To Your Health
December, 2011 (Vol. 05, Issue 12)
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Keep Your Heart Healthy

By Julie T. Chen, MD

Way too often, many people present with atypical signs of heart disease. But because these symptoms are not what we typically expect heart disease to present as, patients frequently ignore the early signs and symptoms, which then often lead to detrimental consequences.

What we typically learn as presenting symptoms for cardiac disease is left chest pain with radiation of pain down the left arm and into the jaw; and can also involve sweatiness, dizziness, lightheadedness, or palpitations. With these symptoms ingrained in our minds as the only way heart disease would ever present, most aren't looking for other signs and symptoms. So unfortunately, other important clinical clues can often be missed until it's too late.

Some of the atypical presentation symptoms or diagnostic concerns of cardiac disease in women and in men can include, but are not limited to:

  1. Epigastric and upper abdominal region pains
  2. Typical symptoms of chest pain, arm pain, and jaw pain may not be present
  3. There may be mild numbness and tingling in the arm instead of pain
  4. EKG treadmill stress test can be falsely normal more so in women than in men
  5. Sweatiness, dizziness, lightheadedness, and palpitations may be the only presenting symptoms with some shortness of breath or chest heaviness
  6. Upper back pain (with or without chest discomfort or any of the other symptoms)

It is important to point out that these atypical symptoms can present in both men and women. They may or may not be associated with cardiac disease but they definitely warrant medical work up and further evaluation; especially if these symptoms occur or worsen with physical exertion or activity (keep in mind though that if you are at rest but you are stressed or emotionally distressed, that may trigger cardiac events as well because the heart rate increases with anxiety and stress and would lead to increased cardiac blood flow demand). These atypical symptoms emphasize that symptoms associated with increased heart demand, however atypical, warrants medical evaluation and hence you should ask your doctor about it sooner than later.

If you are truly concerned about heart disease, there are some preventative steps you can take to help keep your heart healthy:

  1. Maintain a healthy weight
  2. Eat a mostly anti-inflammatory plant-based diet that is the color of the rainbow so you ensure adequate vitamins, minerals, antioxidants, and phytonutrients in your diet
  3. Make sure to get about 150 minutes of weekly exercise at moderate intensity (but get clearance by your physician first before starting any exercise routine to make sure you are safe to do so)
  4. Get plenty of rest and relaxation every day because your body, mind, and heart all require down time from your busy hectic schedule
  5. Stay hydrated with water and avoid processed drinks and foods
  6. Avoid foods with artificial sweeteners and sugars
  7. Eat a diet low in glycemic load
  8. Eat a diet low in saturated fats
  9. Monounsaturated fatty acids found in foods like nuts and avocado will help to keep your heart healthy
  10. Increase fiber intake to 20-30 grams/day (increase fiber intake slowly to avoid gas and bloating)

For the purposes of this article, use these ten key points as a start for a healthy heart regimen and the above examples of atypical symptoms as an example that heart disease can present in many different ways.

Dr. Julie T. Chen is board-certified in internal medicine and fellowship-trained and board-certified in integrative medicine. She has her own medical practice in San Jose, Calif. She is the medical director of corporation wellness at several Silicon Valley-based corporations, is on several medical expert panels of Web sites and nonprofit organizations, is a recurring monthly columnist for several national magazines, and has been featured in radio, newspaper, and magazine interviews. She incorporates various healing modalities into her practice including, but is not limited to, medical acupuncture, Chinese scalp acupuncture, clinical hypnotherapy, strain-counterstrain osteopathic manipulations, and biofeedback. To learn more, visit