Health & Fitness

Shortness of breath? Dizzy? Lightheaded? Don’t ignore these symptoms

Dennis Hengge, who will be 65 in May, runs near his Pembroke Pines home on Sunday, Feb. 12, 2017. Dennis was a longtime marathon runner when he started feeling shortness of breath and noticed his heart was sustaining a fast rate even after he’d stopped running. He learned he had superventricular tachycardia, an extremely rapid heart rhythm that renders the heart unable to pump blood and can lead to cardiac arrest. After getting treated at Memorial Hospital, he has begun to run again.
Dennis Hengge, who will be 65 in May, runs near his Pembroke Pines home on Sunday, Feb. 12, 2017. Dennis was a longtime marathon runner when he started feeling shortness of breath and noticed his heart was sustaining a fast rate even after he’d stopped running. He learned he had superventricular tachycardia, an extremely rapid heart rhythm that renders the heart unable to pump blood and can lead to cardiac arrest. After getting treated at Memorial Hospital, he has begun to run again. pfarrell@miamiherald.com

Dennis Hengge loves to run. Scratch that — he lives to run.

“As a boy in New York, we didn’t even have a car,” says the Pembroke Pines marathoner, who will be 65 in May and works at NexPub Printing in Miramar, a company he founded. “I ran everywhere. It was transportation — it wasn’t thought of as exercise. It was just a way to get to school or the basketball court. It seemed natural. I took up the sport after I was married, when the marathon boom was hitting South Florida in the mid ’70s. I thought, ‘I bet I can do this.’ It was so long ago Gatorade had not even been invented yet.”

So when he started running out of breath during his workouts and noticed his heart was sustaining a fast rate even after he’d stopped running, he was concerned. Heart palpitations were not part of his plan for a healthy, happy life.

After a referral to Dr. David R. Ancona at Memorial Hospital West in Pembroke Pines, Hengge learned he was suffering from superventricular tachycardia, an extremely rapid heart rhythm that renders the heart unable to pump blood and can lead to cardiac arrest. He needed a catheter ablation, a procedure in which catheters are threaded through the blood vessels to the inner heart. Electrodes at the tips transmit energy to erase the flap of tissue causing the problem.

Things got worse for Hengge before they got better: Two years after his ablation he suffered a heart attack. But now, he’s up and running again — and he has been free of any arrhythmia issues ever since.

Hengge’s success story demonstrates the improved success rates for cardiac arrhythmia (a name for any sort of abnormal heart rhythm; atrial fibrillation is the most common arrhythmia). But while treatment has improved for most arrhythmias and patients have a better shot than ever to return to an active life, some patients don’t experience symptoms and thus don’t get checked out regularly. Others don’t bother to be examined after experiencing symptoms they write off as a natural part of aging.

The Centers for Disease Control and Prevention estimates that anywhere from 2.7 to 6.1 million Americans suffer from atrial fibrillation and reports that more than 750,000 related hospitalizations occur annually. With 130,000 estimated deaths each year — a rate that has been rising for more than two decades — atrial fibrillation costs the United States about $6 billion each year, according to the CDC.

Sometimes these heart rhythms occur with no symptoms. And when people think they’re getting older and they’re more accepting of diminished physical ability, it’s hard to get them to come to the doctor. But any onset of new symptoms related to physical stamina or breathing ought to be evaluated and not accepted as the consequences of maturity.

Dr. David Ancona, Memorial Hospital West

Ancona, who says that patients with superventricular tachycardia appear in the ER daily, believes prevention is key. But the nature of the disease can make that difficult.

“Sometimes these heart rhythms occur with no symptoms,” he says. “And when people think they’re getting older and they’re more accepting of diminished physical ability, it’s hard to get them to come to the doctor. But any onset of new symptoms related to physical stamina or breathing ought to be evaluated and not accepted as the consequences of maturity.”

Paying close attention to his body may well have saved Manuel Molina of Miami, 58. Diagnosed almost 38 years ago with Wolff-Parkinson-White syndrome — a condition in which an extra electrical pathway between the upper and lower chambers of the heart causes a fast heartbeat, according to the Mayo Clinic — he was on a fairly rigid regimen of medication including blood thinners.

One night in 2016, though, he woke up and could feel his heart beating oddly. Whisked off to South Miami Hospital, he underwent an emergency ablation and had a second ablation several months later. Now, he works out every morning, walking and running and lifting weights. More importantly, he’s off all medication.

“I tell you, it’s been a miracle,” Molina says. “I feel stronger than ever, with a lot of energy that I didn’t have before. ... I was able to get muscle mass back, and I have a lot of energy. I really haven’t felt like this in a long time.”

Dr. Mario Pascual of the Miami Cardiac & Vascular Institute (part of Baptist Health South Florida) treated Molina and says while paying attention to your body is important, early detection is also key.

“Our understanding of arrhythmia itself is much better than it was 10 years ago,” he says. “We’ve had technological improvements, the electronic mapping catheter that recreates three-dimensional structure of the heart. ... the catheters have sensitive sensors to tell us how much pressure we’re putting on the heart. . . . We see atrial fibrillation on a daily basis. The earlier we catch it, the better our success rates.’’

Common symptoms of arrhythmia include palpitations of the sort Molina and Hengge experienced as well as lightheadedness, dizziness and shortness of breath. You may think walking up a flight of stairs at 60 is harder than it is at 30, but any sudden change in ability should be a warning to call your doctor, Pascual says.

There are potential new technologies to help in detection.

Dr. Jeffrey Goldberger, chief cardiologist at UHealth-the University of Miami Health System, is co-inventor of a new heart mapping technology for ablation that’s now in a clinical trial called Morphology Recurrence Plot mapping. The technology aims for more precise ablation using the only device of its kind in the nation that identifies the source of the problem based on the morphology of electrical signals.

“One of the more disappointing things about treatment is we don’t have very many therapies that are really good at eradicating fibrillation,” Goldberger says. “We haven’t had a good way to identify the source the problem is coming from. So we said, ‘What’s the best way of finding those sources?’”

In the trial, a catheter is inserted into the veins and records electric impulses in the heart, which shows where the abnormal areas are located. Goldberger’s theory is that it will help doctors precisely locate the atrial fibrillation source, which hasn’t been possible to this point.

In the meantime, patients like Hengge and Molina will keep doing what they’re doing — exercising, eating healthy, staying in touch with their doctors and paying attention to what their bodies tell them.

“One of the things that saved me was knowing the signs,” says Hengge, who has cut down the 50 miles a week he used to run but still exercises daily. “If anyone started telling me they had these symptoms, I’d be calling 911. But a lot of men are stubborn about it and would’ve gone upstairs and said, ‘I’m going to bed early.’ And that would’ve been bad.”

Reducing the risk

Here are some ways to reduce your risk of atrial fibrillation, according to the American Heart Association:

▪ Stay active with regular physical activity and try to burn as many calories as you take in

▪ Stick to a heart healthy diet, keeping trans and saturated fats and salt to a minimum and eating nutritious food from all the food groups

▪ Maintain a healthy weight

▪ Don’t smoke

▪ Limit your intake of caffeine and alcohol

▪ Manage high blood pressure and high cholesterol

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