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Heart health: ask Dr. Zipes: a noted cardiologist answers your questions.

READER: Four months ago my heart at times would start racing. In the emergency room, the doctor gave me medicine in my vein that slowed my heartbeat, but the racing heart keeps coming back. The cardiologist told me that I have something called WPW. He wants to do a procedure on my heart, but I am nervous. What is WPW? Can't I just take a pill instead?

DR. ZIPES: WPW is a congenital problem of having abnormal heart tissue that can cause rapid heartbeats. You can just take a pill, but it is often ineffective and can have side effects. A procedure somewhat similar to a heart catheterization called "catheter ablation" can be done to find where your rapid heartbeat is coming from and eliminate that abnormal tissue with a catheter (skinny wire) threaded through a blood vessel and into the heart. When successful (and it usually is, depending on where the abnormality is located), you can be cured of your problem, without the need for medicines and with just a brief stay in the hospital.

READER: Right after my heart bypass last year, I developed an irregular heart rhythm. The doctor said I had atrial fibrillation. She shocked my heart out of it three times, but it kept coming back. Now, she has me on a medicine to slow my heart rate, and a blood thinner. I don't have any pain, but I get tired if i try to walk very far. It seems like I have to live with this, but I don't like taking the blood thinner. What can I do?

DR. ZIPES: You have the choice of mainly three treatments. The first, which was not successful in your case, is to shock the heart back to a normal rhythm and try to prevent recurrent episodes of atrial fibrillation (AF). The second is to control the heart rate and use a blood thinner to prevent blood clots, which is what your doctor is doing now. These two treatments are about equally effective clinically, which means either can be used, depending on your response. The third approach is surgery or ablation (see previous answer) to eliminate the AF. This approach is usually reserved for particularly troublesome AF. The ablation is more difficult for AF than for WPW.

READER: I had a heart attack last month. The doctor said I needed a defibrillator because my heart was weak. I thought those were only for people with fast heartbeats, which I haven't had. Do I really need it?

DR. ZIPES: The defibrillator has been shown to improve survival in many patients who have had a heart attack and "weak" hearts, even without any symptoms. The reason is that the weak heart is prone to developing life-threatening rapid heartbeats that the defibrillator can stop.

READER: I keep having dizzy spells. It used to happen when I got up too fast, but now I have them anytime. I passed out once and broke my nose. My doctor put a heart monitor on me, but it didn't show anything. He put me on a treadmill, but that looked all right. I am afraid to be alone. What can I do?

DR. ZIPES: Treating dizzy spells can be very difficult in some instances because there can be many causes. An abnormal heart rhythm is often the cause and can be diagnosed by special EKG equipment that can record the heartbeat during a dizzy spell. You need a careful evaluation by an experienced doctor to determine the cause.

READER: I went to my doctor because of a fast heart rate. She checked my heart and ordered blood tests, which showed a high thyroid level. She gave me some heart medicine, and now she wants me to go to the hospital to have my thyroid irradiated. Will I still need heart medicine afterwards?

DR. ZIPES: An elevated thyroid level can be responsible for some fast heartbeats, particularly atrial fibrillation (see above). In many (but not all) patients, restoration of normal thyroid function can eliminate the rapid heartbeat without the need for drugs. You need to have your thyroid treated regardless, and determine the need for medicines afterwards.

Internationally acclaimed cardiologist, distinguished professor, author and inventor, Dr. Douglas P. Zipes joins The Saturday Evening Post magazine as a featured columnist in a new department, "Heart Health." Dr. Zipes, an authority on what is called pacing and electrophysiology (rhythms of the heart), hosts a "heart to heart" discussion about your heart-felt concerns.

Like physician-writers W. Somerset Maugham or Michael Crichton, Dr. Zipes will go down in history as one of the most innovative minds in medicine and Literature. Among his many achievements, Dr. Zipes served as president of the American College of Cardiology, chair of the American Board of Internal. Medicine, and director of the Cardiology Division and the Krannert Institute of Cardiology at Indiana University School of Medicine. He has authored more than 700 articles and 16 books. He is married to Joan Zipes, a medical editor of great stature; together, the couple edits professional medical journals and has co-authored two books of fiction, now in the pipeline. Readers may remember "Stolen Hearts," serialized in three issues (Sep/Oct 2002 through Jan/Feb 2003) of The Saturday Evening Post.

Dr. Zipes will answer your questions about heart health in direct, easy-to-understand language. Please send questions to: Dr. Douglas Zipes, SatEvePost, 1100 Waterway Blvd., Indianapolis, LN 46202.
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Author:Zipes, Douglas
Publication:Saturday Evening Post
Date:Nov 1, 2004
Words:899
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