Written by Amanda Menard, LPN

A Guide to Understanding Your Coverage, Costs, and Quality of Care

The health insurance landscape has changed considerably in the past few years, and now, many people are confused as to how to choose the best plan for their needs. The centralized government insurance exchange helps people to be able to see a variety of providers in one place, but it can be difficult for people to choose the plan that is right for them. There are several factors that go into determining which healthcare provider is the best for your needs, and you will have to do some homework if you want to get your selection right. It is important to remember that there is a limited window each year when you can choose your healthcare plan, so be prepared and make your choice before the deadline passes.

Understand the Coverage

  • Be sure to find out which coverage in each planis standard and which coverage is optional.
  • If you have special healthcare needs, then try to find a plan that will pay for as much of your care as possible without taking too much out of your pocket.
  • Check to see if the plan you are considering has coverage for each member of your family.
  • Always look for preventative care coverage such as immunizations and annual check-ups.

Costs of Coverage

  • Understand the out-of-pocket costs you would have with each plan you are considering, and choose the plan that keeps the costs to you down.
  • Utilize online healthcare cost calculators to find out what your healthcare costs would be for your situation. Every situation is different, so be sure to get as many details as you can.
  • The government has set up the opportunity for people to get premium tax creditsthat will help to offset healthcare costs. Check to see if you qualify for a tax credit, and use that when calculating your costs.
  • Your deductibles will determine how much you pay out of your pocket and how much your insurance plan will cover. Take the time to understand your deductibles before making a decision on which plan you want.

Consider Medicare

  • Medicarecould be a cost-effective way for you to get the healthcare you need. Medicare is generally offered to the elderly, but you should check your eligibility to see if you qualify.
  • Medicare offers several different optionsthat can enhance your coverage. You should check out the different options available such as advantage plans, dental plans, and supplemental plans and see if you can put together an overall plan that fits your needs.

Understanding the ACA

  • The most significant change to occur in the healthcare industry in recent years has been the Affordable Care Act. There are laws regarding who must have insurance coverage and consequences for those who do not get insurance. Before you choose an insurance plan, make sure it qualifies under the ACA and you will satisfy your federal obligation to avoid any tax penalties.
  • The ACA has a strict set of guidelineswhen it comes to availability of tax subsidies and who qualifies as being covered by health insurance in a household. When you understand these guidelines, you can make a better decision on which healthcare program is right for you.

What Is Medicaid?

  • Medicaidis a federally outlined medical program for low-income families that is administered by each state. While there are federal guidelines for Medicaid, each state establishes its own eligibility requirements.
  • When the ACA was passed, many states opted to not expand Medicaid. This means that health insurance for low-income families may not be as readily available in those states as it is in others. If your state did not expand Medicaid, then you should contact the state’s health department to determine your available options.
  • Most states have a Medicaid component that is specifically set up to provide for the healthcare of children. Even states that did not expand Medicaid offer access to these programs, which makes this a healthcare option for the children of low-income families.

General Tips

  • To assist with the requirements of the ACA, many states have healthcare cooperatives and other options available for people who cannot afford health insurance. It is important to remember that there are always options to explore when it comes to getting health insurance.
  • The fines for not having health insurance can be very stiff, so it is imperative that every family investigate their healthcare coverage options to avoid having to pay these fines.
  • Healthcare coverage is definitely a buyer’s market, so use your ability to choose to your option. When you investigate the healthcare plans available, compare them side-by-side to make sure that you get the best possible plan for your situation



Written By: Amanda Menar

When a parent is diagnosed with a terminal illness, this new situation will affect the entire family, including the children. In these cases, one of the main concerns is how, when and if this news should be shared with the children. It is normal for parents to want to protect their child, but hiding the terminal illness can oftentimes make matters worse. Namely, withholding information can cause children to feel confused, angry and, many times, guilty.

How to Have the Conversation with Your Children

According to the American Society of Cancer, it is a good thing to tell your children about the terminal illness, but this news should be shared in stages and in a language that a child will be able to understand. Never give a child more information than they will be able to absorb and understand.

If you have a partner, it is best to share this news together; but if you are a single parent then you should tell them alone. A single parent’s greatest concern is to find a reliable person who will take care of their children after they are gone.

But when is the best time to tell your children about your terminal illness? You should talk to your child as soon as the diagnosis is definite. Children know more than parents may think, and they do understand when something is happening in their family, even if you think that you are good at hiding it. Be honest with your children and try to prepare them as much as you can for the future. Keeping your child away from the truth will just make them feel lonely, afraid and guilty.

Preparing Your Child for Loss

In many cases, families have been dealing with the disease for months or even years before it is known that the condition is terminal. In just a few cases, the disease is diagnosed in an advanced stage. This period will help you and your children prepare for the worst. No matter how long you have been dealing with the illness, when it comes to its terminal stage, it won’t be easy for anyone in your family to deal with.

Children have an abstract understanding of life. Young children especially will have difficulties understanding what death is, and the fact that their parent will be gone forever. Usually, after the age of 10, children do understand the meaning of death. Using the right words is very important. Be sure to explain to your child what death really means and that once you are gone, you will not be back. Don’t give hope to your child. Instead, explain to them that once someone has died, they will be physically gone and that the child will no longer see the loved person. In some cases, this conversation might need to be repeated a couple of times because children will usually have questions. Try to answer these as much as you can. For most children, it is very hard to cope throughout the process of losing a parent, especially if they are very young. But in time, the child will accept the reality.

In one way, telling your child the truth can help distract parents from dwelling on the illness. The more they know about the situation, the less afraid they will feel. If you are hospitalized, try to get in touch with your children as much as you can. Reassure your children that you love them and that the illness has no effect on your love for them. Let your child visit you while hospitalized only after you, your partner, a friend or a family member prepares them for this situation. It is not easy for children to see their parent in a terminal condition.

Remember, when a parent suffers from an illness, children will notice that something is going on. Being overprotective of them will just make the situation worse, so be honest. It is normal for you as a parent to not know all the answers, as well as to be unsure of what to say and how to explain the illness to your children. Seek help when necessary from a family member, friend or a professional.

Additional Helpful Resources



Written by Sarah Gehrke, MSN, RN

According to the Center for Disease Control and Prevention (CDC), more than a third of US adults have obesity—this dietary driven disease kills more than twice as many people as infectious disease.

Obesity is a growing problem among people from all walks of life—this is especially true with children since the convenience of technology usage has limited their physical activity, and the availability of overly processed foods, such as pizza, sugary snacks, other fast food, have made children overweight.

Physicians have correlated, through recent studies, that obesity can be attributed to some diseases including diabetes, heart problems, and even some forms of cancer. These non-communicable chronic diseases will cost our global economy $47 trillion over the next 20 years.

Fortunately, preventative measures can be taken to help combat obesity, and with a few lifestyle changes, people of all ages can lose weight, be healthier, and live a longer and fuller life.

WHO: Obesity and Overweight – CDC provides key facts and global estimates about the obese and overweight population

The Global Economic Burden of Non-communicable Diseases – a snapshot of the five major non-communicable diseases and summary of the global economic impact

Provide Healthy Eating Experiences

Offering a healthy eating experience is an excellent way to help prevent obesity. Replacing white flour with whole grains and wheat bread to increase fiber intake is an improvement; however, keep in mind that two slices of whole wheat bread are shown to raise a person’s blood sugar, or blood glucose, more than two tablespoons of table sugar. Bread and packaged food, in general, may have added sugar.

Vegetable and fruit snacks provide a stable energy source. Fresh fruits instead of cake or candy bars are great alternatives for both kids and adults.

The National Institutes of Health (NIH) recommend low-fat dairy in a healthy eating plan. A 2016 study published in Circulation may have a strong influence on policymakers, in the future, to re-evaluate their position against full-fat dairy. Researchers found that out of 3,300 people, the individuals with the highest intake of full-fat dairy products had a 46% decrease in the risk of developing type 2 diabetes compared to people with low-fat dairy.

Science debunked the idea that a diet with high-fat foods is not good for you, in fact, saturated fat is liberated from the do not consume category. Even eggs are back in. Even though the new USDA Dietary Guidelines Committee said that cholesterol is no longer restricted, the guidelines continue to propose a person consume an eating pattern low in added sugars, saturated fats, and sodium. This includes:

A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other

Fruits, especially whole fruits

Grains, at least half of which are whole grains

Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages

A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products


A healthy eating pattern limits:

Saturated fats and trans fats, added sugars, and sodium

Water or a sparkling mineral water without added sugar instead of soda can make a positive impact on weight and overall health.

With a few simple, healthy eating alternatives, people can lose weight and feel better about themselves. Diets rich in fiber and vitamins can also reduce the risk of heart disease.

Glycaemic Index Tables – compilation of reliable tables of the glycaemic load associated with the consumption of different foods

Dairy Fat and Risk of Diabetes Mellitus – an interesting perspective on dairy consumption and the potential health effects of dairy fat

The Guidelines – an executive summary of the dietary guidelines from the Office of Disease Prevention and Health Promotion

Obesity Basics – definition and overview of obesity risk factors and complications

Choose My Plate – answers to your questions about the 2015–2020 dietary guidelines

Choose My Plate (Multiple Languages) – answers to your questions about the 2015–2020 dietary guidelines in multiple languages

Teach Healthy Eating Habits

Most people who are at their proper weight have a lower risk for diabetes and numerous other health problems. Teaching children healthy habits increases the likelihood that they will be an appropriate weight when they get older.

Acquiring a healthy diet can include encouraging kids to eat fruits instead of candy, limiting sodas, and ingesting whole foods. Teaching people healthy eating habits can be fun! Promoting new things like seafood or different vegetables can send someone on a food adventure that will keep them on the right track for their whole life.

Opportunities to teach and improve food choices exist throughout the day and in varied settings. If small shifts made over time, it can add up to real improvements in long-term eating patterns.

Fast Food Alternatives – how to make careful menu choices

Tips for Healthy Eating On the Go or at Home – tip sheets for eating healthy when dining out and shopping

Nutritional Songs – songs for healthy eating habits

Win Over Picky Eaters – tips to keep in mind when your child or other picky eater only wants to eat French fries or pizza for all meals

Healthy Eating Lesson Plan – an empowering lesson plan for teaching students healthy eating choices (adaptable for grades K–5)

Teaching Veterans Healthy Food Choices – this Healthy Teaching Kitchen YouTube channel aims to improve the health of veterans and their families

Living the Total Body Diet Lifestyle – a total body diet designed from the Academy of Nutrition and Dietetics to get people into a wellness state of mind

Fight Belly Fat Foods – a general overview of obesity in American and tips on foods that help with fighting belly fat

Promote Physical Activity

Getting kids or even sedentary adults to become active can be a challenge. However, some things can be done to help promote physical activity.

Walking groups with friends or co-workers are a great way to encourage each other, hold each other accountable, and get people to stay active. Nature walks are also a wonderful way to get outdoors, be active and enjoy the weather.

Taking the stairs at work instead of the elevator and parking your car further away from shopping centres can add up to your health and wellness over time.

You can create fun, loving connections by adding movement into your daily routine—the whole family will benefit. Most early childhood interactions involve movement. Let’s face it; our world is based on movement.

Boosting activity needs taught and encouraged, in the same way awareness does. Keep in mind children learn their behaviours from adults.

Here are some ideas to choose from that inspire activity:

Limit screen time, such as video games, TV, and other electronic devices.

Make activity cards and use them as a game—paste a picture of physical activity on one side of the card. Then, the child, or adult, chooses the card and demonstrates the movement.

Teach posture alignment and silly stretches using helium balloons. Clip the balloon on the back of everyone’s shirt as a gentle reminder to sit up straight during dinner. Or, encourage a fun activity of arm stretching by tying balloons to each wrist.

Read or write a short story that promotes activity as a part of the story.

You do not have to be a full-time athlete to take part in physical activity. Just a few simple changes can make a difference in one’s overall health, and you might even lose a few unflattering pounds in the process.

Physical Activity for Everyone – the CDC explains the benefits of boosting physical activity

Helping Kids be Physically Active – eleven ways to encourage your child to be physically active

Active Resources – the US Department of Health and Human Services provide different ways to be physically active

Staying Active – Harvard School of Public Health reviews why physical activity is just as important as eating nutritious foods

Adults Aged 50+ Staying Active – the CDC explains why adults older than 50 need more physical activity

Exercise Aspects of Obesity Treatment – a review of the negative impact of obesity, heart disease risk factors, and the treatment of obesity

Provide Emotional Support

Often, people who are overweight have a low sense of self-esteem. Exercising might be a little bit embarrassing or awkward.

Commonly, this is why people who are overweight stay overweight, particularly those without the help and support of family and friends. Providing some emotional support and positive reinforcement can do wonders for those trying to lose weight and live a healthier life.

A study in the Journal of Developmental and Behavioural Paediatrics examined the relationship between social support and health-related quality of life in obese youth. Overall, the study found that obese youth perceive varying levels of support. Their greatest level of social support comes from parents and close friends. Interestingly, a classmate’s support has the strongest influence on health-related quality of life, yet obese youth perceive the least amount of support from classmates.

Both children and adults can benefit from support groups—just lending an ear to those who need it are useful ways to give people who are obese some encouragement and steer them in the right direction.

Psychological Effects of Being Obese – the American Psychological Foundation examine whether people’s internalized societal attitudes about being overweight

How to be a Good Support Team – the article explains ways to help a loved one lose weight without hurting their feelings

Perceived Social Support and Quality of Life – an in-depth review of the association between social support and perceived quality of life in obese youth

Self Esteem, Insecurity, and Obesity – the Obesity Action Coalition discusses the role of self-esteem from birth and the awareness of the continuous stream of negative feedback that can shape self-confidence

Support, Wellbeing, and Energy Balance – key resources from the CDC to promote an energy balance in schools

Community Strategies – the CDC explains community efforts to reverse the obesity epidemic

The Health Effects of Obesity

People who are obese, compared to individuals with a healthy weight, are at risk for many serious health conditions, which include the following:

All-causes of death (mortality)

High blood pressure (Hypertension)

High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)

Type 2 diabetes

Coronary heart disease


Gallbladder disease

Osteoarthritis (a breakdown of cartilage and bone within a joint)

Sleep apnea and breathing problems

Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)

Low quality of life

Mental illness such as clinical depression, anxiety, and other mental disorders

Body pain and difficulty with physical functioning

Note. List of diseases and health conditions are retrieved from the Centers for Disease Control and Prevention.





A new study found that training available workforce such as Accredited Social Health Activists (ASHAs) could be effective in rural areas.

Hypertension has emerged as a major health problem in India with one in four Indians suffering from it. Early detection and management of hypertension is necessary to prevent complications such as cardiovascular disease. However, it is a challenge given the shortfall of a trained health workforce, particularly in rural areas.

A new study done by Indian and Australian researchers has found that training available workforce such as Accredited Social Health Activists (ASHAs) could be effective in rural areas.

Researchers led by Amanda Thrift from Monash University developed a training package for health workers and evaluated its effectiveness. The training module helps health workers identify and control hypertension in the community. The study measured the effectiveness of the tool in terms of knowledge, skills, and perception of health workers.

The study was conducted at Thiruvananthapuram in Kerala, West Godavari, and Rishi Valley in Andhra Pradesh. “We selected these places based on the quality of health workforce available there. Thiruvananthapuram has good healthcare facilities, while West Godavari has average and Rishi Valley has poor facilities,” Pallab Kumar Maulik, a member of the research team, said while speaking to India Science Wire.

As part of the study, 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. They then led community-based education support groups for three months. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and measuring blood pressure and body weight. “We have introduced some very simple lifestyle interventions like how to talk with people, how to measure blood pressure, risks of hypertension, the utility of measuring blood pressure etc.,” Maulik said.

The training was designed to provide ASHAs with knowledge regarding hypertension and its factors, strategies to manage hypertension via knowledge about healthy lifestyle and adherence to medications, and skill in the facilitation of group meetings. Health workers were also taught to deliver community group-based education, and provide support for individuals with hypertension. After the training, researchers found that ASHAs’ knowledge of hypertension improved from a mean score of 64 percent before training to 76 percent post-training and 84 percent after the three-month intervention.

Dr.Maulik said results of the study would be shared with Ithe Indian Council of Medical Research (ICMR). “We hope the government will further use this to improve health facilities particularly in rural areas,” he added. According to him, it was not only health workers but communities also responded positively.

The research team included Marwa Abdel, Clara K. Chow, Pallab Kumar Maulik, Rama Guggilla, Rohina Joshi (George Institute, Australia and India); Amanda Gay Thrift, Michaela Riddell, Oduru Suresh, Roger George Evans (Monash University); Ajay Mahal, Brian Oldenburg (University of Melbourne); Kavumpurathu Raman Thankappan, Gomathyamma Krishnakurup Mini (Sree Chitra Tirunal Institute for Medical Sciences and Technology); Kartik Kalyanram and Kamakshi Kartik (Rishi Valley Rural Health Centre) and Nihal Thomas (Christian Medical College, Vellore). The study has been published in the journal BMC Health Services Research.

Source: India Science Wire.



According to the CDC, heart disease is the leading cause of death among women. For some people, this may come as a surprise as heart disease particularly heart attacks have traditionally been associated with men. Heart attacks in women are not uncommon but they may ignore the signs which are sometimes different from those that occur in men. This is one of the reasons why heart disease causes increased mortality in women. Since women do not recognize the signs of a heart attack for what they are, they are less likely to seek emergency medical care and the condition often goes unrecognized and undiagnosed. To avoid this, women must know and understand the significant symptoms that may help them identify the occurrence of heart attack.

Recognizing the Signs

Like men, women also suffer chest pain, but there are other signs that are not typically thought of in terms of the heart. These symptoms include shortness of breath; discomfort in one’s neck, abdomen, shoulder or upper back; nausea, dizziness or light-headedness; and body malaise. When these symptoms are not being assessed and managed, emergency care should be sought.

Knowing the Risk Factors

Women should also recognize what the risk factors are. This goes a long way in preventing heart disease. Common risk factors for women include smoking, stress and a condition known as Metabolic syndrome. Metabolic syndrome is a cluster of conditions that increase the risk of developing heart problems and other serious health problems. These conditions include abdominal obesity, increased levels of triglycerides in the blood, low levels of HDL, hyperglycemia, and hypertension.

  • Factors That Increase Your Risk for Heart Disease: Several heart disease risk factors for women are listed on this page on the Go Red For Women website.

Steps for Prevention

Preventing heart disease in women involves taking the right steps depending on individual circumstances. For example, maintaining a healthy blood pressure, reducing high levels of LDL (bad) cholesterol, decreasing one’s weight from unhealthy levels, and discontinuing smoking. Removing saturated fat and cholesterol from diet and adding omega-3 fatty acids, often found in fish, is also important. Women with diabetes can reduce their risk of a heart attack by keeping their blood sugar at normal levels. At least 30 minutes of aerobic exercise and physical activity per day is recommended for women who are aiming for a healthy heart. Medical solutions for women with established risk factors for heart disease may include regular use of aspirin, lipid-lowering agents and a blood thinner called warfarin for those who are at increased risk of blood clot development.

Further Resources

For more information on women and heart disease, check the following resources:

  • Women’s Cardiovascular Health: Check this link to find articles on topics such as coronary microvascular disease in women, the gender gap in cardiovascular disease, and myths about women and heart disease.
  • Facts about heart disease in women: This website discusses heart disease as the leading cause of death among women. It presents a number of facts broken into categories.
  • Heart Disease: This link opens up the heart disease section on Medline plus website.
  • org: This is an organization that helps, supports, and educates women who have been diagnosed with or are at risk of heart disease and their families.
  • Your Guide to Living Well With Heart Disease: This article about heart disease and how to cope with it.
  • Heart Disease and Black Women: Black women are particularly at risk of developing cardiovascular disease. This article sheds more light on this subject.
  • Formulating Research Questions: Heart disease in women differs from men in terms of its pathophysiology, symptoms, and diagnostic modalities. Gendered Innovations focuses on research questions that address these issues.



Cardiovascular disease (CVD) is an umbrella term used for all conditions that affect the heart and blood vessels. CVD is often perceived as a problem strictly for the older population. However, it is more common in adolescents and young adults than most people realize – it can affect anyone, at any age. The younger population is often unaware that they may be at risk and may fail to take the appropriate actions that could save their lives. Educating parents, adolescents, and young adults about the different risk factors is the best way to help prevent death and reduce problems associated with cardiac disease. In particular, childhood obesity has quickly become a global epidemic where 1 in 10 children are estimated to be overweight. Obesity can lead to precursors for CVD such as dyslipidemia (high cholesterol), hypertension (high blood pressure), type-2 diabetes, and metabolic syndrome. If these conditions are left unchecked, premature cardiovascular disease can occur, leading to significant health problems in young adults. Additionally, cardiac disease in the young can also be caused by undiagnosed or untreated congenital heart defects and abnormalities.

Warning Signs

Cardiac disease in the young is often unexpected, so warning signs are not always recognized. The general warning signs in adults include;

  • breathlessness
  • fatigue
  • chest pain
  • weakness
  • edema

They may also experience pain in the

  • left arm
  • jaw
  • back
  • neck
  • shoulder blades
  • epigastric region (upper central region of the abdomen)

Women often experience slightly different warning signs. As opposed to heart pain, they may feel squeezing or tightness in the chest. Sometimes, they do not feel chest pressure at all, and instead, will feel short of breath upper back pressure, or upper abdominal pain. They may also experience excessive fatigue, cold sweats, dizziness, nausea, vomiting, and sometimes fainting. Heart disease is the No.1 killer of women in the U.S. This is often due to women mistaking their symptoms for other conditions such as a stomach bug, the flu, or indigestion.

For children and adolescents, signs and symptoms may not be as obvious. Dissimilar to adults, chest pain is rarely indicative of cardiac disease in children. However, a physician should be notified if chest pain does occur with strenuous activity such as exercise. Symptoms in children and adolescents may include;

  • The inability to physically keep up with others of the same age
  • Becoming out of breath much sooner than others of the same age
  • Turning blue around the gums or tongue
  • Dizziness with physical exertion
  • Heart palpitations
  • In some cases, fainting (syncope)

If a child displays any of these symptoms, it is always important to notify their primary care physician as soon as possible.

  • Early Warning Signs– Seven early warning signs of a heart attack. Includes statistical information, top clues and factors, and what to do.
  • Heart Attacks Can Strike Young Adults– American Council on Science and Health article about knowing the signs of heart attack in young adults. Includes information on two dangerous underlying causes of heart disease.
  • Symptoms of Heart Problems in Children– SCAI article on symptoms of heart problems in babies, children, older children, and adolescents.

Myths that Young People do not get Heart Disease

There are many misconceptions and myths associated with heart disease. Some people believe that children and young adults do not have to worry about heart disease because they are too young to develop these issues. This is simply untrue as heart health issues, and even a heart attack, can occur at any age. People can begin to develop plaques (atherosclerosis) in their arteries during childhood, and this has only been aggravated with the rise in childhood obesity. In the U.S. alone, the number of overweight children has doubled, and the number of overweight adolescents has tripled since 1980.

Cardiovascular Conditions Found in Children and Adolescents

There are times when the cardiovascular disease in the young is not caused by any precursors for CVD or an unhealthy lifestyle. In these situations, undiagnosed congenital heart defects, abnormalities, or an infection tend to be the culprit.

Any of these situations can lead to *overcirulation failure* or *pump failure* of the heart. Overcirculation failure is usually caused by a structural defect in the heart that causes oxygenated and deoxygenated blood to mix. Because the normal flow of blood is interrupted, the heart beats inefficiently causing heart failure. Eisenmenger Syndrome is one example of overcirculation failure found in adolescents and young adults where, if left untreated, it can result in blood clots, stroke or kidney failure. This syndrome is characterized by a collection of symptoms that include cyanosis (blue or grayish skin), pulmonary hypertension (high pressure in the arteries of the lungs), and erythrocytosis (increased number of red blood cells due to an inadequate supply of oxygen in the blood) caused by a congenital defect where blood is shunted from the left side of the heart to the right side of the heart.

Common congenital defects include;

  • Atrial septal defect
  • Tetralogy of Fallot
  • Ventricular septal defect
  • Coarctation of the aorta
  • Transposition of the great arteries

Pump failure is caused by defects in the coronary arteries or heart valves that are present at birth, an infection that damages normal heart muscle, or a problem with the heart’s electrical conduction system. In these cases, the heart muscle fails to pump as normal and can lead to heart failure. Two examples of an infection causing heart disease are Kawasaki disease and Rheumatic heart disease. Rheumatic heart disease is caused by a streptococcal bacterial infection of the heart muscle and valves as a consequence of rheumatic fever due to untreated, or undertreated, strep throat. Kawasaki disease’s cause is unknown but is thought to be due to an infectious agent.

Young Women and Heart Disease

Heart disease is the leading cause of death in women in the US, taking more lives than lung and breast cancer combined. It affects women of all ages including women who are below the age of forty. The risk of cardiovascular issues in young women is elevated when there is a history of heart problems in the family. Certain conditions such as familial hypercholesterolemia (FH) can lead to heart disease at an early age. This condition causes a buildup of low-density lipoprotein (LDL) cholesterol in the walls of arteries and can lead to heart attack. The risk may also be increased by as much as 20 percent in women who smoke while using oral contraception. Also, women with diabetes have almost double the risk of cardiovascular disease than those without. Coupled with the rise in obesity, these conditions can lead to an increased risk of premature death due to stroke, coronary artery disease, and hypertension.

Cardiac Disease in Young Athletes

Young people who are victims of sudden death often have an underlying cardiac disease that has gone undiagnosed. Athletes are typically at risk because of the continuously increased workload on the heart during physical activities. An athlete is often thought of as an individual who is in good physical health, however, when it comes to cardiac disease, athletes are often taken unawares. One form of heart disease that affects athletes 30 years or younger is hypertrophic cardiomyopathy (HCM) which is the most common cause of sudden death in young athletes. Athletes with this condition have a left ventricular wall thickness that is unusually thicker than normal. In this case, the heart’s electrical conduction system can be disrupted resulting in an irregular heartbeat (arrhythmia) that can cause cardiac arrest.

Other less common causes of cardiac disease in athletes are:

  • Myocarditis
  • Marfan’s Syndrome
  • Dilated cardiomyopathy
  • Congenital coronary artery anomalies
  • Right ventricular dysplasia
  • Mitral valve prolapse
  • QT-Interval Prolongation syndromes

The thought that young trained athletes could succumb to sudden cardiac death is almost inconceivable. Sudden death commonly occurs in basketball and football players who account for two-thirds of all athlete deaths in the U.S. Worldwide, soccer players most frequently succumb to this issue. It occurs primarily in males and affects 1 in 50,000 to 1 in 100,000 athletes every year. Careful heart disease screening of young athletes before participating in sports can help to decrease the incidence of sudden death due to underlying and undiagnosed cardiac disease.

  • Cardiac Disease in Young Trained Athletes– Article by Circulation Journal on insights into methods for distinguishing Athlete’s Heart from Structural Heart Disease.
  • Sudden Death in Young People– Informational article by the Mayo Clinic on common heart problems that cause sudden death in the young, their causes, symptoms, prevention, and risk factors.
  • Young Athletes and Sudden Cardiac Arrest– Brief fast facts article by Boston Scientific on sudden cardiac arrest in young athletes.
  • Sudden Death in Athletes– Cardiologist written article explaining sudden cardiac death in athletes, risks, screening, signs and symptoms of CVD, and current AHA recommendations.

Risk Factors for Young People

Modifiable risk factors are those that can be successfully treated or controlled over time. While there are several modifiable risk factors associated with cardiovascular disease in the young, the most common are smoking and drug use, high blood pressure (hypertension), and elevated LDL cholesterol. Hypertension alone is a risk factor that causes 13% of deaths worldwide. A sedentary lifestyle, alcohol abuse, and obesity also contribute to these risk factors. Additionally, a family history of cardiovascular disease is a non-modifiable factor that can increase the risk of developing heart disease.

Obesity is frequently a causative factor for hyperlipidemia (high cholesterol), hypertension, and type-2 diabetes. While obesity can be detrimental to adult health, childhood obesity carries with it a higher chance of these risk factors becoming more severe as an adult thereby increasing their odds of developing cardiovascular disease. Healthier eating habits, reducing sedentary time, and staying active can significantly reduce the odds of developing CVD or any of its risk factors.

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