How COVID-19 Treatments Could Affect Heart Patients

The COVID-19 pandemic posed a challenge for health care providers to quickly lay out plans for effective treatments for those with the virus. Although there isn’t yet a definitive treatment for COVID-19, there are options depending on your symptoms and their severity. If you have a heart condition, you should know your treatment options and how they may affect your cardiovascular health before getting treated.

Treatments at Home

If you have tested positive for COVID-19 and your symptoms are not severe enough for hospitalization, you should make sure that you’re managing your heart health through telehealth appointments with your doctor. It is especially important for patients with chronic cardiovascular disease to check in with your doctor often so they can advise you on the best course of action for treating your specific symptoms in a safe way.

The best way to treat mild symptoms of COVID-19 at home is to keep up with your general health: Get plenty of rest and drink plenty of water. Acetaminophen is recommended to treat pain but be sure to check in with your doctor for dosage instructions before starting to take it.

Patients with the virus should also self-quarantine at home to limit the spread of the virus. If you live with other people, isolate yourself within your home and limit interactions with other household members and pets. Be sure to wear a mask around others in your home, avoid sharing dishes and other household supplies and have a member of your household regularly disinfect surfaces. Telehealth appointments are widely available, but if you need to leave your home to visit the doctor, wear a mask, practice social distancing and avoid crowded public areas.

Hospitalization

For severe symptoms of COVID-19, you should seek medical attention. The CDC recommends seeking emergency care if you experience trouble breathing, persistent chest pain, new confusion, inability to stay awake or bluish lips or face.

Hospital care will vary depending on the patient. While medical professionals have been testing possible treatment methods, there is no one-size-fits-all treatment. Your doctor will be able to monitor your breathing and overall health closely while hospitalized and recommend the best course of action. You may receive fluids or oxygen depending on your specific symptoms.

Stay Up to Date

New information on COVID-19 treatments is being released every day. For heart patients, it’s important to limit your exposure by staying at home whenever possible, wearing a mask when you leave your home, practicing social distancing and washing your hands frequently. Check in with your doctor regularly for the most accurate information on what you can do to stay safe and healthy at this time. If you suspect that you have symptoms of COVID-19, contact your doctor immediately.

The Cardiac Partners team of specialists are here to help you keep your heart healthy through this crisis. Click here to request an appointment with one of our providers.

What Should Heart Patients Know About COVID-19?

By now, it’s clear that COVID-19 poses a dangerous risk to many people with pre-existing conditions. For those with a cardiac condition, there are even more potential risks. According to early reports, 40 percent of patients hospitalized due to COVID-19 had cardiovascular disease or cerebrovascular disease, a condition affecting blood flow to the brain. And in February, the American College of Cardiology encouraged patients to take “additional, reasonable precautions” for their safety.

COVID-19 can affect heart patients in a variety of ways. Here’s what you should know about how it might affect you and what steps you can take to prevent getting sick.

Risks to Heart Patients

The virus directly affects the lungs, which means your heart may be under more stress than usual if you get sick. For those with heart disease, your heart already has to work harder to get oxygenated blood circulating through the body. With decreased lung function, this can put even more strain on the body and increase the chances for heart failure when it already struggles with pumping blood efficiently.

Getting sick can cause extra strain on the immune system that can lead to complications and an increased chance of hospitalization.

In addition, those who have plaque present in their arteries might be at special risk. Studies of similar viral illnesses have shown that getting sick can destabilize plaque, causing artery blockage and an increased risk of a heart attack.

Although research is still being conducted on COVID-19, we can see that other coronaviruses, such as SARS and MERS, have been linked to heart complications including heart attack in patients with pre-existing heart disease due to stress, low oxygen levels and severe inflammation in many organ systems.

How to Protect Yourself

As a heart patient, it’s better to be cautious in order to protect yourself from getting sick.

The best way to protect yourself from getting COVID-19 is to take the same precautions you would during flu season. The virus appears to spread through droplets in the air when someone coughs or sneezes, much like the flu. Follow CDC guidelines including physical distancing, frequently wash your hands, keep surfaces around you clean, cover your coughs and sneezes and avoid traveling to crowded areas. If you get sick, stay home, even if you don’t think it’s COVID-19.

If you have a heart condition, you should make sure that you’re up to date with vaccinations, including for pneumonia. Cardiologists strongly recommend getting a yearly flu shot for all patients with chronic cardiovascular conditions to protect yourself from another source of fever that could be confused for COVID-19.  If you notice that you have symptoms for COVID-19 and suspect you may have it, contact your doctor right away.

The Cardiac Partners team of specialists are here to help you keep your heart healthy through this crisis. Click here to request an appointment with one of our providers.

Heart Health Outcomes of COVID-19

Although health professionals knew early on that contracting the COVID-19 virus could lead to respiratory infection and permanent lung damage, it’s now becoming more clear that the virus could have lasting effects on the way your heart works as well, even for patients without pre-existing heart conditions. But what if you are already dealing with a heart condition, or are recovering from a recent cardiovascular episode? Cardiac Partners offers heart patients insight to how COVID-19 is affecting their population along with treatment options and prevention methods to help keep you healthy.

Complications for Heart Patients

Studies from past coronavirus and influenza epidemics suggest that patients with symptomatic COVID-19 may develop heart complications from the virus. Data from SARS and MERS viruses point to complications of coronary artery disease, heart attack, arrhythmias or heart failure because of the high inflammatory response associated with the virus. This could happen to any patient, but especially in those with severe symptoms.

 Although developing a heart complication after contracting a coronavirus is a risk for every patient, those with pre-existing heart conditions are not only more likely to catch the virus, but are also more likely to develop severe complications afterward. If you’re over the age of 65 and have heart disease or high blood pressure, there’s even an increased likelihood that you could need critical care if you’ve contracted COVID-19. Some of the most critical cases have reported respiratory failure, septic shock, multiple organ dysfunction, and yes, even the possibility of death in the most severe cases.

If you have a heart condition, it’s important to monitor your health frequently and keep an eye out for symptoms of COVID-19. Leaving the virus untreated could be dangerous. Common symptoms of the virus include fever, cough and shortness of breath. You may also experience muscle pain, sore throat, nasal congestion and headaches if you are sick. It’s important to note that you can be asymptomatic for up to 14 days after contracting the virus. If you experience any of these symptoms, be sure to contact your doctor right away to get tested for COVID-19.

Staying Healthy and Treatment Options

While the outcomes may look or sound threatening for patients with pre-existing heart conditions, there are proven treatments available to combat the virus. Some treatments for COVID-19 are still being researched, so it’s most important to focus on prevention.

  • Practice social distancing, staying six feet away from others (minimum) when in a public space
  • Wash your hands frequently
  • Wear a mask if you need to leave your house
  • Continue taking all medications as prescribed

Some experts even suggest that patients with pre-existing conditions talk to their doctor about getting flu and pneumonia vaccines. These will not prevent COVID-19, but they may help you steer clear of superimposed infections along with the virus.

In addition to your primary healthcare team, Cardiac Partners network of specialists are here to help you keep your heart healthy through this crisis. Click here to request an appointment with one of our providers.

 

 

Home Exercises for Cardiac Rehabilitation

If you’ve experienced heart attack, heart failure, angioplasty or heart surgery, you’re probably enrolled in a cardiac rehabilitation program with your health care provider. Cardiac rehab is an important part of managing and improving your heart health.

A key element of cardiac rehab is getting regular exercise. Getting active on a regular basis is beneficial in a number of ways, including:

  • lower blood pressure
  • lower “bad” cholesterol levels
  • increasing “good” cholesterol levels
  • healthy weight loss
  • more energy
  • better sleep
  • better joint function and ability to complete daily tasks
  • decreased bone mineral loss
  • better control of diabetes.

Due to the COVID-19 pandemic, most gyms and health centers are closed right now and we’ve had to adjust to exercising at home. Even as gyms begin to open back up, you may want to continue your exercise routine at home to reduce your risk of exposure to the virus. Here are some ways to get in your cardiac rehab exercises at home so you can continue to improve your heart health and your quality of life.

Warming Up

Warming up is essential to every exercise routine, as it helps to prevent injury and increase flexibility so you can perform movements with greater ease. Muscles are warmed up through gentle movements that increase your blood flow and heart rate and open up blood vessels. Be sure to breathe normally throughout your warm-up exercises and hold each stretch for about 30 seconds. Examples of stretching exercises to perform before aerobic activity are calf and Achilles stretches, lower back and hamstring stretches, and thigh stretches. Refer to your doctor for instructions on how to do these warm-up stretches.

Aerobic Exercises

Aerobic training is essential to reaching your goals for weight loss and improving cardiovascular health. There are many different forms of aerobic training, which makes it easy for you to choose one that you enjoy and can stick with. Examples include walking, bicycling, swimming, jogging, cross-country skiing and rowing. Many of these you can do at home outdoors, making it easy to get in aerobic exercise even during the stay at home order. If you’re exercising outside and might encounter other people along the way, remember to wear a mask and wash your hands as soon as you get home to prevent illness.

The ideal frequency for your aerobic activity is five to six times per week, but it’s better to gradually increase the amount that you’re exercising instead of jumping right into an intense routine. If you’ve never exercised before, start with five- to ten-minute intervals of exercise a few times in one day, and gradually increase the duration of your exercise to reach 45 to 60 minutes at a time.

For cardiac rehab, it’s important to pay attention to your body as you’re exercising. Your doctor will provide you with a target heart rate (THR) for exercising. At home, you can measure your heart rate by counting your pulse for 15 seconds and multiplying by four. Try to keep your heart rate in the THR range provided by your doctor. You should also pay attention to your breathing and your pain level as you exercise. If you find that you can’t talk at all while exercising or you are in extreme pain, stop and rest.

Resistance Training

In addition to aerobic exercise, you should also incorporate resistance exercises in your routine two to three times per week. Resistance training allows you to build lean muscle to make everyday tasks like shopping, house cleaning and yard work a little bit easier. Increasing muscle tone and mass also helps to burn calories during the day, even when you’re resting.

When resistance training, use weights that allow you to complete 12 to 15 repetitions of each exercise without too much strain. If you’re unable to get weights at home, you can also use resistance bands. Make sure that you’re breathing evenly and using slow, controlled movements throughout the exercises. As with aerobic exercises, you should start small, with just one set of each exercise, and slowly build up to three sets as you build tolerance and stamina.

Examples of resistance exercises that you can perform at home with dumbbells or resistance bands are bicep curls, shoulder presses, upright pulls, triceps dips, lateral flys and deltoid raises. Refer to your doctor for instructions on how to do these exercises.

Cooling Down

It’s important to cool down after every exercise session. Cooling down allows you to gradually decrease your heart rate, avoid dizziness, increase flexibility and prevent muscle soreness. To cool down, you should lower your exercise intensity and maintain a slow pace for two to five minutes, followed by repeating the stretches that you used to warm up.

Be sure to consult with your doctor before starting a new exercise program. These exercises can be done from the comfort of your own home, but you should still seek guidance from your heart specialist if you feel extreme pain or discomfort, or if you’re unsure about frequency and duration according to your specific needs.

If your cardiac rehab routine has been disrupted by the COVID-19 crisis, the team at Cardiac Partners is here to help. Call (833) SJ-HEART to find a cardiac rehab location near you.

CIP-Vergari-News-web

The Effects of Smoking and Heart Heath

It’s long been known that smoking is one of the leading causes of lung cancer in America. But did you know it can greatly affect the health of your heart too?

Despite smoking rates in the United States continuing to decrease, down to just 14% of the population according to a 2017 CDC study, an estimated 34 million Americans still report a habitual smoking habit. “Smoking is a major agent of cardiovascular disease (CVD) and causes approximately one of every four CVD related deaths. Even people who smoke fewer than five cigarettes a day may show signs of early cardiovascular disease.” says John A. Vergari, M.D., a cardiology specialist with the Cardiac Partners at Cooper and Inspira network of providers. “However, it’s important to know it’s never too late to quit. Even long-time smokers can see rapid health improvements after quitting.”

If you are suffering from cardiovascular disease as a result of long-term tobacco use, Cardiac Partners is here to help. At Cardiac Partners, our cardiac rehab programs offer an integrated approach to improving the cardiovascular health and overall well-being of patients living with heart disease. Through a personalized plan of care and collaboration with your cardiology specialist, Cardiac Partners will have you back to full function with reduced risk of future cardiovascular episodes.

CIP Bajpai News

Is Daily Aspirin Therapy Right for You?

Is Daily Aspirin Therapy Right for You?

“Daily aspirin therapy can be a lifesaving option.” Says Enakshi Bajpai, D.O., Cardiologist at Inspira Health and member of the Cardiac Partners at Cooper and Inspira network. “But it isn’t for everyone. It’s important to understand the benefits and the risks before beginning any type of antiplatelet drug.”

If you’ve had a heart attack or stroke, your doctor will likely recommend you take a daily aspirin unless you have a serious allergy or history of bleeding. If you have a high risk of having a first heart attack, your doctor will likely recommend aspirin after a comprehensive evaluation of your individual condition.

How can aspirin prevent a heart attack or stroke?

Dr. Bajpai explains, “Aspirin interferes with your blood’s clotting action. When you bleed, your blood’s clotting cells, called platelets, build up at the site of your wound. The platelets help form a plug that seals the opening in your blood vessel to stop bleeding. But this clotting can also happen within the vessels that supply your heart and brain with blood. This prevents blood flow and can cause a heart attack or stroke. Aspirin therapy reduces the clumping action of platelets — possibly preventing those types of cardiovascular attacks.”

Am I a candidate for a daily aspirin regimen?

Your doctor might suggest daily aspirin therapy if you meet certain criteria, such as:

  • Fall in the proper age rage, generally between 50 – 69 years of age.
  • You’ve already had a heart attack or stroke.
  • You’ve never had a heart attack but are at high risk for one based on other factors.
  • You haven’t had a heart attack, but have had a stent placed, had coronary bypass surgery, or complications from angina.
  • You suffer from diabetes.

“Although aspirin has been recommended in the past for certain groups of people without a history of heart attack, there’s some disagreement among experts about whether the benefits of aspirin outweigh its potential risks.” States Bajpai.  And according to the Food and Drug Administration, the benefits of daily aspirin therapy don’t outweigh the risk of bleeding in people with a low risk of heart attacks. The higher your risk of heart attack, the more likely it is that the benefits of daily aspirin outweigh the risk of bleeding.

What are the risks?

“Because aspirin thins the blood, it can cause several complications.” says Bajpai. Tell your doctor if any of these situations apply to you. 

  • Have a known aspirin allergy or intolerance
  • Are at risk for gastrointestinal bleeding or hemorrhagic stroke
  • Drink alcohol regularly
  • Are undergoing any simple medical or dental procedures
  • Are over the age of 70

There is a risk of developing stomach problems, including stomach bleeding, for people who take aspirin regularly. Alcohol use can increase these gastrointestinal risks. Dr. Bajpai recommends, “If you are told to take aspirin, ask your doctor if it is safe for you to drink alcohol in moderation.”

The bottom line…

While aspirin may be able to help certain patients in specific situations, there are many other things an at-risk patient can do to mitigate their risk of having a first, or repeat, heart attack or stroke. Healthy lifestyle changes, increased levels of exercise and good sleep patterns are all ways to improve your cardiovascular health. If after these good habits are established and a patient’s health does not improve, it may then be time to discuss adding aspirin therapy to your daily routine. But as Dr. Bajpai knows, “The best way to know if you can benefit from aspirin therapy is to ask your health care provider. Never start daily aspirin therapy on your own!”

If you are curious to know if you might benefit from daily aspirin therapy, make an appointment with a Cardiac Partners specialist near you by calling 833.SJHEART (754-3278).

Zinn Unwala

Impella Cardiac Device Helps Patients Recover Closer to Home

The doctors at Inspira Medical Centers Woodbury and Vineland have a new tool in their arsenal to help a damaged heart pump enough blood to support major organs, while also giving the heart time to recover, according to Ashfaque Unwala, MD, cardiac catheterization medical director, Inspira Woodbury.

The Impella Ventricular Support System draws blood out of the heart and pumps it into the aorta, partially or fully bypassing the left ventricle and providing increased blood flow to critical organs in heart attack patients. The device is used most often in patients with cardio- genic shock, which happens when a person’s heart suddenly stops pumping enough blood to meet the body’s needs. This can cause severe organ damage or even death.

“One of the things we have noticed over the last few years is the high percentage of patients who come in with cardiogenic shock,’’ said Andrew Zinn, MD, cardiac catheterization medical director, Inspira Medical Center Vineland. “In the past, we’ve been able to stabilize these patients, but we’ve had to rapidly transfer them to other institutions.“ Zinn added.

As Inspira primarily treats heart attack patients — not those scheduled for complex surgery

— the Impella is used to stabilize patients’ hearts as they recover from a heart attack and/or cardiogenic shock. “Far too often, these patients have been having a heart attack for several hours before coming to the hospital,’’ Unwala explained. “This enables us to support the patient while recovering from a heart attack.’’

Previously, doctors would use a balloon pump or other devices, but those generated less blood flow than what can be achieved with the Impella, Unwala said, adding that the Impella is also easier to manage. “This helps to maintain the functions of the brain, kidneys and other organs,’’ he added. The device is implanted non-surgically into the left side of a patient’s heart through a small incision in a major artery in the leg or through a small incision in an artery in the chest, Dr. Unwala explained. Inspira officials said the procedure will be widely available at both Inspira Woodbury and Vineland this fall, after all protocols are put in place and all staff are trained.

“From the nursing standpoint, we are seeing the evolution of improving care at our facilities with evidence-based practices, especially for cardiac care,’’ said Michele Zucconi, R.N., administrative director, critical care, Inspira Vineland. “This is just one example and it means our patients can get the best treatment locally and be close to their family and other support systems. This is in keeping with our philosophy of treating the patient as a whole.’’

M. Scott Dawson, M.D., is a cardiologist with Inspira Medical Group

Dr. M. Scott Dawson Wins Top Honors for His Award Winning Essay

M. Scott Dawson, M.D., a board-certified cardiologist with Cardiac Partners at Cooper and Inspira, recently earned first place in the Saint Joseph’s University Pedro Arrupe Center’s Graduate Ethics Essay Competition. His writing focused on expanding access to elective angioplasties, a divisive topic in New Jersey. 

His essay titled: New Jersey’s Ethical Dilemma: Restrictive Privileges for Elective Angioplasties, reviews the multiple factors that have led to the continued restrictions, and the benefits that would be realized if, the restrictions were lifted. Dawson’s paper was commended for the substance of its application of ethical concepts to the issue.

“As the region’s leading network of cardiology specialists, Cardiac Partners providers know that our care cannot stop at the patient’s bedside. With five of the eight counties in the Southern New Jersey region seriously lacking in patient access to elective angioplasty procedures, it’s up to us to advance the conversation on a patients moral and ethical right to receive the best care possible, in their community”. says Dr. Dawson. He continues, “My essay offers us all an opportunity to step back and evaluate the obligation each of us – patients, physicians, hospital systems and insurance providers alike – has to the success of our healthcare model. Cardiac Partners is proud to be leading the way in both patient care and advocacy.”

The Saint Joseph’s Ethics Paper Competition is open to all graduate students at the university. Dr. Dawson, along with 13 other organizational leaders from Inspira Health, are currently enrolled in an Advanced Graduate Certificate Program in partnership with the Haub School of Business at Saint Joseph’s. In this program, executive students participate in six university courses as a part of the Pharmaceutical & Healthcare Marketing MBA track.

To read the award-winning essay by Dr. Dawson visit: https://sites.sju.edu/arrupe/student-ethics-competitions/ [sites.sju.edu]

MitraClip

Cooper University Health Care Becomes Region’s Only Hospital to Offer MitraClip Procedure

Heart Valve Device Offers New Options for Patients

Until recently, high-risk heart patients with a severe form of leaky mitral valve disorder, called mitral regurgitation, and who were deemed too frail or sick to undergo open heart surgery had few treatment choices.

Janah Aji, MD, FACC

Janah Aji, MD, FACC

Cooper University Health Care now offers a new treatment option for these patients with the FDA-approved MitraClip device. A medical team including Janah Aji, MD, FACCSajjad A. Sabir, MD, and Georges I. Kaddissi, MD, FACC, performed the first commercial-use procedures using the MitraClip in mid-April, making Cooper the only South Jersey health system offering this treatment.

“We are very fortunate to be able to offer this treatment to patients,” said Dr. Aji, who serves as director of the Cooper Cardiac Catheterization Laboratory. “It can be a life-changing option for patients suffering with severe mitral regurgitation. Following this procedure, patients who have severe heart failure symptoms due to this condition will experience significant improvement in shortness of breath and fatigue.”

Sajjad A Sabir, MD

Sajjad A Sabir, MD

Cooper was instrumental in clinical trials for the MitraClip and was one of 75 leading heart centers in the United States that participated it the COAPT trial that lead to the FDA approval of this device for patients with functional mitral regurgitation.

Mitral regurgitation affects millions of people worldwide. It is the most common type of heart valve defect, affecting one in 10 people aged 75 and older. The condition occurs when the heart’s mitral valve does not close completely, causing blood to leak backward into the left atrium with every heartbeat.  Mitral regurgitation requires the heart to work harder to maintain an adequate forward flow of blood.  Over time, that can lead to serious heart rhythm problems, stroke, heart failure, and death.

The MitraClip device, manufactured by Abbott Vascular, is a small clip that is attached to a patient’s mitral valve. It treats mitral regurgitation by allowing the valve to close more completely, helping to restore normal blood flow through the heart.

Georges I Kaddissi, MD, FACC

Georges I Kaddissi, MD, FACC

“As a high volume cardiac center, the Cooper Heart Institute has long been a leader in clinical trials and utilization of new devices for the treatment of structural heart conditions,” said Dr. Sabir, director of the Cooper Structural Heart Disease Program. “Cooper is proud to be a leader in testing and using these new devices which are rapidly expanding options for patients with these conditions.”

The Cooper Heart Institute is the most comprehensive heart care center in southern New Jersey, earning national recognition for its superior quality and world-renowned team of cardiovascular experts. Cooper was recognized as a top performing hospital for treating congestive heart failure in U.S. News & World Report’s 2018-2019 Best Hospitals survey. At Cooper, patients have access to a full spectrum of heart care from prevention and diagnosis to cutting-edge technology and innovative treatment.

In 2018, Cooper and Inspira Health Network formed a joint venture to integrate cardiac services. This affiliation, called Cardiac Partners at Cooper and Inspira, provides patients in the South Jersey region with access to more coordinated cardiac services across the continuum of care.

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Wendy A. Marano
Public Relations Manager
marano-wendy@cooperhealth.educreate new email
856.382.6463

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Cooper University Health Care First Hospital in Eastern U.S. to Treat Central Sleep Apnea With Newly Approved Device

(CAMDEN) – A medical team at Cooper University Health Care recently was the first in the eastern United States to treat a patient with central sleep apnea (CSA) with a new implantable device to stimulate breathing. Cooper is currently one of only 24 sites in the United States treating CSA with the remedē® System, developed by medical technology company Respicardia, Inc. The remedē® System received FDA-approval in 2017 and is the first commercially available device to treat CSA.  

“CSA is a serious breathing disorder that disrupts the normal breathing pattern during sleep and negatively affects quality of life and overall cardiovascular health,” said John A. Andriulli, DO, FACC, an electrophysiologist at Cooper and director of the Arrhythmia Device Program at the Cooper Heart Institute. “It often occurs in cardiac patients, especially those with severe congestive heart failure, and is associated with a significantly greater risk for morbidity and mortality.”

A multidisciplinary team led by Dr. Andriulli along with Ramya Lotano, MD, FCCP, a pulmonologist and sleep expert, performed Cooper’s first  commercial remedē® procedure in a patient with CSA. 

CSA is different from the more commonly known obstructive sleep apnea, which is caused by upper airway obstruction. CSA results from the brain’s inability to send appropriate signals to the respiratory muscles to stimulate breathing. Treatment of the CSA patient is more challenging because the signal to the body to inhale is not being transmitted from the breathing center in the brain.

The remedē System is a pacemaker-like, battery-powered device that is placed under the skin in the upper chest area during a minimally invasive outpatient procedure by a cardiologist. The device has two small leads (wires): one that senses breathing, and one that stimulates the respiratory muscles to work when irregular breathing is detected. 

“This new device is offering real hope to CSA patients who previously had very few options,” said Dr. Andriulli. “It can reduce the effects of CSA by improving sleep and, most importantly, the patient’s quality of life. Improved quality of sleep often leads to improvement in symptoms of heart disease and other medical problems.”  

Cooper was involved in clinical trials for the device and is currently the only hospital in New Jersey to offer this treatment for CSA.