Thursday March 6, 2014
Cryptogenic stroke - a stroke whose cause remains unknown even after a thorough medical workup - is a common problem, accounting for almost 40% of all strokes in the U.S. A chief issue after any cryptogenic stroke is deciding what should be done to try to prevent another stroke - which is hard to do if the underlying cause is unknown.
Recent evidence suggests that episodes of subclinical atrial fibrillation may be responsible for a substantial proportion of cryptogenic strokes. (Here, "subclinical" means that neither the doctor nor the patient suspected that episodes of atrial fibrillation were occurring.) This information is important, since the risk of stroke from atrial fibrillation can be greatly diminished with appropriate treatment.
Read about atrial fibrillation and cryptogenic stroke.
Monday March 3, 2014
Everyone knows that hypothyroidism - the condition in which the thyroid gland is not producing enough thyroid hormone - negatively impacts the heart. But evidence is accumulating that a lesser known - and less often recognized - thyroid condition called subclinical hypothyroidism may also increase the risk of cardiac disease. In subclinical hypothyroidism, the thyroid gland is in fact producing a "normal" amount of thyroid hormone - but it has to work extra hard to do so.
Read about subclinical hypothyroidism - what it is and what to do about it - here.
Thursday February 27, 2014
Thousands of patients who have had cryptogenic stroke, and are subsequently found to also have a patent foramen ovale (PFO), have undergone PFO closure procedures. While minimally invasive, a PFO closure is not an entirely benign procedure, and can lead to some nasty complications. It is a procedure that should be performed only if there is a strong likelihood that it will lead to a better outcome.
Unfortunately, recent randomized clinical trials have failed to demonstrate a significant reduction in subsequent stroke after PFO closure. And most experts now say that closing PFOs, even after a stroke, should not be done, or should be done only very rarely.
Still, almost everyone agrees that PFOs do sometimes cause strokes, and that closing PFOs would almost certainly reduce the risk of stroke - if only we could identify those particular patients in whom a PFO poses a real threat. And now, investigators appear to be making progress in identifying this high-risk subset of patients.
Read more about closing PFOs to prevent stroke.
Tuesday February 25, 2014
During the last several years, lots of cardiologists have treated lots of migraine sufferers who also have a patent foramen ovale (PFO) with PFO closure devices.
But now the data is in. And it should be quite clear to any objective observer (a category which may or may not include said cardiologists) that this practice is no longer justifiable.
Read the sad truth about migraine headaches and PFO here.