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When You Visit Your Doctor - Mitral Valve Prolapse

Mitral Valve Prolapse

Questions to Discuss with Your Doctor:

  • Have you had an echocardiogram?
  • What did it show?
  • Does your mitral valve leak?
  • Do you get chest pain?
  • What brings it on?
  • How long does it last?
  • What relieves it?
  • Do you ever get a rapid or pounding heartbeat (palpitations) for no reason?
  • How long does it last?
  • Do you feel faint or develop chest pain or shortness of breath?
  • Have you ever fainted?
  • Do you get short of breath when you lie down or exert yourself?
  • Have you ever taken any medications for your heart?
  • Did you develop any side effects from these medications?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Heart rate, blood pressure, and weight
  • Heart (sometimes while you are standing, squatting, or performing other maneuvers)
  • Lungs

Your Doctor Might Order the Following Lab Tests or Studies:

 

Recognizing stroke early

Early treatment of the most common type of stroke, ischemic stroke, can limit brain damage and vastly improve outcomes. Ischemic stroke is the kind caused by atherosclerosis, which causes blood clots that block the blood supply to a part of the brain. Yet too few ischemic stroke patients receive important clot-busting drugs, which are most effective when given within three hours after symptoms start. Patients often arrive at the hospital after that window of opportunity has closed. They delay getting treatment because stroke symptoms may not be that pronounced or they are mistaken as coming from other, less serious problems.

As a result, doctors are looking for ways to make it easier for the layperson to identify a stroke. The Cincinnati Prehospital Stroke Scale is one such attempt. Some experts say it leaves out too many symptoms. Others say it will cause false alarms because it's not specific enough..

Are painkillers also killing your hearing?

Image: iStock

When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. But a Harvard study published in the American Journal of Epidemiology suggests that frequent use of ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be an important contributor. In the study, women who took the pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24%. The findings are similar to a study of men and hearing loss, although aspirin was also found to contribute to risk in that study.

Researchers speculate that the pain relievers may be damaging the cochlea, the snail-shaped hearing mechanism in your inner ear. "Ibuprofen can reduce blood flow to the cochlea, which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage," says study author Dr. Sharon Curhan, instructor in medicine at Harvard Medical School.

Does this mean you should think twice before popping a pill for headache or back pain? These medicines do provide good pain relief for many people. "However, frequent use of these medications and use over long periods of time may increase the risk of hearing loss and may cause other adverse health effects. Therefore, it is important to take these medications mindfully and to limit their use as much as possible," says Dr. Curhan. As always, talk to your doctor before making any changes in your medication use.

To learn more about the things that can threaten your hearing, and what you can to do keep this sense sharp and clear, buy Hearing Loss: A guide to prevention and treatment, a Special Health Report from Harvard Medical School. 

Respiratory tract infection - Is it contagious?

"Stay away from me! I don't want to get sick, too." Most of us have had to utter those words to a family member, friend, or colleague who was sneezing or coughing incessantly. But how do we know how great the chances of catching someone's cold or other illness really are? A medical review published in the New England Journal of Medicine tells us when to exercise concern over eight respiratory tract infections.

Illness

(Infectious agent)

How it gets transmitted

Places of highest risk

Percent risk of infection

Bronchiolitis

(Respiratory Syncytial Virus, RSV)

Direct contact with ill person, large-droplets from coughs or sneezes, contact with tissues, linens, or other surfaces holding the virus

Homes, day-care centers

In day-care centers, 100% of exposed children become ill, previous infection somewhat lowers the risk

Flu

(Influenza viruses)

Direct contact with ill person, large- and tiny-droplets from coughs or sneezes

Homes, schools, bars, dormitories, areas with poor ventilation or recirculated air

20%-60% from a family member, only half of those infected will have symptoms of influenza

The common cold

(Rhinovirus)

Direct contact with ill person, large-droplets from coughs or sneezes, contact with tissues, linens, or other surfaces holding the virus

Homes, dormitories

66% from a family member

Tuberculosis

Tiny-droplets from coughs or sneezes

Homes, bars, dormitories, nursing homes, areas with poor ventilation

25%-50% with close contact with a person with active disease, prolonged exposure is usually required

Upper respiratory illness

(Adenoviruses)

Direct contact with ill person, large- and tiny-droplets from coughs or sneezes

Camps, schools, military camps

10% of those exposed may become ill, 40% among children, many infected individuals show no symptoms and infection leads to immunity from future infection

Strep throat, scarlet fever

(Group A Strep)

Direct contact with ill person, large-droplets from coughs or sneezes

Homes

10% from a family member

Bacterial meningitis

(Neisseria meningitides)

Direct contact with ill person, large-droplets from coughs or sneezes

Homes, schools, camps

2%-3% for a child whose sibling has active illness, 0.2%-0.4% for household contacts of the ill child, more than 95% of the time a second case of the disease does not follow a first.

Pneumococcal pneumonia

(Streptococcus pneumoniae)

Direct contact with ill person, large-droplets from coughs or sneezes

Day-care centers, homeless shelters, camps, prisons, nursing homes

Generally not regarded as contagious, risk of infection depends on one's general health

Treating interstitial cystitis

Interstitial cystitis is a chronic inflammation of the bladder that causes people to urinate -- sometimes painfully -- as often as 40, 50, or 60 times a day. Their quality of life, research suggests, resembles that of a person on kidney dialysis or suffering from chronic cancer pain. Not surprisingly, the condition is officially recognized as a disability.

There's no cure for interstitial cystitis, but many treatments offer some relief, either on their own or in combination.

Pancreatic cancer: Symptoms, treatment, and prevention

Hard to detect and quick to spread, pancreatic cancer is among the deadliest of cancers. Scientists hope that genetic research will make it more like other cancers-a treatable disease. But even if it's caught while confined to the pancreas-and it rarely is-just 16% of patients are alive five years after the initial diagnosis. By comparison, the five-year survival rate for localized breast cancer is 86%. If the cancer has spread beyond the pancreas, the likelihood of living another five years is just 2%. Only the statistics for liver cancer are as grim.

Fortunately, pancreatic cancer is uncommon compared with other major cancers. About 50,000 new cases are diagnosed every year in the United States, in contrast to about 250,000 new cases of breast cancer, and 225,000 new cases of lung cancer. But because it's so untreatable, pancreatic cancer causes about 40,000 deaths each year. It is the 4th leading cause of cancer death.

Diagnosing and treating irritable bowel syndrome

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent bouts of constipation, diarrhea, or both, as well as abdominal pain, bloating, and gas. IBS is a functional disorder, which means that it's not attributable, as far as we know, to any underlying disease process or structural abnormality. It's thought to involve various, often interacting, factors — infection, faulty brain-gut communication, heightened pain sensitivity, hormones, allergies, and emotional stress.

The good news is that IBS doesn't increase the risk for more serious conditions, such as ulcerative colitis or colon cancer. On the other hand, a disorder resulting in (at best) annoying and (at worst) debilitating and worrisome symptoms with no known cause can be difficult to diagnose and treat, not to mention live with. Managing IBS typically involves some trial and error, which can be challenging for patients and clinicians alike. Various tests or procedures may be ordered to rule out other conditions. Many diverse therapies, not all of them proven, are used in treating the symptoms, including antibiotics, antispasmodics, antidepressants, dietary changes, relaxation techniques, and psychotherapy, as well as drugs to relieve constipation and diarrhea.

Benefits of moderate sun exposure

Dr. Robert S. Stern, chair of the Department of Dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center , calls them "solar-phobes": people so concerned about getting skin cancer that they stay inside or cover every bit of skin. "They cover up like they were going out into the Arabian Desert ," he says. The marketing of ultrablocking sunscreens and special sun-protective clothing plays into these fears.

There's no getting around the fact that sunlight is hard on your skin. Age gets blamed for wrinkles and rough, dry skin. But the real culprit is a combination of age and sun that dermatologists call photoaging. The short UVB wavelengths that cause sunburn can also damage DNA and suppress the skin's immune system. The longer, more penetrating UVA wavelengths may create highly reactive oxygen molecules capable of damaging skin cell membranes and the DNA inside.

What are the best ways to treat plantar warts?

Salicylic acid, a prescription-strength medicine, and cryotherapy with liquid nitrogen are common treatments for plantar warts. However, if these do not work, consult with a dermatologist or podiatrist about other options like other injected and topical drugs or laser therapy.

Afib stroke prevention: Go set a Watchman?

Most people with atrial fibrillation take anti-clotting drugs to prevent strokes. For those who cannot take these drugs because of a high risk of bleeding, a tiny, basket-like device implanted in the part of the heart that traps clots may be an alternative. 

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