Today is the day when hearts abound, from the creamy chocolate variety to
puffed-up balloon heart bouquets to hearts snipped from pink paper, signed with
love and sealed with a kiss.
So perhaps today, in the midst of these confectionary hearts, is the best time
of the year to pay tribute to your physical heart – that most important organ
that thump-thumps, thump-thumps inside your chest.
To get you started, we asked Dr. Paul Oh, medical director of the cardiac
rehabilitation and secondary prevention program at Toronto Rehabilitation
Hospital, 14 questions about the heart – about its job, its role in love and how
to treat it right on Valentine's Day.
What fascinates you most about the heart?
The heart beats 100,000 times a day, about 37 million times a year and about 26
billion times in your lifetime. It's amazing that it can get through that
lifespan, for the most part, in a pretty healthy state.
An analogy that I like to think about the heart is: The heart is like a home. It
has got walls. It has got rooms and doors. It has got a plumbing system. An
electrical system. And all of these need to keep running for 70 or 80 or 100
years. So there are opportunities for things to go wrong unless we maintain it
right. And therein lies our challenge: When we're not maintaining, problems will
arise in our plumbing or electrical system, or in the structure of the heart.
Is it, do you think, an under-appreciated bit of our body?
Yes, I think the heart is taken for granted, for the most part. We don't have to
think about it; it just does its duty so effectively every single day.
The fact that most people don't eat properly, don't get enough exercise, means
that we're not maintaining our home particularly well. We're creating the
environment where things can break down.
Is there a time in our day or a time in our lives when we should appreciate the
heart the most?
First thing in the morning is always a good time to appreciate your heart
because it has started and (Oh chuckles as he says this) the alternate is never
very good.
There are key moments in our life – the milestones of birth, death, marriage,
children. These important life moments should be celebrated and maybe it is a
good time to pause and be grateful for our health and our heart health in
particular.
You work to help people rehabilitate their heart. What does that mean to you?
We work mainly with people who have suffered a major heart event – that is,
they've had heart attack, angioplasty or major surgery on the heart. So they've
taken a major knock to their health. We help them get back on their feet through
exercise, lifestyle, and psychological and physical retraining to regain their
health and, hopefully, help them feel better than they have in a long time.
Do you find that people have a better appreciation of their hearts after having
a health problem?
I would say a definite yes. That if you faced a potentially life-threatening
crisis or you become aware of problems that you're developing with your heart, I
think it makes you appreciate your health even more. Hopefully, it creates a
sense of greater motivation to do something about it.
Do some people have bigger hearts than others?
Yes, people do differ in their heart size. Heart size to some degree is related
to body size. So bigger individuals will have slightly bigger hearts. Those who
use their hearts more, athletes in particular, develop positive enlargements of
their heart. They can thicken their muscles just like you might grow your bicep
bigger, and also stretch it so it can accommodate a larger blood volume to pump
things around.
How can you tell if your heart is healthy – without going to the doctor for
tests?
The main way is listening to how your body is functioning. If you're able to get
out and do a reasonable day full of activities – walking to and from shopping or
work or playing with the kids – and you're feeling good with that – there is no
chest discomfort or shortness of breath, arm discomfort, feelings of nausea or
heartburn – then, by and large, you're doing pretty well. The body is pretty
good at telling us when it's starting to get into trouble.
What is the biggest myth or misconception people have about their hearts?
The myth that is popularized is that heart disease is only a man's disease. And
we know that this is completely false. Heart disease is the Number 1 killer for
women, as it is for men. Not that cancer is not important but, for instance,
heart disease is seven times more common than breast cancer for women. So it's
an important health issue.
Women are different because sometimes recognizing heart disease is more
challenging – they may not have the typical features of central squeezing chest
pain, they may have more subtle symptoms of fatigue, shortness of breath or
disturbances in sleep, which may be the clues that something is going on with
heart disease. When a woman has risk factors, such as high blood pressure or
diabetes or cholesterol abnormalities, these things can carry a much greater
weight than it can for men. So it's important that women really recognize what
is going on and advocate for attention.
Now, how about old wives tales? This may be out of your area of expertise but is
there any truth to the old saying, `Cold hands, warm heart?'
I don't know if there is a really good correlation here. If you're exposed to
cold and your hands get cold, you can certainly have a warm, loving heart still.
Of the patients that I see, I actually get a little concerned when they have
cold hands, because that could be a sign their circulation isn't very good and
their hearts, while being warm, may be weak. That may be a bit of a concern for
me.
Are there any other ones that you've heard in your career?
Um, no. I get questions but very specific questions about the heart,
medications, blood vessels. So it's more physiological stuff.
It's Valentine's Day, and everywhere hearts are being pasted to walls, cards and
cookies. Again, this is perhaps out of your realm but do you know why – or do
you have any thoughts on why – the heart is a universal sign of love?
I think we can go back to the early scientists who thought the heart was the
seat of the soul, the seat of emotion. As the source of blood flow for the
entire body, the thought that spirit and emotion might be centred there is not
far-fetched. So that if you had a healthy heart, then good things will flow from
there.
I think also that people recognized early on that when we're emotionally driven,
perhaps in love, that our hearts will beat faster, we may become flushed as our
blood vessels are reacting, we may get the sense of fluttering in the heart as
our hearts beat faster.
Does being in love (or out of love, for that matter) have an effect on your
heart?
I think it probably could. We know that depression is very closely related to
heart health, probably through a few mechanisms. One is that mental happiness or
mental anguish has physiologic effects on the body by causing changes in stress
hormones, such as cortisol, and that can have a direct effect on blood pressure
and your heart.
We know that people who are not attached in relationships, who may have
depression or social isolation, have a higher prevalence rate of heart attacks,
for instance.
What's the best thing someone can do to care for their Valentine's heart today?
Make a conscious effort to improve your heart health with your Valentine. Have a
lovely, healthy meal, take a walk and revel in the emotional and psychological
support you provide for each other. These are the keys to heart health.
As we were chatting, a press release from participACTION came into my email box
urging couples to "get it on" as a way to get more exercise on Valentine's Day.
Any thoughts?
Certainly, sex can count and sex is a very important part of a healthy
relationship. Sex can be viewed as a physical activity, which is both a positive
and a caution. For those who are healthy, engaging in regular relations can be
viewed as one of your more fun kinds of workouts, with all of the added bonuses
of the emotional components that come with it.
For those who might be living with heart conditions or at risk of heart
conditions, sexual relations may be viewed as a rigorous kind of activity so you
need to be prepared for it.
How do you know if you're physically ready? Our rule of thumb here at the
cardiac program is if you can walk up a couple flights of stairs without getting
short of breath, you're probably ready for relations.
