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PFOs: What To Do?

PFOs: What To Do?

Last week, we talked about PFO’s—what they are and how we find them. This week we’ll turn to a discussion of what we do when we find one. Because PFO’s are common and the vast majority of people have no consequences from their presence, we don’t generally close them. It is controversial whether patients with an asymptomatic PFO should take aspirin or…

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Aortic Aneurysms: Defusing the Ticking Time Bomb

Aortic Aneurysms: Defusing the Ticking Time Bomb

We discussed aortic aneurysms in last week’s blog and this week we’ll talk about what we do to prevent their rupture.  First, we have to know that the aneurysm is there. Widespread screening for aneurysms is not practical, so it is usually the case that they are discovered by chance. For instance, a person may have nausea and abdominal pain and get…

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Cardiomyopathy: When the Heart Muscle is Sick

Cardiomyopathy: When the Heart Muscle is Sick

Over the last several weeks, we have been discussing the subject of CHF (congestive heart failure). I discussed the differences between heart failure from systolic dysfunction (problems with the heart contracting/pumping) and problems caused by diastolic dysfunction (problems during the relaxation phase of the cardiac cycle). These are clinical syndromes and are brought on by a variety of conditions, some of which…

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Cardiac Contractility Modulation : The Latest in Device Technology

Cardiac Contractility Modulation : The Latest in Device Technology

We have discussed heart failure and its various treatments over the last few blogs. Last week I delved into a particular class of medications, the so-called SGLT2 inhibitors, which are the newest “kid on the block” in our pharmacologic armamentarium to help patients with CHF. Even more recently, I became aware of a new technology called “cardiac contractility modulation” or CCM.…

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When Negative Is Not Reassuring

When Negative Is Not Reassuring

Last week I described a patient who had an abnormal stress echocardiogram, but turned out to have no significant blockage in her coronary arteries. This week I’ll tell you about a patient I saw not long ago who had had a normal nuclear stress test (see “Services” section of this website to learn more about this test), but ended up having…

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Gregory Koshkarian, MD, FACC