Category: Education

What are the cardiac blues? 

If you’ve had a cardiac event, you might be surprised by your emotional state afterwards. For many people, it triggers an emotional rollercoaster that includes feeling shocked, traumatised, sad, anxious, tearful or worried about the future. 

Welcome to the cardiac blues! They’re not fun, but they are a normal part of recovering from a cardiac event. Most people’s emotional wellbeing improves as their physical recovery progresses. 

That’s not the case for everyone though. For 1 in 5 people, the cardiac blues persist and turn into depression. That’s particularly likely if you already had risk factors for depression such as other illnesses, financial worries, a history of anxiety or depression, or if you’re grieving. 

There are many treatments available that can help you feel better. If you’re making a good physical recovery but are concerned about your mental health, then you can:

? Talk to your GP

? Call Lifeline on 13 11 14

? Call Beyond Blue on 1300 224 636

This article is for reference purposes only – it is not designed to be, nor should it be regarded, as professional medical advice. Please consult your own medical practitioner for health advice specific to your condition.

? Sterols are substances found in plants that lower your absorption of cholesterol. 

Narrowings and blockages in the arteries that supply blood to your heart can develop due to a build up of cholesterol plaque. Reducing your cholesterol can help to prevent this occurring.

You’ll find plant sterols in fresh fruits and vegetables and in sterol-enriched foods like margarine, breakfast cereal, reduced fat yoghurt or reduced fat milk.

If you’re at high risk of cardiovascular disease due to your lifestyle or medical history, the Heart Foundation recommends that you eat 2-3 g of sterols each day.

This article is for reference purposes only – it is not designed to be, nor should it be regarded, as professional medical advice. Please consult your own medical practitioner for health advice specific to your condition.

During the current COVID-19 pandemic, many patients have been reporting that they are struggling with changes to their lifestyle and ability to exercise in their usual ways. Over the last few months, many people with cardiac conditions have expressed concern about a possible increase in risk of exposure to COVID-19 when exercising outdoors. However, it’s very important to maintain regular exercise when you have a cardiac condition, so if you don’t feel that exercising outdoors is an option, we have some suggestions for exercising effectively (and enjoyably) indoors.

The heart is a muscle and like any other muscle, needs to be strengthened and challenged in a variety of ways to stay strong and healthy. Regular activity can help manage weight, blood pressure, reduce risk of diabetes, help you to feel more energetic and assist in managing mental health issues like depression and anxiety.

The Heart Foundation recommends:

• 30 minutes (or more) of moderate-intensity physical activity five or more days per week
• Be active on all or most days of the week
• Muscle strengthening activities on at least two days of the week

Establishing and maintaining an exercise habit is easier when it is convenient and enjoyable and there are many activities you can do without even leaving your home. There is a huge selection of free videos online as well as regular exercise classes, so there is a form of exercise to suit everyone’s interests. With such variety available, now is a great time to try some activities you might not have considered previously – mix it up and try some different things until you find your perfect exercise match!

Have you considered?

• dancing
• aerobics
• yoga/pilates
• light weights/resistance

The Heart Foundation also has a handy downloadable guide of exercises to do at home, at a variety of intensity levels:
www.heartfoundation.org.au/covid-19/exercises-to-do-at-home

If you’re just getting started, you can read the Heart Foundation’s section on this below. If you haven’t been exercising in some time, consult with your doctor before embarking on any vigorous exercise regime. A Heart Health Check (a dedicated assessment of your cardiovascular health, for people aged 45 years and over and people of Aboriginal or Torres Strait Islander descent aged 30 years and over) could be helpful prior to starting regular exercise.

Further reading:

1. www.heartfoundation.org.au/heart-health-education/physical-activity-getting-started
2. www.hopkinsmedicine.org/health/wellness-and-prevention/3-kinds-of-exercise-that-boost-heart-health

This article is for reference purposes only – it is not designed to be, nor should it be regarded, as professional medical advice. Please consult your own medical practitioner for health advice specific to your condition.

With our practice being based in Melbourne, we’re surrounded by a strong culture of coffee drinking. Many people feel the need for a “heart starter” in the morning … but can coffee affect your heart?

Coffee contains caffeine, which acts as a stimulant to the central nervous system and can improve alertness and decrease fatigue. Caffeine can also exert effects on the heart. However, coffee is a complex drink which contains more than 1000 different compounds, including antioxidants, which may account for some the effects on the cardiovascular system.

Palpitations and abnormal heart rhythms

Some people may be more sensitive than others to the effects of caffeine, and feel a forceful or racing heart beat after they drink coffee. However, coffee has:

• not been associated with an increase in numbers of premature atrial or ventricular beats 1
• not been associated with an increased overall risk of atrial fibrillation (AF) in large population based studies 2 though in patients actually presenting to hospital with AF, coffee has been self-reported as a fairly common trigger 3

Regular consumption of up to 300mg of caffeine a day (equivalent of 4 cups of espresso coffee) seems to be safe, and possibly even protective against cardiac rhythm issues 2.

Effects on blood pressure, cholesterol and weight

Minimal effect of coffee on blood pressure is seen in regular coffee drinkers, although blood pressure can increase for a short period in those who do not drink it often.

Unfiltered coffee may contain compounds such as cafestol, which may cause a small increase in serum low-density lipoprotein (LDL). Filtering coffee may decrease this effect.

Adding milk and sugar to coffee, or consuming large quantities of coffee with such additives increases overall caloric intake and may contribute to weight gain and obesity.

Coronary artery disease, stroke and heart failure

The good news is that moderate consumption of coffee (<6 cups per day) has been associated with a lower in risk of heart attack, stroke or cardiac arrest and there also appears to be a protective effect in heart failure 4-5.

Overall, therefore, a moderate amount of coffee seems to be safe for most cardiac issues. It may be wise, however, to minimise or avoid coffee if you are sensitive to its effects or if you feel it tends to trigger your rhythm issues.

Further reading:

1. Consumption of Caffeinated Products and Cardiac Ectopy. JAHA Vol 5, Issue 1, 26 Jan 2016. https://doi.org/10.1161/JAHA.115.002503
2. Caffeine and Arrhythmias. Time to Grind the Data. J Am Coll Cardiol EP 2018; 4: 425-32. https://doi.org/10.1016/j.jacep.2018.01.012
3. Arrhythmia-provoking factors and symptoms at the onset of paroxysmal atrial fibrillation. BMC Cardiovascular Disorders 2004, 4:13. https://doi:10.1186/1471-2261-4-13
4. Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 2014 Feb;129(6). https://DOI: 10.1161/CIRCULATIONAHA.113.005925
5. Habitual Coffee Consumption and Risk of Heart Failure. Circulation: Heart Failure 5 (1): 401-405. https://doi.org/10.1161/CIRCHEARTFAILURE.112.967299

This article is for reference purposes only – it is not designed to be, nor should it be regarded, as professional medical advice. Please consult your own medical practitioner for health advice specific to your condition.

If you have a blood pressure monitor at home, it’s really important to be consistent in how you take your readings, to get an accurate picture of your blood pressure control.

Take your home blood pressure reading:

• while seated with feet flat on floor, legs uncrossed with back and arm supported, cuff on bare upper arm and at heart level (with properly fitting cuff)
• at around the same time in the morning and evening
• after sitting quietly for 5 minutes (don’t take if feeling stressed or in pain)
• before taking medications or exercise
• before food and avoid caffeine/nicotine for 30 minutes beforehand

Take two measurements 1 minute apart and write down the results – it’s a good idea to keep a diary with measurements, date/time and how you were feeling at the time. Take this with you when you visit your GP or specialist.

You can develop your own blood pressure action plan at:
https://www.heartfoundation.org.au/Heart-health-education/action-plans/blood-pressure-action-plan
You can also check whether your home blood pressure monitor is validated here:
https://bihsoc.org/bp-monitors/

This article is for reference purposes only – it is not designed to be, nor should it be regarded, as professional medical advice. Please consult your own medical practitioner for health advice specific to your condition.