Ivabradine is a relatively new drug, available in the most of the developed world except the United States, which is used for the treatment of angina. In recent years, reports from abroad indicate that ivabradine may be uniquely useful in relieving the symptoms of IST - as well as some other dysautonomia syndromes such as postural orthostatic tachycardia syndrome (POTS), and vasovagal syncope.
Not only does ivabradine, in early reports, appear highly effective for at least some patients with these conditions, but also it is said to have remarkably few side effects.
Read about the status of ivabradine for IST and other dysautonomias, and where Americans stand who might like to try this drug.
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.
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.
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.
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.
Patent foramen ovale (PFO) is a diagnosis that is becoming more and more common - up to 25% of adults have it. PFO is said to increase the risk of stroke, and has been implicated as a cause for migraine headaches. As a result, patients are being asked to undergo an invasive procedure to close their PFOs. But is this common echocardiographic finding really as significant as all that?
Most strokes are caused by an interruption in blood flow to part of the brain, producing damage to that portion of the brain. Usually, the blood flow is disrupted by a clot that forms in the blood vessel (a thrombus), or a clot that travels to the brain from elsewhere (an embolus). Subsequent treatment for a given patient depends on identifying the specific cause of the interruption in blood flow.
But, despite best efforts, in up to 40% of patients with stroke, the specific cause cannot be identified. These patients are said to have had a "cryptogenic stroke." A number of issues need to be taken into account when deciding on therapy for a person who has had a cryptogenic stroke.
Statins have become a mainstay in preventive cardiology. A large number of clinical trials have demonstrated that statins, in high-risk patients, can substantially reduce the risk of subsequent cardiovascular events.
So how can it be that the benefits of statins have not been proven in women?
We have known for a long time that eating too much sugar is bad for us. But now, a new study says that consuming even what most of us might consider moderate amounts of sugary foods significantly increases our risk of cardiovascular death. If you love her, guys, pass on the candy and go for the flowers.
While therapy with aspirin is known to benefit patients with coronary artery disease, evidence that it significantly helps people who have heart failure has been more difficult to come by.
A new study, published last week, suggests that aspirin may indeed improve the survival of patients with heart failure - but only at doses substantially lower than have been typically used in practice, or in prior clinical trials.