Last week I described a patient who had an abnormal stress echocardiogram, but turned out to have no significant blockage in her coronary arteries. This week I’ll tell you about a patient I saw not long ago who had had a normal nuclear stress test (see “Services” section of this website to learn more about this test), but ended up having…
A couple weeks ago I had a conversation with a patient that surprised her. Her test result had been incorrect. She is a 57-year old woman who had been having chest pain for the last several months, though the symptoms weren’t necessarily with exertion. I had ordered a stress echocardiogram (see “Services” section of this website for a description of what this test…
Last week, we talked about PFO’s—what they are and how we find them. This week we’ll turn to a discussion of what we do when we find one. Because PFO’s are common and the vast majority of people have no consequences from their presence, we don’t generally close them. It is controversial whether patients with an asymptomatic PFO should take aspirin or…
What does it mean to have a “hole” in your heart? Is blood leaking out? How can you have this without knowing about it? A hole in the heart means that there is a connection between two chambers that shouldn’t be there. A patent foramen ovale (PFO) is a connection between the right and left atria. Blood normally passes from…
We discussed aortic aneurysms in last week’s blog and this week we’ll talk about what we do to prevent their rupture. First, we have to know that the aneurysm is there. Widespread screening of aneurysms is not generally recommended, so it is usually the case that they are discovered by chance. For instance, a person may have nausea and abdominal pain and get…
This week we turn our attention to a problem outside the heart—aortic aneurysms. An aneurysm is a focal enlargement or bulging of a blood vessel. It comes from the Greek word meaning “dilation.” In fact, radiology reports will often use the term “dilated” to refer to a vessel that is larger than normal, but not large enough or focal enough to use…
This week, I want to take a break from our series on cardiac disorders and turn to a more general and practical discussion of how you can get can the most out of a cardiology consultation. Let’s assume you’ve made an appointment to see a new cardiologist—perhaps you’ve been having chest pain. Or shortness of breath. Or palpitations. Or you have had a cardiologist…
In the last two weeks, I have discussed the two most common valvular problems that we cardiologists see—AS and MR. This week I’ll give a quick overview of the other valvular problems that we can encounter. First of all, the aortic valve can also develop regurgitation. Called “AR,” aortic regurgitation, when severe, can lead to heart enlargement, shortness of breath, chest pain,…
We turn this week to another valvular problem: mitral regurgitation. Unlike aortic stenosis, where the valve doesn’t open all the way, in mitral regurgitation (often abbreviated “MR”) the mitral valve (sitting between the left atrium and left ventricle) doesn’t close completely, allowing blood to regurgitate backward. Physicians usually describe this condition to their patients as having a “leaky valve.” The causes…
Last week we introduced the concept of valvular heart disease, starting with a discussion of how valves in the heart work, and then touching briefly on how they malfunction. Today we’ll be talking about one such valvular dysfunction: aortic stenosis (often abbreviated “AS”). AS is increasingly prevalent as we age, though not by any means an invariable development. The normal aortic valve…