heart disease

Aortic Valve Surgery in Coach John Fox of the Denver Broncos

February 4, 2014 by admin

Aortic valve replacement in November has allowed coach John Fox, of the Denver Broncos, to lead his team to the Super Bowl according to Dr. Steven Reisman, a New York City cardiologist. Dr. Reisman was interviewed by CNN on November 3, 2013 when coach Fox was taken to a hospital in Charlotte, North Carolina for urgent surgery to replace his aortic valve. It was known to coach Fox for several years that he had this condition and doctors were following him and planning surgery after the football season. However,. on Saturday November 2, while golfing with his buddies he collapsed on the golf course and was rushed by ambulance to the hospital. Two days later, on November 4^th , he underwent surgery to replace his stenotic or blocked aortic valve. He missed four games due to his surgery and his recovery.

The medical condition coach Fox had was aortic stenosis, which in his age group is mostly secondary to a calcified congenital bicuspid aortic valve. The aortic valve usually has three leaflets and most likely his valve had only two leaflets. This condition is usually detected by a simple twenty minute test called an echocardiogram or cardiac ultrasound. A doctor may follow a patient with this condition with echocardiograms on an annual basis or more frequently as the stenosis is becoming more severe. The development of chest pain, shortness of breath and lightheadedness or fainting, are signs that surgery may be needed on an urgent basis. Fortunately for coach Fox, as Dr. Reisman, a cardiologist in New York City and director of the New York Cardiac Diagnostic Center, predicted on CNN on November 3^rd, the surgery was life saving and allowed coach Fox to finish the season as head coach and participate in the Super Bowl. Dr. Reisman recommends that anyone who feels that they may be at risk for this condition, undergo an examination along with a cardiac ultrasound or echocardiogram.

DR. STEVEN REISMAN, A NEW YORK CITY CARDIOLOGIST, DISCUSSES THE RELATIONSHIP BETWEEN DIABETES TYPE 2 AND HEART DISEASE

April 8, 2011 by admin

Type 2 diabetes is also known as adult-onset diabetes and is a chronic condition that affects the way your body metabolizes sugar or glucose. With type 2 diabetes one’s body is resistant to the effects of insulin or the body does not produce enough insulin to maintain a normal glucose level. Type 2 diabetes symptoms may develop slowly. Some of the symptoms include an increase in thirst, frequent urination, increased hunger, weight loss, fatigue, blurry vision, and slow healing sores. Importantly, this condition may be asymptomatic.

The risk factors for type 2 diabetes include being overweight which is a primary risk factor, inactivity, family history, and a condition known as pre-diabetes in which the blood sugar level is higher than normal but not high enough to be classified as type 2 diabetes. The most important complications of type 2 diabetes include an increase in risk for various cardiovascular disease entities such as coronary artery disease, heart attack, stroke, and narrowing of the arteries along with high blood pressure.

Type 2 diabetes can be diagnosed by a simple blood test. There are two commonly done tests: one is called the A1C test and the other one is a fasting blood sugar test. The American Diabetes Association recommends routine screening for type 2 diabetes after age 45 especially if one is overweight. Screening is also recommended for those under 45 who are overweight and if there is other heart disease or diabetes risk factors such as a family history of type 2 diabetes or an elevated blood pressure.

In a recent article, HealthDay (3/2/11, Gordon) describes the findings of the ACCORD Study. This study evaluated “intensive” glucose therapy compared to “standard” therapy in patients with type 2 diabetes and heart disease. This study found that intensive blood sugar control in a very aggressive manner does not benefit people with type 2 diabetes and heart disease and, in fact, may harm them. This study found that very aggressive attempts to control A1C may result in a decrease in the rate of heart attack but an increase in mortality. This study was published in the New English Journal of Medicine on March 3, 2011 and involved a large group of patients. One finding in this study appears to be that it is important to decrease blood glucose levels to the recommendation of below 7% A1C but possibly not below 6% A1C.

Initial treatment for type 2 diabetes includes blood glucose monitoring along with healthy eating and regular exercise. Healthy eating should emphasize plenty of fruits, vegetables, and whole grains. In addition, counting carbohydrates is important and this can be done with the help of a dietician. Aerobic exercise is important and one should aim for 30 minutes of vigorous aerobic exercise most days of the week. In addition, if one is overweight, losing excess pounds is part of the treatment regimen in type 2 diabetes. In some instances, diabetes medication may be necessary if this initial treatment program does not work.

Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, advocates prevention of type 2 diabetes with emphasis on eating healthy foods, increasing physical activity and losing excess pounds. This can be done after an initial consultation to evaluate the individual’s blood sugar level and can also be done in conjunction with a registered dietician.

LOWERING BLOOD PRESSURE MAY HELP REDUCE WOMEN’S HEART DISEASE RISK.

March 15, 2011 by admin

In an article in WebMD (1/24, Hendrick), review of a recent study suggested that middle-aged and older women who lower their blood pressure could reduce the risk of having a stroke, heart attack, or developing heart failure.

This study conducted in over 9,000 adults follow for a median of 11 years found that three risk factors accounted for 85% of reversible risk for women and men. This included high systolic blood pressure, high cholesterol, and smoking. The most important risk factor in this study was felt to be high systolic blood pressure.

By lowering systolic blood pressure by 15 mmHg in hypertensive women, the study found there would be an increased benefit in quality of life by prevention of cardiovascular disease in about 40% of women. In this study, the researchers used 24 hour ambulatory blood pressure monitoring. This device measures blood pressure both during the day and at night at certain intervals.

Dr. Steven Reisman, a New York City Cardiologist states that at the New York Cardiac Diagnostic Center the doctors have recently been using a new in office automatic blood pressure device called BPTru to diagnose hypertension. This may also prove to be an excellent and more practical way to measure and treat high blood pressure in the prevention of heart disease.

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heart disease