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A New Mindset: How You Can Take Steps to Prevent Heart Disease

Mar 1, 2022 | Your Health

Heart disease is the leading cause of death in the United States. Some risk factors are unavoidable, but there are some simple things you can do to lower your chances of developing this condition by improving your overall health.

In fact, many patients are focused on losing weight but do not ask about how they can lead a healthier lifestyle to prevent illness, says Jeffrey I. Mechanick, MD, Professor of Medicine and Medical Director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart

“It’s interesting to think about what patients don’t ask,” he says. “They don’t say: How can I be healthier? How can I prevent chronic disease? How can I prevent heart disease? Weight loss is important, but the more significant issue is boosting your overall health.”

In this Q&A, Dr. Mechanick explains how you can start.

What are the major risk factors for heart disease?

Several types of causes, or drivers, can lead to heart disease. Primary drivers are genetics, environment, and behavior. Genetics and some environmental factors are things you cannot change—they are not modifiable. These include family medical history, gender, and heart defects you are born with (called congenital defects). Some primary drivers have to do with the environment you live in, such as exposure to solvents, pesticides, or other pollutants.

Other primary drivers can be changed or are modifiable. These include behaviors, such as tobacco use, being physically inactive, and consuming fatty/sugary foods, and the “built” (or human-made) environment, such as elevators, super-sized portions, and unsafe living conditions, which together fashion someone’s personal lifestyle. Secondary drivers are metabolic in nature and depend on primary drivers, create a risk level for heart disease, and are also modifiable. In other words, smoking; alcohol and drug abuse; not getting regular exercise; eating too much saturated fat, transfat, and cholesterol; being overweight or obese; stress; and irregular sleep patterns can all increase your chances of developing heart disease. Lifestyle issues can lead to metabolic problems, such as developing too much sugar in your blood (abnormal glycemia), prediabetes and type 2 diabetes, high blood pressure (hypertension) and high cholesterol. These metabolic issues increase your chance of developing heart disease.

How can I lower my risk of heart disease?

There are two ways to look at dealing with heart disease. One way is to wait until you have a problem, and then go see a doctor. The doctor will perform blood and urine tests and prescribe medication. Then the doctor will monitor your cholesterol, blood sugar level, blood pressure, and other factors.

The other approach is to prevent heart disease from developing in the first place. For years, doctors have focused on addressing issues such as blood pressure and cholesterol. We didn’t have a mindset for prevention. But now we know there are certain lifestyle choices you can make that can keep you from having to deal with heart disease.

This new mindset involves exercising every day, having healthy eating patterns (including plenty of fruits and vegetables and beans, and avoiding sweets), limiting alcohol consumption, reducing stress, and not smoking. Probably the most important message is not to wait until you have a heart problem, but to think about prevention. You can talk to your doctor about how to make these lifestyle changes. They will make sure you are healthier and have a longer, higher quality life ahead of you

What if I’m at risk of developing heart disease?

You need to take inventory of your risk factors. If there’s a family history, or if you smoke or are overweight or have been in the past, you may want to think about adopting a healthier lifestyle. The challenge with prevention is it takes place over a long period of time. So its value becomes diluted when you think about all the other more pressing issues of life. Because heart disease seems so remote—it’s usually not going to happen tomorrow or next week—people think they can deal with it later. But it’s important to take stock of your lifestyle and focus on prevention. You will reap the rewards.

How do you find a good heart doctor who focuses on preventative health?

I would encourage patients to speak to friends and family. Of course, if you have a doctor to speak to, they may have suggestions. Do a little research and look for strong health programs near where you live. Major medical centers often have programs that specialize in preventive health. You’re going to have to put a little elbow grease into this to locate doctors who are trained in traditional medicine and have expertise in preventive health and preventive cardiology.

How do I talk with the doctor?

First, meet with the doctor for a consultation. It’s important to be prepared. Write down the issues that you think are important, any areas that are of value for you, and any risk factors you may have. Also, write what you want in life so you can have a high-level discussion about what health is. In this way, you will establish a very fruitful, rewarding encounter with your physician that will become a good working relationship.

My Child Has a Heart Condition. What Should I Do?

Updated on Feb 9, 2025 | Children's Health, Heart Health, Your Health

Becoming a parent is exciting, sometimes nerve-wracking, and comes with a heap of responsibility for the health and well-being of your child. And if your child has been diagnosed with a heart condition, anxiety can ratchet up due to the uncertainty of what the condition may mean for their future.

Robert H. Pass, MD, Chief of the Division of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai and co-Director of the Mount Sinai Kravis Children’s Heart Center, answers common questions that parents may have about diagnosing a pediatric heart condition and explains the safe, minimally invasive treatments that are now available.

How do I know if my child has a heart condition?

Many heart problems in children are obvious nearly from the moment of birth. In fact, the most common types of heart disease in children are congenital heart diseases, which are birth defects that affect how the structure of the heart as well as how the heart functions. Congenital heart disease is the most common birth defect, affecting a little less than one percent of the population.

One of the most common signs of heart disease among newborns is cyanosis, which is when a child has a low oxygen level, which lends a bluish tint to the skin and mucous membranes. Additionally, some newborns have symptoms such as poor feeding or sweating as they feed. Heart problems can also cause poor growth.

Still other concerns—like heart murmurs—are identified only through a physical examination or sonogram. Heart murmurs can be signs of a problem, or they can be what we call “innocent,” which means there’s actually nothing wrong. Some studies suggest that if a doctor listens closely enough, nearly half of all kids have murmurs. Fortunately, though, only a very tiny fraction of this group actually has a heart problem.

How are congenital heart diseases diagnosed and treated?

Most congenital heart conditions are diagnosed either on physical examination or ultrasound and increasingly can be diagnosed prenatally on ultrasound.

Depending on the diagnosis, there are a variety of surgical and non-surgical treatments for congenital heart disease. Non-surgical treatment or the “wait and see approach,” may be the best option for problems such as small holes in the heart and some forms of abnormal heart rhythm which can resolve spontaneously. If your child has a condition that needs surgical intervention, options range from open heart surgery to the use of catheter-based therapies.

What are catheter-based therapies?

Catheter-based treatment is a minimally invasive alternative to traditional open heart surgery in which small tubes are inserted into the blood vessels and allow for diagnosis and treatment of many heart problems. Among many conditions that can be addressed in this way, we use these procedures to close holes between the upper two heart chambers—called atrial septal defects. In the past, we routinely treated this condition with surgery. Now we manage about 75 percent using catheter-based treatments.

During a catheter-based procedure the thin, flexible catheter is inserted through the child’s groin into a blood vessel and up to the heart. A device is then introduced through the catheter to seal the hole. With open heart surgery, the child would spend two to four days in the hospital and another six weeks recuperating at home. Using this minimally invasive approach, most patients are in the hospital only one evening and then back in school within three or four days.

What makes the Mount Sinai Children’s Heart Center special?

Our Children’s Heart Center stands apart due to the integration among our services throughout the expanded Mount Sinai Health System. Our cardiology team works closely with our surgical team, and we seamlessly transition our pediatric patients into our very large and always growing adult congenital heart program headed by Ali N. Zaidi, MD, Professor of Medicine (Cardiology), and Pediatrics; Director of the Adult Congenital Heart Disease Center; and Director of Pediatrics to Adult Transition of Care Program, at Icahn Mount Sinai. We view our work as a team sport, with many players working together to achieve the best possible outcome.

We develop individualized treatment plans for children with a wide range of heart problems, always taking into account the needs of our patients and their families. While there are outstanding cardiologists in many of the major centers in New York City, I have never worked with a group where every single physician is outstanding. It is inspiring for me and keeps me on my toes. Our patients inspire us every day.

Learn more about the Mount Sinai Kravis Children’s Heart Center

Simple Tips to Improve Your Heart Health

Updated on Jun 26, 2024 | Heart Health, Your Health

Get more exercise and focus on healthy eating. That’s the message cardiologists from Mount Sinai Heart are promoting to lower the risk of heart attack and stroke during American Heart Month. This is especially important among high-risk groups.

Doctors continue to see increased sedentary behavior, unhealthy eating habits, and weight gain among patients—putting them at higher risk for heart conditions, including some that are potentially serious.

“It is so important for all, but especially the high-risk groups, to watch their diet and exercise more for heart disease prevention,” says Icilma Fergus, MD, Director of Cardiovascular Disparities for The Mount Sinai Hospital. “There are simple ways to get moving, not just going to the gym, but simply walking or doing housework to avoid being sedentary.”

Nearly half of adults in the United States—more than 121 million people—have some type of cardiovascular disease. The Centers for Disease Control and Prevention says it is the leading cause of death among men and women in the United States; nearly 650,000 die from it every year and, heart disease is preventable 80 percent of the time.

Certain minority groups, including Blacks and Latinos/Latinas, are also at higher risk due to genetic predisposition, diet, lifestyle factors, and socioeconomic factors. However, illness in any population can be prevented by taking simple steps towards a healthier lifestyle.

Tips for Lowering Your Risk of Heart Disease

Know your family history
Manage your blood pressure
Control your cholesterol
Maintain a healthy diet, eating nutrient-rich food and eliminating sweets
Limit alcohol consumption to no more than one drink per day for women and two drinks per day for men
Quit using tobacco or other inhaled substances, including both smoking and electronic cigarettes or vapes
Watch your weight and exercise regularly
Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in your arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness

COVID-19, Heart Disease, and Vaccinations

Adults with heart disease are also at increased risk of severe illness from COVID-19. According to the American Heart Association, COVID-19 patients with underlying conditions including cardiovascular disease are six times more likely to be hospitalized and 12 times more likely to die than patients without any chronic health problems. About one in three people with COVID-19 has cardiovascular disease, making it the most common underlying health condition.

Mount Sinai cardiologists encourage people in these high-risk groups to get their full dose of the COVID-19 vaccine, including the booster.

“People with heart disease and with risk factors including diabetes, hypercholesterolemia, and obesity are at higher risk of contracting a severe COVID-19 infection and having complications due to COVID-19 infection. Thus, we strongly recommend these patients get vaccinated. I know some patients have been reluctant; however, vaccines have been proven to be safe and to prevent severe infections and for the most part, are well tolerated,” says Johanna Contreras, MD, Director of the Ambulatory Heart Failure Network for the Mount Sinai Health System.

It is also important that you not put off getting regular medical care.

“It’s critical for patients to check in with their doctors and continue to schedule and keep their doctor appointments, along with following up on medications and taking them as prescribed,” says Dr. Contreras. “If you have any issues do not be afraid to call your doctor. It is important to see medical attention.”

Have Questions About COVID-19 Tests? Here Are Some Answers

Updated on Jun 30, 2022 | COVID-19, Featured, Your Health

As the highly contagious Omicron variant continues to spread, more and more people are thinking about getting tested for COVID-19. You may be feeling under the weather, or you may have recently spent time with someone who has COVID-19. You may want to get tested before seeing family or friends, or attending a large indoor gathering.

With a number of different tests available, many people have questions about which test to take, when to take it, and what their results may mean. In this Q&A, Aaron E. Glatt, MD, MACP, FIDSA, FSHEA, Chair of the Department of Medicine and Chief of Infectious Diseases at Mount Sinai South Nassau, explains how you can decide which test may meet your needs.

What types of tests are available? What are the differences between them?

There are a number of different ways that we can diagnose a COVID-19 infection. None of them are perfect, and each has their benefits and disadvantages. Let’s break it into two groups of testing: We have antigen tests, and we have PCR tests. Each of them has a role, and each of them has a slightly different situation where they may be preferable.

So we start off with the antigen test. This is what most people use at home. These are the tests you can buy at your local pharmacy. They are often referred to as “rapid tests.” If an at-home test is positive, and you are symptomatic, it’s highly likely that you have a COVID-19 infection. If you are taking this test because you’ve been exposed to somebody with COVID-19, it is also likely that a positive test is reliable. On the other hand, when these tests are negative, they’re just not good enough to necessarily rule out that a person does not in fact have COVID.

The other type of test is a PCR test. There are many different types of PCR tests. Most PCR tests will take 24 to 48 hours to return your results. PCR tests are somewhat more sensitive than rapid antigen tests. If your PCR test result is positive, that will almost always represent a true positive, meaning it is accurate and you do have COVID-19 or that you had it in the recent past. The issue with these tests, however, is that they’re so specific. That means they can remain positive even when somebody is no longer contagious, and they no longer have COVID-19. But in general, the PCR tests are very good. They can tell you with a little bit more certainty that you did have an exposure to COVID-19.

How do I know which test I should take?

We usually recommend you talk to your health care provider if you’re concerned that you may have COVID-19. If you have symptoms or if you were exposed to COVID, then you may want to go get an at-home rapid test. If your rapid test is positive, you should talk to your doctor to decide what, if any, additional tests need to be done. If you have more serious symptoms, you should be evaluated by a doctor no matter what the antigen or PCR test shows.

When should I get tested?

If you have symptoms, you should get tested right away. If you’re being tested because of an exposure, we usually recommend waiting at least two days, or 48 hours, before testing. There are always exceptions to the rule. But that’s the general recommendation.

How reliable are at-home tests?

There are different at-home tests, and some of them are more reliable than others. If you have symptoms, or you think there’s a likelihood that you do in fact have COVID, then these tests can be very useful if they’re positive.

If my test result is positive, what should I do?

The first thing to do is contact your doctor. This could be a telehealth visit. We want you reaching out to your provider and getting expert medical advice from the person who knows you and your medical history. Not everyone has the same level of risk. It’s best to have a health care provider decide what evaluation needs to be done, and what potential treatments, additional testing, and ongoing monitoring you may need.

If my test result is positive, when should I retest?

There isn’t necessarily a reason to retest if you’re positive and your clinical care is being handled and you’re doing better. Typically, we wait a certain length of time to decide that a person is no longer contagious, and that they can stop isolating. That may be a five day period of time, assuming your symptoms are resolving and you have no fever. After that, we recommend that you be extremely careful in terms of distancing and wearing a mask whenever you’re going indoors among other people for at least an additional five days. For somebody who’s having a little bit more of a complicated clinical course—for example, they are having symptoms that aren’t resolving or they’re having persistent fevers—then you can’t assume that in five days, they’re no longer contagious. This should be something that your doctor helps you decide based upon your particular symptoms and medical history.

If my test result is negative, does that mean I’m good to go?

Anyone who has symptoms should not be going into public gatherings with other people. If they do have to go indoors, they should be wearing a mask and distancing as much as possible. A negative test doesn’t mean you don’t have COVID, and it doesn’t mean you can’t be contagious. Even if it’s not COVID, it might be the flu or some other virus that could be contagious to other people. As a result, you should really try and protect everybody from whatever illness you may have.

If I have symptoms, but my test was negative, what should I do?

In that situation, there are additional tests that you can take, such as testing for the flu or additional testing for COVID-19. You should talk to your doctor if you have ongoing symptoms and you have a negative COVID test. It can be a telehealth discussion. You should speak with your doctor, who knows you, and knows your background and your risk factors for serious illness.

Why are testing and vaccination still important?

It’s very important that patients realize that while the press reports that Omicron is a mild illness—you just get a little bit of flu-like symptoms, and you’re fine—that’s not really true for everybody. If you’re not vaccinated, Omicron can cause severe illness. Even in vaccinated people, if they’re not boosted, they are still more likely to get into trouble. So the best recommendation at this point is to get a booster dose of the vaccine if you’ve gotten vaccinated, and certainly, if you haven’t been vaccinated, this is still a great time to get vaccinated.

A misconception is that the vaccines don’t work because there are breakthrough infections. Nothing can be further from the truth. These vaccines are phenomenally successful in preventing death, in preventing serious illness, in preventing admissions to the hospital. Omicron, while “milder” than the Delta variant, can still cause all of these things for some people. It’s critically important for everyone to protect themselves, protect their loved ones, and protect their community by getting vaccinated.

How to Develop—and Maintain—Better Nutritional Habits

Updated on Jun 30, 2022 | Diet and Nutrition, Your Health

Man writing down habits for better nutrition while eating quinoa bowl at table

Most of us want to eat better. But how should you start? Should you ‘kick start’ weight loss with a five-day juice cleanse or maybe try the meat-heavy paleo diet?

It doesn’t need to be that complicated. In fact, juice cleanses and fad diets can sometimes do more harm than good.

Perri Halperin, MS, RD, Clinical Dietitian at The Mount Sinai Hospital, offers some simple ways to develop a healthier diet—without depriving yourself—and explains how working with a nutritionist can help support your weight loss or weight management goals.

What small changes can I make for a healthier diet?

It’s always easier to add something to your diet, rather than subtract. To increase micronutrients and fiber, I recommend adding a non-starchy vegetable—like green beans, carrots, or spinach—or a fruit with every meal.

Make sure to start your day with breakfast. A lot of people think that skipping breakfast is best, but in doing so you are confusing your body. Food is fuel. When you skip breakfast—or any meal—your body holds onto the food it has as an energy reserve. A healthy breakfast, and any meal, includes non-starchy vegetables, fruit, and protein. Protein gives you a feeling of being full, something nutritionists call satiety, after you eat.

Avoid sugar-sweetened beverages. Instead of drinking juice or soda, try fruit-infused water or seltzer. You can infuse water with watermelon, blueberries, strawberries, cucumber, or mint.

Should I count calories?

When you think about calories, focus on quality, not quantity. Eating 300 calories worth of cake, candy, and chips is not the same as eating 300 calories of salad and chicken. Try to have a protein with every meal and snack. Good sources of proteins include eggs; plain nonfat Greek yogurt (which has more protein, less sugar, and a thicker consistency than regular yogurt); low-fat cottage, or ricotta cheese; fish or shellfish; chicken and turkey; beans or chickpeas; seitan or tofu.

If you eat a protein and a non-starchy vegetable at every meal and snack, you will put yourself in the right calorie range. You’ll also feel good because you are giving your body the fuel that it needs. If you do well with counting something, count grams of protein instead of calories. Aim to consume about 60 grams of protein a day. An eight ounce glass of milk skim milk has about 8 grams and a chicken breast has about 30 grams.

Do I need to detox or cleanse my body?

Your body cannot use food to detox or cleanse. Your body cleanses and detoxes itself using your kidneys and liver. The best way to help your body cleanse itself is to feed it the fuel that it needs to carry out those processes efficiently and without overwhelming those organs.

Are there habits that people think are healthy that are not?

Yes. I call these habits false friends—things we eat or drink because we think they’re healthy but they’re not. Smoothies and juicing are false friends. They trick us into consuming calories and sugar from foods we probably wouldn’t sit down and eat in one sitting. It’s better to eat your food, not drink it.

Granola, granola bars, and trail mix are also false friends. These foods are often high in sugar and fat. A third type of false friend is vitamin and mineral supplements (micronutrients) that our body doesn’t need. Our body’s internal processes help itself maintain equilibrium. When we overload ourselves with B-12 supplements, magnesium, or other supplements that we don’t need, all we’re doing is giving our body an extra job—to get rid of those extraneous micronutrients.

Some people think tropical fruit—like bananas—are off limits, and I want to dispel that myth. Don’t be scared of a banana. It’s true that berries—strawberries, blueberries, blackberries—tend to be lower in sugar than bananas, pineapples, papayas, and mangoes; that doesn’t mean you should never have a banana. It means you should think about variety and moderation when making food choices.

Yogurt choices can be overwhelming. Plain, nonfat Greek yogurt is a good choice. If you need a little flavor, take a look at the label. You should get at least 12 grams of protein and less than six or seven grams of sugar per serving.

How can a nutritionist help me?

Nutritionists can help in a variety of ways, depending on what you need. If you need information, a nutritionist can explain calories, proteins, fats, and carbs. They can help you figure out what to eat. Nutritionists can also help you identify obstacles that may be preventing you from healthy eating. Sometimes you know what to eat, but you’re not eating it. Talking to a nutritionist can help you work through those issues and come up with solutions. In addition, working with a nutritionist can provide accountability.

Like when consulting with any health care professional, it’s important to know what your weight loss and/or weight maintenance goals are and to build a good rapport. Working with a nutritionist can help you live life while reaching these goals. You can celebrate the holidays or go on vacation without sabotaging your efforts or giving up the foods and flavors you love. A nutritionist can help.

Why is it so important to have the right mindset?

In my experience, having the right mindset is the number one indicator of successful weight loss and weight maintenance. People who make the connection between food and exercise choices and how they feel become strong and empowered—and have the most long-term success.

Weight loss, in particular, can feel really overwhelming. You think you need to lose 20 pounds in a month and can’t figure out how to do it. Breaking it down into smaller chunks is helpful. Instead of worrying about 30 dinners at once, look at the meal that’s right in front of you at that moment. Focus on making the best choice you can—then do that again and again. Consistency is important. Don’t let perfection be the enemy of good. Making good choices every day is more effective than one ‘perfect’ meal.

I often hear people say, “I did a liquid diet and it worked, but now I’ve put weight on.” That makes you ask the question: Did it really work? Having the mindset, understanding that getting and maintaining a healthy weight is a lifelong journey with ups and downs, is really important.

How Is the Omicron Variant Affecting Children?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The Omicron variant is the latest strain of COVID-19 that is causing concern. While far more contagious than earlier variants, there are indications that it causes less serious disease—especially in the vaccinated.

Despite this sliver of good news, reports of increased pediatric hospital admissions has many parents and guardians worried that this variant may be more dangerous for children. Pediatric infectious disease specialist Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai, dispels that belief and explains how to protect yourself and your family. The key takeaways: if eligible, get vaccinated; wear a high-quality face covering while indoors; and practice social distancing.

Is the Omicron variant more of a risk to infants and toddlers than older kids and adults? What are the symptoms?

The Omicron variant is very widespread and it affects people of all ages. That includes infants, toddlers, school-age kids, adolescents, and adults. It does not discriminate by age—everybody is at risk.

For the vast majority of children, symptoms of this variant are very similar to other common illness of childhood. This includes fever, a runny nose, cough, congestion, a sore throat, and/or difficulty swallowing. Some kids also complain about abdominal pain and diarrhea.

My child has COVID-19. How can I treat them at home?

Treatment depends on how ill your child is but the vast majority can be treated at home using over-the-counter medications. For instance, children who are experiencing minor symptoms, like fever and body aches, can be treated with acetaminophen (Tylenol) or ibuprofen.

However, if you think that your child is sicker than you can handle at home or if they are having difficulty breathing or eating so little that you are worried about dehydration, call your doctor right away.

How can we protect children from the Omicron variant?

Vaccination goes a long way toward protecting children—and adults—from the Omicron variant, and a booster shot provides additional defense against the virus. So, if you (or your child) are eligible for a booster but have not received one, I encourage you to schedule an appointment. By protecting yourself, you are protecting your child.

In addition to getting vaccinated, wearing a mask and maintaining social distance are very important. Since COVID-19 is circulating at very high levels, try to avoid crowded places. Also, make sure that your child understands the importance of washing their hands frequently, either with soap and water or an alcohol-based sanitizer.

If your child happens to feel sick, keep them home from school so that you can prevent an infection from spreading to others. If you think somebody in your family has COVID-19, reach out to your doctor about testing for the virus. If your child attends a daycare or school, you might need to alert them as other close contacts of your child may need to get tested. Be sure to follow whatever directives their daycare/school has outlined.

My child is not yet eligible for vaccination. How can I protect them from contracting COVID-19?

Unfortunately, the vaccine is not available yet for kids who are younger than 5 years of age. In that case, it’s even more important for parents, older siblings, and whoever else lives at home to be fully vaccinated and to get a booster shot. In addition, all household members should diligently follow the rules we have followed throughout this pandemic: avoid crowded places, wear a face covering, maintain social distance, and wash your hands frequently.

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