DEAR DOCTOR K: I have heart disease. Will chelation therapy help reduce my risk of a heart attack?
DEAR READER: That's a timely question, because a recent study of chelation therapy has generated a lot of interest and debate. Chelation therapy is used to eliminate metals or other toxins from your body. Its use for heart disease is more controversial.
DEAR DOCTOR K: My father recently saw his doctor, complaining of fever, fatigue, joint pain and rashes. His doctor suspects vasculitis. What is vasculitis? How is it diagnosed and treated?
DEAR READER: Vasculitis is an inflammation of the blood vessels. This inflammation can be severe enough to reduce blood flow to tissues and organs. We don't know for sure what causes it, but scientists believe it is an autoimmune disease.
DEAR DOCTOR K: I recently had an electrocardiogram and my doctor gave me a copy of the tracing. Can you tell me what I'm looking at?
DEAR READER: When the 20th century began, more than 100 years ago, doctors had no way of looking inside the body of a living person. Yet we knew from autopsies of people who had died that all of the normally invisible internal organs could become diseased. So the search was on for ways to "see" inside the body.
DEAR DOCTOR K: I've heard there's a new test that can help doctors diagnose a heart attack more quickly. Can you tell me about it?
DEAR READER: A heart attack is instantly recognizable on TV and in the movies: The actor breaks into a sweat and clutches his heart. But in real life, a heart attack isn't always so easy to identify.
DEAR DOCTOR K: I often feel lightheaded when I stand up, especially first thing in the morning. Why does this happen?
DEAR READER: You are probably experiencing a drop in blood pressure when you stand up. This is called orthostatic hypotension. As a result, not enough blood reaches your brain, and you feel lightheaded or dizzy.
DEAR DOCTOR K: I take a daily aspirin to prevent a heart attack. I just read that aspirin can cause macular degeneration. Should I stop taking it?
DEAR READER: No, you shouldn't stop taking aspirin. Medicine — and life — is full of trading off one risk for another. Doctors and medical scientists aren't (yet) smart enough to discover or invent treatments that have absolutely no risks, only benefits. So you have to compare the risk of a treatment against your risks if you don't take it.
DEAR DOCTOR K: Why is abdominal fat worse for your health than fat around the hips and thighs?
DEAR READER: When it comes to body fat, location counts. Fat above the waist (the "apple" shape) is much more dangerous than fat in the butt and thighs (the "pear" shape). In most people, about 90 percent of body fat lies in a layer just beneath the skin. The remaining 10 percent -- called visceral fat -- lies out of reach, deep within your abdomen.
DEAR DOCTOR K: My wife has atrial fibrillation. Her medication was recently changed from warfarin to Pradaxa. Her doctor says the new medicine does not require regular INR tests and is just as effective. Is that so?
DEAR READER: Yes, it is. Before I explain why, let me provide some background. In people with atrial fibrillation, the upper chambers of the heart (the atria) lose that strong beating action that keeps the blood moving efficiently. As a result, blood tends to pool in the atria. When it does, clots are more likely to form.
DEAR DOCTOR K: I have aortic valve regurgitation and need to have my aortic valve replaced. What will happen during this procedure?
DEAR READER: When it's working properly, your aortic valve opens to allow oxygen-rich blood to flow from your heart into your aorta and out to the rest of your body. The aorta is the body's largest blood vessel.
DEAR DOCTOR K: I have atrial fibrillation. It doesn't bother me, but I still have to take medications because the condition apparently increases my risk of stroke. How does it do that?
DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. The atria are the upper two chambers of the heart; they receive blood from the rest of the body. The atria pump blood into the lower two chambers of the heart (the ventricles). Then the ventricles pump blood to the rest of the body. During atrial fibrillation, the atria do not beat normally. Instead, they quiver or "fibrillate."
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Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. Learn more »
Harvard Health Publications is the publishing division of Harvard Medical School, providing the general public with authoritative, trustworthy, and accessible health information. Learn more »
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