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Heart Disease

"Bad" cholesterol levels on the decline

February 04, 2010

Overall prevalence for high LDL levels fell from 31.5% in 1999-2000 to 21.2% in 2005-2006.

Triglycerides linked to diabetic neuropathy and amputations

June 24, 2009

Serum triglyceride levels may allow clinicians to predict which patients with type 2 diabetes will develop neuropathy, while fenofibrate therapy can reduce the risk of diabetes-related amputations by more than a third.

Peculiar violaceous, atraumatic rash

By Esan O. Simon, MD, MBA June 02, 2009

A 79-year-old Caucasian man with a history of chest pain, light-headedness, and diaphoresis was admitted to rule out acute coronary syndrome. He incidentally noted a bruise that had appeared spontaneously on his chest without trauma four days prior to admission.

Primary care on front line for atrial fibrillation

May 22, 2009

Diagnosing atrial fibrillation could sharply reduce strokes in the United States, and primary-care physicians have a key role to play, according to experts at the American College of Cardiology.

Hair loss as a side effect of statins?

Question by Jyoti Khatri, MD, Omaha; response by Peter F. Cohn, MD April 15, 2009

A 63-year-old woman wants to discontinue the simvastatin (Zocor) 10 mg she is taking for hypercholesterolemia because she believes the medication is causing her to lose her hair. Is there any evidence supporting this side effect of Zocor?

New findings challenge Framingham heart risk tool

April 14, 2009

Three recent studies indicate that the venerable Framingham risk score goes only so far as a predictor of cardiovascular problems.

Secondary stroke prevention lags

April 07, 2009

Even as researchers are fine-tuning approaches to preventing primary coronary events, a new analysis of unrelated CDC data found that primary-care providers need to focus more on secondary stroke prevention too.

New aspirin guidelines stress gender differences

By Myra Dembrow April 06, 2009

Men and women don't respond the same to prophylactic aspirin therapy. Updated recommendations from the U.S. Preventive Services addresses this aspect of heart disease prevention.

Excessive sleepiness linked to CVD mortality

By Myra Dembrow March 30, 2009

Daytime drowsiness may warn of impending death in elderly people, particularly from cardiovascular causes, new population-based research suggests.

Transient severe breathing difficulty while shoveling snow

By Benjamin M. Kaplan, MD, and Albert J. Miller, MD February 05, 2009

An elderly woman returns home from a balmy South Pacific vacation and finds very cold temperatures. While shoveling snow, she finds that she can't get air into her lungs. With no history of pulmonary or heart disease, what's wrong?

Fibrate used in combination with statin approved

December 16, 2008

The FDA has approved Trilipix (fenofibric acid), a delayed-release capsule for use along with diet to treat dyslipidemia. Trilipix is the first fibrate to be approved for use in combination with a statin.

Statins protect against CVD, not renal disease

December 04, 2008

Statin use does not decrease renal-function loss in patients without cardiovascular disease (CVD) or in those at risk for it, but the drug is effective for primary prevention of CVD, a study found.

Kidney marker warns of heart disease, diabetes

November 20, 2008

A new meta-analysis confirmed "a strong and continuous association between urinary proteinuria and subsequent risk of coronary heart disease (CHD)." Meanwhile, a team of French scientists has tied excessive UAE levels to substantially higher risks of developing diabetes in men.

Osteoporosis drugs increase AF risk

October 24, 2008

Patients who take bisphosphonates for osteoporosis were significantly more likely to experience serious atrial fibrillation, including hospitalization or death, compared with placebo, according to a new study.

Omega 3s plus statins help lipids

October 20, 2008

In patients with mixed dyslipidemia, a combination of statin therapy and prescription omega-3 fatty acids may help improve lipid profiles, according to a report in the Oct. 15 issue of the American Journal of Cardiology. Reported at HealthDay.

Secondary heart failure

October 08, 2008

As physicians, we need to remind ourselves that congestive heart failure (CHF) is not a diagnosis but rather a complex of symptoms with one or more of five major causes: myocardial ischemia, valvular heart disease, chronic hypertension, arrhythmias, or cardiomyopathy. Thus, if a patient has symptoms of CHF, the diagnosis would be CHF secondary to one of those five causes.

Chill on fish oil

Clinical Pearl submitted by Jack Wang, MD, Beloit, Wis. October 06, 2008

Storing fish-oil tablets in the freezer will eliminate the fishy smell and aftertaste.

Nighttime aspirin lowers BP

October 02, 2008

Timing is everything in aspirin therapy for prehypertension, according to a new Spanish study. Patients who took low-dose aspirin at bedtime reported much better responses than those who took the medicine in the morning.

Treating LDL in patients with high HDL

Question by David Y. Kawashiri, MD, Beverly Hills, Calif., and answer by Peter F. Cohn, MD September 24, 2008

When does a high HDL counterbalance a high (or even borderline) HDL?

Addressing cardiac risk in the young

Question raised by Derek Olson, DO, Chicago and answered by Peter F. Cohn, MD July 01, 2008

What should I do for patients younger than 40 who have zero to two risk factors for coronary artery disease (CAD) and LDL 130-160 mg/dL and have not responded to lifestyle modifications?

An unusual, elusive, postsurgical sequela

Case and Analysis By Sailatha Padmanabhan, MD, AND Rajan Krishnamani, MD March 14, 2008

Fatigue, fever, and chills plague a patient following valve replacement.

Do elevated lipids call for more than statins?

By Robert M. Guthrie, MD January 23, 2008

The goal of cholesterol management is not the correction of lipid numbers but the reduction in heart attack and other cardiac end points. The benefit of adding a second or even a third drug to a statin is unproven at best. There are even potential downsides.

Typical angina with an atypical diagnosis

Case and analysis by Mark A. McElhannon, MD October 17, 2007

The patient continued her aerobic workouts despite persistent chest pressure with an unknown etiology. When she finally saw her physician about the symptoms, everyone was in for a surprise.

Multislice cardiac CT: Who will benefit?

By Joe F. Lau, MD, PhD, and Richard M. Steingart, MD September 11, 2007

As technology offers more tools to help diagnose heart disease, you'll need to adjust how you approach certain patients. Here's the latest on one of those new tools.

Stents: What you now need to know

June 07, 2007

Once hailed as a breakthrough in the care of heart disease, stents have been in the news and in the crosshairs of skeptics. Here's what you need to know to deal with your heart patients.

Caveat on post-ARB angioedema

Question raised by Burl R. Don, MD, Sacramento, Calif. and answered by Peter F. Cohn, MD April 04, 2007

In contrast to an earlier response, angioedema has been reported years after starting an ACE inhibitor.

High lipids, high liver enzymes

Question raised by Tony Pham, DO, Dallas and answered by Peter F. Cohn, MD February 21, 2007

How should I manage a 62-year-old Hispanic man who has hyperlipidemia and abnormal liver enzymes?

Post-ACE inhibitor angioedema

Question raised by Elizabeth George, MD, Dallas and answered by Peter F. Cohn, MD February 21, 2007

Acute Coronary Syndrome: Find the heart of the matter

By William E. Cayley Jr, MD, MDiv February 10, 2007

Establishing a diagnosis of acute coronary syndrome (ACS) allows you to stabilize the patient while you provide a more thorough evaluation and identify the specific form of unstable CAD involved.