June 21, 2008
Lessons to Learn From Tim Russert’s Death
By Cory Streeter, The Kansas City Star, Mo.
Jun. 21--After Tim Russert's autopsy revealed an enlarged heart, middle-aged Americans had yet another health condition to worry about.
But local cardiologists say that's a misplaced concern.
"In general, an enlarged heart is kind of a manifestation of another heart disease," said Steve Owens, cardiologist at the University of Kansas Hospital. The enlargement itself is not the main issue but a red flag for serious underlying problems such as hypertension, coronary artery disease, cardiomyopathy, heart valve disease or a combination of risk factors, he said.
With any of those problems, the heart can't squeeze as vigorously as it should. The heart then enlarges so it can pump the same amount of blood with each beat. It becomes even more strained and weakened.
In Russert's case, an autopsy showed he had an enlarged heart and significant blockage in the coronary artery, where the small clots that caused his heart attack formed. The 58-year-old suffered from coronary artery disease (a narrowing of the blood vessels to the heart ). He also had diabetes.
Any heart enlargement would be best diagnosed by an echocardiogram that measures the sizes of the heart chambers, Owens said. And the greater the enlargement, the greater risk for heart attack.
Doctors use a variety of treatments, depending on the cause of the problem.
Stopping heart enlargement before it begins is the key. "(Russert's health) was not so different from a lot of normal American adults," said James O'Keefe, a cardiologist at St. Luke's Mid America Heart Institute. It calls for "garden variety preventative cardiology," he said.
Along with monitoring diabetes, weight, diet and exercise and abstaining from smoking, O'Keefe said, it's important to remember the buzz words: "Know your numbers."
Blood pressure, cholesterol levels, blood glucose and waist circumference should all be closely monitored, he said.
Waist sizes for males should be less than 40 inches and less than 35 inches for females. A better determination for a healthy waist size is one half of your total height, O'Keefe said.
WARNING SIGNS --Shortness of breath
--Fatigue and loss of energy
--Heart arrhythmia (abnormal rhythm)
DID YOU KNOW? Athletes -- often long-distance runners -- sometimes have slightly enlarged hearts due to extensive physical activity, but few have any problems from it.
To reach Cory Streeter, send e-mail to [email protected] Sources: Steve Owens, University of Kansas Hospital; Martha Grogan, Mayo Clinic Web site Sources: Steve Owens, University of Kansas Hospital; James O
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