WELCOME to the ATRIAL SEPTAL DEFECT COMMUNITY: This Patient-To-Patient Community is for discussions relating to Atrial Septal Defect (ASD) which is a hole in the part of the septum that separates the atria (the upper chambers of the heart). This hole allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing into the left ventricle as it should. This means that oxygen-rich blood gets pumped back to the lungs, where it has just been, instead of going to the body.
Treatment for coronary artery disease (CAD) may include lifestyle changes, medicines, and medical procedures. The goals of treatments are to:
Making lifestyle changes can often help prevent or treat CAD. For some people, these changes may be the only treatment needed:
For a heart healthy eating plan, go to the National Heart, Lung, and Blood Institute's (NHLBI's) Aim for a Healthy Weight Web site. This site provides practical tips on healthy eating, physical activity, and controlling your weight.
Therapeutic Lifestyle Changes (TLC). Your doctor may recommend TLC if you have high cholesterol. TLC is a three-part program that includes a healthy diet, physical activity, and weight management.
With the TLC diet, less than 7 percent of your daily calories should come from saturated fat. This kind of fat is mainly found in meat and poultry, including dairy products. No more than 25 to 35 percent of your daily calories should come from all fats, including saturated, trans, monounsaturated, and polyunsaturated fats.
You also should have less than 200 mg a day of cholesterol. The amounts of cholesterol and the different kinds of fat in prepared foods can be found on the Nutrition Facts label.
Foods high in soluble fiber also are part of a healthy eating plan. They help block the digestive track from absorbing cholesterol. These foods include:
A diet high in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber.
Fish are an important part of a heart healthy diet. They're a good source of omega-3 fatty acids, which may help protect the heart from blood clots and inflammation and reduce the risk for heart attack. Try to have about two fish meals every week. Fish high in omega-3 fats are salmon, tuna (canned or fresh), and mackerel.
You also should try to limit the amount of sodium (salt) that you eat. This means choosing low-sodium and low-salt foods and "no added salt" foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in the item.
Try to limit alcoholic drinks. Too much alcohol will raise your blood pressure and triglyceride level. (Triglycerides are a type of fat found in the blood.) Alcohol also adds extra calories, which will cause weight gain. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day.
See the NHLBI's "Your Guide to Lowering Your Cholesterol With TLC" for more information.
Dietary Approaches to Stop Hypertension (DASH) eating plan. Your doctor may recommend the DASH eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in salt/sodium.
This eating plan is low in fat and cholesterol. It also focuses on fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan is reduced in red meat (including lean red meat), sweets, added sugars, and sugar-containing beverages. It's rich in nutrients, protein, and fiber.
The DASH eating plan is a good heart healthy eating plan, even for those who don't have high blood pressure. See the NHLBI's "Your Guide to Lowering Your Blood Pressure With DASH" for more information.
Regular physical activity can lower many CAD risk factors, including LDL ("bad") cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your levels of HDL cholesterol (the "good" cholesterol that helps prevent CAD).
Check with your doctor about how much and what kinds of physical activity are safe for you. Unless your doctor tells you otherwise, try to get at least 30 minutes of moderate-intensity activity on most or all days of the week. You can do the activity all at once or break it up into shorter periods of at least 10 minutes each.
Moderate-intensity activities include brisk walking, dancing, bowling, bicycling, gardening, and housecleaning.
More intense activities, such as jogging, swimming, and various sports, also may be appropriate for shorter periods. See the NHLBI's "Your Guide to Physical Activity and Your Heart" for more information.
Maintaining a healthy weight can decrease risk factors for CAD. If you're overweight, aim to reduce your weight by 7 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for CAD and other health problems.
After the first year, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25.
BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for preventing and treating CAD.
You can calculate your BMI using the NHLBI's online calculator, or your health care provider can calculate your BMI.
For more information on losing weight and maintaining your weight, see the Diseases and Conditions Index Overweight and Obesity article.
If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for CAD. Talk to your doctor about programs and products that can help you quit. The U.S. Department of Health and Human Services also has information on how to quit smoking.
You also should avoid exposure to secondhand smoke.
Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress, such as drinking, smoking, or overeating, aren't heart healthy.
Physical activity can help relieve stress and reduce other CAD risk factors. Many people also find that meditation or relaxation therapy helps them reduce stress.
You may need medicines to treat CAD if lifestyle changes aren't enough. Medicines can:
Medicines used to treat CAD include anticoagulants (AN-te-ko-AG-u-lants), aspirin and other antiplatelet (an-ty-PLAYT-lit) medicines, ACE inhibitors, beta blockers, calcium channel blockers, nitroglycerin, glycoprotein IIb-IIIa, statins, and fish oil and other supplements high in omega-3 fatty acids.
You may need a medical procedure to treat CAD. Both angioplasty and CABG are used as treatments.
Angioplasty opens blocked or narrowed coronary arteries. During angioplasty, a thin tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. This widens the artery and restores the flow of blood.
Angioplasty can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure.
In CABG, arteries or veins from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
You and your doctor can discuss which treatment is right for you.
Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after CABG, angioplasty, or a heart attack. Cardiac rehab, when combined with medicine and surgical treatments, can help you recover faster, feel better, and develop a healthier lifestyle. Almost everyone with CAD can benefit from cardiac rehab.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians, and psychologists or other behavioral therapists.
Rehab has two parts:
For more information on cardiac rehab, see the Diseases and Conditions Index Cardiac Rehabilitation article.
Author/Source: National Heart, Lung & Blood Institute, Division of the National Institutes of Health [NIH]
Retrieved: June 2008