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Matters of the Heart

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Marisa Telesca has added more fruits and vegetables to her diet to lead a heart-healthy life.


Marisa Telesca admits she has spent a lifetime focusing on the needs of others, while ignoring her own health. But as age 60 approached, she began reassessing.

Her mother died of a heart attack at age 61. Her brother died while awaiting a heart transplant. Telesca had just beaten ovarian cancer after six months of chemotherapy. Was she going to let heart disease get the best of her?

"No way," said Telesca, who turned to Sasanka Jayasuriya, MD, at Yale New Haven Health Women's Cardiovascular Center at Greenwich Hospital, located at 15 Valley Drive in Greenwich. The center takes a holistic approach to heart health by combining a cardiologist, nutritionist and exercise physiologist who emphasize prevention and education to live a heart-healthy life.

Marisa Telesca has added more fruits and vegetables to her diet to lead a heart-healthy life.

Now Telesca is making "small lifestyle changes that are having a big impact," such as eating more nutritious food, staying physically active, partnering with her cardiologist to manage blood pressure and cholesterol levels, and practicing stress-reducing techniques.

"This experience taught me that i need to calm down and pay attention to my body," said Telesca, who lives in Port Chester, NY. "It's my responsibility to stay strong and healthy."

jayasuriya

Sasanka Jayasuriya, MD, an interventional cardiologist who specializes in women’s heart health, advises women to take care of their physical and mental well-being.


Why a women's center?

Heart disease is the leading cause of death for women and men in the United States. Although heart disease is responsible for one in every four deaths among women, only 54 percent of women recognize the condition as the number one killer, reports the Centers for Disease Control and Prevention.

"Women are more likely to be diagnosed at a later stage of heart disease and, in general, experience poorer outcomes than men when they have a cardiac episode," said Dr. Jayasuriya, an interventional cardiologist at Greenwich Hospital and Yale New Haven Hospital.

The reasons for the disparities are unclear, but heart attack symptoms unique to women may play a role. Women are more likely to have symptoms unrelated to chest pain, such as heartburn, shortness of breath, nausea, vomiting, sweating, dizziness, extreme fatigue, and neck, jaw, shoulder and back pain.

"Women have atypical symptoms about one-third of the time, so they may not realize they're having a heart attack. They often come to the Emergency Department when it's too late to salvage the heart muscle in jeopardy. Women also have a tendency to take care of everyone else except themselves, so they may ignore symptoms or delay medical attention," said Dr. Jayasuriya.

Risk factors for a heart attack include family history, smoking, exposure to secondhand smoke, high cholesterol, high blood pressure, diabetes, sedentary lifestyle, excess weight or obesity, and depression. Women of child-bearing age who have experienced preeclampsia or gestational diabetes during pregnancy or difficulty during labor and delivery are also more vulnerable to heart disease.

"The good news is that women can control many risk factors for heart disease with medications and lifestyle changes," said Dr. Jayasuriya.

Making a personal connection

For Telesca, her family history of heart disease was a major concern. She met Dr. Jayasuriya when her husband had triple bypass surgery at Yale New Haven Hospital. Telesca liked the idea of getting individualized attention at the Women's Cardiovascular Center in Greenwich, close to home. "Anyone can take notes from the Internet," she said. "But without that interpersonal experience, the information doesn't really sink in. Everyone at the center was supportive. There were no scare tactics."

As part of the visit, Telesca had a stress test because she had several concerning symptoms. A stress tests takes pictures of the heart to examine blood flow while at rest and during exercise. "It put my mind at ease to know that i didn't have any blockages," said Telesca, who was prescribed medication to manage her blood pressure and cholesterol levels.

staffieri

Catherine Staffieri, RD, a registered dietitian, recommends patients keep track of portion sizes and eat a balanced diet with plenty of fruits and vegetables.


Food for thought

Next, Telesca met with Catherine Staffieri, RD, a registered dietitian who clarifieded the connection between healthy eating, weight control and heart disease.

"Waist circumference is a good predictor of heart disease," said Staffieri. "Studies show women with apple-shaped figures who carry most of their fat around their waist are at greater risk for heart disease. Women with a waist measurement greater than 35 inches are at increased risk."

Staffieri recommends the Mediterranean diet, which has been scientifically proven to benefit the heart and emphasizes fruits, vegetables, healthy fats, whole grains and lean sources of protein. She also encourages using a portion plate, focused on vegetables, to help patients build a balanced meal.

Telesca didn't realize her high-sodium frozen meals could impact blood pressure, until meeting with Staffieri. "I never put two and two together. Now I lay off the frozen burritos and breakfasts!" She also focuses on portion control. "i thought shopping at a natural food market made me healthy. i understand now that just because a certain food is considered healthy doesn't mean it's free of calories."

Get moving!

As part of her healthy-heart regimen, Telesca walks two miles a day and tracks her steps with an app on her smart phone.

"Walking is an excellent heart health exercise," said Lisa Elpi, an exercise physiologist at the Women's Cardiovascular Center. "Regular physical activity can lower many risk factors for heart disease, including high cholesterol, high blood pressure and excess weight."

Elpi reviews each woman's risk factors and then develops an individualized exercise plan that includes aerobic, strength training and stretching exercises. "You don't need a gym membership to exercise. ere are plenty of options people can do at home or in the community to stay fit," she said.

Take a breath

For Telesca, the Women's Cardiovascular Center "opened my eyes," by helping her understand that "just because I take medication for high blood pressure or another condition doesn't mean I shouldn't focus on making lifestyle changes. I still need to eat well and exercise."

Still, though, Telesca struggles with managing stress. Studies show stress can lead to narrowing of the arteries, which raises blood pressure, and with it, the risk for heart attack. Depressed individuals are up to three times more likely to develop heart disease, and women are twice as likely as men to experience depression.

A self-described perfectionist at home and work, Telesca admits she sometimes sets unrealistic expectations that can lead to stress. "I never leave the house in the morning unless the dishes are washed and the laundry is put away. Everything has to be nice and neat. It's crazy!" she said. Telesca ends her day, though, with the muscle relaxation techniques she learned from Mary Motwani, PhD, a Greenwich Hospital psychologist.

"It's hard for women to make their health their first priority," she said. "But I'm determined to try because life is good."

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