Does Chest Pains = Heart Disease?

Dr. Pascal Meier Talks Blood Pressure, Diet & Chest Pains Relating To Heart Disease

By Fallon Davis

Doctor Pascal Meier is an internationally experienced cardiologist. He has training in general medicine and cardiology from the University Hospital in Bern, Switzerland. Specializing in interventional cardiology, Dr. Meier received his training at the University of Michigan and earned his medical license in 2009.

Having accomplished many surgeries as a young doctor, Dr. Meier has performed many operations on the heart, performing coronary interventions such as whole aortic valve replacements (TAVI), closure of holes in the heart (PFO, ASD) and mitral valve procedure for patients with heart failure after a heart attack.

His interests in stents, cardiac death and new drugs for patients shows his passion in wanting to help people. In fact, Dr. Meier is so serious about his work he took his career to the next level and is the founder of two publications committed to making our lives healthier, providing information and solutions to individuals with questions concerning their body.

Pascal is the Editor-in-Chief of the BMJ journal and OpenHeart where they uncover the latests news on cardiology, medicine and general health. Dr. Meier is also very active on his Twitter and loves to update his followers on his latest findings. I jumped at the opportunity to pick Dr. Meier’s brain on some very serious issues and questions concerning women with heart disease and how to prevent early death.

In a perfect world, what combination of foods would ensure a healthy heart?

Our understanding of what’s healthy for our heart is clearly changing. While we thought we need to limit fat and cholesterol intake as much as possible, I no longer think this holds true. What’s important is a balanced diet, we should limit processed meat and increase the intake of fish and proteins.

We should eat things that saturate for a long time so that we generally eat less and have a better weight control, this means we should limit the intake of carbohydrates which cause spikes in blood sugar levels, especially processed carbs because the beneficial fibers got stripped away.

Can frequent (1x per month) pain/pressure/numbness/tingling in either side of the chest and arm area indicate a heart attack?

This can be a sign to take seriously, yes. If these symptoms come up predominantly during effort, it could indicate that the heart muscle does not get enough blood supply due to a narrowing of the heart arteries and that there is a risk for a heart attack. A heart attack happens if one of these narrowing [arteries] block the blood completely. In this case, the pain persists > 15–20 minutes. In this case, I strongly recommend to call 911.

What is a major red flag for heart disease while doing daily activities?

Red flags are chest pains or a strong pressure during physical activities. This could mean that there is a narrowed heart artery which does not cope with the increased need for oxygen during exercise. If the pain does not disappear after 15–20 minutes even after stopping the physical effort, this could mean that one artery has blocked off completely and that you are having a heart attack.

Besides the fact that women do not get regular exams, why are women leading in heart disease in your opinion?

The reason that we should pay special attention to women is because their symptoms are often less “typical”. They may for example feel their pain in the back or in the abdomen, and so it is often misdiagnosed.

Also, women may not primarily think of heart disease when they develop such symptoms, again, because signs are often less typical and because they use to be a bit more protected due to estrogen until their menopause. However, after menopause they unfortunately “catch up” with men and need to be aware of that risk.

Why do some women have problems keeping their blood pressure under control even if they follow all the rules (low sodium intake, manages weight, low cholesterol, regular exercise, etc)?

Life style change needs to be the first step in controlling increased blood pressure, especially in case of obesity, lack of exercise or poor diet. However, often these changes are not fully sufficient to bring the blood pressure down to an ideal level. It is very important to accept if is the case and take medications when necessary.

I often see patients being rather reluctant because it usually means that this tablet needs to be taken indefinitely. However, we have nowadays so many different treatments and most of them have no or minimal side effects. Furthermore, if tablets are not sufficient we now have also the options of so called “renal denervation”, which is a catheter based procedure via the kidney artery which can further lower blood pressure.

Many women complain of frequent episodes of shortness of breath, pain in their chest and heaviness of their arms-sometimes with blood rushing to their hands. What’s your best advice, besides, calling 911, if you think you’re experiencing a heart attack?

These symptoms could indeed indicate a heart attack. If the symptoms persist > 15–20 minutes, beside calling 911, patients should take an aspirin if at hand, avoid physical activity and avoid being alone but rather stay around people, or if living alone may be go to a neighbor.

During a heart attack, there is a certain risk that the situation deteriorates all of a sudden, due to drop in blood pressure or arrhythmias. Do not,however, drive a car or go to the hospital on your own. Wait for the emergency service to arrive.

Should people with bradycardia be concerned with the possibility of having a heart attack in the near future?

No, bradycardia is rarely caused by a heart attack and can have many reasons. If the bradycardia is associated with relevant dizziness (or worse passing out), 911 should be called.

Why do perfectly healthy people with no prior heart disease die from a heart attack?

This is indeed something which can happen and is very frustrating of course. Unfortunately, heart attacks can develop very quickly and during such health checks we can only get a picture of this very moment. We can not look into the future. However, checking risk factors is still very important and helps to relevantly reduce the risk for future heart attacks.

What tips do you have for physicians looking to get into your

I strongly recommend everybody who is interested in this field to pursue a career in cardiology. It is a very interesting and rewarding field which continues to develop and improve the treatment options for patients.

I recommend to do an internship in a cardiology unit as soon as possible to make sure it is really what they expect. It is helpful to make contact early with a possible mentor, a senior cardiologist in a teaching hospital who can advise along the way.

What are the cons and pros of your daily work activities?

The pros are clearly outweighing the cons. It is very rewarding to be able to help patients so significantly. We see many patients in very serious conditions and in most cases we can quickly improve their situation with the different treatment options we have nowadays. It is very interesting to see these treatments possibilities improving constantly.

On the negative side, it is a field with a lot of emergencies, patients often present with acute heart failure or heart attacks. This means that work can not always be planned and on call shifts are often busy. I am personally working in interventional cardiology, which also means a certain exposure to X rays but of course we try to limit this as much as possible with protection measures.

For more information on Dr. Pascal Meier, visit his website at drpascalmeir.com.

This expert interview was originally published in the Dress A Med newsletter on February 23, 2016.