If you have a heart-zapping defibrillator implanted in your chest, you’re not supposed to compete in sports any more intense than bowling or golf. Lots of patients ignore those guidelines, trying everything from school basketball teams and community tennis leagues to running marathons and rock climbing — although no one knows if the life-saving implants work as well under that kind of stress.

Many of these athletes will now take part in a nationwide registry to see once and for all if this is a validated risk. Do the athletes need more “shocks” to the heart than other persons that would watch from the sidelines? Can the implanted defibrillators withstand a direct hit to the chest? This registry will hopefully be able to give us more answers.

With more and more ICD’s being used to combat fatal heart beats in younger patients, I think that a registry is a welcome idea. In my opinion, this is pertinent information that needs to be examined further!

via Associated Press, SFGate.com

Post from: Blisstree

Registry for athletes with AICD’s

The graveyard shift is the worst time to call code blue, a new study finds. Patients who go into cardiac arrest while in the hospital are more likely to die if it happens after 11 p.m., when staffing may be lower or patients are watched less closely.

The ER is the only place that there was no difference in death rates. Among day shifts in all other units hospital wide the success rate of patients that cardiac arrested was 20% and the night shift rate was 15%. Either way it is not real good odds but I would take the first over the latter.

Why the difference? I would suppose most would blame it on fatigue and lower staff numbers. Interesting enough, while weekends had lower success rated then weekdays they were not nearly as pronounced as night versus day.

via Houston Chronicle

Post from: Blisstree

Working the nightshift… stay on your toes for that code blue!

A large study has found that black Medicare patients are less likely than white patients to receive blood vessel opening procedures such as angioplasty following a heart attack, whether they are admitted to hospitals that provide or do not provide these procedures, but also experience higher mortality rates at 1 year, according to a study in the June 13 issue of JAMA.

Why the difference? Do you really think it is solely race related or are there other factors that play in to the decisions for interventions?

“These differences could be due to unmeasured clinical or socioeconomic factors, patient preferences, and unmeasured aspects of medical decision making but are unlikely to be related to differences in access to hospitals performing revascularization procedures. Although differences in revascularization may reflect overuse of procedures in white patients, the receipt of revascularization could also explain some of the differences in longer-term mortality in black patients and may represent a broader marker of differences in post-AMI care between black and white patients”

I want to know what your opinion is on this topic. Don’t hold back, don’t be scared, all opinions are welcomed and wanted. I have not personally experienced nor observed this in my clinical practice. And for a point of reference, I work at a hospital approximately 15 miles outside Baltimore City.

Don’t you think there should be standardized care for post MI patients across the board? Doesn’t everyone deserve the same treatment, regardless of insurance, income, gender, race or status?

via Science Daily

Post from: Blisstree

Does race make a difference post heart attack?

1. Author of Frankenstein Mary Shelley kept her dead husband’s, poet Percy Shelley, heart wrapped in silk until she died. Imagine how that smelled!

2. You can purchase the largest model of a human heart for a small price of $5795.95 US dollars. Um huh, I said five thousand. It is 8 times the size of an anatomical heart at 100×90×70 cm. Wow, that is a lot of money!

3. The smallest person believed to ever have open heart surgery was just over 25 weeks gestation and about 1.4 lbs. This was back in 2002 and I think it to still be the smallest baby to have open heart. I searched and searched. If you know different, shoot me a hello.

4. Throughout your life your heart contracts about 70 times a minute and pumps about 5 liters of blood each minute. That is amazing!

5. You heart muscle, or myocardium, is unique to just that… your heart. It is not found anywhere else in your body!

6. When you are in love, you really do “feel” with your heart. Yes, it is true. Your heart, more than any other organ, feels and senses emotions and responds accordingly. Everybody now… awwwww!

7. During an average lifetime, your heart will beat over 2.5 billion times. Seriously, that is one hard working muscle!

8. About 1.2 million Americans have heart attacks every year and over 400,000 of them will never make it to the hospital.

9. The word heart, meaning soul or feeling, is termed cor in Latin.

10. The cardiovascular system is my favorite by far, and always has been. Anatomy, micro, nursing, physiology, biology, chemistry, psychology… the heart is so fascinating in every capacity! I am absolutely amazed by it and at times can not even wrap my brain around the fact that it’s muscle never, ever gets a break and keeps us going from the time we are born till the time of our death. Wow!!!

Post from: Blisstree

10 Hearty trivia facts…

When you really stop and think about it, aren’t you more active in the summer months than the winter months? I think I am with the pool, walks in the evenings and running with the kids all day long. So this little tidbit of information shouldn’t come as a huge surprise.

A five-year study found people treated in the summer were on average 8% more likely to see their blood pressure come down to healthy levels.

These same findings were reported from 15 VA hospitals across the US. Not only are blood pressure’s elevated in the winter months but the incidence of stroke and heart attacks are also higher. Is it the slowed activity, the colder weather and thus vasoconstriction or the salty “winter”type hot foods that we consume? Maybe it is all of the above.

via BBC 

Post from: Blisstree

Winter brings cardiac implications

Anyway- there was a thirty something year old women that had issues with herself due to scares from many heart operations. She was born with a very rare type of congenital heart defect- where her heart did not form properly and needed to be rebuilt- and she had some large scars on her chest and back and belly from chest tubes and incisions.

She was so beautiful and a great person. She was very pretty and when I looked at her all I saw was a gorgeous young women- and all she saw was someone who was not perfect.

Do you have scars that you wish where not there? Whether it be form open heart or something else? Do you feel non perfect because of your heart disease?

I have many scars and each tell a story- kind of like a map of my life! My hubby loves them and I do not see them when I stare at myself in the mirror! I hope you know you are perfect and we are all beautiful on the inside.

Post from: Blisstree

Scars from heart disease- Love them or hate them?

Researchers found that 16 percent of these patients reported refusing one or more medical or surgical interventions recommended by their physician. The most frequently refused interventions were cardiac catheterization and surgery, with refusal rates of over 10 percent. Other interventions refused included chemotherapy, radiation, intubation, dialysis, and transplantation. Hospitalization was rarely refused.

I can not count the amount of times I sent a very elderly, frail, compromised, extremely sick and helpless patient off to open heart surgery, let alone stress tests and catheterizations. And what I really wanted to do was say, “You are the boss of yourself. You make the final decisions and can say no to anything you want to. If you were my Grandfather, I would say don’t do it”. But I don’t, at least not for the most part.

What do you think about the quality versus quantity? And what do you think about getting second opinions and saying no to physicians? Would you feel comfortable questioning a clinician? I am always amazed at how patients hold them up high and feel like they have no say in the situation. When it should be them who are being held way up high. Be your own advocate. Don’t you think?

via Science Daily

Post from: Blisstree

Quality versus Quantity? What do you think?

“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.

What are the drugs being above mentioned? Actos and Avandia. If you take these medications please talk to your physician if you have any concerns or questions.  Remember, you need the risk factors to be affected in a negative way.

via Wake Forest 

Post from: Blisstree

Actos and Avandia being linked to increased heart failure

This will take the place of open heart surgery for those that are too old and frail to undergo surgery. This will also help with cost and recovery time.

Post from: Blisstree

Heart valve received through groin- wow!

The team first did ultrasound exams of the carotid arteries of 1,268 patients at high risk of cardiovascular disease because of multiple risk factors, such as smoking, diabetes, high blood pressure, high cholesterol, or known blockages in other blood vessels such as the coronary arteries. Then they concentrated on the 574 patients that showed the most plaque buildup.

What did they find?

Over a follow-up of slightly more than three years, the GSM levels decreased in 230 patients, or 40%, and increased in 344, or 60%. Those in the lowest GSM group, with the darkest plaque, were about 1.7 times more likely to have a cardiovascular event than those whose GSM went up the most, reflecting less dense plaque, during the follow-up. Those whose GSM declined the most had a 68% survival rate at three years, compared to a 78% survival for those whose GSM increased.

This is what one would expect but it is really cool to know that we can now actually ‘view’ this process in order to combat stroke and heart attacks. The researchers did state that this is not ready for the general population and more science is necessary.

via Web MD 

Post from: Blisstree

Repeat US prove to benefit at risk individuals