Harvard Heart Letter: August 2009

I am an 82-year-old man with borderline leakage in my mitral valve. Your article on mitral valve prolapse said, “The operation to repair or replace a leaky mitral valve is big enough that you don’t want to undergo it unnecessarily, but important enough that you don’t want to wait until symptoms develop.” What symptoms or tests would help me and others recognize when it is time to consider having the valve fixed?

Many people who take aspirin and clopidogrel (Plavix) to prevent blood clots also take a proton-pump inhibitor (PPI) to ease the gastrointestinal bleeding the other medications can cause. But a study found that PPIs can limit the effectiveness of Plavix.

Stroke victims are more likely to have a patent foramen ovale, a hole between the heart's left and right atria, but closing the hole may not prevent the occurrence of another stroke.

Adding fruits and vegetables to your diet is a simple way to eat more healthfully. Here are some suggestions to make healthy eating more fun and interesting.

Fainting occurs when blood flow to the brain is blocked or interrupted. An incident of fainting should be reported to a doctor, because if it was caused by a problem in the heart, it may lead to more serious problems. Read More »

Readers suggest alternative terms for a transient ischemic attack.

Everyone wants to live longer, and there are many preventable causes of death that can be avoided with proper health habits.

When someone has a stroke, immediate treatment is essential. The American Stroke Association says a clot-destroying drug called tPA may work for up to four and a half hours after the onset of a stroke, but should be given within an hour if possible.

Brief reports on CPR and an improved cardiac arrest survival rate, chewable aspirin as a rapid heart attack aid, and the effect of lack of sleep on blood pressure.

Long ago I was told that isometric exercises, like weight lifting, shouldn't be done by anyone with a heart condition. Is that still the prevailing wisdom?

What are silent heart attacks? How are they different from regular ones? If they are silent, how does anyone know about them?

I work out regularly six times a week, but suffer from exercise-induced angina and what my doctor calls a vascular problem. If I start exercising without first warming up, my chest starts to feel “tight” before I’ve walked 100 yards. The same thing happens if I start walking after being seated for a while, such as when I walk to the baggage claim area to get my luggage after getting off a plane. If I warm up properly, though, I can walk for several miles at a pretty fast pace without any chest pain. Can you explain what is going on?