 Dr.
Rogal has a special interest in preventative cardiology, non-invasive
imaging and valvular disease. He co-founded the Integrative Medicine
Program for cardiovascular disease at Saint Barnabas Medical Center
and Newark Beth Israel Medical Center, one of the largest integrative
medicine programs for cardiac patients in the United States. Dr. Rogal
has published several journal articles and is a diplomat of the American
Board of Internal Medicine and a Fellow of the American College of
Cardiology. He serves as a board member of the Heritage Affiliate
of The American Heart Association.
In this month’s interview, we asked Dr. Rogal to share with us
the answers to some of the most common questions he hears from patients.
Email us the question
and or cardiology topic at: info@sbhcs.com
Exercise, even a small amount at lower intensity, can be beneficial
from a fitness perspective and can help benefit the patient’s
cardiovascular health and reduce the risk of cardiovascular events.
Several medical studies have demonstrated that the more we move our
bodies and the more vigorous we are as we go about our daily activities,
the lower the risk of cardiovascular and other types of chronic diseases.
You can have a perfectly normal electrocardiogram
and still be at risk for a coronary event. Your
doctor will evaluate your risk for blockages
in your heart or other locations based on a number
of factors, including cholesterol, high blood
pressure, diabetes, smoking, obesity, family
history and whether you are active or sedentary.
Any one of these factors alone doesn’t determine
your risk but combined factors will give your physician
an overall impression of your level of risk. Once
this is determined, your doctor will review the
tests, medication and other preventative measures
that can help keep you safe from a future cardiac
event.
Yes, there is good evidence that consuming
Omega 3 fatty acids can have a positive effect
on the heart. There is gathering evidence that
Omega-3 can contribute to overall cardiac health
and help prevent heart attacks. Some studies have
looked at the high intake of fish in the Eskimo
and Japanese populations and compare that to the
low incidence of heart attacks in these groups
and it is believed that there is a direct correlation.
Other investigators have tested patients who consume
these substances and have seen a positive effect
on blood’s viscosity (thickness) and have
shown that platelets and blood elements don’t
stick as much versus patients who don’t consume
these substances. Omega-3s may also have an anti-arrhythmic
effect (calming the rhythm of the heart). A recent
study demonstrated that patients who consumed Omega-3
fatty acids, had a lower incidence (down from 30%
to 15%) of atrial fibrillation (irregular heart
beat).
Finally, there is very good physiological evidence
that patients who consume Omega 3 fatty acids have
beneficial effects on the structure and physicology
of the heart that can be demonstrated by a good
cardiography.
A CT Angiogram test is a non-invasively examination
of the heart arteries, allowing the physician to
examine the structure and see if there is cholesterol
deposits within the vessels.
A stress test is a functional test that tells
us how good the blood flow is to the heart muscle.
Typically we will order this type of test if we
suspect that there is a critical obstruction (70%
or greater) in an artery. The stress test will
not tell if there is disease that is less than
70% and might need attention. For instance, in
many cases, patients who have heart attacks have
plaque rupture, or a disruption of the cholesterol
deposits. Those deposits are typically less than
70% and not detectable through stress testing.
It is possible that your doctor may want to see
if you have earlier evidence of heart disease,
which may be detected in a CT Angiogram but would
otherwise be missed during a stress test. In that
way, if you have milder heart disease, you can
start therapy to slow the disease or, in some cases,
cause disease regression.
Atrial afibrillation and atrial flutter
are rapid heart rhythms originating from the upper
chambers of the heart, which subsequently drives
the lower chambers to beat very fast.
We typically treat this arrhythmia with anti-
arrhythmia drugs and blood thinners. Both of these
classes of drugs can be difficult to use and cause
unpleasant side effects for the patient.
Investigators have developed a technique where
catheters are passed from the lower extremity up
into the upper chamber of the heart to ablate (or
remove) a specific area of the muscle with radio
frequency energy, a highly successful technique
that we have been using at Saint Barnabas and Newark
Beth Israel Medical Centers and for several years
now.
To determine if you are a candidate for atrial
afibrillation, you need to be evaluated by an electrophysicologist,
a sub-specialist within the field of cardiology.
Aortic stenosis is abnormal narrowing
of the aortic valve, valve through which all of
the blood must flow from the heart to the rest
of the body. Treatment is exclusively surgical,
so that once you get to a critical degree of blockage
in the valve, you need to have an operation.
As our population ages, aortic stenosis becomes
more common but risks for complications after open
heart surgery increases. So, we have followed the
general guideline that patients who are 85 years
or older and are otherwise in good health (patients
need to be free from lung disease and kidney problems)
may be candidates for this type of surgery. So,
age alone is not the deciding factor when determining
if a patient is a candidate for this type of surgery,
which can extend and greatly improve the quality
of one’s life.
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