Heart Matters

Host: Janet Wright, MD Guest: Scott Sharkey, MD Takotsubo, or stress-induced cardiomyopathy (also known as 'broken heart syndrome'), was first recognized in Japan in the 1990s. Acute emotional or physical stress trigger the condition, which mimics the symptoms of a myocardial infarction (or MI). How can physicians differentiate between stress-induced cardiomyopathy and a more conventional MI, and...

Host: Janet Wright, MD Guest: David Wilber, MD Although medications are generally first-line therapy for patients with atrial fibrillation, or a-fib, adverse events or inadequate efficacy often make drug therapy suboptimal. How effective is catheter ablation, and should it be considered first-line therapy for some patients? Host Dr. Janet Wright talks with Dr. David Wilber, director of the Cardiov...

Host: Janet Wright, MD Guest: John Spertus, MD, MPH Addressing the totality of care for patients with heart failure is crucial to reducing readmissions. How can physicians better recognize the comorbities that may affect older patients with heart failure in order to improve outcomes? What type of benefits can a more holistic, nuanced approach to managing heart failure offer patients? Dr. John Sper...

Host: Janet Wright, MD Guest: Mohammad Madjid, MD, MS, FACC* When high-risk patients, such as the elderly, develop respiratory infections there can be a cascade effect of inflammation that moves from the lungs to the heart, triggering myocardial infarction (or MI). What is the mechanism by which vaccination might prevent MI? Dr. Mohammed Madjid, senior research scientist at Texas Heart Institute i...

Host: Jack Lewin, MD Guest: Jim Guest Recommendations and ratings are a dime a dozen for patients looking for more information about a physician or procedure online, but finding quality, consumer-friendly information that's also reliable can be more of a challenge. What tools can physicians recommend to patients for understanding the implications of both reform and other healthcare matters? Jim Gu...

Host: Jack Lewin, MD Guest: Rita Redberg, MD, MSc Guest: Bram Zuckerman, MD The FDA's premarket approval (or PMA) process was first established over 30 years ago, but thanks to technology, the development of devices has dramatically changed since then. How should the FDA modernize its premarket approval process to ensure medical device safety? Guests Dr. Rita Redberg, professor of clinical medicin...

Host: Janet Wright, MD Guest: Karol karol When patients present with shortness of breath, physicians often face a quandary: Is it the heart or is it the lungs? What is the relationship between chronic obstructive pulmonary disease, or COPD, and cardiac function? Are patients with even subclinical emphysema at risk for showing reductions in cardiac output and left ventricular volume? Dr. Karol Wats...

Host: Jack Lewin, MD Guest: Mark McClellan, MD, PhD Defensive medicine and medical liability concerns create a symbiotic relationship that costs everyone in the medical system. Has healthcare reform legislation addressed the medical malpractice issue, and will it do enough to contain healthcare costs? Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Inst...

Host: Janet Wright, MD Guest: Christian Wolpert, MD It's one thing to produce guidelines, and quite another to encourage guideline adherence. The first step in this might be to gather data about current practices, and then determine ways to standardize treatment and increase access to quality therapy. The European Heart Rhythm Association (a branch of the European Society of Cardiology) conducts a...

Host: Janet Wright, MD Guest: Nathalie Farpour-Lambert, MD Childhood obesity is a significant health concern in the US and worldwide. How does obesity impact a child's cardiovascular function and influence future risk of heart disease? Dr. Nathalie Farpour-Lambert, head of the Pediatric Exercise Medicine and Obesity Care Program in the department of pediatrics at the University Hospitals of Geneva...

Host: Janet Wright, MD Guest: Randall Thompson, MD It's widely believed that modern behaviors of inactivity, stress and poor diet are primary causes of the development of cardiovascular disease, but history may suggest otherwise. What is new evidence from ancient Egyptian mummies teaching us about heart disease? Dr. Randy Thompson, cardiologist at St. Luke's Hospital Mid America Heart Institute in...

Host: Jack Lewin, MD Guest: David Blumenthal, MD, MPP Electronic management of health information will someday replace the pen and paper chart. How significant a role will health information technology, or HIT, play in the newly-reformed healthcare system? What incentives are the federal government offering to foster the widespread, meaningful use of or HIT, and more importantly, what qualifies as...

Host: Jack Lewin, MD Guest: Kevin Weiss, MD Although the Maintenance of Certification (MOC) program may conjure up unpleasant testing jitters, its value to both patients and the medical professional community should not be underestimated. How does MOC improve clinical performance, increase physician accountability and ultimately improve quality of care for patients? How will the MOC program evolve...

Host: Jack Lewin, MD Guest: Ralph Brindis, MD, MPH How will the recently-passed health reform legislation impact cardiologists and other physicians in the next year? What can physicians do to prepare for the changes ahead? Dr. Ralph Brindis, senior advisor for cardiovascular disease for Northern California Kaiser Permanente, clinical professor of medicine at the University of California, San Franc...

Host: Jack Lewin, MD Guest: Stephen Ubl How do physicians play a particularly crucial role in the development of medical devices, and how does the device innovation model differ from the drug development model? How can we encourage transparent, ethical relationships between healthcare professionals and the medical device industry, as collaborations between these parties are vital to the developmen...

Host: Jack Lewin, MD Guest: John Tooker, MD, MBA, FACP How can cardiologists and our internal medicine colleagues work together to promote the patient-centered medical home as an efficient strategy for re-organizing care that will reduce costs and improve quality of care? How can we improve communication between specialist and subspecialist providers? Dr. John Tooker, executive vice president and...

Host: Alfred Bove, MD Guest: Leslie Miller, MD Options for patients with advanced heart failure used to be limited to heart transplantation, but ventricular assist devices have rapidly evolved into viable treatment options for these patients. How is the newest generation of continuous-flow devices impacting the way we care for patients with advanced heart failure? Which patients are the best candi...

Host: Alfred Bove, MD Guest: Gregg Stone, MD Results of a recent study may change the standard of care for patients with acute coronary syndromes. Although clopidogrel is generally the antiplatelet therapy of choice for patients for whom an invasive strategy is planned for treating their acute coronary syndromes, bleeding can be of concern. Prasugrel often presents the same dilemma. Enter, ticagre...

Host: Janet Wright, MD Guest: Mikhail Kosiborod, MD Elevated blood sugar levels are quite common among even non-diabetic patients presenting with acute myocardial infarction (or AMI). Does lowering a patient's glucose level actually improve outcomes, and if so, what glucose-control therapies are most effective for these patients? Dr. Mikhail Kosiborod, associate professor of medicine at the Univer...

Host: Janet Wright, MD Guest: Eduardo Marbán, MD, PhD Stem cell therapies across multiple disciplines continue to demonstrate promising results. How successful are autologous cardiac stem cell treatments proving to be at regenerating cardiac tissue after a heart attack? Which patients would be the best candidates for this procedure, and when might this treatment move from clinical trials into the...

Host: Janet Wright, MD Guest: Glenn Chertow, MD, MPH Guest: Kirsten Bibbins-Domingo, MD, PhD We are well aware that the overabundance of processed, frozen and fast foods contribute to many Americans exceeding the recommended daily allowance of sodium. But there are potentially enormous cardiovascular benefits to cutting down on salt intake by even a very modest amount. How can we quantify the actu...

Host: Jack Lewin, MD Guest: Richard Katz, MD Use of electronic medical records (EMRs) and personal health records (PHRs) can improve adherence, increase efficiency and better coordinate patient care. What role are health information exchanges playing in the integration of EMRs and PHRs, and how effective are disease management software programs? How can we meet the challenges of integrating health...

Host: Jack Lewin, MD Guest: Chris Kaiser What payment cuts does the 2010 Medicare Physician Fee Schedule include for cardiology? How will these lower reimbursements affect cardiology practices and impact patients' access to care? Chris Kaiser, editor of Cardiovascular Business , joins host Dr. Jack Lewin to discuss ways cardiology practices can try to adapt to payment cuts by increasing practice e...

Host: Janet Wright, MD Guest: Michael Ho, MD, PhD Medication adherence is a significant problem in the US. Patients with chronic conditions such as hypertension or high cholesterol can be particularly susceptible to non-adherence, because patients may not experience symptoms that would seem to justify taking medication, and thus may not notice any immediate benefits from their medications. What ar...

Host: Janet Wright, MD Guest: Michael Mooney, MD Therapeutic hypothermia is a relatively new treatment option for patients who suffer cardiac arrest, that can significantly improve neurologic outcomes. What factors determine the success of cooling therapy for cardiac arrest, and what resources does the procedure require? Dr. Michael Mooney, Director of Interventional Cardiology, Minneapolis Cardio...