Heart Matters

Drastic lifestyle changes can seem daunting to patients and physicians alike. Fortunately, new research is demonstrating the importance of moderation in improving cardiovascular health. How can small tweaks to a patient's lifestyle have a substantial impact his or her heart health? Dr. Steve Kopecky, cardiologist at Mayo Clinic's Cardiovascular Health Clinic, specifies some of the minor changes patients can make, and the data demonstrating the cardiovascular benefits of these modifications. How can physicians help patients implement these lifestyle changes? Dr. Janet Wright hosts.

Takotsubo, or stress-induced cardiomyopathy (also known as 'broken heart syndrome'), was first recognized in Japan in the 1990s. Acute emotional or physical stress trigger the condition, which mimics the symptoms of a myocardial infarction (or MI). How can physicians differentiate between stress-induced cardiomyopathy and a more conventional MI, and how is stress-induced cardiomyopathy treated? What characteristics might make a patient more susceptible to developing this condition? Our guest is Dr. Scott Sharkey, senior consulting cardiologist at Minneapolis Heart Institute and director of the Takotsubo cardiomyopathy research program at the Minneapolis Heart Institute Foundation in Minnesota, shares some of the key diagnostic tests for differentiating between stress-induced cardiomyopathy and conventional MI. How common is this condition, and how can we limit the effects of stress-induced cardiomyopathy? Dr. Janet Wright hosts.

Although medications are generally first-line therapy for patients with atrial fibrillation, or a-fib, adverse events or inadequate efficacy often make drug therapy suboptimal. How effective is catheter ablation, and should it be considered first-line therapy for some patients? Host Dr. Janet Wright talks with Dr. David Wilber, director of the Cardiovascular Institute and the George M. Eisenberg professor of cardiovascular sciences at Loyola University Chicago Stritch School of Medicine, about recent findings on the efficacy of catheter ablation for a-fib. What are the most significant risks to be aware of when considering catheter ablation therapy?

Addressing the totality of care for patients with heart failure is crucial to reducing readmissions. How can physicians better recognize the comorbities that may affect older patients with heart failure in order to improve outcomes? What type of benefits can a more holistic, nuanced approach to managing heart failure offer patients? Dr. John Spertus, cardiologist and professor of medicine at the University of Missouri-Kansas City, and clinical director of outcomes research at Saint Luke's Mid America Heart Institute, discusses some of the non-traditional patient characteristics and symptoms physicians should consider and address when caring for patients with heart failure, including impaired mobility, dementia and depression. How can physicians promote a multidisciplinary approach to system-based processes when caring for patients with heart failure, and how is health policy impacting the delivery of care? Dr. Janet Wright hosts.

When high-risk patients, such as the elderly, develop respiratory infections there can be a cascade effect of inflammation that moves from the lungs to the heart, triggering myocardial infarction (or MI). What is the mechanism by which vaccination might prevent MI? Dr. Mohammed Madjid, senior research scientist at Texas Heart Institute in Houston, explains the cause and effect relationship between the influenza and pneumococcal vaccines, and MI. What are the vaccine guideline recommendations for patients with heart disease, and can early use of antibiotics help reduce the risk of infection-related cardiovascular events? Dr. Janet Wright hosts.

Recommendations and ratings are a dime a dozen for patients looking for more information about a physician or procedure online, but finding quality, consumer-friendly information that's also reliable can be more of a challenge. What tools can physicians recommend to patients for understanding the implications of both reform and other healthcare matters? Jim Guest, president at CEO of Consumers Union, which publishes Consumer Reports, and ConsumerReportsHealth.org, discusses ways physicians can encourage better communication and health literacy with their patients, and stresses the importance of bringing up costs with your patients. How can healthcare ratings based on outcomes data improve quality of care? Hosted by Dr. Jack Lewin.

The FDA's premarket approval (or PMA) process was first established over 30 years ago, but thanks to technology, the development of devices has dramatically changed since then. How should the FDA modernize its premarket approval process to ensure medical device safety? Guests Dr. Rita Redberg, professor of clinical medicine at the University of California, San Francisco, School of Medicine, and director of women's cardiovascular services at the U-C-S-F National Center for Excellence in Women's Health, and Dr. Bram Zuckerman, director of the division of cardiovascular devices at the FDA, discuss current and ongoing research about the quality of the FDA PMA process.

When patients present with shortness of breath, physicians often face a quandary: Is it the heart or is it the lungs? What is the relationship between chronic obstructive pulmonary disease, or COPD, and cardiac function? Are patients with even subclinical emphysema at risk for showing reductions in cardiac output and left ventricular volume? Dr. Karol Watson, director of the Women's Cardiovascular Center, co-director of the program in preventative cardiology, and director for the Center for Cholesterol and Hypertension Management at the University of California Los Angeles, discusses recent findings about mild- to moderate-COPD and cardiac function, and how this new evidence should impact the way physicians diagnose and manage patients with shortness of breath. Dr. Janet Wright hosts.

Defensive medicine and medical liability concerns create a symbiotic relationship that costs everyone in the medical system. Has healthcare reform legislation addressed the medical malpractice issue, and will it do enough to contain healthcare costs? Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, former commissioner of the FDA and administrator of the Centers for Medicare and Medicaid Services, discusses the impact of defensive medicine on the healthcare system. Dr. McClellan also suggests that health information technology will play a significant role in bending the healthcare cost curve by ensuring safety, as well as increasing coordination of care and effective communication. Among states have taken up tort reform, how successful have these reforms been at reducing liability pressure and overall healthcare costs? Hosted by Dr. Jack Lewin.

It's one thing to produce guidelines, and quite another to encourage guideline adherence. The first step in this might be to gather data about current practices, and then determine ways to standardize treatment and increase access to quality therapy. The European Heart Rhythm Association (a branch of the European Society of Cardiology) conducts an ambitious annual survey of the management of arrhythmia in dozens of European and neighboring countries, which is intended to be a foundation toward standardizing quality of care. Dr. Christian Wolpert, medical director of the department of medicine-cardiology, nephrology and internal intensive care medicine, at Klinikum Ludwigsburg in Ludwigsburg, Germany, and chairman of the National Sciences Committee of the European Society of Cardiology, explains to host Dr. Janet Wright that the disparities are not directly correlated to a country's wealth, but rather, a variety of other factors. Tune in to hear more about ways to reduce the disparities in the practice of electophysiology in Europe and worldwide.