The Saturday Evening Post » Coronary circulation

Heart Health and Hope

Dr. Zipes — Thu, 01 Jan 2009 05:00:58 +0000

I have a question concerning the angiogenesis procedure that may be FDA approved in 2009. Might I possibly be a candidate? I am 76 years old with a 20-year history of heart problems. My electrophysiologist said I was a prime candidate for a heart transplant, but I would never move up the list because of my age. I still work full-time as a carpenter for the local school district. Thank you for your articles of hope for those of us who wonder.

I am glad my articles are of interest to you. There is much research going on in the field of angiogenesis—that is, the creation of new blood vessels in the body. The goal of angiogenesis is to improve blood flow to areas of the body supplied by partially or totally blocked arteries. Naturally, this includes the heart, in patients with coronary artery disease, and peripheral muscles (such as the legs), in patients with peripheral vascular disease. Approaches include injecting genes and altered cells that can encourage new blood vessel growth. Ask your doctor to investigate the many trials that are going on in these areas to see if you might be a candidate to participate in one of them.

Advances in treating heart failure have also improved in recent years. While you may not be a candidate for a heart transplant at your age, there are other options that can be explored. Above all, do not give up hope, and be sure to keep on working. New procedures are being developed all the time. In fact, we have explored a procedure called spinal cord stimulation that we have shown to improve heart failure in dogs (Heart Rhythm 2008; 5:S53) and hope to test in humans in the coming year.

Heart Health and Hope The Saturday Evening Post

Convoluted Heart Vessels

Dr. Zipes — Thu, 01 Jan 2009 05:00:45 +0000

My heart catheterization was normal, other than “very tortuous cardiac vessels.” Are you aware of studies showing the cause or consequence of my cardiac vessel condition? Should my offspring or “grands” be tested, and can it be detected without a cardiac cath?

Tortuous coronary arteries are usually a normal variant of no concern. Sometimes they can be associated with high blood pressure. There is no need for routine testing of your children or grandchildren unless they have symptoms.

Convoluted Heart Vessels The Saturday Evening Post

Hallucinations and Heart Surgery

Dr. Zipes — Thu, 01 Jan 2009 05:00:27 +0000

I had coronary bypass surgery late last year and recently have been having visual hallucinations. Can coronary surgery cause this problem? I have not yet consulted my cardiologist about it and would appreciate your opinion.

Changes in mentation (mental activity) can occur in a minority of patients after coronary artery bypass surgery. The reason(s) for this are not entirely clear but may relate to use of the heart-lung machine to which your blood circulation was connected as a “substitute heart” when your own heart was stopped to make repairs. In some patients it is thought that very tiny clots form in the tubes of this machine and travel to the brain, affecting its function. A second possibility for your hallucinations is a side effect from medications. You don’t mention taking any drugs, but sometimes narcotics like Percocet or other medications can be responsible. Whatever the cause, if these hallucinations continue, you should definitely tell your doctor about them so you can be evaluated. They are not fun to have.

Hallucinations and Heart Surgery The Saturday Evening Post