Heart health is the ability of the heart and vascular system to efficiently transport oxygen and nutrients to all organs of the body. What is good for the heart is a holistic lifestyle that supports this vital function. This includes regular physical activity, a Mediterranean-style diet and avoiding smoking. Especially healthy nuts such as olive oil and walnuts, omega-3 rich fish such as salmon, green leafy vegetables such as spinach and fruits such as blueberries are among the foods that repair the heart. Adequate consumption of water and unsweetened herbal teas is also critical for cardiovascular health.

So, What is Heart Health in Real Terms?

We can liken heart health to the maintenance of a car. You don’t just take your car to the mechanic when it breaks down so that it doesn’t leave you stranded, right? You regularly check the oil, water, tire pressure. This is what heart health is all about. It is taking care to keep it at peak performance without waiting for a problem to arise. Modern medicine has turned this care into concrete steps. We now know that heart health is a combination of specific health behaviors that we can manage and measurable health factors that we need to track. When we put these elements at the center of our lives, we do our heart the greatest favor. It is a kind of “instruction manual” for our heart, and following it is the key to a long and healthy life.

What Behaviors Should We Adopt for the Health of Our Heart?

Small but consistent changes in our daily lives can make a huge difference for our heart. These habits are the pillars of our health. These behaviors are at the top of the list of things to do for heart health.

These core health behaviors are:

Better Nutrition

Becoming More Active

Avoiding Tobacco

Healthy and Quality Sleep

These are not just headlines, but a philosophy of life. “Eating Better” does not mean strict and boring diet lists. On the contrary, it means adding color, naturalness and flavor to your table. Choosing unprocessed, unpackaged foods, fresh vegetables and fruits, healthy fats and lean proteins will ease the burden on your heart.

“Being More Active” does not mean that you have to be confined to a gym. Even taking the stairs instead of the elevator, walking short distances, turning on your favorite music and dancing can speed up the rhythm of your heart in a healthy way. The important thing is regularity. A goal of 150 minutes of brisk walking per week is a great place to start.

“Tobacco Abstinence” is a non-negotiable rule. Any product containing nicotine, be it cigarettes, electronic cigarettes or hookahs, destroys the lining of your arteries like sandpaper. The moment you give up this harmful habit, your heart will be grateful to you.

Finally, “Healthy Sleep” is an often neglected but vitally important element. Spending quality sleep during this precious time when our bodies renew, repair and prepare for the next day positively affects everything from blood pressure to stress levels. A sound sleep of 7-9 hours a night is the best time of rest and care for your heart.

Which Health Values Should We Monitor?

In addition to health behaviors, we should also listen to the story our body tells us in numbers. These values are a kind of report card of our heart and regular checks can help us recognize a potential problem early.

The key health factors you need to follow are as follows:

Your weight
Your Cholesterol Levels
Your Blood Sugar
Your Blood Pressure (Blood Pressure)

Managing your weight is not just an aesthetic concern. Excess fat, especially around the waist, puts a direct burden on the heart, raising blood pressure and blood sugar. A BMI below 25 is ideal, but even losing just 5-10% of your current weight can make miraculous improvements.

Cholesterol is made up of two main types: ‘bad’ (LDL), which causes plaque to build up in our arteries, and ‘good’ (HDL), which helps to clear this plaque. Your doctor will guide you to ensure that this balance is optimal for your heart health.

Blood sugar is a critical indicator, especially for diabetics. High blood sugar damages blood vessel walls over time, hardening them and making them more prone to blockages. The hemoglobin A1c test gives you a clear picture by showing your average sugar levels for the last three months.

Blood pressure is often called the “silent killer” because it damages the heart and blood vessels, often without warning. The ideal blood pressure is below 120/80 mmHg. Getting your blood pressure checked regularly is the simplest and most effective measure you can take against this silent danger.

Which Foods are Good for the Heart?

A heart-healthy diet does not mean eating tasteless, unsalted food. On the contrary, it means turning our tables into a feast with the rich and delicious foods that nature offers us. Foods that repair the heart are actually natural and fresh foods that we can easily access every day.

You can enrich your table with these foods for heart health.
Berries: Berries such as blueberries, strawberries, raspberries; citrus fruits such as oranges and tangerines; potassium-rich bananas and avocados.
Vegetables: Dark green leafy vegetables such as spinach, chard, kale; tomatoes, broccoli, cauliflower.
Healthy Nuts and Seeds: Walnuts, almonds, hazelnuts, flaxseeds, chia seeds.
Legumes: Lentils, chickpeas, dried beans.
Whole Grains: Oats, buckwheat, brown rice, whole wheat bread.
Oily Fish: Salmon, sardines, mackerel.
Healthy Fats: Olive oil

See this list as a source of inspiration, not a list of rules. Adding a handful of walnuts to your salad, choosing oatmeal for breakfast or eating an apple as a snack are small messages of love to your heart. The best food for the heart is not a single magic food, but a colorful and balanced diet of these foods.

So, what are the foods and drinks that are not good for the heart?

Just as the right fuel protects the engine of a car, the right foods protect our heart. Some foods are the worst enemies of our heart and create a rusting effect on our blood vessels.

For your heart health, it is useful to stay away from those on this list as much as possible.

Processed meat products (salami, sausage, pepperoni)
Packaged snacks (chips, pretzels)
Sugary and carbonated drinks
Pastries and bakery products made with white flour
Margarine and all packaged foods containing trans fats
Excessively salty foods (ready-made sauces, pickles, preserves)
Fried and ready-to-eat foods (fast food)

What these foods have in common is that they are highly processed, contain unhealthy fats, excess salt and sugar. They raise blood pressure, increase bad cholesterol and lead to a general state of inflammation in the body, setting the stage for heart disease. Sugary drinks in particular are one of the biggest culprits for the empty calories we take in without realizing it and the risk of heart disease.

What Are the Most Common Types of Heart Disease?

The diseases we encounter as a cardiovascular surgeon are often structural or functional problems affecting different parts of the heart. Understanding these problems is the first step in understanding why a treatment or surgical intervention is needed.

Coronary Artery Disease: This is the best known and most common heart problem. It is the narrowing or blockage of the arteries called “coronary arteries” that feed our heart and give it life. We can liken this situation to the calcification and clogging of the water pipes in our homes over the years. Cholesterol, fat and lime accumulate on the inner wall of the arteries and form hard layers called “plaques”. As these plaques grow, they narrow the arteries and prevent enough blood from reaching the heart. This manifests itself as pressure or pain in the chest, especially during exertion. The most dangerous scenario is when one of these plaques suddenly cracks. The body recognizes this crack as a wound and quickly forms a blood clot. If this clot completely blocks the blood vessel, the area of the heart muscle it feeds begins to die. This is what we call a “heart attack”.

Heart Failure: This term is often misunderstood. Heart failure does not mean that the heart stops beating completely. Rather, it is a chronic condition in which the heart’s contractile force decreases so that it cannot effectively pump the blood the body needs. To make up for this deficit, the heart develops a number of compensatory mechanisms: it starts beating faster, its chambers dilate, it increases muscle mass. But these efforts are like giving a tired horse more whip. Over time, the heart becomes more and more fatigued and this is manifested by symptoms such as shortness of breath, weakness, swelling of the feet and abdomen.

Rhythm Disorders (Arrhythmias): Our heart has an electrical system that works in perfect synchronization. Any disruption in this system causes the heart to go out of its normal rhythm. The heart can beat much slower than it should (bradycardia), much faster (tachycardia) or completely irregularly (such as atrial fibrillation). These irregular beats prevent the heart from pumping blood efficiently and can cause dizziness, blackouts, palpitations and even fainting. Atrial fibrillation, in particular, causes clots to form inside the heart, significantly increasing the risk of stroke.

Heart Valve Diseases: Our heart has four valves that allow blood to flow in one direction. These valves work almost like a door. Over time, two main problems can arise with these doors:

Stenosis (Stenosis): Just as door hinges rust and get stuck, the valves can become calcified and hardened and cannot open. The heart then has to exert much more force to move the blood through this narrow doorway and becomes tired over time.

Regurgitation: Just as the door does not close completely but remains ajar, the valves may become loose and start leaking back. In this case, some of the blood pumped forward escapes backwards. The heart works double time because it has to pump both the forward blood and the backward blood again. This causes the heart to enlarge and, over time, its function deteriorates.

What Tests Are Performed in Suspected Heart Disease?

After listening to the patient’s complaints, we need a series of objective data to make the right diagnosis and plan treatment. These tests guide us by opening a window into the inner world of your heart.

The most common basic tests we use in the diagnostic process are the following:

Electrocardiogram (ECG)
Echocardiography (ECHO or Heart Ultrasound)
Effort (Stress) Test
Coronary Angiography

An ECG is the simplest and fastest test to record the electrical activity of the heart on a piece of paper. In seconds, it can diagnose a heart attack in a patient presenting with chest pain or reveal an underlying arrhythmia.

Echocardiography, or ECHO for short, allows us to obtain moving images of the heart using sound waves. With this test, we examine in detail the strength of the heart’s contraction (ejection fraction), how well its walls work, the size of its chambers and, most importantly, the structure and function of the heart valves. We can clearly see a stenosis or leakage in the valves.

An Exertion Test measures how your heart reacts under load, i.e. under stress. Your ECG and blood pressure are continuously monitored while you walk on a treadmill. Vascular stenoses that are asymptomatic at rest but become apparent with exertion can be detected with this test.

Coronary angiography is considered the “gold standard” in imaging vascular blockages. A thin tube (catheter) is usually inserted through an artery in the wrist or groin to access the coronary arteries supplying the heart. A special dye is injected into these vessels and X-rays are taken. This procedure clearly maps the location, number and severity of the stenoses. This map guides us in deciding whether we need a stent or bypass surgery.

Which treatment methods are used for heart diseases?

The next step after diagnosis is the treatment plan, which is tailored specifically for each patient. This plan is shaped by the type and extent of the disease and the patient’s general health. Sometimes only lifestyle changes and medications are sufficient, while other times more advanced interventional or surgical treatments are required.

How to Open a Blocked Artery?

The main goal in coronary artery disease is to open the narrowed vessel and restore blood supply to the heart muscle. We have two main methods for this: Stent and Bypass Surgery.

Stent (Percutaneous Coronary Intervention): This procedure is performed during the angiography procedure. The narrowed area of the vessel is first widened with the help of a balloon and then a “stent”, a metal cage, usually coated with medication, is placed in the area to prevent the vessel from closing again. The stent is a less invasive procedure, does not require general anesthesia and the patient can return to normal life within a few days. It is usually a great option for patients with appropriate stenoses in one or two vessels.

Bypass Surgery (Coronary Artery Bypass Grafting): Bypass is a more comprehensive solution. Just like building a new freeway to replace a blocked road, this surgery uses healthy blood vessels from another part of the body (usually the chest wall, arm or leg) to create new pathways to carry blood beyond the blockage. Bypass surgery is an open heart operation and the recovery time is longer. However, it offers a much longer-lasting and permanent solution than stenting, especially in patients with diabetes with multiple blockages or critical stenosis in the main artery of the heart. The decision is made by a “Heart Council”, taking into account the patient’s vasculature, age and comorbidities.

How to Correct Rhythm Disorders?

In cases of persistent arrhythmias where medication is insufficient, we treat the source of the problem.

Ablation: In this procedure, catheters are inserted into the heart through the groin, similar to angiography. Foci of abnormal electrical signals that “short-circuit” the heart, causing the arrhythmia, are found. These foci are neutralized by radiofrequency energy (heating) or cryoablation (freezing). This prevents abnormal signals from spreading to the heart.

Pacemaker: A pacemaker may be needed when the heart is too slow or the rhythm cannot be controlled. This system, consisting of a small device implanted under the skin and thin wires leading to the heart, keeps the heart beating in a regular rhythm.

How to Treat Deteriorating Heart Valves and Aortic Vessels?

The treatment of structural heart disease has undergone a major technological shift in recent years. In addition to traditional open heart surgery, less invasive “closed” methods are now available.

Aortic Valve Replacement: Severe aortic valve stenosis is a condition that reduces the patient’s quality of life and shortens life expectancy. The treatment is to replace the diseased valve.

Surgical Aortic Valve Replacement (SAVR): This is a traditional open-heart surgery that has been performed for many years and has very good long-term results. The diseased valve is removed by opening the rib cage and replaced with a mechanical or biological prosthetic valve. It is still the gold standard, especially for young and low-risk patients.

Transcatheter Aortic Valve Replacement (TAVR): In this procedure, the rib cage is not opened. A catheter is inserted through the inguinal artery and a new compressed biological valve is inserted into the diseased valve in the heart, where it is expanded and allowed to function. Because TAVR is less invasive, recovery is much faster. Initially, it was only applied to patients with a very high risk of surgery, but today, with the development of technology, it has become a strong alternative to surgery in patients with lower risk.

Aortic Aneurysm (Enlargement) Repair: Dangerous enlargement of the aorta, the body’s main artery, requires treatment because of the risk of rupture.

Open Surgical Repair: The enlarged vein section is surgically removed and an artificial vein (graft) is sewn in its place. This is a very durable and permanent solution.

Endovascular Repair (EVAR/TEVAR): A special coated stent called a stent-graft is inserted into the aneurysm through the groin veins. This prevents blood from entering the aneurysm sac and eliminates the risk of rupture. It is a safer option for patients at high risk of surgery.

What should be considered during the postoperative recovery period?

Successful heart surgery is not the end of the story, but the first step towards a healthy future. How well the repair done in the operating room serves you for many years depends on how involved you are in the process. It is a teamwork between the surgeon and the patient.

The postoperative period is as important as the surgery itself. The most critical points to be considered in this process is to return to the principles of healthy living that we discussed at the beginning. It is vital to take the medications recommended by your doctor on time, without missing a day. To prolong the life of the bypass vessels or the new valve, it is a non-negotiable rule to stop smoking completely.

You need to reorganize your diet in a way that does not tire your heart, but rather gives it strength. Reducing salt, choosing healthy fats and avoiding processed foods will keep your blood pressure and cholesterol under control, protecting your new arteries and valves.

Finally, getting back to physical activity. Of course, this will be gradual and to the extent permitted by your doctor. Starting with small walks and increasing your activity level over time will make you feel much better both physically and mentally. Remember, surgery is a repair; the long-lasting health of your heart and the permanence of this repair is in your hands. May this new beginning bring health and happiness to you and your heart.