August 2018

As You Become Increasingly Frail, Your Heart Attack and Stroke Risk Grow

Frailty is not necessarily associated with older age alone. More often than not, itís a consequence of poor lifestyle choices that lead to deconditioning. Thatís why there are 60-year-olds whose descent into frailty is preceded by years of high blood pressure, diabetes, and other cardiovascular risk factors that cause them to become increasingly sedentary and at risk for heart attack and stroke.   More...

Heart Beat: August 2018

After a careful review of 17 years of statin studies, the European Atherosclerosis Society concluded that the potential benefits of statins outweigh the risks. Their consensus document, published online April 27, 2018, in the European Heart Journal, examined the incidence of several serious side effects attributed to statins and weighed them against the drugsí benefits. Statins were associated with one case of new-onset diabetes per 1,000 patients per year, but prevent three to five new cardiovascular events per year in the same population. They found no evidence that statins have an adverse effect on cognitive function or cause Parkinsonís disease, Alzheimerís disease or any other form of dementia. Risk of harm to the kidneys is minor, because statins are largely metabolized by the liver. There was a small increased risk of hemorrhagic stroke in patients with a history of ischemic stroke who take high-dose atorvastatin, yet statin therapy significantly reduces the risk of ischemic stroke.   More...

Abandoned Leads Can Cause Major Problems Later On

Various types of CIEDs are used to restore a normal rhythm when a heart starts beating too slowly, too fast or irregularly. They range in sophistication from a simple, single-chamber pacemaker with one lead to a biventricular pacemaker with defibrillator, which has three leads. Regardless of the number of leads, all CIEDs have a battery that sends electrical impulses down the wires into the heart muscle to make itcontract.   More...

Should Your Replacement Valve Be Made of Tissue or Metal?

Subscribers Only — ďPorcine valves typically fail suddenly and unpredictably by tearing. If this were to happen in the aortic position, the patient would require emergency surgery. Thatís why we use porcine valves in the mitral position. If a mitral valve fails, we can lower the patientís blood pressure or use a balloon pump to hold the patient until the valve can be replaced,Ē heexplains.   More...

Don’t Let a Stress Test Stress You Out

Subscribers Only — This is a special type of stress test ordered to evaluate heart failure or a potential heart transplant recipient, or to determine whether shortness of breath is caused by heart or lung disease. It is performed on a treadmill or cycle with EKG, but a breathing apparatus is used to measure oxygen use and carbon dioxide production.   More...

Thrombectomy Does Not Alter the Need to Treat Stroke Quickly

Subscribers Only — Paramedics are taught to take stroke victims to the nearest stroke center. But it may be in some patientsí best interest to be taken to a center that performs thrombectomy, even if itís farther away. These may be patients with severe strokes, in which case one-half their body may be paralyzed, their eyes may be pulling to one side and they may have difficulty speaking. Because itís not always that straightforward, Dr. Hussain and colleagues are developing a grading system to help paramedics identify the severity of a stroke, so they know how to make this judgment call.   More...

Ask The Doctors: August 2018

The effect of egg consumption on cardiovascular disease (CVD) has been controversial. Because of the known relationship between blood cholesterol levels and CVD, we used to think that eating eggs, especially egg yolks that are high in cholesterol, would increase cholesterol levels in the blood and risk of cardiovascular disease.   More...