Acceptance: the first step in treating cardiovascular disease

By Angela Nunnery, M.D., Board certified family physician

Modern medicine has made major advancements in the diagnosis and treatment of the number one cause of death, but the healing process is stifled by patients who are in denial of their condition.

Cardiovascular disease is the number one cause of death in the world, resulting in more than 17 million deaths worldwide each year, according to the World Health Organization. In America, more than 80 million Americans have some form of cardiovascular disease which leads to the death of about 2,200 people daily, according to Texas Heart Institute.

While many of the causes and conditions that can lead to cardiovascular disease are well known − hypertension, high cholesterol, smoking, obesity, heredity, inactivity and stress, for example − a significant number of at risk patients are in denial about their condition. They ignore warning signs that are indicative of an escalating problem that could be treated or even reversed with proper diet, exercise and medication.

For some, ignorance is bliss. While they are aware lifestyle choices may have a negative impact on their overall health, they choose not to consider the ramifications of their actions.

Others actively deny the possibility of health concerns out of fear. They simply do not want to confirm the concerns they have about their condition − fearing the alteration of their lifestyle would be too difficult, that their condition is too far advanced to be treated or that the inevitable will come when it comes no matter what they do.

Many simply ignore warning signs, attributing symptoms of a cardiovascular event to other causes. Chest discomfort, shortness of breath, nausea and other symptoms that don’t linger can be dismissed − all too often with wishful thinking − as passing conditions that don’t warrant seeing the family doctor or a cardiologist.

Women are especially prone to ignoring symptoms, attributing warning signs to gastrointestinal disorders that are part of life. Many are reluctant to talk about such symptoms during routine examinations or annual physicals without being prodded for specifics.

Ironically, among the unlikeliest group of people to address physical symptoms related to cardiovascular disease is physicians. Many doctors work long hours, eat poorly and are under incredible stress. Doctors many know the risk factors and symptoms of cardiovascular disease better than laymen, but that doesn’t mean they don’t fall victim to self denial. They do.

As pervasive and deadly as cardiovascular disease is, there are a wide range of effective treatment options available. It is important for physicians to educate patients on the subject. Denial is often based on the fear of the unknown, so it is incumbent upon doctors to explain the dangers of high blood pressure, coronary artery disease, valvular heart disease and other forms of cardiovascular disease.

The goal is not to reinforce fears, but to explain the situation in a manner patients can understand and offer them viable, attainable solutions. Sometimes baby steps in the right direction can be more effective than harsh directives and mandates about major changes in the patient’s lifestyle.

It is also important to focus on positive outcomes. If patients experience warning signs consistent with cardiovascular disease, they should consult their physician. If they have extreme symptoms they should take a blood-thinning aspirin and call 911.

Equally important is to make sure patients understand that time is of the essence during a myocardial infarction or cardiovascular event. The quicker a patient is able to obtain medical treatment, the greater the possibility for a favorable outcome.

Thrombolysis, the breakdown of blood clots by pharmacological means − commonly called clot busting − is a revolutionary technique that works by stimulating secondary fibrinolysis by plasmin through infusion. It is well known within the medical community, but not so familiar to laymen.

Educating patients about effective treatments and options can do a lot to encourage patients to reduce their level of self denial and take a more active and productive role in managing the health of themselves and those important to them.

Once we get patients beyond their fears, we have a better chance of treating the conditions that can cause more permanent damage.