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February 26, 2019 Heart disease is the leading cause of death in the United States among both men and women, but with a healthy lifestyle, you can lower the risk of heart disease significantly. The reason the heart is so important is because it pumps blood throughout our bodies, delivering oxygen and nutrients and removing carbon dioxide and waste products. There are three main reasons the heart can stop working at full capacity: blocked blood vessels, valves that don’t open and close properly, or a weak heart muscle. CORONARY ARTERY DISEASE – WHERE HEART ATTACKS CAN COME FROM Coronary artery disease (CAD) occurs when the arteries around the heart become hard and narrow because cholesterol and plaque have built up on the arteries’ inner walls. When arteries are less flexible and don’t allow as much blood to flow, the heart has to work harder to do its job. Think of narrow arteries like a skinny straw. When you’re trying to drink a milkshake, you can do it through a skinny straw, but it requires a lot more effort. When the arteries narrow too much, it can cause chest pain (angina) and shortness of breath. If the arteries get blocked altogether, you can have a heart attack. VALVULAR DISEASE – WHERE CONGESTIVE HEART FAILURE CAN COME FROM Valvular heart disease involves damage or malformation of one of the four heart valves (usually the mitral or aortic). Valves are important because they keep blood flowing in the right direction at the right intensity at the right time. If a valve doesn’t close all the way, blood can leak back into the chamber it came from. If a valve narrows or hardens, it may slow down blood flow and cause blood to get backed up. People with valvular heart disease don’t always have symptoms, but they can have heart palpitations or chest pain, fatigue, dizziness or fainting, fever or rapid weight gain. CARDIOMYOPATHY – WHERE BROKEN-HEART SYNDROME CAN COME FROM Cardiomyopathy is a weakening of the heart muscle. It can be inherited (genetically) or acquired (caused by another condition). In most cases, cardiomyopathy causes the heart muscle to become enlarged, thick, or rigid, making it hard for the heart to pump blood and maintain a normal electrical rhythm. This can lead to irregular heart beats (arrhythmias), congestive heart failure and/or valvular disease. Stress-induced cardiomyopathy, or takotsubo cardiomyopathy, is called the broken-heart syndrome. It can feel like heart attack with sudden, intense chest pain, but it is actually a surge of stress hormones, which can result from either intense sadness or intense happiness. In broken-heart syndrome, a part of your heart temporarily enlarges and doesn’t pump well, while the rest of your heart functions normally or with even more forceful contractions. The good news is that most people recover completely in a few weeks, but it can be serious, so if you have intense chest pain, go to your nearest hospital emergency room. SKIP THE CIGARETTES AND TAKE THE STAIRS RATHER THAN THE ELEVATOR While your genetic predisposition can influence your risk of heart disease, eating a heart-healthy diet, not smoking, and exercising regularly can increase your chances of living a long, healthy life. Reducing stress can also increase your heart health. Making healthy lifestyle choices reduces the risk factors that lead to heart disease, such as high blood pressure (hypertension), diabetes, high cholesterol, and obesity. You don’t have to join a gym and become an expert in nutrition. Just make little adjustments. Choose water over soda at lunch. Take the stairs instead of the elevator whenever possible. Limit red meat in your diet and eat more plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. Replace butter with healthy fats like olive oil. Make time in your day to decompress, whether that means meditating, listening to relaxing music or taking a hot bath. Little healthy choices can add up to a big healthy life.   Dr. Jerry Douglas is the chief medical officer at MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.