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…
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…
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…
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…
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…
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…
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.…
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 “must use”…
In last week’s blog, I talked about sudden death, a quite terrifying term—and it does refer to a scary and sometimes life-ending event. Another cardiac problem that sounds almost as terrifying is heart failure. Does that mean that the heart has stopped working? Or is it about to stop? What else could that mean? While heart failure is not a benign diagnosis, it is…
I want to wrap up our discussion of heart attacks by addressing the question in the title. Patients often assume that people who collapse suddenly and need CPR—what we term cardiac arrest—have had a heart attack. But the two entities are not the same thing. While it is true that a person who is having a heart attack can have a cardiac arrest…