POTS (postural orthostatic tachycardia syndrome) is commoner than we think. 1 in 3 people with a diagnosis of Chronic Fatigue Syndrome(CFS) or ME also have POTS. Similarly a large number of patients with Fibromyalgia probably also have POTS. In my practice, I have the privilege of managing the treatment of about 150 patients with POTS . I have found that lifestyle and behaviour change recommendati [...]
SINUS ARRHYTHMIA Sinus rhythm means that the electrical impulses which regulate the heart rhythm are being produced in the pacemaker that god gives us all when we are born. This ‘pacemaker’ is otherwise called the Sino-atrial node and this is why this rhythm that is generated from the sinus node is called sinus rhythm. A nice analogy is to think of the sinus node as a drummer who beats th [...]
Patients with a diagnosis of atrial fibrillation (Afib) who are above the age of 65 or who have co-morbidities such as heart failure, diabetes, high blood pressure, vascular disease or previous strokes are believed to be at a higher risk of future strokes. There is overwhelming evidence that such patients should be started on lifelong stroke prevention medications. All currently prescribed stroke- [...]
Cocaine is purported to be the most potent stimulant of natural origin and is extracted from the leaves of the coca plant which is indigineous to the andean highlands of south america. It is a highly addictive and once someone uses it, it causes an irresistable craving in the user to use it again. Despite the ecstacy and euphoria, it never gives a feeling of satisfaction. Pure cocaine was first is [...]
The heart is a muscle and as with any muscle, when it has to work against a higher pressure over a prolonged period of time, it becomes more muscular. This increased muscle mass is seen as an increased thickness in the walls of the heart and is known as hypertrophy. Doctors sometimes erroneously refer to this as an enlarged heart. This is not true - the heart is not bigger but it is heavier; the w [...]
Vaping and the heart - e-cigarettes Very recently, there have been a large number of news reports alerting the public about possible dangers of vaping after 5 deaths and 450 possible causes of vape-related lung illnesses were reported across 33 states in the USA. Whilst it is unclear what the exact cause is, it is believed that chemicals like Vitamin-E acetate which are used to emulsify THC (tet [...]
Today I am going to talk about a really interesting blood test that detects weakness of the heart muscle (heart failure). This test is called BNP. BNP stands for brain natriuretic peptide and this test is already being used commonly in medical practice. Before I talk about this BNP, I wanted to start off by talking about heart failure. In heart failure, the fundamental problem is that the heart [...]
If there is one thing that causes a tonne of anxiety, it is the mention of high blood pressure. A common scenario, for example is that the patient goes to see his doctor for a routine visit or a completely unrelated complaint and the first thing the doctor or the practice nurse will do is measure the patient’s blood pressure. Then the doctor will shake his head, and say the words “your blood pres [...]
A lot of my work involves talking to and reassuring people who suffer from ectopic heart beats which seem to cause a great deal of anxiety and really seem to have a negative impact on quality of life. Most patients I have spoken to have already seen a doctor for their symptoms of ectopic beats and the doctor has told them that they are not dangerous but for many this reassurance is seldom enough. [...]
Introduction Patients with AF who are above the age of 65, or have co-morbidities such as diabetes, high blood pressure, vascular disease or heart failure are at an increased risk of stroke. It is understood that these patients are at a higher risk of stagnation of blood within the heart; the stagnant blood can form clots within the heart and these clots can get dislodged, travel to the brain, and [...]
An echocardiogram is an ultrasound-based assessment of the heart. It is painless, harmless, readily available in most hospitals and can give a large amount of very useful information about the structure and function of the heart. As atrial fibrillation can be caused by a structural problem with the heart such as heart valve disease or heart muscle weakness, the echo can help to elucidate the und [...]
A patent foramen ovale (PFO) is best thought of as a communication at the level of the atrial septum between the left heart and the right heart. It is found in 25-30% of a normal healthy population and usually does not cause any symptoms, impact on quality of life or lifespan. Many people refer to it as a ‘hole in the heart’ although strictly speaking, a PFO is more like a flap or a partially ope [...]
Introduction: Medical care for patients who have a diagnosis of POTS remains hugely unsatisfactory. POTS or rather dysautonomia is a very heterogenous condition. No two people are exactly the same. There is no one single aetiology that can even sometimes be identified. Often the patient who is really suffering looks alright from the outside. Many doctors, largely out of ignorance or perhaps arroga [...]
I got sick with Lyme Disease in 2012. I did get bites and presented to a doctor with the bulls eye rash, they gave my a week of standard antibiotics and a steroid cream and sent me on my way. I knew nothing about Lyme Disease at the time and unfortunately neither did the doctor I saw. I wish I knew what that rash meant at the time and got a course of doxycycline and would have been spared the comp [...]
Today I wanted to discuss an interesting but also potentially very dangerous condition called pulmonary hypertension. I refer to it as interesting for 3 reasons: Most heart disease tends to affect older people but pulmonary hypertension can affect young people as well. The symptoms in the early stages can be non-specific and not dramatic and therefore may not get taken as seriously by the patient [...]
What is it? SCAD is an uncommon but potentially dangerous cause for heart attacks in young patients and especially young women (less than 50 years of age). Most heart attacks occur because of a blockage in the lumen of a coronary artery. This is usually because of build-up of atherosclerotic plaque over a number of years and this is why heart attacks are more common in the elderly. In SCAD however [...]
Wolff Parkinson White syndrome is an unusual heart rhythm condition in which patients can develop sudden onset of fast heart palpitations. These can be associated with light-headedness/dizziness, blackouts, chest pain and in very rare cases, sudden death. However the good news is that this is a completely curable condition. Wolff –Parkinson-White syndrome was first described by 3 physicians – Loui [...]
What is peripartum cardiomyopathy? This is also known as pregnancy associated cardiomyopathy and is a relatively uncommon condition which affects women either late during pregnancy or within 5 months of giving birth and is characterised by the development of heart muscle weakness (also called heart failure) To be diagnosed with peripartum cardiomyopathy, 3 criteria need to be met 1) Development of [...]
