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Medical Intel

Oct 16, 2018

Typical symptoms of the flu, which affects up to 20 percent of Americans annually, can take a toll on one’s health in their own right. However, there’s an even more serious concern to consider. Dr. Allen J. Taylor explains how the flu can increase heart attack risk.



Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine.

Host: Thanks for joining us today. We’re speaking with Dr. Allen J. Taylor, Chair of Cardiology at MedStar Heart & Vascular Institute. Welcome, Dr. Taylor.

Dr. Allen J. Taylor: Thank you.

Host: Today we’re discussing how the flu can affect a person’s risk of heart issues, particularly heart attack. It’s widely known that the flu can be dangerous, and it kills thousands of otherwise healthy people each year in the U.S. Increasing the concern, a 2018 study published in the British Medical Journal suggests that a patient’s risk of heart attack might be six times higher within the first week of a lab-confirmed diagnosis of influenza. Dr. Taylor, is this another scary media story or is the flu a real concern for patients when it comes to heart attack risk?

Dr. Taylor: This really is not a scary media story. This is the impact of the flu on health in total. People think the flu is a self-limited illness. They’ll feel bad for a few days. And while that’s true, each year the flu causes over 130,000 hospitalizations; 62,000 deaths. And those deaths include deaths from heart attacks - six times more likely after the flu. It’s a real issue.

Host: How can the flu, which many people consider a sinus or respiratory illness, affect heart attack risk?

Dr. Taylor: Yeah, it might seem hard to connect. But, in fact, the flu triggers a host of inflammatory reactions that activate problems throughout the body and activate chronic conditions and inflammation is an important part of heart risk. And, we believe that that’s the mechanism, that through the inflammation triggered by the flu, heart attack risk is six time higher in the week after the flu.

Host: Why is the flu such a concern when vaccinations are available for infants through seniors?

Dr. Taylor: Right. The CDC recommends that all healthy adults receive the flu shot. And the problem we’re having is that folks aren’t getting vaccinated. Fewer than half of individuals get vaccinated, for a variety of reasons and concerns and it’s unfortunately too little. And so, many of those adults that are not getting vaccinated, in fact, are subjecting themselves to the risk of not just the flu but of many conditions, including heart attack. My recommendations at this point would be to first, get a flu shot and have your family members and other loved ones get flu shots. Even if you think you’re healthy, the flu is a risk for you. If you have a chronic condition, even high blood pressure, you particularly need to get a flu shot. And they’re simply easy to get. Every drug store now provides flu shots and they’re inexpensive and typically covered by insurance companies. So, DO vaccinate yourself. And then, stay as healthy as you can. And if you are unlucky enough to contract the flu, look for these other symptoms, and if you experience them, get prompt medical attention.

Host: So, when we think of the flu as a risk, we tend to think of older adults. Could you discuss why this population’s also at increased risk for heart attack?

Dr. Taylor: Well, problems from the flu can affect any otherwise healthy person. There is a group that’s at increased risk and that’s a middle-aged and older group of individuals who have at least one chronic health condition, which could include simply high blood pressure. So, there’s many middle-aged and older adults with chronic health conditions and they’re the ones at most increased risk. So, with the low rates of vaccination and this heightened risk, we really need to do a better job of getting the word out of “get vaccinated, protect yourself and protect others by protecting yourself.” This idea of more immunizations reducing the transmission of flu during flu season is an important one. By your getting a flu shot, you could help somebody else.

Host: Aside from older adults, are other patient populations at increased risk for heart attack after catching the flu?

Dr. Taylor: The increased risk of heart attack seems to affect all people, so it’s not just older individuals but it’s the older individuals with chronic health conditions that are at the greatest risk. But, again, the CDC recommends that ALL adults receive the flu shot.

Host: When an individual has the flu, what sort of symptoms might they watch out for if their heart is becoming damaged?

Dr. Taylor: We commonly think of things like joint aches and muscle aches and fevers and respiratory symptoms. But if you have the flu and you’re experiencing chest discomforts or unusual breathing problems is when I would become particularly concerned. The flu can increase risk for pneumonia, can inflame the lungs, and then, chest pains, either from inflammation around the heart or heart attack. Any worsening symptoms or new symptoms, besides what you’d otherwise expect from the flu, that you’d experience, I’d seek prompt attention for.

Host: Is this a year-around concern or is it just during flu season?

Dr. Taylor: That’s an interesting question. Obviously, there’s flu season, and the flu season for us runs from the fall into the late spring. We do see individuals, though, that travel to other parts of the world and, realizing there’s a South American group, we’ve seen patients that have gone to vacation in the summer, say in the Bahamas, and folks that winter in the Southern Hemisphere will also go to those locations, and bring the flu with them. So, we’ve, in fact, had several recent cases of people contracting the flu and serious problems from it in the summer.

Host: What can patients do, aside from getting the flu vaccine, to reduce the risk?

Dr. Taylor: Well, the first thing is, in the flu season, being very attentive to things like hand washing. And if they’re around sick contacts, to make sure that they’re being particularly attentive. Folks with the flu should be careful about transmission—you know, the way they sneeze, touching objects, also washing their hands. And then, staying as healthy as possible. The more vulnerable populations are folks that are stressed, fatigued, chronic illnesses. So, as always, proper diet, proper rest, good exercise. It could be all part of a healthy lifestyle that could protect one from problems from the flu. But, that said, vaccination is the most important thing. And, right now, we’re simply not vaccinating enough of Americans.

Host: Why is MedStar Heart and Vascular Institute the best place for people who want to reduce their risk of heart-related issues because of the flu?

Dr. Taylor: The heart consequences of the flu can be many, not just heart attack. We see cases of serious heart inflammation, for example, that can be very life threatening. And, we’ve successfully cared for those patients - identifying the flu, treating it, and supporting them through the illness. Properly supported patients usually do well, but prompt identification, aggressive treatment, is essential. So, we really serve as a regional resource for this and patients in our entire region, if they become very, very sick from the flu, we take excellent care of them. We’ve really had some great patient outcomes - folks that, for instance, travelled into the Bahamas and got sick, or in the flu season, and really have been fortunate that they’ve been able to survive.

Host: Could you share a treatment success story from your practice?

Dr. Taylor: I can think of several, but one that was particularly dramatic, was a perfectly healthy middle-aged woman who had gone out of the area to vacation. It was flu season and came back and started feeling poorly and started experiencing chest pains. And, what she had was serious inflammation of the heart muscle and a rapidly failing heart muscle. And in the course of just 12 hours, basically her heart could no longer support her body. So, she actually went on to artificial circulation, outside of her body, for a period of days while her heart recovered. Eventually that was removed and she’s back to full-functioning. And, we had literally hours to act, to identify the problem and to put her on artificial circulation. But today she’s alive and well and really is a great success story.

Host: Thanks for joining us today, Dr. Taylor.

Dr. Taylor: Thank you very much.

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