All aspects of cardiovascular diseases

My colleagues and I, from "Clínica Puerta de Hierro" – Madrid, Spain
are interested in discussion about current practices in the very early
postoperative period after implantation of mechanical heart valves.
        Our current strategy is to initiate subcutaneous heparin as soon as the
patient leaves the ICU (and chest tubes are removed), as well as
coumadin. That means that we initiate anticoagulation at the third day.
What are your routine experience?
        Thank you.
        Marcelo Sanmartin
        E-mail: marc…@OMC.telprof.es

My husband has COPD (Chronic Obstructive Pulmonary Disease).  He is 66
years old.  6 feet tall – weighs 220#.  He gained 25# after he stopped
smoking. He is planning on going into a Pulmonary Rehab program but we
need to have an OK from his cardiologist.
3 years ago my husband had angioplasty after a mild heart attack.
Because of the COPD, the cardiologist indicated that the conventional
stress test would probably not be an option because of his poor
pulmonary function.  He indicated that a medication induced stress test
might be an option.  He said that one of several drugs (I am not sure
of the spelling but it sounded like PERSANTIUM, the other sounded like
IDENDICARD) would be injected and then the nuclear medicine (thallium
or other choice) would be used.

Does anyone have any information on the chemically induced stress test?
What are the chemicals?  Is there any danger?  Will this bring on a
heart attack?  

We think that the pulmonary rehab program would be very beneficial for
him but do not want to put him in any kind of additional jeopardy.

Any information would be appreciated.  

I’m looking for a FAQ for High BP, particularly covering drug types,
side-effects, etc.  Where do I look.
TIA

                                        …Jim Thompson

In June of this year I founded a support group for Noonan Syndrome.
Here is a little information:
It is believed that 1 in 1000 children worldwide are born with this
    condition.
    Each day 1 child is born with the condition.
    It’s possible that 1:100 people carry the gene yet
    are virtually unaffected and undiagnosed.
    Once affected there is a 50/50 chance of passing
    the gene on to one or more of their children.
    It can also occur sporadically, presumably due to a
    new mutation.

Often called a "Hidden" condition, the children affected
may have no obvious casual signs to the onlooker, but
the problems are many and complex with no clinical test
available. This is a genetic condition affecting the heart,
growth, blood clotting, mental and physical development. Affected individuals
may have behaviour problems, learning difficulties and many other anomalies.
Noonan Syndrome may be the second commonest to Down’s Syndrome of
those conditions with congenital heart abnormality.
For additional information you can check out our web page or e-mail me.

Thank you for your time.

Wanda

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Can someone tell me where can I find information about antihypertensive
drugs and interactions during breast feeding?

Thanks in advance.

Alfredo.

I work for a publishing house and we have recently published a new
journal on heart failure.
The name is Heart Failure Reviews.
If you would like to have more information: please visit us:(at the
moment a gopher service, in 1997 we will have our own website)

http://www.wkap.nl

Annemarie

I am interested in acquiring information about Fehling Endomyocardial
Biopsy Forceps. Number of uses and overall satisfaction are things I would
interested in.

Thanks,

Kim

If someone has pulmonary conjestion,
and a swan-catheter is used to determine if the
conjestion is due to fluid overload, what value
of wedge pressure would determine that fluid overload
is the cause?

If the wedge pressure is high in someone who has
known kidney failure (creatinine = 2.5), and possible
heart failure, how can one determine which organ
is causing the problem?

Thank you very much for your help.

Marty Braff

The newsgroup for people affected with or concerned by the Marfan
syndrome:      alt.support.marfan

Visit the National Marfan Foundation Web site at:  
               http://www.marfan.org/
E-mail the NMF staff at: st…@marfan.org

The National Marfan Foundation is located at 382 Main Street,
Port Washington, NY  11050.  Telephone:  1-800-8-MARFAN
An informative booklet on the Marfan syndrome is available
upon request.  Become a member of the NMF and recieve the
quarterly, "Connective Issues".

Marfan syndrome is a heritable disorder of the connective tissue
which can affect the following body systems:

      1.  The skeletal system: An affected individual will often
          be tall, slender, and somewhat loose-jointed or limber.
          The arms, legs, fingers and toes may be disproportionately
          long when compared to the trunk; the face may appear long and
          narrow in keeping with the general body shape.  Scoliosis may
          be present.  A protruding or indented breastbone (pectus
          carinatum or excavatum) may also be present.
      2.  The eyes: The lens of the eye is off-center or dislocated
          (ectopia lentis) in about 50% of people with Marfan.  Detection
          is possible only through fully enlarging (dilating) the pupils
          with eye drops. A slit lamp then must be used for examination.
          Dislocation of the lens occurs in relatively few other conditions,
          and is, therefore, an important hallmark of Marfan syndrome when
          present.
      3.  The lungs:  Pneumothroax, or spontaneous collapse of a lung.
      4.  The heart and blood vessels:  Mitral valve prolaspe occurs in 75-
          85% of people with the syndrome.  However, m.v.p occurs in 5% of
          general population, and is not in and of itself diagnostic of
          Marfan.  Mitral valve regurgitation can occur.  As well dilation
          of the aorta (widening often referred to as an aneurysm) can result
          in a dissection or rupturing of the aorta.  A dilation or a
          dissection for that matter can only be detected through the use
          of an echocardiogram or MRI.

It must be stressed that all of the preceding symptoms need not be present
in order for a person to be diagnosed with the Marfan syndrome.  A
variety exists in manifestation.  As well, it can not be assumed by sight
that since a person appears healthy, he or she is unaffected.  Cases in
point are the NBA players as well as Flo Hyman, the Olympic volleyball
player who all succumbed to the syndrome mid sports career.  

Mutations or spontaneous occurances can occur in the syndrome.
There is a 50-50 chance that the offspring of a person affected will
also be affected.  The syndrome does not skip generations.

There is hope once diagnosed.  Follow-up monitoring (usually done annually
unless otherwise needed); treatment with beta blockers (to ease pressure
on the heart); and if necessary, surgery to repair valve or aortic dilation
(done with great success and improving yearly) all offer positive results.

The essential nature of diagnosis should be evident.  No specific lab
test exists at this time.  It is important therefore to be seen by
physicians and subsequently echo and MRI technicians knowledgable
with the Marfan syndrome.

Best wishes,

Angela

I have had what I now know as PVCs for about the past 10 years.  During
that time I hardly noticed them.  It just felt like a hiccup and i only
noticed it a couple times a year.  Then 4 months ago they got worse.  I
am 34, dont smoke, drink, or do drugs.  The cardiologist said to much
caffeine was causing them to get worse.  I didnt drink alot of coffee but
i did drink alot of soft drinks, chocolate, and took alot of
decongestants because i have allergies.  I have been clean for aboout
5 months and they havent gotten any better.  Now i think that it is
excercise that is causing them to get worse.  I used to be very active
and in great shape.  Now all i do is 30 minutes a day on the treadmill.  
I get PVCs during transition from a walk to a run.  I dont know if it is
the accelerated heartrate or the pounding of a jog on my body that causes
it.  They stop after about 3 minutes or when my heartrate increases and
stays steady.  I have had all the test(stress,echo,blood) and nothing is
physiologically wrong with my heart.  Currently taking 400 mg magnesium a
day(gives me the shits) and 400 mg l-carnitine(amino acid).  Anyone else
have similar circumstances.  I would like to hear from you about your
course of treatment, lifestyle changes etc.  The doctors say my condition
is not bad enough to warrant medication.  Apparently they are finding out
that the best medicine is no medicine.  

Mario Alvarez