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Wrapping Up Atrial Arrhythmias

Before we leave the atria behind, let’s conclude our discussion of atrial arrhythmias this week with a discussion of some other abnormal heart rhythms arising from these chambers. The simplest and most prevalent are premature atrial complexes (PACs). We call them “complexes” because that is how we refer to individual electrical impulses seen on an EKG. Virtually everybody has PACs, some people more,…

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Atrial Flutter: “Organized” Atrial Fibrillation

We’ve spent a lot of time discussing atrial fibrillation these past few weeks—and with good reason. Atrial fibrillation is the most common arrhythmia that requires treatment, and it accounts for numerous visits to cardiologists’ offices and emergency rooms. But the atria can misfire in other ways, too. Often lumped together with atrial fibrillation, atrial flutter is also a fast heart rhythm arising…

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Atrial Fibrillation: Minimizing Stroke Risk

Picking up where we left off last week, we now turn to the most serious aspect of atrial fibrillation—that it can cause a stroke. And, as I indicated previously, strokes occur in people with atrial fibrillation whether they are aware of the atrial fibrillation or not. In fact, when looking at people older than 55 who have had a stroke with no…

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Atrial Fibrillation: The “Irregular” Heart Rhythm

Patients often tell me “I was diagnosed with an irregular heart rhythm.” But, as we learned in last week’s blog, “irregular” is a fairly broad description.  It may be something benign—and actually normal—like having PACs or PVCs. Or the irregularity can be something that needs to be taken quite seriously, like atrial fibrillation. Atrial fibrillation is an irregular heart rhythm caused when…

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“Irregular” Heart Rhythms and Arrhythmias: Should You Be Worried?

Most people have heard of an “irregularity” in the heart rhythm or having an arrhythmia. But there are several types of irregularities and arrhythmias. Many arrhythmias are benign, but some require treatment. So, knowing you have an arrhythmia is not the end of the subject—it is important to know what type of arrhythmia it is. We use the term normal sinus rhythm (abbreviated…

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Alcohol: Part of a Heart-Healthy Lifestyle?

Summer is here and we’re enjoying barbeques—which means beer, lighter wines, along with gin and tonics. So I’d like to tackle a somewhat controversial question: Is alcohol OK to drink? What if you have heart problems? And how much is acceptable? First, I have to point out straightaway that too much alcohol can cause major toxicity to the body—particularly to the liver, the…

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Right Ventricle: The Overlooked Pump

We have spent a lot of time in the last several blogs on heart failure. Virtually all of these discussions have focused on left ventricular heart failure. What about right ventricular heart failure? Yes, the right ventricle (RV) can fail, too. But many of the most common cardiovascular problems—coronary heart disease, hypertension, valvular heart disease, atrial fibrillation—create dysfunction either exclusively or predominantly in the…

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High-Output Heart Failure: When High Isn’t Good Enough

We have touched on multiple aspects of CHF in several blogs this year, including discussions of how it occurs—whether in the setting of systolic dysfunction or diastolic dysfunction—what its manifestations are, how it is treated, and most recently a look at cardiomyopathies and how they cause CHF. All of these aspects of CHF have one thing in common—the heart isn’t doing…

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Takotsubo Cardiomyopathy: “Broken Heart Syndrome”

Before I leave the topic of our previous three blogs, I wanted to discuss a relatively new form of cardiomyopathy. Described first in Japan in 1991, Takotsubo cardiomyopathy or Takotsubo syndrome (hereafter abbreviated TTS) has been increasingly recognized as a fairly frequent type of cardiac dysfunction. Also called “broken heart syndrome” and “transient apical ballooning syndrome,” the name derives from the…

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Cardiomyopathy (Part III): When the Heart Muscle is Sick

In the last two blogs, we discussed what a cardiomyopathy is, paying particular attention to the categories of dilated and hypertrophic.  This week we’ll complete our review of cardiomyopathies with a look at the category of restrictive. While dilated and hypertrophic cardiomyopathies are defined by anatomic features (an enlarged heart chamber in the first and thickened ventricular walls in the…

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Gregory Koshkarian, MD, FACC