Heart Failure

Q: I got a stent after a heart attack. Now I hear that medical therapy is just as good. Was the stent unnecessary? A: In the ISCHEMIA study, more than 5,000 patients with stable coronary artery disease (CAD), at least moderate ischemia on stress testing and mild symptoms were randomized to catheterization followed by stenting […]

If you have heart failure, you might want to give careful consideration as to whether the potential benefits of a surgical or interventional procedure are likely to outweigh the risks. “Heart failure is a known risk factor for postoperative complications, including death,” says Cleveland Clinic heart failure specialist David O. Taylor, MD. “Unfortunately, there are […]

The American Heart Association recommends a minimum of 150 minutes of moderate activity or 75 minutes of vigorous activity weekly. Moderate is often defined as 50 to 70 percent of maximally predicted heart rate (MPHR); vigorous is 70 to 85 percent.

When patients are involved in competitive sports, activity restrictions should be tailored to the risk of dissection or rupture. "We may recommend exercise stress testing to assess a patient's heart rate and blood pressure response to exercise," says Dr. Roselli. "We are developing research protocols to learn more about the interaction between these variables so activity recommendations can be tailored to the individual."

The FDA mandated a cardiovascular safety trial of celecoxib (Celebrex). This trial, spearheaded by Dr. Nissen, compared moderate doses of celecoxib to ibuprofen and naproxenin 24,081 arthritis patients at increased cardiovascular risk needing daily pain relief. The cardiovascular risks from celecoxib were no greater than those conferred by the other NSAIDs.

According to the Centers for Disease Control and Prevention, more than 30.3 million people in the U.S. have diabetes. Another 84.1 million have pre-diabetes, a condition that can lead to type 2 diabetes within five years, if its not treated. Diabetes is a major risk factor for early death from heart attack, stroke and many cancers. It also increases the risk of kidney disease, blindness and amputation. But these outcomes are not inevitable, if you learn about the disease and your role in managing it.

A rare, but serious, problem can occur when a DVT blood clot breaks off and is carried into a heart that has a hole between its upper chambers (patent foramen ovale, or PFO). If the clot passes from the right side of the heart into the left and is pumped into the arteries supplying the brain, it can cause a stroke.

Small calcium deposits in breast arteries are not associated with breast cancer, but they may be a marker of coronary artery disease (CAD) long before other symptoms appear. Researchers evaluated 2,100 asymptomatic women ages 40 and older using mammography and computed tomography angiography imaging of the coronary arteries, among other tests.

A rare, but serious, problem can occur when a DVT blood clot breaks off and is carried into a heart that has a hole between its upper chambers (patent foramen ovale, or PFO). If the clot passes from the right side of the heart into the left and is pumped into the arteries supplying the brain, it can cause a stroke.

In the past, niacin, fenofibrates, bile acid sequestrants and fish oil were widely used to help normalize blood lipid levels. Most have fallen out of favor. But in November, physicians were wowed when a key study revealed that prescription-strength doses of eicosapentaenoic acid (EPA), a form of omega-3 fish oil, reduced the risk of cardiovascular death, heart attack, stroke, revascularization and unstable angina by 25 percent in patients with CAD or diabetes and high triglyceride levels.

If there are specific concerns that you would like to have addressed, please write them down before you leave home and raise them early in the appointment. Please don't wait until the end of the visit to speak up. Knowing what's on your mind helps us plan our time with you, and you will be more likely to leave the office satisfied, if your questions have been answered.

You're standing in a friend's dining room with a magnificent spread before you. On a table sparkling with ornaments and candles, you see an endless array of food. In an instant, you are seduced by the sights and smells of the holiday season. You reach out and pick up a plate-and your resolve to eat sensibly flies out the window.