City of Plantation Podcast

Episode 30 - February is Heart Health Month - Dr. Chaleff

February 19, 2021 City of Plantation
City of Plantation Podcast
Episode 30 - February is Heart Health Month - Dr. Chaleff
Show Notes Transcript

Thank you for listening to the City of Plantation's Podcast. In this episode, Cary and I 
speak with Dr. Chaleff, a Board Certified Interventional Cardiologist from Westside Regional Medical Center. Dr. Chaleff speaks about Heart Disease and the associated risk factors, as well as how COVID interacts with Heart Disease and steps we can take to reduce those risk factors. This Podcast is aimed at keeping the residents of Plantation informed of events and important information happening throughout our city. Please subscribe to this podcast, as we will be producing new episodes regularly.


Hosts: Cary Blanchard and Ezra Lubow
Guest: Dr. Fredrick M. Chaleff
Music: Oakwood Station
Graphics: City of Plantation

Speaker 1:

Welcome to the city of plantations podcast. I am Carrie Blanchard, battalion chief of public affairs for the plantation fire department. Thank you for tuning in our podcast is designed to keep you up-to-date on all the latest happenings and activities in about and around the city of plantation on our episodes, we talked directly with the leaders decision makers and the movers and shakers who make plantation the great city that it is

Speaker 2:

Welcome back to another episode of the city of plantation podcast. February is heart health month. So Carrie and I thought it was appropriate to bring in Dr. Frederick M Shalan . He is a board certified interventional cardiologist at Westside regional medical center. He's going to join us today to talk to us about heart health, including risk factors and what we can do to improve our overall health, which will benefit our heart health. So, doc, thanks for coming in today. Thank you very much for having me here today.

Speaker 1:

Can you tell us about heart disease and heart health and risk factors and things like that?

Speaker 3:

Right. So heart disease is the number one killer of Americans in the United States. And it is very important. We do have some control over our outcomes. And when I talked to patients, I talk to them about their risk factors for heart disease, diabetes, cholesterol, smoking their diet exercise. And I really emphasize to them, we can modify these risk factors if we're diligent and proactive. And those are the risk factors. I really try to emphasize with my patients in the office.

Speaker 2:

So in other words, I doing things I , uh, eating a little bit healthier, getting your heart rate up through some exercise. Uh , even if it's not, you know, CrossFit or Olympic level training, just getting out and moving those types of things.

Speaker 3:

Yeah. And those are excellent questions. And I'll tell you this to put in a perspective a little bit. So my patients say to me, how much do I have to exercise? They think they have to go to the gym and run a marathon. The answer is no. And to give you an idea, a slice of bread has about a hundred calories give or take now for you to run on a treadmill. On average, you would have to run about 20 minutes to burn those hundred calories. So I tell all my patients, do you want to run for 20 minutes on a treadmill? Or you want to give up that piece of bread right now? Can you imagine if you did both right, then you would really be proactive and reducing your calorie intake , uh, helping you, of course your triglyceride levels, your, your, your sugar levels and everything and burning fat. When you exercise

Speaker 2:

Right real quick back, circling back to diabetes are the majority of, of PE diabetic patients. Are they born with diabetes or do they develop diabetes because of poor habits or genetics or other factors?

Speaker 3:

That's another good question. The answer is it's probably both. Um, yeah, some people are born with the genetically. You see the diabetes star , the juvenile onset, where they take the insulin. Then there's the adult onset where we get in as adults. Now, sometimes our pancreas only will produce so much insulin genetically, but when you start gaining weight and you start putting a load on that pancreas to produce the insulin, you cannot keep up. And that body mass index goes up. That fat content that you carry goes up, you cannot handle the sugar. And then you start to develop the complications of diabetes. Now there's one thing I do want to say with diabetes, you ever noticed when you go to your doctor and they say, well, your sugars are a little high. You don't have kind of diabetes yet. Right. We call that pre-diabetes we did a study on prediabetics. And even though you don't take medicines or you don't take insulin, there's still about a 20% increase in progression to , uh , worsening heart disease, even with pre diabetes. Oh, wow. Okay. So that's the time to really start being active when you know that you can be ahead of the curve with those sugars. Right? Excellent. So what are some of the signs and symptoms to look out for, for heart disease? It's a good question because believe it or not, some of the signs and symptoms are different for men than women. And we, we kinda know, we hear about that a little bit, but it is really true. Men tend to have more of the typical chest pain, shortness of breath, although when we can get it too , we tend to see sometimes in women, a little more GI symptoms or some of the atypical pains. I've had patients, women come to the hospital with nausea and vomiting to the emergency room. They think it's , it's a gastroenteritis. And it turns out that having a heart attack. So the chest pain, the shortness of breath, the weakness, the heaviness, the, when you exert yourself, you get short of breath much quicker when you get this pressure. And then it goes away when you rest those more classic signs of angina, right ? The arm pain, the jaw pain you hear about all those are pretty classic, right? So those are like the textbook, either textbook things. But you know, when something's wrong, a lot of my patients to say, Hey, just don't feel right. And a lot of times they hear, you know, I just don't have the energy I used to. And that is a very nonspecific complaint, low energy. Everybody's got that these days. But if you have risk factors, then your cardiologist is going to start to think, Hey, could it be a heart ? Maybe you need the stress test . Maybe you need that echo things of that nature. Right.

Speaker 1:

I'm just curious, like, cause you're talking about the signs and symptoms that between men and women, and I know a lot of people kind of ignore some of the signs and symptoms, but it would appear easy to ignore if you're a female or having like, when you're saying GI problems, what you could perceive to be a GI problem. It's easy. Ignore that. Absolutely.

Speaker 3:

It's too late. So you want to address it, correct? Absolutely. And that's when the being proactive and you know, your body. So what happens is yes, a lot of women do get those GI symptoms more so than men. And then what happens is they started taking the Pepcid and the Tums , Oh, it's what I ate last night. I went to this restaurant and, but they keep having it. Then the symptoms get worse and hopefully they never end up in the emergency room with a heart attack. They see their doctor first. So we know our bodies best. We should not be ignoring any of these things unusual, especially when it comes to heart disease, because your first presentation could be a heart attack, acute myocardial infarction. And that's when you don't want to damage that heart.

Speaker 2:

Awesome. So you want to try and avoid getting to that point by doing whatever you can to minimize your risk . Because in other words, you might not get a warning. Okay .

Speaker 3:

Exactly. Okay . There's a very small percentage. Unfortunately, the initial presentation is sudden death, although it's a very small percentage, you obviously don't want to be that or presentation. Um, yes. And that's why you want to get out there and be proactive and get your testing done accordingly.

Speaker 2:

Excellent. Excellent. So, you know, we've all been we've on this show. We've been talking about COVID and the effects on , uh, various industries, specifically EMS and medicine as a whole. We've spoken to the CEOs of both West side and PGH and talked about this, but how has COVID changed heart disease or has it ,

Speaker 3:

Uh, it's changed it . And in many ways, of course it's a novel virus. It's new, we're still learning, but what's happened. And you kind of see that there's a dichotomy of issues here with COVID. Now, some patients don't come to the hospital and they don't go to the office. So the routine testing, their blood work, their medications is not being attended to like it normally would be they would neglect their health. And then they're having issues with that complications from their inherent heart disease, even without COVID cause they're neglecting their routine healthcare then with COVID what we've seen is a wide array of issues with heart disease, especially with people who have history of , let's say congestive heart failure. Those people do not have the reserve capacity to deal with the complications of COVID because it's, it's very taxing on the immune system. And if you're not young and healthy without that reserve, that congestive heart failure and all the other complications that may be associated with , uh, with COVID be very taxing on your cardiovascular system. What we've also noticed in patients is that COVID like some of the other viruses, but COVID can cause what we call a mild carditis. That's an inflammation of the heart muscle, either young or old. And this we've seen when people have had enzymes in their blood a little bit, especially a couple of weeks out that they have a subclinical or ongoing low grades, mild carditis, which is inflammation of the heart muscle. And this does persist for a while , usually recovers, but sometimes in some instances it may not, and you can lead to heart failure. It could have guessed some outlying heart disease issues. It could have of course lead to some blood clotting issues, which has cause my cardiac infarction when it does happen. So it , a lot of things can happen with heart disease on COVID .

Speaker 2:

Do you think that's socially people have changed their habits as well because of COVID. So maybe they're not going out as often to the supermarkets in areas where there's a lot of people. So they're eating worse, maybe not going to the gym and exercising, eating. Those are factors as well.

Speaker 3:

They're changing their diets. They're not exercising. We've seen people gain a lot of weight because I'm just not out and about now acutely a little weight gain is not going to change much, but usually what happens is they don't lose it so fast. Right. And then you start running into other issues. Sure. That

Speaker 1:

I know you said it like it exacerbates it, but does it actually like increase your risk of having a cardiac event if you have COVID or is there just not enough information on that now?

Speaker 3:

Well, we don't think it doesn't accelerate the actual, let's say development of plaque per se, that we know of, but what it does is as a result of the massive cytokine and the blood clotting , um, issues that happen, that something called a protein factor, D we gets changed in your body. You can clap more. That means a little plaque or the plaque that you had with increased coagulability. You can thrombose and get your heart attack. And we've been seeing that.

Speaker 2:

And when you say thrombosis , what you mean is basically a clot that travels through the body and ends up in arteries in the heart, creates a blockage.

Speaker 3:

The thrombus that I'm talking about specifically in your heart is in that coronary artery where the lesion is what's the flow is limited. Got it . So that's with respect to heart disease, but the thrombosis can occur in your legs and lead to DVT and pulmonary embolus, things like that. It is a systemic effect, but if you have underlying heart disease with a clinic, with a significant lesion that clot in that coronary artery is where you would get the heart attack. And that may not have happened. Of course, if you didn't have the COVID. Sure.

Speaker 1:

Um, so doc, what can people do to improve their , I know we touched on a couple of things, exercise and things , but what specific things like probably stopping smoking and things like that, what specific things can people do to improve?

Speaker 3:

All right . So there's a little, couple of guidelines that I use as a general rule for patients. 20 minutes of exercise, three times a week, getting your heart rate up to about 75% of your maximum predicted heart rate is probably what you should do. Then I tell them how to count cholesterol , um , or total fat. So what I say, you need to restrict your total diet consumption to about 20 to 30 grams of fat per day. So go to a smart app, start looking. You'd be surprised how fast that fat content adds up. Then they asked me, well, how much cholesterol can I eat? I don't even know. So the answer is we like to keep it less than 300 milligrams a day. Now how much is that? One egg yolk has about 187 milligrams. Oh wow. Okay. And just the pigeon is another perspective. If you want to keep the 20, 30 grams of fat a day, a burger King Whopper has about 30 to 40. So you're done

Speaker 2:

For the day. You're going to have a Whopper and that's it. And barely let us,

Speaker 3:

So it really adds up quickly. Even the olive oils and things like that, that say are healthy. There's still fat in there, right? And there's many grams of fat. He says no cholesterol, but it's a lot of fat. So that adds up also. So really count your calories. Look at really what you're eating. I tell my patients, they have apps on their phone, but how many steps they take for the day? And one thing everybody always does. I tell them and you go to park somewhere. You always look for the closest spot, right? You really need to do it the other way around. That's going to encourage you to walk. And that adds up. You need to get about those 10,000 steps a day in

Speaker 2:

Stop taking the elevator. Exactly . And yeah ,

Speaker 3:

Parked farther away. Everybody go to the gym, they parked really close. They take the elevator up, down , and then they go to the gym and I have a smoothie. So you really have to be serious.

Speaker 2:

One last question on that. Cause you had mentioned olive oil and I think a lot of people are under the misconception, that healthy things like avocados and olive oils and almonds, right? I was told like these are the healthy alternatives to chips and candy and sugary foods, but everything still has to be in moderation, right. Everything .

Speaker 3:

And I see a lot of patients that say the vegetarians and I see that their triglycerides or cholesterol is early elevated and they're not eating any meat, but eating a lot of these cheeses and the cheese alternatives with a lot of oils and their cholesterol is, and triglycerides are high. Oh, but I'm a vegetarian. I go, yeah. But you're eating the United eating and moderation's with the fats and the oils . So yes. Everything in moderation, be aware of what you're eating, be aware of, how much you're really exercising, watch your steps. Yes, of course the smoking is key. And if there's a family history, then you need to just really be even more active about it.

Speaker 2:

I have one last question for you. We hear a lot about Omega threes and fish oils. And I know a lot of people take that supplement any definitive research to that, that Omega threes are helpful or that eating more fish than other meats or even taking the supplement, any definitive data that it's helpful.

Speaker 3:

At one point we thought it was very helpful. We looked at some of the data. Then we look at retrospective analysis and some randomized controlled and we found it really is not what we thought it was. Is it good to take? Yes. It's FDA approved to take the Omega three triglycerides for elevated triglycerides and just say, ask a question. I'm a very big proponent of a krill oil. I like the side Crow . And that's because the Omega three phospholipids that you see in krill oil a much more water-soluble . So what happens is you don't get that upset, GI discomfort, the bloating, the gas, the diarrhea, those fishy burps. It gets about three times the , uh , plasma serum level than it does with the regular Omega threes. So you need to take less for that. VATE regular to get that good level. And then the tissue penetration for your brain, your eyes, your heart , and your joints is a lot better. So I'm a proponent of that, but it has to be good quality. Right . Uh , and that's why I recommend the Crow . So don't, don't just go on Amazon and randomly pick or do some research, the high , the phospholipid content for the krill oil, the better the tissue penetration. Okay. And that's what's key. Excellent.

Speaker 1:

Okay. Well again, thank you for joining us, Dr. Shalev. We really appreciate you taking the time. I know you're busy , um, but we definitely want to get the information out about heart health and educating our listeners. Thank you everyone for joining us on this episode. Thank you very much. I appreciate much . Thanks doc . Stay safe. Everyone. You've been listening to the city of plantation podcast. We strive to bring you accurate and timely information. Please continue to tune in to our podcast episodes and also catch up with us on social media, including Twitter, Facebook, and next door. If you have questions, send them to ask [email protected] and we will answer your questions directly. Thank you for taking the time to listen to our podcast and stay safe, everyone.