By: Patricia Hudak, RN and Chelsea Cassidy, LCSW

History of American Heart Month

It’s February – American Heart Month – a time when the nation spotlights heart disease, the number one killer of Americans. President Lyndon B. Johnson, among the millions of people in the country who have had a heart attack, issued the first proclamation in 1964. Throughout the month, the American Heart Association’s “Heart to Heart: Why Losing One Woman Is Too Many” campaign will raise awareness about how one in three women are diagnosed with heart disease annually. The first Friday of American Heart Month, Feb. 5, is also National Wear Red Day as part of the AHA’s Go Red for Women initiative. This campaign recognizes that the risk factors of this silent killer can be vastly different in women than in men. Knowing and understanding your risk factors, whether male or female can literally save your life.  We encourage you to talk to a health professional about risk factors and prevention. Traditional risk factors common to both women and men:

• Obesity
• Smoking
• Diabetes
• High blood pressure
• Family history
• High levels of C-reactive protein (a sign of inflammatory disease that can occur along with other cardiovascular risk factors)
• Metabolic syndrome(the co-existence of high blood pressure, obesity, and high glucose and triglyceride levels)

Risk Factors Specific to Women:

• Relatively high testosterone levels prior to menopause
• Increasing hypertension during menopause
• Autoimmune diseases such as rheumatoid arthritis(more common in women than in men)
• Stress and depression (also more common among women)
• Low risk factor awareness (lack of recognition of many of the above conditions as risk factors for heart disease is a risk factor in itself)

Since COVID-19 pandemic struck our world, people have been engaging in less than healthy activities while in lockdown. These activities may include overindulgence in food and beverage, isolating, lack of routine, and less than average movement can and do increase a person’s risk factors. The heart is an organ that acts like a muscle. The more you work a muscle the stronger and more supportive that muscle becomes even to the surrounding tissue. Everything in our bodies needs oxygen to function properly. COVID-19 has now become an added risk factor- for males and females. Atrial Fibrillation is a known heart related effect of COVID-19 in some patients as well as long term respiratory problems. Pictured above is Anna Laughlin.  Anna is married to Dr. Jeff Laughlin, Pediatric Dentist (Virginia Family Dentistry) and they have three children, Charlie (15), Garnes (11) and Helena (8) and they live in Richmond, Virginia.  Anna is an educator and founder of Mission Equip, a non-profit organization focusing on the professional development of teachers and doctors in their Teacher to Teacher and Doctor to Doctor program. Anna was unfortunately diagnosed with COVID-19 in March 2020 when our country was first digesting the news of coronavirus and the sudden impact it was having on our lives.  Anna recalls developing her first symptom on March 21, 2020 of chest pain.  She had run five miles that day and was unsure if the chest pain was related to her physical activity.  Her symptoms continued and five days later she was tested for COVID-19.  Nine days later her primary care doctor and the Virginia Health Department contacted her by phone to notify her that she was positive for COVID-19. During this time, she had mild to moderate symptoms that continued to improve 10 days following the diagnosis. However, on the 11^th day, she experienced a steep decline. She had ongoing chest pain, breathing difficulty, and was fearful to go to sleep at night not knowing what could come next.  She felt the need to go to the emergency room several times though she was advised to only go to the hospital if she could not finish verbalizing a sentence.  She had feelings of fear and frustration throughout the process. Anna voiced she felt “beyond alone” throughout this process. She was often asked “how did you get COVID?”  Her guess was as good as anyone’s and this type of question lead her to feelings of guilt and embarrassment.  She was one of the first to be diagnosed in Richmond even though she followed all the regulations to protect herself and her family. Our polarized political climate in 2020 increased her feelings of despair.  There was misinformation given from a wide variety of sources causing our nation to have strong divisive opinions on COVID-19 and how to respond.  Our whole world has been in isolation which limits our support system in the ways we can be cared for.  One of the lessons she and her family have learned throughout this experience is how to respond to those suffering – she states the best response to someone experiencing a hardship is to say  “I am so sorry you are going through this.”  This statement gives acknowledgment, empathy, and validation of the person’s experience.  Her children are now implementing this into their conversations which will enhance their ability to connect and support others.  The best gift we can offer those in a crisis is no judgment. Anna was one of the first people seen at VCU hospital cardiac and pulmonary clinic to be considered a “long hauler” which is now medically termed “long COVID”. Her COVID-19 symptoms lingered well into the summer and the most concerning physical symptom has been heart palpitations.  At first, she was unsure what was happening and labeled the symptom as anxiety, however she noticed that after experiencing the heart palpitation she would have a cough.  She had times that she could barely walk upstairs without being fatigued and sometimes even collapsed. Anna spent time researching medical journals to best guide her.  One of the hardest realizations she has had to come to terms with is that each day is like a grab bag full of COVID-19 symptoms – you never know what symptoms you will get. In September, Anna’s condition deteriorated, and her A-Fib episodes were increased from every two weeks to every 2-3 days. She reports that the most severe episode led to her to falling on the stairs and passing out in front of her young children. After consulting a Cardiologist at VCU Health she was admitted to the hospital for testing and what is considering ‘drug loading’.  She was unable to tolerate the medications, was discharged home, and was scheduled for a heart ablation procedure several weeks following. She is now three weeks post procedure and showing gradual signs of improvement of A-Fib.  The goal is for her A-Fib to be managed so she can focus on her ongoing healing and return to a healthy lifestyle to include participating in Yoga Therapy. Healing Your Heart This month is a reminder to evaluate your own heart health, and those we love.  Look at how we can make better choices to reduce and improve the risk factors that are within our control.  Practice relying on our health professionals, being honest if you are experiencing unusual symptoms such as shortness of breath, chest pain, indigestion, arm pain, and confusion.  These could be symptoms you may have not responded to in the past, however, please use these warnings signs to take care of you – and your heart. COVID-19 has not only impacted our lives – it has also deeply affected our bodies.  Our bodies may be experiencing many forms of grief all at the same time.  Loss of jobs, income, people, lifestyle, homes, freedom, independence, and travel are just to name a few.  This can make the grieving process complicated and messy.  When grieving, people often refer to having a “broken heart” or feeling “heartbroken”.  Grief is a feeling and mourning is the action of grief.  These feelings can be intense at times and have significant impacts on our bodies – particularly, our hearts. For example, high blood pressure, chest pain, heart palpitations, irregular heartbeat and/or heart attacks can be associated with the stress of grief on the cardiovascular system.  This condition is more clinically referred to as Takotsubo Syndrome (Psychology Today).  It is important for a person in the grieving process to be mindful of their body and assess how they are feeling, emotionally, physically, and spiritually.  Your body may feel torn apart and it needs extra attention and care.   When the body is under stress, it is more vulnerable to physical problems or chronic conditions could be exacerbated due to the emotional trauma you are experiencing.  During the grieving process, it would be good practice to notify your primary care physician of your recent loss.  Your physician may recommend scheduling an appointment to offer support and further asses your health.  When a patient under hospice services has a significant loss in their lives, the hospice team offers to increase their visits, makes a referral to the bereavement coordinator, and notifies the medical director.  This extra layer of communication and support is to help the patient have safe and healthy outlets to express their grief and monitor their health.  The medical director understands the impact of grief and that it can have a significant impact on the patient’s health. (Center for Loss and Life Transition) Now that we have discussed the history and significance of heart health, as well as, the impacts grief can have on our body, let’s review good and nurturing tips on how to care for our heart:

• Eat a heart-healthy diet: vegetables, fruit whole grains, fish, nuts (limit sodium, saturated fat, and added sugar)
• Get active: 150 minutes of moderate intensity per week
• Control your blood sugar: Aim for fasting blood glucose less than 100 mg/dL
• Monitor your cholesterol: Strive for a total cholesterol less than 200 mg/dL
• Maintain a healthy weight: Target a body mass index (BMI) of less than 25
• Monitor your blood pressure: Keep your numbers below 120/80mm Hg
• Live a smoke free life
• Drink green tea
• 30 minutes per day of meditation and practice deep breathing

We want to sincerely thank Anna for her open discussion and vulnerability walking us through her COVID experience.  Our hope and prayers are to watch her make a full recovery.