You had a heart attack. You survived. Now what?
One of the most critical first steps: cardiac rehabilitation. The three-month recovery program ensures proper blood flow while the patient works to manage weight and stress to strengthen the heart.
“Cardiac rehab should start immediately as instructed,” cardiologist Dr. Fan Ye of Novant Health Cardiology - Lexington said.
Bouncing back from a heart attack or heart surgery requires discipline throughout: the right medication, a healthy diet and an exercise regimen. Life after a heart attack also means working closely with your cardiologist to walk you through the process and following up when appropriate.
Heart disease is the leading cause of death in the U.S. It killed some 695,000 people in the U.S. in 2021. More than 800,000 Americans have a heart attack every year, according to the Centers for Disease Control and Prevention.
“Recovery is a long process,” Ye said. “It requires taking medication properly, modifying the lifestyle and continuing with physical activity. But physical activity is only one area of a cardiac rehab program; it also includes nutrition counseling, emotional support and stress management.”
Exceptional cardiovascular care.
Aside from cardiac rehabilitation, how else should patients address their health after a heart attack?
Cardiologists follow up with the patient at least once a year to consistently review detailed medication instructions with them. Patients require long-term follow-up care. Even if they had a stent put into the artery, there’s a risk of it narrowing again if the patient doesn’t take medication as prescribed.
Patients also have to be ready to change their lifestyle. Initially that means taking it easy and gradually resuming physical activity. It also requires quitting smoking, eating a healthy diet and managing stress long-term.
At some point, should everyone – including healthy patients – make an appointment with a cardiologist?
Before you see a heart doctor, check with your family doctor to ask whether you carry a risk of a heart attack. If heart attacks or coronary artery disease don’t run in your family and you’re generally healthy, your primary care doctor can decide whether seeing a cardiologist is necessary. Those who have congenital heart disease in their family history or have other risks should ask their doctor whether it’s time to see a heart specialist.
What type of patients do you typically treat?
I treat adult and geriatric patients. I don’t see a lot of congenital heart disease patients because they usually see a specialist. Many patients I see have a heart-valve disease called aortic stenosis. That’s when the valve becomes too narrow to allow proper blood flow. As we age, a lot of calcium starts to collect on the valve, which means your liver and kidneys are not getting a sufficient blood supply. And that can lead to problems with breathing or feeling dizzy all day, despite keeping hydrated.
The most common patients with valve disease require a heart doctor to watch them very closely. We typically see patients with a mild disease only once a year. But if patients become more symptomatic — chest pain, dizziness or shortness of breath — we need to follow up every three to six months to monitor the progression of the valve disease. Putting in a new valve can affect heart conductivity and make it beat slower. For those patients, I can put in a pacemaker and monitor them remotely.
Years ago the surgeon had to open the chest to replace a valve. But now, if you’re a good candidate for a minimally invasive cardiology procedure (known as the transfemoral approach), the physician can treat the valve using a catheter through a small incision in the groin area. This avoids open-heart surgery and a long recovery for aging people. And most patients stay in the hospital for no more than 48 hours.
What are the differences between heart failure and heart valve disease?
You’re born with congenital heart disease, but not every person born with it is also born with valve disease. Congenital heart disease can include valve disease, and valve disease can also develop later in life.
As we age, we build up calcium in our heart vessels. When enough plaque builds up and blocks the vessel, that’s a heart attack. The same thing can happen in our valves. We have varying grades for valve narrowness: mild, moderate and severe. The patient may not have any symptoms at all; they’re active and have no chest pain or problems with breathing. But valve conditions can get worse, to the point where it becomes narrow enough to block blood flow to the brain and liver. At that point, you’re going to start having symptoms such as dizziness or chest pain.
What’s the best way to build trust between the patient and the provider?
I like working in a smaller hospital – Novant Health Thomasville Medical Center – because the cardiologists and the patients are like family. I treat my patients like family because I know from personal experience: My dad had been smoking for about 50 years when he had a heart attack. My grandfather also had a heart attack. So when I meet with my patients face-to-face, it’s easier to convince them to take better care of themselves and modify their lifestyle. I make sure to also communicate with their family how important it is that they are all involved with the patient’s long-term follow-up care.
Dr. Fan Ye was born in Nanjing, China, where he graduated from medical school in 2005. Then, his medical journey took him to the U.S. for the first time.
“I wanted to come to the United States for continued patient care and to pursue a research background,” he said. “So I applied to a research program and was accepted as a PhD candidate.”
Fan earned his doctorate in muscle rehabilitation at the University of Florida, and he completed internal medicine residency training at the University of Central Florida.
While training in cardiology and cardiovascular disease at Wake Forest School of Medicine, Fan had opportunities to work with cardiologists and hospitalists at Novant Health Forsyth Medical Center. It was there he got to know the internal medicine team and observe providers in action.
Fan started full-time at Novant Health Cardiology - Thomasville in April.
