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Exercise General Cardiology General Medicine Healthy Living Knowledge

Get smart

As if we need more evidence that schools should bring back daily gym class. Researchers at the University of Illinois studied 9-10 year-old children with MRIs (no radiation exposure), VO2 treadmill testing, and memory evaluations. Their findings should spank those in the educational elite who give regular gym class only lip service. “Dr M, you […]

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Atrial fibrillation General Cardiology General Medicine Knowledge

See everything…

Do you see anything wrong with this picture? (Hint: right column) It is certainly true that atrial fibrillation management guidelines needed an update; the last comprehensive update was in 2006.  Much has changed in AF therapy, including the expanded role of catheter ablation and the soon-to-be warfarin substitutes. I guess the European electrophysiologists couldn’t wait […]

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General Cardiology General Medicine Health Care Healthy Living

Statins are so misunderstood…

The medical assistant who checked the patient in tells me, “Dr Mandrola, this guy had coronary artery disease since the 1980’s.  He is 90 years-old now, and his only medicines are that statin and aspirin.”  One of the more common questions that arises in cardiology is whether a person should take a statin drug. Despite […]

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General Cardiology

New tools to rescue one from heart attacks…

Any doctor who tries to counsel patients on the importance of making good lifestyle choices has heard these oft repeated phrases. Doc, “I don’t eat french fries.” “I just smoke a little.” “I really do not eat that much.” “I do not have time to exercise.” “My blood pressure is always better at home.” “I […]

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General Cardiology General Medicine Healthy Living inflammation

Statin drugs are much more than cholesterol lowering agents…

Statin drugs are in the news.  The real truth is coming out. The truth that statin drugs (Zocor, Lipitor, Crestor are a few of the more recognizable names) are much more than simple cholesterol lowering agents. This very informative WSJ piece presents the thesis–first published by renowned experts in the Annals of Internal Medicine this […]

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General Cardiology Healthy Living

Even the AHA fails to master the obvious…

AHA is now endorsing a video-game, for 1.5 million dollars.  Shocking. On this nonsense one has to write fast.  Dr Wes is in. CardioBrief is in. Even GMA whacked the AHA. It took 900 words for the AHA to explain their position. Hint: in medicine, long notes usually imply a shaky thesis. A central argument […]

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Doctoring General Cardiology inflammation

An electrician’s view of smooshing blockages…

Really sound information is out there in the internet universe. DrRich has put out an incredibly timely and pertinent piece of advice concerning the common practice of stenting blockages in the coronary arteries. He succinctly summarizes a small retrospective study that showed an increased risk of cardiac events after non-cardiac surgery in patients who have […]

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Cycling Stuff General Cardiology General Medicine Nutrition

Don’t double down on improving the nutrition of Americans…

Images taken via the iPhone on visiting the cardiac nurses lounge today.   Indeed, it seems America is running to Dunkin.  Now for the closer: KFC’s double down.  Fried chicken as the bun, processed white flour, saturated fat, pork fat, dairy fat, special sauce and nearly an entire days worth of sodium masquerading as food.  […]

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General Cardiology General Medicine Reflection

Five “real” world issues with the complex decision to recommend heart catheterization…

Malpractice and heart catheterization are in the news today.  A spicy concoction for sure.   An epidemiological study published in an obscure online (and overpriced) subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and medical costs.  The summary details of the study have already been published in many […]

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Doctoring General Cardiology General Medicine Knowledge

Fixing the heart rhythm is but just one chapter…

The heart’s resilience and fixability is striking.  That is, compared to the frailty of other components of the birthday-ravaged body.  We cardiologists are advantaged by the attention heart disease garners in the minds of patients.  We get priority over the polyp, or the bulging disc. But should we? He is an older man living a […]

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General Cardiology Health Care Health Care Reform Healthy Living

Coronary CT scans for the evaluation of chest pain illustrates the health care expenditure debate…

During residency, there was always a case of mis-diagnosed chest pain to discuss in conference.  Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent but repetitively observed phenomenon. So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a […]