ISCHEMIA study: that blockage isn’t a time bomb in your chest

by Carolyn Thomas     @HeartSisters  

If you’re a heart patient living with stable angina, the ISCHEMIA clinical trial presented last weekend at the 2019 American Heart Association Scientific Sessions is all about you. Cardiologist Dr. John Mandrola described the impact of this study in his must-read Medscape column like this:

CARDIOLOGY CHANGES TODAY!”      .

But realistically, does one study have the power to actually change the practice of cardiology?      .
Continue reading “ISCHEMIA study: that blockage isn’t a time bomb in your chest”

Bed rest and other kinds of cardiac overtreatment

by Carolyn Thomas    @HeartSisters  

“From my earliest days in medicine, I have struggled against the prevailing model of health care” is how the pioneering cardiologist Dr. Bernard Lown sums up his long and impressive career as a rebel.

Dr. Lown is now Professor of Cardiology Emeritus at Harvard, but to me he is the physician I love to quote here on Heart Sisters – as in my blog post title, Why Aren’t More Doctors Like Dr. Bernard Lown?         . Continue reading “Bed rest and other kinds of cardiac overtreatment”

Would you drive your car if its brakes were “failing”?

by Carolyn Thomas      @HeartSisters

Imagine your mechanic telling you that your brakes are failing. Would you voluntarily get behind the wheel of that car – and then happily drive it home? Of course you wouldn’t.  Yet right now, as you are reading these words, doctors around the world in a medical office or hospital clinic somewhere out there are casually saying out loud the words “HEART FAILURE” to diagnose people who will leave that place feeling scared to death.   .   Continue reading “Would you drive your car if its brakes were “failing”?”

A tumor? In my heart?!?

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Paula is a “youngish 60”, as she describes herself, recently retired after a long career in public relations and marketing, and very active. A couple of years ago, for example, Paula and her husband hiked 530 miles together across northern Spain on the famous Camino de Santiago trail. So, definitely “youngish”.
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But this past spring, Paula was admitted to the hospital after a week of chest pain, shortness of breath, jaw pain and crushing fatigue. Her initial diagnostic tests suggested she was NOT having a heart attack – but what was discovered after that was something very rare.  .

Denial? Or doctorly deference?

by Carolyn Thomas     @HeartSisters  

Last week, the British Medical Journal (BMJ) ran a compelling opinion piece from Boston physician Dr. Abraar Karan on why some patients just don’t seem to understand what their doctors are telling them.  Here’s how he opens his essay:

Why am I here?’  Mrs. S looked up at me for the first time since I had entered the room and begun speaking to her. I had spent the past five minutes talking about the need for her to start new medications for her heart failure. She had nodded along for most of the conversation, but I wondered if she had heard, or more importantly understood, anything I had been saying. She had had three admissions for worsening heart failure in the past few months. And yet she looked at me and said, ‘Do I have heart problems? No one ever told me!'”   . Continue reading “Denial? Or doctorly deference?”

Heading home tips following open heart surgery

by Carolyn Thomas    @HeartSisters     May 5, 2019

Open heart surgery.   Is there any medical procedure in history so surrounded by genuine awe and surreal mystique? Cracking open the sternum to reveal the beating heart beneath, and then somehow trusting a heart-lung machine to temporarily take over the jobs of both the human heart and lungs – now, that’s heroic! But when it comes to explaining just how that happens, few of us might guess that the most compelling and straightforward description comes not from the world of medicine, but from the venerable magazine, Popular Mechanics.
Continue reading “Heading home tips following open heart surgery”