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Cleveland Clinic  
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Cleveland, OH

My Posts
I hope this is not a silly question...
Feb 01, 2007 in the Heart Disease Expert Forum
Hi, thanks for the post. People are effected differently by the things we see, hear and do in medicine. There are some aspects of medicine that profoundly effect me emotionally and others that do not as much. While profoundly prosaic, the columnist description is a personal one and I wouldn't percieve it the same. Good luck, I hope this helps.
tachycardia
Jan 30, 2007 in the Heart Disease Expert Forum
Raj, Thanks for the post. Tachycardia is kind of a broad term. Gerally we break tachycardia in to that derived from normal heart rhythm(sinus) and abnormal rhythms (atrial fibrillation, atrial tachycardia, etc..). The former is usually associated with non-cardiac etiology (thyroid, deconditioning, infection) or a normal response to things like stress...
Cardiomyopathy and improving ef values
Jan 28, 2007 in the Heart Disease Expert Forum
xtrasalt, I rally have no idea without being able to review her full history and even then, the answer would be better posed to a pediatric cardiologist. There are some cardiomyopathies that can arise from myocarditis that may be self limited and some that are inherited that present early in life. The latter would probably be more likely to recur/progress....
Firefighter training and EKG situation
Jan 26, 2007 in the Heart Disease Expert Forum
Bruiserman, Thanks for the post. It's hard when we find an abnormality in an otherwise healthy person. Left Bundle Branch block is a marker for underlying structural heart disease. Overall, people with isolated bundle branch block do display a higher prevalence of underlying cardiac pathology and risk. This is why, especially in the setting of your job...
slight right sided heart enlarement
Jan 22, 2007 in the Heart Disease Expert Forum
pdberger, thanks for the post. It sounds like your heart was checked into. Certainly, a normal stress and echo would be somewhat reassuring to me as a cardiologist and steer me away from the heart as a cause of your symptoms. It sounds like you are making great progress with your exercise program. I would continue to work with your physician on that ...
Will Diet Pills help with Orthostatic Hypotension?
Jan 22, 2007 in the Heart Disease Expert Forum
Dizzy, There is not really a magic pill for patients with orthostatic hypotesnions. Florinef, salt tabs and volume loading help some. Lifestyle changes such as avoiding dehydration and sudden changes in position can also help. Phenteramine is an addictive drug with a poor side effect profile. I do not prescribe it for this particular indication. I ...
Lightheadedness and OI
Jan 18, 2007 in the Heart Disease Expert Forum
Dizzy Gal, Thanks for the post. 1st a positive tilt doesnt neccessarily mean that you have autonomic insufficiency or POTS. There are a good number of false positives. Additionally, some patients with these conditions do not respond to the medications. If the cure is worse than the condition I wouldnt continue the medications. If you havent had a si...
bed time angina
Jan 18, 2007 in the Heart Disease Expert Forum
Shoe, thanks for the post. Your body goes through natural cycles through the day. Blood pressure, heart rate and various hormones all change in a cyclic manner. it is not uncommon to have regular fluctuations in your symptoms. Sometimes, altering the timing of medication dosages helps. Also, another angioplasy may certainly help if there is a specific t...
3rd ablation
Jan 16, 2007 in the Heart Disease Expert Forum
heart, thanks for the post. Its difficult to tell you specific answers since you have such a complex case. You may have more than one pathway or a pathway that was incompletley ablated. Also, you have other underlying rhythm issudes with your atrial tachycardia. You are doing the correct thing by seeking an opinion at an experienced tertiary care center...
PFO, MVP, arhythmia
Jan 15, 2007 in the Heart Disease Expert Forum
froptop, thanks for the post. Its impossible to make firm recommendations over the internet. It is still unclear if patients with a CVA or TIA and a PFO are at an increased risk of having a recurrent event. We usually identify specific risk associated with the PFO such as the amount of shunt and the presence of an atrial septal aneurysm to help det...