A heavyset, 51-year-old truck driver with a history of hypertension presented at Norton Heart & Vascular Institute with four months of intermittent, sharp, substernal chest pain that was exacerbated by activity and becoming increasingly frequent. Should he be evaluated with anatomic or functional testing? Updated clinical practice guidelines offer guidance on whether to choose coronary…
Atrial fibrillation, or A-fib, is an increasingly common chronic condition seen in the primary care setting. Management is multifaceted and requires a team-based approach. Risk for A-fib increases with age and is greater if there is a family history. Modifiable risk factors for A-fib are obesity, diabetes, hypertension, sleep apnea, and excessive caffeine or alcohol…
Different substrate mapping techniques are available to identify myocardial sites for catheter ablation in ventricular tachycardia (VT) patients. A recent study has for the first time looked at how well they work compared with one another. Published in the journal Heart Rhythm, the study, “Comparison of Combined Substrate-based Mapping Techniques to Identify Critical Sites for…
Norton Heart & Vascular Institute welcomes Keith A. McLean, M.D., cardiologist, to Norton King’s Daughters’ Health in Madison, Indiana. The office is located in the Norton King’s Daughters’ Health Downtown Medical Building at 630 N. Broadway. With the addition of Dr. McLean, the office will have three providers seeing patients Monday through Friday. Dr. McLean…
Kevin A. Graham, M.D., a cardiothoracic surgeon, has joined Norton Heart & Vascular Institute. Dr. Graham, who earned his medical degree from Indiana University, Indianapolis, and completed his residency there, has been practicing in Illinois. Dr. Graham has participated in the Summit trial, Optimize Pro study, Early TAVR trial and, as site principal investigator, the…
Ischemic heart disease in women can lead to a heart attack, but this risk may go unnoticed. This is because a patient’s diagnostic coronary angiogram shows “clear” arteries. “When diagnosing women for ischemic heart disease, it is important to consider risk factors specific to women — and those that pose a greater risk to women,”…
Borderline hypertension or subclinical hypertension is a substrate for myocardial dysfunction, and patients can go for a long time with hypertension that isn’t clinically recognized, according to a heart failure specialist at Norton Heart & Vascular Institute. Additionally, high hypertension effects can be accelerated to a cardiomyopathy. “When we start thinking about the burden of…
The risks and consequences of hypertension in women differ from those in men and change throughout women’s lifetimes. Overall, hypertension in women is less prevalent than in men until age 60 and becomes more prevalent afterward. This pattern may be the result of longer life expectancy, postmenopausal hypertension and lower response rate to treatment. “Understanding…
Norton Heart & Vascular Institute launched a Women’s Heart Program in 1995. Today it has expanded to include more providers and services for a region where heart disease, especially in women, is a deadly issue. According to the Centers for Disease Control and Prevention, heart disease is the No. 1 killer of women, taking the…
The patient In July 2022, a 45-year-old male with a six-year history of chest pain went to the emergency room complaining of chest discomfort and shortness of breath over the previous two weeks. He was evaluated by Jacqueline Gray, APRN, and no markers of heart attack were found. Previously, nuclear stress single-photon emission computerized tomography…
Diet and exercise many times are not enough to lower the risk of hyperlipidemia (HLD). As we’ve learned over the years, genetics can play the biggest role. Fortunately, we now have treatments we didn’t have only a few years ago, giving options for patients who previously had none. At Norton Heart & Vascular Institute’s Lipid…
When symptoms of heart failure begin progressing or patients start decompensating, there is a brief opportunity for referral to an advanced heart failure center. The American Heart Association calls this the “golden window.” Primary care providers and others should consider referring a patient to the Norton Heart & Vascular Institute’s Advanced Heart Failure & Recovery…