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Managing mitral valve disease: Progress and promise

Operations to fix faulty mitral valves are on the rise. But less invasive nonsurgical strategies are under development.

The mitral valve — so named because it resembles a miter, a bishop's formal headdress — sits between the two chambers on the left side of your heart. Inherited conditions, diseases, or a combination of the two can cause changes in the size, shape, flexibility, or mechanics of the mitral valve, leaving it unable to close properly. When that happens, blood may flow backward between heartbeats, a problem called regurgitation.

While mild cases are generally harmless and cause no symptoms, more severe cases can increase the heart's workload, leading to breathlessness, fatigue, and other symptoms. Mitral valve regurgitation also produces a distinct sound (heart murmur) that a doctor may hear through a stethoscope.

Pay less for heart drugs without using insurance?

Research we're watching


 Image: © Gligatron/Getty Images

Do you take generic drugs to lower your blood pressure or cholesterol? You may save money by paying out of pocket at Walmart instead of a paying a Medicare prescription copay, according to an analysis in the July 24 Annals of Internal Medicine.

Walmart (and a number of other large chain stores) offer generic drug discount plans; they sell 30-day supplies of popular generic drugs for $4.

New nasal spray may stop rapid heart rhythm

Research we're watching

An experimental nasal spray shows promise for quickly treating an abnormally fast heart rhythm known as supraventricular tachycardia (SVT), a new study reports.

Caused by an electrical misfire that overrides the heart's natural pacemaker, SVT occurs unpredictably, lasting anywhere from minutes to hours. Although usually harmless, the condition can make people dizzy or lightheaded. People with persistent SVT usually need to go to an emergency room for an injection of a drug to slow the heart.

Rating heart monitors

Here is why you should invest in this fitness technology.


 Image: © Nastasic/Getty Images

There is a lot of technology that tracks your health, from counting steps to counting burned calories. One of the most valuable fitness tools though is a heart rate monitor, which tells you how many beats your heart takes per minute.

"Whether you're just getting started with an exercise routine or are a committed fitness enthusiast, tracking your heart rate can help you maintain the necessary moderate level of intensity for optimal benefits without worrying about doing too much or too little," says Dr. Aaron L. Baggish, associate director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital.

More antidotes for newer blood thinners

New medications add advantages to treatments that help prevent stroke, pulmonary embolism, and deep-vein thrombosis.


 Image: © Mohammed Haneefa Nizamudeen/Getty Images

The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa).

Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). A dose of vitamin K is used to reverse the action of warfarin (Coumadin), a blood thinner used routinely for more than half a century and, until recently, the only such option for most people.

Depression risks in the medicine cabinet

News briefs

Are you taking a medication that has depression or suicidal thinking as a potential side effect? One or both risks have been linked to use of more than 200 prescription and over-the-counter pills, including medicines that treat high blood pressure, heartburn, pain, and headaches. The more of these drugs you use, the higher the likelihood that you'll experience depression, suggests a study published June 12, 2018, in The Journal of the American Medical Association. Working with five surveys conducted over a nine-year period, researchers evaluated health information from 26,192 adults. About 37% of them reported taking such medications. Of individuals taking three or more of the medications with depression as a possible side effect, about 15% reported depression, compared with about 5% in people not using those medications. Even for people already taking an antidepressant, the addition of one or more of the identified medicines was linked to higher rates of depression. This study was based on surveys, so it didn't prove that the medications caused the reported depression. Nonetheless, if you think you're depressed (and have symptoms such as apathy, hopelessness, changes in sleep or eating habits, and persistent fatigue), ask your doctor if any of the medicines you are taking may be responsible.

Image: © Tero Vesalainen | GettyImages

Your health through the decades

These strategies keep you healthy and safe through your 60s, 70, and 80s.


 Image: © kali9/Getty Images

After age 60, men tend to get thrown together — the so-called 60-and-older group — even though most are quite different in terms of their health.

"While many men are still very fit well into their 60s, 70s, and 80s, others face health challenges and chronic diseases that make daily living difficult," says Dr. Howard LeWine, assistant professor of medicine at Harvard Medical School.

Arthritis drugs do little for sufferers’ mental health

In the journals

Many people with rheumatoid arthritis (RA) also deal with ongoing depression and anxiety related to their pain and disability. While drugs used to treat the disease help alleviate the joint pain and stiffness, a recent study suggests they may not extend to improving patients' mental health.

The findings, published online June 6, 2018, by Arthritis & Rheumatology, reviewed more than 70 clinical trials and found only a small association between various drugs used for RA, such as adalimumab (Humira), rituximab (Rituxan), abatacept (Orencia), and tocilizumab (Actemra), and mental health outcomes in patients.

Early therapy helps people with low back pain avoid medication

In the journals

If you suffer from low back pain and want to avoid taking strong pain medication, you might want to consult a physical therapist first, suggests a recent study published online May 23, 2018, by Health Services Research.

Researchers reviewed insurance claims for approximately 150,000 adults, ages 18 to 64, who had been newly diagnosed with low back pain. They found that those who first consulted a physical therapist had an 89% lower probability of receiving an opioid prescription compared with those who saw another type of medical provider. They were also less likely to have an MRI or CT scan or to seek out emergency care for their pain.

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