Cardiology Quotes That Might Just Save Your Heart!
For more than three decades, Barry A. Franklin has focused his career on preventive and evidence-based medicine, especially in the field of prevention of coronary artery disease. He worked scientifically, regularly reviewed manuscripts for numerous scientific and clinical journals, and has given many invited presentations to national and international medical and lay audiences.
After his talks, he is regularly asked for cartoons, joke slides, and, perhaps most of all, the “memorable cardiology quotes.”. In his publication “Memorable Cardiology Quotes” in the American Journal of Cardiology in 2009, he listed some of the favorites that he has used in his teaching and presentations over the years, with specific reference to cardiology.
Let us use some of them to spread knowledge about cardiology essentials.
Heart-Healthy Eating
“How do you make a hot dog? First you slaughter the animals and cut out all the good parts, the steaks and chops. But you’ve got a lot of animal left…. The hot dog industry took off when a clever guy invented a machine that works like a kitchen disposal—you dump everything in, eyeballs and all, and grind it up. Voila, the hot dog.”
—William Castelli, MD, *1931 – †2025
In theory, eating healthily is simple. The basic rule: If you can make your own meal or easily identify its ingredients, you’re on the right path. Homemade food is often healthier than processed foods, ready-made meals, and restaurant cuisine. Because cooking at home allows you to control the ingredients and cooking processes. You can use fresh, unprocessed foods (ideally vegetables) and healthy cooking methods like grilling, baking, or steaming.
Have a look inside a supermarket! How many cereals with peculiar consistency are there for breakfast? Why not simply oats? What’s in all those “fruit quetschies”? Why not just one apple? What we need from a bakery is nice, fresh bread, but we also need to withstand cakes, cookies, and sweets. Can you count all of the different black, blue, red, and undefined soft drinks? Why do we need them when we already have clean water? Who can resist the abundance of chocolates, sweets, jellies, and candy? But can they truly beat a nice date?
Back to hot dogs: you won’t be able to know what you’re eating with a sausage. However, you can select from a grilled piece of meat, a chicken drum, or a liver. Be aware that a healthy diet week includes only two or three days of meat and one day of fish. On vegetarian days, mushrooms, chickpeas, lentils, and a variety of other plant-based foods supply ample protein.
Healthy eating is difficult in supermarkets, fast food restaurants, and bakeries since there are so many tempting options available. They provide us far more than we really need. Try to keep things simple. Eat what you know. Discover your kitchen.
Benefits of a Healthy Lifestyle
“Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.”
—James F. Fries, MD, *1938 – †2022
To be fair, not all diseases are preventable, and even the healthiest individual can get cardiovascular disease. Genetic variations can raise cardiovascular risk. For example, if familial hypercholesterolemia is not detected and treated, it causes early artery damage. Several cardiomyopathies – illnesses of the heart muscle itself – have a hereditary component. Infections and autoimmune diseases can cause damage to the arteries and heart. However, most of the damage to our arteries and hearts is caused by an unhealthy lifestyle. Do you know that…
- Smoking increases the risk of heart disease by more than twice that of non-smokers. Fortunately, quitting smoking results in a significantly reduced risk of heart disease practically immediately. Over the course of five years, quitting smoking reduces the risk of heart disease by around 40%.
- Highly obese individuals (>40kg/m2) have approximately three times the risk of heart attacks, strokes, and other cardiac events compared to those of normal weight. Even persons with a BMI that just classifies them as overweight (BMI >25kg/m2) are at a much higher risk of developing cardiovascular disease at a younger age, resulting in a greater proportion of their lives spent ill or disabled.
While 10-15% weight loss does not equate to becoming slim for obese persons, it does result in improvements in major cardiovascular disease events, with a 21% reduction in CVD death, acute myocardial infarction, or stroke.
- Sedentary behavior and physical inactivity are significant risk factors for cardiovascular disease (CVD) and all-cause death. It is critical to note that sedentary behavior differs from physical inactivity, and might be even worse. A study of 17.013 Canadian adults monitored for an average of 12 years found that those who reported sitting nearly all of the time were 54% more likely to die from CVD than those who reported sitting almost none of the time. study of 8.800 Australian adults produced similar results. Individuals who watched television ≥4 hours per day had a 45% and 80% higher risk of all-cause and CVD death, compared to those who watched <2 hours per day. According to the WHO Global Physical Activity Profile 2022, many inhabitants do not engage in the level of physical activity suggested for a healthy lifestyle, with our out of five teenagers aged 11 to 15 having a sedentary lifestyle.
Get yourself and your children up from their sofas as often as possible! Every step counts.
Diagnosis of Heart Disease Needs Cardiological Expertise
“Reading a technically poor echocardiogram is like looking at a polar bear in a snow storm.”
—Lynn Y. Zoiopoulos, DO
While routine check-ups such as testing blood pressure or monitoring blood lipids, can be handled by a primary care physician, there will be times when a specialist is needed.
One of the most common reasons for consulting a cardiologist is persistent chest pain or discomfort. While chest pain can have many origins, including non-cardiac disorders, it is crucial to rule out any heart-related conditions. Cardiologists are skilled at performing diagnostic tests, such as electrocardiograms (ECGs), echocardiograms, and stress tests, to assess cardiac function, enabling a comprehensive understanding of the underlying causes. Seeking the assistance of an experienced cardiologist helps ensure an accurate diagnosis and the most appropriate treatment to manage a heart or vascular condition effectively.
Coronary Artery Disease – If Coronary Angiography is Normal
“It’s not the hole in the doughnut where the action is. It’s the doughnut itself.”
—Steven E. Nissen, MD
A heart attack, also known as a myocardial infarction, happens when the flow of blood to the heart is significantly decreased or blocked. The obstruction is mainly caused by an accumulation of fat, cholesterol, and other substances in the heart’s coronary arteries. Plaques are fatty deposits that carry cholesterol. The process of plaque buildup is known as atherosclerosis.
A plaque can rupture and generate a clot, which inhibits blood flow. Coronary angiograms can reveal this obstruction. A shortage of blood flow may cause damage to part of the heart muscle.
However, heart attacks are not always caused by blocked arteries. This is where doughnuts come into play. Consider the doughnut to be the coronary artery, with the hole representing the interior of the vessel where the blood is floating. Coronary angiography does not reveal an obstruction inside the coronary arteries in approximately five out of every 100 patients who have had a myocardial infarction. In these circumstances, the issue is within the coronary artery wall (the doughnut). Potential underlying mechanisms include cardiac spasm (a constriction of the small muscle fibers within the aretry wall), coronary microvascular dysfunction (a problem in very small vessels within the heart muscle), and Takotsubo cardiomyopathy (the heart’s main pumping chamber alters shape, impairing the heart’s capacity to pump blood adequately into the coronary veins; also known as “broken heart syndrome”), and myocardial disorders.
As a result, if coronary angiography performed in response to heart attack symptoms reveals a normal interior of the arteries, cardiologists must be aware of the less common coronary artery dysfunctions.
Coronary Artery Disease – Do I Really Need Statins?
“Statin drugs, in my view, are the best cardiovascular drugs ever created, … These drugs are to atherosclerosis what penicillin was to infectious diseases.”
—William C. Roberts, MD, *1932 – †2023
Yes. If you have coronary artery disease, statins are recommended.
Statins are highly effective and safe medications for treating coronary artery disease, independent of cholesterol level.
Statins lower low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, in the bloodstream. Traditionally, they were regarded as solely cholesterol-lowering medications. So it made sense to use them only for persons with high cholesterol. However, research trials have shown that they also benefit those with lower levels of cholesterol who are at high risk of heart disease. Statins are now being utilized as risk-reduction medications. This profound shift in thinking implies that people who were previously unsuitable for statins are now prescribed them to reduce their risk of cardiovascular disease.
Statines draw cholesterol from plaque while also stabilizing it. A plaque is a waxy substance made up primarily of cholesterol deposits that can accumulate within the walls of arteries, interfering with blood flow to and from the heart and leading to heart attacks and strokes.
Plaque buildup can be decreased early on by adopting a heart-healthy diet, exercising regularly, and quitting smoking. If those efforts are unsuccessful, or patients are at high risk of developing plaques, doctors will prescribe statins to assist the arteries and prevent further damage.
Coronary Stents and Bypass – When Do I need Angioplasty?
“Angioplasties are a little like potato chips. You can’t have just one.”
—William Castelli, MD, *1931 – †2025
Coronary angiography and stent implantation in the event of a heart attack save lives. However, stenting is frequently performed in patients with “stable angina pectoris” or even in the absence of symptoms. Is that beneficial?
Chest pain, commonly known as “angina pectoris,” indicates that the heart muscle is not receiving adequate blood flow, specifically oxygen. Calcium and fatty deposits, known as plaques, cause narrowing of the coronary arteries. A person with narrowed arteries may develop angina with activity, exercise, or any other physical or mental stress that increases the heart’s demand for blood. Angina is unstable when there is a shift in the regular pattern, such as an increase in frequency, severity, length, or triggering factor. Unstable angina may be accompanied with heart muscle injury (or a heart attack), hence stenting in this emergency scenario can save lives.
When compared to patients on a thorough medical program, placing a stent (“angioplasty”) that widens and reopens the artery may improve symptoms and exercise capacity but does not reduce mortality or the risk of myocardial infarction. Stenting may be advised in addition to medication therapy for two types of patients with stable angina:
- People who have persistent and intolerable symptoms despite optimal medical treatment
- People who have specific patterns of arterial narrowing and a high risk of either a heart attack or death
Stenting frequently involves the placement of more than one stent. Furthermore, hospitals may propose periodical control angiographies, which in fact are only necessary if new symptoms develop. Unnecessary controls frequently result in additional stentings – the “potato chip phenomenon.” However, stenting is an invasive treatment that comes with hazards. It is critical to discuss realistic expectations and risks with your doctor—or to seek an independent second opinion.
Health Literacy is Important for Survival
“The central problem in heart failure is not that patients are short of breath or that they retain fluid: the problem is that they die. Heart failure is a mortal illness, more serious than most malignancies.”
—Arnold M. Katz, MD, *1932 – †2016
In the past, heart failure was referred to as “weakened heart” syndrome, a term that is prone to misunderstanding. Many individuals believe that being weaker, losing breath more quickly, or feeling exhausted sooner after engaging in physical activity is typical as they age. Heart failure, however, is not an ordinary component of aging.
Heart failure is a progressive illness where the heart’s muscle gradually loses its capacity to pump enough blood to meet the body’s needs after suffering damage from a heart attack or high blood pressure. There are two ways that the heart can be impacted: either it becomes stiff and cannot fill with blood sufficiently (diastolic heart failure) or it becomes weak and unable to circulate blood (systolic heart failure). In the end, both circumstances result in congestion or the retention of excess fluid. Congestive heart failure is the term used to describe the condition in which individuals experience symptoms.
Since symptoms are frequently confused with aging, many people are unaware that they have it. Heart failure is a progressive condition that in most cases begins slowly and worsens with time. It only appears quickly after a major event such as a heart attack.
Congestion or excess fluid are common signs of heart failure, which can lead to
- Shortness of breath from walking stairs or simple activities (dyspnea)
- Trouble breathing when resting or lying down
- Waking up breathless at night
- Needing more than two pillows to sleep
- Frequent coughing
- Swelling of feet, ankles or legs (edema)
- Increased need to urinate at night
- Swelling of the abdomen (ascites)
- Lack of appetite and nausea
- Fatigue
- Cold legs and arms
- Difficulty concentrating
Life expectancy for a patient depends on many factors and there is no one answer for an individual patient. When you look at large groups of patients with heart failure, overall, 50% of patients will have an average life expectancy of 5 years. This is a worse prognoses than for many cancer types.
Patients that have less severe heart failure, are well treated with medications, have good renal function, normal blood sugar, and live a healthy life-style, can have much better life expectancy than the average heart failure patient. For patients with more severe or advanced heart failure and additional non-cardiac conditions such as poorly controlled diabetes mellitus and poor kidney function, only around 10 to 20% of patients will be alive after one year.
Be mindful of the signs of a “weakend heart”! A timely and correct diagnosis by a cardiologist is crucial. Effective treatment is available for heart failure. Your prognosis and quality of life will improve the earlier treatment begins.
Knowledge & Trust – Treatment is Teamwork!
“The healing process demands more than science; it requires mobilizing patient’s positive expectations and stimulating faith in physician’s ministrations. I know of few remedies more powerful than a carefully chosen word. Talk, which can be therapeutic, is one of the underrated tools in a physician’s armamentarium.”
—Bernard Lown, MD, *1921 – †2021
Patient empowerment has emerged as a new paradigm. It is a process through which people gain greater control over decisions and actions affecting their own health.
An empowered patient looks like anyone. It is the education, patient´s and doctor´s willingness, and motivation what foster a relationship in which the patient is successfully involved in their own care.
Those who have survived a cardiovascular incident or experienced a health scare are more prepared to use patient empowerment. Although cardiovascular events and health scares are regrettable, they also present a chance for healthcare professionals to educate and build a collaborative team approach with their patients.
Keep in mind that empowering patients does not equate to disempowering doctors. Patients can only be empowered by their healthcare professionals if they receive ongoing medical input that facilitates a seamless transition to self-responsibility. Giving patients the tools they need to prioritize self-care can help them feel less anxious, more confident, and able to take care of themselves.
Heart failure is a progressive illness where the heart’s muscle gradually loses its capacity to pump enough blood to meet the body’s needs after suffering damage from a heart attack or high blood pressure. There are two ways that the heart can be impacted: either it becomes stiff and cannot fill with blood sufficiently (diastolic heart failure) or it becomes weak and unable to circulate blood (systolic heart failure). In the end, both circumstances result in congestion or the retention of excess fluid. Congestive heart failure is the term used to describe the condition in which individuals experience symptoms.
Since symptoms are frequently confused with aging, many people are unaware that they have it. Heart failure is a progressive condition that in most cases begins slowly and worsens with time. It only appears quickly after a major event such as a heart attack.
Congestion or excess fluid are common signs of heart failure, which can lead to
- Shortness of breath from walking stairs or simple activities (dyspnea)
- Trouble breathing when resting or lying down
- Waking up breathless at night
- Needing more than two pillows to sleep
- Frequent coughing
- Swelling of feet, ankles or legs (edema)
- Increased need to urinate at night
- Swelling of the abdomen (ascites)
- Lack of appetite and nausea
- Fatigue
- Cold legs and arms
- Difficulty concentrating
Life expectancy for a patient depends on many factors and there is no one answer for an individual patient. When you look at large groups of patients with heart failure, overall, 50% of patients will have an average life expectancy of 5 years. This is a worse prognoses than for many cancer types.
Patients that have less severe heart failure, are well treated with medications, have good renal function, normal blood sugar, and live a healthy life-style, can have much better life expectancy than the average heart failure patient. For patients with more severe or advanced heart failure and additional non-cardiac conditions such as poorly controlled diabetes mellitus and poor kidney function, only around 10 to 20% of patients will be alive after one year.
Be mindful of the signs of a “weakend heart”! A timely and correct diagnosis by a cardiologist is crucial. Effective treatment is available for heart failure. Your prognosis and quality of life will improve the earlier treatment begins.
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A contribution of Dr. Gabriele Stumm,
