Penn Heart and Vascular Update | Penn Medicine

Video: Recognizing the Dangers of Atrial Fibrillation

2012-02-21T16:00:00.000-05:00

Atrial fibrillation is a heart rhythm disorder in which patients experience rapid, irregular heartbeats.

The most severe danger of atrial fibrillation is an increased risk of stroke. Other dangers include heart failure, and possibly even death. The disease progresses, making atrial fibrillation episodes become more frequent and last longer.

In this video, Matthew Hutchinson, MD, Penn Medicine cardiologist and electrophysiologist, presents an in-depth overview of atrial fibrillation. He describes in detail its symptoms, dangers and how it’s diagnosed and treated.

Visit pennmedicine.org to learn more about the treatment options available for atrial fibrillation.

A Broken Heart Can Hurt More Than You Think

2012-02-14T16:00:00.000-05:00

Marietta Ambrose, MD, consultative cardiologist who practices at the Penn Heart & Vascular Center in the Ruth and Raymond Perelman Center for Advanced Medicine, discusses broken heart syndrome.

"Broken heart syndrome" kills about 10,000 Americans per year.

Whether it’s losing a loved one, or putting a family pet to rest, a “broken heart” hurts. But there may be more truth to the phrase than was intended. That’s because serious medical repercussions can occur after any highly stressful situation. Dr. Ambrose answers questions about what it means to have a “broken heart.”

Q. What is broken heart syndrome?
A. Broken heart syndrome, officially called stress cardiomyopathy or takotsubo syndrome, is a rare disease in which the heart function becomes abnormally low. It can happen during extremely stressful moments, extreme emotional reactions to particular events in a person's life or significant illness. This syndrome seems to occur more often in postmenopausal women.

Q. What are the signs and symptoms?
A. This varies but includes severe chest pain, new onset of unusual and unexplained breathlessness, marked swelling of the feet and sudden unexplained weight gain following extremely stressful events.

Q. How long does it last?
A. This is variable but it is usually temporary. With the proper medical attention, it usually resolves within days or weeks, but sometimes it takes months.

Q. Can it be prevented?
A. We currently do not know of a way to medically prevent this very rare disease.

Q. Can it be treated?
A. Yes, it can be treated, and the majority of patients do well with medical attention and heart function usually is fully recovered over time.

We are still learning more about this disease. It also mimics more common heart conditions like a heart attack. The important takeaway is to seek medical attention if you develop the symptoms listed above so you can be evaluated.

Facts about broken heart syndrome:

Women are 7.5 times more likely to develop broken heart syndrome than men.
About 1% of all heart attacks are caused by “broken heart syndrome.”
The risk for women older than 55 developing the syndrome is nearly three times that of women younger than 55.
Among people younger than 55, women are 9.5 times more likely to develop the syndrome compared to men.

Photograph by Joe Penna.

Preventing Heart Disease with Life’s Simple 7

2012-02-07T17:33:00.000-05:00

Craig McMackin, MD, Penn Medicine cardiologist, explains the importance of choosing a healthy lifestyle to prevent heart disease.

During American Heart Month, the American Heart Association encourages people to do seven simple things to reduce their risk of heart disease. Called Life’s Simple 7, the program includes four ideal health behaviors and three ideal health factors. These measures all have one thing in common: they are simple to understand, but require a commitment and hard work to achieve.

Don’t smoke
Eat better
Get active
Lose weight
Control cholesterol
Maintain a normal blood pressure
Reduce blood sugar

Here are a few thoughts about Life’sSimple 7:

Quit smoking: The two most important things for quitting smoking are to be ready and ask for help. Smoking is an addiction, and you have to want to quit if you are to be successful. Most people cannot quit on their own, but there are programs and treatments that can tip the odds in your favor. Penn Medicine has a Comprehensive Smoking Treatment Program or you can try the Quitline at 800-QUITNOW.

Get active: There are many barriers to a successful exercise program, but they are nearly always beatable. One of the most common barriers is a lack of time. To cross this barrier, block out a regular amount of time during the day, instead of exercising when time allows it. Another common barrier is consistency. Don’t get discouraged when you don’t see the pounds melting off right away. DON’T GIVE UP. It is better to be “fat and fit” than “fat and unfit.” In fact, there is scientific proof that being “fat and fit” is healthier than “thin and unfit.” In other words, the chubby jogger is healthier than the skinny couch potato.

Lose weight and eat better: Fad diets don’t work. When you are trying to lose weight, it is important to choose a diet and exercise program that focuses strongly on developing lifelong health eating and exercise habits.

Achieve health and wellness: Health and wellness is not only a state of the body, but a state of mind. Getting healthy does not start with action, it starts with attitude. The most important thing to achieve a healthy body and mind is to be honest with yourself, identify your weaknesses, and be honest with your health care provider.

Penn Medicine also has a comprehensive Preventive Cardiovascular Program that offers a wide range of services to individuals looking to learn what their risk is for cardiovascular disease or those who currently suffer from cardiovascular disease and are seeking optimal medical therapy.

Penn Medicine Supports Go Red for Women

2012-01-31T13:27:00.002-05:00

Fight heart disease in women by wearing red on Feb. 3.

Friday, Feb. 3, is National Wear Red Day®. On that day, the American Heart Association encourages men and women to wear red – whether it is a red dress, a red shirt, a red tie or red lipstick — to help raise awareness about women and heart disease.

In 2004, the American Heart Association launched “Go Red for Women,” a movement dedicated to raising awareness of the most deadly disease among American women: heart disease.

“The impact of cardiovascular disease in American women is shocking,” says Mariell Jessup, MD, medical director of the Penn Medicine Heart and Vascular Center and an international expert on women’s heart health. “About 460,000 American women die of cardiovascular disease annually. The good news is that heart disease can mostly be prevented.”

Go Red for Women provides women with tools to prevent heart disease and stroke. By visiting the Go Red for Women website, they find links to heart disease risk assessment tools, heart health tracking tools and information about getting and staying healthy.

“Go Red for Women is all about spreading the message,” says Dr. Jessup. “Unhealthy habits are so ingrained in our culture, that it’s important to keep reminding people heart disease is preventable.”

Go Red for Women encourages people to find personal ways to help spread the message of heart disease prevention, like encouraging loved ones to get physically fit.

Penn Medicine supports Wear Red Day, and encourages its employees and patients to support the movement by wearing something red on Feb. 3.

Visit goredforwomen.org to learn how you can help prevent cardiovascular disease in yourself and others.

Exercise for a Healthy Heart

2012-01-24T17:30:00.000-05:00


Walking 30 minutes a day significantly lowers your risk of heart disease.

Health experts agree that adding more exercise to your daily routine is a great way to improve your health and life. The benefits are especially useful for people with heart disease and other cardiovascular health issues. And it’s never too late to begin. Studies have shown that midlife increases in exercise are beneficial to your health.

How does the heart benefit from exercise?

"Like all muscles, the heart becomes stronger through regular exercise," says Emma Meagher, MD, associate professor of medicine and pharmacology and attending physician in Penn Medicine's Preventive Cardiovascular Program. "A strong heart pumps more blood with less effort, which means it doesn’t
have to work as hard at rest, and can help lower high blood pressure."

In addition toa stronger heart, exercise also benefits the cardiovascular system by:

Reducing blood pressure, especially in people with hypertension.
Reducing inflammation in the arteries, a common component of heart disease.
Helping weight loss, which reduces the chance of heart disease and other medical complications.
Reducing triglyceride levels, which when high, are linked to developing heart disease and other cardiovascular complications.
Increasing “good” HDL cholesterol, which removes “bad” LDL cholesterol from your bloodstream.
Improving your body’s use of insulin, which can prevent and possibly reverse metabolic syndrome.

It's easier than you think

"In addition to its well-known positive impact on your overall health, exercise is also the least expensive way to improve your health," says Dr. Meagher. "You don’t need expensive gym memberships. Even just increasing the number of steps you take each day is a great place to start."

According to the American Heart Association, walking 30 minutes a day, five days a week, significantly reduces your chances for heart disease.

Given thesebenefits, it’s easy to see why experts agree that exercise is a crucial elementfor improving heart health. And if thatwasn’t enough, exercise has a number of other positive benefits like relievingstress and anxiety, strengthening bones and preventing the physical and mentaldeterioration associated with aging.

Remember, it is important to seek medicaladvice before starting a workout program, particularly for people with heartdisease and other medical conditions.

Saving lives with cell phones

2012-01-17T12:41:00.000-05:00

Can a mobile app save a life? Researchers at Penn Medicine think so. They are using smartphones and the wisdom of the crowd to create the myHeartMap Challenge, a map of automated external defibrillators (AEDs) in Philadelphia. The person or team locating the most devices stands to win $10,000.

When someone collapses and stops breathing, an AED can save his or her life. There is currently no comprehensive map of AEDs, even though they are found throughout the city. As a result, AEDs are often not used when they are needed most. To solve this problem, Penn Medicine researchers are taking a 21st century approach to the problem: a method called “crowdsourcing.”

Crowdsourcing means taking a task that would be difficult for one person to accomplish, like mapping all the AEDs in Philadelphia, and redistributing it to a large group of people. A famous example of crowdsourcing is Wikipedia, which has used thousands of volunteer writers and editors to create the world’s largest encyclopedia.

The researchers running the AED project, called MyHeartMap Challenge, areasking individuals to submit photos and locations of AEDs in Philadelphia byusing a mobile app. A contest is being held to encourageparticipation. A grand prize of $10,000 will be given tothe person or team who can find andphotograph the most AEDs. Other prizes include $50 tothose that find andphotograph “golden” AEDs, whoseidentification only the researchers know.The contest hasn’t started yet, but is scheduled to start in late January 2012.

Official updates and contest rules are on the program’s web page.View the fullnews release on the Penn News blog.

MyHeartMap Challenge has also been featured in a variety of newspublications. The leader of the MyHeartMap Challenge project, Raina Merchant, MD, MS, was featuredon CBS 3 yesterday. Dr. Merchant stressed the importance of AEDs in savinglives, and how many people don’t know where they are located or how to usethem.

Learn to live longer and healthier at Penn Medicine Heart Health Event: February 3

2012-01-10T16:30:00.001-05:00

Most people know a healthy diet and regular exercise can keep their heart strong. But what does a healthy diet entail? What kind of exercise is best? And how often? The fact remains; more people are overweight than ever before while heart disease remains the number one killer in America.

Penn Medicine kicks off heart month with "A Heart Healthy You,” at 2 pm, Friday, Feb. 3 at Penn Medicine Valley Forge. It’s time to change the way you approach staying fit and heart healthy.

• Do you know what crunchy snacks can help you lower your cholesterol?
• Are wine and chocolate really good for your heart?

Penn cardiologists Kelly Anne Spratt, DO, and Theodore Diamanti, MD, along with noted author and dietitian Janet Brill, PhD, RD, LDN, (pictured above) discuss ways to live healthy. Plus, you can learn how to cook healthier meals during a heart healthy cooking demonstration from Wegmans.

Learn lifestyle strategies to help you live a long and healthy life at this free event Space is limited so please register by calling 800-789-PENN (7366). Parking is always free at Penn Medicine Valley Forge.

Schedule of events:

Welcome and Introductions
Kelly Anne Spratt, DO
10am

Book Signing – Cholesterol Down and Prevent a Second Heart Attack
Janet Brill, PhD, RD, LDN
*Books available for purchase10am - 2pm

Blood Pressure Screenings
Penn Medicine staff
10am - 2pm

Healthy Heart, Healthy You: 10 Lifestyle Strategies to Keep Your Ticker Beating Strong
Janet Brill, PhD, RD, LDN
10:30-11am

Women and Heart Disease: Are Wine and Chocolate Really Good for My Heart?
Kelly Anne Spratt, DO
11:30am-12pm

Heart Healthy Recipes and Cooking Demonstration
Wegmans Food Markets
12:30-1:30pm

Coronary Artery Disease: What Are All the Tests and What do They Mean?
Theodhor Diamanti, MD
1:30-2pm

Join this event on Facebook.

For the New Year, For Your Heart: Quit Smoking

2012-01-03T19:00:00.000-05:00

“Smoking is more than a dirty habit,” says Frank Leone, MD, MS, director of Penn’s Comprehensive Smoking Treatment Program.

Studies have shown that cigarette smoking is a major cause of coronary heart disease, leading to heart attack and sometimes death. According to the American Heart Association, more than 2.4 million annual deaths can be attributed to smoking. A chief contributor to the high number of deaths from cigarettes is atherosclerosis (buildup of fatty substances in the arteries), which is also a leading cause of heart disease.

Cigarette and tobacco smoke is at the top of the six major modifiable risk factors for heart disease. In addition, it has been shown that two weeks to three months after quitting, the risk for heart attack drops and lung function improves. One year after being smoke-free, the risk of heart disease is 50 percent less than it is for a smoker.

Penn’s Comprehensive Smoking Treatment Program recognizes it is hard to quit, but undoubtedly worth it when it comes to your health. The treatment program provides a supportive environment that does not rely on fear or shame to motivate smokers to quit.

Read more about Penn’s Comprehensive Smoking Treatment Program at "Take a Deep Breath and Quit Smoking Comfortably this Holiday Season."

Learn about Penn's Coronary Artery Disease Program.

Why It’s Important to Eat Heart Healthy This Holiday Season

2011-12-27T18:30:00.000-05:00

Tricia Stefankiewicz, MA, RD, CNSC, clinical dietitian specialist at the Hospital of the University of Pennsylvania, stresses the importance of healthy eating during the holidays.

For some people, it is incredibly difficult to lose any weight gained during this time of holiday food extravagance. The temptation to overeat or indulge in fatty foods like cookies and cakes can increase the risk of obesity, a known risk factor of heart disease. Obesity has become an ever more prevalent disease in the U.S.

The American Heart Association describes obesity as being 20 percent or more above your ideal body weight and between 60 and 70 percent of Americans are either overweight or obese. Letting your weight gain get out of control can increase your risk for health problems such as heart disease, stroke, high blood pressure, diabetes and more.

Because losing weight can be challenging, strategies that focus on weight maintenance and obesity prevention can be helpful in getting you through the holiday season and in not raising your risk factors for cardiovascular disease.

"Seven Tips for Eating Healthy During the Holidays" discusses some helpful advice on how to healthily enjoy the holidays and all the food that comes along with this season of celebration.

Read more on heart disease and diet.

Patient Gives Heartfelt Bagpipe Performance

2011-12-23T15:05:00.000-05:00

Many people choose the holidays as a time to spread cheer and give thanks for family, friends and health. One Penn heart patient showed his thanks and celebrated the holiday season with a special musical gift. Penn Medicine Heart and Vascular Center patient Joe Tobin performed seasonal music on the bagpipes at the Perelman Center for Advanced Medicine on Wednesday, Dec. 21.

Just three years ago, Mr. Tobin suffered a major heart attack. At the time he entered the Hospital of the University of Pennsylvania he was barely able to walk or breathe. He underwent procedures to treat a heart rhythm disorder and had stents placed to open his blocked arteries. His condition was so severe that his doctors feared he may need a heart transplant.

But thanks to the care of his dedicated team of Penn Heart and Vascular cardiologists, nurses and social workers, Mr. Tobin avoided a heart transplant and is once again healthy and active. He is able to play his bagpipes in regular performances with fellow members of the Philadelphia Emerald Society Pipe Band.

Mr. Tobin’s Penn Heart and Vascular Team, including Penn cardiologists, Thomas P. Cappola, MD, ScM, and Jonathan Gomberg, MD, FACC, were there to enjoy the performance and celebrate his recovery.

Mr. Tobin's performance was also featured in the Philadelphia Business Journal.

Avoiding "Holiday Heart" Syndrome

2011-12-20T17:07:00.000-05:00

The holidays have a special way of enticing us to overindulge in our favorite foods and drinks. For some people, that extra piece of pie can lead to some scary, heart-related symptoms.

Irving Herling, MD, director of consultative cardiology in the Penn Medicine Heart & Vascular Center, shares ways to avoid "holiday heart" syndrome.

New Technology Helps Prevent Stroke without Medication

2011-12-14T17:39:00.002-05:00

Fermin C. Garcia, MD, Penn Medicine cardiac arrhythmia specialist and principal investigator of a new clinical trial, explains how a closure device is an alternative treatment option for patients with atrial fibrillation.

A new alternative to commonly prescribed blood-thinning medication is now available to some patients with atrial fibrillation, or A-fib.

The PREVAIL (Prospective Randomized Evaluation of the Watchman LAA Closure Device in Patients with Atrial Fibrillation Versus Long-term Warfarin Therapy) clinical trial is under way at Penn Medicine. The first patient enrolled had the device successfully implanted in early December 2011.

The PREVAIL trial tests the implantable device for treating patients with A-fib, a form of irregular heartbeat. Electrophysiologists at Penn use a catheter to implant a small, umbrella-shaped mesh device, called the Watchman closure device, into the left atrial appendage. The devices isolates the area of the heart, preventing blood clots from escaping and entering the blood stream, which could lead to a stroke.

A-fib can cause blood clots in many patients so they are often prescribed blood-thinning medications, such as warfarin (Coumadin®) to prevent blood from clotting. Warfarin is effective in reducing the risk of stroke, but may cause other side effects, such as bleeding and loss of hair. It also requires frequent blood draws to monitor dosage levels.

For the PREVAIL trial, patients are randomly selected by computer to either have the device implanted or remain on warfarin without the device (control group). Those selected to receive the device remain on warfarin for 45 days following implantation. If the heart tissue has healed after 45 days, participants are taken off Coumadin and placed on aspirin therapy and possibly, clopidogrel, an anti-platelet medication.

Researchers follow both groups of study patients for five years, monitoring those no longer taking warfarin very closely. If the U.S. Food and Drug Administration approve use of the device at the end of this clinical trial, participants in the control group will then have the option to receive the device.

Read more about the Penn Medicine’s Cardiac Arrhythmia Program.

Learn more about arrhythmias.

Meet New Physicians and Surgeons from Penn's Heart and Vascular Team

2011-12-07T12:32:00.004-05:00

Raymond Rodriguez, MD, the newest member of the Penn Heart and Vascular team, talks about his new position with Penn Medicine and the opening of the cardiology practice in Chestnut Hill.

Penn Medicine's commitment to collaboration and dedication to their patients aligns with my own patient care philosophy. As a cardiologist working in the community for more than 20 years, it seemed to be a natural progression to join Penn's heart and vascular team. This new partnership allows me to offer my patients the most advanced treatment options and therapies not available anywhere else in the region.

Penn Medicine’s newest cardiology practice opens in Chestnut Hill in January 2012. In addition to having direct access to breakthrough clinical trials, advanced care for heart failure, heart rhythm (arrhythmia) disorders, valve disease, and cardiovascular surgical services at Penn Presbyterian Medical Center and the Hospital of the University of Pennsylvania, this new practice will provide a wide range of cardiovascular services, including:

Office consultations
Second opinions
Preventive cardiology
Echocardiograms
Electrocardiograms
Routine stress testing
Women's Heart Health
Holter monitoring
Pacemaker/ ICD management
Peripheral Artery Disease (PAD) care

I look forward to working with the entire team of specialists at Penn Medicine and continuing to offer comprehensive cardiology care to my patients.

My cardiology practice at Penn Medicine Chestnut Hill officially opens in January 2012. Please call 800-789-PENN (7366) to schedule an appointment.

Penn Medicine Chestnut Hill

33 East Chestnut Hill Avenue

Philadelphia, PA 19118

Read about other new Penn heart and vascular specialists. See all new physician announcements.

Learn more about Penn Heart and Vascular.

Are You At Risk for A Heart Attack?

2011-12-01T08:58:00.003-05:00

Did you know that coronary artery disease (atherosclerosis) is the leading cause of death in the United States in both men and women?

Join Penn Cardiologist Theodore Diamanti, MD, for a free educational event on coronary artery disease. Coronary artery disease can lead to serious health problems, including pain or pressure in the chest, heart attack, congestive heart failure, arrhythmias and sudden cardiac death.

Most heart attacks begin slowly with subtle symptoms, such as discomfort. Symptoms are often downplayed or brushed off as indigestion or anxiety. Many people are not sure what is wrong and because they are not in pain wait too long before getting help. Knowing your risk factors for a heart attack is critical.

Dr. Diamanti’s seminar, Coronary Artery Disease: Prevention, Diagnosis and Treatment, answers some of the most common questions, including:

What is coronary artery disease?
How is coronary artery disease diagnosed?
What are the risk factors?
What are symptoms of a heart attack?
How is coronary disease treated?
What prevention methods are available?

When: Wednesday, December 7, at 2pm

Location:

Penn Medicine Valley Forge

1001 Chesterbrook Boulevard

Berwyn, PA 19312

To register for this free event, call 800.789.PENN (7366).

Check the Facebook event page.

Learn about Penn's Coronary Artery Disease Program.

Happy Thanksgiving from Penn Heart and Vascular

2011-11-22T14:58:00.003-05:00

Penn Heart and Vascular wishes everyone a happy and healthy Thanksgiving.

How Physicians Can Better Recognize, Approach and Prevent Heart Disease in Patients

2011-11-17T12:13:00.004-05:00

Emil DeGoma, MD, FACC, director of the Preventive Cardiovascular Program at Penn, discusses how physicians can proactively assess patients' risk for cardiovascular disease through both traditional and modern techniques in a recent interview for Penn's ReachMD* podcast series.

Dr. deGoma discusses the Preventive Cardiovascular Program’s three-pronged approach to risk assessment:

1. Utilizing the traditional risk assessment techniques forms the foundation for preventive care. An essential part of this traditional technique determines whether the patient has any coronary disease risk equivalents , such as:

Peripheral artery disease
Cerebral vascular disease
Diabetes

2. The Framingham coronary heart disease (CHD) risk assessment is the foundation of traditional preventive measurement and continues to be a central tool.

3. Some well-known risk factors are not yet formally included in traditional risk assessment scores. These risk factors play an important role of the overall evaluation, and include:

family history
Impaired fasting glucose
Obesity
Physical activity

"The risk of CHD guides the intensity of management," says Dr. deGoma. He also discusses the benefit of electronic medical records and the percentage of adults that are at high-risk for heart disease. Learn more about Penn's Preventive Cardiovascular Program and listen to the full interview with Dr. deGoma on cardiovascular risk assessment.

Hear other physician interviews on heart-related topics.

You can also log onto myPennMedicine.com to read more about how patients can now manage their health care, all online. myPennMedicine allows patients to communicate conveniently with their doctor’s office, request prescription renewals, physician referrals and pre-certifications, view lab results, list of medications and health summaries, and request appointments.

*ReachMD’s Medical Breakthroughs features the newest medical advancements in the areas of oncology, cardiology, neurology, orthopedics, and genetics featuring America’s leading physicians and medical researchers from Penn Medicine.

Join Penn Medicine’s Heart Walk team on Saturday, Nov. 12

2011-11-09T11:00:00.000-05:00

Join the Penn Medicine community, the American Heart Association (AHA) and thousands of Philadelphia residents at Citizens Bank Park on Saturday, Nov. 12, to support the fight against heart disease and stroke by participating in the 2011 Philadelphia Heart Walk.

Philly's Heart Walk is a non-competitive, 3-mile walk to raise awareness and funds to support the AHA's mission to build healthier lives free of cardiovascular disease and stroke. More than 7,500 people are expected to attend this year's event. The funds raised from this nationwide walk go toward developing programs and research initiatives dedicated to finding better treatments and cures for heart disease and stroke, the #1 and #4 killers of Americans.

Walkers of all ages are invited to join Penn Medicine's Heart Walk team and take action in helping fight heart disease and stroke:

Date:

Saturday, November 12, 2011

Time:

Festival Area Opens at 8 am
Walk begins at 10:30 am

Location:

Citizens Bank Park

1 Citizens Bank Park Way

Philadelphia, PA 19148

Register online for Penn Medicine's Heart Walk team.

Your participation and fundraising efforts can directly support Penn Medicine and the AHA in their goal to improve cardiovascular health of all Americans by 20% by 2020. Each day, nearly 2,400 Americans die from a cardiovascular-related condition. Walk with us and show your support for healthier hearts and bodies.

Those who can’t attend can still show their support by making a donation. The AHA has set $1,900,000 as the goal for the 2011 Philadelphia Heart Walk. For every dollar the Greater Philadelphia Chapter of the AHA raises, $3 goes to fund cardiovascular research in the community. More than $335,600 in donations has already been raised.

In 2010, more than 1 million people walked to raise more than $100 million in Heart Walk events in cities and towns across the country, led by Leadership Committees who involve more than 10,000 companies and almost 100,000 teams of fundraising walkers.

Last year, Penn Medicine's team of 1,600 participants raised nearly $136,000, a significant contribution to the total amount raised by the Philadelphia AHA chapter, $333,763.

See AHA event information.

Check out our Facebook event page!

FDA Recommends Trick or Treaters Skip This Halloween Candy

2011-10-29T14:00:00.003-04:00

Just in time for Halloween, the Food and Drug Administration (FDA) warns consumers too much black licorice can be harmful to the heart. Cardiac arrhythmia specialist Michael P. Riley, MD, PhD, assistant professor of medicine at Penn, explains the new warning.

Q. What is the latest information from the FDA about eating too much black licorice?

A. Recently, the FDA issued a consumer update, encouraging people to limit their consumption of black licorice candy. Specifically, they said that adults over 40 years old with heart conditions probably shouldn't overindulge. The FDA says more than two ounces a day for more than two weeks could lead to heart arrhythmia, also known as an irregular heartbeat. The FDA also advised that no matter what your age, you shouldn’t eat large amounts of black licorice at one time.

Q. Why is too much black licorice bad for you?

A. FDA experts say black licorice contains the compound glycyrrhizin, which is the sweetening compound derived from licorice root. Glycyrrhizin can cause potassium levels in the body to fall. When that happens, some people experience abnormal heart rhythms, as well as high blood pressure, edema (or swelling), lethargy and possibly congestive heart failure.

Black licorice can also interact with some medications, herbs and dietary supplements. Consult a health care professional if you have questions about possible interactions with a drug or supplements you take.

Q. What are the signs and symptoms of an arrhythmia?

A. An arrhythmia may be present all the time or it may come and go. You may or may not feel symptoms when the arrhythmia is present. On the other hand, you may only notice symptoms when you are more active.

Symptoms can be very mild when present, or they may be severe or even life threatening.

Common symptoms may include:

Chest pain
Fainting
Fast or slow heartbeat (palpitations)
Light-headedness, dizziness
Paleness
Shortness of breath
Skipping beats - changes in the pattern of the pulse
Sweating

Q. What else can cause an arrhythmia?

A. An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm. A heartbeat that is too fast is called tachycardia. A heartbeat that is too slow is called bradycardia.

Arrhythmias are caused by problems with the heart's electrical conduction system. Other areas of the electrical system may also send out signals. Other times, electrical signals are not able to move as easily or at all.

Q. Are there any other substances that could lead to heart rhythm abnormalities?

A. Yes, arrhythmias may also be caused by other substances or drugs, including:

Amphetamines
Caffeine
Cocaine
Beta blockers
Psychotropics
Sympathomimetics

Q. What else do I need to know about this new warning?

A. Most arrhythmias are harmless, but some are not. The outlook for a person who has an arrhythmia depends on the type and severity of the arrhythmia.

Even serious arrhythmias often can be successfully treated. Most people who have arrhythmias are able to live normal, healthy lives.

People concerned about their risk or think they have symptoms of an arrhythmia, should talk to their doctors.

Penn Medicine has a comprehensive program for treating cardiac arrhythmias. Learn more by visiting Penn Medicine’s heart and vascular website.

Dr. Riley also discusses this new update from the FDA in an interview with CBS 3 news.

If you have been eating a lot of black licorice and have an irregular heart rhythm or muscle weakness, stop eating it immediately and contact your healthcare provider.

Read the entire consumer update.

Women and Heart Transplants: A Special Event

2011-10-25T15:29:00.002-04:00

For women suffering from end-stage heart failure, a heart transplant is the final treatment option. A heart transplant is a surgical procedure in which a diseased heart is removed and replaced with a healthy heart from a deceased donor.

"Heart transplants are the third most common transplant procedure in the US, performed in about 2,200 patients each year, 25% of them women. Another 2,800 patients remain on the waiting list each year, with wait times ranging from a few weeks to as much as 18 months," states hearthealthywomen.org.

In the nearly four decades since the performance of the first human heart transplant in 1967, heart transplantation has changed from an experimental operation to an established treatment for advanced heart disease. Thanks to the persistence of pioneers in cardiology, cardiovascular surgery and transplant medicine, including experts at Penn Medicine, thousands of heart transplant patients in the U.S. are living longer and healthier lives than ever before.

On Friday, October 21, over 50 female heart transplant patients and their caregivers joined Penn Medicine heart failure expert Joyce Wald, DO, assistant professor of Medicine and director of Programmatic Development for the Heart Failure/Transplant Program, for a special event for female heart transplant patients in the Tri-state area focusing on their individualized needs and celebrating their survivorship. Penn Medicine Heart and Vascular Center partnered with the Second Chance Transplant Support Group to host this event.

Statistically speaking, more men than women receive a heart transplant in any given year, but women face a host of distinctive needs in regards to their transplant. Female heart transplant patients must often face special challenges concerning reproduction, depression, family and care-giving stresses, along with the ability to exercise, aging and menopause.

The event took place at The Penn Medicine Translational Research Center in West Philadelphia and was featured in a KYW News Radio, 1060 AM story.

Heart Disease & Menopause

2011-10-19T16:48:00.002-04:00

Did you know that a woman’s risk for heart disease automatically increases on her 40th birthday?

Heart disease is the leading cause of death in women over age 40, especially in women experiencing menopause. Menopause typically occurs between the ages of 45 and 65. At this phase in a women’s life, her ovaries gradually produce less estrogen. This causes changes in her menstrual cycle along with other changes in her body, including the cardiovascular system.

The decrease in estrogen at menopause may have negative effects on a woman’s cardiovascular system.

To learn more about how heart disease can affect menopausal or post-menopausal women, read the full article in the Penn Health for Women Newsletter.

If you are interested in learning more about how Penn Medicine cares for heart disease, visit the Preventive Cardiovascular Program and Women's Heart Health Program Web pages.

American Heart Association offers diversity scholarships in medicine for women

2011-10-11T16:40:00.003-04:00

Statistics show African-American and Hispanic women are disproportionately affected by heart disease and its risk factors. They confront barriers to diagnosis, disparities in care and experience poorer health outcomes than their male and Caucasian counterparts.

"More than 80 percent of midlife African-American women are overweight or obese, 52 percent have hypertension, and 14 percent have been diagnosed with diabetes. Some 83 percent of midlife Hispanic women are overweight or obese, and more than 10 percent have been diagnosed with diabetes," says a report from the National Lung and Blood Institute.

Factors that contribute to poor health outcomes among African Americans include cultural barriers and lack of access to quality care, according to the Office of Minority Health and Health Disparities (OMHD). The lack of diversity among medical students and healthcare professionals continues to promote these factors.

”The American Heart Association’s 2020 impact goal is to improve the cardiovascular health of all Americans by 20%. To accomplish that goal, we need health providers who represent our underserved patients.” says Mariell Jessup, MD, professor of medicine and medical director of the Penn Heart and Vascular Center.

Of last year's medical school graduates, only 6.7 percent were African American and 7.5 percent were Hispanic, according to the Association of American Medical Colleges.

In an effort to promote diversity in medicine and address important gaps in the diagnosis and treatment of minority women that lead to heart health disparities, the American Heart Association’s Go Red for Women movement is offering scholarships for under-represented female medical students.

"This scholarship is an important step to broaden ethnic diversity among health care providers. In doing so, the American Heart Association hopes to reach a greater number of at-risk Hispanic and African-American women. As these women enter the health care system and are educated on treating these risk factors to prevent heart disease, they can be empowered to make heart healthy choices for themselves and their families. We hope that they will then communicate the educational message to their communities and become part of the grass roots dynamic of Go Red for Women," says Kelly Anne Spratt, DO, clinical associate professor of medicine at Penn Medicine.

The application process for scholarships is open now through Nov. 30, 2011. Scholarships of $2,500 will be awarded to 16 deserving racially and ethnically diverse female medical students to support them in their studies.

Applications and scholarship requirements.

More information.

Get Rid of Those Varicose Veins Once and for All

2011-10-05T14:30:00.002-04:00

Did you know that approximately 25 million Americans suffer from veins that are diseased or damaged? Abnormal veins often result in varicose veins and other painful symptoms of venous disease. In fact, it is estimated that in the US, 72 percent of women and 42 percent of men suffer from varicose veins by the time they reach their 60s.

If you are affected by venous disease or think you might be, Penn Medicine invites you to take advantage of a free vein-screening event from 3 to 7pm on Monday, Oct. 24, at its Woodbury Heights location. Screening is an important first step in determining the extent of vein health issues.

Varicose veins are more than a cosmetic issue. Mild venous disease does not usually cause problems for patients, but as it advances, it can become crippling, chronic venous insufficiency: a condition in which the veins have problems sending blood from the legs back to the heart. Venous insufficiency occurs because of partial vein blockage or blood leakage around the valves of the veins. Varicose veins can range from small, thin purple lines just under the skin, known as “spider veins,” to thick, bulging, painful veins that can protrude beyond the surface of the skin.

Varicose veins also serve as indicators of venous reflux, a progressive disease that can cause significant circulatory problems as it worsens.

Venous disease may include:

Spider veins: Unwanted blood vessels that appear on the skin. They are generally not painful, but they can be unattractive.
Varicose veins: Swollen, twisted, painful veins filled with blood that usually develop in the legs. The valves in varicose veins may be damaged, deformed, or missing.
Leg swelling and pain: Abnormal buildup of fluid in the ankles, feet and legs, often called edema.
Leg skin changes: Blood vessel changes in the skin that cause a patchy appearance, also called mottling or mottled skin due to vascular changes.
Leg ulcers: Caused by poor circulation in the veins (venous insufficiency) and may cause stasis dermatitis and craters (ulcers) in the skin.
Phlebitis: Swelling of a vein caused by a blood clot and is also known as thrombophlebitis (inflammation). Phlebitis may be painful or lead to redness of the skin, warmth and tenderness.
Vascular malformations: Any blood vessel abnormalities.
Venous malformations: Superficial or deep veins that are abnormally formed and dilated.

Often, the root cause of these painful and unattractive venous diseases symptoms can be prevented with appropriate awareness and prevention. Early detection of vascular disease helps to prevent potentially serious complications. Cramping, throbbing, and tingling in the legs can be signs of serious venous disease, which is why screening is important in determining the extent of your vein health issue.

The underlying cause of varicose veins and heavy, painful legs can now be treated in the doctor’s office with the VNUS Closure Procedure—a minimally invasive alternative to surgery. Penn Medicine offers this procedure as an alternative to traditional vein stripping for patients with superficial venous reflux, an underlying cause of varicose veins.

The VNUS Closure procedure results in less bruising when compared to traditional vein stripping surgery and laser treatment. Using VNUS Closure, physicians close diseased veins and as a result, blood is re-routed to healthier veins. Patients can usually return to normal activities within a day or two after this outpatient procedure. The VNUS Closure procedure helps relieve symptoms and is covered by most health insurance providers. This procedure is also available at Penn Presbyterian Medical Center. Schedule an appointment for this free vein screening conducted by Penn vascular medicine specialists. This screening is to help detect and prevent suffering from venous disease, as well as provide an informal setting to answer any questions you might have. Those screened are encouraged to share their results with their primary care provider.

Find out if you are a candidate for this minimally invasive alternative to painful surgery and get rid of those unwanted varicose veins.

What: Free varicose vein screening events

When: Monday, November 28, 2011, 3 – 7 pm

Where: Penn Medicine Woodbury Heights

1006 Mantua Pike

Woodbury Heights, NJ 08097

Appointments are necessary and space is limited. To make a reservation, please call 800-789-PENN (7366).

Visit our Free Varicose Vein Screening event page to learn more about risk factors and symptoms of venous disease.

Symposium Highlights Latest Strategies for Managing Ventricular Arrhythmias

2011-09-27T08:30:00.005-04:00

www.VTsymposium.com

Francis E. Marchlinski, MD, director of electrophysiology for Penn Medicine and director of the electrophysiology laboratory at the Hospital of the University of Pennsylvania, announces the Sixth Annual International Symposium on Ventricular Arrhythmias: Pathophysiology and Therapy.

It is my pleasure to announce Penn Medicine’s Sixth Annual International Symposium on Ventricular Arrhythmias: Pathophysiology and Therapy (VT symposium), a CME-certified course*, scheduled for Friday and Saturday, October 21 and 22, 2011 at the Hyatt at the Bellevue on Broad Street in Philadelphia. The VT symposium is co-hosted by the Mount Sinai Hospital and co-sponsored with the Heart Rhythm Society.

Sudden cardiac death, typically from a life threatening ventricular arrhythmia, remains the leading cause of death in the United States. Identifying risk, particularly in young and athletic individuals, is essential and risk stratifying for arrhythmia events in patients with prior myocardial infarction or other structural heart disease is paramount. In addition, ventricular arrhythmias lead to considerable morbidity. One goal of the VT symposium is to provide in depth understanding of the various strategies that are currently being developed for the management of ventricular arrhythmias in various disease states, including non-pharmacological therapies such as implantable device therapy and advances in catheter ablation.

Using a combination of didactic presentations, panel discussions, and question and answer sessions, the program educates and provides participants with state-of-the-art information on the pathophysiology and treatment of ventricular arrhythmias. There will also be VT ablation cases streamed live from the Hospital of the University of Pennsylvania during which a moderated panel discussion and question and answer session occurs to educate and demonstrate to audience members the most up-to-date techniques for complex ablation procedures.

The course is appropriate for:

Electrophysiologists
Cardiologists
Internists
Associated professionals
Nurses
Trainees

This CME course has been designed to expose the attendees to over 30 internationally recognized experts in the field through didactic lectures, interactive session and live case presentations/discussions.

This is an excellent learning experience for all attendees and I hope you will be able to join us. Attendance is limited by the size of the lecture hall and this course has a six-year history with a loyal following of individuals who are striving to move the field forward. Pre-registration is recommended as soon as possible.

When: Friday and Saturday, October 21-22, 2011

Where: Hyatt at The Bellevue

200 South Broad Street

Philadelphia, PA 19102

For more details or to register, please visit www.VTsymposium.com.

See program agenda.

Mail or Fax Payment and Registration Information to:

Conference Coordinator, University of Pennsylvania School of Medicine

Office of Continuing Medical Education

333 Blockley Hall, 423 Guardian Drive

Philadelphia, PA 19104-6021

Phone: 215-898-6400 or 215-898-8005; Fax: 215-898-1888

penncme@mail.med.upenn.edu

Designation of credit: The Perelman School of Medicine at the University of Pennsylvania designates this live activity for a maximum of 18.0 AMA PRA Category 1 Credits™.

Penn Recognized for Quality Care for Heart Failure Patients

2011-09-21T16:04:00.006-04:00

To ensure heart failure patients receive the best care possible, the Hospital of the University of Pennsylvania (HUP) continues to work with the American Heart Association (AHA) on implementing quality improvement guidelines and protocols through the Get with the Guidelines® program.

HUP recently received the Get With The Guidelines–Heart Failure Gold Quality Achievement Award. Centered around evidence-based guidelines, this award exemplifies HUP’s commitment and success in implementing excellent care for heart failure patients.

"HUP serves a large population of patients with heart failure, and our health care team remains committed to the very best care for these vulnerable patients," said Mariell Jessup, MD, medical director of the Penn’s Heart & Vascular Center. "We are thrilled to see our efforts recognized once again by the American Heart Association."

Learn more about this award.

Read about the Get with the Guidelines program.

Why Getting a Second Opinion Matters

2011-09-15T16:23:00.003-04:00

Medicine is not an exact science. Physicians often have different opinions about how to diagnose or treat heart disorders and those differences can sometimes be based on how familiar doctors are with a test or treatment; how willing they are to use them, and whether they have had time to think through other options.

William J. Untereker, MD, associate director of cardiology at Penn Presbyterian Medical Center, recommends patients make sure any high-risk procedure is done by a high volume, experienced provider. A physician with this expertise has the best chance of getting a good outcome. He also recommends that patients get a full, written explanation of any procedure that is recommended, including the risks and benefits. If there are serious risks, that is the time to get a second opinion.

As a leading center for heart care in the region, physicians at Penn Medicine are often asked to provide second opinions on patient care.

Read the full article on "second opinions" from Penn Medicine's quarterly publication Advances in Medicine.

Symposium Highlights Latest Strategies for Managing Cardiac Arrhythmias

2011-08-31T11:00:00.000-04:00

Francis E. Marchlinski, MD, director of Electrophysiology for Penn Medicine and director of the electrophysiology laboratory at the Hospital of the University of Pennsylvania, announces the 2011 Penn Medicine State-of–the- Art Arrhythmia Symposium.

Cardiac arrhythmias affect the practice of all busy clinicians, regardless of their subspecialty. Sudden cardiac death, typically from a life threatening ventricular arrhythmia, remains the leading cause of death in the United States. Identifying risk, particularly in young and athletic individuals, is essential. Risk stratifying for arrhythmia events in patients with prior myocardial infarction or other structural heart disease is paramount.

In addition, atrial fibrillation(AF) remains a leading cause of stroke and a major reason for hospitalization in our aging population. AF can affect all age groups and frequently causes distressing symptoms. Treatment strategies for these common arrhythmias range from antiarrhythmic drugs and anticoagulants to device therapy and catheter ablation: all treatments that are rapidly evolving.

It is my pleasure to inform you of Penn Medicine’s State-of-the-Art Arrhythmia Symposium (SOAAS), a CME-certified course*, scheduled for Monday, September 12 at the Hyatt Regency Penn’s Landing on Columbus Boulevard in Philadelphia.

Penn Medicine’s SOAAS program is designed to provide excellent and up-to-date diagnosis and management strategies for patients with suspected or documented atrial or ventricular arrhythmias. This course is highly interactive with 3 separate simultaneous sessions presenting a potpourri of materiel directed to attendees with a variety of clinical experience with arrhythmias.

The course is appropriate for:

Internists
Cardiologists
Electrophysiologists
Associated professionals
Nurses
Trainees

This CME course has been designed to demonstrate the extensive clinical and educational expertise available from the Hospital of the University of Pennsylvania’s Cardiac Electrophysiology 14-member physician team with special input from internationally recognized experts such as Silvia Priori, MD, from New York University and University of Pavia, Italy and David Hayes, MD, from Mayo Clinic. Interactive case presentations and in-depth, concise lectures on the management of the arrhythmia patients will be highlighted.

This is an excellent learning experience for all attendees and I hope you will be able to join us.

Attendance is limited by the size of the lecture halls and this course has a 19-year history with a loyal following of individuals who regularly desire to sharpen their arrhythmia management skills. Pre-registration is recommended as soon as possible.

When: Monday, September 12, 2011

Where: Hyatt Regency Philadelphia at Penn’s Landing

201 South Columbus Blvd.

Philadelphia, PA 19106

Download SOAAS Course Brochure

Mail or Fax Payment and Registration Information to:

Conference Coordinator, University of Pennsylvania School of Medicine

Office of Continuing Medical Education

333 Blockley Hall, 423 Guardian Drive

Philadelphia, PA 19104-6021

Phone: 215-898-6400 or 215-898-8005; Fax: 215-898-1888

penncme@mail.med.upenn.edu

Designation of credit: The Perelman School of Medicine at the University of Pennsylvania designates this live activity for a maximum of 7.5 AMA PRA Category 1 Credits™.

Transradial Cardiac Catheterization Now Offered

2011-07-28T09:45:00.000-04:00

Interventional cardiologists at Penn Presbyterian Medical Center (PPMC) are now offering transradial cardiac catheterization (TCC) for coronary angiography and angioplasty.

Unlike standard catheterization, which uses the femoral artery as the point of access, TCC is initiated through the radial artery in the wrist. This difference makes TCC the preferred option in the majority of patients seeking angiography and angioplasty, says Alan S. Moak, MD, who specializes in the procedure at PPMC.

Like standard angiography, in TCC a slim wire is inserted into the artery to guide a catheter that is threaded to the desired position in the heart, great vessels, or coronary arteries. A contrast dye is injected, and the procedure is monitored on a fluoroscope. TCC can be used to perform both coronary angiography and angioplasty. As such, the procedure helps doctors detect heart disease, evaluate heart muscle function, determine optimal treatments and, in selected cases, treat coronary artery blockages.

According to Dr. Moak, the transradial approach offers three significant advantages versus standard catheterization. The first involves a substantial reduction in periprocedural bleeding, the leading cause of mortality at one to two years following coronary angioplasty.

Bleeding complications, including such things as retroperitoneal bleeds, false aneurysms and large hematomas are significantly reduced or largely eliminated with TCC,” Dr. Moak says, noting that this advantage extends even to patients on anticoagulant therapy, who do not have to suspend therapy to have transradial catheterization.

The second comparative advantage of TCC is that its costs are lower than those for the femoral approach. “Not only are the equipment costs less, but overall hospital costs are reduced substantially due to a decrease in the bleeding complications that occur with femoral catheterizations and often leading to expensive and prolonged hospital stays.” That this cost reduction is attended by an increase in safety only adds to the equation.

The third element in Dr. Moak’s triad involves patient satisfaction. “By comparison to standard catheterization, patient satisfaction with the transradial approach has been very high,” says Dr. Moak, “in part because patients like the simplicity and convenience of the procedure. Most patients are able to ambulate immediately after the procedure with no need for prolonged bed rest. As a result, I’ve never had a patient say he or she preferred the femoral approach.”

Transradial catheterization is now the default approach in many countries, but hasn’t caught on yet in the United States. Here, only about two percent of catheterizations are performed by the radial approach. Dr. Moak estimates that this proportion will rise to 50 percent in just a few years, however, and currently performs TCC at the cath lab at PPMC for about 70 to 80 percent of patients who are candidates for the procedure.

"At PPMC, we have both the facilities and the expertise to perform transradial catheterizations with both a high success rate and an extraordinarily low number of complications,” he says, adding that experience is the key to good outcomes. “The procedure is somewhat more complex than the femoral approach, but once you’ve reached the point where you’re doing it very well––and we have reached that point––there’s no better way to perform a catheterization.”

To learn more about these options or to refer a patient, please call 800-789-PENN (7366).