St. Clair Health: Making A Collaborative Effort to Prevent Heart Disease and Stroke

By Daniel Casciato

February is American Heart Month making now the perfect time to learn about your risk for heart disease and stroke, as well as the steps you can take to help your cardiovascular system.

"Stroke and heart disease are vascular diseases," says Dr. Andy C. Kiser, Chief of Cardiac Surgery. "The vessels in the brain and the vessels in the heart are very small and don't tolerate a lot of trauma – repeated trauma to the vessel causes plaque to form, which narrows the vessel. When that plaque in the narrowed vessel ruptures, it causes an immediate heart attack or an immediate stroke."

Several things can increase your risk of vascular disease, including:

  • Diabetes

  • Gender (with men at a higher risk than women)

  • High blood pressure

  • High levels of fats like cholesterol and triglycerides

  • Lack of physical activity

  • Being overweight or obese

  • Smoking

  • Stress

  • Family history of vascular disease, heart attack, or stroke

"One thing we can't control is our genes," says Dr. Kiser. "There's a large component of family history that contributes to heart disease as well as stroke. And while we can't control that, we can certainly be more aggressive about mitigating the other comorbidities."

While vascular disease can be treated with medications that help improve blood pressure and cholesterol or help prevent blood clots from forming, people can also incorporate lifestyle changes that make a big difference, including:

  • Eating a healthy diet to help lower blood sugar or cholesterol

  • Exercising regularly

  • Utilizing stress management techniques

  • Quitting tobacco

"Smoking is a big part of vascular disease," explains Dr. Kiser. "We don't pay as much attention to it now because most public places are smoke-free, but there's still a large population of people who smoke. Smoking is a real problem with heart disease and stroke, not to mention lung disease. Blood pressure management is also a big part of vascular disease because the trauma to the blood vessel sometimes comes from higher blood pressure."

Dr. Kiser further explains that while many people are aware of the classic signs of heart disease – such as chest tightness, pressure, or pain – one surprising cue from your body that could be a cardiovascular concern is a gradual shortness of breath.

"Many patients don't even know it's happening," he says. "So many folks don't realize they have been getting more and more short of breath over time – and it may progress so slowly that they don't pick up on it at all. Maybe you can go up four flights of stairs without much of a problem one day, but then a month later you get a little winded. Next thing you know, you're really struggling – but you've adjusted your lifestyle and maybe you're just taking the elevator now. It could actually be an issue with your heart causing this shortness of breath."

To help break down the impact of heart disease and stroke plus advancements in the respective fields that help mitigate the risks associated with them , St. Clair Health held a virtual Heart + Stroke Symposium in 2021 which brought together a team of their experts to discuss stroke awareness and a pair of new procedures now available at the Hospital. Dr. Maxim D. Hammer, Chief of Neurology, opened the series with a presentation on stroke awareness.

"The symposium was a way for us to put our collaborative program out in front of the community," says Dr. Kiser. "We want patients to be better equipped to manage heart disease and stroke. With Dr. Hammer joining us, we've really elevated our stroke program and we've been able to incorporate some of the things we can do to help prevent a stroke. It's really a team effort to make sure every patient receives what they need, and to help educate them so that we can help prevent strokes and cardiovascular problems."

Also featured at the symposium: Dr. Kyle D. Buchanan discussing the patent foramen ovale (PFO) closure device that helps reduce the risk of stroke and Dr. Jeffrey C. Liu presenting on the Watchman device for patients with atrial fibrillation (AFIB) who aren't good candidates for blood thinners.

Dr. Kiser adds that St. Clair is making a concerted effort to bridge the gap that ensures patients in the community have access to the best care possible.

"With events like the annual Pittsburgh Heart Team Summit, we try to be as collaborative as possible with other healthcare institutions in the city such as UPMC and AHN," says Dr. Kiser. "Our goal is to focus not on outperforming each other, but toward creating a healthcare community that outperforms the nation in patient care."

For more information, visit stclair.org/heart-stroke-symposium.