Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following quote from a "healthcare expert.""I'm not at all sympathetic with the cardiologists,'' said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a ...
Posts tagged Heart
Treating atrial fibrillation with catheter ablation on TV may not be ethical
Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently.The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying a hard-to-explain disease like atrial fibrillation and an even harder-to-explain procedure like catheter ablation. Instead of making any effort to truly educate their viewers, the producers took the easy ...
The power of a doctor’s choice of words in explaining CPR
Words have power. Language has power.The words we use may comfort or shock, allay or provoke, sooth or batter. Words often imply layers of meaning that are not explicitly articulated, yet rest beneath the surface:“I worry that time is short for you” (You are dying) (I care about you)“I wish we could have done more” (Nothing would have changed her death) (I am on your side)“I hope with you that ...
How hypertension increases the risk of dementia
Originally published in MedPage Todayby John Gever, MedPage Today Senior EditorAnother study has found that hypertension may contribute to increased risk of dementia, this time with evidence of actual brain abnormalities.
Data from an offshoot of the Women's Health Initiative found that participants' baseline blood pressure was strongly correlated with volume of lesions in their brains' white matter, according to Lewis ...
How television can shorten your life
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterToo much television watching could be shortening lifespans, a study of Australian adults showed.Aussies who reported watching four or more hours of TV a day were 46% more likely to die during a 6.6-year period than those who watched less than two hours a day, according to David Dunstan, PhD, of Monash University in Melbourne, and colleagues.
Cardiologists discuss how far myocardial infarction management has come
Originally published in MedPage Todayby Peggy Peck, MedPage Today Executive Editor"What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best."The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 ...
How can we stop the spread of unproven heart scans like CT angiography?
There's no question that CT scans are among the most overused medical tests.One newer application has been using CT scans to detect coronary artery calcification for primary prevention of heart disease. It's a technology of unproven promise, with entities like the USPSTF recommending against it.Worse, especially in light of the recent data suggesting significant radiation exposure from CT scans, it may even be harmful. Patients need to ...
Radiation exposure from excessive imaging tests after a heart attack
Hopefully, by now, people are realizing that more is not necessarily better. A new study reported at the American Heart Association 2009 Scientific Sessions showed that patients with acute myocardial infarction (AMI) receive large doses of ionizing radiation per hospital admission.They looked at patients treated at 55 academic hospitals and found, on average, each patient received seven studies per AMI admission. The studies included chest X-rays, chest CT, head CT, ...
How salt is associated with stroke and heart disease risk
Originally published in InsidermedicineSodium intake has a direct and independent impact on the risk of stroke and cardiovascular disease, according to a meta-analysis published online ahead of print in the British Medical Journal.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
Doctors can improve treating LDL cholesterol
Originally posted in Insidermedicine
Identification and treatment of individuals with high LDL or "bad" cholesterol has improved in recent years, but patients are still slipping through the cracks, according to a survey published in the Journal of the American Medical Association.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
How does Zetia and niacin affect the carotid intima-media thickness (CIMT)?
Originally published in MedPage Todayby Peggy Peck, MedPage Today Executive EditorBy a margin of 0.014 mm in carotid intima-media thickness (CIMT), extended-release niacin (Niaspan) demonstrated superiority over ezetimibe (Zetia) as an add-on for high risk patients on long term statin therapy.
But is a difference of 0.014 mm clinically significant?The niacin versus ezetimibe findings come from the ARBITER 6-HALTS trial, ...
Why you should stop taking Vytorin for high cholesterol
At the American Heart Association meeting in Orlando, the results of the ARBITER 6-HALTS study were released. No Vytorin was used in the study, but I am sure that all the headlines will mention Vytorin.The actual study published ahead of press online in the New England Journal of Medicine. Essentially, they enrolled over 200 patients from Walter Reed and Washington Adventist who had known heart disease or were at ...
Niacin beats Zetia in the ARBITER 6-HALTS trial, and what this means for ezetimibe
Originally published in MedPage Todayby Peggy Peck, MedPage Today Executive EditorBoosting HDL cholesterol with extended-release niacin (Niaspan) is a more effective way of slowing atherosclerosis in high-risk patients on long-term statin therapy than seeking additional LDL cholesterol reductions by adding ezetimibe (Zetia), researchers here reported. Compared with ezetimibe, 2 grams of niacin led to significant reductions in both the mean ...
Depression is bad for your heart
Originally published in Journal Watch Psychiatryby Steven Dubovsky, MDAnd attaining remission significantly improves mortality risk in patients with acute coronary syndromes. 
Depression is common after myocardial infarction (MI), and medical outcomes are worse in depressed patients. These researchers addressed long-term survival in a 6.7-year follow-up study of 361 patients with acute coronary syndromes (ACS) and major depression. The patients had ...
Are we underusing aldosterone antagonists in congestive heart failure patients?
Originally published in Insidermedicine Less-than one third of eligible patients being discharged from hospital with heart failure are being prescribed guideline-recommended treatment, even though the hospitals are participating in a program aimed at improving compliance with treatment guidelines, according to research published in the latest issue of the Journal of the American Medical Association.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
Why doctors should reconsider ordering a CRP to screen patients for heart disease
The CRP, or C-reactive protein, is a test that many doctors use to screen for heart disease.And indeed, studies have associated an elevated level with an increased risk of coronary artery disease. But there is little data showing that reducing the CRP level saves lives. That hasn't stopped both doctors and patients from inappropriately ordering the test.Although not expensive by itself, it serves as a gateway to ...
Do heart attack patients benefit from an implantable cardioverter defibrillator (ICD)?
Originally published in Insidermedicine Implanting a cardioverter-defibrillator (ICD) is no better at saving lives than simply providing optimal medical therapy for individuals who suffer damage to the heart from a heart attack, according to research published in the latest issue of the New England Journal of Medicine.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
Did the 1918 flu pandemic increase the risk of heart disease?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentMen who were in utero during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s, and 80s, researchers said. In those men, the rate of heart disease was more than 23% higher than among those whose mothers ...
Will there really be an impending shortage of cardiologists?
There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people.However, that doesn’t mean that the message conveyed ...
How to protect yourself from abdominal aortic aneurysms
by Mark Adelman, MDWhile diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented.An AAA, which ...
