Tuesday, Apr 23rd

Menopause or heart attackContributed by Dr. Shalini Bobra, Cardiology at White Plains Hospital

Heart disease remains the leading cause of death for women in the U.S., accounting for about 1 in every 3 female deaths when combined with stroke, according to the Centers for Disease Control and Prevention (CDC). The organization goes on to say that it is the #1 killer of both African American and White women in this country, while it is either tied with, or second to, cancer for female fatalities in other ethnicities.

These are alarming statistics, made even more so when one considers the CDC’s noting that only 56% of women recognize that heart disease is their leading cause of death.

We should all take a moment to consider what can help women avoid contracting this terrible disease.

Although traditional gender roles no longer hold true in many households, I still see a general disparity in the patients I see. A lot of women bring their husbands in when they show signs of heart trouble; when I ask them how they themselves are doing, the women usually respond, “Oh, I’m fine.” That may well be the case, but putting off regular examinations in favor of other family members’ is never a good idea.

Many women still put themselves last when it comes to taking care of health, putting children, spouses, and their own parents ahead of themselves; as a result, they don’t come in as frequently as they should for checkups. Basic blood tests for the likes of cholesterol and diabetes can catch developing conditions early, and an annual visit with your primary care physician is a must.

One thing that many people dismiss is the simple fact that, unfortunately, COVID-19 is still with us. I see a lot of patients with long COVID who are experiencing chest pain and heart palpitations two or more years since their initial infection. The full impact of COVID-19 on the heart is still being studied, but we know it can cause severe inflammation, raising your risk of blood clots. The bivalent booster is safe and effective, and I strongly advise my patients to stay up to date with their vaccines.WPHospitalBest

In addition, the pandemic created a mess in people’s schedules, some of which have yet to be corrected. Regular exercise fell by the wayside, accompanied by an increase in unhealthy eating and drug and alcohol use, among other factors.

In fact, the #1 heart health mistake people make remains smoking tobacco, as well as marijuana, now that it has been legalized in so many states, including New York. While the potential effects on the heart of smoking marijuana are still being determined, some studies have suggested that the activity can increase one’s risk of heart disease and heart attack.

Good nutrition, not surprisingly, can play an important role in the fight against heart disease as well. A plant-based diet (like many physicians, (I recommend the Mediterranean diet) can lower the risk of heart disease and stroke by as much as 25% – the same effect that cholesterol medicine can have.

Dr.BobraA family history of heart disease is also an indicator that you yourself may develop (or already have) the condition. If you have such a family history, be sure to discuss it with your primary care physician and/or cardiologist.

Indeed, such healthcare providers can go into more depth with you about ways to avoid developing heart disease, as well as how to properly treat it. Bringing the number of cases and fatalities down – in women, and in all of us – should be a goal for everyone.

Dr. Shalini Bobra is a cardiologist with White Plains Hospital Physician Associates, seeing patients at 99 Business Park Drive in Armonk. To make an appointment, call 914-849-7900.

Salmon(The following was submitted by White Plains Hospital)

As part of our “What the Doctor Ordered” series, we asked some of our favorite local restaurants to create heart-healthy meals with five cardiologist-approved ingredients.

White Plains Hospital Physician Associates cardiologist Dr. Gary Gabelman challenged Robb Garceau, Executive Chef at Sam’s of Gedney Way, to create a dish using salmon, almonds, lentils, kale and quinoa.

Chef Robb created a Slow-Roasted Faroe Island Salmon dish, paired with Warm Black Lentil + Sweet Potato, Moroccan Spiced Yogurt, Cara Cara Orange, and Spinach Sauce.

Heart-Healthy Benefits Include:

• Salmon is high in omega-3 fatty acids
• The healthy fats in almonds help manage cholesterol
• Low in salt: a low-sodium diet helps manage blood pressure
• Kale is a great source of Vitamin K
• Citrus fruits help reduce heart disease risk
Try this delicious meal at Sam’s or using the recipe below!

Slow-Roasted Faroe Island Salmon

Ingredients:

1 each Faroe Island salmon filet – 6.5 oz

Procedure:

1. Preheat your oven to 250° Lay the salmon filets out on a baking sheet lined with parchment paper. You can put them skin-side up or down, depending on what you like better (I prefer up). Smear them with a little grapeseed oil.
2. Put the salmon in the oven and set a timer for about 10 minutes. Just 10 minutes!
3. After 10 minutes, check the salmon. The meat should flake. It might look undercooked, but if it flakes and the skin comes off easily, it is done. If you would like it more done, just leave it in the oven for longer, checking it again every 2 minutes or so. Remove the skin. You can scrape any gray, fatty stuff or white protein off of the filets before plating the dish.

French Black Lentils

Ingredients:WPHospitalBest

5 Tbsp. extra-virgin olive oil
2 cups vegetable broth
½ cup French black lentils
¼ cup unsalted almonds, roughly chopped
1 Tbsp. sherry vinegar
2 each medium sweet potatoes, small diced
1 each Cara Cara orange, supremed and small diced
3 Tbsp. parsley
1 Tbsp. chives
Salt + Pepper to taste

Procedure:

1. Preheat the oven to 400°. Dice the sweet potatoes, skin on, into 1 ½ in. cubes. Drizzle with 1 Tbsp. oil; season with salt. Continue to roast until flesh is lightly browned, 12–15 minutes. Set aside.
2. Cook lentils in a small pot of vegetable broth until tender, 20–25 minutes. Drain and add 1 Tbsp. oil; season with salt, sherry vinegar, and mix well.
3. Roughly chop the almonds. Transfer to the drained lentils.
4. Now add the oranges, herbs, and sweet potatoes to the lentils.
Moroccan Spiced Yogurt

Ingredients:

1 cup plain Greek yogurt
3 Tbsp. olive oil
3 Tbsp. cilantro, finely chopped
2 tsp. cumin seed
2 tsp. coriander seed
1 tsp. smoked paprika
1 pinch Aleppo pepper
2 cloves roasted garlic
1 pinch sugar
½ each lime juice and zest
3 grinds black pepper
Salt to taste

Procedure:

1. Pan toast the cumin and coriander for 3 minutes in a hot pan over high heat. Grind in a spice grinder.
2. In a small mixing bowl, combine all ingredients, and whisk well.

Spinach Sauce

Ingredients:

3 oz. fresh spinach, blanched, shocked, squeezed
8 leaves fresh basil
1 cup vegetable broth
2 Tbsp. roasted garlic puree
Juice of ½ lemon for each serving
Salt + black pepper to taste

Procedure:

1. Blanch basil and spinach together in boiling water for 90 seconds. Then immediately shock in an ice bath. Squeeze both the basil and spinach to release some chlorophyll.
2. Place both into a blender; while blending, add garlic puree, then lemon juice, vegetable broth and salt and pepper to taste.
3. Remove from the blender and pour into a small saucepan to heat the sauce.

Red Wine Reduction

Ingredients:
3 cups good quality, full-bodied red wine

Procedure:
1. Pour wine into a small saucepan over medium heat. Reduce to a viscous or almost syrup-like consistency, which should take about 10-15 minutes.
Sam’s of Gedney Way is located at 52 Gedney Way in White Plains. For reservations, visit samsofgedneyway.com or call (914) 949-0978.

Want to read more from White Plains Hospital? Find other useful news you can use on the Hospital’s HealthMatters blog. You can also stay connected by signing up for our e-newsletter!

pediatriccardiologySubmitted by Dr. Daphne Hsu, Pediatric Cardiology at White Plains Hospital

One in 100 babies is born with congenital heart disease, an abnormality of the heart that occurs as it develops. Until recently, heart defects were a grim diagnosis for newborns and their families. But in the past two decades, thanks to surgical advances, 98% of those born with heart defects will now survive to adulthood.

However, even those statistics should be a cause of concern. Serious congenital heart defects are often – but not always – diagnosed before or soon after a child is born. Signs that parents should watch out for include:

• Cyanosis: pale gray or blue lips, tongue or fingernails
• Shortness of breath during feedings, which can contribute to less-than-standard weight
• Continued shortness of breath/labored breathing
• Swelling in the legs, stomach, or around the eyes
There are also less serious congenital heart defects, which may not be diagnosed until the child grows older. Those include:
• Being short of breath/easily tiring during physical activity, where before there were no such symptoms
• Fainting
• Selling in the hands, ankles or feet

If any of these symptoms are present, contact your healthcare provider.WPHospitalBest

As noted, congenital heart disease can reveal itself as a child gets older – or may not show up until adulthood. There are some 20 congenital heart conditions, each with their own characteristics; some of the most common are:

• A ventricular septal defect, which account for about 20% of all congenital heart defects, according to the American Heart Association. These are small- to large-sized holes between the lower chambers of the heart; the larger the hole, the greater the chance is that the infant will develop congestive heart failure. Treatments can include a relatively simple surgery where the holes are sewn shut.

• An atrial septal defect, where an abnormal hole exists between the upper two chambers of the heart, or atria; such conditions are usually asymptomatic. A cardiac catheterization is usually the recommended treatment.

• A tetralogy of Fallot, consisting of an abnormal position or orientation of the ventricular septum, with a hole present between the two lower heart chambers. All cases of TOF require surgical repair at some point, usually when the child is around six months old.
Not that surgery in childhood is not a permanent fix: Valves can narrow; connections can fail; sutures can weaken. And as the heart matures, issues such as arrythmias or heart failure may develop.

Whether a child or adult, the following can help:
• Heart-healthy lifestyle. The same advice for warding off adult-onset heart disease — eat a healthy diet, exercise regularly, and monitor your weight and blood pressure — applies even more to patients managing a congenital condition. Their hearts are already under stress, so anything raising their risk for hypertension, coronary artery disease, or similar conditions is something to avoid.

• Starting a family. Women with congenital heart disease often worry that they will pass their condition on to their babies. While that risk is about five times higher, it’s still a low risk in the broad sense. Early detection can further dispel anxiety. If an anatomy scan in utero detects an issue, patient education on the plan of action begins immediately.

• Upkeep and maintenance. When surgical heart repairs need a refresh or some upkeep, those procedures can almost always be done in a hospital’s cardiac catheterization lab. This minimally invasive approach requires a one-night stay, with far less recovery time than open-heart surgery. Stents may be placed to open up arteries that have been narrowed, other devices can be deployed to close residual holes, and transcatheter valves can be implanted. All of these are minor adjustments that can relieve stress on the heart and help keep it healthy for years to come.

White Plains Hospital has recently opened a Pediatric Specialty Center, where a range of pediatric cardiac and gastrointestinal specialists from the Children's Hospital at Montefiore (CHAM) are available.

Dr. Daphne Hsu is Director of the Montefiore Einstein Adult Congenital Heart Disease Program and a Professor of Pediatrics and Medicine at the Albert Einstein College of Medicine. For an appointment, call 914-849-KIDS (5437).

WPHospital2With more than 2,200 hospitals surveyed, White Plains Hospital is the only hospital in Westchester County ­– and one of nine in New York – to be named to Money’s “Best Hospitals for Bariatric Surgery” list. In total, 101 hospitals across the United States received this honor.

Bariatric surgery is a procedure designed to help seriously obese patients lose weight. White Plains Hospital is an accredited Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) and offers preoperative and postoperative care designed specifically for those patients who are committed to losing a significant amount of weight and improving their health.

“This honor is a testament to the patient-centric approach our team takes when it comes to proper care,” said Dr. Philip Weber, Director of the Division of Minimally Invasive Surgery, Robotics and Bariatrics at White Plains Hospital. “Weight-loss surgery can increase people’s lifespan and decrease their risk of heart attack, stroke and certain cancers, so patients will not only live longer, but better.”

Led by Dr. Weber, the Hospital’s comprehensive approach ensures that bariatric surgical patients receive multidisciplinary care, not just a surgical procedure, which improves patient outcomes and long-term success. The bariatric surgeons at White Plains Hospital perform two types of minimally invasive bariatric surgeries, Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy, and patients are supported by a team of certified registered nurses, psychologists, nutritionists, physical therapists and plastic and reconstructive surgeons to help them succeed. The Hospital also offers monthly support groups to patients following surgery to help them develop meaningful relationships with others on the same journey. More information about White Plains Hospital’s bariatric surgery program can be found here.

The “Best Hospitals for Bariatric Surgery” list, developed by Money in partnership with the Leapfrog Group, is based on those hospitals and surgery centers that completed Leapfrog Surveys in 2022. The Leapfrog Group is a nonprofit organization that aims to help consumers make informed decisions about their health and access safe, high-value care.

To qualify for the list, eligible hospitals were required to meet criteria specific to bariatric surgery, including achieving Leapfrog’s standard for bariatric surgery quality and receiving a “B” or better grade on the organization’s most recent “Hospital Safety Grade.” White Plains Hospital received its eighth consecutive “A” from Leapfrog last year and also was named a “Best General Hospital” by the organization in December, making it one of 115 in the United States and one of just two hospitals in New York state to receive that distinction.

About White Plains Hospital

White Plains Hospital is a proud member of the Montefiore Health System, serving as its tertiary hub of advanced care in the Hudson Valley. The Hospital is a 292-bed not-for-profit health care organization with the primary mission of providing exceptional acute and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. White Plains Hospital has outpatient medical facilities across Westchester, including multispecialty practices in Armonk, Larchmont, New Rochelle, Rye Brook, Somers and Yorktown Heights; and Scarsdale Medical Group locations in Harrison and Scarsdale.

The Hospital is fully accredited by the Joint Commission and in 2022, White Plains Hospital received a 5-star rating from the Centers for Medicare and Medicaid Services (CMS) — the highest distinction offered by that federal agency. In addition, the Hospital received its third Magnet® designation from the American Nurses Credentialing Center (ANCC), a distinction held by only two percent of hospitals in the country. White Plains Hospital has consistently received the Outstanding Patient Experience Award from Healthgrades®, and in 2022 became the only Hospital in Westchester to be awarded an A Safety Grade from the Leapfrog Group for the 8th time.

football(The following was written by Dr. Gary Gabelman, a cardiologist at White Plains Hospital.)
I was stunned to see Buffalo Bills safety Damar Hamlin collapse on the field with cardiac arrest during the Jan. 2 game against the Cincinnati Bengals. And, like many of us, I was relieved to see cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) administered on the field before he quickly was sent to a local hospital in critical condition.

That the medical staff tending to Hamlin were trained in CPR and AED came as no surprise – and it underscores the important role these procedures can play in saving lives, as they certainly did with the Bills’ defensive back. Hamlin underwent a remarkably speedy recovery in the hospital and is now home recuperating.WPHospitalBest

As opposed to a heart attack, cardiac arrest refers to the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease. It can come on suddenly, as was the case with Hamlin, or follow other symptoms. A number of irregular heart rhythms, such as tachycardia (where the person has a heart rate of over 100 beats a minute, compared with 40 to 100 bpm for most resting adults), can lead to cardiac arrest.

The American Heart Association reports that about 350,000 Americans die from cardiac arrest each year, making it one of the most common causes of death in the U.S. While that is a big number, the AHA says that immediate CPR can double or even triple the chances of survival after cardiac arrest.

Stayin’ Alive

Most people are familiar with at least the basics of CPR from watching a movie or TV scene where the hero starts pressing on a victim’s chest and counting.

It is of course a bit more complicated than that. Knowing when/how often to make those chest compressions is vastly important. While performing CPR, one should apply chest compressions at a rate of 100 to 120 beats per minute (bpm), according to AHA.

How do you measure those beats during such a crisis? The AHA recommends – believe it or not – that you keep the hit song “Stayin’ Alive,” or another memorable song at 100-120 bpm, in mind (at regular speed, of course). It may sound corny, but it’s certainly an easy thing to remember.

What if you’re in a situation where someone is suffering a cardiac arrest and your knowledge is limited to what you’ve seen on television? The answer: call 911 (as you would even if you know CPR), and then do what you can. Any action is preferable to taking no action at all.

As for an AED, if you are fortunate enough to have access to one in such a situation, it is relatively easy to use. Most have instructions printed right on them, along with verbal instructions and visual prompts; again, they can make a real difference while waiting for an EMT or other medical professional to arrive.

Many of us are reluctant to put ourselves into a situation involving people we don’t know (or, in some cases, even those we do) – a perhaps understandable point of view, given the litigious society we live in. However, good Samaritan laws allow even the untrained to do what they can to save another person’s life; even if those actions do not achieve the desired results, one can take solace from the fact that they did their best.

Getting Certified

There are a number of places where one can learn and be certified in CPR, including some (but not all) firehouses, places of worship, schools, and online. One resource you can explore is the American Red Cross, which has a searchable site here.

An average CPR training class lasts two or three hours, with an exam at the end. Upon passing the exam, you will receive a certificate testifying to your accreditation, which in New York lasts for two years.

gabelmanBenefiting yourself and those around you when it comes to good health should always be an essential goal; I especially encourage new parents to learn CPR, should their child unfortunately suffer a choking incident or other event that affects their breathing.

The AHA maintains that, with your help, we can reshape the world into one where no one dies of cardiac arrest ¬¬– certainly a goal worth aiming for.

Dr. Gary Gabelman is a cardiologist at White Plains Hospital. He sees patients at his White Plains office. To make an appointment, call 914-849-4800.

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