Tag Archives: cardiology

If I’d had my heart attack decades ago . . .

24 Jan

by Carolyn Thomas

“When I first became a GP in England well over 30 years ago, the early diagnosis of myocardial infarction (heart attack) was a matter of slight importance, since there was no intervention which made any difference to survival.

“You tried to reach patients in their homes quickly to relieve their pain with heroin, but only sent them to hospital if their pain was not controlled, or they were going into shock.  Studies at the time indicated that patients with heart attacks survived better at home, where they were less likely to be killed with injections of lidocaine.”

Quite a difference, according to Dr. Richard Lehman, writing this in the British Medical Journal last month, compared to modern cardiac care options like clot-busting thrombolytic drugs or invasive coronary angioplasty procedures that are now routinely available to patients presenting with heart attack symptoms these days. (Unless, of course, you happen to be a woman under the age of 55 presenting to the E.R in mid-heart attack, in which case, as reported in the New England Journal of Medicine, you are seven times more likely to be misdiagnosed and sent home compared to your male counterparts with the same symptoms).  But I digress . . .      (more…)

Physical exercise vs. the ‘plumber’s pipe’ theory of heart disease treatment

18 Nov

plumber pipes

A billboard in cardiologist Dr. William Bestermann‘s hometown of Kingsport, Tennessee is sponsored by a local hospital there. It recently proclaimed: “More procedures equal better outcomes in heart disease”. So, he explains, the public in Kingsport likely understands coronary artery disease to be a progressive blockage, like hard crusty scale building up in a plumber’s pipe. And thus the more procedures, the more treatment, the more technology you can throw at coronary artery disease, the better. Dr. Bestermann adds:

“The current system of cardiac care works like this: even if a patient has a 60% blockage of a coronary artery, it does not interfere with blood flow. It does not cause chest pain or other cardiac symptoms. The patient is thought to be safe, and nothing much is done for or to the patient.

“But if the blockage is 70% or greater, it begins to interfere with blood flow. It may cause some pain or other symptoms. The patient is thought to be in danger, and this level of disease activates our entire health care system of treadmill stress tests, cardiac catheterizations, implanting stainless steel stents and doing open heart bypass graft surgery. A 100% blockage is a heart attack, but if we can catch the blockage before it becomes 100% and open it with a bypass or a stent, then we have saved the patient from having a heart attack. This is the way most patients and physicians currently understand the problem of coronary artery disease, and it is the way our current system operates.”

But Dr. Bestermann maintains that our current cardiac treatment does “too little, too late”. In cardiovascular disease, the care model is built entirely around opening blockages in patients with late disease, which can relieve symptoms, but does not prevent heart attack.  Find out how a heart attack happens …