DEAR MAYO CLINIC: My neighbor spends a lot of time outdoors gardening and doing yard work, especially during the summer. Recently, after working outside on a hot day, she became lightheaded and noticed her heart racing. She suspected dehydration was to blame, but it made me wonder: Can dehydration affect your heart? When should symptoms like this be taken seriously? 

ANSWER: Dehydration can affect much more than your thirst. It also can place extra stress on your heart and cardiovascular system. 

Think of the heart as a pump. For it to work properly, enough blood needs to return to it with every heartbeat. When you become dehydrated, the amount of fluid circulating in your bloodstream decreases. That means less blood returns to the heart, so it has to work harder to keep blood moving throughout your body. 

Your body has several built-in ways to respond to dehydration. Blood vessels narrow to help maintain blood pressure, and your heart beats faster to keep blood moving. If dehydration becomes more severe, those usual responses can begin to fail. As a result, organs such as the brain, kidneys, liver and digestive system may not receive enough blood to function properly. 

Recognizing dehydration and knowing your risks

As dehydration worsens, symptoms can include: 

• Racing heartbeat or palpitations 

• Fatigue 

• Lightheadedness 

• Dizziness 

• Vision changes 

• Shortness of breath 

• Chest discomfort 

If dehydration becomes severe, it can lead to heatstroke or fainting. These are medical emergencies and should be evaluated by a healthcare professional immediately. 

Anyone can become dehydrated, but some people are at greater risk, including: 

• Older adults 

• Children 

• Athletes 

• Outdoor workers 

• People with heart disease 

• People taking certain medications, such as diuretics or GLP-1 receptor agonists 

People with heart failure or other forms of heart disease should be especially careful. Their hearts may have less reserve to respond to the added stress of dehydration. Many also take medications that remove fluid from the body, lower blood pressure or slow the heart rate, which can limit the body's usual ability to compensate.  

Staying hydrated and preventing compliations

There isn't a one-size-fits-all recommendation for how much water you need. For most healthy people, thirst is a reliable guide. If you feel thirsty, drink something. If you know you'll be spending time outdoors in the heat or exercising for an extended period, increase your fluid intake beforehand. 

Dehydration isn't always easy to recognize, so it helps to look for other signs. Dry mouth, dry skin, dark urine, foamy urine or a burning sensation when you urinate may all indicate you need more fluids. One of the simplest ways to monitor your hydration is to pay attention to the color of your urine. Pale or clear urine generally suggests you're well hydrated, while darker urine may be a sign that you need more fluids. 

Water is an excellent first choice for staying hydrated, but if you're truly dehydrated, water alone may not always be enough. Your blood contains electrolytes such as sodium, potassium and magnesium. Drinking water along with consuming something salty may help replace both fluids and electrolytes. People participating in prolonged exercise or endurance activities also may benefit from electrolyte-containing sports drinks. 

Alcohol is a large contributor to dehydration because it changes how the brain and kidneys regulate fluids and can increase fluid loss. Highly caffeinated drinks also can contribute to dehydration. If you're trying to rehydrate, choose water or electrolyte-containing drinks instead of sugary drinks or soda. 

The best way to prevent dehydration is to stay ahead of it. Make drinking fluids a regular part of your day. Drinking smaller amounts throughout the day is often more effective than consuming a large amount all at once. If you'll be gardening, exercising or working outdoors in hot, humid weather, plan ahead, stay aware of how you're feeling and adjust your activities if needed. 

Most importantly, know your personal risk. If you're older, have heart disease or take medications that affect your body's fluid balance, you may need to pay especially close attention to staying hydrated. Planning ahead, listening to your body and recognizing the signs of dehydration can help protect your heart and your overall health. 

Brodie R. Marthaler, M.D., Cardiology, Mayo Clinic Health System, Eau Claire, Wisconsin  

The post Mayo Clinic Q&A: How does dehydration affect the heart? appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My father frequently experiences heartburn, but sometimes I worry that what feels like heartburn to him could be a heart attack. How can you tell the difference, and when should someone seek emergency care? 

ANSWER: Many people worry that heartburn-like symptoms could be a heart attack — and that concern is understandable. Heartburn and chest discomfort caused by a heart problem can sometimes feel remarkably similar. Although there are important differences between the two, the symptoms can overlap enough that it isn't always possible to tell the difference without a medical evaluation. 

One reason the distinction is difficult is that internal organs don't signal pain the same way muscles, bones and joints do. If you stub your toe, your brain quickly recognizes where the pain is coming from. But the heart, esophagus, lungs, and even the muscles and joints of the chest can all cause discomfort in a similar area. Because those sensations overlap, it can be hard to know where the pain is coming from. Even healthcare professionals often need to get additional information from a good physical examination, an electrocardiogram (ECG or EKG), blood work and other testing to determine the source of the symptoms. 

Heartburn is most commonly caused by acid reflux, which occurs when stomach acid flows back into the esophagus. It typically causes a burning sensation behind the breastbone and may leave a sour or acidic taste in the mouth. Symptoms often develop after eating and may become worse when lying down or bending over. Certain foods and beverages, large meals, excess weight, tobacco use, and lying down soon after eating all can increase the likelihood of heartburn. 

Heart-related chest discomfort has some characteristic features, although symptoms can vary from person to person. Many people describe pressure, heaviness, squeezing or tightness in the center of the chest rather than a burning sensation. A common misconception is that every heart attack causes sudden, severe chest pain. While some people experience symptoms that way, others notice milder pressure or fullness instead. The discomfort also may spread to the shoulders, one or both arms, neck, jaw, back, or upper abdomen. And it may occur with shortness of breath, nausea, lightheadedness or dizziness. 

Some symptoms make a heart problem less likely. Chest pain that's very sharp, lasts only a few seconds, changes when you take a deep breath or moves from one location to another is generally less suggestive of a heart problem. However, that doesn't necessarily mean it's harmless. Conditions affecting the lungs, major blood vessels or digestive system also can cause chest pain and may require prompt medical evaluation.  

If your chest discomfort is new, different from your usual symptoms or occurs with shortness of breath, nausea, dizziness or pain that spreads to the arm, jaw, neck or back, call 911 or seek emergency medical care right away. Don't wait to see whether an antacid relieves the symptoms or assume they will simply pass. 

It's also important to remember that heartburn and heart disease aren't mutually exclusive — many people have both. Having a history of heartburn or acid reflux doesn't rule out the possibility that new chest discomfort could be related to your heart. Likewise, frequent heartburn shouldn't be ignored simply because it isn't an emergency. Persistent reflux symptoms can signal an underlying digestive condition that may require evaluation and treatment. 

If you're unsure whether you're experiencing heartburn or a heart problem, don't try to diagnose yourself. It's far better to be evaluated and learn your symptoms weren't caused by your heart than to delay treatment for a condition that could be life-threatening. 

Andrew Calvin, M.D., Cardiology, Mayo Clinic Health System, Eau Claire and Bloomer, Wisconsin 

The post Mayo Clinic Q&A: Heartburn or heart attack? How to tell the difference appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I've seen emergency defibrillators in public places, but I've also heard that some people need to wear them or have them implanted for heart rhythm problems. Can you explain the differences? 

ANSWER: Pacemakers and defibrillators are devices that help manage heart rhythm problems, but they work differently. 

A pacemaker helps the heart when the rhythm is too slow or irregular. A defibrillator is a specialized pacemaker designed to treat life-threatening heart rhythms that are dangerously fast or chaotic. It acts by shocking the heart out of a dangerous rhythm. 

Sometimes people unexpectedly have an irregular heartbeat that can cause sudden cardiac death or unconsciousness. During this emergency situation, the heart stops or quivers uselessly and is unable to pump in a coordinated way.   

That's when an automated external defibrillator (AED) can be lifesaving. These are the portable devices you see in airports, schools, gyms and other public places. An AED analyzes a person's heart rhythm during sudden cardiac arrest. If it detects a dangerous rhythm, it delivers an electrical shock to help the heart return to a normal rhythm.  

While people who take CPR courses learn how to use an AED, the devices also provide simple step-by-step instructions, including written, picture and voice prompts, so that a bystander can use one in an emergency.  

Defibrillators also can be worn or implanted. In general, they are used for people who are at higher risk of dangerous heart rhythms, including: 

• Those with heart conditions, such as a weakened heart muscle (also called cardiomyopathy), low pumping function or a history of heart attack. 
• Those born with electrical abnormalities of the heart, called channelopathies, or other inherited heart conditions. These can sometimes affect younger people, including athletes, and may cause fainting, sudden cardiac arrest or sudden cardiac death.  

A wearable defibrillator looks like a vest and is worn under clothing. It continuously monitors the heart rhythm and can deliver a shock if it detects a life-threatening rhythm. It's usually worn temporarily, often while a care team is deciding whether a person needs a permanent, implanted device or while the heart is recovering.  

An implantable cardioverter-defibrillator (ICD) is a permanent device placed inside the body. It monitors the heart rhythm and can deliver treatment if a dangerous rhythm occurs. Some ICDs are placed under the skin in the chest, with one or more wires, called leads, connected to the heart.  

Recovery after ICD placement usually takes about four to six weeks. During that time, patients may need to limit certain arm movements, especially on the side where the device was placed, and watch for signs of infection or increasing pain around the incision.  

After recovery, most people return to their usual daily activities. However, they should avoid strong magnetic fields and certain activities, such as arc welding, unless their care team says it's safe. 

Most patients aren't aware of their defibrillator unless it delivers treatment. If a person is unconscious when a shock occurs, they usually don't feel it. If they're awake, the shock may feel like a sudden jolt or kick in the chest. It can be startling, but it's meant to save a life. In some cases, people may not feel the shock at all, and the event is only found later during a device check. 

Anyone who feels a shock from their defibrillator, or is notified by their healthcare team that a shock occurred, should contact their care team for further evaluation. The device may need to be checked, and medications or other parts of the treatment plan may need to be adjusted. 

There's another type of device therapy called cardiac resynchronization therapy (CRT), which may include features of a pacemaker or defibrillator. It's used for some people with moderate to severe heart failure whose lower heart chambers don’t beat in a coordinated way. 

When the heart’s pumping chambers are out of sync, the heart may not pump blood as efficiently. CRT helps coordinate the timing of the heartbeat. 

As with implanted pacemakers or defibrillators, CRT implantation requires a minor surgical procedure to place a device in the chest, and the recovery and post-procedure care are similar. There are two main types: 

• Cardiac resynchronization therapy with a pacemaker (CRT-P). This device sends electrical signals to help the lower chambers of the heart beat together. 
• Cardiac resynchronization therapy with a defibrillator (CRT-D). This device combines resynchronization pacing with defibrillator protection. It may be recommended for people with heart failure who also are at risk for sudden cardiac death. 

Defibrillators, whether they're used in public places, worn temporarily or implanted permanently, are designed to protect people from dangerous heart rhythms. They can be lifesaving, helping people live more safely and confidently. 

Divya Korpu, M.B.B.S., Cardiology, Mayo Clinic Health System, Eau Claire, Wisconsin 

The post Mayo Clinic Q&A: How is a defibrillator different from a pacemaker? appeared first on Mayo Clinic News Network.

After years of testing performed at multiple hospitals that could not explain his intense, and sometimes painful, symptoms, long-distance runner Mike Singh found answers through an athlete-specific approach at Mayo Clinic, helping him adapt his routine and continue running. 

A marathon moment that raised questions 

In November 2018, long-distance runner Mike Singh was competing in a marathon when he suddenly felt that something was not quite right. 

"I was on mile 22 or 23,” Mike remembers. "All of a sudden, I felt sort of out of breath, lightheaded. I thought I was having a heart attack." 

However, as a confident athlete who had completed many races, Mike kept going and finished the race without further incident. 

It would not be a one-time experience, though. The symptoms would often return during Mike's runs, usually when he pushed himself at longer distances. 

More than just exercise 

Running is, and has long been, a central part of Mike's routine. 

"It's not just exercise for me," he says. "Running is a huge part of my life and identity. The thought of losing that was a lot to process." 

Mike runs daily and trains for races throughout the year. So when something did not feel right during that 2018 marathon, it stood out significantly to him. 

Years of tests, no answers 

Early on, Mike sought care at multiple hospitals and medical centers, undergoing extensive testing. 

Despite numerous evaluations, the results always came back the same — no explanations, no real answers. Still, the symptoms continued during Mike's long runs, and so did the uncertainty. 

"I passed all those clinical tests with flying colors," Mike says. "But all that did was leave me with questions, unanswered questions." 

Up to that point (nearly four years into Mike's medical odyssey), no one had been able to re‑create the symptoms he experienced while running. 

Mike decided to visit the Mayo Clinic Sports Cardiology Clinic in Rochester, Minnesota, hoping a different approach could finally explain what others could not. 

Re-creating the run 

At Mayo Clinic, the Sports Cardiology team met Mike and focused on understanding when and how his symptoms occurred. As Mike described the clinical signs, the team immediately identified one key detail: Mike's symptoms typically began several miles into his long-distance runs. 

Instead of relying on standard tests, the team focused on re-creating the exact conditions that triggered his specific symptoms. 

"If symptoms are not reproduced on a stress test, you can't definitively say the test is negative," explains Nadia Elfessi, a physician assistant on Mike's care team in Sports Cardiology. 

"My care team said, 'Let's just do whatever is necessary to re-create those symptoms,'" Mike says. 

 To do that, Mike ran long enough to trigger the exact symptoms he experienced during long-distance races. Then, while those symptoms were still occurring, the Mayo Clinic team moved immediately into testing. 

Because Mike's symptoms had eluded diagnosis for years, the team also developed a customized testing protocol to evaluate whether abnormal vagus nerve activity was contributing to the problem. Drawing on Mayo Clinic's expertise in cardioneural ablation, specialists temporarily blocked vagal activity with medication and had Mike exercise again under carefully monitored conditions. 

For the first time, the team was able to observe changes in Mike's heart rhythm as they happened. While the testing ruled out vagus nerve overactivity as the cause of Mike's symptoms, it revealed an underlying problem with his heart's electrical conduction system, helping the team arrive at a diagnosis and management plan tailored specifically to him. 

Finding the cause 

Now, Mike had an answer.  

"They adapted the protocols to fit my situation," Mike says. 

Dr. Guru Kowlgi, a cardiac electrophysiologist at Mayo Clinic, says the team's approach focused on recreating the exact conditions that triggered Mike's symptoms — something that had not happened during years of previous testing. 

Once the symptoms were reproduced, the team identified a disruption in the electrical communication between the heart's upper and lower chambers that occurred only during intense exertion. The findings led to a diagnosis of exercise-induced chronotropic incompetence, a rare condition in which the heart cannot appropriately increase its rate during physical activity. 

"It took a level of creativity and time that went beyond a standard evaluation," Dr. Kowlgi says. 

Why it was difficult to detect 

Exertion made the difference. 

"High-level athletes, like Mike, may only experience symptoms when they're pushing themselves at nine-tenths or even ten-tenths of maximal performance," says Dr. Darrell Newman, a cardiologist and director of Mayo's Sports Cardiology Clinic. 

Choosing a path forward 

With a diagnosis in hand, Mike's medical odyssey was over. He now had options. He now had hope that he could possibly pursue his love of running throughout the rest of his life. 

One option was a pacemaker to help regulate Mike's heart rhythm, but it was unclear whether it would improve his symptoms enough to return him to his desired level of performance. Rather than pursue a pacemaker, Mike chose a personalized management plan focused on adjusting his training and monitoring his symptoms during exercise. As part of that approach, he uses wearable technology to track his heart rhythm and capture electrocardiogram (ECG or EKG) recordings that he can share with his Mayo Clinic care team. 

Still running — with a different approach 

Today, Mike still runs regularly, but his approach has changed. 

"It's a little bit of an inversion," he says. "Instead of my heart adjusting to my level of effort, I have to do the opposite and adjust my level of effort to my heart rate." 

"I can take that ECG, send it to the Mayo team and get pretty quick feedback," he says. 

Today, Mike continues to run (and compete), adjusting his effort but not giving up. 

"I'm still able to do it," Mike says. "Working with the experts at Mayo Clinic, I am able to continue living my lifestyle. I just enjoy running so much. It is a huge part of my life, and the Mayo care team was able to give that back to me."  

A new understanding 

For Mike, having answers made the difference. 

"It wasn't a simple answer, and not having any answers after so many years of searching can be defeating and also disheartening," Mike says. "But having this team of experts at Mayo just take time with me, work with me and find the information changed everything. In a manner of speaking, they saved my life, and they've allowed me to continue living that life." 

Today, Mike continues to run (a lot), adjusting his effort but not giving up the part of his life that matters so much to him. 

The post Racing to find answers: Yearslong search lands Mike Singh at Mayo Clinic  appeared first on Mayo Clinic News Network.

A simple 10-second heart test with the aid of artificial intelligence is helping physicians detect a serious, often-overlooked disease.

For Rochester businessman Mike Busch, that technology proved life-changing. After months of unexplained symptoms, an AI-enhanced ECG helped doctors at Mayo Clinic quickly uncover a diagnosis that might otherwise have been missed.

Watch: AI-ECG helps physicians detect hidden heart condition

Journalists: Broadcast-quality video (2:31) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

At the age of 77, Mike Busch says he has no plans for retirement.

"I still work full time," he says.

Spending time with Carol, his wife of 51 years, running his business and promoting youth wrestling in the region means Mike is always on the go.

But in 2023, his health became a concern.

"I wasn't feeling well for a few months, felt like somebody was sitting on my chest," Mike says. "I kind of lost my balance and kind of fell a little bit. I knew I had to probably go in and see somebody. I had been putting it off too long, and went into Mayo."

His doctor ordered an electrocardiogram, or ECG. It's a simple 10-second test that records the heart's electrical signals. Unbeknownst to Mike, he had developed a heart condition called cardiac amyloidosis.

"Cardiac amyloid is a condition where abnormal proteins deposit in the heart. It makes the heart stiff and causes problems with heart failure," says Dr. Martha Grogan, a cardiologist and director of the Cardiac Amyloidosis Clinic at Mayo Clinic in Rochester, Minnesota.

"I kind of suspected something, but I didn't think it was that serious," Mike says.

His doctors were able to quickly diagnose him, thanks in large part to AI.

"Artificial intelligence, isn't it? I think," Mike says. "I'm not sure."

"The algorithm that we have to detect amyloid was strongly positive. Our scale goes from zero to 100, and he ranked a 98," says Dr. Grogan.

"It begins to learn what the patterns are, and then when it's all done, we can give it an unknown ECG and say, 'Is the pattern that suggests amyloid heart disease present, yes or no?' And it's a very powerful classifier. It can see signals that are hidden to humans," says Dr. Paul Friedman, a cardiologist and Norman Blane and Billie Jean Harty Chair, Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D., at Mayo Clinic in Rochester, Minnesota.

That's vital for patients with cardiac amyloidosis, which is often misdiagnosed as other types of heart problems, delaying important treatment.

"I couldn't believe it, put it that way," Mike says.

This AI-ECG tool was developed at Mayo seven years ago and recently received FDA clearance.

"Since the introduction of the AI-ECG at Mayo Clinic, it's now been used over a million times by clinicians in screening for various heart conditions," says Dr. Friedman. "It's a powerful test, and it can have us point not our stethoscope but maybe our looking glass in the right direction, so we don't miss things that are important and that are treatable."

Mike takes his medication, continues to follow up with his doctors, and still stays busy.  

"I don't see any changes as far as my work ethic goes," he says. "I'm fortunate to be where I'm at, and I'm happy with Mayo Clinic and what they've done."

The post AI-ECG helps physicians detect hidden heart condition (VIDEO) appeared first on Mayo Clinic News Network.

Life on the mat 

For Casey Lamb, the mat has never just been a place to compete. It's where he's spent more than four decades teaching, mentoring and testing himself.

 "It's really who I am," Casey says.  

As a Brazilian jiu-jitsu instructor, gym owner and lifelong competitor, Casey's life has long revolved around helping others grow through the sport he loves. Then chest tightness during training forced him to imagine a future without the life he had spent decades building. 

A diagnosis that raised difficult questions 

While ramping up training at his Rochester, New York, gym for an upcoming jiu-jitsu competition and staying active with his children's wrestling, Casey began experiencing chest tightness and pressure. Having seen friends and students suffer serious heart-related emergencies, he decided not to ignore the warning signs. Hoping for reassurance and a quick return to training, he sought care at his local hospital. 

Instead, he left with an unexpected diagnosis: an ascending aortic aneurysm, a dangerous weakening of the body's largest artery that can tear or rupture without warning. 

Just as devastating for Casey, the diagnosis meant he was told to stop competing and avoid the heavy exertion that had defined both his work and personal life. 

At about 4.7 centimeters, Casey's aneurysm fell below the size threshold at which surgery is typically recommended. Physicians usually continue monitoring an aneurysm until it reaches 5 centimeters or larger. 

Until then, treatment often focuses on reducing risk through lifestyle changes, including avoiding heavy lifting and limiting strenuous activities that can place additional strain on the aorta. 

For Casey, avoiding strenuous activity wasn't a temporary inconvenience. Coaching, training and competing in jiu-jitsu were central to his livelihood and daily life.  

"I'd rather have 15 years doing what I love than 30 years miserable sitting in a chair," Casey says. 

For Casey, the diagnosis threatened far more than his health. It jeopardized the identity he had spent most of his life building. 

Searching for another option 

That conviction led Casey to seek another opinion at Mayo Clinic in Rochester, Minnesota. 

There, the conversation shifted. Instead of focusing only on the size of Casey's aneurysm, specialists from cardiology, vascular medicine, sports cardiology and cardiovascular surgery worked together to understand the person behind the diagnosis — his profession, his goals and the life he hoped to return to. 

Although his aneurysm had not yet reached the standard threshold for surgery, the demands of his life as a coach, competitor and gym owner called for a more individualized approach. 

"Guidelines are essential," says Dr. Thais de Azeredo Coutinho, a Mayo Clinic cardiologist and vascular medicine specialist in the Mayo Clinic Aortic Center. But they don't replace individualized care. Some patients deserve a closer look because their circumstances aren't fully captured by the guidelines. This was Mr. Lamb's situation." 

"It wasn't, 'Here's what you have to do,'" Casey says. "It was, 'Here are your options. What do you want to do?'" 

Rather than asking him to walk away from the sport, Casey's Mayo Clinic care team focused on helping him understand the risks, weigh his options and choose the path that aligned with his goals. 

"Let's figure out how to get you back doing what you want to do," Casey recalls. "We'll tell you the risks; we'll make the risks as low as possible; we'll let you know what they are; and you make the decisions." 

For the first time since his diagnosis, Casey saw a path forward — one that didn't force him to choose between protecting his health and preserving the life he loved. 

After weighing the risks with his care team, Casey decided surgery offered the best chance to continue the activities he wanted. 

A surgery built around his goals 

The expertise and collaboration he experienced at Mayo Clinic gave him confidence in that decision. 

"I believed I was at the best place to have this procedure, with the best surgeon and the best team," Casey says. 

Dr. Gabor Bagameri, a Mayo Clinic cardiovascular surgeon who specializes in complex aortic surgery, repaired the enlarged section of his ascending aorta while preserving his native aortic valve. 

"Our goal wasn't simply to repair the aneurysm," Dr. Bagameri says. "It was to repair it in a way that gave him the best opportunity to safely return to the life he valued." 

For Casey, the operation wasn't simply about repairing his aorta. It was about preserving something equally important: the opportunity to return to coaching, competing and the community he had built on the mat. 

Back to training 

Recovery didn't end after surgery. Working with Mayo Clinic's Sports Cardiology team, Casey gradually rebuilt the strength and confidence needed to return to high-level competition.   

Every walk, every rehabilitation milestone and every workout brought Casey one step closer to a single goal: getting back on the mat. 

"I knew if I made it through surgery, I would get back to where I was because that was the plan we had put together," Casey says.  

Just three months after surgery, that plan became reality. Casey stepped back onto the mats — not as someone watching from the sidelines but as a coach, mentor and athlete once again. 

"I was back on the mats," Casey says. "I was teaching classes. I was training again." 

For the first time since his diagnosis, Casey wasn't wondering what he might lose. He was back doing what he loved. 

His students once again had their longtime coach leading classes, demonstrating techniques and training alongside them. Stepping back onto the mat wasn't simply a return to training, it was proof that the future he feared might slip away was still within reach. 

"For someone like Casey, it's about helping him return to the activities that matter most while understanding the risks involved," says Dr. Kathryn Larson, a Mayo Clinic sports cardiologist who helps athletes safely return to activity after heart conditions and procedures. 

Looking ahead 

Nearly two years after surgery, Casey says he finally feels like himself again. 

Today, Casey continues coaching, training and preparing for future competitions, including a return to the World Master Jiu-Jitsu Championship. 

The chance to pursue those goals again is something he doesn't take for granted. 

"It's just the fact that I've gotten back to it at that level," Casey says. "Doing what I love and what I've gone through, in itself, it's a victory." 

For a man who once feared he might never return to the mat, stepping back onto it became more than a comeback. It became proof that personalized care can help restore the life that matters most. 

The post Personalized heart care helps a martial arts instructor return to competition  appeared first on Mayo Clinic News Network.

World Brain Day is July 22

SCOTTSDALE, Ariz. — The same lifestyle choices that reduce your risk of heart disease, diabetes and cancer also can reduce your risk of cognitive decline. Bryan Woodruff, M.D., a cognitive neurologist at Mayo Clinic in Arizona, explains the brain-body connection, lifestyle changes to foster brain health and why work to make earlier detection of Alzheimer's disease and other dementias is important.

“What’s good for your overall health is good for your brain too,” Dr. Woodruff says.

You may have heard that Alzheimer’s disease is caused, in part, by the buildup of beta-amyloid plaques and twisted tau proteins in the brain. While true, other brain changes also are likely involved, Dr. Woodruff says.

“When scientists look at the brains of people with Alzheimer’s disease after they’ve died, they find more than just plaques and tangles,” he adds.

They often find a buildup of fats, cholesterol and other substances in the vessels that supply blood to the brain. They also discover evidence of microscopic strokes — also called microinfarctions.

Unlike major strokes with noticeable symptoms such as facial drooping, physical numbness, a severe headache and trouble speaking, microscopic strokes are silent. As more occur, they can starve brain tissue of oxygen and nutrition. If enough microvascular changes occur, there may be symptoms like slowed thinking and trouble concentrating.

“Your brain, as with every other organ in your body, depends on your cardiovascular system,” Dr. Woodruff says: This is why it’s so important to care for your heart and blood vessels.

Lifestyle choices help reduce risk

Thanks to this connection, what benefits your heart also protects your brain. To get these benefits:

• Manage heart disease risk factors. Treat elevated blood sugar, high blood pressure and undesirable cholesterol levels. Don’t use tobacco products. Keep your weight in the healthy range. “The earlier you address these, the better the benefit is for your brain,” Dr. Woodruff says.

• Follow a heart-healthy diet. The Mediterranean diet's emphasis on minimally processed whole foods and fruits and vegetables may improve brain health by helping to keep body fat and chronic inflammation in check. The Mayo Clinic Diet takes a similar approach to establishing a healthy-eating lifestyle.

• Get enough sleep. Research has linked insomnia to cognitive decline. And poor sleep can also increase your risk of other diseases that can impact cognition, such as high blood pressure and diabetes.

• Maintain social connections. Social connections are thought to benefit the brain in many ways. Research suggests that social engagement triggers the release of chemicals such as serotonin and dopamine, which improve mood and outlook. Social connections may help to spur the growth of new connections between nerve cells.

• Treat hearing and vision loss. If you can’t see and hear what’s going on around you, you’ll find it more difficult to communicate and remain social. “Those sensory functions are integral to how we think and interact with the world,” Dr. Woodruff says. “If you don’t see or hear it, then you can’t encode and remember it.”

• Avoid chronic use of sedating medications. Some medicines used to treat pain, insomnia and other conditions can dull thinking, slow reaction time and make you feel sleepy. If you’re not sure of the side effects of the medications you take regularly, talk with your healthcare professional, who can look at what is on your medication list and suggest alternatives, Dr. Woodruff advises.

• Exercise. Physical and mental exercise can benefit brain health. A large study found rates of cognitive decline were twice as common in sedentary people.

Keeping your mind active through activities you find enjoyable, particularly trying new things, can also exercise your brain. When you have difficulty learning something new, your brain builds new connections between nerve cells. If you continually learn new skills and information over time, experts believe that these networks of nerve cell connections create a cognitive reserve, sort of like savings in a bank account.

“Cognitive reserve doesn’t mean you’re immune,” Dr. Woodruff says. “But it buys you some cushion against a neurodegenerative problem.”

The importance of early detection

Dr. Woodruff is among Mayo Clinic researchers working to make earlier diagnosis of dementia and its precursor mild cognitive impairment possible, to allow for earlier treatment. This will be essential if therapeutic advances eventually make it possible to slow or even halt progression, he says.

It is never too late to make lifestyle changes to protect and improve brain health, he adds: “I tell all my patients, regardless of the severity of their cognitive decline, to take care of their overall health."

For more information about brain health, visit Mayo Clinic Press and the Mayo Clinic News Network.

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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 Brain-body connection: Expert shares tips to reduce risk of cognitive decline, Alzheimer’s disease appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My neighbor is in his 60s and has spent years competing in marathons and long-distance cycling events. Despite being in excellent shape, he recently learned that he has a high coronary calcium score. I thought endurance athletes were less likely to develop heart disease? I'm in my 50s, run regularly and am training for a half-marathon. Should I be worried about this? 

ANSWER: It's understandable to wonder how this can happen. Regular exercise is one of the best things you can do for your heart. It lowers the risk of heart disease, improves blood pressure, helps control weight and supports overall health. 

However, being physically fit doesn’t make someone immune to heart disease. A coronary calcium score can help identify people who may be at increased risk despite having an active lifestyle. 

A coronary calcium score measures calcium buildup in the arteries that supply blood to the heart. The test uses a CT scan to identify calcified plaque, which is a marker of atherosclerosis, also known as hardening of the arteries. 

The score helps estimate a person's future risk of heart disease and provides additional information about overall cardiovascular health. In general, a score of 0 is associated with a lower likelihood of future heart disease than higher scores. Scores above 100 suggest a higher risk, while scores above 300 may lead healthcare professionals to recommend treatment or other steps to lower that risk. 

It's important to understand what the test does and does not show. A high score doesn’t mean a heart attack is about to happen, nor does it automatically mean an artery is blocked. Some people have elevated calcium scores but still have enough blood flowing to the heart and may not experience any symptoms. Instead, the score can help guide decisions about prevention, treatment and follow-up care. 

Researchers continue to study why some older endurance athletes have higher coronary calcium scores than people who participate in moderate levels of exercise. While this finding has been observed in studies, more work is needed to understand why it occurs and what it means for long-term cardiovascular health. 

At the same time, people who regularly participate in endurance activities generally have lower rates of heart-related problems than those who are sedentary and tend to have better overall cardiovascular fitness. Even so, some highly active people still develop elevated calcium scores despite years of regular exercise. 

A high calcium score shouldn’t be viewed as a reason to stop exercising. Instead, it should prompt a discussion with a healthcare professional about your overall risk for heart disease. 

The score is only one piece of the puzzle. Other important factors include: 

• High cholesterol. 

• High blood pressure. 

• Diabetes. 

• Obesity. 

• Smoking history. 

• Family history of heart disease. 

• Dietary habits. 

Many of these risk factors can be managed through lifestyle changes, medications or both. Addressing them can help lower overall cardiovascular risk and support long-term heart health. 

Depending on your symptoms and other risk factors, your healthcare team may recommend additional testing, such as a cardiac stress test. 

If you notice any of the following symptoms during physical activity, even if you otherwise feel healthy and active, talk with your healthcare team: 

• Chest pain or pressure. 

• Unusual shortness of breath. 

• Symptoms that seem unusual for your normal level of activity. 

The most important takeaway is simple: Don't stop exercising. Instead, use the results as an opportunity to better understand your heart health and work with your healthcare team to address any modifiable risk factors. Understanding your overall risk for heart disease and taking steps to lower it can help you continue exercising safely for years to come. 

Gurpreet Singh, M.D., Cardiology, Mayo Clinic Health System, Eau Claire, Wisconsin 

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A routine mammogram may do more than detect breast cancer, it also could help identify early signs of heart disease.

Heart disease is the leading cause of death among women, responsible for 1 in 3 deaths. It often develops without symptoms until a major event occurs. Despite this, there is not a standard for annual heart disease screening, a critical gap in early detection for women.

Doctors typically assess heart disease risk using factors like cholesterol, blood pressure and body weight. These tools don't fully account for how heart disease develops differently in women or what's happening inside the blood vessels themselves.

A missed opportunity in routine mammograms

Mayo Clinic recommends women at average risk begin annual mammogram screening at age 40, and most women do. Researchers say this creates an opportunity to assess heart disease risk during a test many women already receive without additional radiation or testing.

Breast arterial calcification (BAC) is captured during a mammogram. For two decades, studies have demonstrated that it can be used to help identify patients at risk for heart disease. However, the challenge has been measuring it accurately and consistently, and assigning a value to it.

"BAC is difficult to measure because it appears as a very subtle finding on standard 2D mammograms and cannot be consistently quantified by eye, even by experts. As a result, it typically requires specialized computational methods to reliably detect and measure it," explains Dr. Imon Banerjee, scientific director of the Arizona Advanced AI and Innovation Hub at Mayo Clinic. "AI allows us to measure these calcium deposits quickly and more accurately than before."

Large study shows strong link to risk

A retrospective cohort study published in the European Heart Journal included more than 120,000 women who had screening mammograms at two healthcare systems. They evaluated whether AI-derived BAC measurements could help clinicians predict a woman's risk of cardiovascular disease and death, independent of traditional risk factors. Researchers note the study was observational and evaluated associations between BAC and future cardiovascular outcomes.

"Breast arterial calcification occurs when calcium builds up in the walls of the arteries within breast tissue," says Dr. Banerjee. "Calcium seen on mammograms correlates with calcification in other parts of the body. This type of calcium in the breast is different from calcium in the heart. Instead of blocking blood flow, it makes the blood vessels stiffer and less flexible, signaling a higher risk of heart problems because it affects how blood moves."

Using a deep learning model, the team developed a tool that identifies calcium deposits, measures their extent and classifies severity. Researchers then tracked whether higher levels were associated with cardiovascular events or death over time.

The findings were significant. Women with severe BAC had more than 10 times the risk of developing a cardiovascular event within five years compared to those with no or mild BAC. The model was validated across 12 institutions, comparing AI-generated measurements with radiologist assessments. The AI model is now undergoing Food and Drug Administration review.

WATCH: Dr. Imon Banerjee - AI can accurately measure heart disease risk

 Journalists: Broadcast-quality sound bites are available in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Name super/CG: Imon Banerjee, Ph.D./ Radiology /Mayo Clinic.

Moving towards clinical use

"We created an AI algorithm that allows us, with a single click, to measure BAC. It can now easily be added to the radiologist's report," Dr. Banerjee says. "That measurement becomes a new input for the prediction models. This could completely change the screening workflow for women and improve early detection of heart disease."

Adoption remains the next challenge

"The challenge with BAC is that we have the algorithm, we have the validation, we know that it works. Now, how do the institutions adopt it?" acknowledges Dr. Banerjee. "There are currently no clinical regulations of BAC. Mayo Clinic physicians are translating this research into practice."

Teams across Cardiovascular Medicine, Primary Care, Women's Health and Radiology at Mayo Clinic's Arizona and Florida campuses are working to integrate the technology into clinical practice and develop a framework for broader use before expanding to all Mayo Clinic sites.

Related article: How researchers are using AI to accelerate the path to cures (VIDEO)

The post Mammograms may help identify heart disease risk (VIDEO) appeared first on Mayo Clinic News Network.

Tony Wazwaz was told he had days to live — until an innovative treatment approach at Mayo Clinic brought his heartbeat back into rhythm.

Tony Wazwaz is in his kitchen, cooking for his family. Clipped to his belt, two battery packs hum softly, powering the mechanical pumps inside his chest. One helps move blood to his body. The other to his lungs. Together, they do the work his heart no longer can. He takes his medications, sees his healthcare team regularly, and follows the routines that now keep him alive.

"It isn't easy," Tony says, "but I've never been more grateful."

Not long ago, his doctors in Minneapolis told the 44‑year‑old husband and father of two that no further treatment options remained. After months in and out of the hospital, his condition worsened as both sides of his heart began to fail. Fluid filled his lungs. Swelling spread through his body. Medications and temporary support devices no longer worked.

He was not a candidate for a heart transplant. Doctors told him he had about 10 days to live, and to go home to say goodbye to his family.

"That was the end of the road. There was no more road," Tony says. "But something inside me told me, 'You've got to keep fighting.'"

A new road ahead

Watch: Mayo Clinic performs its first dual mechanical heart pump procedure, giving father of two a path to transplant

Journalists: Broadcast-quality video (2:54) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

At his mother's urging, he asked for a referral to Mayo Clinic. He made the call, got in the car and they drove to Rochester, Minnesota. He arrived in cardiogenic shock, a life-threatening condition in which the heart can no longer pump enough blood to sustain the body.

Within minutes of reaching the emergency department, his heart stopped.

"I flatlined," he says. "But when I woke up, I was in the ICU at Mayo Clinic, surrounded by a team already working to find a way forward."

Leading that team was Dr. Mauricio Villavicencio, surgical director of Heart and Lung Transplantation and Mechanical Circulatory Support at Mayo Clinic.

Dr. Villavicencio and his team moved quickly to stabilize Tony, ultimately placing him on extracorporeal membrane oxygenation, or ECMO, a form of life support that circulates blood outside the body, allowing the heart and lungs to rest.

"ECMO can keep you alive," Dr. Villavicencio says. "But it doesn't get you out of the ICU. The goal is to find a way to transition to something that allows the patient to recover, leave the hospital and move forward."

For many patients, that path involves a left ventricular assist device, or LVAD, a mechanical pump designed for long-term use that helps the heart move blood through the body. But those devices are designed to support the left side, the heart's main pumping chamber. Durable options to support the right side of the heart are limited. When both sides of the heart are failing, as in Tony's case, there are often no viable treatment options.

'Sign me up'

Dr. Villavicencio proposed something that had never been done at Mayo Clinic: implanting two durable LVADs, one to support each side of Tony's failing heart. He believed the paired devices could get him off ECMO, out of the ICU and potentially onto a path toward heart transplant eligibility.

Around Tony, a multidisciplinary team of surgeons, cardiologists, intensivists and nurses weighed the risks. They had spent weeks at his bedside, adjusting care and closely tracking his condition.

"Tony pushed the balance to do it," Dr. Villavicencio says. "And that really made it happen."

For Tony, the choice was clear.

"Sign me up," he says. "I knew this was my chance. From the time I arrived, it wasn't just one doctor, it was the whole team around me. They took the time to talk to me and get to know me. I trusted them."

A bridge to the future

Inside the operating room, the challenge was precision. Each pump had to be carefully balanced. Too much support on one side could overwhelm the other. Too little could send his organs into failure. Throughout the procedure, Dr. Villavicencio and the team adjusted the devices until his circulation stabilized.

With both pumps in place, blood flow steadied through his body. In the days that followed, his condition improved, marking a turning point in his recovery. Weeks after the surgery, Tony returned home.

Now, back in his kitchen, the rhythms of daily life have resumed as he rebuilds his strength and works toward a goal that once felt impossible: becoming eligible for a heart transplant.

"Going to Mayo Clinic saved my life," Tony says. "Dr. Villavicencio gave me another chance and I'm going to make the most of every minute."

The post Mayo Clinic performs its first dual mechanical heart pump procedure, giving father of 2 a path to transplant (VIDEO) appeared first on Mayo Clinic News Network.