious diet and maintain a healthy body weight to reduce your heart attack risk by as much as 50 percent, compared to just 25 percent with medication alone.

    Related reading: Dr. Taylor discusses silent MI in a WTOP Radio news article.

    3 ways we detect silent MI

    Electrocardiogram

    The EKG is our primary tool to detect silent MI. This test shows us your heart’s electrical system and can show whether you’ve suffered any heart damage. For example, I cared for a young, overweight man at MedStar Heart & Vascular Institute who was transferred to us in poor shape. He was in his early 30s, and he had trouble breathing and was retaining fluid. Something just didn’t feel right about his condition, so we ordered an EKG.

    We found evidence of a previous silent MI, which led us to the discovery of a completely blocked artery that led to heart damage and his vague symptoms. These discoveries helped us get to the root of the problem and focus his care plan before another heart attack could occur.

    Echocardiogram

    This test employs sound waves to test how well the heart is working. If an area of the heart isn’t functioning properly, we’ll order additional testing to determine whether it has been damaged by an unrecognized heart attack. If you have vague symptoms you can’t put a finger on or simply feel “off,” talk to your doctor about getting tested for silent MI.

    Stress test

    For this test, we’ll ask you to walk or lightly jog on a treadmill while we monitor your heart with an EKG. If the heart shows distress during exercise, you may need additional workup to evaluate your heart arteries.

    More intensive tests can tell us deeper information if we need it. Based on the cumulative results, our heart team will devise a care plan to minimize your risk of further heart damage and future heart troubles.

    If you have new or unusual chest sensations, call the doctor. It could be #silentMI, a heart attack without obvious symptoms. via @MedStarWHC #HeartMonth

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    Anyone who experiences unexplained symptoms—even if it’s just a feeling that something is not right—should get their heart checked out by a cardiologist. Too many heart attacks go unrecognized. Proper evaluation and treatment can help ensure better heart health in the future.

    To request an appointment with one of our cardiologists, call 202-877-3627 or click below.

    Request an Appointment