Conversation with a Cardiologist: Maintaining Heart Health in the Pandemic

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October 14, 2020


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This post is available in: Spanish

The coronavirus pandemic has us focused on our health like never before. Yet, ironically, some of us are letting ourselves slide back into old, not-so-healthy habits. We’re overeating or eating poorly. Not getting enough exercise. Neglecting our check-ups. And ignoring symptoms of something that could be serious.

Resource sat down recently with Paula Montana de la Cadena, M.D., a cardiologist at Miami Cardiac & Vascular Institute. Dr. Montana shares what she’s seen in her practice over the past seven months and offers practical steps each of us can take to maintain and improve our heart health – now or anytime.

RESOURCE: How has your practice been affected by the pandemic?

Paula Montana de la Cadena, M.D., a cardiologist at Miami Cardiac & Vascular Institute

DR. MONTANA: It’s been a significant adjustment for all of us, certainly. Many visits were cancelled in March and April, so we started doing telehealth appointments, which was a learning experience for many of us, not to mention our patients – many of whom tend to be older and not very comfortable with the technology. Even after we reopened, a lot of patients were reluctant to come in for appointments because they are afraid, as they represent the population at high risk for complications from COVID-19.

RESOURCE: How does a cardiology telemedicine appointment work?

DR. MONTANA: Most of our telemedicine patients are established patients; therefore, we already know their history and diagnosis. Most of those visits are to review results, answer any questions they may have, and make any needed adjustments to their therapy. Telemedicine is very effective. Ideally, we prefer a video conference, but we’ve also done over-the-phone appointments for some of our patients who don’t have access to a camera. We can’t perform a physical exam or an EKG, obviously.. However we can evaluate a lot of their symptoms and assess their overall health. If we feel the patient needs to be seen in person, we arrange an in-office visit. But there are many things that don’t require an in-person visit, such as medication adjustments, labs or studies orders.

RESOURCE: Who’s at greater risk for heart disease, and for developing complications from COVID-19 – men or women?

DR. MONTANA: Heart disease is the leading cause of death for men and women. Even though heart disease is thought of as a men’s disease, almost as many women  as men die each year of heart disease — especially postmenopausal women. In regards to COVID-19, data suggest that more men than women  have died of COVID or have had more severe disease.

RESOURCE: Do you think that stress caused by the pandemic lost jobs, political uncertainty or any number of other factors is impacting people’s health?

DR. MONTANA: Absolutely. We have a lot of patients who were doing great and then, as soon as the pandemic hit, they went back to bad habits such as unhealthy eating choices, lack of exercise to absolute sedentarism, essentially neglecting their overall health. However, there has also been a small percentage of patients who have made very positive changes during these several months by increasing their exercise activity, improving their nutrition and adopting a healthier lifestyle.

RESOURCE: What specific recommendations can you offer to Resource readers who want to maintain or improve their heart health during the pandemic?

DR. MONTANA: Pandemic or no pandemic, you want to embrace a healthy lifestyle that you can sustain over time. What does that mean? Adopting healthy eating habits, getting regular exercise and maintaining a healthy weight. Exercise brings many benefits, and can be the best medicine — not only for your heart but also for your mental health. A sedentary lifestyle is a risk factor for heart disease. I encourage my patients by telling them that they don’t need to go to the gym, they can exercise by doing whatever  cardio activity they enjoy the most, such as walking, dancing, swimming or whatever. There are also countless videos online that can help get you off the sofa and get you moving. And, our community health team has daily online classes and programs for all sorts of interests. Don’t take this pandemic as an excuse for not keeping up with your health and your daily routines. Also meditation or yoga can help relax your mind and ease your stress.

RESOURCE: You mentioned a healthy diet – what does that include?

DR. MONTANA: I don’t really like to use the word “diet” as it carries a lot of baggage. If we see something as mandatory, we’re not likely to keep up with it. Instead, I encourage my patients to focus on lifestyle, and to make healthy choices whenever they have the chance. Don’t stop bad eating habits all at once – you’re just setting yourself up for failure. Baby steps are the way to go. Allow yourself a cheat day and keep moving in the right direction.

That said, there are some foods we should avoid as much as possible, such as processed food, red meat, or in general food with high content of saturated fat, trans fat, sodium, sweets and sugar-sweetened beverages. Try to include more fruits and vegetables in your daily meals. And remember: everything in moderation. Find a balance that works for you. Find a motivation for maintaining a healthier lifestyle, like being around for your daughter’s wedding or the birth of a grandchild. 

RESOURCE: Do you have any other advice for people trying to stay healthy?

DR. MONTANA: Lifestyle impacts everything – even if you have heart disease, diet and exercise can help you avoid bad complications from other disease, especially COVID-19. You have years ahead of you, so what you do today will impact your health in the future. Take care of yourself and watch your risk factors.

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