Selected Podcast
COVID-19, Atrial Fibrillation, and Heart Health
Dr. David Jones discusses COVID-19 and its effect on Atrial Fibrillation and heart health overall as well as the correlation between all three.
Featuring:
David Jones, MD
David Jones, M.D., F.A.C.C. is a Board Certified Cardiologist with Palouse Heart Center, part of the Pullman Regional Hospital Clinic Network. Dr. Jones graduated from the Keck School of Medicine at University of Southern California and completed his residency and fellowship training at U.C. Davis. Transcription:
With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.
Deborah: You know, we've all been hunkered down at home, learning new ways to live and work during the COVID-19 crisis. Let's face it, it's been stressful. So have you wondered how it might be affecting your heart health? To talk about COVID-19, atrial fibrillation and heart health, today we're joined by Dr. David Jones, board-certified cardiologist with Palouse Heart Center, part of the Pullman Regional Hospital Clinic Network. Dr. Jones, what is cardiovascular disease?
Dr David Jones: Well, cardiovascular diseases is a rather broad spectrum of ailments that would affect the heart or vascular system. Primarily, the things we would think about would be arrhythmias. Those could be things like atrial fibrillation, atrial flutter, supraventricular tachycardias, premature ventricular beats, premature atrial beats. Those would be the most common. There are others that are less common.
Other things might include atherosclerotic diseases, which might lead to angina, heart attacks, bypass surgery. And finally, things that might be diseases of the heart muscle itself or the valves. And those would be things such as cardiomyopathy, which could lead to congestive heart failure, or valvular heart disease, which also could lead to heart failure, but by obstructing blood flow through a stiff valve or a regurgitant valve,
Deborah: And what are some common conditions?
Dr David Jones: So the most common conditions that are dealt with would be heart attacks; angina, which would be chest pain; heart failure, which would usually have symptoms of shortness of breath, fatigue, or weakness; or arrhythmias, which would have symptoms of palpitations.
Deborah: Got it. So what can each of us do or not do to take preventative action?
Dr David Jones: Well, the general recommendation for everybody is to have a physician that you're engaged with and check in on some routine schedule. That's usually a dialogue that is developed between the patient and the physician and the schedule might look like once a year, it might look like once every two years, and it might also be more frequent depending on symptoms or problems that might be managed.
Deborah: Okay. Now you've shared with us that a common question you're asked about is atrial fibrillation. What is AFib? And when is it dangerous?
Dr David Jones: Yeah. So I think atrial fibrillation is a common problem. Lots of people have it and I think it's probably more in the public eye with devices, such as the Apple watch, which monitors and detect atrial fibrillation. Atrial fibrillation is an irregular heartbeat. There's a lot of things that cause irregular heartbeats that are not atrial fibrillation. But atrial fibrillation is a sustained, irregular heartbeat, often rapid. And for some people, it can lead to stroke. It can also lead to heart failure. And it's dangerous if the setting is right, the patient has the right risk factors, which can put them at risk for a stroke or if the heart rate's rapid and it lasts for a long period of time, then it can lead to heart failure and ultimately also stroke.
The important thing is the atrial fibrillation can be managed, it can be prevented with cardioversions and antiarrhythmic medications. And if atrial fibrillation is not managed in that way, the risks of stroke and heart failure can be managed with meds that slow heart rates or meds that thin the blood and prevent strokes.
Deborah: So when a patient's in AFib, what are they feeling?
Dr David Jones: Yeah, there's really a spectrum of symptoms. I think the most common symptom people might report would be a rapid heartbeat or a rapid irregular heartbeat. People might also feel their heart shift in their chest or palpitate, or they might feel a jump or a fullness in the neck. Some people might notice a discomfort. Other people might report shortness of breath or a need to cough. A large number of people surprisingly have no symptoms. Maybe as many as close to half of people who have atrial fibrillation don't even know it's occurring.
Deborah: Well, that's unfair. So if they don't know they're having an AFib, what do you call it? Episode?
Dr David Jones: Right. So, there's not a good answer for that. This is part of the reason for why patients are encouraged to have an established relationship with a physician and to be checked on from time to time. It's often caught in the doctor's office. The other thing is people with atrial fibrillation who don't feel it and don't know they have it, the risk of problems in that subset is a little less certain.
Deborah: Okay. Let's switch gears now to something a little bit newer on our minds. What's the relationship between COVID-19 and heart problems?
Dr David Jones: Yeah. So there's a couple things with COVID-19 and heart problems. For the most part, people who have mild COVID or asymptomatic COVID or even moderate COVID where they don't end up admitted to the hospital don't have heart problems and aren't going to get them. There is a small subset of patients who may be asymptomatic, mild or the moderately symptomatic, who might have a dysautonomic syndrome after recovering from the COVID. And that can lead to symptoms of shortness of breath, of racing heartbeats, even of chest pain. Whether those are truly coming from the heart or not, not entirely clear at this point. The knowledge on cardiac disease or cardiac problems from the coronavirus remains to be an evolving set of knowledge.
The most alarming things that do happen with the coronavirus that some people are screened for, particularly patients who are athletes, particularly if they've had moderate or worse coronavirus, some of them will have an inflammation of their heart, myocarditis, which can lead to a weak heart or even heart failure. Symptoms of that can be very similar to the other symptoms that might correlate with a non-cardiac condition, shortness of breath, chest discomfort, faster than expected heart rates with just standing or sitting or light activity.
Deborah: Is there anything we should be doing at home to help our hearts during the COVID situation when we were not out and about, and maybe we're a little bit stressed?
Dr David Jones: Yeah. So for everybody, regardless of the pandemic, we recommend a heart-healthy diet and routine aerobic exercise. We can follow the recommendations for social distancing and avoiding large gatherings and still exercising. Walking 40 minutes four times a week exceeds the national recommendation from the American Heart Association for routine aerobic exercise, which is 150 minutes, which is occurring on most days of the week.
The other thing, of course, is just heart-healthy diet, which means a selection of fresh vegetables and fruits, and avoiding foods that are high in cholesterol and high in fat.
Deborah: I'm glad you clarified about aerobic exercise because a lot of people think, "Oh man. I got to go to the gym or I got to lift weights or I got to run." Walking is aerobic.
Dr David Jones: Correct. And nothing more than a moderate paced or a brisk paced walk for 30 minutes five times a week or 40 minutes five times a week achieves the goal for exercise.
Deborah: I just read an article today that said even 15 minutes a day of exercise will add three years to your longevity. There you have it.
Dr David Jones: Yeah. And that's kind of like getting a free gas mileage, isn't it?
Deborah: There you go. Well, Dr. Jones, we so appreciate your time and everything you do. Thanks so much for being with us today
For more information as well as more podcast episodes, learn more at pullmanregional.org. This has been The Health Podcast from Pullman Regional. I'm your host, Deborah Howell. Thanks for listening and have yourself a terrific day.
With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.
Deborah: You know, we've all been hunkered down at home, learning new ways to live and work during the COVID-19 crisis. Let's face it, it's been stressful. So have you wondered how it might be affecting your heart health? To talk about COVID-19, atrial fibrillation and heart health, today we're joined by Dr. David Jones, board-certified cardiologist with Palouse Heart Center, part of the Pullman Regional Hospital Clinic Network. Dr. Jones, what is cardiovascular disease?
Dr David Jones: Well, cardiovascular diseases is a rather broad spectrum of ailments that would affect the heart or vascular system. Primarily, the things we would think about would be arrhythmias. Those could be things like atrial fibrillation, atrial flutter, supraventricular tachycardias, premature ventricular beats, premature atrial beats. Those would be the most common. There are others that are less common.
Other things might include atherosclerotic diseases, which might lead to angina, heart attacks, bypass surgery. And finally, things that might be diseases of the heart muscle itself or the valves. And those would be things such as cardiomyopathy, which could lead to congestive heart failure, or valvular heart disease, which also could lead to heart failure, but by obstructing blood flow through a stiff valve or a regurgitant valve,
Deborah: And what are some common conditions?
Dr David Jones: So the most common conditions that are dealt with would be heart attacks; angina, which would be chest pain; heart failure, which would usually have symptoms of shortness of breath, fatigue, or weakness; or arrhythmias, which would have symptoms of palpitations.
Deborah: Got it. So what can each of us do or not do to take preventative action?
Dr David Jones: Well, the general recommendation for everybody is to have a physician that you're engaged with and check in on some routine schedule. That's usually a dialogue that is developed between the patient and the physician and the schedule might look like once a year, it might look like once every two years, and it might also be more frequent depending on symptoms or problems that might be managed.
Deborah: Okay. Now you've shared with us that a common question you're asked about is atrial fibrillation. What is AFib? And when is it dangerous?
Dr David Jones: Yeah. So I think atrial fibrillation is a common problem. Lots of people have it and I think it's probably more in the public eye with devices, such as the Apple watch, which monitors and detect atrial fibrillation. Atrial fibrillation is an irregular heartbeat. There's a lot of things that cause irregular heartbeats that are not atrial fibrillation. But atrial fibrillation is a sustained, irregular heartbeat, often rapid. And for some people, it can lead to stroke. It can also lead to heart failure. And it's dangerous if the setting is right, the patient has the right risk factors, which can put them at risk for a stroke or if the heart rate's rapid and it lasts for a long period of time, then it can lead to heart failure and ultimately also stroke.
The important thing is the atrial fibrillation can be managed, it can be prevented with cardioversions and antiarrhythmic medications. And if atrial fibrillation is not managed in that way, the risks of stroke and heart failure can be managed with meds that slow heart rates or meds that thin the blood and prevent strokes.
Deborah: So when a patient's in AFib, what are they feeling?
Dr David Jones: Yeah, there's really a spectrum of symptoms. I think the most common symptom people might report would be a rapid heartbeat or a rapid irregular heartbeat. People might also feel their heart shift in their chest or palpitate, or they might feel a jump or a fullness in the neck. Some people might notice a discomfort. Other people might report shortness of breath or a need to cough. A large number of people surprisingly have no symptoms. Maybe as many as close to half of people who have atrial fibrillation don't even know it's occurring.
Deborah: Well, that's unfair. So if they don't know they're having an AFib, what do you call it? Episode?
Dr David Jones: Right. So, there's not a good answer for that. This is part of the reason for why patients are encouraged to have an established relationship with a physician and to be checked on from time to time. It's often caught in the doctor's office. The other thing is people with atrial fibrillation who don't feel it and don't know they have it, the risk of problems in that subset is a little less certain.
Deborah: Okay. Let's switch gears now to something a little bit newer on our minds. What's the relationship between COVID-19 and heart problems?
Dr David Jones: Yeah. So there's a couple things with COVID-19 and heart problems. For the most part, people who have mild COVID or asymptomatic COVID or even moderate COVID where they don't end up admitted to the hospital don't have heart problems and aren't going to get them. There is a small subset of patients who may be asymptomatic, mild or the moderately symptomatic, who might have a dysautonomic syndrome after recovering from the COVID. And that can lead to symptoms of shortness of breath, of racing heartbeats, even of chest pain. Whether those are truly coming from the heart or not, not entirely clear at this point. The knowledge on cardiac disease or cardiac problems from the coronavirus remains to be an evolving set of knowledge.
The most alarming things that do happen with the coronavirus that some people are screened for, particularly patients who are athletes, particularly if they've had moderate or worse coronavirus, some of them will have an inflammation of their heart, myocarditis, which can lead to a weak heart or even heart failure. Symptoms of that can be very similar to the other symptoms that might correlate with a non-cardiac condition, shortness of breath, chest discomfort, faster than expected heart rates with just standing or sitting or light activity.
Deborah: Is there anything we should be doing at home to help our hearts during the COVID situation when we were not out and about, and maybe we're a little bit stressed?
Dr David Jones: Yeah. So for everybody, regardless of the pandemic, we recommend a heart-healthy diet and routine aerobic exercise. We can follow the recommendations for social distancing and avoiding large gatherings and still exercising. Walking 40 minutes four times a week exceeds the national recommendation from the American Heart Association for routine aerobic exercise, which is 150 minutes, which is occurring on most days of the week.
The other thing, of course, is just heart-healthy diet, which means a selection of fresh vegetables and fruits, and avoiding foods that are high in cholesterol and high in fat.
Deborah: I'm glad you clarified about aerobic exercise because a lot of people think, "Oh man. I got to go to the gym or I got to lift weights or I got to run." Walking is aerobic.
Dr David Jones: Correct. And nothing more than a moderate paced or a brisk paced walk for 30 minutes five times a week or 40 minutes five times a week achieves the goal for exercise.
Deborah: I just read an article today that said even 15 minutes a day of exercise will add three years to your longevity. There you have it.
Dr David Jones: Yeah. And that's kind of like getting a free gas mileage, isn't it?
Deborah: There you go. Well, Dr. Jones, we so appreciate your time and everything you do. Thanks so much for being with us today
For more information as well as more podcast episodes, learn more at pullmanregional.org. This has been The Health Podcast from Pullman Regional. I'm your host, Deborah Howell. Thanks for listening and have yourself a terrific day.