Keep your heart healthy during the colder months
Welcome, Dr. Kurian
Dr. Thomas Kurian, MD, FACC, joined Cardiovascular Specialists of Lawrence in late 2021, bringing more than 37 years of experience in the field of cardiology. He is board certified in internal medicine, cardiovascular disease and interventional cardiology. Dr. Kurian is a part of a team of top-rated, exceptional physicians in a facility with cutting edge, lifesaving technology. The LMH Health Heart Center ranks nationally in the top five percent for heart attack treatment, according to the American College of Cardiology.
Heart health is important in every step of your life. The CDC states that heart disease is the leading cause of death for men, women and people of most racial and ethnic groups in the United States. With a stat like this, it is very important to know the signs of a heart attack, when to be extra careful and how we can avoid heart related illnesses.
As we get into the colder months, strenuous activities such as raking, shoveling and more cause sudden exertion which can trigger a heart attack. Dr. Thomas Kurian, a cardiologist who recently joined the team at Cardiovascular Specialists of Lawrence, said that these are the reasons it is important to talk about heart health and how to stay safe in the winter and beyond.
“Talking about heart health is very important, and in some instances, it can be lifesaving,” he said. “When you are doing strenuous activity or just anything in general, symptoms of a heart attack could be anything like chest pains, or discomfort that extends to the arms, neck, back, between the shoulder blades. If these symptoms last longer than 5-10 minutes, this could be the signs of a heart attack.”
Dr. Kurian said cold weather causes blood vessels to constrict, often due to the sudden changes in surrounding temperatures. This sudden change can raise blood pressure which then increases the risk of experiencing heart attacks and strokes.
“This sudden change can also increase the risk of developing angina. Angina is a symptom of a narrowed down coronary artery which can onset due to exertion but also on occasions of not being physically active. The symptoms can be severe pain, discomfort or pressure in the chest, neck, back, arm or jaw due to restricted blood supply to the heart,” he said. “Angina disappears in a few minutes either spontaneously or with nitroglycerine – a spray or tablet taken under the tongue. Activities and cold weather coupled together increases the overall chance of a person developing angina spells.”
Dr. Kurian said it is important to note that angina can mean a precursor to heart attack. If symptoms appear, it is important to take caution and get help.
“A heart attack is essentially a case where angina persists and does not seem to go away. It can increase and decrease, but it never fully goes away and this can be the sign of a heart attack in progress,” he said.
In the depths of winter, Dr. Kurian said the heart also tends to work harder to maintain a stable body temperature. Cold winds and extremely low temperatures can make your heart work even harder.
“Outdoor activities, in particular, require the heart to work harder than usual,” Dr. Kurian said. “This increased work of the heart means the heart needs more blood supply for performing a more intense workload. This too can cause episodes of angina, which is essentially a cry for help that your heart needs more blood supply. This can be an indicator of finding narrowed coronary arteries - small arteries that run on the surface of the heart - supplying oxygen and nourishment to the pumping heart that sustains us. These are all significant, and imperative, warning signs of a potential heart failure.”
Cold weather means...snow! What is playful and beautiful can at the same time be dangerous, even when you’re not on the road. Snow means shoveling and shoveling means strenuous activity. Snow also means a simple walk can become a trudge through inches of compact snow. Any of these combinations can mean trouble if blood supply is constricted.
“Shoveling, changing tires in the cold or pushing a vehicle that was stuck in a snowdrift are not only taxing activities but also correlate with high levels of stress,” Dr. Kurian said. “Add that on to the already present stress of the holidays, and you may experience an increased overall level of stress hormones. All of this in conjunction can lead to the rupture of pre-existing atherosclerotic plaques. Plaques such as these are a build-up of cholesterol and inflammation in the wall of a blood vessel. The rupture could form a clot and cause stoppage of blood flow to a coronary blood vessel, thus, marking the beginning of a heart attack.”
Signs of a heart attack may be non-stop chest or arm pain, or other angina symptoms mentioned above. Dr. Kurian said plaque ruptures in the arteries can occur with plaques of varying degrees, from severe to simple. They do not have to be severe to rupture. The more narrowed the artery, the greater likelihood of it rupturing. Though angina is more of a warning sign, a heart attack can leave permanent heart damage.
“Full damage to the heart can take 6-12 hours,” Dr. Kurian said. “If a patient seeks early medical attention, the damage can be greatly limited. In some cases, when people have sought help early, the damage can be very small – so small that it can be as though the heart attack did not even happen. When symptoms last 5-10 minutes or longer, it is time to seek medical attention. The people who seek treatment fast can have significantly better results. The quicker, the better.”
Dr. Kurian said it is imperative not to wait and to call 911 immediately. It quite literally can save your life.
“Do not wait, do not drive yourself and do not have someone else drive you. Call 911 immediately and get the help you need,” he said. “Heart attacks can bring the dreaded irregular heartbeat (arrhythmia) which can cause sudden death. I cannot stress enough the importance of not being hesitant.”
Dr. Kurian said it is better to err on the side of caution than it is to wait and risk your life. Though people may spring into action and drive themselves to the emergency department, this is unwise.
“When you call 911 and are transported in an ambulance, they can often care for you while on the way to the hospital,” Dr. Kurian said. “Often the EKG is taken in the ambulance. The paramedics can assess your situation then and there and will contact the hospital to warn them you are coming. The team in the Emergency Department can prepare and equip their team to handle your care right away. Timeliness can be lifesaving and the heart muscle can be saved. At the hospital, we can deliver clot-busting medicines and have a heart catheterization lab that is better still so we can get the artery open emergently if needed.”
Dr. Kurian said that in the winter months you should consider the following eight things to ensure the best possibility of avoiding a heart issue:
- Dress warm.
- Do not shovel for long periods. Take breaks often and do small patches at a time. Pace yourself and do not get flustered.
- Avoid excess alcohol.
- Get your flu shot and wash your hands often.
- Take precautions prescribed for COVID-19.
- Take vitamin D as suggested by your primary care provider.
- Get help immediately if you think you’re having a heart attack. Don’t second guess yourself.
- Maintain a healthy diet, exercise, manage stress and know your cholesterol, sugars and family history. These can reduce the risk for heart problems related to coronary artery disease. Work closely with your primary care provider.
“Take care of yourself during these winter months, and remember, do not wait,” Dr. Kurian said. “Watch for symptoms and warning signs and listen to your body. Call 911 and get the care you need. The team at LMH Health is here and ready to help address your needs.”