Your heart matters.

Cara King, DO

“Chronic pelvic pain is defined as pain in the lower abdomen, pelvis or genital area that lasts longer than six months,” says Cara King, DO, a Cleveland Clinic Ob/Gyn physician and surgeon who specializes in minimally invasive gynecologic surgery. Dr. King treats patients at Cleveland Clinic Hillcrest Hospital and main campus. “For many women, the pain can be traced to the reproductive organs, but it can also come from the bladder, the gastrointestinal system, or nerves of pelvic and abdominal muscles. In some cases, the pain comes from multiple causes, making it difficult to diagnose the exact cause.”

As a result, Dr. King explains that a woman could experience and deal with pain for seven to 10 years before seeking care and receiving a formal diagnosis.

“During those years, a lot of things can start to contribute to the pain. Years of painful periods can be from endometriosis, which can then lead to pelvic floor issues or changes to nerve pathways, and affect other systems like the bowels and ovaries,” she says. “The longer a woman has lived with the pain, the longer it often takes to get better.”

Dr. King explains that due to its many possible causes, it is truly a team effort to diagnose, then treat, chronic pelvic pain. Cleveland Clinic’s Center for Endometriosis and Chronic Pelvic Pain includes a team of physicians, nurses, psychologists, counselors, physical therapists and occupational therapists working together to address all aspects of care.

The most common causes of chronic pelvic pain are adenomyosis and endometriosis. The inner lining of the uterus, called the endometrium, is shed through the vagina during menstruation. In adenomyosis, tissue from the lining of the uterus grows into the uterine wall, enlarging the uterus. Symptoms include heavy periods, cramping, painful sex and infertility. In endometriosis, tissue similar to the lining of the uterus grows outside the uterus and may involve the ovaries, fallopian tubes, pelvic side walls or bowel. It’s most common in women ages 25 to 40.

Other causes of chronic pelvic pain include uterine fibroids, interstitial cystitis (painful bladder syndrome), pelvic floor dysfunction, irritable bowel syndrome and vulvodynia (chronic pain of the vulva).

It’s important to manage cardiac conditions during the pandemic.

COVID-19 dramatically changed our lives. Many people have stayed home to protect themselves and others. Some have even avoided going to doctor appointments or making a trip to the hospital.

But, even though COVID-19 is here for a while, it’s important to stay healthy during the pandemic — especially when it comes to your heart.

“Patients should continue to seek medical care when necessary,” says Surovi Hazarika, MD, PhD, a cardiologist at Avon Hospital at Richard E. Jacobs Campus and Lorain Family Health and Surgery Center.” “We don’t want those with heart-related issues not taking prescribed medication or avoiding medical care. Both can contribute to unnecessary cardiac issues.”

COVID-19 and your heart

Those with heart disease — a term used to encompass a range of disorders that affect the heart — have an increased risk of developing more severe symptoms and issues if they contract COVID-19.

In some patients, COVID-19 can affect the heart muscle and lining, coronary arteries and nerves. It can cause cardiovascular implications and can affect the vascular system as well as cause long-term effects.

“Many COVID-19 patients with underlying heart disease have had more severe side effects to the disease,” explains Albert Chan, MD, a cardiologist who sees patients at Cleveland Clinic Avon Hospital, Fairview Hospital, Lakewood Family Health Center, and Richard E. Jacobs Health Center in Avon. “It’s important to continue social distancing and wearing masks. Everything we’re doing is necessary to mitigate the virus spread — especially for those who are at high risk.”

Heart disease conditions can include:

Are you at risk?

Most people have heard of common heart attack risk factors such as family history, race, smoking, diabetes, high blood pressure, obesity and high cholesterol, but there are heart attack risk factors that many don’t know about.

Lesser-known heart attack culprits include:

Intense emotions. Studies have shown that both intense anger and grief can occasionally trigger a heart attack.
Sudden exertion. A bout of sudden, strenuous physical activity can lead to heart attack in people who are not physically fit.
Extreme cold. Cold temperatures cause the arteries to constrict, which can cause a sudden increase in blood pressure.
Eating a heavy meal. A heavy meal can occasionally trigger a heart attack. No one knows exactly why this happens, but eating does divert blood away from the heart and pushes it toward the GI tract, which can be problematic for susceptible individuals.

“Knowing if you’re at risk is imperative in order for cardiac issues to be treated as early as possible,” says AR Wattar, MD, a cardiologist at Cleveland Clinic Avon Hospital, Fairview Hospital, Lakewood Family Health Center, and Richard E. Jacobs Health Center in Avon. “Weight gain and stress are two common results of the pandemic. Both of which are precursors to increasing heart conditions.”

Preparation is key

On top of dealing with the stress of the pandemic, visiting a cardiologist can be stressful — especially when an individual is concerned about their health and unsure about their future. It may feel like things are out of your control, but there are some proactive steps you can take to prepare for and ensure the success of your appointment:

Write down your symptoms, when they occur and what makes them worse or better.
List your cardiac risk factors. Family history is especially important.
Compile a list of your medications — include prescription medications and over-the-counter medications, including any vitamins and supplements.
Include a list of medications you may have tried in the past for your condition and had an allergic reaction or poor response to.
Write down any specific questions you have, and include the most important reason you are seeing your cardiologist (specific symptom, second opinion, etc.)

“It’s important to have a good relationship with your physician and to be fully informed. Feeling like you’re part of a team helps patients be empowered and aids in a positive outcome,” advises Dr. Wattar.

Podcast: What Do You Know About COVID and Your Heart?

Caring for your heart

Your primary care physician can refer you to a cardiology specialist if there are concerns or risk factors. To pinpoint any issues associated with your heart, your cardiologist can order a stress test (to see how your heart works during physical activity), heart scan (to look for calcium issues), or blood tests (to check for concerning issues like high cholesterol).

If you’re currently taking prescription medication for your cardiac condition, it’s important to continue taking the medication unless otherwise instructed by your physician.

“We all know that the uncertainty in the world can be scary, but taking your medication and seeking medical care is important now more than ever,” says Dr. Hazarika.

Nationally recognized

For the 26th consecutive year, Cleveland Clinic’s heart program is ranked No. 1 in the nation by U.S. News & World Report. Since 1995, no hospital in the country has ranked higher in cardiac care. But there’s another nationally ranked heart program in town. And it’s right in your neighborhood. U.S. News & World Report ranks Cleveland Clinic Fairview Hospital No. 48 in the country for cardiology and heart surgery.

Cleveland Clinic is here to care for you

Although COVID-19 is still around and still contagious, Cleveland Clinic has taken steps to allow you to return safely for your healthcare needs — including cardiac and emergency care.

To protect you, Cleveland Clinic continues to: