Insight and Tips From Local Cardiologists

There’s a lot you can do to stay “young at heart.” Learn from local cardiologists how you can take action against heart disease.

Sometimes, heart disease is inevitable. Other times it’s preventable.
Regardless, heart disease is the leading cause of death in America, according to the Centers for Disease Control and Prevention (CDC). So, it’s important to stay proactive when it comes to your heart.
Whether or not you’re currently diagnosed with heart disease, here are four recommendations from local cardiologists when it comes to prioritizing your heart health.

Find a Doctor You Can Trust Long Term

It’s been almost 16 years since Dr. Greg Nowak, a board-certified cardiologist, saw his first patient at Mercyhealth Heart and Vascular Center-Rockford.
One patient in particular has been seeing Nowak once every six months for the past 15 years.
“She had a heart attack back in 2003, and the chance of her surviving was very slim,” Nowak says. “She went to the hospital and got a stent and defibrillator before I saw her. Now, she comes every six months to Mercyhealth.”
At this six-month checkup, Nowak listens to any concerns the patient is having. If she claims to be asymptomatic, he performs a routine checkup and prescribes the proper medications for continued treatment.
However, if she complains of any pain, shortness of breath or other symptoms, Nowak must investigate further.
“Knowing this patient, who has coronary artery disease and a prior cardiac arrest, we intervene right away if she tells us anything is wrong,” Nowak says. “But most of the time, it’s a routine checkup where we make sure she’s on the right medications and we make sure she goes to our defibrillator clinic.”
This patient is practically a family member to Nowak and the office staff. They’ve known her personally and developed trust with her for 15 years.
“There’s a lot of bonding,” Nowak says. For him, it’s much easier to treat patients he knows well and has a relationship with.
“I know what to expect and then how to approach it. Every patient is different, even if they have the same medical problem. Knowing the patient so well over the years helps to discuss treatment for them.”
Nowak finds that the longer he treats his patients, the more likely they are to follow his recommendations. In fact, patients who want a second opinion on a completely different health issue – non-cardiac related – will sometimes go to him for advice.
“I find that really interesting because it shows how much my patients trust me,” Nowak says. “I think a problem nowadays is that the doctor-patient relationship can be broken when there are frequent changes in the physician staff, or when a patient has a change of insurance and needs to see another physician. Establishing a relationship with a patient, and continuing a partnership with a patient for years, is useful to building trust and improving patient outcome.”
That’s why Nowak intends to stay at Mercyhealth Heart and Vascular Center-Rockford for many years to come.
“I enjoy being here, and I want to continue to treat my patients into the future,” he says. “That’s what my mission is.”

Know What You’re Up Against

According to the CDC, about 610,000 people die of heart disease in the U.S. every year (which is one in every four deaths). It’s the leading cause of death for both men and women.
In addition to finding a doctor you can trust, it’s also important that he or she can clearly explain the conditions of your heart disease as well as the treatment options.
“Heart disease is a serious condition; people have good reason to be concerned,” says Dr. Mazen Hadid, interventional cardiologist at SwedishAmerican Heart Institute, in Rockford. “Usually, patient anxiety comes from not knowing what’s going on. So, it’s very important for me to explain to a patient exactly what’s happening.”
Two of the most common diseases Hadid treats are coronary artery disease and atrial fibrillation (AFib).
According to the CDC, coronary artery disease is the most common type of heart disease, with more than 370,000 deaths annually. It’s caused by a plaque buildup in artery walls that causes the inside of the arteries to narrow over time, which can partially or completely block blood flow. When your heart doesn’t get enough blood, symptoms of chest pain (angina) may result, and, over time, heart failure and arrhythmias may result. Treatments include lifestyle changes, medications and angioplasty (a procedure to restore blood flow by widening the obstructed arteries).
“The majority of our work focuses on the arteries of the heart,” Hadid says. “We treat patients both in the hospital and the office. Patients in the hospital are usually a bit sicker, coming in with heart attacks and such, whereas people in the office are usually a bit healthier but are coming in with chest pain or shortness of breath.”
The scenario is the same for Dr. Prasad Kilaru, cardiologist and cath lab director at the FHN Judy and Virgil Bocker Cardiovascular Center at FHN Memorial Hospital in Freeport.
“The most common problem I see is patients coming in with chest pain,” he says. “Second would be atrial fibrillation.”
When a patient arrives at FHN with chest pain, Kilaru does an electrocardiogram (EKG) to record the heart’s electrical activity. If the patient is in the emergency room, the EKG is done immediately to determine whether or not the patient is having a heart attack.
“If they are, most of the time we would take them to the cath lab for an emergency angiogram so we can look at the arteries of the heart to see if there are blockages,” Kilaru says. “If we do find blockages, we may be able to unblock them and put in a stent or two.”
Sometimes, however, patients schedule an office appointment to address their chest pain.
“With those patients it’s a different approach because it’s not an emergency situation,” Kilaru says. “We also do an EKG on those patients, and if the EKG confirms they’re not actually having a heart attack, then we’d do a stress test to help diagnose their heart issue.”
A typical stress test involves walking on a treadmill while having your blood pressure, heart rate and EKG monitored continuously. Other forms of stress tests include nuclear medicine injections and echocardiograms.
“Some patients have EKG’s that aren’t useful to interpret in a plain old stress test,” Kilaru says. “So, we inject a nuclear chemical into their vein which is taken up by the heart to identify areas of trouble. Or, there is a stress echocardiogram, an ultrasound of the heart, that allows us to look at the heart continuously before and after exercise to see if it’s appropriately responding to the stress.”
If the stress test shows a problem in the heart, Kilaru can do an angiogram procedure on the patient.
When it comes to atrial fibrillation (AFib), patients can also show up in the emergency room or office with symptoms of palpitations, dizziness, fatigue or shortness of breath.
“AFib is extremely common in this country and the world,” Kilaru says. According to the American Heart Association, 2.7 million Americans are living with AFib.
“There are four chambers in the heart,” Kilaru explains. “When the upper two chambers (atria) are normally squeezing, the bottom two chambers (ventricles) are normally relaxed, and vice versa. There is a beautiful dance between the atria and ventricles in a normal, healthy person.”
But with AFib, the upper two chambers “go rogue.”
“They start beating nearly 300 beats per minute without any regard to what’s going on with the ventricles. I remember reading it described as a bag of worms; if you have a bag of worms, you can see them squirming inside. That’s what the atrium looks like when somebody is in atrial fibrillation.”
The ventricles try to catch up with the atrium, going as fast as 160 to 170 beats per minute, Kilaru says. This often results in patients feeling short of breath.
“Patients feel the palpitations and generally, they end up in the emergency room because they don’t feel well at all. These people are treated with medications that we can give to slow down the ventricles, so the patient doesn’t feel so tired and fatigued. Sometimes, to straighten out the upper chambers, we can shock the patient to get them back into regular rhythm.”
The worst part of AFib? If left untreated, tiny pieces of clot can form as blood coagulates in the atria. These clots can potentially travel to the brain, causing a stroke.
“To prevent this, we can put patients on blood thinners like warfarin, or a couple of other anticoagulant medications,” Kilaru says. “So this is a long-term therapy. If the disease is long-standing and not well controlled with medications, an ablation procedure is typically the next step to correct the abnormal heart rhythm.”

Take Heart in Technology

Cardiology is a field that’s consistently advancing in technology and procedural techniques.
“There’ve been leaps and bounds of advancement in the past 25 to 30 years,” Hadid says. “We have more devices and medications to control many aspects of heart disease. It’s nice to see continuous advancement in our field.”
Cardiologists often go to conferences and receive one-on-one training to learn new innovations, Kilaru adds. They also read and contribute new research to scientific journals.
One of the biggest advancements in the field of cardiology has been a new valve surgery technique.
“In the past, if somebody had a valve that didn’t work, they were sent for open-heart surgery, which has a high mortality rate and a long recovery process,” Kilaru says. “People who weren’t good candidates for the surgery were told to live with the problem.”
But today, transcatheter aortic valve replacement (TAVR) can be done to replace a narrowed aortic valve that fails to open properly. Now, elderly patients who cannot undergo a major surgery can have this minimally invasive procedure.
According to the American Heart Association, TAVR is a procedure in which a cardiologist wedges a replacement valve into the heart without removing the old, damaged valve. Once the replacement valve is delivered to the site through a catheter, it takes over the job of regulating blood flow.
“That’s an example of a miraculous procedure that we’re able to offer today that wasn’t even offered 10 years ago,” Kilaru says.
For him, advancement in cardiology has been beneficial to his own family. He went to medical school in India and spent some time in Jamaica and the United Kingdom before coming to America. He has witnessed advancements in health care all over the world.
“For example, angioplasty wasn’t even available when I was in medical school,” Kilaru says. “When I was a young person, my dad had a heart attack (in India) and there were no angiograms or angioplasty available. So, my dad died from the heart attack. I also had a brother-in-law who had a heart attack, 10 years ago, and a few years ago my brother had a heart attack. Both were able to have angioplasty and stents put in, in India. I can look at those three heart attacks and say ‘yes, there has been a huge progress.’”
Hadid has also witnessed advancement in cardiology throughout his career. He went to medical school in Syria, where access to health care was different from America.
“It makes you more thankful for the advancement in the technologies that we have in our hands right now, right here,” Hadid says. “Other places in the world might not have what we have, and we take it for granted. It’s a privilege to be able to help patients with heart disease in the northern Illinois area.”

Intervene Early with Healthy Habits

In spite of advancement in technology, pre-intervention through a healthy lifestyle is the best way to treat heart disease before it even begins.
“Every one should look for the thing that will lead to heart disease,” Hadid says.
Some things, you can’t fix. You might inherit “bad genes” from your family that put you at risk for heart disease.
However, there are lifestyle choices you can control.
“Do not smoke,” Hadid says. “Eat healthy. Stay active. Stay on top of things that lead to heart disease, like high blood pressure, high cholesterol or diabetes. And again, don’t smoke.”
The American Heart Association recommends at least 150 minutes of moderate exercise per week (2.5 hours), or 70 hours a week of vigorous exercise.
“Even a simple act like walking 30 minutes a day is good for your physical and mental health,” Kilaru adds. “When it comes to your diet, avoid eating too many starches or sugars. Fruits and veggies are still the best thing you can eat.”
You can also eat more whole grains, limit milk and meat products high in fat, and try to eliminate processed food altogether.
By intervening early, you might be able to save yourself from further complications down the road.
“Once you have heart disease, it’s up to us, the doctors, to treat you,” Hadid says. “I think everybody’s part starts before that.”