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  • it's only a heart attack if you have chest pain.

  • Uh you can't die from a broken heart.

  • Can you die from a broken heart?

  • The answer is yes.

  • A keto diet is the best for your heart.

  • This one you can see by my face really, really angers me.

  • I'm Eugenia Jonah's the professor of cardiology at the Zucker School of Medicine and director of Cardiovascular prevention at North Well health.

  • My goal is to keep people from having heart attacks from having strokes high.

  • I'm Vinita shaw.

  • I am an interventional cardiologist at the Grossman School of Medicine.

  • I open up blockages when people have heart attacks and try to save their lives in the moment.

  • And today we'll be debunking myths about the heart.

  • Red wine is good for your heart.

  • Well, I love my red wine.

  • So I'm gonna give this one to you.

  • I'm sorry to be the bearer of bad news but we don't really encourage people to start drinking to have better heart health.

  • So one glasses, okay, one glass is fine.

  • Today there are good things about red wine.

  • There is reserve a trawl in red wine which can decrease inflammation and help the arteries relax.

  • However, the negative aspects, there's calories in wine and leads to weight gain and you get higher blood pressure.

  • Your heart can get stretched and you may have more irregular heart rhythms.

  • There could be liver problems down the line up to one glass a day of red wine could potentially be good for your heart.

  • You can't die from a broken heart.

  • I will take that one.

  • Not not only have I had some heartbreaks personally, but unfortunately, I do end up treating a lot of patients in the cath lab who do come in with what we call broken heart syndrome.

  • The medical term is really a stress induced cardiomyopathy.

  • What happens is that there's an emotional stressor, something that allows a surge of cata cola means to release from your body that's toxic to your heart muscle and constricts down the vessels around your body so that the heart has to pump even harder to get the blood flow out there with all those stresses, the heart muscle definitely starts to fail.

  • So, can you die from a broken heart?

  • The answer is, yes, luckily if you make it to the hospital in time and were able to treat you, the likelihood of actually dying from it is quite low at the end of the day, broken hearts are real and you have to manage your stressors in life.

  • A keto diet is the best for your heart.

  • This one, you can see that my face really, really angers me.

  • I can't tell you how much time I spend in my practice debunking the myth that the keto diet is good for you.

  • It's not a sustainable diet.

  • Not a long term thing.

  • Yes, it's really good for weight loss because it's really low in carbs and then your body ends up being depleted of sugar.

  • So then it breaks down fat, but what are you eating if you're not eating carbohydrates, you're eating more protein and a lot of fat?

  • Most people who do this diet do it in a heavily animal based way.

  • When you eat animal products in general, there are some direct components that are bad for the heart, something called tri methyl amine that gets converted in the gut and that leads to heart disease.

  • There's also saturated fat in your animal products that is causing your cholesterol to go really, really high.

  • You're also getting very little fiber and fiber is what lowers your cholesterol.

  • And you and I actually worked together a few years ago looking at this a little bit more closely.

  • What we were sort of looking for was to change animal based protein for plant based protein.

  • And we saw that with the plant based protein, vegetables, fruit, whole grains, their cholesterols were lower, their inflammation levels were lower.

  • So really it's that whole foods.

  • Plant based diet, that's probably better than this keto diet, eggs are bad for your heart, are they?

  • So when it comes to eggs, there's a lot of controversy, eggs are good in a lot of ways.

  • They have some protein and B 12 and bullied and omega three fatty acids, but they also do have a lot lot of that cholesterol, a little bit of saturated fat and animal products in general are associated with more heart disease?

  • If you're eating the eggs with cheese and bacon on a white process role?

  • probably not so great.

  • How about egg whites versus yolks?

  • Good question.

  • So if you're going to have any component of the egg, then the egg white probably has the most protein at least fat.

  • Even that I would say still keep in moderation, but definitely a better part of the egg.

  • Heart attacks don't happen to healthy people, not true heart attacks really can happen to anyone.

  • So many people come to me and say I exercise a ton.

  • I'm at the gym all the time.

  • I'm in really good shape.

  • I should be fine, right?

  • And I say, well unless you know your numbers, you do not know that you need to know what your cholesterol looks like.

  • You need to know what your blood sugars look like.

  • You need to know what your blood pressure look like because there is a genetic component.

  • And then the other thing I want, I want to talk about is what defines healthy skinny is not necessarily healthy.

  • Obesity is not necessarily unhealthy.

  • What is going on in your bloodstream and your arteries in your entire body with your organs.

  • That's really the marker of your true health.

  • All fats are unhealthy.

  • I think I probably thought this was the case when I was in college and I lived on things like frozen yogurt and pasta and pretzels, but all fats are not bad good fats.

  • Mono, unsaturated poly unsaturated fats in nuts and in avocados and in healthy fish such as salmon, cod, mackerel herring.

  • But the bad fats definitely to be avoided are the saturated ones.

  • And what we call trans fats, because trans fats are actually fats that are created synthetically and our bodies can't break them down when you exchange goods fats for bad fats in your diet, your heart disease risk goes down.

  • So why is that one?

  • It does actually lower your cholesterol to some extent to it causes your arteries to relax better and they help plaque in the arteries?

  • Hell so my handful of almonds and my handful of walnuts, those are good choices.

  • I'm making those are great.

  • So limit saturated fats, eliminate trans fats and get more good fats in your diet.

  • It's only a heart attack if you have chest pain.

  • Uh no way, why not?

  • Do you know how many people come to me?

  • And I say, oh, did you have chest pain patients?

  • Like, no, no chest pain?

  • And I say, well, did you have any pressure in your chest, any discomfort in your chest and your shoulder and your arm and your jaw?

  • And they're like, oh yeah, I had all of that.

  • It's like an elephant sitting on my chest.

  • Some people will also have symptoms of just feeling the sudden nausea or wanting to vomit.

  • A bunch of hiccups along the way.

  • There are a few cases of what we call silent heart attacks.

  • I think in actuality it's usually not silent, it was usually just a symptom that somebody missed along the way.

  • If you feel suddenly unwell and you're not quite sure why come in, get checked out.

  • Make sure you're not having a heart attack cholesterol is bad for your heart.

  • It's all about diet.

  • So I'm giving it right back to you.

  • So there's both good and bad cholesterol in your bloodstream.

  • The good cholesterol actually helps to clear the bad cholesterol out of the bloodstream, which is really important.

  • That bad cholesterol.

  • The LDL is really the one that is most linked to people developing plaque in their arteries that make them end up in dr shaw's lab needing procedures so that bad cholesterol optimally in everybody should be less than 100 and in people who are at high risk less than 70 and some would argue that if we can keep our bad cholesterol even at the level of about 50 for our whole lives.

  • That's how we really prevent heart disease.

  • The most important way to get your cholesterol down and to keep it low is through diet full of vegetables, fruits, whole grains, legumes, low in saturated fat, processed foods, fried foods.

  • Trans fats focus on that lowering of your bad co cholesterol.

  • Then on raising your good and following a heart healthy lifestyle overall.

  • You only need cardio for heart health.

  • So cardio is important.

  • But most the guidelines now also recommend things called resistance training with weights, squats are different kinds of exercises that provide resistance that can make you more tone build muscle, build bone and really improve your heart health overall.

  • The american Heart Association recommends to try to get your 10,000 steps In a day.

  • We also say do about 150 minutes a week of moderate intensity exercise or 75 minutes of intense exercise per week.

  • Not everyone's going to be running miles and lifting £200. Do what you can start slow and build up.

  • I'm too young to worry about heart disease.

  • I've seen patients in their thirties having major heart attacks.

  • There are a few risk factors to think about when you're on the younger side tobacco you smoking number one and then thinking about the genetics that may put you at increased risk of having high cholesterol or having diabetes.

  • And then unfortunately in our culture there's just a lot of really, really poor lifestyle.

  • Sedentary lifestyle.

  • We also have diets that tend to be very, very high and processed foods.

  • Put those two things together and that's why we see both of us such young patients with disease.

  • So it's never too early actually, I think To see somebody understand your risk and prevent heart disease.

  • Heart disease is a man's problem.

  • We should not be thinking about cardiovascular disease based on sex assignment at all.

  • Heart disease still remains the number one killer of women, but in the 50s and the 40s, people just assume this only happened to men.

  • They used to actually advise wives on what they can do to keep their men healthy for their hearts.

  • What we do is we sort of ignore this whole problem until menopause.

  • Probably because of the links to different hormones that actually protect you during your early years, until you get to menopause and then all of a sudden it's kind of too late.

  • It's important to get that awareness out.

  • This is everybody's problem and we all need to be more aggressive at screening, preventing and treating heart disease.

  • This is a disease that is largely preventable smoking only affects the lungs, so not the case damages the endothelial EUM of the heart muscle, of the arteries of the heart.

  • And so that damage allows plaque to be built up cause a lot of inflammation in the body, which also damages the endothelial e.

  • Um and then that inflammation as well as the endothelial damage can also allow blood clots to form.

  • If you think about the biggest artery in the heart, you're lucky if you have one that's four or five millimeters in diameter.

  • But for the most part it's three millimeters in diameter.

  • So all you need is a little clot to block off blood flow to that heart muscle.

  • And the good thing is we have so many ways to help people quit smoking.

  • Nowadays we prescribe medications to help them quit.

  • We have patches, we have these groups available counseling once you quit within 20 minutes to a few days, you'll already start seeing some benefit.

  • With a decrease in blood pressure, a decrease in heart rate Within a year, your risk will be down to half of what it would have been if you had continued smoking.

  • But unfortunately it really takes 10 to 15 years before your risk normalizes to those who never smoked before.

  • Still beneficial.

  • And really you'll get there eventually.

  • We want you to know all your numbers.

  • If we recognize your risk at an early stage, we can completely change your destiny.

  • And then sometimes, no matter everything that you do, you will still have a heart attack or stroke heart failure.

  • These are things that we take very seriously.

  • So if you're not feeling well, come on in, get checked out.

it's only a heart attack if you have chest pain.

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