Clinic News

Alcohol: Part of a Heart-Healthy Lifestyle?

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

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”

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

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

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

Last week we discussed what a cardiomyopathy is, including the three categories of dilated, hypertrophic and restrictive. We then focused on types of dilated cardiomyopathies, along with some discussion about their treatment.  Today I’ll continue our review of cardiomyopathies by focusing on hypertrophic. Whereas a dilated cardiomyopathy is defined by the heart chamber being enlarged, a hypertrophic cardiomyopathy is defined by…

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Cardiomyopathy: When the Heart Muscle is Sick

Cardiomyopathy: When the Heart Muscle is Sick

Over the last several weeks, we have been discussing the subject of CHF (congestive heart failure). I discussed the differences between heart failure from systolic dysfunction (problems with the heart contracting/pumping) and problems caused by diastolic dysfunction (problems during the relaxation phase of the cardiac cycle). These are clinical syndromes and are brought on by a variety of conditions, some of…

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My Ankles Are Swollen—Does That Mean My Heart is Failing?!

My Ankles Are Swollen—Does That Mean My Heart is Failing?!

Hardly a day goes by that I am not asked that question by a patient. The causes of swollen ankles are numerous, but most people’s biggest fear is that they have CHF (congestive heart failure).  Indeed, peripheral edema (edema fluid causing swelling of the extremities, usually the legs) is often seen with CHF, and probably is its most visible manifestation. In that…

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Cardiac Contractility Modulation: The Latest in Device Technology

Cardiac Contractility Modulation: The Latest in Device Technology

We have discussed heart failure and its various treatments over the last few blogs. Last week I delved into a particular class of medications, the so-called SGLT2 inhibitors, which are  the newest “kid on the block” in our pharmacologic armamentarium to help patients with CHF. Even more recently, I became aware of a new technology called “cardiac contractility modulation” or CCM. The device,…

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SGLT-2 Inhibitors: The New Kid on the CHF Block

SGLT-2 Inhibitors: The New Kid on the CHF Block

We have spent a couple blogs discussing heart failure (CHF)—what it is and how we treat it. As time goes on, our armamentarium has expanded.  When I started practicing cardiology over 25 years ago, ACE (angiotensin converting enzyme) inhibitors had recently been found to save lives and prevent progression of CHF in patients with systolic heart failure. They became the first…

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Gregory Koshkarian, MD, FACC