Matters of the heart
What you need to know to reduce your risk for cardiac illness.
Winnipeg Health Region
Wave, Summer 2011
Dr. Davinder Jassal is a cardiologist and researcher
with the Winnipeg Health Region's Cardiac
Sciences program at St. Boniface Hospital. In
addition to treating patients, Jassal also conducts
heart-related research designed to enhance
care for cardiac patients. He recently took
time out to talk about heart issues with Wave.
Is heart disease a big problem in Manitoba?
Yes. Heart disease is the leading cause of morbidity
and mortality in Manitoba. Every seven minutes in
Canada, someone dies of a heart attack or a stroke. The
Winnipeg Health Region's Cardiac Sciences Program at
St. Boniface Hospital sees about 50,000 people a year
for heart-related issues.
What is heart disease? How many
types are there?
Cardiovascular disease is a class of diseases that involve the heart
and/or blood vessels.
Heart disease can involve the coronary arteries (heart attack),
the cardiac pump (heart failure), the valves (heart murmurs), the
pericardium (fluid around the heart), and the electrical system
(pacemakers and defibrillators). Blood vessel disease can involve the
carotid arteries (TIA and stroke) and the lower extremities.
Does heart disease have a root cause?
Although heart disease can manifest itself in different ways, it
usually stems from one basic problem - a narrowing of the
arteries, which in turn restricts the flow of blood to the heart.
Who is at risk for developing
While heart disease can strike anyone at
any age, it tends to be more prevalent in
older, sedentary smokers who may also
have other health issues, such as high
blood pressure, diabetes, high cholesterol
What are the symptoms of
For heart attacks, symptoms include chest/
jaw pain, shortness of breath, nausea,
vomiting, and sweating. For heart failure,
symptoms include shortness of breath and
leg swelling. For stroke, symptoms include
slurred speech, paralysis or numbness of
face/arm/leg, dizziness and loss of vision.
How much heart disease
is attributable to lifestyle and
how much to genetics?
This is a difficult question to answer.
Heart disease can be caused by many
factors, including genetics (family history
of premature coronary artery disease)
and lifestyle issues (diabetes, high blood
pressure, high cholesterol, and smoking).
Many people with heart disease will have
both lifestyle and genetic risks factors.
What I can say for sure is that there is an
increase in the number of patients with
heart disease in their 30s and 40s. Many
of these patients have a history of heart
disease in their families. But I think it's
also fair to say that in many cases, the risk
factor for these patients has been increased
because they also smoke, eat the wrong
foods and aren't as active as they should
be. Put another way, if you have a family
history of heart disease, chances are you
can reduce your risk - or at least postpone
the onset of heart disease - by eating a
balanced diet, exercising regularly and
not smoking. The odds of reducing your
risk are even better if you do all these
things and have no family history of heart
I have an older friend who
works in an office and doesn't
get much exercise during the
winter. But come summer, he is
out playing tennis for an hour
at a time, twice a week. Is this
good for his heart?
Let me answer your question this way.
Cardiologists in Winnipeg know that
a heavy snowfall generally results in a surge of emergency department visits
from middle-aged males who experience
chest pains after shovelling snow for an
hour. So, yes, a "weekend warrior" who
engages in strenuous activities without
proper conditioning can experience
heart problems such as a heart attack,
especially if they are already a prime
candidate for heart disease. What I like
to tell people is that you should always
condition yourself. Avoid the temptation
to over-exert yourself playing tennis on
the first warm day of spring, but take the
steps to increase your conditioning so
that you can play tennis safely all summer
You sometimes hear about
developing heart problems.
Can you damage your heart
by working out too much?
What can a person do to
make sure they get some
exercise without straining their
Good question. Here in the Winnipeg
Health Region, we have been doing quite
a bit of research on people participating
in the Manitoba Marathon. What we have
found is that with appropriate training,
there is no permanent damage to the heart
from strenuous physical activity, such
as running. But again, the key is proper
Is it possible to reverse the
effects of heart disease? If so,
Not really. Once you have a build-up of
plaque in your arteries, chances are the
best you can do is work to stabilize the
condition. The same is true for people
who have a heart attack. Once you have
a heart attack, there is some damage
to the heart muscle. Although we have
developed a number of lifestyle and
pharmacological methods to treat heart
attacks, once they have occurred, there
is no reversing the damage to the heart.
That's why prevention is so important.
What can a person do to
reduce their risk of developing
A person can significantly reduce their
risk of heart disease by simply taking
care of themselves. Quitting smoking is
huge. The Heart and Stroke Foundation,
for example, points out that within one
year of butting out, your risk of suffering
a smoking-related heart attack is cut
in half. Being active is also important.
Exercise gets the blood flowing, which
helps prevent plaque from forming in the
Adults should perform 150 minutes of
vigorous-intensity aerobic physical activity
per week, in bouts of 10 minutes or more.
To maximize the benefits, physical activity
should take place every day of the week.
During the winter, I recommend indoor
activities like swimming and walking in
malls, or at the Reh-Fit Centre or Wellness
Healthy eating is one of the most
important things you can do to improve
your general health. Nutritious, balanced
meals may reduce your risk of heart
disease and stroke. By increasing
your intake of heart-healthy nutrients,
managing your weight, controlling your
blood sugar levels and lowering your
cholesterol, you can significantly decrease
the rates of heart disease. And, of course,
it is also important to keep stress levels
low. If you take these steps, chances are
you will reduce your risk of developing
heart disease and won't have to worry
about reversing its effects.
Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.
Read the Summer 2011 issue of Wave