August 2009 references and further reading

Stanek EJ, Aubert RE, Flockhart DA, et al. A national study of the effect of individual proton pump inhibitors on cardiovascular outcomes in patients treated with clopidogrel following coronary stenting: The Clopidogrel Medco Outcomes Study. Society for Cardiovascular Angiography and Interventions annual meeting, presented May 6, 2009. Bhatt DL, Scheiman J, Abraham NS, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology 2008; 52:1502-17. Statement on "A National Study of the Effect of Individual Proton Pump Inhibitors on Cardiovascular Outcomes in Patients Treated with Clopidogrel Following Coronary Stenting: The Clopidogrel Medco Outcomes Study". Society for Cardiovascular Angiography and Interventions, Washington DC, May 6, 2009. (Locked) More »

Trials test closing a PFO

Strokes without a known cause are called cryptogenic strokes. One possible cause of these is a hole in the wall separating the right atrium from the left. Whether fixing this opening, called a patent foramen ovale (PAY-tent foe-RAY-men oh-VAH-lee, PFO) prevents such strokes has yet to be determined. It's possible we'll never have an answer because some doctors, researchers, and stroke victims seem to be convinced that closing a PFO is good medicine. That's why the American Heart Association, American Stroke Association, and American College of Cardiology are urging doctors to enroll patients with cryptogenic stroke in one of the ongoing trials testing the benefits and risks of PFO closure. These trials include: GORE HELEXTM Septal Occluder for Patent Foramen Ovale Closure in Stroke Patients (Gore REDUCE) in the United States (Locked) More »

Stomach-protecting drug could block Plavix

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. (Locked) More »

Hole in the heart opens questions

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. (Locked) More »

When the lights suddenly go out

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. More »

Heart Beat: Extending the time for stroke treatment

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. (Locked) More »

In Brief

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. (Locked) More »

Ask the doctor: Why do I get chest pain when I don't warm up before exercising?

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? (Locked) More »

Ask the doctor: How can you tell when a leaky mitral valve needs to be fixed?

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? (Locked) More »