Heart and cardiology

1,642 articles · Since 2004

Articles, page 45

Shared decision making to determine implantable defibrillator need

February 15, 2011Feb 15, 2011

Implantable defibrillators are truly life saving devices that have prevented sudden death in thousands of patients. No bigger than an iPod nano, the device can sense when the heart is beating irregularly and deliver an electrical jolt that kicks it back into proper rhythm. But like so many of medicine’s miracles, defibrillators are not always used on the right patients. According to a study published recently in the …

Conditions and diseases

Does screening and treating high cholesterol save money?

Richard Young, MD

February 10, 2011Feb 10, 201141

A commenter (I believe a physician) on one of my posts wrote the following: "I can prevent heart attacks and strokes (caused by atherosclerosis – "blockage") in people (minimal cost) who have no symptoms. If I wait for their heart…

A commenter (I believe a physician) on one of my posts wrote the following: “I can prevent heart attacks and strokes (caused by atherosclerosis – “blockage”) in people (minimal cost) who have no symptoms. If I wait for their heart attack or stroke – it costs a whole lot more.”

The implication is that screening and treating high cholesterol saves money in the long run. Unfortunately, the truth is the opposite. …

Patient voices

Dabigatran (Pradaxa) questions in atrial fibrillation

Larry Husten, PhD

January 27, 2011Jan 27, 20113

The approval of dabigatran (Pradaxa) has been long awaited in the cardiology community. Although just about everyone agrees that a good alternative to warfarin is highly desirable, there are many remaining questions about the drug as it prepares to enter…

Here are a few questions raised by electrophysiologist John Mandrola on his blog:

In the RE-LY trial, dabigatran was used twice daily. When not symptomatic, patients often

…

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Patient voices

How often to see your doctor when feeling well

Eric Van De Graaff, MD

January 17, 2011Jan 17, 20116

How often do you see your doctor? Once a year? Every 6 months? Never? Most of you are pretty healthy and only show up for screening physical exams or aches and pains. Some of you may have more health problems…

What if you had diabetes, coronary disease, hypertension, high cholesterol, and sleep apnea, but no symptoms to indicate any …

Patient voices

Heart attack symptoms in women, in their own words

Carolyn Thomas

December 31, 2010Dec 31, 201025

Having a heart attack felt nothing like I thought it would feel. For one thing, unlike sudden cardiac arrest, in which the heart stops beating and you stop breathing, during my heart attack (myocardial infarction), my heart continued beating, and…

Physician voices

Suspicious withdrawal of a publication from an academic journal

Larry Husten, PhD

November 30, 2010Nov 30, 2010

The official ESC journal Europace publishes an online case report by Dr. Martin Hudec about the extremely rare and spectacular failure of a recently implanted Biotronik 340 VR-T ICD in a 46-year-old man. The battery of the device apparently overheated,…

The official ESC journal Europace publishes an online case report by Dr. Martin Hudec about the extremely rare and spectacular failure of a recently implanted Biotronik 340 VR-T ICD in a 46-year-old man. The battery of the device apparently overheated, causing the device to malfunction and leading to severe internal burning.

On Wednesday, October 6, US electrophysiologist Westby Fisher summarizes the Europace article on his blog and reprints several extremely gruesome …

Patient voices

Never hesitate to seek a second medical opinion

Eric Van De Graaff, MD

November 19, 2010Nov 19, 201013

To celebrate your 50th birthday you head to your doctor’s office to get your yearly exam. He rewards you for your diligence by poking and prodding you, sticking you with needles, and arranging for a colonoscopy (happy birthday!). He also…

A slightly abnormal treadmill test leads to …

Physician voices

How dietary guidelines can help prevent disease

Stephen C. Schimpff, MD

November 13, 2010Nov 13, 20106

Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease. These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are…

Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease.

These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are not all that difficult to prevent. Unfortunately, our dietary guidelines are of little or no help in this regard but could be.

In 1941, following studies that demonstrated …

Physician voices

Conflicting stories on alcohol and heart disease

John Mandrola, MD

November 4, 2010Nov 4, 20105

Have you ever had a cold beer after a mountain bike ride? Oh my! But does such indulgence put one at risk for an arrhythmia? Does alcohol exacerbate an existing arrhythmia? How much, if any, alcohol is acceptable? These are…

Have you ever had a cold beer after a mountain bike ride?

Oh my!

But does such indulgence put one at risk for an arrhythmia? Does alcohol exacerbate an existing arrhythmia? How much, if any, alcohol is acceptable?

These are questions I am asked frequently. And for those asking, they are very important questions.

I wish the answer was straightforward. But it is not.

Undoubtedly, excessive alcohol can precipitate an abnormal rhythm. Look no farther …

Drugs and prescribing

Controversy about NSAIDs and heart health

Marianna Rakovitsky, RPh

October 18, 2010Oct 18, 20102

Recently there has been a lot of controversy about the use of NSAIDs and heart health. NSAIDs are medications for pain and inflammation. Many of them are sold over the counter and they are used by millions of people for…

Recently there has been a lot of controversy about the use of NSAIDs and heart health.

NSAIDs are medications for pain and inflammation. Many of them are sold over the counter and they are used by millions of people for various aches and pains as well as for more serious chronic conditions such as arthritis. Aspirin is technically an NSAID, but its effects on the heart …

Drugs and prescribing

Why a marketing study for Niaspan was published in a medical journal

Larry Husten, PhD

September 3, 2010Sep 3, 20102

The authors call it “an in-office linguistic study” and write that it “was conducted to assess physician–patient discussions of mixed dyslipidemia.” But it’s really an Abbott marketing study for Niaspan, the company’s long-acting niacin product, and the question is: why…

The study involves the recorded conversations of 12 cardiologists and 12 PCPs with 45 patients with low levels of HDL. The …

Drugs and prescribing

Statins for heart disease and stroke, and debunking statin myths

Eric Van De Graaff, MD

August 27, 2010Aug 27, 201022

There is no class of medications in the history of the world that has been better studied that statins. This class of drugs is more properly termed HMG CoA reductase (3-hydroxy-3-methyl-glutaryl co-enzyme A reductase) inhibitors, but with a name like…

There is no class of medications in the history of the world that has been better studied that statins.

This class of drugs is more properly termed HMG CoA reductase (3-hydroxy-3-methyl-glutaryl co-enzyme A reductase) inhibitors, but with a name like that a terser nickname is almost mandatory (the name statin comes from the suffix of the members of this class: lovastatin, pravastatin, etc.).

Simply …

Conditions and diseases

Heart health depends on healthy behaviors

John Mandrola, MD

August 17, 2010Aug 17, 201015

Everyone knows that the heart health of Americans is dismal. Obesity, diabetes, and high blood pressure are all on the rise. For now, technological advances in cardiac care continue to maintain, or in some cases, lower the death rate from…

Everyone knows that the heart health of Americans is dismal. Obesity, diabetes, and high blood pressure are all on the rise.

For now, technological advances in cardiac care continue to maintain, or in some cases, lower the death rate from heart disease. Squishing blockages, ablating abnormal heart tissue, and installing cardiac devices have successfully kept the abysmal lifestyle habits of so many at bay. Despite all the fury of modern technology …

Conditions and diseases

Unread echocardiogram fallout at Harlem Hospital Center

Larry Husten, PhD

August 3, 2010Aug 3, 20103

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician. It turns out that out…

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician.

It turns out that out of 7,000 tests that went unread, only 14 patients “might have been misdiagnosed because their tests had not been handled properly,” according to the hospital spokeswoman quoted in the story. …

Conditions and diseases

Diabetes is responsible for many heart disease deaths

MedPage Today

July 30, 2010Jul 30, 2010

by Kristina Fiore More than one in 10 heart disease deaths may be attributable to diabetes, researchers say. In a meta-analysis of more than 100 studies, diabetes was associated with a twofold increased risk of the disease and was estimated…

by Kristina Fiore

More than one in 10 heart disease deaths may be attributable to diabetes, researchers say.

In a meta-analysis of more than 100 studies, diabetes was associated with a twofold increased risk of the disease and was estimated to be accountable for 11% of vascular deaths, according to Nadeem Sarwar, MD, of the University of Cambridge in England, and colleagues.

They reported their findings online in The Lancet and will present …

Drugs and prescribing

Homocysteine lowering does not reduce heart attack risk

MedPage Today

July 29, 2010Jul 29, 2010

by Crystal Phend Homocysteine-lowering supplements do not help prevent further cardiovascular events in heart attack survivors, a large randomized trial affirmed. The trial, which followed more than 12,000 heart attack survivors over nearly seven years, found that folic acid plus…

by Crystal Phend

Homocysteine-lowering supplements do not help prevent further cardiovascular events in heart attack survivors, a large randomized trial affirmed.

The trial, which followed more than 12,000 heart attack survivors over nearly seven years, found that folic acid plus vitamin B12 effectively reduced homocysteine levels, but did not reduce major vascular events overall nor any other individual endpoint compared with placebo, reported Jane M. Armitage, BM BChBSc, MBBS, of the University …

Conditions and diseases

Smoking, hypertension, obesity, and 7 other stroke risk factors

MedPage Today

July 22, 2010Jul 22, 20103

by Kristina Fiore There are 10 factors that appear to make up the vast majority of stroke risk, and half of those are modifiable, a large population study found. Hypertension appears to be the strongest predictor of stroke, along with…

by Kristina Fiore

There are 10 factors that appear to make up the vast majority of stroke risk, and half of those are modifiable, a large population study found.

Hypertension appears to be the strongest predictor of stroke, along with smoking, abdominal obesity, diet, and physical activity, according to Martin J. O’Donnell, MB, PhD, of McMaster University in Hamilton in Ontario, Canada.

“This is good news in the sense that the causes of …

Conditions and diseases

Echocardiogram reading by cardiologists needs to improve

MedPage Today

July 16, 2010Jul 16, 2010

by Crystal Phend Insufficient training among cardiologists in reading echocardiography results is wasting healthcare dollars and subjecting patients to unnecessary procedures, researchers said. A review by sonographers of cardiologist-interpreted echocardiography findings at a Milwaukee medical center during a period of…

by Crystal Phend

Insufficient training among cardiologists in reading echocardiography results is wasting healthcare dollars and subjecting patients to unnecessary procedures, researchers said.

A review by sonographers of cardiologist-interpreted echocardiography findings at a Milwaukee medical center during a period of just over a year indicated major discrepancies in 29% of cases, leading to unnecessary further diagnostic testing or treatments for the wrong indication, according to a study presented here at the American …

Conditions and diseases

Stents to treat blocked heart arteries are not an easy fix

John Mandrola, MD

July 15, 2010Jul 15, 20102

Cardiologist Richard Fogoros -- aka DrRich -- has put out an incredibly timely and pertinent piece of advice concerning the common practice of stenting blockages in the coronary arteries. He succinctly summarizes a small retrospective study that showed an increased…

Cardiologist Richard Fogoros — aka DrRich — has put out an incredibly timely and pertinent piece of advice concerning the common practice of stenting blockages in the coronary arteries.

He succinctly summarizes a small retrospective study that showed an increased risk of cardiac events after non-cardiac surgery in patients who have recently undergone either a bare metal or drug-eluting coronary stent.

On a website clearly designed to educate patients, DrRich rightly points …

Conditions and diseases

Short stature increases heart disease risk

MedPage Today

July 9, 2010Jul 9, 2010

by Todd Neale People of short stature appear to have a heightened risk of adverse cardiovascular outcomes compared with their taller counterparts, according to a new meta-analysis. Among 22 studies analyzed, the shortest people had a 1.46-fold greater risk of…

by Todd Neale

People of short stature appear to have a heightened risk of adverse cardiovascular outcomes compared with their taller counterparts, according to a new meta-analysis.

Among 22 studies analyzed, the shortest people had a 1.46-fold greater risk of coronary heart disease or death, Tuula Paajanen, MD, of the University of Tampere in Finland, and colleagues reported online in the European Heart Journal.

A critical height cutoff point for increased risk could …

Heart and cardiology

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