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Tim Russert's Death: Questions, Answers

Get Answers to Questions About Tim Russert's Heart Attack -- And Your Own Risk

A lot of people may still have the idea of plaque being something that clogs the arteries like hair in a drain. Can you explain to them how they should picture it inside the walls and how a blockage and rupture happens?

Patterson: Plaque can be the kind of buildup you're talking about -- that's where the water doesn't flow through the drains right. But that's not really what a vulnerable plaque is. If you want to think about what a vulnerable plaque is, it's like having a pimple in the side of a blood vessel wall, a pimple that's prone to open up and rupture. It's when that rupture occurs that the blood will clot and the heart attack will happen. So it's really a very different process, fundamentally, than the obstruction of the flow of blood.

Would you expect that Mr. Russert's death is a wake-up call?

Ostfeld: I think that's a great way to look at it. Out of this tragedy, maybe positive things can arise. Atherosclerosis, and diseases related to it, is the No. 1 killer of adult men and adult women. Also, when you have atherosclerosis, although you may not feel it, your blood vessels do not function as well as they could. So it may reduce, subtly, your quality of life, as well.

Zipes: If they are symptomatic -- palpitations, chest pain, shortness of breath, dizzy spell, blackout spell, go see a doctor. No. 2, routine evaluations of individuals after the age of 50 is a very reasonable thing to do. Early presentation of heart disease could be picked up at that time. If he had significant coronary disease, as apparently he had, very aggressive treatment with statins, ACE inhibitors, aspirin, beta-blockers, are indicated.

Patterson: No. 1: Have a dialogue with your physician about your risk and whether you're at high risk or not. No. 2: Identify those things under your power to control and to change those that you can. No. 3: Make those changes as part of a lifestyle commitment and not as a diet you fall on and off of; it really needs to be a lifestyle commitment. No. 4: Understand that cardiovascular disease is the No. 1 cause of death and disability in our society, so it's something you really can't afford to ignore.

What would you want women to keep in mind, because it's the No. 1 killer of women as well?

Patterson: My comments to women are these. The No. 1 disease women are afraid of is breast cancer, but the No. 1 cause of death in women is heart disease. The second point to make is symptoms of heart disease are frequently much more subtle in women and much more difficult to diagnose, so women shouldn't allow themselves to be judged by the same standards as men in terms of whether or not they're having symptoms of heart disease or whether or not they're at risk for heart disease.

Ostfeld: Women are approximately six to seven times more likely to die from heart disease than they are from breast cancer. Clearly, you do not want either, but it highlights how critically important it is for women to take their heart health very seriously as well.

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