SPRING 2011 • CARDIOVASCULAR SERVICES

HEART-HEALTHY

RECIPE

BaylorHealth.com/GrapevineHeart

Find out more about the most common vascular conditions in women and the treatment options available.PAGE 2

VASCULAR HEALTH

Listen to Your Legs

Learn the basics of choosing a heart-healthy diet.PAGE 4

HEART FOODS

The need for follow-up care in adults previously treated for childhood heart conditionscontinues to grow. PAGE 3

FOLLOW-UP CARE

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2 Heart Smart / Spring 2011 Visit us at BaylorHealth.com/GrapevineHeart

Approximately 50 - 55 percent of women in the United States will experience some type of vein problem in their lifetime, according to the U.S. Department of Health and Human Services. From varicose veins to peripheral arterial disease, many women remain unaware of the causes of vascular disease and steps they can take to treat it.

Common Vascular ProblemsVaricose veins remain one of the most common vascular issues reported by younger women. These enlarged, swollen veins, often found in the legs, are caused by weakened or damaged vein valves.

If valves become weakened in leg veins, blood may flow back into the veins and pool, instead of being pumped out of the legs and into the heart. Venous insufficiency is a term used to describe this impaired flow of blood back to the heart.

“Women with varicose veins or venous insufficiency often have symptoms of burning, itching or pain at the abnormal vein site,” said Richard Wilkerson, MD, a vascular surgeon on the medical staff at Baylor Regional Medical Center at Grapevine. “They also may have associated leg swelling.”

As women reach age 50 and above, their risk for Peripheral Arterial Disease (PAD) increases. PAD occurs when the build up

of plaque in the arteries reduces essential blood flow in the extremities.

Common symptoms of PAD include leg pain while walking and sores or ulcers on feet that will not heal. Women with PAD also have an increased risk of stroke and heart attack. Risk Factors and PreventionVascular disease has many of the same risk factors as heart disease. Primary risk factors include: high blood pressure, high cholesterol, diabetes and smoking. Family history also plays a role in a women’s risk of developing a vascular condition.

To prevent vascular disease, physicians recommend monitoring blood pressure and cholesterol numbers and stress the importance of tobacco cessation.

“Women can prevent vascular disease by aggressively controlling risk factors and avoiding any form of tobacco use,” said Dr. Wilkerson. “Genetics can play a role, but controlling risk factors is the most important.”

Help for Vascular Disease Women experiencing symptoms such as burning or painful veins, leg swelling or leg pain while walking should see a physician to discuss their symptoms and concerns.

Baylor Grapevine offers comprehensive care for vascular conditions, from diagnosis to treatment. Simple tests, such as ultrasound, can be used to detect and diagnose vascular disease. The hospital also provides numerous procedures and treatment options for patients with vascular conditions.

“For some, treatment may be simple risk factor modification,” said Dr. Wilkerson. “If a patient has a condition requiring intervention, a vascular surgeon can provide minimally invasive procedures to traditional surgical bypass.”

Listen to Your LegsKnow when to seek help for vascular issues

HEART HEALTH NUMBERSby the The American Heart Association

recognizes at least 15 types of congenital cardiovascular defects, with many additional variations.

15The American Dietetic Association recommends women eat at least three one-ounce servings of whole grains each day.

3According to the Society for Vascular Surgery, walking 30 minutes three times a week may help improve symptoms of PAD.

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Treatment OptionsVisit BaylorHealth.com/GrapevineHeart to learn more about treatment options for heart and vascular conditions.

Heart-Healthy Recipe

Lump Crab Guacamole INGREDIENTS• 4 Haas avocados, halved, seeded and

peeled • 1 lime, juiced • ½ teaspoon kosher salt • ½ medium red onion, diced • 2 Roma tomatoes, seeded and diced • 1 tablespoon chopped cilantro • 1 lb lump crab meat • 3 ears of corn, grilled • 3 grilled poblanos diced (seeded,

stemmed and peeled)

DIRECTIONS• Grill poblanos until charred on all sides,

then place in a bowl and wrap with plastic and let steam for 10 minutes.

• Peel, stem and skin poblanos. Cut into small pieces.

• In a large bowl, place the avocado pulp and lime juice, toss to coat.

• Drain, and reserve the lime juice, after allof the avocados have been coated.

• Using a potato masher add the salt, and mash.

• Then fold in the onions, tomatoes, cilantro, crab, corn and diced poblanos.

• Serve with warm tortilla chips.

Recipe courtesy of the Vine Café, which provides the culinary services for guests at Baylor Grapevine.

Visit us at BaylorHealth.com/GrapevineHeart Heart Smart / Spring 2011 3

Congenital Heart Disease in AdultsFollow up for adults with childhood heart defects

Find a physicianLearn more about care for adults with congenital heart disease. Call 1.800.4BAYLOR or visit FindDrRight.com for a referral to a physician on the medical staff.

Thousands of babies are born each year with a heart defect, but in recent years, children are no longer the only ones who need treatment for congenital heart disease.

Today, the need for treatment and follow up in adult patients is growing. The National Heart, Lung and Blood Institute estimates at least 1 million adults currently are living with a congenital heart defect.

“The options for congenital heart surgery were limited 30 to 40 years ago, and some of these anomalies weren’t treatable,” said Patrick Roughneen, MD, a cardiothoracic surgeon on the medical staff at Baylor Regional Medical Center at Grapevine. “With advances in congenial heart surgery, the vast majority of these infants and children are now living to adulthood.”

Several types of congenital heart defects exist, and often patients who were treated for a heart defect as an infant or child should continue to see a physician who specializes in congenital heart disease to monitor their condition in adulthood.

Common congenital heart conditions that may require follow up include:• Atrial Septal Defect (ASD)• Ventricular Septal Defect (VSD)• Pulmonary or Aortic Stenosis• Partial Anomalous Pulmonary Venous

Return• Tatralogy of Fallot (TOF)• Coarctation of the Aorta• Those who have undergone the Fontan

Procedure for Ventricular Insufficiency• Ebstein Anomaly• Transposition of Great Arteries (TGA)

The need for physicians with experience in congenital heart disease in adults also is growing because some adults might not have received treatment as a child.

“We see some patients who knew about it in childhood and didn’t have it treated,” said Dr. Roughneen. “Commonly, there is a gap in care from childhood to adulthood, and these people go into adulthood without any careful follow up from a physician trained in the care of adults with congenital heart conditions.”

To monitor an adult who has been previously diagnosed with a heart defect, physicians can use echocardiogram, a simple, non-invasive test. Routine echocardiograms allow physicians to follow the condition closely and watch for any changes that might require treatment or surgical attention.

Baylor Grapevine offers numerous procedures to monitor and treat the specific needs of adult patients with congenital heart defects. The hospital also has cardiologists and surgeons on the medical staff who are trained in the specialized treatment of these patients.

If you were diagnosed with heart defect at birth, talk with your physician about any follow up care you may require.

“The need for further procedures as people get older may be very necessary,” said Dr. Roughneen. “Patients should ensure they receive appropriate follow up care from a hospital with surgeons and cardiology team who can effectively follow, manage and treat this important new group of patients.”

Heart-Healthy LivingLearn more ways you can lower your risk for cardiovascular disease. Visit BaylorHealth.com/GrapevineHeart, and click on Prevention.

Visit us at BaylorHealth.com/GrapevineHeart Heart Smart / Spring 2011 4

In This Issue

• Listen to Your Legs

• Congenital Heart Disease in Adults

• Heart-Healthy Recipe

• Choosing a Heart-Healthy Diet

WHAT’S INSIDE

Baylor Regional Medical Center at Grapevine is pleased to bring you Heart Smart, a quarterly newsletter dedicated to your cardiovascular health.

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Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community, or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Regional Medical Center at Grapevine, or Baylor Health Care System. © 2011 Baylor Health Care System EA BRMCGV 579_3.11

This educational material is designed to provide general information. As always, if you have any questions, please discuss them with your doctor.

If you do not wish to receive future mailings from Baylor, please call1.800.4BAYLOR or 1.800.422.9567.

Choosing a Heart-Healthy Diet

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When it comes to controlling your risk factors for heart disease, a heart-healthy diet remains one of the key ingredients. Foods low in saturated fat, trans fat and dietary cholesterol can help you maintain a healthy weight and blood cholesterol levels.

“A diet consisting of fruits, vegetables, nuts, whole grain foods and fish is generally good for your heart,” said Neeraj Arora, MD, a cardiologist on the medical staff at Baylor Regional Medical Center at Grapevine. “Plant foods like fruit, vegetables and grains do not contain cholesterol, so increasing their amount in your diet helps achieve a desired blood cholesterol level.”

Most of the fat consumed as part of a heart-healthy diet should be unsaturated fat, which includes monounsaturated and polyunsaturated fats. Replacing saturated fats with unsaturated helps lower LDL or “bad” cholesterol.

Sources of these unsaturated fats include oils like olive, canola, sunflower or soybean; avocados; and many nuts and seeds. Fish also is a good source of unsaturated fats.

“Omega-3 fatty acids found in fish are a type of polyunsaturated fat that may lower triglycerides and reduce risk for heart disease,” said Dr. Arora. “The American Heart Association recommends eating at least two servings of fish per week.”

Foods high in saturated fat, such as fatty meats, poultry with skin, eggs and whole milk dairy products, should be eaten in moderation, paying close attention to the serving size.

“Saturated fats and trans fats are the main dietary fats that raise ‘bad’ cholesterol,” said Dr. Arora. “For people with heart disease, less than seven percent of their calories should come from saturated fats.”

To help lower saturated fats in your diet, prepare foods by grilling, broiling and baking instead of frying. Take skin off poultry, consume lean cuts of pork and beef and consume more fish and low-fat dairy products.