Your Cardiologist in Barcelona commenting on…

Dr. Juan Carlos Portugal cardiólogo en Barcelona

Your english speaking cardiologist in Barcelona

As a cardiologist I would like to give you my personal comments on some hot topics. In this blog,  I will answer some of the most frequent and researched querys on Google or presented from patients.

Heart Disease – how it presents in women versus men

(overwhelming research done on men)


Lifestyle will influence cardiac heart disease in both men and women. Since estrogens will protect women, heart disease will eventually occur later in life (10-15 years of difference). However, with increasing age this “protective gap” will be lost and by the decade of 60-70 this gap will no longer be perceived. Preventive measures and check ups should be performed similarly  encouraging a healthy lifestyle that will have an effect on us earlier or later.


Fasting -implication to heart health


My medical education and early years were full of advice towards frequent feeding and putting emphasis on breakfast as the “most important meal of the day”. Later research, has not only showed that this information might not be accurate or effective to all. First studies were conducted secondary to observations in Muslim communities showing less cardiovascular events during Ramadan and the ability of some endurance athletes to work better while training on an empty stomach. Some years ago, first studies concluded that, not all fasting diets which might be referred as fad-diets but the Ramadan-like Time Restricted Eating Interval Pattern will enhance health condition status and that will be able to actually counteract insulin resistance not only responsible for diabetes and inflammation but also for our inability to maintain a healthy weight. Also, lower blood pressure, total cholesterol levels and improved energy and sleep quality were reported, all of these significantly improving the overall health condition.



Role of genetics in heart disease


Genetics is inherently (never better said) responsible of our health condition and the cardiovascular events that might affect our life. However, genetics need a proper environment to affect our health and quality of life. And, most of the time, is not genetics that will condition our possibilities of suffering a heart attack. Let me explain this further, a family with history of heart disease and cardiovascular conditions might be genetically predisposed to cardiovascular events, however, lifestyle will be most of the time (>90% of cases in my practice) the driver that will trigger those adverse events. Parents that will not do sports, have cereals and orange juice for breakfast, eat a lot of comfortable food, rice, white bread, will enjoy barbecues and won’t encourage salads in the diet will eventually pass their lifestyles to their children who will repeat the same patterns. Those parents might become hypertensive or even suffer a cardiovascular event in their 40s but their children who will exercise, and change their diet might never follow the same patterns.



Irregular heartbeats – are they dangerous?

(Increasing with age?)


Extra beats or irregular heart beats might be a sign of different heart conditions ranging Stress or anxiety Premature Ventricular Beats that might not be dangerous and are frequent in young patients to atrial fibrillation or flutter and non sustained ventricular tachycardias that might be really dangerous and are specially frequent with increasing age. Any of this arrhythmias might be triggered by stress, over training, reduced sleep or excessive intake of supplements and stimulants but they should never be considered benign until properly assessed. The signs that should trigger an immediate assessment by your cardiologist are chest pain, syncope (fainting) and shortness of breath.


How can a cardiologist help with sports performance?


Provided that a cardiac check up has already been performed to rule cardiac disease, a sports cardiologist can assess your exercise capacities and the energy source of all of them. Our capacities need to be balanced according to the goals that athletes will try to achieve. For example, a marathonian will need really high aerobic capacities so most of the efforts will be performed under aerobic capacities that will almost not generate any fatigue so he will endure and will prefer to use fats as energy source. However, a 10 km athlete will be more interested in increasing his tolerance to fatigue without reducing his aerobic capacity. This is really important because our aerobic capacity is related to our recovery capacity, meaning that if we don’t stimulate it we won’t be able to recover after the specific 10k trainings. The ergospirometry can assess which are the thresholds of our capacities and your cardiologist can advise you how to plan your training in order to balance your capacities for the specific goal. I frequently see athletes that will complain of lack of progression that will occur when they have stopped stimulating their recovery capacities or they have overestimated where the threshold for aerobic capacity occur.

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