November 2018

Dieting? Go Ahead and Enjoy a Traditional Thanksgiving Dinner

If you don't want to be seduced by the dessert table, try one of these approaches: - Take one bite (not one slice) of every dessert you like, so you won't feeldeprived. - If you can't resist a piece of pie, take one, but pass up the stuffing, rolls andpotatoes. - Walk around the block instead of eating dessert. Your desire for it will fade, ifyou wait long enough. - Offer to clean up the dishes instead of eating dessert. By the time you are done, most desserts will be gone, and the remainder will look messy and unappetizing.   More...

Heart Beat: November 2018

Patients with heart failure with preserved ejection fraction (HFpEF) find their ability to walk and carry out the American Journal of Medicine suggests lack of vitamin D may be partly responsible. Vitamin D is thought to play a role in cardiovascular and muscle function, but its relationship with exercise capacity has been unknown. Researchers measured vitamin D levels in 112 HFpEF patients and 37 matched controls, all of whom took a six-minute walk test and had their peak oxygen capacity measured. Vitamin D levels were found to be significantly lower in HFpEF patients than in controls. More than 90 percent of HFpEF patients had insufficient vitamin D levels or were frankly deficient. These low levels were associated with more severe exercise intolerance. This study laid the groundwork for a randomized, controlled clinical trial to evaluate whether vitamin D supplementation could be effective in improving exercise tolerance.   More...

The Evolution of a Heart Attack

Subscribers Only — Immediate testing is done to determine whether or not a heart attack has occurred. These include an electrocardiogram (ECG) and a blood test for troponin, a protein that spills into the blood when heart muscle dies. If the troponin test is negative, a heart attack has likely not yet occurred. These patients are given several types of medication to prevent their condition from deteriorating.   More...

Read This Before Taking Any Kind of Herbal Supplement

"One of my patients, who was on dual anti-platelet therapy after stenting, decided to take large doses of garlic. He ended up in the emergency department with dangerous internal bleeding," Dr. Cho recalls. "Another patient took hawthorn, and it increased the potency of her digitalis. This caused her ejection fraction and kidney function to plummet."   More...

Leadless Pacemakers Prove Unlikely to Cause Infection

Each year, about 1 million people in this country receive a pacemaker to regulate their slowing heart rate. These pacemakers are implanted in a pocket of tissue under the skin and send electrical pulses down a lead (wire) inserted into the heart muscle. Pockets can be a source of infection, which then spreads into the bloodstream via the lead and can infect the heart.   More...

New Tests Improve the Ability to Predict Future Heart Attack

Subscribers Only — Many of us know that cholesterol, blood sugar, blood pressure, body-mass index and smoking are modifiable risk factors for heart disease. If you smoke or have high levels of the other risk factors, you will need to make lifestyle changes and/or take medications to prevent a heart attack. But these measures don't always stop a serious cardiac event fromoccurring.   More...

Ask The Doctors: November 2018

Whether to continue taking clopidogrel with aspirin over the long term is a different issue. Aspirin alone can increase the risk of bleeding, and this risk increases with the combination of medications. Low-dose aspirin plus clopidogrel or other anti-platelet drug is recommended for up to one year after MI. Continuing the combination beyond that point is not common practice in all patients, since the increased bleeding risk may outweigh the benefits. However, the combination may be continued in certain patients, including those who received a left main artery stent, complex overlapping or branch-point stents, recurrent MI, in-stent clots or vascular events such as a transient ischemic attack while on aspirin alone. Even in these situations, an individualís bleeding risk needs to be considered to ensure safety.   More...