Dr. Ariel Soffer of Miami Jackson North Medical Center joined Gator Clause on Tuesday to answer questions about heart disease and how it might relate to Florida Gators coach Urban Meyer. Jackson North's chief cardiologist, Soffer is also an assistant clinical professor of FIU's School of Medicine. He's also a sports fan. Soffer was the Florida Panthers' official cardiologist for four years but no longer travels with the team because he "couldn't handle the losing anymore."
Sounds vaguely familiar. Florida coach Urban Meyer does not react very well to losing. After Florida's first loss in 23 games, Meyer resigned as head coach of the Gators only to return one day later. Is he simply burned out or is it something more severe? Meyer has declined to go into detail about his apparent medical condition. On Tuesday, Gator Clause gave the good folks at Miami Jackson North Medical Center a buzz to see if we could get some answers about what exactly might be wrong with Meyer. The most likely culprit? Heart disease.
GATOR CLAUSE: How does stress affect heart disease?
DR. SOFFER: It has been clearly shown in the literature in multiple different peer-reviewed publications that stress in and of itself can be an independent risk factor along with the more commonly known ones such as smoking, diabetes, high cholesterol, obesity and family history. But stress in and of itself is being really evaluated and considered by most of us in the cardiologic community to be a risk factor along with them.
The problem with that is cholesterol is very nice because and you have a number and your number is either high or low. It’s a very simple matter to diagnose and to quantify. Stress is really something that is how a person perceives a particular situation. Unfortunately, one person can take one situation and it can be stressful to them and another person can take that same situation and it can be non-stressful. Unlike cholesterol or weight or sugar levels, it is not as quantifiable yet to be able to predict who’s having a certain amount of stress and how they might be affected by it. The long story short, stress is considered an independent risk factor. Quantifying the type of stress and how it affects a person has been pretty illusive to most of us. That being said, I have in my practice a clinical psychologist that often sees patients that I think have stress worsening their heart conditions and that’s shown to be very helpful across the country to a variety of cardiologists.
GATOR CLAUSE: Is 45 young to have heart problems that are related to stress or does age not matter?
DR. SOFFER: It’s pretty much not young anymore. We’re seeing in our society because of other risk factors—mostly cholesterol and weight-related issues—we’re seeing heart disease younger and younger. So, 45 used to be considered young for heart disease but I can tell you in my clinical practice we’re seeing it in folks in their 20s that come in when we really didn’t see it as much in the previous decade. I don’t know enough about his medical history to comment on his other risk factors—his family history, whether or not he smokes or has high cholesterol or diabetes—but certainly Urban has self proclaimed that he’s under a lot of stress.
We saw what happened to President Clinton, a person that had multiple risk factors, including probably a high fat diet and certainly under a lot of stress and ultimately ended up with a bypass at also a fairly young age. People under stress that particularly have other risk factors tend to compound it. That’s the big question with Urban. Does he have other risk factors? If it’s stress alone, I would say 45 is pretty young to have developed a form of heart disease. If it’s stress with other risk factors we find that it’s generally compounding, where one plus one doesn’t equal two but one plus one, say if you’re smoking and possibly high cholesterol and you have a high-stress situation, you are many more times more likely to have developed heart disease than you would be with any of those risk factors removed. It wouldn’t just be one-third less. It would be much, much less.
GATOR CLAUSE: How does stress manifest itself physically in the human body as it relates to the heart?
DR. SOFFER: Stress releases hormones and the hormones have a very interesting affect on blood vessels. They tend to tighten the blood vessels when they maybe don’t need to be tightened. In particular, we find that that tightening of blood vessels and the hormonal changes that it does within the entire circulation can bring out heart disease more quickly than if those stress hormones that are elicited, the fight or flight response if you will, that we’re normally suppose to have. If that happens too frequently, those stress hormones can cause circulation problems. Generally, for lack of a better term or for the lay public, a premature both hardening of the arteries as well as during a period where we have these plaques in hardened arteries and they’re more likely to rupture in stressful situations.
GATOR CLAUSE: Urban has also lost a considerable amount of weight. Can this be related to heart disease or perhaps something else?
DR. SOFFER: The times that you worry about it is when it’s not planned weight loss. That can be a manifestation of other underlying disease — oftentimes chronic diseases or cancer. If it’s weight loss because of diet and exercise, it’s generally good for the heart. If you’re losing weight because you have an underlying pathology or possibly a mental issue, such as depression, generalized anxiety disorder or anorexia — the list goes on — it’s not good.
GATOR CLAUSE: The ultimate question is can this be fatal? He's not walking away from a job that pays $4 million a year for nothing.
DR. SOFFER: If it’s heart disease in general, almost every type of heart disease can be fatal. The old saying serious as a heart attack prevails here. If it’s anything to do with the heart and he’s not responding to stress appropriately it can be fatal. It only takes one arrhythmia to kill a person. So, if he’s got any form of heat disease, stress can be very problematic.
GATOR CLAUSE: How do you treat heart disease?
DR. SOFFER: We understand the heart pretty well and we can fix most of what’s there. If you look at Phil Jackson, for instances, Phil Jackson had a closing of one of his arteries during a playoff game, had it opened with a balloon and a stent in the 90s and went back, I believe, to the next game two days later. We can fix a lot of these plumbing and mechanical related issues. What takes a long time to do is to teach a person to deal with stress in a better more healthful way.
GATOR CLAUSE: Please explain.
DR. SOFFER: It’s sort of like, you know, there are two ways of reacting to a pterodactyl flying at you. One is to become extremely concerned about it and frozen, if you will, and the other to sort of say, ‘OK, it’s a pterodactyl and I’m used to it flying towards me and I’m simply going to, you know, and dip into my little hole right here until it flies away and not allow the hormones that are released to really wreck havoc on my circulatory system.