Monday, March 13, 2017

Sixteen years ago, Kinzo Evans was diagnosed with congestive heart failure. His stomach was swollen. At night, he couldn’t lay prostrate to sleep because it was hard for him to breathe. He was also fatigued. Evans’ deteriorating condition eventually necessitated a heart transplant, which he had at VCU Health in December 2016.

After a follow-up appointment this month, however, Evans said he’s feeling better and ready to do more.

“I’m getting ready to start my physical therapy to rebuild my muscles and restore my body,” he said.

Evans is part of a demographic disproportionately affected by heart disease: African-Americans. According to the American Heart Association, many African-Americans are prone to high blood pressure and diabetes, which are triggers for heart disease.

Evans’ doctor, Keyur Shah, M.D, a cardiologist at VCU Health Pauley Heart Center, is encouraging all who are susceptible to heart disease to be both proactive and reactive. He recently spoke with VCU News about ways individuals can safeguard their health against the disease.

What exactly is heart disease?

The heart is a muscular pump that delivers blood to the vital organs of the body. Normal heart function is dependent on healthy muscle tissue, normal functioning heart valves and a normal heart rhythm. Heart disease is a broad term referring to conditions that can disrupt any of these. Examples include blockages in the heart arteries leading to myocardial infarctions (heart attack), thickening of the heart walls from high blood pressure, leaky heart valves, irregular heartbeats and weakening of the heart from a virus.

In what ways does heart disease affect a healthy lifestyle?

Heart disease causes a wide range of life-threatening symptoms that can limit a patient’s quality of life. They can lead to chest discomfort, fatigue, shortness of breath, palpitations, light headedness and even fainting spells. As the disease progresses, patients can develop heart failure where the heart cannot pump blood efficiently to the body. Patients develop swelling, difficulty catching their breath, tiredness and damage to other vital organs.

“It is important to highlight that high blood pressure is highly prevalent in African-Americans. It is one of the leading causes of heart disease in younger African-American men.”

Why are African-Americans disproportionately affected by the disease?

This is an important question with complex answers that has social, genetic and medical components. It is important to highlight that high blood pressure is highly prevalent in African-Americans. It is one of the leading causes of heart disease in younger African-American men. There is a need for early screening and treatment for prevention of the disease. But it goes beyond access to care and awareness of disease. Medications have been shown to have differing benefits in African-Americans. Therefore it is important to acknowledge that studies showing benefit of therapies in Caucasians don’t necessarily translate to African-Americans. Also, heart disease in African-Americans may be genetically and pathophysiologically distinct, thus warranting independent study.

What steps can people in these communities and demographics take to be proactive against heart disease?

I think health screening is critical, especially if you have a family member with heart disease. I would recommend everyone visit their primary care physician routinely. Factors that patients can control without a doctor include eating a healthy diet, exercising routinely, and avoiding smoking and excessive alcohol.

What types of health care plans are in place at VCU Health Pauley Heart to treat current or potential heart disease patients?

There are numerous resources available at the VCU Pauley Heart Center that go beyond usual cardiovascular clinical care. We offer group classes to promote self-care and disease management for patients with heart disease. Patients can be seen in expert-led clinics for heart transplant, heart valve disease, cardio-oncology, irregular heartbeats and heart pumps. We also have multidisciplinary clinics for rare diseases of the heart such as cardiac amyloidosis, sarcoidosis and genetic heart disease.

How important is diet in preventing heart disease?

In general, a diet low in sugar and high in fruits and vegetables can lower the risk of heart disease. Moderate exercise is also important for cardiovascular health.

Is heart disease hereditary?

Absolutely. Conditions that cause heart muscle disease are frequently hereditary. These include coronary disease, elevated cholesterol, aortic aneurysms and irregular heartbeats. Several cardiomyopathies are also genetically inherited. Hypertrophic cardiomyopathy, dilated cardiomyopathy, left ventricular non-compaction cardiomyopathy, hereditary amyloidosis and arrhythmogenic right ventricular cardiomyopathy are a few examples. Patients and their family members should seek consultation in specialized cardiology clinics with genetic counseling. We offer a genetic heart disease clinic at VCU Pauley Heart Center. For more information visit pauleyheart.vcu.edu.

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