Heart Failure

Persistent Coughing Can Be a Symptom of Heart Failure

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.
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Your Heart Is Your Responsibility

If you have risk factors for cardiovascular disease, or have been diagnosed with heart or vascular disease, what are you doing to lessen the likelihood you will suffer a heart attack or stroke? Are you eating a heart-healthy diet and exercising? Keeping your blood pressure, blood sugar and cholesterol levels under control? Have you tossed your cigarettes to thecurb?
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Heart Beat: September 2018

Patients with type 1 diabetes require multiple insulin injections a day. This can make it difficult to keep blood glucose levels within the ideal range. Now theres a smartphone app that can help. The Guardian Connect continuous glucose monitoring system works hand-in-hand with the Sugar:IQ app to analyze how patients glucose levels are responding in real time to food intake, insulin and other variables. Data are sent to the cloud for processing, and the information is returned to the app for viewing on an iPhone. The system helps patients identify foods and habits that cause their glucose to spike, as well as times of the day or week when glucose levels fluctuate. This allows them to adjust their insulin use accordingly. In a pilot study, patients using the system spent 33 minutes more per day in the ideal glucose range and had one less hyperglycemic event per month. When the Sugar:IQ app explained the dangers of hypoglycemia, the number of hypoglycemic events dropped in more than half of app users. The system, which has been approved by the U.S. Food and Drug Administration (FDA), is now being retooled for Android users.
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Stay Active After a Heart Attack

If you were not active before your heart attack, its particularly important that you make exercise a priority. If you were active before your heart attack, dont be afraid to resume the same activities, once you get clearance from your physician, he says. The best way to do this is to enroll in a cardiac rehab program. In fact, we recommend cardiac rehab for all patients after a heart attack.
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Alternative Anticoagulants Gaining in Popularity

The first DOAC was approved for stroke prevention in AFib in October 2010. Until that time, the only option was warfarin. Although this old standby is highly effective, its dose must be raised gradually, and patients must undergo regular testing to ensure they maintain enough anticoagulant to prevent clots without incurring unwanted bleeding. They must also eliminate a long list of vitamin K-containing vegetables and fruits from their diet.
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Small Pumps Help Failing Hearts

Patients with heart failure rely on multiple medications to keep their heart pumping as efficiently as possible. For many, medications slow the progression of heart failure long enough so they can live a normal length and quality of life. But when maximum medical therapy no longer controls the symptoms of heart failure, other measures may be necessary. These options include ventricular assist devices (VADs), which provide new hope for selected patients with advanced heart failure.
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Ask The Doctors: September 2018

You can improve your sleep habits by getting regular exercise, avoiding daytime naps, avoiding caffeine and powering down electronics before bed. Maintain a strict sleep schedule, which means going to bed and getting up at the same time every day. If youre overweight, snore or have been told you stop breathing during sleep, see a sleep specialist and be evaluated for sleep apnea. Otherwise, if you have insomnia or other type of sleep problem, avoid rushing to use over-the-counter sleep aids. Work with your health provider to determine the cause and discuss remedies.
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Download The Full August 2018 Issue PDF

Frailty is not necessarily associated with older age alone. More often than not, its a consequence of poor lifestyle choices that lead to deconditioning. Thats 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.
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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, its a consequence of poor lifestyle choices that lead to deconditioning. Thats 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.
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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 drugs 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 Parkinsons disease, Alzheimers 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.
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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.
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Should Your Replacement Valve Be Made of Tissue or Metal?

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