KATV: Dr. Morris Kelley, Interventional Cardiologist, Discusses Heart Attack Awareness

KATV: Dr. Morris Kelley, Interventional Cardiologist,  Discusses Heart Attack Awareness

Good evening and welcome. I’m Beth Hunt
in the KATV studios tonight. Thanks for watching along with us. This is the
second in a series of webcasts focused on your health that KATV is producing in
partnership with CHI St. Vincent. I’m joined tonight by Dr. Morris Kelley,
interventional cardiologist with CHI St. Vincent Heart Institute at the North
Little Rock clinic and over the next half hour we’ll be focusing on heart
attack awareness and we’d like to answer any questions that you may have about
heart disease and heart attacks. We invite you to submit them in the
comments section of this web stream. We’ll answer your questions as we get
them. In the meantime Dr. Kelley thanks for being with us tonight. My first question what’s the difference in a cardiologist and an interventional
cardiologist which is what you are? So, a general cardiologist can help to
diagnose problems, find out that you have blockage in your heart arteries, notice
if your blood pressure is running high, if you have high cholesterol. An
interventional cardiologist is basically a general cardiologist they can also
provide an intervention or step in and provide a service that will allow us
to fix a blockage in your heart arteries by either doing angioplasty or stenting. We know that this is an important topic because heart disease continues to
be the leading cause of death among Arkansans. How does Central Arkansas
compare to other regions? Central Arkansas has a higher rate of
heart disease including strokes and any kind of other kind of vascular disease
than most areas in the country especially in Arkansas. Why do you think
that is? Well, unfortunately we’re always in
the top in terms of poorest diet and obesity levels and lack of
exercise and so those things contribute to our higher rates of having heart
disease. What are some of the causes for heart attacks? I’m sure it’s different
for everyone. We worry about people having heart attacks when they
exert themselves or are under extra stress. Those kind of things can lead to
a heart attack. We really believe that a lot of it has to do an inflammation in
the heart arteries and so you have a blockage that gets inflamed and then
either some sort of stress physical stress or emotional stress can lead to
that that artery become inflamed and and developing a heart attack. There are
a lot of different ideas about what a heart attack looks like. What should
people be looking out for? What should they pay attention to? Any
symptoms that get worse when you exert yourself, whether it be chest pain,
shortness of breath, lightheadedness, dizziness, palpitations, nausea, anything
like that either when you climbing a flight of stairs or you’re carrying
something heavy across the parking lot. Any something that gets worse when you
exert yourself, that’s something that you should be concerned about being a
potential sign of a heart attack. Are the symptoms different in men and women? We
generally think that men will have a the classic heavy chest pain that goes into
their neck and down their arm. Women will have more of the associated symptoms of
nausea, sweatiness or lightheadedness, that sort of thing. So, again, any symptom
that gets worse when you exert yourself, whether you’re a man or a woman ,you
should consider that a flag for possible heart disease. Is there such a thing as a
minor heart attack? I mean people who may not feel that it’s that serious. I wouldn’t say that there’s such thing as a minor heart attack, especially
since you don’t know how major or minor it’s going to be when you’re having the
symptoms. We can tell how much damage you’ve had to your heart later on. We can
say that there was a small area that was involved, but when you start having those
symptoms and when you come into the hospital, we have no way of knowing how
bad the blockage is going to be or how severe it’s going to be. So, you can’t
just say that it’s going to be a minor heart attack. You should always treat
every heart attack as if it’s a major one. Is it possible that someone could
have a heart attack and not even know it? Not not have many of these symptoms?Yes,
because the symptoms aren’t classic necessarily especially in women, and men
may tend to downplay some of their symptoms. They may say ‘hey I had a
little bit of nausea and it wasn’t that big of a deal or I climbed a flight of
stairs and got a little short of breath’ and you can have some damage to your
heart, whether it’s minor or major, with those symptoms and just not know that it
was a heart attack that you were having and we can do some tests later on
that determine ‘yes, in fact you had a heart attack and when you describe your
symptoms and say hey that happened six months ago we can say okay well that’s
probably when it happened. What is the difference between a heart attack and
cardiac arrest? Well the heart attack is any blockage to the heart arteries or
blood supply to the heart. If that blockage or blockage is enough that
it causes the heart to stop beating or causes a an arrhythmia that doesn’t
allow the heart to be like it’s supposed to then we call that cardiac arrest. Is
there a group of people that are at a higher risk of a heart attack than
anyone else? I would say that diabetics particularly are at higher
risk of having a heart disease. Basically, if you have diabetes. The patient
who has diabetes but has never had a heart attack before has the same risk of
having a heart attack as someone who’s already had heart attack before and so
we call that a a cardiac equivalent when you have diabetes. Well, one procedure that can help doctors diagnose and treat cardiac
patients is called cardiac catherization a procedure that is generally considered
very safe. With more tonight, here’s Channel 7’s Erin Holly. This is a cardiac
catheterization. It’s a procedure to determine how well the heart is working. The doctor gets access either in the arm artery which is the radial
artery or the leg artery which is the femoral artery
and puts in a plastic tube which is what we use to work through to be able to do
the procedure. Dr. Morris Kelley an interventional cardiologist with CHI St. Vincent Heart Institute in North Little Rock explains a catheter is set
up to the heart and dye is used to see any blockages. Generally the procedure is
done when patients show symptoms of a blockage. They may or may not have
already had a stress test or some other procedure that demonstrates that they
are getting decreased blood flow to their heart or their lab work suggests
that there’s a blockage or something like that. He says there are three
scenarios; either we get in there we don’t find anything so it sounds like
your chest pain that did sound like it was coming from your heart isn’t coming
from your heart, you may have some minor blockage that we can treat with medicine. The second scenario is you have a blockage that we can fix with either
angioplasty or stents and we generally do that while you’re in the cardiac
catheterization lab at that time or you have too much blockage for us to fix
with stents and then we’re talking bypass surgery. And again Dr. Morris Kelley, the
cardiologist with CHI St. Vincent Heart Institute in North Little Rock and
that procedure is it is it fairly common for people to come in and have this done
and how quickly can they get in and out? Yeah, it’s a fairly routine procedure
that we perform on a daily basis It takes about 20 to 30 minutes to take the
pictures to kind of determine if you have a blockage that severe enough that
needs intervention or not. If we do an intervention, it can take up to an hour
an hour to an hour and a half sometimes to fix it. We have some Facebook questions
coming in so let’s go ahead and get to those. First up we have Mike Meadows and
he wants to know is a pulse rate of 120 suspect for a heart attack? We
consider a normal heart rate between 60 and 80 beats per minute. We call it
fast if it’s over a hundred beats per minute. So, 120 beats per minute is
definitely in the fast range. Does it suggest as a heart attack specifically?
Not necessarily, you can have some sort of other arrhythmia that may lead to
your heart running fast. So, I would say that if you’re having if you’re having a
heart rate of 120 beats per minute and you’re having palpitations, symptoms with
it especially dizziness or lightheadedness it’s definitely something to get
evaluated. Okay, here’s another one Eric Hayes, he says I had a bad heart
attack this year and sometimes I have a sharp pain in my chest. I have two stents
put in. Why does it hurt sometimes and sometimes I still can’t sleep. Right
after we put stents in sometimes you can have a little bit of residual chest pain
just because we’re kind of modifying that artery and then creating and
getting it back to the size that it’s supposed to be. Sometimes you can have
blockages that didn’t need to be fixed at the time that we placed
the stents and therefore we need to keep an eye on those. So if you’re having
residual chest pain after you’ve had stents put in, we need to check it out to
make sure that it’s not an issue with the stent that was put in or another
blockage somewhere else. About how long should that pain last? Oh usually just a
few days so if you’re having more pain further out than that then it’s something
to get evaluated. Up next Nann Burns, how can we tell the difference between a heart attack versus
a panic or stress attack? We kind of talked about the symptoms of a
heart attack at the beginning so anything that gets worse when you exert
yourself that is more likely to be to your heart. If you can identify the
stressor in particular that’s causing your symptoms, then you can usually
attribute that to panic or stress. Here is one from April and I’m sorry,
I’m not even going to attempt to pronounce her last name but she says my husband is
a diabetic with high sugar and an LDL of 1600 is this a concern? Absolutely, LDL of
1600 is very high. We worry about it being elevated when it’s above
a hundred and sixty or so. So even a total cholesterol of over two hundred
is worrisome. So, definitely that needs to be evaluated and treated if
possible. This is from Diane Collier. She says are medically induced stress tests as accurate as physical? Yes we get a ittle bit more information from a physical stress test. That’s where we the
patient is placed on a treadmill and exercised to a certain heart rate and we
are able to monitor their heart rate and the heart rhythm. It gives us an idea
of their exercise tolerance so we can see how fit you are when you do the
treadmill. But in terms of how much information we get from the imaging part
of that stress test, where we’re able to actually look at the blood flow to your
heart, that’s about the same. Here’s another one from Darryl Parker tonight–
what are the signs of a blockage? Every now and then I get a sharp pain above my
heart yet my left arm tingles should I get checked out? Yes, any
chest pain that is related to an associated symptom where it’s radiating
or moving down into your arm, I would say is something to be concerned about. Not
everyone has the heavy pressure like pain that we described before. Sometimes
it can be sharp. Sometimes it can be dull. Sometimes it can just be kind of a
nagging achy pain. Any chest pain that is radiating like that should be evaluated,
especially to make sure it’s not your heart. But it could also be other things.
How important is it, just in general, for people to know their bodies, first of all,
and and really take action if they feel like something is wrong? I get a lot
of patients that say well this is just naturally part of aging and this is just
me getting older and there are certain things that you can say or attributable
to just getting older but if you’re able to usually walk say three
blocks without having any symptoms and all of a sudden you’re down to two
blocks or one block, any limitation of your usual
activity, you should be worried about your heart. Quick shout-out to you
Whitney Reid says love Dr. Kelley so thankful for the care he provides to my
patients. I’m sure that makes you feel good. Absolutely. Here’s another one Malsha Reid, I’ve been having chest pains and pains in my
shoulder and hands should this be a big concern if blood pressure stays high?
Yes especially if your blood pressure runs high and we call you know depending on
your age but anything about we called normal blood pressure 120 over 80 so
above that we start to get concerned about it. But any kind of symptom that
you have especially when your blood pressure runs high, we worry about
sort of a hypertensive emergency or urgency. Symptoms associated with high
blood pressure – headache, blurry vision, arm pain, numbness any kind of weakness-
focal weakness especially. Those are concerning. Real quickly what are some of the resources for people
here in Central Arkansas specifically at CHI St. Vincent North I guess with
regard to cath lab and other things that you have access to. We really have a
state-of-the-art cath lab at CHI St. Vincent North. We are able to perform numerous procedures in terms of angioplasty and stenting and perform procedures that can be performed anywhere in the state or
anywhere in the country. Actually we’re able to perform numerous seizures in
terms of angioplasty and stenting we can provide EP studies which are in literal
physiology studies where we could diagnose arrhythmias and treat those
arrhythmias at the same time providing hemo dynamic support in case of
patients that need to have high-risk procedures. So, the cath lab at CHI St. Vincent North is really top of the line. Let’s also talk a little bit about
technology and best practices and have they changed the ways that we determine
whether someone is having a heart attack or even how you respond. Yes, we’re
always trying to revamp and improve how we treat heart attacks and
one thing that we’ve incorporated is being able to get an EKG in the field so
the patient is out in a remote area the EMS staff is able to transmit an EKG
that lets us know, “hey this patient is having a heart attack and that will
allow us to expedite them getting care that they need. What range of
cardiology resources will someone encounter when they come to CHI St.
Vincent North? Well pretty much it’s one-stop shopping. I mean you come to CHI St. Vincent and we are able to provide specialists that provide
interventional care, EP specialists, congestive heart failure specialists.
Pretty much any procedure that you need done we can provide at CHI St. Vincent.
Just to overall what are some ways that that patients can take control
of their heart health and reduce their risk of having a heart attack. There are
so many things, just day-to-day that they can do to reduce their risk. So, if you have high blood pressure make sure that you’re getting it checked and
you’re taking your medications make sure that your blood pressure is getting
under control. Continue to take your hyper cholesterol medication to lower
your cholesterol. Try to get in some regular exercise three to five times a
week. Try to get your body weight down to as close to ideal as possible. And then again if you’re having any kind of symptoms that you’re concerned about,
talk to your regular doctor who may be able to set you up with a cardiologist and
also be aware of your family history. If you have a family history of early heart
disease, also be concerned about getting checked out even earlier. Here’s
another question tonight from Katie Koch, what symptoms require an ER visit? I
recently did a 24-hour holter and there were some episodes of beats that were
pausing for 4.6 seconds and I’m still having random chest pains quite a bit my
appointment is a little far out and she’s wondering if she should go to the
ER instead? How do you determine how big of an emergency it is? It sounds
like if she’s already having a procedure done there was at least some monitoring
done and she’s at least gotten involved with the cardiologist or being seen by a
cardiologist. When we place Holter monitors on patients we were able to see
how their heart rhythm is working, if they’re having any pauses or gaps in
their beats and we’re able to get that information back to us and pretty
quickly within 24 hours to 48 hours. So that information
should be passed on to her cardiologist already. But, if she’s continued to have symptoms even while she’s being
monitored and it’s before her scheduled visit then absolutely go to the
emergency room to get it checked out. Listen to your body. Joshua
Cook wants to know at what age should he start thinking about his heart health if
he hasn’t had any notable problems or should it even be a concern? I would
say again, if you have an early family history then you want to kind of take
that as a marker. If your father had a heart attack at age 40, then you know you
should really start thinking about getting it evaluated at age 30 or so. But
for most people, the general population, I would say men should start worrying
about it in age 40 and women over age 50 or so. Eric Hayes wants to know if
there is a good SmartWatch to help him keep an eye on his heart? We did a story
earlier this week about one of the smartwatches and how it was able to
detect AFib. How accurate do you feel these smartwatches. I think the the smartwatches are actually a good screening tool. We’ve
been able to use those in our clinic in terms of patients that can say hey look
I have a SmartWatch my rhythm shows that it’s irregular or my heart rate is
always above 100. Smartwatches and those types of devices kind of help us out in
terms of giving us some information that we wouldn’t normally get without
providing a procedure or doing a test beyond that. Teresa Tyler says under
your sternum I have what it feels like twisting with heartburn and then the
area is tender should she be concerned? We worry about heartburn
especially if your symptoms are related to you eating and so if you’re having
symptoms that only come on when you eat or eat certain foods and it’s usually
heartburn. Again, if it’s not worse when you exert yourself it’s usually not
your heart necessarily. Also, if it’s tender to touch that usually
reflects a musculoskeletal problem, where you either have muscle a pulled muscle
or inflammation in your muscle or bone. if it’s tender
you can usually can’t bring on heart pain by pushing on it, So if it’s
tender to touch then it’s usually not your heart. Here is one
from Diane Hobbs she says hi doctor can a hiatal hernia lead to heart problems? What is that first of all? A hiatal hernia, your esophagus, your food pipe goes down your chest and then it goes
through your diaphragm to get into your abdomen and your stomach is below. So a hiatal hernia happens when your stomach pushes up through the diaphragm
and so now you have a portion of your stomach that’s now in your chest cavity
and therefore the muscle that usually keeps food from going from your stomach
back into your esophagus is exposed and it allows gas or acid to get back from
your stomach into your esophagus. It can mimic symptoms of a heart attack because
your esophagus does go right behind your heart in your chest and so if you’re
having acid into your esophagus it feels like it’s right there in the middle of
your chest and you worry about it being a heart attack. If you take some antacids
and it gets better or if you stop eating certain foods and it goes away, then it’s
usually not your heart. Kate wants to know and we addressed this
earlier but for those just now joining us it may be good to revisit it what are
some of the warning signs of heart issues for women since they may not be
the same symptoms for men? Yes, so again we talked about how women may have more
of the associated symptoms than the necessary chest pain that men would have.
So any sort of nausea, sweatiness, lightheadedness, dizziness, palpitations,
stuff like that that comes on when you exert yourself. Like I said, climbing
stairs or carrying something heavy, or walking a long distance, any symptom
like that that gets worse with exertion, then I would worry about it. James
Humble wants to know if if you have a greater risk of having a heart
attack down the road if you’ve had open-heart surgery before. It
doesn’t necessarily mean a one to one relationship necessarily, but
obviously if you’ve already developed a blockage to the point that you need to
have open-heart surgery, then there’s a lot of lifestyle changes and
modifications that you need to make to try to prevent yourself from having
further blockage or having a heart attack and so it’s very important that
you do the things that we talked about as terms of the blood pressure and
exercise and getting your cholesterol checked. ecky Wagner with another
shout-out tonight, she said that’s my doctor. So, a lot of your patients on here
tonight. We mentioned before some of the risk factors when it comes to
having a heart attack. Let’s talk about those again. So, the risk factors
for having a heart attack, well the risk factors for developing
heart disease in general high blood pressure, high cholesterol, diabetes,
smoking, lack of exercise and then a poor diet, all of those things can contribute
to you developing blockage in your heart
arteries and then if you develop blockage in your heart arteries in the
first place and that’s what she had risk of having heart attack. Just living a
healthy lifestyle, I would imagine would really cut down on the number of
patients that you see. Oh absolutely who have heart problems. Talk about the
importance of diet and exercise. Diet trying to get into
balanced diet that is not high in fat and cholesterol, high in salt, so you
want to stick to a low sodium, low cholesterol diet. I generally recommend
like the Mediterranean diet. It has a lot of grilled chicken, grilled fish, a lot of
green vegetables, a lot of good oils. That’s a good diet to kind of stick to
and look up and follow. Getting in some exercise, even if you’re just walking 30
minutes a day, five days a week. Something like that. Start there. Increase your pace. Increase your distance. Decrease the amount of time that it takes you to walk
that same distance and that you can kind of push yourself. Along with that,
maintaining a good body weight trying to get down back to your ideal weight or as
close as possible. Here’s a question from Doug Westgate he says long QT
interval scary or not so much? It can be. That’s a rhythm problem where
the amount of time that it takes for your heart to sort of reset after a beat
is longer than it should be. The problem with that is, if a
beat comes quick after that, then they can cause an arrhythmia. It’s
definitely something that needs to be monitored. We used to do EKGs when when
you come into the office so we can kind of keep an eye on how long your QT was
before and kind of compared to in the future and then we have special doctors
that can evaluate that and treat that if needed
Shirley Davis tonight she says my valve in the back of my heart is leaking. I
don’t know how bad, but they said I might have to come to Little Rock to CHI St. Vincent. She says she feels weak to go through it
she has congestive heart failure on top of the other therapy in three times a
week trying to get her heart stronger so it sounds like she has a lot of issues
going on. We worry about leaky valves when they get to be severe. There’s three grades that can be monitored, a mild, moderate or severe. We
don’t usually do anything about them until they’re severe, but we do kind of
watch them and monitor them when they’re mild and moderate. Having a leaky valve
just by itself isn’t a major issue. It doesn’t usually cause symptoms
necessarily, but if we identify that you have a leaky valve and you start having
symptoms of shortness of breath or dizziness or swelling in your legs,
that’s when we would kind of keep a closer eye on it and make sure it
started getting to the point that we needing to do something about it.
Kathryn Murray encouraging all diabetics to check their heart after her husband
she says had triple bypass. Really important for them to to stay monitored.
Yes, especially diabetics wanting to keep their their blood sugar under
control, can keep them from developing heart disease. They’re already at higher
risk and so anything that they can do to to modify that risk is good. Is there a
certain age where people just even if for peace of mind they need to maybe
have a full workup and just really get checked out to make sure everything is
working properly? Yes, especially if you have a family history I encourage you to get
that done as early as possible. In general we try to use sort of symptom
driven tools. In other words patients come in with specific symptoms to say
this is what’s going on and we say okay this is the tests you need for that or
this is the test you need to evaluate that. I don’t generally do just overall
testing or kind of blanket testing, but if a patient comes in with a specific
symptom then we’ll try to tailor their care and do tests that are specific to
their problem. What is the number one concern among people who come to see you?I’d say you know we see a lot of chest pain. We see a lot of
palpitations, patients that are having difficulty getting their blood pressure
under control. We also treat peripheral artery disease so blockage in the leg
arteries which can also lead to claudication or pain in your legs when
you walk. Different arrhythmias, so we are a full-service clinic we treat
general cardiology, interventional cardiology, EP, everything. You have
some more questions coming in here and actually I think you already answered
these but may be a good good time to revisit them. Talking about the the age
and heart health and how big of a factor that is–someone’s age and you know
whether they could have a heart attack or not. It comes back down
to family history. I mean if you have grandparents who lived to be 80s and 90s
and it’s it’s your genes are pretty good. I would say that if you
identify someone your family that has heart disease early it’s also important
to understand their lifestyle so if your father had a heart attack in his 40s but
he smoked. Hhe didn’t take care of himself. He didn’t monitor his diabetes
and that’s those things also are additive to the family history so
you want to try to avoid those things as much as possible, especially if you have
a strong family history. We’ve had a lot of great questions tonight. Can you
think of anything that you really wanted people to know about their heart health
tonight in your visit with us here in the studio. I would definitely say do not
delay getting evaluated if possible if you’re having any symptoms that you’re
worried about, being concerned for your heart or heart problems. Talk to your
regular doctor and explore that avenue first. Most of them are a lot of them
will send you to a cardiologist to be evaluated if they’re concerned that it
might be your heart. Again as you said several times, listen to your body. You
know what you’re able to do on a regular basis and if you find it you’re not able
to do that as much as part of and listen to your doctor. Dr.
Morris Kelley thanks for being with us tonight. We really appreciate your time.
He’s with CHI St. Vincent, the North Little Rock clinic. And if you would like
to learn more about heart attack awareness and the latest treatments you
can go to CHIStVincent.com/heart and if you missed any part of
tonight’s web stream you can catch it anytime here on the KATV Facebook page. Thanks for being with us tonight. Good Night.