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Wednesday, October 31, 2012

WHAT FOODS COULD LOWER HIGH BLOOD PRESSURE?


Fewer foods.. If you're overweight, losing weight, ie eating less food, will lower your blood pressure. Avoiding excess sodium chloride (table salt) will also lower BP. There aren't any effective foods that will actively lower your BP - it's all about what you DON'T eat. 

POSTED BY:  STEVEN AJLUNI, MD

Monday, October 29, 2012

WHAT PHYSIOLOGICAL SIGNALS IN THE HEART CHANGE SYSTOLIC BLOOD PRESSURE WITH EXERCISE?


Sympathetic nerves During exercise the sympathetic nervous system is stimulated. The catecholamines released as well as direct stimulation on the heart result in a faster heart rate as well as increased contractility which raises cardiac output. This increases the rate of volume/pressure rise into the vasculature (dp/dt). This increases BP.

POSTED BY:  STEVEN AJLUNI, MD

Friday, October 26, 2012

HEART CATHERATERZATIONS AND BRUSING


Bruising is common, typically soreness should last only a few days whereas bruising might persist for weeks. Reabsorption of blood between facial layers takes time (the cause of the bruising). If femoral nerve trauma or irritation is present the pain in the groin might persist for some time ( neuropathic). 

POSTED BY:  STEVEN AJLUNI, MD

Wednesday, October 24, 2012

IS A RIGHT BUNDLE BRANCH BLOCK DANGEROUS AND CAN IT CAUSE CARDIAC ARREST?



RBBB is usually safe IRBBB is usually an ECG anomaly that may speak of some right sided enlargement or strain (can occur in atrial septal defect or in pulmonary processes with right heart strain ). It can also occur innocuously and unrelated to cardiac structural changes. It does not typically imply impending conduction system collapse and is not a predictor for cardiac arrest or sudden cardiac death. 

POSTED BY: STEVEN AJLUNI, MD

Monday, October 22, 2012

WHAT IS SUDDEN CARDIAC DEATH?


Arrhythmia SCD typically refers to a sudden loss of effective contraction of the heart muscle and implies a life-threatening arrhythmia. Usually this is VT or VF. It occurs primarily in patients with a damaged heart (cardiomyopathy, postMI) where there is scar tissue that alters normal electrical conduction. It can also occur in patients w nl hearts (Brugada syndrome, ARVD, long QT) which are rare.

POSTED BY: STEVEN AJLUNI, MD

Friday, October 19, 2012

WHAT AFFECT DOES EXERCIESE HAVE ON THE CARDIOVASCULAR SYSTEM?



Improves output Aerobic exercise helps the heart by improving conditioning through enhanced delivery of oxygen to the tissues and enhanced extraction of oxygen in tho muscles. Over time richer vascular networks in those muscles enhances cardiac output by reducing afterload (the "load" that the heart has to pump against). Isometric exercises (example lifting heavy weights) benefits less and increases lvh 

POSTED BY: STEVEN AJLUNI, MD

Wednesday, October 17, 2012

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



Monday, October 15, 2012

WHAT ARE PROLOGED QT INTERVALS?


ECG measurement QT intervals are measured on a heart electrocardiogram (ECG). They measure "repolarization". Longer QT intervals may be associated with arrhythmias (irregular heart beats) such as torsades de pointes or ventricular tachycardia (VT). There are also inherited disorders that are associated with prolong QT intervals. 

POSTED BY: STEVEN AJLUNI, MD

Friday, October 12, 2012

WHAT CAN CAUSE POTS DISEASE (POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME)?


Adrenergic stimulati 
Abnormal and excessive secretion of catecholamines due to sympathetic nervous system stimulation secondary to changes in position (due to gravity effects on circulating intravascular volume). This unchecked catecholamine surge causes a stimulation of heart rate. 

POSTED BY:  STEVEN AJLUNI, MD

Wednesday, October 10, 2012

WATCH SALT, LOSE WEIGHT...

Blood Pressure is in 90% of cases a function of genetic susceptibility (increased vascular tone) and lifestyle factors (weight,salt intake, alcohol, smoking). Body wt is 60% water, so sharp volume increases drive up BP. Improving lifestyle factors can typically drop BP 10-15 points. For many, that's not enough and meds will be required. Lowering BP <140 and="and" diabetics="diabetics" heart="heart" in="in" lowers="lowers" nbsp="nbsp" p="p" risk="risk" vasc="vasc">
POSTED BY: STEVEN AJLUNI, MD

Monday, October 8, 2012

SURVEY: SIDE EFFECTS TOP REASON PATIENTS STOP USING STATINS

MedPage Today (6/23, Kaiser) reported, "Experiencing side effects such as muscle-related pain or weakness was the top reason why patients stopped taking statins, according to results from a large survey" published online in the Journal of Clinical Lipidology. Investigators reported that, "of the 1,220 respondents who stopped taking statins, 62% cited side effects as the main reason, compared with 17% who cited cost and 12% who said the drug lacked efficacy." The survey found that "muscle pain or weakness was reported by 29% of all survey respondents, but the rate was higher among former users compared with current users (60% versus 25%

POSTED BY:  STEVEN ALMANY, MD

Friday, October 5, 2012

RESEARCHERS EVALUATE RENAL NERVE ABLATIONAS HYPERTENSION TREATMENT


In an article titled "Trialists: Will Interventional Tx Tame BP?,"  Reported on a study that is currently "evaluating renal nerve ablation as a way to curtail" hypertension. The article also discusses another trial that evaluated the therapy. "In the nonrandomized Symplicity HTN-1 trial, the percentage of responders increased over time, reported Paul A. Sobotka, MD, from Ohio State University in Columbus, at the 2012 American College of Cardiology meeting." The researchers found that "at one month, 69% of 143 patients responded; at 12 months, it was 79% of 130 patients; at two years, it was 90% of 59 patients; and at three years, 100% of 24 patients followed for 36 months responded."

WBH Comment-Approximately 25-30% of Americans are hypertensive.  Nearly 10 Million take 3 or more drugs to treat their hypertension.  Renal Denervation may offer these patients a procedure
that may significantly lower their blood pressure and need for medications.  There are nearly 40 start up companies currently working on devices to offer this therapy.  It should be commerically available in the US in 2013-2014.


POSTED BY:  Steven Almany M.D.

Wednesday, October 3, 2012

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.

Monday, October 1, 2012

LOW CARB-HIGH PROTEIN DIETS MAY PUT HEART AT RISK




Consuming a low carbohydrate-high protein diet -- like the Atkins diet -- may be associated with a greater risk of cardiovascular disease in women, researchers found.
Decreases in carbohydrate intake and increases in protein intake, as well as in a score combining carbohydrate and protein intake, were all associated with significantly greater risks of incident cardiovascular disease events in young Swedish women, according to Pagona Lagiou, MD, PhD, of the University of Athens in Greece, and colleagues.
The findings, which were reported online in BMJ, "do not answer questions concerning possible beneficial short-term effects of low carbohydrate or high protein diets in the control of body weight or insulin resistance," the authors wrote.
"Instead, they draw attention to the potential for considerable adverse effects on cardiovascular health of these diets when they are used on a regular basis, without consideration of the nature of carbohydrates (complex versus refined) or the source of proteins (plant versus animal)," they wrote.
Low carb-high protein diets have become popular because of the short-term effects on weight control, but concerns have been raised about the potential cardiovascular effects over the long term. Studies exploring the issue have given mixed results, with a U.S. study showing no relationship between such a diet and rates of ischemic heart disease.
But three European studies showed a greater risk of cardiovascular mortality with such a diet.
Lagiou and colleagues examined data from the Swedish Women's Lifestyle and Health Cohort, a prospective study conducted among women living in the healthcare region of Uppsala. The current analysis included 43,396 women, ages 30 to 49 at baseline, who completed a comprehensive questionnaire on lifestyle and dietary factors, as well as medical history. They were followed for an average of 15.7 years.
The researchers scored each participant according to their carbohydrate and protein consumption. Carbohydrate intake was scored from 1 (very high) to 10 (very low). Protein intake was scored from 1 (very low) to 10 (very high). A combined carbohydrate-protein score ranged from 2 (very high consumption of carbs and very low consumption of protein) to 20 (very low consumption of carbs and very high consumption of protein).
During follow-up, there were 1,270 incident cardiovascular events, which included ischemic heart disease, ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, and peripheral arterial disease.
After adjustment for energy intake, saturated and unsaturated fat intake, and numerous cardiovascular risk factors, each one-point decrease in carb intake was associated with a relative 4% increase in cardiovascular events (95% CI 0% to 8%). A one-point increase in protein intake also was associated with a relative 4% increase in events (95% CI 2% to 6%).
Each two-point increase in the low carbohydrate-high protein score -- equivalent to a 20-gram decrease in daily carb intake and 5-gram increase in daily protein intake -- was associated with a relative 5% increase in cardiovascular events (95% CI 2% to 8%).
There was a suggestion that the associations were stronger for women whose protein came mostly from animal sources, but the test for interaction did not reach statistical significance for nearly all of the individual outcomes.
"Although these results are based on an observational study, their biological plausibility seems self evident," according to Anna Floegel, MPH, of the German Institute of Human Nutrition Potsdam-Rehbruecke, and Tobias Pischon, MD, MPH, of the Max Delbrück Center for Molecular Medicine Berlin-Buch.
"A low carbohydrate diet implies low consumption of whole-grain foods, fruits, and starchy vegetables and consequently reduced intake of fiber, vitamins, and minerals. A high protein diet may indicate higher intake of red and processed meat and thus higher intake of iron, cholesterol, and saturated fat," they explained in an accompanying editorial.
"These single factors have previously been linked to a higher risk of major chronic diseases, including cardiovascular disease, in observational studies, so it is not surprising that this combination of risk factors is linked to a higher incidence of disease and mortality," they said.
Lagiou and colleagues acknowledged that their study was limited by the possible misclassification of diet 
based on participant self-report only at the beginning of the study, the lack of information on cardiovascular medication use and blood cholesterol levels, and the possibility of residual confounding.
The study was supported by grants from the Swedish Cancer Society and the Swedish Research Council.
The study authors and the editorialists reported no conflicts of interest.
From the American Heart Association:


POSTED BY:  Steven Almany M.D.