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Issue Date: March 2009


Best Docs 2009 - Heart of the Matter

Dr. Samir Kapadia
LT
How To Avoid Seeing This Doctor

Heart disease
1 Hit the Gym.
Those workouts stimulate the liver to produce HDL, which clears LDL from the bloodstream, says Dr. Samir Kapadia, director of the Cleveland Clinic’s Interventional Cardiology Fellowship.

2 Eat more fish. According to the American Heart Association, catches such as salmon and albacore tuna are high in protein, low in fat, and high in omega-3 fatty acids.

3 Take your meds. High blood pressure and diabetes can cause plaque buildup when left unchecked. Make sure to take medications exactly as prescribed, Kapadia urges.
Believe it or not, LDL cholesterol is actually trying to mend your body.

Sure, low-density lipoproteins are known as “bad” cholesterol, but they accumulate on arterial walls to fix damage caused by smoking, high blood pressure, diabetes and aging.

The problems start when the resulting fatty deposits, or plaques, narrow arteries by 70 percent or more, restricting the blood supply to the heart.

Known as coronary artery disease, individuals suffering from this condition will usually experience symptoms such as chest tightness or pain that can be brought on by exercise, emotional stress, even going out in cold weather. If the plaque ruptures, a blockage can occur.

“If you have a sudden blockage from blood clots or plaques, you have a heart attack,” says Dr. Samir Kapadia, the director of the Cleveland Clinic’s Interventional Cardiology Fellowship.

Over the years, doctors have developed less-invasive surgical techniques to reroute blood flow around a blockage. Smaller incisions result in shorter hospital stays and recovery times, says Kapadia. Nonsurgical procedures include angioplasty, in which a catheter is inserted near the blocked or narrowed artery. A small balloon at the tip of the catheter is inflated, compressing the plaque against the artery walls. Other catheter tips grind and cut away at plaques. A stent, made out of either metal or tissuelike material, may also be inserted in the artery to hold it open. And studies show cholesterol-lowering medications, called statins, serve as a sort of arterial Drano, reducing plaques by as much as 4 percent a year.

But in this era of high-tech medical and pharmaceutical advances, Kapadia prefers to treat coronary artery disease by modifying risk factors (if symptoms are stable). He spends much of his time educating patients about what constitutes a heart-healthy lifestyle, including exercise and a low-fat, low-sugar diet.

“That pays off much more than putting in a few stents in the long term,” he says.

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