James GandolfiniI was recently viewing an old rerun of The Sopranos and found myself ruminating over the premature death of its star. James Gandolfini’s passing from a heart attack was tragic given his relatively young age. The former Soprano’s star was 51 years old and a father of two. Part of the tragedy in such cases lies in their often unexpected occurrence. We don’t always get a clear warning to let us know there is a need for intervention with our health. When it comes to heart disease there are means and measures to address the issue before the consequences of not doing so turn tragic. It is important to understand the known risk factors surrounding it and its potential warning signs.

Heart disease is the number one killer of men and women in this country. Remember that the heart is a muscle, and like all muscle it needs a rich supply of blood and oxygen to function. Just as the heart serves to pump needed nutrients to the rest of the body through its connected arteries, it must also supply itself with the same. These vessels can become gradually blocked with plaques in a process termed atherosclerosis. If one of these channels becomes blocked, then the needed blood and oxygen can’t get to the heart muscle and it can lead to irreversible injury of an area of the heart that channel supplies. This is what is meant by the term “heart attack.”

Understanding the warning signs of such an occurrence is important for all of us. Angina is the term to describe the pain or pressure someone may feel when their heart is experiencing ischemia, the term for that inability to provide itself with the needed blood and oxygen. Classically, it can be described as a weight or pressure over the center of one’s chest. It can often radiate into the jaw or left arm and may be triggered by exertion or exercise as the additional need for nutrients rises and the heart can’t provide it because of the blocked arteries.

But life and medicine don’t always present in a classic fashion so it is important to recognize the known risk factors for heart disease so that we can be more attentive to screening for such a concern. The western diet places us at a higher risk for heart disease then in many other countries. Obesity and a sedentary lifestyle are certainly contributing factors. Of perhaps even greater significance is the association between certain diseases and heart disease: high blood pressure, high cholesterol, and diabetes being the three biggest. Smoking is a major factor as well, and lastly a family history for premature heart disease is particularly relevant. If your father or grandfather had heart issues before the age of 55, or mother or grandmother before the age of 65, then this places you at higher risk for the same.

Understanding who is at higher risk allows for more attentive screening through the use of various testing measures. Here at Austin Family Medicine Associates we have several different valuable screening modalities including echocardiograms, stress testing, pulse wave analysis, and nitric oxide testing. . Additionally our focus on prevention extends to a keen focus on nutrition and lifestyle from a collaborative team approach.

Once an issue is identified, a blocked artery or vessel can often be corrected through angioplasty, using a balloon to open the vessel back up, the placement of a metal stent in the vessel to keep the channel open, or even sewing in a new vessel to go around the blockage, termed a bypass. Such procedures can conceivably prolong an individual’s life for years and years – but only if the problem is identified in a timely fashion

Whether Mr. Gandolfini had experienced any such warning signs or symptoms, or where his risk may have lain is unknown by this author. But we can all take heed from his untimely passing as an opportunity to remind ourselves to consider where our own risk may lie and to have a discussion about it with our personal physician.

Dr. Andrew Dale