All About Telehealth for Heart Disease Telehealth allows doctors to care for people virtually over a phone call, text message, or most commonly, video chat. Although some situations require an in-person visit, telehealth is a great option when you can't get to the doctor's office for your heart disease. If you're new to telehealth, here's what you need to know. Medicare will cover telehealth visits just like in-person visits, but state Medicaid programs and private insurers vary, so confirm your coverage in advance. With telehealth, even though you're not in the doctor's office, your private health information is still covered by HIPAA, so it will remain confidential and secure. Although your cardiologist can't give you a physical exam via telehealth, they can write prescriptions and offer quality care, especially if you prepare in advance. Before your telehealth appointment:- List any heart disease symptoms (including dates and severity)- Note any side effects from your heart disease medications or therapies- Record your vital signs if you own a heart rate monitor, blood pressure monitor, thermometer, or another device- Compile a list of your health conditions and all medications- Write down any questions you have for your cardiologist- Charge your computer or phone- Make sure your internet is reliable- Download any telehealth apps your specific provider may require- Find a quiet, private space to conduct the call- Be prepared with pen and paper or a note-taking app Turn to Healthgrades to connect with the right cardiologist to treat heart disease via telehealth. And share this video to spread the word!

Dr. Lee Marcus: How did you know you were having a heart attack? Beth: I didn't. Beth: I was at work. I was nauseous, dizzy, and my pain was majority in my back. Juan: I felt a sharp pain in my chest. I broke out into a sweat. Peter: I felt like I was going to pass out. Some pain kind of radiating up through my neck. Kevin: I was out on a bike ride. I started having severe chest pain. Spread to my shoulder, my left arm, my left jaw. Sharon: I had lower back pain and I equated it to being back spasms. Juan: Then the EMT arrived. And they were like, "You know, mister, I don't think this is a heart attack." Well, if it's not a heart attack, then I'll wait it out. The next morning, the burning is still very intense in my heart. Kevin: So I drove myself to the emergency room. And when you walk into the emergency room and you say chest pains and shortness of breath, you go to the front of the line. Juan: The nurse behind the desk was like, "Are you crazy? You're lucky you're alive." Kevin: They run all the tests, EKG. They draw blood. They said, "You're not going home today. You're actually having a heart attack now." Sharon: It completely blew my mind. I couldn't understand how I had a heart attack. A person who goes to the gym and that eats healthy. Kevin: 90 minutes after I left the house that morning, I'm in the cardiac catheter lab with my hero, my cardiologist, who did find a torn artery. Peter: One of my major arteries was blocked, so I needed a stent. Kevin: There was a lot of mental wrestling with what exactly was going on. Did my body betray me? How do I deal with this? Juan: You need to realize that your body may feel strong, like your arms and legs, but your heart took a major hit. Beth: I did cardiac rehab for six months, and it was the best exercise and informative program that I've ever done in my life and I learned so much from it. Dr. Lee Marcus: The value of cardiac rehab is equivalent to the effect of medications, lowering risk 25 to 30% of having a second heart attack. Beth: That's what I've heard. Kevin: When you go to cardiac rehab, they have classes, and they're teaching you proper nutrition, exercise. They're trying to get you to change all these behaviors that may have led to your heart attack. Peter: That was really the beginning of a change in my lifestyle. I exercise. I watch my diet. I take my medicine, my medications diligently. Sharon: Knowing what I can and cannot do is extremely important. Juan: It gave me a sense of where the limit is. When I would work out on my own, I had a sense of when I was pushing too much. Peter: I started to feel much better, stronger. I don't feel any fear. Sharon: Because I know the signs of a heart attack, I can act quicker. Juan: And I'm not wasting time. In a weird way, this heart attack has been like a new beginning for me. Kevin: We can't really change what just happened. What we can do is learn from it and adapt and move forward.

Dr. Abed: What happens to the heart after a heart attack is quite dynamic. Initially, it stops pumping well in the area where the heart attack occurred and then it starts to heal and remodel. The other parts of the heart muscle actually start to compensate for the loss of the function in the area of the heart that was damaged during that heart attack. Dr. Marcus: Your heart attack was really caused by plaque build-up combined with probably a local inflammation in the blood vessel. Dr. Aziz: This plaque, when it ruptured, it ruptured because of a reason. Either accumulation of more fat into the tissue or strenuous activity. That stress on the vessel can cause these very minimalistic plaques to rupture. Dr. Abed: It is important that you start your new life after your first heart attack and that means paying attention to how you live and what medications you're going to have to take. Kevin: They put me on an anti-platelet for the stent. Sharon: I'm also on cholesterol medicine. Beth: An aspirin, a blood thinner, as well as beta blockers and blood pressure medications. Dr. Faraz: The most important thing for vascular health is diet and exercise, minimizing the intake of salt, sugar, and flour. Dr. Marcus: Make sure you're eating a very plant protein-based diet. Dr. Faraz: Exercise doesn't necessarily translate into going to a gym. It means that you're active from the time you get up to the time you go to bed. Kevin: I can't ever imagine not being a runner and a cyclist. Dr. Aziz: I have to tell you, athletes are the worst patients because they can push themselves very hard. So moderation in exercise is the best thing. Dr. Marcus: And that includes walking, jogging. Sitting is the new smoking, they say. Dr. Faraz: I recommend all my patients to go through a cardiac rehab program after a heart attack. Dr. Abed: It entails giving them the confidence to start walking, to start exercising without the fear of developing pain or shortness of breath in that process. Dr. Marcus: I'm assuming you follow up at regular intervals with your cardiologist. Beth: Four times a year. Sharon: You cannot and no longer diagnose yourself. I write down what I want to talk about when I go see the doctor. Dr. Abed: When women present with a heart attack, it is often with chest pain, shortness of breath or sweatiness. They will feel maybe dizziness, they can feel back pain. Men, more typically, present with chest pain, shortness of breath. Beth: I'm afraid I'm not going to get up in the morning. Anything can happen a second time. Dr. Abed: In my experience, people who've had a heart attack often will run to the emergency room at the slightest symptom at the beginning. I will say that it's better to do that than to blow off the symptoms completely. Kevin: I have to find that sweet spot where I get the fitness and the benefits without going back to the extreme. Dr. Aziz: You have to find that medium where you're happy but you're not hurting yourself. You've reached that balance by understanding more about the disease. I'm glad that you're an advocate for this because it's just awesome.

Dr. Jones: So, tell me what happened when you had your heart attack. Rina: Okay. I think my story is a little unusual because I was walking up a hill. I started to feel short of breath every time and when I walked up steps, same thing, short of breath. No pain, just for me, this was not normal. Mariana: I was running and I was doing intervals and I had this terrible, terrible pain and I thought it could be a heart attack but then I thought, it's probably just because I was lifting heavy weights at the gym. Mariana: So, I continued to walk and I walked, oh, I think about a half a mile before I collapsed. Mike: I didn't know I'd had a heart attack. I didn't go to the hospital. I wasn't diagnosed as having had a heart attack. I went to my primary care annual physical, had some chest tightness, he suggested I see a cardiologist and I did and one test led to another test. Then the phone call to come in and, "Let's talk about this, because it looks like you've already had a heart attack." Mariana: And a runner and a jogger found me. The ambulance came and they said that I had had a massive heart attack, I went into cardiac arrest, they put two stents in. The cardiologist that came in my room told me that that runner and that jogger saved my life because had it been five minutes after that, they would not have been able to bring me back. Rina: The cardiologist did whatever normal investigations and he said, "Well, I have to admit you to the hospital. I'm calling the EMT and we'll have an ambulance." And I said, "That's ridiculous." Dr. Jones: Well, unfortunately, you're quite classic for women. Rina: Is that so? Dr. Jones: Yes! Because it's so funny, people say, "Oh, women present differently with heart attacks." No, women don't present differently that often. They still have chest pain. We just ignore it. Mike: Given the fact that I found out that I had a heart attack through testing. I kind of really don't even know what a heart attack is. Dr. Jones: The definition of a heart attack is essentially injury or damage to the heart muscle from a lack of blood flow. Dr. Williams: How often do you see your doctor? Mariana: I'd say every three months. Dr. Williams: Oh, that's great. Mariana: So, it's ... yeah. Dr. Williams: So, you have a lot of interaction? Mariana: Yeah. Dr. Williams: It's very important to have an interaction and communication and follow up with your doctor. It's one of the most important ways to prevent another heart attack. Mariana: Right. Rina: Am I at risk more for having a second heart attack? For having another one? Dr. Jones: That's a really good question. Unfortunately, yes. Just even you thinking about this more and thinking about exercise, taking that statin, keeping your blood pressure under control, is preventing. Dr. Williams: There are three main ways that you can reduce your risk of having a second heart attack. Mariana: Okay. Dr. Williams: Careful follow up with your doctor, taking your medications as prescribed, and diet and exercise.

Dr. Williams: What other factors have changed in your life since your heart attack? Mariana: My diet. But I still have a little ways to go. Dr. Williams: Dietary management is all about balance. Something that encompasses whole grains, lean protein, vegetables, but definitely no saturated fats and the sugars. Mike: A lot of the food I am eating is better. The number of calories I eat over the course of the day is slightly less, but it's better quality food. Dr. Jones: People are becoming a lot more aware of fat. They're like, "Oh, fat. We don't want fat." But there are good fats and bad fats. You get cholesterol in your body mostly from saturated fat in food, and saturated fat only comes really from animals. So mostly from beef, and in our country, dairy or cheese. The good fats, which are the poly and the monounsaturates, those come essentially from vegetables. Dr. Williams: You have to be a student of the labels. Anytime you buy foods, I would recommend that you look on the back- Mariana: And see the saturated fat. Dr. Williams: ... and you read not only just the saturated fat, but all the components. Mariana: Right. Dr. Williams: That's how you can educate yourself, and that's how you can make sure that you're eating the foods that you need to eat. Dr. Jones: What are you doing as far as non-medical things? Do you exercise? Rina: Exercise, yeah. Dr. Jones: How much are you doing? Rina: I've gone back to yoga, slowly. I actually try to go a couple of times a week to yoga, and that's all the exercise that I do. Dr. Jones: People just limit their activity and don't realize it. Rina: I mean, I could walk up and down the stairs in my house. Dr. Jones: You could. Dr. Williams: Are you still doing intervals? Mariana: You know, I'm still running, but I don't push myself the way I used to. Dr. Williams: Have you had a discussion with your cardiologist about what your limits are? Mariana: When I see my heart rate go to 120, that's about all I ... then I start to slow down. Dr. Jones: Listen to your body. That's always my first thing. I'm not a real fan of very high intensity. I'm much more about consistent, steady exercise. I would rather have you go for a power walk every day for 30 minutes, than do a crazy intensity workout once a week. Rina: Right. Dr. Jones: But for the cardiac effect, I think you do need to raise that heart rate a little bit.

New Speaker: Has your doctor gone over with you the types of medications you're taking and the importance of these medications? Mariana: Yes. New Speaker: I'm sure you're on a beta blocker. Mariana: Yes. Dr. Williams: Okay, and probably an ACE inhibitor medication. Mariana: Yes. Dr. Williams: Mm-hmm, now these are two medications that are blood pressure medications. However, in the instance of a patient who's had a heart attack, their role is not necessarily to control blood pressure. Mariana: Right. I get that. They do other things. Dr. Williams: Mm-hmm. Mike: The meds, it hasn't been overly intrusive. It's really one or two additional medications. Dr. Jones: One of the big things when people have heart attacks is actually, it's not just a plaque buildup, but it's a blood clot and so being on an anti-platelet agent is really important because the platelets get sticky and stick together. In addition, you didn't get them, but if people have stents placed in the arteries with a heart attack, they are then on two anti-platelet agents for at least six months and even a year in order to keep the stent from forming clots also. Dr. Jones: Did you know your cholesterol was high? Rina: I did. Dr. Jones: So that was probably- Rina: Not horribly high and my ratio was good. Dr. Jones: Yeah. This is a lifelong process for you, as you see. Rina: Yeah. Dr. Jones: I'm going to assume, I shouldn't assume, but let me assume you are on something to lower your cholesterol. Rina: True. Dr. Jones: A statin. Rina: True. Dr. Jones: One of the statin medicines. Rina: Mm-hmm. Dr. Jones: Do you know your cholesterol numbers? Rina: I don't. Dr. Jones: Okay, you should. We should know just to know. Rina: Well they're low thanks to taking the statin. Dr. Jones: Good. Dr. Williams: I'm certain one of those medications is aspirin. Mariana: Yes. Yes, baby aspirin. Dr. Williams: Okay. Mariana: Absolutely. Dr. Williams: So baby aspirin is essential in patients who have had heart attacks to continue. Mariana: Right. Dr. Williams: What it does is prevent clotting inside the arteries of the heart. Mariana: Which is what the blood thinners do too, right? Dr. Williams: That is correct. There's other types of blood thinning medications. Works in a similar manner on similar cells within the blood as aspirin, but a different mechanism, but the two of them together work in conjunction to reduce your risk of having a second heart attack.

Dr. Marcus: Essentially, heart failure is when the heart is unable to pump enough blood to meet the needs of the body. Dr. Grayver: The heart really is nothing but a pump. It's supposed to pump in one direction, and in one direction only. Dr. Green: When the heart isn't pumping efficiently, the body adjusts and tries to compensate. The main way that the body adjusts is to accumulate fluid. Dr. Grayver: It starts to back up. It goes into the lungs, it goes into the liver. Beth Warren: That means their body is holding on to a lot of fluid. Dr. Marcus: The main causes of heart failure are related to coronary artery disease or heart attacks. Dr. Green: Long-standing high blood pressure. Dr. Grayver: Congenital heart disease. Dr. Marcus: People can get heart failure after pregnancies. Dr. Green: There are a variety of medicines and lifestyle modifications that patients can make to improve their quality of life and long -term prognosis, their length of life, with heart failure. Beth Warren: I look to make things practical and simple. Small changes carry over in the long run a lot more effectively than these huge changes. Dorothy H.: Stress management is key. The meditation, prayer, exercise ... That absolutely is a game changer. Beth Warren: Be physically active, but with their doctor's guidance. Dr. Green: Good healthy muscles can accommodate a little bit better and make the overall body healthy. Dr. Marcus: Heart failure patients also should be on a low-sodium diet. Beth Warren: We could eat foods that damage the heart, and you could eat foods that improve the heart. Dr. Grayver: We start off by a water medication. Dr. Green: Usually with diuretics so patients urinate that extra fluid out. Dr. Grayver: And then there's a slew of drug classes. There's a beta blocker, there's an ACE inhibitor, there's an ARB inhibitor. And when the drugs do not work, that's when we have to go through more of a mechanical support for those patients. Dr. Marcus: We've found out that putting something called a pacemaker defibrillator in people can improve mortality up to 50%. Don't let yourself get down and depressed about the diagnosis. There are so many treatment options. Dorothy H.: Your body is miracle machine. If you give it the least amount of help, it will find the resources to heal your disease. Dr. Marcus: Cardiologists that treat heart failure really are "never-say-die" cardiologists. We never like to give up. Dr. Green: It represents a transition to a new outlook on life, but this does not mean that their life is coming to an end by any stretch of the imagination.

Dr. Green: A lot of patients come to see me and they have a lot of questions about what it means to have heart failure and what the implications are for their future. Dr. Grayver: So some of the misconceptions of heart failure is the fact that it is a disease of the elderly. That is not the case. I have had patients that are in their early twenties after a bout of some sort of a GI bug and they have what's called viral myocarditis where sort of the immunoglobulins, or the viral little particles, attack their heart muscle as well and left them with a chronic heart failure. Dr. Marcus: An infected valve can occur at a young age and the valve can leak and cause the heart to become dilated. I've seen many, many people with heart failure in their twenties and thirties and even teenagers with congenital forms of heart failure. Dr. Grayver: So heart failure is not biased. It's not biased towards age and it's definitely not biased toward gender. Heart failure can definitely affect anybody from young to old, male or female. Dr. Marcus: Heart failure is not just a disease of the heart. It's a syndrome that affects the entire body. Dr. Grayver: In light of the fact that the pump is not working, then there's not enough blood flow through the arteries to the kidneys. Because the kidneys cannot function appropriately, the absorption of sodium is very different in everything else. Dr. Marcus: The muscles don't utilize oxygen the same way. The legs get fatigued out of proportion to what they would normally be. Dr. Green: Other misconceptions are that heart failure and heart attack are the same. They are not. Dr. Marcus: A heart attack is a blockage of an artery to the heart. Dr. Grayver: There's not enough blood that goes to the heart muscle and it starts to infarct. Dr. Marcus: The consequence of that muscle dying, if you don't open up that artery fast enough, can be a weakening of the heart muscle and heart failure down the road. A heart attack can lead to heart failure but a heart attack is certainly not the equivalent of heart failure. Dr. Green: When patients come in with heart failure, many of them are scared that they are dying, that their heart might stop. Dr. Marcus: You can live a long life with heart failure provided you are compliant and adherent with the doctor's recommendations. Dr. Grayver: It's not a hopeless disease. There are a significant amount of both medical managements and things that you can do at home.

Arlene: My name is Arlene and I'm living with heart failure. Arlene: Two years ago I had the flu and I got up and the next thing I know, I hear paramedics saying, "Should we remove the dog from her chest?" I don't remember getting to the hospital. I do remember that my face was bruised up because when I fell, I hit a piece of furniture. Hassan: I was actually instructing a class. 20, 30 minutes into the workout, I just feel this pain, like it was just like, whoa. I just knew something wasn't right. Anne: I started to feel short of breath. I remember coming in one day from food shopping, holding the grocery bags, and the room was spinning. I literally thought I was dying. Arlene: Doctor comes over and says, "You know, we'd like to do some more tests on you." He comes back after the test and he said, "You had heart failure. That's why you passed out." I said, "No, I didn't." He said, "Yes, you did." Hassan: I was so shocked about it because I'm very active. Anne: I was just devastated at the time. Arlene: I ignored all the signs. My ankles swelled up and I said, "Oh, I must have worn the wrong shoes." Hassan: Maybe I didn't drink enough water. Maybe I ate something that I wasn't supposed to. Arlene: I run up the steps of the subway and I went [gasps]. I said, "Oh, I have to get back to the gym." Hassan: So I'm like, you know, you're playing these tricks with your mind and you're like, "Well, what's going on?" Arlene: And I'm ... sometimes I'm still in denial of it until I get tired. Until sometimes I feel that flutter in my heart and then I realize, oh, you know, I have a pacemaker. Hassan: The things that I was worried about were dying young, life being jeopardized, having kids and having a wife. Anne: Slow yourself down. Quiet your mind. Think. Pray. Because the relaxation that you can experience in your body will help your heart failure. Hassan: My objective was to live life light. So any kind of stress, you just have to let it go. Anne: Try to find support within your family, friends, but also other people who've experienced heart failure. Arlene: Beware of the signs. They could be so mistaken for so many other things. If your ankles swell, if you're out of breath, if you feel that heart flutter, go to your doctor immediately. Don't wait to see what happened to me.

Inflammation has been linked to many chronic diseases like rheumatoid arthritis, psoriatic arthritis, heart disease, and depression. Medication is crucial to treat these conditions, but you can also turn to your fridge to ease inflammation. Here's what to add to your grocery list. 1. Cold-water fish. One of the main elements of an anti-inflammatory diet is cold-water fish, rich in inflammation-fighting Omega-3 fatty acids. To catch these benefits, add salmon, mackerel, tuna, sardines, or anchovies to your meals twice a week. 2. Nuts. Next, go nuts. Walnuts, almonds, and pistachios have been associated with reduced inflammation. They can even lower your risk of heart disease and diabetes. 3. Add colorful fruits to your diet, strawberries, blueberries, oranges, and cherries can reduce inflammation and they're delicious. 4. Get plenty of leafy greens. Spinach, kale, and collards are not only anti-inflammatory but are rich in vitamins and antioxidants that can prevent against cancer. 5. Olive oil. Finally, enjoy plenty of olive oil. Extra virgin olive oil can prevent inflammation from developing using the same mechanism as ibuprofen. Reducing inflammation through food is an easy way to keep pain at bay. Keep these five elements stocked in your kitchen and you'll be on the right track to better health.

We all know proteins are essential to good health. Problem is, not all proteins are created equal. Often, they're full of fat. Fortunately, lean proteins can make your taste buds, and your heart, just as happy. 1. Protein plays a crucial role for almost every part of your body. It helps build bone, muscle, skin, and blood. Protein also helps your body repair tissue, fight infection, and regulate your hormones and lean protein provides all these benefits without the extra fat. 2. Meat isn't the only source of lean protein. There are plenty of plant-based sources, including nuts, beans, legumes, soy products, and whole grains. 3. Lean meats have less fat and cholesterol than other meats. For the carnivores, skinless poultry, grass-fed beef, and fish, like salmon and tuna, are healthier options than their higher fat counterparts. 4. Eating plenty of beans, low fat meat, nuts, and soy can help you lose weight. Lean protein makes you feel fuller for longer, so you're less likely to snack. 5. Experts recommend that about a third of your daily calories should come from lower fat proteins. There are endless ways to make delicious meals with lean proteins. Try skinless chicken kebabs, turkey and quinoa meatloaf, spicy baked tofu, and more.

1- It's well-known the Mediterranean diet reduces the risk of heartdisease, cancer, and dementia. It's even been ranked as the top diet for people with diabetes,and it's delicious. This Mediterranean tricoloresalad is simple to make with the fresh ingredientsfrom your local market. Start by slicing tomatoes in half. Blanch the green beans in a large sauce pan of gentle boiling water. Cook uncovered for four to five minutes until brightly colored and still tender. Open a can of cannellini beansand drain the excess water. Toss together the beans and tomatoes. Add a few pitted Kalamata olivesfor color and briny flavor. Lightly drizzle extra virgin olive oil over the salad for a healthful dressing. Add roughly chopped basilleaves and toss together again. Finish by sprinkling a pinch of sea salt and you're on your way to healthy living.

5 Things You Didn’t Know About Heart Attack Recovery 1. Most people survive their first heart attack.More than 90% of heart attack victims who make it to the hospital will make it out and be on the road to recovery. 2. Most heart attack patients return to work within two weeks to three months.The timeline will depend on the severity of the heart attack, as well as the physical and mental activity required of the job. 3. Depression can be a normal part of the heart attack recovery.Heart attack patients can experience a wide range of emotions after their first heart attack, including depression, fear and anger. Don’t be afraid to reach out for help and support. 4. Some chest pain is common.It’s possible to feel light pain or pressure in your chest after activity, an emotional moment or a heavy meal. It’s important to tell your doctor about any chest pain. 5. The right doctor can mean a world of difference.Finding the best doctor to help you with your heart attack recovery can increase your quality of life. Turn to Healthgrades.com to search for the right doctor for you. Share this video to help educate others about heart attack recovery!