Dr. Zhen-Yu Michael Tong, MD, MBA

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

Asthma is a chronic disease where swollen, inflamed airways make it hard to breathe. It is often brought on by specific triggers. While asthma is a common condition, affecting millions of people, it can also be serious and even fatal in severe cases. Treatment involves avoiding triggers and using inhaled corticosteroid medications.

COPD, or Chronic Obstructive Pulmonary Disease, is the name given to two illnesses that both cause difficulty breathing: emphysema and chronic bronchitis. In emphysema, the air sacs of the lungs become damaged, while with bronchitis they become clogged with mucus. COPD is the fourth leading cause of death in the United States. It is almost always caused by breathing irritants into the lungs, such as smoking or heavy pollution.

Pneumonia is a lung infection that can be caused by bacteria, a virus, or fungi. Most healthy people recover from pneumonia in a week or two, but for some people pneumonia can be fatal. There are treatments available for pneumonia, but the best treatment is to prevent getting sick in the first place. People who are at risk should make sure they get a flu shot every year. There is also a vaccine available for the type of bacteria that causes pneumonia.

Lung cancer occurs when abnormal cells inside the lung grow into a tumor, destroying healthy tissue. Because it is so difficult to detect lung cancer in early stages when it has few symptoms, it is the deadliest form of cancer, responsible for the most cancer deaths both in the U.S. and worldwide. Most lung cancer is caused by exposure to tobacco smoke, but between 10-15% of cases are not linked to smoking.

Some problems with the lungs are minor and are not cause for concern. However if symptoms have lasted for a month or more, even if they are minor, it is worth checking with a healthcare professional. A cough, shortness of breath, or excess mucus production that lingers for weeks are all worth getting looked at.

There are several different kinds of VAD. While the controller and power source are always outside of the body, the pump itself can be internal or external. Most pump blood with a rhythm, like a human heart does, but some pump blood continuously. A VAD is usually placed in the left ventricle (to move blood to the body) but can be placed in the right ventricle (to move blood to the lungs) or on both sides of the heart.

VADs with external pumps are for short-term use and can be inserted in different ways. Some are mounted on a catheter (a thin, flexible tube) that is attached to the external pump and motor. This requires minor surgery to thread the catheter through a vein in the groin. Other VADs with external pumps require a larger incision on the chest, where inflow and outflow tubes are inserted. These tubes are connected to the external pump and power source. The chest remains open but covered with sterile material until the patient receives his or her heart transplant, which usually occurs within ten days. The patient must remain in the hospital during this period.

Implantable VADs have pumps that are placed within the chest cavity during open heart surgery. Two tubes are attached to the pump, which is implanted in the upper part of the abdomen. One of the tubes is inserted into the heart, pulling blood into the pump, which then sends the blood into the aorta. The other tube goes out of the abdominal wall to the outside of the body and is connected to the power source, which is worn around the waist. Since placing an implantable VAD requires open heart surgery, both the surgery and recovery are longer and more difficult than for VADs with external pumps. However, implantable VADs have a huge benefit in that they are not hooked up to a large machine -- patients are free to move around after being fitted with one. For this reason, they are more common when heart support is needed long-term. They may be used for patients who are waiting for a heart transplant, or as a permanent treatment for those who do not qualify for a transplant.

VADs come with their set of challenges. For instance, placement of the device can take several hours, and recovery can take as long as two months. Often, people who need VADs have experienced heart failure, and their weakened heart and lungs need careful monitoring and support. Patients with VADs that have external pumps need to sacrifice their mobility, while those who have implantable VADs must learn how to keep their device clean, safe, and working properly. Despite any difficulties of adjusting to life with a VAD, they can be lifesaving devices for those who need them.