From the Heart with Dr. Ashley Simmons

We sat down with Dr. Ashley Simmons to talk about our winter KALOS theme--the heart. 

Dr. Ashley Simmons, Director of the Adelaide C. Ward Women's Heart Center at the University of Kansas Hospital, answered a series of questions on the heart and how it relates to our theme. Not only is Dr. Simmons a renowned cardiologist, she's also one of the original supporters of KALOS.

KALOS: What is the connection between the heart and the breath?
Dr. Simmons: The heart and breath are intimately related.  Without breath, there is no oxygenation, which helps the heart muscle to squeeze and pump  oxygenated blood throughout the body.  Without the heart beating, there is no blood flow to deliver oxygenated blood to the other vital organs, including the brain.  The resting heart rate can be reduced with routine cardiovascular exercise and with relaxation techniques such as deep breathing.  Deep breathing activates the parasympathetic nervous system which tells the body to relax.   The parasympathetic  nervous system is one part of the autonomic nervous system.  Its’ counterpart is the sympathetic nervous system.  The sympathetic nervous system allows us to “fight or flight”.  Our pupils dilate, heart rate increases, stomach digestion decreases as blood flow is diverted, muscles contract, adrenaline and cortisol levels are released.  The parasympathetic system does the opposite: muscle relaxation, heart rate reduction, decreased adrenaline levels.

In our culture, many believe that we live with over activation of the sympathetic nervous system. Deep breathing and relaxation is important for us to do to tell our body that everything is ok- we are not running from tigers all of the time.  Relaxation techniques, such as deep breathing, can help sleep, energy levels, lower blood pressure, and stabilize blood sugars. Deep breathing and relaxation help us deal with the chronic stress life throws at us.

 

KALOS: Most women don’t understand they’re at risk for heart disease-what is heart disease? What puts us at greater risk? What prevents it?

Dr. Simmons: Heart disease includes coronary artery disease (blockage in heart arteries), high blood pressure, arrhythmias, valve disease, heart muscle problems (cardiomyopathies).   Risk factors for coronary artery disease include: high blood pressure, high cholesterol, diabetes, chronic kidney disease, family history, smoking, illicit drug use.  Other risk factors include:  prior left sided chest radiation, some chemotherapy regimens, pre-eclampsia, gestational diabetes, pregnancy induced high blood pressure, stress, and chronic inflammation.   Knowing your family history is very important for all types of heart disease.

Taking care of all of those risk factors helps prevent and treat heart disease.  Knowing your family history, blood pressure, fasting blood sugar, and cholesterol are important places to start.  We have great medicines available to help control blood pressure, cholesterol and blood sugars.  The changes in behaviors are more difficult to treat because they require changing habits: stopping smoking, getting good sleep, following a low processed food nutritious diet, getting good exercise and managing stress in a healthy way.  Both behavior modification and medications work for prevention of heart disease.

KALOS: Is it possible to have a broken heart?

Dr Simmons: Yes, the technical term is “stress induced cardiomyopathy”, “broken heart syndrome”, or “Takotsubos cardiomyopathy”.  Takotsubo is a Japanese word for octopus trap, which is what the heart looks like when it contracts with this disease.  Broken heart syndrome occurs primarily in postmenopausal women.  It is not clear why this mostly affects women.  The disease is thought to be caused by excessive stress hormones (norepinephrine) that are released when patients are under physical or emotional stress.  It can cause EKG changes and elevated cardiac enzymes and mimics a heart attack but the coronary arteries show no blockage.  It is treated with medications called beta blockers.  Sometimes patients get very sick and require ICU care.  It is typically reversible but can cause a lot of complications when the heart is stunned and not contracting.

KALOS: Is the heart the organ that keeps everything together and connected in the body?

Dr. Simmons: All organs in the body need to be functioning well and communicating with each other for the body to function well.   The heart is one of the vital organs – meaning you cannot survive without it.  It is responsible for pumping oxygenated blood to all of the organs.

KALOS: Any idea on how many beats one heart might have over the course of a standard 75 year long life?
Dr. Simmons: According to some online references, an average human heart will beat 2.5 billion times in an average lifetime.

Info about my speciality.  

Cardiology is a subspecialty of internal medicine.  To become a cardiologist, you go to medical school (4 years), then internal medicine residency (3 years), and then cardiology fellowship (3 years).  It is a long haul but a great specialty.  I am interested in women’s heart health and noninvasive imaging.   I am the Director of the Adelaide C Ward Women’s Heart center at the University of Kansas Hospital and spend my days reading imaging studies including echo, cardiac CT, cardiac MRI, nuclear stress tests, and peripheral vascular images.  I see patients on rounds in the hospital and in clinic.  I am very lucky to work with amazing people every day.  I do practice a lot of deep breathing some days and am grateful for my days that I get to practice yoga ☺

I see patients primarily at the Adelaide C Ward Women’s Heart Clinic at KU, but I also go to our offices in Overland Park and St Joseph.  Our scheduling phone number for Cardiology at the University of Kansas Health System is 913-588-9700.