CHEST PAIN WITH EXERCISE

Sometimes muscles in the chest wall are strained when doing an exercise like the exercise bike (if certain positions are uncomfortable or if the work is extreme). This is usually a pain that u can reproduce by pressing over the upper rib cage. However, one has to be concerned about a deeper chest discomfort that comes on after exercise, as it could signify a heart problem like angina.

POSTED BY:  STEVEN AJLUNI, MD

ANATOMY OF A VASOVAGAL EVENT

Nervous stimuli of the vagus nerve can lead to low BP (hypotension) and heart rate slowing (cardioinhibitory) reflexes. This vasovagal event can lead to fainting (syncope).

POSTED BY:  STEVEN AJLUNI, MD

DIFFERENCE BETWEEN CARDIAC ARREST AND ASYSTOLE

Asystole is one form of cardiac arrest (sudden cardiac death), but others include dangerous ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation.

Cardiac arrest refers to any situation in which the heart is not pumping blood. This may occur with abnormal electrical activity in the heart in which the heart is quivering ( ventricular fibrillation) or beating so fast in can not pump blood effectively (Ventricular tachycardia,) Asystole is a kind of cardiac arrest in which the heart is electrically silent ( flat line) on EKG.

POSTED BY:  STEVEN AJLUNI, MD

CADUET AND DIABETES

Two factors that influence CV risk the most in diabetics include HTN and hyperlipidemia. Caduet contains amlodipine for BP and atorvastatin for lipid reduction. Clinical trials have demonstrated efficacy of atorvastatin in CV protection in diabetics REGARDLESS of baseline lipid levels.

POSTED BY:  STEVEN AJLUNI, MD

BYPASS...NOT A CURE

By 10 years after bypass, there is a 50% risk of having experienced closure of one or more vein grafts . Bypass is not a cure. Atherosclerosis is an ongoing problem and requires lifelong treatment of risk factors.

POSTED BY:  STEVEN AJLUNI, MD

HOW SHOULD ONE KEEP TRACK OF THEIR HEART HEALTH?

A good knowledge of your risk factors (of which family history is clearly one). Knowing your status with regards to traditional factors,like cholesterol profile, diabetes, and blood pressure. Lifestyle indicators like exercise tolerance, smoking, etc. further risk delineation might be possible with advanced screening modalities such as stress testing and coronary CT angiography might help too.

A cardiologist or internist can help define your risk profile by getting a history (family history, smoking, diabetes, hypertension, hyperlipidemia), and arranging for a fasting lipid level.  In high risk settings additional risk can be found with a lipid NMR study assessing non traditional risk factors such as lipoprotein particle size. Other risk factors, PLAC, CRP, homocysteine could help.

POSTED BY:  STEVEN AJLUNI, MD

MICHIGAN HEART GROUP INTERGRATES WITH WILLIAM BEAUMONT HOSPITAL

On June 1, 2012 a change occurred at Michigan Heart Group we became integrated with William Beaumont Hospital in the form of a Professional Services Agreement. Our signage will soon read Beaumont Michigan Heart Group, Beaumont Michigan Heart Rhythm Group and Beaumont Western Wayne Heart Group.

This professional agreement will integrate some of the services that we provide with the hospital as well as some of our operations including our outpatient testing and billing, but will allow Michigan Heart Group to maintain operational control of the practice. Management of these operations still occurs locally within Michigan Heart Group. We have not experienced that these changes with Beaumont have disrupted any of the services that you currently receive from your physician.

We believe that with this integration model, we will be best able to provide you with the high quality of care that you have come to expect and deserve from our practice. All of our physicians will continue practicing from their current locations and your records will remain available to your physician without any further actions taken on your part. This is intended to be essentially a transparent change to you, the patient, in terms of how your care is delivered. Such a change has been made necessary after we have experienced years of progressive cuts in insurance reimbursement while our fixed costs have steadily increased. The status quo was no longer a viable option for the future.

You will notice changes specific to billing. Beaumont will bill applicable charges to your insurance. You will receive a billing statement from Beaumont rather than from Michigan Heart Group. You may still call Michigan Heart Group for billing inquiries however questions/determinations will be advised and directed by Beaumont.

We value your loyalty and trust that you have placed in our physicians and staff over the past several years and we continue to look forward to serving you in the future. As we indicated above, we believe that most of these changes will be transparent to your healthcare needs. If you have any questions, please contact our administrator, Darlene Nichols at 248-267-5050, select option 2.

Thank you for choosing Michigan Heart Group, in affiliation with William Beaumont Hospital for your healthcare services. We look forward to serving you now and in the future.

Very truly yours,

Beaumont Michigan Heart Group

SYNCOPE AFTER GETTING SICK FROM A MIGRAINE

A migraine produces a host of changes in vascular tone in blood vessels that are in the brain. The end result of vasodilation of these vessels is a stimulation of central reflexes that stimulate the vagus nerve. This nerve in turn stimulates the stomach and has important nervous effects on the heart. The end result--vasodilation (low BP), along with nausea and a slow heart rate-a vasovagal event.

POSTED BY:  STEVEN AJLUNI, MD

HOW ARE PRO ATHLETES DYING FROM CARDIAC ARREST

Cardiomyopathy is either linked or acquired and represents a high risk condition to trigger dangerous arrhythmias during high stress situations. Many times this predisposition can be discovered ahead of time with the appropriate screening ( history, physical exam, and ECG).

POSTED BY: STEVEN AJLUNI, MD

DIFFERENCE BETWEEN COSTOCHONDRIS AND ANGINA

Costochondris is inflammation of the junction between cartilage in the front of the rib cage and the bony rib. It is a sharp soreness that hurts particularly as the chest moves (most noticeable in inspiration or with palpating). It lasts a split second. Angina is a deeper more visceral sensation. It represents nervous stimulation due to lack oxygen in heart tissue. Lasts minutes.

POSTED BY:  STEVEN AJLUNI, MD

NORMAL HEART RATES FOR ATHLETES

Typically a well-conditioned athlete's heart will run slower than normal because of well-conditioned autonomic reflexes as well as a larger stroke volume with each heart beat. It is not uncommon to see resting heart rates in 40's-60's in such cases.

Normal heart rates range from 60-100 beats per minute, though heart rates at times can easily be outside this range if other factors are present.

POSTED BY:  STEVEN AJLUNI, MD

MICHIGAN HEART GROUP'S PHYSICIAN LIAISON IS HERE TO HELP YOU

Michigan Heart Group has a Physician Liaison on staff to assist with questions, concerns or problems you, your staff or your patients may have with our office.

Stacie Batur is available Monday through Thursday at (248) 267-5050 (x6509). She is often between two buildings or visiting referring physician offices. If you get her voice mail, please leave a message and she will call you back shortly. If you need to speak to her immediately you can reach her on her cell phone at (248) 765-4466.