October 2018

Soothing the Stresses of Heart Disease

How involved a patient wants to be in music therapy depends on their diagnosis and whether they sing or play an instrument. Many simply want to listen to music. For these patients, the music therapist will select works likely to be therapeutic. When McFee sees the potential to help improve a patient’s medical condition, she encourages them to participate in music-making using an instrument on her cart that doesn’t require special training or talent to play.   More...

Heart Beat: October 2018

Depression after a heart attack can have serious, even deadly, consequences. However, the effect of antidepressants on outcomes has been unknown. A 300-patient study published in the July 24/31 issue of JAMA suggests that treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro®) significantly reduced the risk of a major cardiac event. Patients who had recently suffered a major or minor heart attack were randomized to the antidepressant or placebo for 24 weeks and then followed for a median of eight years. All-cause death, deaths from heart disease, heart attacks and revascularizations with angioplasty and stenting were tracked. At the end of the study, 40.9 percent of the patients on escitalopram had met one of these outcomes, compared with 53.6 percent of those who had received the placebo. When individual outcomes were examined, the SSRI beat placebo in all measures. However, only reduction in heart attack (8.7 percent vs 15.2 percent) was statistically significant.   More...

Fainting May Indicate an Underlying Heart Problem

Subscribers Only — Sixty percent of people in the world have fainted at least once in their life. In most cases, the underlying reason is a benign condition called vasovagal syncope (the medical word for “fainting”). It occurs when blood pressure suddenly plummets, causing a drop in blood flow to the brain.   More...

Keys to a Longer Life Revealed

Subscribers Only — The average life expectancy in the United States is estimated to be 79 for a woman and 75.5 for a man—lower than that of other developed nations. A prosperous life with too much food and too little exercise is to blame. Experts say the rapid rise in obesity and decline in physical activity are mainly responsible for high levels of cardiovascular disease in this country and many cancers. They say three-fourths of premature deaths from cardiovascular disease and half of premature deaths from cancer can be attributed to lack of a low-risk lifestyle.   More...

How to Stay Out of the Hospital

Subscribers Only — Cleveland Clinic offers heart-failure education classes designed to teach patients and their families what they need to know about the condition, its progression, its impact on day-to-day life and its medications. Ask your cardiologist if there’s a similar program in your area. If not, ask for information in writing.   More...

New Approaches to Losing Weight and Gaining Blood Sugar Control

Subscribers Only — Fasting: Intermittent fasting has been shown to be effective for both weight loss and diabetes resolution. With this approach, you eat a very low-calorie diet (500 calories if you’re a woman, 600 if you’re a man, split between two meals) two days a week, but not on successive days. “Just make sure you talk with your physician first to ensure fasting will not interact with your medications,” she advises.   More...

Persistent Coughing Can Be a Symptom of Heart Failure

Subscribers Only — “I have met patients who were first diagnosed as having a respiratory issue. Over time, when their symptoms did not improve with appropriate treatment, heart failure was entertained as a diagnosis,” says Cleveland Clinic heart failure specialist Miriam Jacob, MD.   More...

Ask The Doctors: October 2018

In clinical trials, certain newer diabetes medications have been shown to reduce CVD events in addition to lowering blood sugar in diabetics at high risk for CVD. The GLP-1 receptor agonists liraglutide (Victoza®, Saxenda®) and semaglutide (Ozempic®), and the SGLT2 inhibitors empagliflozin (Jardiance®) and canagliflozin (Invokana®) have been shown to be superior to placebo at preventing CVD death, heart attack, stroke and heart failure in patients with known CVD. Both drug classes are associated with lower risk of symptomatic low blood sugar levels (hypoglycemia) and weight loss.   More...