Tag Archives: Cardiology

Heart Disease: Minimally Invasive Procedures (2023)

UC Davis Health (February 22, 2023) – Dr. Jeffrey Southard, a cardiologist at UC Davis Medical Center, explains minimally invasive procedures for structural heart disease, including transcatheter aortic valve replacement (TAVR), left atrial appendage occlusion, and transcatheter management of mitral and tricuspid valve disease.

Video timeline: 0:00 Introduction 0:21 Transcatheter Aortic Valve Replacement (TAVR) 4:39 Left Atrial Appendage Occlusion 7:00 Transcatheter Management of Mitral and Tricuspid Valve Disease

Cardiology: When Chest Discomfort Is Serious

Mayo Clinic – Chest discomfort and pain account for more than 6.5 million emergency department visits in the U.S. each year. Discomfort can be the first sign of a serious heart event or a symptom of other medical conditions. Dr. Regis Fernandes, a Mayo Clinic cardiologist, says people should seek medical care at the first sign of chest pain.

Reviews: Heart Attacks Vs. Sudden Cardiac Arrest

Sudden cardiac arrest (SCA) isn’t the same as a heart attack, though people often use the terms interchangeably. While both are life-threatening heart conditions, understanding the differences could be lifesaving.

When it comes to cardiac arrest versus a heart attack, it can be easy to get them confused. You may be wondering, Is cardiac arrest the same as a heart attack?

Both a heart attack and cardiac arrest can be scary and life-threatening medical conditions affecting your heart, but there are differences in how and why they occur.

A heart attack is caused by a blockage. It happens when an artery blocks the blood flow to your heart.

Cardiac arrest is an electrical issue. It occurs when quick, irregular impulses take over your heart’s rhythm.

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BMJ Podcast: Diagnosis & Management Of Heart Failure – Dr. Carolyn Lam

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Professor Carolyn Lam, a world expert in heart failure from the University of Singapore and the National Heart Centre, also in Singapore.

They discuss updates in the diagnosis and management of heart failure, including wearables, biomarkers, the 4 pillars of therapy, and how and why there has historically been an under-representation of women in heart failure trials. This episode is sponsored by an educational grant from the Boehringer Ingelheim-Lilly Alliance. The sponsor has no influence over podcast content, the selection of speakers or any associated educational material.

Professor Carolyn Lam is a Senior Consultant from the Department of Cardiology and Director of Women’s Heart Health at the National Heart Centre Singapore, having pioneered the first Women’s Heart Clinic in Singapore.  Academically, she serves as a tenured Full Professor at the Duke-National University of Singapore, having also graduated from the Standford Executive Programme in 2015, and obtained a PhD at the University Medical Centre Groningen, the Netherlands in 2016. In the field of MedTech, Prof Lam is co-founder of Us2.ai, an award-wining startup dedicated to the automation of the fight against heart disease by applying artificial intelligence to echocardiography (ultrasound of the heart). 

Prof Lam is a world-renowned specialist in heart failure (particularly heart failure with preserved ejection fraction [HFpEF]). Her work in the PARAGON-HF and EMPEROR-Preserved trials led to the first FDA-approved treatment for HFpEF and the first robustly positive clinical outcomes trial in HFpEF to-date, respectively. She leads several multinational global and regional clinical trials, and has received numerous prestigious awards and global recognition for her work. Her recent appointments on the 2021 European Society of Cardiology Heart Failure Guidelines Task Force, and as International Honorary Fellow of the Heart Failure Society of America 2021, attest to her contributions in both cardiology and research fields. 

Prof Lam is a proud recipient of the National Medical Research Council (NMRC) Senior Investigator Clinician Scientist Award in 2020, and served as the Founding Programme Lead of A*STaR’s Asian neTwork for Translational Research and Cardiovascular Trials (ATTRaCT) and Principal Investigator of ASIAN-HF (a multinational study across 11 Asian countries). In 2019, She initiated the Asian Diabetes Outcomes Prevention Trial (ADOPT), an ongoing trial involving 5 countries and aimed at reducing the cardiovascular adverse outcomes of diabetes in Asian patients.

She has published with over 350 articles in major high impact journals including New England Journal of Medicine, Journal of the American Medical Association (JAMA), Lancet, Circulation, and European Heart Journal; and has been recognised as a World Expert by Expertscape’s PubMed-based algorithms (top 0.1% of scholars writing about Heart Failure over the past 10 years; Heart Failure: Worldwide – Expertscape.com). Besides being an Associate Editor for Circulation (top Cardiology Journal) and European Journal of Heart Failure, she is also the lead author of the chapter on HFpEF for Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 12th Edition – the award-winning textbook trusted by generations of cardiologists for the latest, most reliable guidance in the field.

Cardiology: What Is A Calcium Heart Scan?

A CT scan of the heart measures the amount of calcium in the heart’s arteries. The more calcium in the arteries, the greater your risk of a heart attack or stroke. 

Knowing your coronary artery calcium (CAC) score can help you and your care team decide how best to lower your risk of heart problems. But it’s only once piece of the puzzle. 

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Regenerative Medicine: How It Slows Down Aging

“Diverse aging populations, vulnerable to chronic disease, are at the cusp of a promising future. Indeed, growing regenerative options offer opportunities to boost innate healing, and address aging-associated decline. The outlook for an extended well-being strives to achieve health for all,”

Andre Terzic, M.D., Ph.D., a Mayo Clinic cardiologist

Regenerative medicine could slow the clock on degenerative diseases that often ravage the golden years, a Mayo Clinic study finds. Life span has nearly doubled since the 1950s, but health span — the number of disease-free years — has not kept pace. According to a paper published in NPJ Regenerative Medicine., people are generally living longer, but the last decade of life is often racked with chronic, age-related diseases that diminish quality of life. These final years come with a great cost burden to society.

Researchers contend that new solutions for increasing health span lie at the intersection of regenerative medicine research, anti-senescent investigation, clinical care and societal supports. A regenerative approach offers hope of extending the longevity of good health, so a person’s final years can be lived to the fullest.

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Heart Health: Sudden Cardiac Arrest Risks

You may think the most common single cause of death in the United States is heart attack. Or cancer. Or stroke.

But it’s actually sudden cardiac arrest (SCA). SCA is a problem with your heart’s electrical system (usually called ventricular tachycardia or ventricular fibrillation).

Most SCA victims survive if they get help very quickly. But SCA is fatal 95% of the time.

Clinical: Yale Women’s Heart Health Program

The Women’s Heart and Vascular Program provides state-of-the-art cardiac care for women with heart disease, as well as expert screening of women at risk for heart disease.

Heart disease remains the number one killer of American women and there is a great need for specialized care directed at women’s cardiac needs. The Women’s Heart and Vascular Program is dedicated to screening, educating and treating women at risk for, or with established heart disease.

Under the direction of Lisa A. Freed, MD, FACC, the Women’s Heart and Vascular Program incorporates not only her expertise in cardiology, but also collaborates with experts in diabetes, menopause, nutrition, exercise physiology, and smoking cessation. In addition, Dr. Freed consults with experts in sleep apnea and mental health professionals for intervention with co-existing depression and anxiety.

The program also focuses on clinical research in collaboration with Yale’s Women’s Health Research Center in order to advance the care of women with heart disease. 

Cardiology: The Ten Types Of Heart Specialists (Yale)

1. General adult cardiologists

Why you might need one: You have symptoms of heart disease, such as chest pain, fainting, a fluttering sensation in the chest, or shortness of breath. Or, you don’t have symptoms, but you are concerned about a risk factor such as high cholesterol, a history of smoking, or a family history of heart disease.

What they do: General adult cardiologists diagnose and treat general problems that affect the heart and blood vessels, including high cholesterol and high blood pressure, as well as heart attacks, valve problems, abnormal heart rhythms, and congestive heart failure, among other conditions. Cardiologists also help to prevent the onset of heart disease.

General adult cardiologists perform physical exams and order blood work and other tests to evaluate the heart’s health and function, including electrocardiograms, echocardiograms, stress tests, and MRIs of the heart. They can help you make lifestyle changes, as well as recommend medications (such as cholesterol-lowering statins) and procedures (such as inserting stents and pacemakers, as well as performing ablations of abnormal heart rhythms and replacing heart valves).

What else you should know: If you are a woman concerned about your cardiac health, you should know that heart disease is the number 1 cause of death in women. Women may experience symptoms of heart disease differently than men commonly do—for instance, they are more likely to have symptoms other than chest pain, such as indigestion, unusual fatigue, and discomfort in the abdomen, jaw, neck, or upper back.

One type of heart disease, called “broken heart syndrome” (a temporary condition that can be caused by extreme emotions and situations), is more common in women than in men. Cigarette smoking is also a bigger risk factor for heart disease in women, especially in those who are pre-menopausal. “If you are a woman, it’s important to find a cardiologist who will listen to you and take your symptoms seriously,” says Yale Medicine cardiologist Erica Spatz, MD, MHS.

2. Cardiac imaging specialists

Why you might need one: Your doctor suspects heart disease or wants to monitor a condition that has already been diagnosed. Imaging may be used to evaluate your heart’s anatomy and function. Your doctor may want an imaging test if you have symptoms of a heart problem such as chest pain, irregular heartbeats, heart flutters, or shortness of breath. “Multimodality cardiac imaging uses a comprehensive approach to choose the best test for a patient when there is concern for cardiac disease,” says Lauren Baldassarre, MD, cardiology director of Cardiac MRI and CT at Yale Medicine. Heart imaging may also be used as part of cardiac treatment.

What they do: Cardiac imaging specialists provide imaging that can help in diagnosing, evaluating, and treating the heart. Sophisticated imaging tests use different approaches for a variety of problems, from chest pain and valvular heart disease to cardiac tumors and heart device infections, among others. For example, an echocardiogram, a common test, uses high-frequency sound waves to make pictures of the heart’s chambers, valves, walls, and blood vessels. Cardiac nuclear medicine involves an injection (depending on the type of exam) of small amounts of radioactive materials that travel to the area in the body being examined, providing a picture that helps the doctor evaluate for coronary artery disease or cardiomyopathy, among other things.

What else you should know: Today, cardiac imaging is such a broad field with so many choices that you may need to find a specialist within it that has very specific training. The appropriate imaging subspecialist can help determine whether one prescribed test might be used in combination with another to provide better information. Or an imaging specialist may provide imaging during surgical treatment—MRI and CT scans are commonly used to guide surgeons in some heart procedures, which makes the surgeon’s work more precise and less invasive, resulting in quicker recoveries for patients.

Learn about the Cardiac Advanced Imaging Program

3. Electrophysiologists

Why you might need one: You have heart rhythm abnormalities (also known as arrhythmias), where heartbeat sequences are too fast or slow—or a heartbeat that is otherwise irregular. Your heartbeats may be traveling through the heart on an abnormal pathway, and you may be experiencing symptoms like weakness or fainting. (Arrhythmias are electrical abnormalities that can occur in the setting of heart disease, but may also occur in otherwise completely normal hearts. They can affect patients of all ages.)

What they do: Electrophysiologists diagnose and treat arrhythmias. “It can be critical to treat an abnormal heart rhythm, because some arrhythmias can be potentially life-threatening or carry an increased risk of stroke,” says Joseph Akar, MD PhD, chief of cardiac electrophysiology for Yale Medicine. Electrophysiologists may provide tests such as electrocardiography or wearable monitors—or long-term, implantable monitors—in order to record heart rhythm and diagnose the condition. They provide treatment ranging from lifestyle changes to medications to cardiac ablation, which deliberately creates scar tissue to eliminate electrical short circuits and even out erratic rhythms. Electrophysiologists also implant artificial pacemakers and cardiac defibrillators, which could be life-saving—they protect against sudden cardiac death, and improve heart function.

What else you should know: Radiation has been a recent concern with fluoroscopy, an imaging technology that provides electrophysiologists with a continuous X-ray image, so they can visualize their progress in performing a real-time procedure. Yale Medicine electrophysiologists use cutting-edge ultrasound and 3-D mapping technology to minimize radiation exposure to patients. Yale Medicine electrophysiologists have significant expertise in implanting leadless pacemakers, as well as other devices that prevent blood clots from forming in the heart and migrating to the brain during certain arrhythmias. 

Learn about the Electrophysiology & Cardiac Arrhythmia Program

4. Adult congenital heart specialists

Why you might need one: If you were born with a heart issue (called a congenital heart problem), you will likely need specialized and ongoing care through adulthood. Adult congenital heart specialists help with the transition from pediatric to adult heart care—and will schedule a first visit at any age. New issues can surface at any time in life—even if you are feeling healthy—and these specialists can monitor you to detect them early and treat complications or new issues as they arise, helping to avoid urgent interventions. They can discuss exercise, fertility, and childbearing issues, and other lifestyle topics, and advise on scheduling routine checkups with them, depending on your situation.

What they do: Adult congenital heart specialists provide lifelong care if you have ever been diagnosed with a problem with your heart’s structure that developed before you were born, whether the problem was treated in childhood with surgery or catheterization procedures—or found years later. “When we routinely monitor an adult patient with a congenital heart defect and identify new symptoms as early as possible, we can limit complications or avoid them altogether,” says Robert Elder, MD, director of Yale Medicine’s Adult Congenital Heart Program.

What else you should know: A congenital heart specialist can advise on how your condition could affect the choice of medications for certain conditions—for women, for example, a congenital heart defect can affect the type of birth control they choose.

While some women who have had mild heart defects have successful pregnancies, they should still ask about any issues that could threaten their safety during pregnancy and labor—and about possible genetic risks for their baby. (Both men and women are at risk for passing congenital heart disease along to their children.) 

Learn about the Adult Congenital Heart Program

5. Interventional cardiologists

Why you might need one: You are having chest pain that could indicate a blockage of an artery and you need an emergency evaluation. Or you have chronic symptoms, like chest pain or shortness of breath, and need to be evaluated for disease in the arteries or valves that call for further treatment. Interventional cardiologists treat a long list of conditions, from angina to aortic stenosis to heart attack. If you have a highly specialized condition, like congenital heart disease, valvular heart disease, or chronic total occlusion, you can seek out one with special training in that area.

What they do: Interventional cardiologists assess and treat heart conditions using nonsurgical, catheter-based procedures that involve inserting a thin, flexible tube through a small incision in the skin and through the blood vessels to the heart. They use this approach to place a stent to open a blocked artery, repair or replace a damaged heart valve, and perform other procedures. While open-heart surgery is still the most appropriate treatment in some cases, “many patients can’t undergo open-heart surgery due to their general medical health or age, and some don’t want to,” says Yale Medicine interventional cardiologist Yousif Ahmad, BMBS, PhD. “We’re able to improve their prognosis and make them feel better without open-heart surgery.”

What else you should know: There have been advances in interventional cardiology in the last five to 10 years. Notable ones are transcatheter aortic valve replacement (TAVR), which involves the insertion of a new heart valve, leaving the old one in place. (The new valve, which is collapsible, is inserted into the original valve, then expanded so that it can take over the job of controlling blood flow.) 

Another is MitraClip™, a small clip that is attached to the mitral valve to help it close more completely. In addition, there is percutaneous coronary intervention (PCI), commonly known as angioplasty, for chronic total occlusion—angioplasty improves blood flow to the heart in patients with a 100% artery blockage who would otherwise need bypass surgery.

Learn about the Interventional Cardiology Program

Why you might need one: You are about to begin cancer treatment and have a personal history of cardiac disease; you are about to begin or are already undergoing cancer treatment with a therapy that has the potential for cardiac side effects; you are undergoing cancer chemotherapyradiationimmunotherapy, or another therapy, and are experiencing cardiac issues; or, you are a cancer survivor who had these treatments at some point in the past. 

What they do: Cardio-oncologists care for cancer patients by detecting, monitoring, and treating heart disease that occurs as a side effect of such cancer treatments as chemotherapy, radiation, targeted therapies, and immunotherapy. While these treatments can be effective for cancer, they can also affect organs and organ systems, including the heart and cardiovascular system. If a patient is showing signs of heart issues, cardio-oncologists may recommend closer monitoring, cardiac medications, or adjusting the cancer treatment.

What else you should know: Cardiac health is important for cancer survivors to be aware of years—and even decades—after their cancer was treated. “Survival of cancer patients has significantly improved as cancer treatment has improved,” says Dr. Baldassarre, who is also director of the Cardio-Oncology Program at Smilow Cancer Hospital. “They are living longer, and as a result, we’re now thinking about cardiac side effects not just as an immediate concern, but for years later.”

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