ROCHESTER, Minn. — A new Mayo Clinic study finds that many heart attacks in people under 65 — especially women — are caused by factors other than clogged arteries, challenging long-standing assumptions about how heart attacks occur in younger populations.

Study findings published in the Journal of the American College of Cardiology examined over 15 years of data from the Rochester Epidemiology Project, providing the most comprehensive population evaluation of heart attack causes in people aged 65 and younger.

More than half of heart attacks in women under age 65 were caused by nontraditional factors, such as spontaneous coronary artery dissection (SCAD), embolism and other conditions unrelated to artery-clogging plaque. Heart attack incidence was significantly lower in women than in men — but when women did have heart attacks, the underlying causes were often misdiagnosed.

SCAD, which typically affects younger, otherwise healthy women, was frequently missed and misclassified as a typical heart attack due to plaque buildup. The most common cause of heart attack in both sexes was atherosclerosis, or artery-clogging plaque, but this accounted for only 47% of heart attacks in women, compared to 75% in men. Five-year mortality rates were highest in people who had heart attacks triggered by stressors such as anemia or infection, even though these patients had lower heart injury levels.

"This research shines a spotlight on heart attack causes that have historically been under-recognized, particularly in women," says Claire Raphael, M.B.B.S., Ph.D., an interventional cardiologist at Mayo Clinic and first author of the study. "When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective — or even harmful."

This new understanding could save lives. A misdiagnosed SCAD, for example, may be treated with a stent unnecessarily, increasing the risk of complications. Recognizing and correctly diagnosing these nontraditional heart attacks allows for more appropriate care and better long-term outcomes.

Key findings from the study:

• Out of 1,474 heart attacks, 68% were from typical plaque buildup (traditional heart disease), but nontraditional causes made up a majority of heart attacks in women.
• SCAD was nearly 6 times more common in women than men.
• Heart attacks caused by stressors such as anemia or an infection were the second-most common cause overall, and the deadliest, with a five-year mortality rate of 33%.
• Truly unexplained heart attacks were rare, making up less than 3% of cases after expert review.

Overall, the study provides insights that could reshape how heart attacks are diagnosed and managed in younger adults.

"Our research highlights the larger need to rethink how we approach heart attacks in this patient population, and for younger adult women, in particular. Clinicians must sharpen their awareness of conditions like SCAD, embolism and stress-related triggers, and patients should advocate for answers when something doesn't feel right," says Rajiv Gulati, M.D., Ph.D., chair of the Division of Interventional Cardiology and Ischemic Heart Disease at Mayo Clinic. Dr. Gulati is senior author of the study.

"Understanding why a heart attack happened is just as important as treating it," says Dr. Raphael. "It can mean the difference between recovery and recurrence."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study reveals hidden causes of heart attacks in younger adults, especially women appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I've read that following the Mediterranean diet is good for your heart, but I'm not quite sure why. If I decide to give it a try, how would I get started? 

ANSWER: Extensive research over the years continues to pinpoint the Mediterranean diet as one of the best for your heart. Why? It helps reduce chronic inflammation in the body.

Not all inflammation is bad, but once it becomes chronic, it can lead to heart disease, type 2 diabetes, dementia and cancer. One of the main risk factors for chronic inflammation is a high-fat, high-sugar diet. 

The Mediterranean diet is the opposite of that. And the best part is that eating healthy with the Mediterranean diet feels more like eating and living well. Basically, it's a model eating plan for good health.

What the Mediterranean diet does

Built around plant-based foods, the Mediterranean diet:

• Replaces harmful fats with healthy, monounsaturated fats, which have been found to lower total cholesterol and low-density lipoprotein, also known as LDL, or "bad" cholesterol levels.
• Includes food rich in antioxidants and phytochemicals that help reduce inflammation in the arteries.  
• Supports healthy blood pressure by stressing potassium-rich foods and decreasing salt intake.
• Promotes whole grains, legumes, fruits and vegetables, which are high in fiber, support gut health and reduce blood sugar fluctuations. 
• Encourages healthy weight because it focuses on nutrient-dense, satisfying foods that naturally curb overeating.

Change up what you eat

If you're interested in trying the Mediterranean diet, these tips will help you get started:

Aim for 2 to 3 servings of fruit and 4 or more servings of vegetables daily.  

Expand your fruit and veggie horizon with pomegranates, figs, grapes, peaches, nectarines, cantaloupe, spinach, kale, Swiss chard, and collard and mustard greens. Wander through a farmers market for local choices. Swap in fruits and veggies when you're craving a snack.

Opt for whole grains.

Switch to 100% whole-grain bread, cereal and pasta. Experiment with whole grains, such as bulgur and farro.

Add in nuts and seeds.

These foods are high in fiber, protein and healthy fats. Try to eat 4 servings of raw or unsalted nuts and seeds per week. One serving is ¼ cup.

Use healthy fats.

Try olive, avocado or grapeseed oil instead of butter when cooking. Rather than putting butter or margarine on bread, try dipping it in flavored olive oil. 

Eat fish twice a week.

Fresh or water-packed tuna, salmon, trout, mackerel, sardines, and herring, along with seafood such as shrimp, crab and mussels, are high in healthy omega-3 fats. Opt to grill, steam, or bake fish and seafood rather than frying it.

Reduce red meat.

Substitute fish, poultry, eggs, or beans and lentils for red meat. If you eat red meat, make sure it's lean, keep portions small — usually about 3 ounces of cooked meat — and eat it sparingly.

Don't forget dairy.

Eat low-fat Greek or plain yogurt, cottage cheese, milk, and a variety of soft cheeses. Try cheeses made from goat or sheep milk, such as chèvre and feta. Stir fresh or frozen fruit into yogurt to avoid added sugars. 

Spice it up.

Herbs and spices boost flavor and lessen the need for salt.

Drink wine, alcohol sparingly.

While red wine is often a choice in the Mediterranean diet, it's optional. If you do drink wine or alcohol, limit your intake to one glass or less each day. Light to moderate alcohol consumption may reduce heart disease risk, but it's generally not advised to start drinking alcohol or increase your consumption. Remember to include water, since it's the best fluid for your body.

Modify your lifestyle

While much of the Mediterranean diet revolves around healthy eating, a large part includes slowing down and savoring life — something most of us can benefit from for our well-being and mental health. 

The basics of Mediterranean-style eating include:

• Sitting down at a table for at least two lunches or dinners per week.
• Taking time over the meal, not eating and running.
• Eating with friends and family.
• Engaging in physical activity with a goal of at least 150 minutes of moderate intensity exercise per week.

Plenty of eating plans are out there, but the Mediterranean diet is a holistic approach that encompasses healthy, delicious food and lifestyle choices that promote well-being. Many people who switch to this style of eating say they'll never eat any other way again.

For more information, talk to your healthcare professional or a registered dietitian nutritionist.

Janet McCann, Registered Dietitian Nutritionist, Mayo Clinic Health System, Eau Claire, Wisconsin

The post Mayo Clinic Q&A: What makes the Mediterranean diet so healthy for your heart?    appeared first on Mayo Clinic News Network.

World Heart Day is September 29

ROCHESTER, Minn. — You may have heard of the mind-body connection: the broad concept that  thoughts and feelings, especially those related to stress, can influence physical health. Mohamad Alkhouli, M.D., an interventional cardiologist at Mayo Clinic in Rochester, Minnesota, is researching the relationship between the brain and the heart. Each can have a powerful impact on the other, Dr. Alkhouli explains.

"The mind-heart connection is part of the broader mind-body relationship, but it’s uniquely powerful. Emotional states like anxiety, grief, or even joy can directly influence heart rhythms, blood pressure, and even the risk of heart attacks," Dr. Alkhouli says. "At the same time, the heart sends signals back to the brain through nerves, hormones, and pressure receptors — affecting our mood, attention, and stress levels. So, it’s not just the brain talking to the heart; the heart talks back."

Conditions with a brain-heart connection include spontaneous coronary artery dissection (SCAD) and stress-induced cardiopathy (SICM), also known as broken heart syndrome. Both conditions can result from stress. Dr. Alkhouli has been part of Mayo Clinic research teams exploring aspects of each.

Broken heart syndrome often is sparked by stressful situations and extreme emotions; it briefly interrupts the way the heart pumps blood. People experiencing it may have sudden chest pain and think they're having a heart attack.

The tools typically used to screen for heart attacks cannot identify when broken heart syndrome is actually the cause of a patient's chest pain. In most cases, invasive coronary angiography is required to differentiate SICM from myocardial infarction due to coronary obstruction. Mayo research found that a novel technology called magnetocardiography, which measures magnetic fields generated by the heart, can help identify broken heart syndrome. 

Another Mayo study suggests that SCAD, a type of heart attack that often results from physical or emotional stress, can be a secondary event instigated by broken heart syndrome.

In broken heart syndrome, the heart's temporary weakening doesn't happen evenly: Some parts of the heart fail to contract well, while others work harder to compensate, Dr. Alkhouli says. This uneven motion creates twisting forces on the heart muscle. 

"Because the coronary arteries, the main blood vessels that supply blood to the heart, sit on top of the heart, they can be stretched or stressed at the junctions between these overactive and underactive areas during broken heart syndrome," he explains. "In some cases, this stress may cause a tear in the artery wall, what we call SCAD."

A question still to be answered is why some people develop broken heart syndrome after emotional trauma while others do not, Dr. Alkhouli notes.

Emotional stress also can increase the risk of other heart conditions, such as:

• High blood pressure, also known as hypertension.
• Heart disease.
• Atrial tachycardia.
• Bradycardia.

"What fascinates me most is how deeply intertwined our emotional and cardiovascular systems are, and how much we still don't understand," Dr. Alkhouli says. "Could we one day 'rewire' this connection for healing, using therapy, neuromodulation (alteration of nerve activity at targeted sites in the body by electrical or chemical means), or even digital tools? At Mayo Clinic, we're exploring these questions, and we're beginning to see the heart and brain not as separate organs, but as a single, dynamic network."

That network works in both directions. Dr. Alkhouli is part of Mayo's Heart Brain Clinic, where cardiologists and neurologists work together to evaluate patients who may have neurological symptoms that can be attributed to a cardiac event.

In these patients, the heart and brain are closely linked, such as strokes caused by clots that form in the heart, known as cardioembolic strokes. The causes of a transient ischemic attack, a short period of stroke-like symptoms, may include a blood clot that moves from another part of the body, such as the heart, to an artery that supplies the brain. The heart condition atherosclerosis, the buildup of fats, cholesterol and other substances in and on the artery walls, can also lead to a transient ischemic attack.  

More research is needed to better understand how to harness the mind-heart connection for disease prevention and healing. There are steps you can take now for your mental health that will benefit your heart, and things you can do for your heart health that will benefit your brain, Dr. Alkhouli says.

"The good news is that what's good for your mind is often good for your heart, and vice versa," he explains. That includes:

• Managing stress.
• Getting quality sleep.
• Staying socially connected.
• Practicing mindfulness or prayer.

"All have measurable benefits for heart health," Dr. Alkhouli says. "Likewise, regular physical activity, a heart-healthy diet and controlling blood pressure and cholesterol can boost mood and cognitive function. It's a powerful feedback loop: Caring for one supports the other."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post The brain-heart connection: Mayo Clinic expert explains powerful tie that works both ways appeared first on Mayo Clinic News Network.

(Video animation shows blood stem cells dividing and multiplying. Getty Images).

Deep inside the body, a slow-growing cluster of mutated blood cells can form. This cluster, found in 1 in 5 older adults, can raise the risk of leukemia and heart disease, often without warning. 

To better understand this hidden risk, Mayo Clinic researchers have developed an artificial intelligence (AI) tool to help investigators uncover how it contributes to disease risk and progression.

In a study published in Genomics, Proteomics & Bioinformatics, the tool showed promising results in identifying early signs of this condition, known as clonal hematopoiesis of indeterminate potential, or CHIP.

When blood cells mutate

CHIP starts in the bone marrow, where blood stem cells make the cells that keep organs working, oxygen flowing and the immune system strong. But if one of those cells acquires a mutation in a gene linked to blood cancer, it can multiply abnormally, forming a cluster of mutated cells that gradually expands. 

This can cause CHIP, a condition with no symptoms that researchers link to higher rates of death, especially from heart disease. Because its effects vary, CHIP is hard to track and often goes undetected for years. 

CHIP makes leukemia more than 10 times more likely and raises the risk of heart disease up to four times, even in healthy adults. Finding it earlier could help guide proactive monitoring or preventive care.

A new tool for early detection 

The new tool, called UNISOM — short for UNIfied SOmatic calling and Machine learning — was developed by Shulan Tian, Ph.D., under the leadership of Eric Klee, Ph.D., co-senior author of the study and the Everett J. and Jane M. Hauck Midwest Associate Director of Research and Innovation.  

UNISOM helps clinicians identify CHIP-related mutations in standard genetic datasets, opening new avenues for research and discovery. In the past, that level of detection required more complex and advanced sequencing methods. 

"Detecting disease at its earliest molecular roots is one of the most meaningful advances we can make in medicine," says Dr. Klee. "UNISOM is just one of many examples of how we're translating genomic science into innovative tools that support timely and informed care." 

UNISOM helped researchers detect nearly 80% of CHIP mutations using whole-exome sequencing, which analyzes the protein-coding regions of DNA.  

The team also tested UNISOM on whole-genome sequencing data from the Mayo Clinic Biobank, which captures nearly all of a person's genetic code. In that data, it detected early signs of CHIP, including mutations present in fewer than 5% of blood cells. Standard techniques often miss these small but important changes.

"We're engineering a path from genomic discovery to clinical decision-making," says Dr. Tian, the co-senior author and a bioinformatician at Mayo Clinic. "It's rewarding to help bring these discoveries closer to clinical care, where they can inform decisions and support more precise treatment." 

Next, the team plans to apply UNISOM to larger and more diverse datasets to support research and expand its use in clinical practice. 

Review the study for a complete list of authors, disclosures and funding.   

The post Mayo Clinic AI tool finds early signs of blood mutations linked to cancer and heart disease appeared first on Mayo Clinic News Network.

After more than 22 months at Mayo Clinic Children's, 13-year-old Ava Weitl went home to Iowa. She and her family were met with tears and cheers as dozens of members from her care team, who are now considered friends of the family, said goodbye and wished her well. 

This was a day Ava had been looking forward to after a long journey with heart failure, two lifesaving extracorporeal membrane oxygenation (ECMO) therapies, a heart transplant, kidney failure and a kidney transplant. 

Watch: 13-year old Ava Weitl leaves Mayo Clinic Children's after a 22-month hospital stay

Journalists: Broadcast-quality natsound video is in the downloads at the end of the post. Please courtesy: "Mayo Clinic."

Born with hypoplastic left heart syndrome (HLHS), a life-threatening condition where the left side of the heart is severely underdeveloped, Ava faced three open-heart surgeries before she would reach her 5th birthday. Within 90 minutes of her birth, her first surgery was performed. Her second surgery was completed months later, but the third, typically required for HLHS patients between the ages of 3 and 4, was not possible due to other medical concerns. 

For a handful of years, Ava's care team monitored her to see what her body would do. During that time, Ava felt good and was "defying the odds," as her mom, Christina DeShaw, would say. 

It was in 2021, during third grade, when Ava began to show signs of her heart and lungs struggling. While cardiac catheterization improved the blood flow to her lungs, it was a temporary improvement, and by early 2023, doctors determined a heart transplant was her only option.

Officially listed for a heart transplant in February 2023, Ava's condition worsened, leading to hospitalization at Mayo Clinic in September 2023. That hospital stay was the start of her long journey of constant monitoring and tests, and it wasn’t easy on her family as they navigated life split between Minnesota and Iowa. 

In December 2023, Ava's condition took a critical turn. Ava was placed on life-sustaining ECMO, which provides heart and lung support when those organs are failing. Then, Feb. 26, 2024, the call came: a donor heart became available. The surgery was successful, but postoperative challenges arose.

Weeks later, complications with her lungs led to a return to ECMO for three months. She also needed a tracheostomy placed. While trying to save her lungs, her kidney function began to fail, leading to another gift of life — a kidney transplant on Jan. 25, 2025, thanks to a donation from her uncle through a kidney exchange with the National Kidney Registry. 

"She's a walking miracle," her mother says. "We can't even wrap our heads around what she's been through."

Ava is excited to be home with her parents, Christina and Brad, her twin brother, Aiden, and her younger brother, Miles. She says she looks forward to hanging out with friends, going back to school and having a barbecue with her family. 

The post (VIDEO) 13-year-old Ava is home with a new heart, kidney following a 22-month hospital stay  appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — An artificial intelligence (AI) model developed by Mayo Clinic and Ultromics, Ltd., an AI echocardiography company based in Oxford, England, is highly accurate in screening for cardiac amyloidosis, a rare and progressive type of heart failure, according to a new study. The model is the first and only AI tool of its kind.

Researchers from Mayo Clinic and Ultromics, with investigators at the University of Chicago Medicine and collaborators around the world, validated and tested the model on a large and multiethnic patient population and compared its abilities to other diagnostic methods for cardiac amyloidosis.

Their findings, published in the European Heart Journal, show that the AI model was highly accurate, with 85% sensitivity (correctly identifying those with the disease) and 93% specificity (correctly identifying those without the disease). Using a single echocardiography videoclip, the model was effective across all major types of cardiac amyloidosis and distinguished it from other conditions with similar characteristics.

Cardiac amyloidosis is a life-threatening condition where an abnormal protein, called amyloid, builds up in the heart, causing it to stiffen and not work properly. It is often missed because the symptoms and imaging features can be similar to other heart conditions. However, early diagnosis is crucial because new drug therapies are now available that can slow or stop the disease's progression.

This work builds on the previous experience of Mayo Clinic and Ultromics in developing an AI echocardiography model to detect heart failure with preserved ejection fraction (HFpEF), which received Food and Drug Administration (FDA) clearance in 2022. HFpEF is a common type of heart failure, associated with high morbidity and mortality, but can be challenging to diagnose. An estimated 15% of patients with HFpEF have cardiac amyloidosis.

"This AI model is a breakthrough tool that can help us identify patients earlier so they can receive the treatment they need," says Patricia Pellikka, M.D., a cardiologist at Mayo Clinic and past director of the Mayo Clinic Echocardiography Lab in Rochester. "We found that AI performed better than traditional clinical and transthoracic echo-based screening methods, providing clinicians with stronger insights on which to base decisions for further confirmation tests. New treatments are available for cardiac amyloidosis but are most effective if administered early in the course of the disease." Dr. Pellikka is senior author of the study.

The amyloid AI model is FDA-cleared and is currently being used at multiple centers in the U.S. Dr. Pellikka says she looks forward to applying this technology in the clinical practice at Mayo Clinic.

This study was partially supported by a grant from Ultromics and Dr. Pellikka is supported as the Betty Knight Scripps-George M. Gura, Jr., M.D. Professor of Cardiovascular Diseases Clinical Research at Mayo Clinic. Mayo Clinic has a financial interest in this technology and will use any revenue it receives to support its not-for-profit mission in patient care, education and research.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post AI-enhanced echocardiography improves early detection of amyloid buildup in the heart appeared first on Mayo Clinic News Network.

Sue Baker started having issues with her heart in 2015. By 2019, she began experiencing heart failure. Living in Southeast Georgia, her condition landed her in the hospital seven times before the last visit led to her being transferred to Mayo Clinic in Florida, nearly 90 minutes away, critically ill.

"She was really sick — in cardiogenic shock, intubated, connected to a breathing machine — she was not going to make it," says Dr. Parag Patel, a Mayo Clinic transplant cardiologist. "She only had three to six months to live, and we needed to act fast."

Watch: Sue Baker's story

Journalists: Broadcast-quality video pkg (2:21) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

Sue's situation had become dire. She was presented with two options: enter hospice care or have a left ventricular assist device (LVAD) implanted to serve as a bridge to a heart transplant. While she chose the LVAD to buy more time, by 2023 she was experiencing dangerous heart rhythms and other challenges.

Complicating matters, her body was producing more antibodies, making it increasingly difficult to find a suitable transplant donor.

"It was devastating to know that I'm actually going to die," says Sue. Still, she did not lose hope. "You just grab hold of God and keep praying," she says.

Sue's care team also remained determined to help her hold on. They explored an innovative approach — called Heart After Liver Transplant with a Domino Liver to another patient (HALT-D) — that had shown success in patients with similar antibody counts.

HALT-D, however, had never been attempted on someone with a heart pump like hers. This procedure would be a first for Mayo Clinic, at any of its transplant sites.

Although Sue's liver was healthy, she would need to get not just a heart transplant but also a donor liver to help remove the antibodies from her body and reduce the risk of her new heart being rejected. This meant a rare and complex domino transplant, involving both a liver and a heart, where Sue's liver would also become part of the donor chain.

"We take the liver of the patient who's receiving the heart after liver, and we take that liver and we put it into another recipient so that we do not waste an organ," says Patel.

Preparing for this complex procedure involved extensive multidisciplinary collaboration between a variety of Mayo Clinic departments. Sue spent months in the hospital, waiting for a match. During her wait, fellow patients and staff began calling her "mama" for the care and support she provided everyone else, despite her own challenges.

"We get to know each other and kind of help each other out," says Sue. "That was a lot of healing and helpfulness there."

"Sue not only helped people on the floor, but she's helped other patients who didn't have an opportunity" for transplant, says Patel.

Finally, in September 2024, the domino transplant was performed successfully.

Today, Sue is on the path to recovery, growing stronger each day. Her motivation to live is fueled by the desire to honor her donor, whose gift has given her a second chance at life.

"I would love to thank and meet the family," says Sue. "I'm not going to sit back and do nothing. That person will always be special."

Her story is a testament to the power of medical innovation, the dedication of healthcare professionals, and the resilience of the human spirit.

"I love her, and I appreciate the doctors and all the nurses that have been so loving and caring for Sue,” says Charlene Taylor, Sue's caretaker.

The post A Mayo first: Innovative transplant procedure saves patient’s life after heart failure appeared first on Mayo Clinic News Network.

Mayo Clinic Healthcare cardiologist offers simple tips to maximize health at outdoor events

LONDON — Festival season can be surprisingly physically demanding. Hours spent standing, walking or dancing can put extra strain on the heart, especially for those with preexisting conditions such as heart disease, high blood pressure or diabetes, explains Gosia Wamil, M.D., Ph.D., a cardiologist at Mayo Clinic Healthcare in London.

For people with heart failure, this can lead to shortness of breath or a worsening of symptoms. For those with coronary artery disease, in which the major vessels that supply blood to your heart become narrowed or blocked, sudden intense activity can trigger chest pain or even a heart attack, Dr. Wamil says.

"Key warning signs of heart distress at festivals include chest pain or pressure, shortness of breath, dizziness, nausea, cold sweats, or fainting," Dr. Wamil adds. "These symptoms should never be ignored, and immediate medical help should be sought if they occur."

Noise exposure at outdoor concerts, carnivals and other events also can affect heart health.

"Short-term, loud noise can trigger the body's 'fight or flight' response, raising blood pressure and heart rate," Dr. Wamil says. "Long-term, chronic noise exposure has been shown to increase the risk of high blood pressure and heart disease."

Overindulging in alcohol, caffeine or salty food poses another serious risk. It can trigger holiday heart syndrome, in which even healthy individuals develop an irregular heartbeat, or atrial fibrillation, Dr. Wamil says.

"Alcohol is a direct toxin to the heart muscle and can cause a sudden rise in blood pressure," she explains. "For those with existing heart conditions, binge drinking can trigger heart failure or even a heart attack."

People with diabetes or heart disease should plan ahead when attending festivals and other events, advises Dr. Wamil, who specializes in the link between diabetes and heart disease. It's important to take medications on time, bring medical identification and carry essential supplies, such as snacks, water and a list of medications.

Keeping blood sugar stable with healthy food choices and staying hydrated can help prevent complications. Comfortable shoes and regular rest breaks are also key, especially for those with neuropathy or fatigue.

"If you have a heart condition or other serious medical issue, staying near the edge of crowds is a sensible precaution. It allows quicker access to medical help and an easier way out if needed," Dr. Wamil suggests. "Crowded environments can lead to overheating, anxiety or unexpected physical exertion, so choosing a shaded, quieter area can reduce risk."

For everyone, staying healthy during festival season means hydrating often, especially with water, and seeking out shade on hot days.

"Try to balance fun with rest, and include healthy foods when possible," Dr. Wamil says. "Protect yourself from the sun, pace your activities, and keep your phone charged in case of emergencies."

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About Mayo Clinic Healthcare
Mayo Clinic Healthcare, located in London, is a wholly owned subsidiary of Mayo Clinic, a not-for-profit academic medical center. Mayo Clinic is top ranked by U.S. News & World Report in more specialties than any other hospital for a reason: quality of care. Mayo Clinic Healthcare is the U.K.'s front door to that unparalleled experience. Visit Mayo Clinic Healthcare for more information.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Holiday heart: The overindulgences during festival season that put even healthy people at risk appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: When I go for a walk or to the gym, people always seem to be checking their pulse, whether by hand or with a wearable. Why is heart rate so important?

ANSWER: Your heart rate, or pulse, is the number of times your heart beats per minute. Your resting heart rate is when the heart is pumping the lowest amount of blood you need because you're not exercising. If you're sitting or lying down ― and you're calm, relaxed and aren't sick ― your heart rate is typically between 60 and 100 beats per minute. 

Other factors that can affect your heart rate include: 

• Air temperature 
  When temperatures or humidity increases, the heart pumps more blood, so your pulse or heart rate may increase. 
• Body position 
  Sometimes, when going from sitting to standing, your pulse may go up a little. After a few minutes, it should return to a typical rate. 
• Emotions 
  If you're stressed, anxious or incredibly happy, your emotions can raise your heart rate. 
• Body size 
  Body size usually doesn’t increase your heart rate. However, if you're obese, you may have a higher resting heart rate. 
• Medication use 
  Medications that block adrenaline tend to slow your heart rate. Thyroid medication may raise it. 

Why your heart rate matters 

Cardiovascular exercise, also called cardio or aerobic exercise, keeps you and your heart healthy. This specific type of exercise gets your heart rate up and your heart beating faster for several minutes. Cardiovascular exercise helps strengthen your heart, allowing it to pump blood more efficiently and improving blood flow to all parts of your body. It also boosts your high-density lipoprotein (HDL), or "good" cholesterol, and lowers your low-density lipoprotein (LDL), or "bad" cholesterol. This may result in less buildup of plaque in your arteries.

Abnormal heart rate 

If you experience irregular heartbeats, including a racing heartbeat, slow heartbeat or a feeling of fluttering in your chest, you may be experiencing a heart arrhythmia. Heart rhythm or heartbeat problems can occur when the electrical impulses that coordinate your heartbeats don't work properly, causing your heart to beat too fast, slow or irregularly. Talk with your healthcare team if you have heart rhythm concerns.  

Know your numbers 

Many wearable activity trackers can monitor your heart rate when you exercise and periodically throughout the day. If you don't have an activity tracker, you can use the radial artery in your wrist or the carotid artery in your neck. If you have heart disease or long-standing diabetes, it's best to use the artery on your wrist. 

To find your heart rate manually: 

• Locate the artery you will use to find your heart rate. 
• Using the tips of your first two fingers, press lightly over the artery. 
• Count your heartbeats for 30 seconds and multiply by 2 to find your total beats per minute.  

What's your target heart rate? 

Your target heart rate is the rate you need to maintain over a set amount of time to reach the energy level necessary to give your heart a good workout. The first step in finding the target heart rate that will maximize your cardiovascular exercise is determining your maximum heart rate. 

Your maximum heart rate is 220 minus your age. Your target heart rate for moderate to vigorous exercise is about 50%–85% of your maximum heart rate. 

A general guide for averages by age is: 

• 20: 100–170 beats per minute 
• 30: 95–162 beats per minute 
• 35: 93–157 beats per minute 
• 40: 90–153 beats per minute 
• 45: 88–149 beats per minute 
• 50: 85–145 beats per minute 
• 55: 83–140 beats per minute 
• 60: 80–136 beats per minute 
• 65: 78–132 beats per minute 
• 70: 75–128 beats per minute 

How to give your heart a good workout

Start slowly. 
If you’re beginning an exercise program, aim for the lower end of your target heart rate zone, and then gradually build up intensity. If your heart rate is too high, take it easier. If it's too low, add some intensity and push yourself to get your heart rate closer to your target.

Try interval training. 
Interval training, which includes short bursts of 15–60 seconds of higher-intensity exercise, alternated with longer, less strenuous exercise, effectively increases cardiovascular fitness. Talk with your healthcare team before trying interval training, but it’s typically safe for those with existing heart disease and type 2 diabetes. 

Take the "talk test." 
If you can carry on a conversation in brief sentences while exercising, you're probably in the moderate intensity range. You'll be breathing faster, developing a light sweat and feeling some muscle strain. If you're working at a vigorous intensity, you won't be able to say more than a few words without catching your breath. If you can sing while working out, you're probably in the low-intensity range, so step it up.

Xiaoke (Ken) Liu, M.D., Ph.D., Cardiovascular Medicine, Mayo Clinic Health System, La Crosse, Wisconsin

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DEAR MAYO CLINIC: I've been diagnosed with atrial fibrillation. I've read that it puts me at greater risk of stroke. Can you tell me more about this?

ANSWER: You may not have known you had atrial fibrillation (AFib) until your condition was discovered during a physical examination. For others, AFib can have life-altering symptoms that affect their ability to perform daily activities.

Atrial fibrillation is a common type of heart rhythm disorder where the heart doesn't beat efficiently. This makes the heart unable to pump enough blood out to the body with each heartbeat. It’s estimated 12.1 million people in the U.S. will be diagnosed with AFib by 2030.

Lowering stroke risk

People with AFib are at a higher risk of stroke — about 1 in 7 strokes are AFib related — due to clots that can form in the upper chambers of the heart. Of the strokes resulting from atrial fibrillation, 90% occur from clots originating in the left atrial appendage in the left atrium of the heart.

Key risk factors for stroke in people with atrial fibrillation include:

• Age
• Gender
• High blood pressure
• Prior history of stroke
• Chronic health conditions, including congestive heart failure, coronary artery disease and diabetes

Treating AFib

There are three main approaches to treating AFib. These are:

• Medical therapy for maintaining normal rhythm and preventing clots.
• Therapy to reset the heart rhythm, called cardioversion.
• Procedures to obtain and maintain normal heart rhythm. 

Medications.

Medications for treating AFib are the front line for managing symptoms and preventing stroke. These medicines can:

• Prevent blood clots.
• Control the speed of the heartbeat.
• Restore the heart rhythm.

This group of medications includes beta blockers, calcium channel blockers, digoxin, arrhythmics and anticoagulants. Your cardiology team will work together to determine which medication will work best for you.

Cardioversion.

Cardioversion is usually done in a hospital as a scheduled procedure. Patients may still need to take medicines for the rest of their lives to control their heart rhythm and prevent future episodes of atrial fibrillation. Even with medicine, AFib could return.

Procedural options.

People who are candidates for procedural options are cared for by a team of cardiologists, including cardiac electrophysiologists and additional specialists as needed. Potential procedures include:

• Left atrial appendage occlusion. The left atrial occlusion is a pouch-like extension of the heart. A minimally invasive procedure provides an alternative to long-term blood-thinner medications. It involves implanting a device, via a catheter, to close and seal off the left atrial appendage. This decreases the risk of blood clots entering the bloodstream, traveling to the brain or other body organs, and causing a stroke or organ damage. Patients typically leave the hospital the same day or the next day.

• Ablation. Ablation stops the generation of abnormal electrical signals in the heart and keeps it in normal, or sinus, rhythm. During ablation, a catheter is fed into the heart through the groin area using a minimally invasive approach and delivers heat or cold to modify the tissues in the heart that are causing the arrhythmia.

• Pulsed field ablation (PFA). PFA stands out from traditional atrial fibrillation (AFib) treatments due to its precision and safety. Unlike radiofrequency or cryoablation, which use heat or cold to destroy heart tissue, PFA uses short electrical pulses to target the myocardium, minimizing damage to the esophagus and nerves.

Benefits to patients include:

• Reduced procedure and anesthesia time
• Quicker recovery time
• Surrounding tissue protection

• Hybrid ablation. For people who have long-standing, persistent atrial fibrillation, ablation alone is successful half of the time. Hybrid ablation is an option for people with atrial fibrillation that's hard to manage or who have been in atrial fibrillation for more than a year. It combines the best of the catheter lab ablation and an open surgical approach.

The procedure is done in two parts:

• Part one is performed by surgeons with a scope inserted through a small incision under the breastbone to ablate the back side of the heart, followed by closure of the left atrial appendage.
• During part two, a catheter ablation modifies the tissues on the inside of the heart.

This whole-heart approach allows patients to return to normal rhythm with excellent results.

Vaibhav Vaidya, M.B.B.S., Gurpreet Singh, M.B.B.S., and Nishant Saran, M.B.B.S., Cardiology, Mayo Clinic Health System, Eau Claire, Wisconsin.

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