Heart
New Cardiac Arrest Study May Help EMS Crews and ERs
When someone’s heart suddenly stops beating – a condition called cardiac arrest—there’s a lot that bystanders and ambulance crews can do to get it started again. But if the victim doesn’t respond, when should such efforts stop?
And when should emergency crews rapidly transport a patient to a hospital with lights and sirens on, potentially endangering the lives of paramedics and other motorists and pedestrians — even though the care provided by the emergency crew is the same as what can be provided in the emergency department?
Currently, there’s no one “right” answer to these questions, which arise in the majority of the cardiac arrests that strike 166,000 Americans each year — and kill 93 percent of them. As a result, emergency medical services crews and hospital ER teams spend countless hours and healthcare resources on patients who have no chance of making it home alive – at the expense of other patients who need an ambulance or have spent hours in an ER waiting room.
3-D MRI technique helps radiologists detect high-risk carotid disease
Canadian researchers have used three-dimensional magnetic resonance imaging (3-D MRI) to accurately detect bleeding within the walls of diseased carotid arteries, a condition that may lead to a stroke. The results of the study published in the October issue of Radiology suggest the technique may prove to be a useful screening tool for patients at high risk for stroke.
When major arteries are affected by atherosclerosis, fatty deposits, or plaques, accumulate on the inner lining of the vessel walls. Progression of the disease over time leads to narrowing, restricting blood flow or becoming completely blocked.
Until recently, scientists believed that this narrowing, called stenosis, was responsible for most heart attacks or strokes. But new studies have identified the composition of complicated plaques as being a major cause of vascular events and deaths. These complicated plaques are characterized by surface ulcerations, blood clots and bleeding into the vessel wall.
Bleeding gums linked to heart disease
Bad teeth, bleeding gums and poor dental hygiene can end up causing heart disease, scientists heard today (Thursday 11 September 2008) at the Society for General Microbiology’s Autumn meeting being held this week at Trinity College, Dublin.
People with poor dental hygiene and those who don’t brush their teeth regularly end up with bleeding gums, which provide an entry to the bloodstream for up to 700 different types of bacteria found in our mouths. This increases the risk of having a heart attack, according to microbiologists from the University of Bristol and the Royal College of Surgeons in Ireland.
“The mouth is probably the dirtiest place in the human body,” said Dr Steve Kerrigan from the Royal College of Surgeons in Dublin, Ireland. “If you have an open blood vessel from bleeding gums, bacteria will gain entry to your bloodstream. When bacteria get into the bloodstream they encounter tiny fragments called platelets that clot blood when you get a cut. By sticking to the platelets bacteria cause them to clot inside the blood vessel, partially blocking it. This prevents the blood flow back to the heart and we run the risk of suffering a heart attack.”
Active video games burn calories, boost heart rate
Kids who play the latest physically challenging video games expend energy at levels that might help protect them from becoming overweight and boost their heart health at the same time, according to a new study.
Children burn roughly four times as many calories per minute playing a physically active video game than playing a seated game and their heart rate is also much higher, report Robin R. Mellecker and Alison M. McManus of the Institute for Human Performance at University of Hong Kong in Pokfulam in the latest issue of Archives of Pediatrics and Adolescent Medicine.
These observations are “important because electronic entertainment is not going away,” Dr. Russell R. Pate of the University of South Carolina, Columbia, wrote in a commentary in the journal.
Class of Diabetes Drugs Carries Significant Cardiovascular Risks
A class of oral drugs used to treat type 2 diabetes may make heart failure worse, according to an editorial published online in Heart Wednesday by two Wake Forest University School of Medicine faculty members.
“We strongly recommend restrictions in the use of thiazolidinediones (the class of drugs) and question the rationale for leaving rosiglitazone on the market,” write Sonal Singh, M.D., M.P.H., assistant professor of internal medicine, and Curt D. Furberg, M.D., Ph.D., professor of public health sciences. Rosiglitazone and pioglitazone are the two major thiazolidinediones.
In the editorial Singh and Furberg say, “At this time, justification for use of thiazolidinediones is very weak to non-existent.”
Heart attack patients who stop statin risk death, say McGill researchers
Patients discontinuing statin medication following an acute myocardial infarction (AMI) increase their risk of dying over the next year, say researchers at McGill University and the McGill University Health Centre (MUHC). Their study was published in a recent issue of the European Heart Journal.
Using data on British patients who survived an AMI and were still alive three months later, Dr. Stella Daskalopoulou and colleagues found that those who discontinued their statin medication were 88% more likely to die during the following year compared to those who had never been on the medication.
“Statins were found to be beneficial drugs,” said Dr. Daskalopoulou, of McGill’s Faculty of Medicine and the Department of Medicine and the Division of Clinical Epidemiology at the MUHC. “Patients who used statins before an AMI and continued to take them after were 16% less likely to die over the next year than those who never used them. So even if it appears that the statins failed to prevent your AMI, it is beneficial to continue taking them and potentially quite harmful to stop.”
High Resolution Heart Images Now Available at Peak Stress
While treadmill exercise stress testing is an essential tool in the prevention, detection and treatment of cardiovascular disease, physicians are often challenged to gain clear images of the heart when a patient is at peak stress level.
That is changing at the Ohio State University Medical Center where researchers have designed equipment to provide high resolution images of the heart at a critical stage of testing that have previously been difficult to obtain using standard testing procedures. Superior images of the heart are obtained with a test lasting less than one hour.
“In the past, we were constrained by the time lapse between the completion of exercise and capturing the images,” said Orlando “Lon” Simonetti, PhD, associate professor of internal medicine and radiology.
New Method Assesses Risks for Heart Failure Patients
Data from 260 hospitals across the United States has led to the creation of a new method for physicians to more accurately determine the severity of heart failure in patients upon hospital admission, with a goal of reducing in-hospital mortality and more quickly identifying triage methods and treatment decisions. The model is discussed in the July 29 issue of the Journal of the American College of Cardiology.
“Heart failure patients experience high rates of hospital stays and poor outcomes,” said Dr. William Abraham, director of cardiovascular medicine at Ohio State University Medical Center and primary author of the article. “By utilizing this model, we can more quickly identify patients at risk for in-hospital mortality who might benefit from more aggressive monitoring and intervention.”
The model was developed as part of the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) study, which offered recommendations to improve treatment of congestive heart failure based on monitoring more than 48,000 patients.
Joint Inflammation and Heart Disease Linked
People coping with rheumatoid arthritis or lupus already have a lot to deal with. Even so, paying attention to heart health may be especially important for this group. The August 2008 issue of the Harvard Heart Letter reports that rheumatoid arthritis doubles a person’s risk of heart attack or cardiac arrest. Heart disease risk is even higher with lupus, and a new study suggests that gout, another common kind of arthritis, is also linked to cardiovascular disease.
Rheumatoid arthritis, lupus, and related autoimmune disorders are caused by a misguided immune system. Certain white blood cells, which ordinarily protect the body from infection, attack its tissues instead. Although no one knows exactly how these conditions are connected to cardiovascular disease, it is possible they all spring from the same source—inflammation.
Inflammation is an essential part of the body’s defenses. In people with rheumatoid arthritis and lupus, though, inflammation turns against the body and damages joints and other tissues. In heart disease, inflammation kicks off artery-clogging atherosclerosis, keeps it smoldering, and influences the formation of clots, the ultimate cause of heart attacks and many strokes.
Kelsey Grammer nearly died after heart attack
Television star Kelsey Grammer, best known from “Cheers” and his sitcom “Frasier,” nearly died after suffering a heart attack last month, he told U.S. showbiz news program “Entertainment Tonight.”
Grammer, 53, felt chest pains while paddle-boarding with his wife in Hawaii, where they have a second home, and was taken to hospital, where he was found to have suffered a heart attack.
At the time, about seven weeks ago, his spokesman Stan Rosenfield said it was a mild heart attack but declined to give further details of Grammer’s condition or medical treatment.
Beijing pollution may trigger heart attacks, strokes
Olympic athletes aren’t the only ones who need to be concerned about the heavily polluted air in Beijing. The dirty air may trigger serious cardiovascular problems for some spectators.
Two researchers in pulmonary medicine and critical care at Northwestern University’s Feinberg School of Medicine warn that for people in certain risk groups, breathing high levels of pollution can cause heart attacks and strokes within 24 hours of exposure and increase the possibility of having blood clots in their legs on the plane home.
The people who are vulnerable include those who already have known cardiovascular disease or risk factors for cardiovascular disease such as high blood pressure, high cholesterol, diabetes, obesity, lung disease, a current smoking habit or a family member diagnosed with heart disease before age 55.
Pioneering heart surgeon DeBakey dies at age 99
Surgeon Michael DeBakey, whose ground-breaking heart transplants and coronary bypass operations made him one of the giants of 20th century medicine, has died at age 99.
The Baylor College of Medicine and Methodist Hospital said DeBakey died on Friday of natural causes. Methodist Hospital in Houston was his primary surgical hospital for many years.
In a career that spanned more than seven decades, DeBakey developed a number of new surgical procedures that now are standard in treating heart ailments and led many to consider him the father of modern cardiovascular surgery.
Heart disease strongly impairs quality of life
Heart disease can markedly impair a patient’s quality of life with the impact varying by age, gender and racial group, researchers report in the journal Circulation.
The findings indicate that heart disease has the greatest negative effect on the quality of life of people between 18 and 49 years of age, women, and blacks and Hispanics. “Younger people may feel more pressure—especially younger men—in the workplace and may be more threatened by limitations imposed by their disease,” lead author Dr. Jipan Xie said in a statement.
Using data from the Medical Expenditure Panel Surveys for 2000 and 2002, Xie, from the Centers for Disease Control and Prevention in Atlanta, and associates examined how quality of life differed between people with and those without heart disease in the United States. Of the 37,386 individuals surveyed, 2,091 had heart disease.
Novel Approach May Protect Against Heart Attack Injury
Researchers at The Children’s Hospital of Philadelphia have manipulated cell activity that occurs during the interruption of blood flow to strongly protect heart tissue in animal studies. The finding has the potential to become an emergency treatment for heart attack patients, particularly since already existing drugs might be pressed into service to produce the protective effects.
“Reduced blood flow, or ischemia, is a major problem in many organs, where it can lead to cell death and tissue damage,” said study leader Peter J. Gruber, M.D., Ph.D., a cardiothoracic surgeon at Children’s Hospital and a faculty member of the University of Pennsylvania School of Medicine. “We decided to look for a global approach to protecting heart tissue by inhibiting enzymes that govern how cells respond to ischemia.”
Gruber’s team published their findings online July 7 in the journal of the Federation of American Societies for Experimental Biology (FASEB). The article will appear in the journal’s October 2008 print issue.
Heart disease and diabetes: Which statins have been well-investigated?
All of the five different statins that are licensed for use in Germany can lower the cholesterol level in the blood. But the deciding factor for patients is how well the medicine can prevent heart attacks and other coronary artery problems. From this point of view, simvastatin (marketed under various brand names) is the best tested. It has been shown to lengthen life expectancy of people with diabetes and particular heart diseases.
The statins are medicines that might be able to lower the risk of another heart attack among people who have already had one. These five types of statins are licensed for use in Germany: atorvastatin, fluvastatin, lovastatin, pravastatin and simvastatin. Statins are known as cholesterol-lowering or fat-lowering medicines. This is because they can reduce the levels of cholesterol in the blood.
Many doctors are convinced that this cholesterol-lowering effect is also responsible for lowering the risk of a heart attack. However, it is not known exactly how this might work. Statins have an impact on the blood vessels, and there could also be other, yet unknown effects. Which of these might be responsible for the effectiveness of statins is still unclear.
