Diseases & Conditions Archive

A rapid heartbeat can be frightening, but this often-fleeting problem is usually harmless.

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If you're exercising or feeling very nervous, you expect your heart to beat faster than normal. But what if your heart sometimes starts racing out of the blue, for no apparent reason? You might have supraventricular tachycardia, or SVT. SVT is an umbrella term that covers several different types of rapid heart rhythms, all of which are caused by an electrical glitch in the upper part of the heart.

The most common SVTs are atrial fibrillation — a rapid, chaotic rhythm that increases the chance of having a stroke—and atrial flutter, a fast but usually regular heartbeat. But when cardiologists talk about SVT, they're usually referring to three different, less-common conditions (see "What is supraventricular tachycardia?").

Most people who are suffer from fecal incontinence do so in silence. As a result, the number of people with the condition — which results in the involuntary release of gas or stool — isn't known. But the scant evidence at hand indicates that it usually begins during one's 40s or 50s.

You don't have to live with incontinence — there are treatment options, which include dietary changes and bowel training regimens, and surgery for some people.

Those extra inches around the middle may signal increased fat around abdominal organs and rising health risks.

It's a rare woman over age 50 who has the same waist measurement she had as a teenager. But in the past decade or so, women's waistlines have been expanding regardless of age. A 2014 report from the National Health and Nutrition Examination Survey found that from 1999 to 2012, the average body mass index (BMI) for women age 20 or older held steady. But during the same period, the average female waistline grew slowly and steadily, from 36.2 inches to 37.8 inches. Researchers are still searching for an explanation for this phenomenon, but they do know one thing: increasing waistlines are linked to greater risks for heart disease, diabetes, and osteoporosis.

What's in a waistline?

Regardless of whether your weight has changed over the years, your height is likely to have decreased, the result of declining volume in the intervertebral discs of the spine. As your torso shortens, your abdominal organs have less vertical space to inhabit, so they move horizontally. If you haven't gained weight, an increase of an inch or two around the waist may simply reflect lost height.

Research we're watching

Aging brains often show signs of microscopic strokes, which result from damage to tiny blood vessels within the brain. Those that occur in the brain's outermost layer — called cortical cerebral microinfarcts (CMIs) — usually don't cause any symptoms. But they are more common in autopsies of people diagnosed with dementia. Now, new research suggests a link between blood markers for early heart disease and CMIs.

The study, published online Feb. 6, 2017, by JAMA Neurology, included 243 people who attended a memory clinic. All had brain scans to check for CMIs and blood tests that measured two substances associated with early signs of heart damage. People who had CMIs (nearly 29% of the participants) were much more likely to have heart disease than those who didn't have CMIs. Higher levels of both substances associated with heart damage were also linked to CMIs — even when the researchers left out people who already had obvious symptoms of heart disease.

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

This common type of arthritis can show up suddenly and cause debilitating pain.

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The great artists Ludwig van Beethoven, Luciano Pavarotti, and Leonardo da Vinci had more than extraordinary talent in common; they were also sufferers of a type of inflammatory arthritis called gout. You may be at risk of joining their ranks if you have any potential triggers for the condition. "Most people are surprised by their initial gout diagnosis, unless they have a strong family history," says Dr. Mark Fisher, a rheumatologist at Harvard-affiliated Massachusetts General Hospital.

About gout

Gout is mostly a man's condition, although women can experience it, too. It's caused by a buildup of uric acid — a waste product from the breakdown of natural chemicals called purines (an essential part of DNA).

Because medications cannot effectively treat aortic stenosis, a stiff, narrowed aortic valve needs to be replaced.

Your aortic valve is the gateway between your heart and body. With every heartbeat, it opens to allow blood to flow to your body, then snaps shut to keep blood from moving back into the heart.

As people age, calcium deposits may collect on the hard-working aortic valve, causing it to stiffen and narrow. Known as aortic stenosis, this condition also can result from a genetic abnormality (see "What is a bicuspid aortic valve?"). But most cases are in older people, often — but not always — those with high blood pressure, high cholesterol, and other risk factors linked to heart disease. In the United States, about three to four of every 100 people ages 75 and older have severe aortic stenosis.

On call

Q. I have had a dandruff problem for years. I have tried selenium and zinc shampoos, as well as ketoconazole shampoo. Nothing has worked. Are there other options?

A. Dandruff, which is a chronic skin condition known as seborrheic dermatitis of the scalp, can range from a minor irritant to a severe rash of the entire scalp.

Ask the doctor

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Q. I've been taking the blood thinner warfarin (Coumadin) for a few years. I know there are new kinds of blood thinners, but I've heard they have downsides. Should I stick with warfarin?

A. Here's what you need to know. Some medical conditions lead to blood clots. The most common one is the irregular heart rhythm called atrial fibrillation. About 20% of all strokes are caused by clots that result from atrial fibrillation — usually because of inadequate treatment with blood thinners.

Research we're watching

Following a Nordic diet — which features fish, whole grains, plus fruits and vegetables popular in Scandinavian countries — may help lower the risk of stroke, a new study suggests.

The study, published in the February 2017 issue of Stroke, included more than 55,000 Danish people from a national health registry, all of whom filled out questionnaires about their diets and other lifestyle habits. Researchers looked at how closely the participants followed the Healthy Nordic Food Index, which includes six food categories: fish, apples and pears, root vegetables (such as carrots and celery root), cabbages (which also include broccoli, cauliflower, kale, and Brussels sprouts), rye bread, and oatmeal.