June 23, 2017
Two years ago, Kyle Schwandt began having shortness of breath while on the elliptical machine in his apartment complex. It shocked him. Usually, he could endure 30 minutes on the machine. This time, he could barely go five minutes without feeling exhausted.
“I thought I was coming down with the flu. I started having heartburn … so I just took some antacids, but [the pain] came back after a while,” said Schwandt. “Then I started having aching in my joints, but I ended up not going to the hospital for two days. Denial is strong. At 43, I just thought it’s not possible that I am having a heart attack.”
But Schwandt was having a heart attack — brought on, in part, by a genetic predisposition that causes his body to produce abnormal amounts of cholesterol. It’s an issue his father and grandfather endured, too. When he was admitted to the Virginia Commonwealth University Medical Center emergency room, the swiftness of the medical personnel’s actions let him know his situation was serious.
“[Medical personnel] did an EKG and then flew out of the room with the paper [results],” he said. “Then, they came back in immediately with more people, put me on a stretcher and I was flying through the halls and the doctors and nurses started working on me. You could feel that people were worried.”
Men’s Health Month
Schwandt was experiencing a type of heart attack called anterior wall acute myocardial infarction. He was taken to a catheterization laboratory, or Cath Lab, for a procedure to restore blood flow in his coronary artery, which was obstructed by a clot.
Between 70 and 89 percent of sudden cardiac events occur in men, according to a men and heart disease fact sheet by the Centers for Disease Control. Heart disease is the leading cause of death for men in the United States. As part of Men’s Health Week and Men’s Health Month, VCU Health is highlighting ways men can actively avoid cardiovascular issues, like heart attack and stroke.
This month, VCU Health hosted two Facebook Live events on men’s heart health and nutrition with Salvatore Carbone, research instructor of medicine in the Department of Internal Medicine, and Jose Emilio Exaire, M.D., associate professor of medicine, specializing in interventional cardiology. Carbone worked with Schwandt while he was recovering from his heart attack. Both clinicians work and conduct research within VCU Health’s Pauley Heart Center and offered information about the type of nutrition that’s best for avoiding heart issues, as well as the importance of preventative care.
“Every man should take heed to the advice of embracing preventative care and not waiting until the last minute to seek help at the onset of discomfort or pain,” said Antonio Abbate, M.D., vice-chairman for the Division of Cardiology.
Men and women alike can protect their cardiovascular health by paying attention to their personal heart risks. Lifestyle basics such as scheduling regular physical activity and maintaining a normal body weight apply to everyone. Still, awareness of how gender differences shape personal cardiovascular risk profiles is key.
“Since its initial description, coronary artery disease — the condition where plaques build up in the coronary arteries and lead to angina and heart attacks — is a male-preponderant disease,” Abbate said. “The reasons are likely found in the protective effects of female hormones. Premenopausal women are in many ways protected from this disease.”
“If I were to have a gender-specific message regarding men, I would say that men are more likely than women to have manifestations of coronary artery disease at younger ages,” Abbate said. “Prevention and screening is indicated for everyone and it is never too early to start. It may be advisable to stress [preventative care] for men starting in their early 30s while perhaps women can be approached more aggressively in the late 30s and early 40s.”
Since his hospitalization at VCU Medical Center, Schwandt has run 5k and 10K races and is extra strict with his diet. He lauds his rehabilitation team at VCU for helping to strengthen his mental and physical dexterity.
“My trainer, Matthew Browning, was amazing and pushed me hard,” he said. “He was all those things for me when I needed that support. I was steady on my feet, but I had to build back up to be able to walk, jog, run.”
Now, Schwandt returns to the hospital once a year to see Abbate and have his defibrillator checked. His once tidy diet is now tidier, with the subtraction of cheese and sugar and the addition of avocado, more seafood and red wine.Antonio Abbate, M.D. and Kyle Schwandt. [View Image] Antonio Abbate, M.D. and Kyle Schwandt.
It’s a good menu, said Carbone, who studies obesity and heart failure.
“Generally, a dietary pattern that has shown to be effective in preventing cardiovascular events and mortality is a Mediterranean-like diet, rich in healthy fats, whole grain products, fruits and vegetables and limited amounts of red meat and processed food,” he said.
Every VCU patient who experiences a heart attack sees a nutritionist during their Intensive Care Unit time and receives counseling before their release. Abbate remembers Schwandt when he was initially admitted to the hospital and is impressed by his recovery.
“When I saw him in the emergency department I was genuinely worried about him,” he said. “And it has been so fulfilling to see him recover step-by-step. To see him complete 5K races one year after his large heart attack was a true surprise and gift. He is now in a better shape than he was before his heart attack. The coordinated and comprehensive medical and nursing care he received at VCU served as a platform for his recovery.”
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