Are the Blackhawks Causing Heart Attacks?

Maybe:



"No more overtimes, okay?"

-Wes

h/t: The Toronto Sun

When A Cardiologist Has a Heart Attack

... the revelations for both the cardiologist and his patients are profound:

The doctor-turned-patient admits he’s faced some challenges in following the advice that he has given cardiac patients all these years.

“I try to go to the gym several times a week. It’s very difficult to fit that into my schedule,” he said. “I had adjusted my diet years ago, avoiding salt and eating less red meat. Now I’m eating oatmeal for breakfast five days a week.”

Lewin joined the cardiac rehabilitation program at the Ortenzio Heart Center at Holy Spirit, where he often ran into his own patients, who were surprised to see their doctor walking the treadmill.

“Some of them thought I was just coming to exercise,” Lewin said with a laugh. “People would tell me, ‘Gee, I have an appointment to come see you next week.’”

Lewin said his personal experience with cardiac rehab helps him relate better to his patients. “I can identify more now with what they’re going through and the concerns they face,” he said — and the challenge it can be to follow doctor’s orders.

-Wes

How to Catch a Perp

... thank him for saving someone's life:

"He administered CPR until paramedics arrived and then left. We just want to identify him and thank him. It's nice to know that people are there to help."

Police released a photo of the man in the store.

But Wright said the man "also committed a crime at this convenience store, but we . . are not releasing any of this information at this time."

Gee, I wonder if he'll step forward...

-Wes

How to Vote When You Have a Heart Attack on Election Day

... it can be done, but is harder than you might think:

Someone who knew Kopplin and who lived in the same municipality had to print a form from the Internet, take it to the City of Milwaukee Election Commission and testify that he knew Kopplin. Then he had to bring the form to the hospital where Kopplin filled it out and signed it in front of two witnesses. The absentee ballot had to be returned to the commission by 5 p.m. Tuesday. His neighbor couldn't make it and Kopplin's kids don't live in Milwaukee. Kopplin eventually found a friend who is a Milwaukee resident to do the grunt work.

"What I had to go through to get a ballot and get it signed and get it turned in by 5, leave it to politicians to come up with this," Kopplin said.

Kopplin received a stent in his heart and is hoping to go home from the hospital on Wednesday.

This man is a Great American indeed.

-Wes

How Nurses Deal With a Heart Attack

... on one of their own:

Although the EKG told a different tale, Glowacki felt well enough to call her husband and explain to him she was having a heart attack.

"My fellow employees were just looking at me going, 'You don't look like you're having a heart attack,' " Glowacki said. "I said, 'I don't feel like it,' and they said, 'Get off the cell phone.' "

Good idea.

-Wes

Tweeting Your Own Heart Attack

It's funny, until it's not:

Opportunity + Instinct = Profit. A good journalist can sense the moment that a story is developing and seize the moment. That’s why when White House correspondent Tony Christopher started having a heart attack, he immediately logged into Twitter and started covering it:

Approximately at 6pm on Sunday afternoon Christopher wrote, “I gotta be me. Livetweeting my heart attack. Beat that!” Presumably a few minutes later the paramedics arrived to tell Christopher he will be stable after his crisis.

An hour later Christopher joked about needing to own a cardiac cat, referencing a viral video in which a cat is trying to revive his dead feline friend. He also updated his followers about the pain he was feeling, “even after the morphine.”

So is this the message the White House wants sent to America?

Seems to me his time might have been better spent on (1) taking an aspirin, (2) calling 911, and (3) calling a friend, (4) and assembling a list of his current medications and past medical history for the doctors in case he loses consciousness.

But that's just me...

-Wes

Why Every Heart Patient Should Order Pizza

... because the delivery man might just save your life:

Linn's wife says he had just gone into cardiac arrest Friday when the pizza deliveryman knocked on the door of their Colorado home to bring their order. Kami Linn says she opened the door to "some burly-looking dude" and immediately asked for help.

-Wes

The Incidence of Self-Reported US Heart Attacks by Age

As told by Gallup survey:

Click image to enlarge

-Wes

The Costs of a Heart Attack

Quite a bit, according to some:

According to an article from the National Business Group on Health, the average total (editor's note: lifetime) cost of a severe heart attack–including direct and indirect costs–is about $1 million. Direct (lifetime) costs include charges for hospitals, doctors and prescription drugs, while the indirect costs include lost productivity and time away from work. The average (lifetime) cost of a less severe heart attack is about $760,000. Amortized over 20 years, that’s $50,000 per year for a severe heart attack and $38,000 per year for a less severe heart attack.

I'm all for maintaining a healthy lifestyle, but before we get all hot and bothered about performing more testing to "prevent" a heart attack as a means to save health care costs going forward, remember the lessons we learned from the Tim Russert fallout.

-Wes

Reference: The WISE Study:

Shaw LJ, Merz CNB, Pepine CJ, et al. The Economic Burden of Angina in Women With Suspected Ischemic Heart Disease: Results From the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation. Circulation. August 29, 2006 2006;114(9):894-904.

Could a Heart Attack During A Trial Help a Defendent in Court?

Perhaps:

Assistant U.S. Attorney Christopher Graveline wrote in a motion that after the judge told the jury about the heart attack “many jurors in their body language and facial expressions, rightly expressed concern for Mr. Cicchetti.” The prosecutor said the government did not object to the judge telling the jury about the heart attack because it assumed that Cicchetti would be prosecuted later before a different jury.

“It is only natural for the jury to feel sympathy for Mr. Cicchetti’s condition and this sympathy may well play into its consideration of the evidence against Mr. Cicchetti especially in light of his defense that he is a sick harmless older man who is only guilty of loving motorcycles and cocaine.”

“The government believes that allowing Mr. Cicchetti to continue in absentia would prejudice its ability to have a fair hearing and that there would be a high probability that an extrinsic factor, i.e. the defendant’s health, could affect the jury’s decision rather than the evidence presented in court.”

-Wes

Better Care or Economic Necessity?

Now with the Dow Jones Industrial Average parked to it's lowest level since 1997, hospitals are doing the best they can for their patients (and rankings) by shortening their door-to-balloon times for heart attack patients by mandating that their cardiologists be on site in the hospital 24/7. It's such a simple thing to accomplish in the name of patient care, right?

But there's a dark side to government idealism: doctors jumping through hoops in the name of "quality" as they struggle for economic survival.

As competition between hospitals for patients continues to heat up, the press for perfect care becomes more acute lest the hospital's Medicare reimbursements fall. Teams of staff are mobilized to study the door-to-balloon time process. If hospitals find they can't shave enough seconds off the door-to-balloon time process to correct this measure, they resort to constant in-house staffing spun, of course, as "better care." The pressures on doctors to "perform," faster becomes more acute, but so does the toll on their personal lives. Unfortunately, if hospitals are not careful, they may lose doctors to their competitors because of other, non-economic, real life incentives.

Then what will become of the patient's door-to-balloon time?

-Wes

A Classic Case of Denial

Mark Taylor, a veteran health reporter for Post-Tribune, tells the story of his heart attack rather humorously. Gratefully, all turned out just fine.

But his story demonstrates the most common reaction to new chest tightness: rationalization and denial.

And how many times have I heard similar stories?

More often than not. I would even go so far to say his story is typical.

Unfortunately for many others, not all of these stories had such happy endings.

-Wes

On Young Women, Heart Attacks and Denial

I read this article that appears in the Chicago Tribune today about a 27 year-old woman who reportedly had a "heart attack." I'm not sure what the point of the story really was - perhaps to wake up young women that heart attacks can occur in their demographic - and if so, well, fine.

But there is another, more sinister tone in the article: one that doctors should not be trusted and are mostly interpersonal buffoons. Nowhere is there a thoughtful discussion about the potential causes of why a young woman might have a heart attack, like spontaneous coronary dissection, paradoxical embolis, congenital coronary anomalies or familial hyperlipidemias. Nowhere do we hear from the doctors who interacted with this patient. No, that would require some thought and journalistic background analysis.

Instead we are greeted, once again, to only the patient's perspective: "If your doctor won't listen, fire him and find one who will."

To that, I say, remember the case of Hank Gathers - a young basketball star with exercise-induced ventricular tachycardia and hypertrophic cardiomyopathy who was presribed beta blockers and advised not to play competetive sports. But he didn't like what the first doctors had to say to him. Instead, he "fired" his doctors and shopped around for another doctor who "listened" to him.

The rest, as they say, is history: Hank Gathers ultimately died of sudden cardiac arrest playing the game he loved.

Sometimes, doctors don't listen, that is true. Overburdened by higher patient volumes, more documentation requirements, and reduced compensation models in health care today, doctors are pressed like never before to do more with less time. Listening to patients sometimes takes a back seat to these demands. But patients, too, increasingly expect that they know what's best for them - after all they read it on the internet - and don't hear what their doctor says, or they ignore their advice completely.

Believe it or not, sometimes patients need to realize they have a role in their health care, too.

Even when the advice isn't what they want to hear.

-Wes

What Your Heart Attack Might Be Like

The Brits showed this ad from the patient's perspective:



Although one would hope the symptoms wouldn't get to this extreme, the ad makes the point that heart attacks aren't really just about chest pain: but also chest or arm tightness or a discomfort, dizziness, shortness of breath, nausea, vomiting, sweating, and the like.

But back pain, especially between the scapula, was not mentioned, nor was incessant burping typical with some inferior myocardial infarctions (lower wall heart attacks).

Not only are people unfamiliar with the more common symptoms of heart attacks, but there's a tremendous amount of denial when they happen to one of us. Worse yet, many people I have seen were ashamed to call the ambulance because they didn't like the idea of flashing lights and sirens in front of their residence.

And one more thing to consider: if a friend wants to call an ambulance for you, let them. Remember they are objective observers, and might just save your life even despite yourself.

-Wes

CMS-Mandated Mortality Data: Whoop Dee Do

I wonder how much money was spent to collect, collate, process and puree the hosptial mortality rates of heart attacks, pneumonia and heart failure in our nation's hospitals, and plotting these data nice little graphs on a website?

I looked at data from most of the hospitals near our facility and was not surprised to find that there was really no big difference in mortality between centers.

So I guess what this data tells us is this: all hospitals are pretty good at collecting data. Whoop dee do.

Now, can we get back to treating patients?

-Wes

They Missed Something

By causing the blood vessels that supply the heart to abruptly occlude, cocaine can also cause your heart to fibrillate (stop) resulting in

sudden
	cardiac
		death

... and can happen before you ever get to an Emergency Room.

Any questions?

-Wes

RA Drugs for the Heart?

Although rheumatoid arthritis drugs (including glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs), and biologic agents) were associated with significant 8% to 58% reductions in the risk of the developing heart attacks, strokes, and cardiovascular disease in one poorly-controlled international study, there might be other side effects that preclude their widespread use.

Here's just one reason I'd never consider using this therapy to prevent heart disease or stroke.

If that doesn't make your stomach turn, I'd don't know what will...

-Wes

Is the Superbowl Hazardous to Your Health?

Once again, the New England Journal of Medicine has sunk to new lows in the interest of increasing its impact factor.

The very notion that an article that used retrospecive ER chart reviews to evaluate the incidence of heart disease and claims to have identified "risk factors" that increase the incidence of heart attacks in people at the time of world cup soccer while conveniently excluding years when the World Cup was not in Germany is ludicrous. And if not enough, the authors go on to conclude that "in view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed."

Give me a break.

What should we do, turn off the TV? Or maybe we should ban all hot dogs and salted pretzels at the soccer games?

But the media, oh baby, the media takes this well-timed drivel and extrapolates that men with coronary disease are more likely to have a heart attack watching the Superbowl! (See here, here, and here, for instance).

Well OF COURSE they will! It's really a conspiracy to lower the world's population of men with coronary disease! Why else would they have the halftime band be Tom Petty and the Heartbreakers?

Maybe Barry Manilow would be more calming and preserve a few more lives. (Heck, that would kill me, but I digress).

It is a shame that journalistic marketing of medical journals has sunk to this new low - but hey, it's all about the advertising revenues...

... and the egos.

Here's what I say: Watch. Cheer. Socialize. Be Happy.

After all, it's good for your heart.

-Wes

Coffee and Heart Attacks

Now this is important news.

-Wes

Pardon Me While I Puke

I've got a brilliant idea.

I want to set up a study to determine is panic attacks cause an increased incidence of heart attacks.

So I developed the "Big Important Trial" sponsored by the world's Most Important Drug Company to see if a relationship exists.

So I ask a bunch of older women (especially since this is a major health care problem in just women), are you anxious? And some of them say "yes."

Now of those, I decide to ask them to describe the symptoms they feel when they're anxious, and when they check at least one quarter of my twelve-symptoms list, I will call them a bonafide full-blown, Katie-bar-the-door panic attack.

For the ones that check a few less boxes, heck, we'll call them panic attack "lite."

Then I follow them for five years.

And lo and behold statistically, more of 'em drop dead, or have a heart attack or stroke than the folks who said they weren't anxious.

The drug company thanks me after I publish my results in a medical journal and leaked the results to the Wall Street Journal, so now they can sell more drugs to anxious women and I can go on a speaking circuit for the drug company and make lots of money.

But there's a little issue I'd rather not discuss: did anyone in my Big Important Trial screen for heart disease before they took the questionaire to see if these women might have already had heart disease? I heard that it is well established that the symptoms for heart disease are dramatically different for women than men! Did we screw up?

I'm getting nauseous.
* * *
I can't overemphasize the number of women I have treated with supraventricular tachycardia that were originally diagnosed as "anxious" or with "panic attacks" or from "mitral valve prolapse" by their primary care physicians only to discover years later that they had been inappropriately labeled due to sexist practices relying on presumptions about the reduced prevalence of heart disease in women compared to men. What's to say in this trial that these women didn't already have heart disease that was undiagnosed and was manifested as "panic attacks?" In other words, maybe the egg came before the chicken?

-Wes