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Show Arterial inflammation may explain why people with no classic risk factors(like high was unpredictable. and many hadseriousside effects even whenthey did work. We now often can permanently stop or “ablate” these rhythm disturbances with various techniques, including radio wavesdirected at specific areas of the heart. ® Defibrillators are no longerjustfor the ER. The leading cause of sudden death in someone whose heart has been damagedbya heart attack is an un- heart orin the brain, may cause anyplaquesit conexpected life-threatening rhythm disordercalled ven- tains to rupture and obstructit. This inflammation tricularfibrillation. The heart beats rapidly and ir- mayexplain whypersons with noneoftheclassic risk regularly—resembling a bag of worms—andcannot factors for arteriosclerosis suffer heart attacksin the pumpits blood. Defibrillators, which shock the heart primeoflife. andrestore normal rhythm, have been placed in many A blood test now being usedfairly widely measures public areas. Compact, easy-to-use models for the the C-reactive protein (CRP)level, a markerofinhomealso are now available. flammation in the body. A high CRP is a morereliBetterstill, a defibrillator wire can be threaded able predictor of heart attacks and strokes than an into the heart of a vulnerable individual. It shocks the elevated level of LDL, the bad cholesterol. heart into normal rhythm as soonas it senses the onset of ventricular fibrillation. You no longer are dependenton havHefinally found. his one and onl ing someone who'll go looking Only somebodyelse foundherfi st. for a defibrillator (and who knows how to useit) to save yourlife. These implanted devices could save manythousandsoflives everyyear. © Heart surgery is safer, quicker, less traumatic. Heart surgery doesn’t have to be “open” anymore. Surgeons can now often repair or replace heart valves and perform bypass surgery on a beating heart through smallincisionsin the chest wall. Patients are discharged from the hospital much sooner and suffer fewer complications than after open-heart surgery. Researchis now being conducted using robots to perform these operations. A few already have been done successfully at several hospitals. Don’t misunderstand me: It’s not asif a robot has pushed the surgeon aside and is doing the operation. The doctorinserts robotic “fingers” intothe smallholes in the chest and manipulates them fromoutside. an original movie premiere © Inflammationand the CRP test: a newpredictor. Doctors are increasingly convinced that & Br to you in part by inflammationofthe lining of an artery wall, whetherin the cholesterol) have heart attacks. ne SUNDAY FEBRUARY9 8PM E/P =... D “& lary Worderde rc AY RegnReserves Whenthe CRPlevelis hi I rigorously controlallrisk fa tors for vascular disease. I also makesure the patienttakes aspirin forits anti-inflammatory action as well as protection gainst clot formation. Most important, I usually prescribe oneofthe statin drugs, such as Lipitor or Zocor, even if the cholesterolis normal orlow. In addition to lowering cholesterol, these medications reduce inflammation. (Incidentally, so doesalcoholin moderation.) © Folic acid supplements reduce risk. Homocysteine, an aminoacid (protein) in the blood is another markerofvulnerability toa stroke orfatal heart attack.It can be lowered byfolic acid supplements. Always ask to be tested for homocysteine as part ofthe routine physical. If it’s high, be sure totakeatleast 1 milligram offolic aciddaily © Newdrugs strengthen weak hearts. When | was a medical student. we had only digitalis to help a weak heart muscle. Thoughdigitalis is still used, there are now varieties of diuretics, beta-blockers and ACE inhibitors that singly and in combination moreeffectively strengthena failing heart © Improved MRIs provide clearer diagnoses. Magnetic continued |
