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Emergency Cardiac Medicine

Posted on November 30, 2009 at 1:26 AM

The previous five discussions in Daily Topic have primarily touched on matters of heart disease prevention. Today, will detail a little on non-invasive cardiovascular interventions and the not-so-terrific intervention in cardiac care.

When autopsies are actually performed on those who died of a heart attack, there are often no blocked arteries found whatsoever. During an occlusion of the artery, new collateral vessels are formed through a process called angiogenesis. In most cases these new blood vessels more than compensate for existing blocked arteries.

In contrast, the result of a heart bypass procedure is largely inferior, as veins from the patients legs must be stripped and used to "bypass" the clogged vessels.

The difference in pressure is not significant and with already existing collateral vessels, the procedure offers little more than the placebo effect. However, it is even worse than placebo due to potential complications and frequent memory loss suffered through anesthesia and the surgery itself.

I have an entirely different approach to bypass--I call it natural bypass and it costs almost nothing! However, before I explain how it works, I feel that some detail about a more costly method should be brought to your attention first.

A procedure known as enhanced, external, counter pulsation (EECP) is a very viable alternative to coronary artery bypass surgery. EECP is a non-surgical, solution that naturally augments and accelerates the process of angiogenesis or growth of new blood vessels.

EECP is essentially a natural bypass that costs between five and ten thousand US dollars, and is very well studied and approved by medical authorities. Unfortunately, it is passed over in favor of more profitable procedures such as surgery. Cardiologists are taught to believe it is a "last line" therapy. Funny how a non-invasive treatment is ignored--of course it's the money!

EECP is intended to be a first line therapy, and it is a very appropriate treatment for many heart patients suffering from angina, peripheral artery disease (PAD), coronary artery disease and congestive heart failure. Some patients with preexisting conditions such as blood clots and very low ejection fraction are excluded from this treatment.

My ultra low cost alternative to EECP is the use of a rebounder. A rebounder is similar to a trampoline and comes with a stabilizer bar. As a patient grips the stabilizer bar, they hop on the rebounder and let gravity and a little push from the stabilizer bar to create a lift between bounces.

The force of gravity promotes a rapid growth of collateral vessels via angiogenesis. It is an incredibly non-invasive therapy with an initial investment that is almost trivial when compared to other methods, about a hundred US dollars.

One of the leading conditions facing heart patients is congestive heart failure (CHF). Congestive heart failure is severe weakening of the heart muscle, resulting in a number of potentially life threatening complications.

Congestive heart failure is the leading cause of hospitalization for patients over the age of 65. This is a growing epidemic and I suspect it has to do with the undeserved popularlity of cholesterol-lowering statin drugs.

Drugs like Lipitor (atorvastatin), Crestor (rosuvastatin calcium) and other HMG-CoA reductase inhibitors not only lower cholesterol, they deplete essential co-enzyme Q10, the virtual spark-plug of the heart. It has been well documented that there is a deficiency of Co-enzyme Q10 in human heart disease.

Do these statin cholesterol drugs hasten the path towards congestive heart failure?  I think so.

Make no mistake, cholesterol is not the enemy here, but a life-saving nutrient! The body makes it when your diet does not provide it and when the cholesterol hypothesis of heart disease emerged, most doctors did not buy it, they knew then that hormones cannot be made without cholesterol.

Congestive heart failure is synomonous with low ejection fraction, which is a measure of the efficiency in the blood pumping action. As the heart contracts, it ejects blood from the ventricles and when it relaxes these ventricles refill with blood. The percentage of blood volume pumped out from the ventricles is the relative efficiency of the heart.

An ejection fraction of 55 percent or greater is considered a good reading. When it falls below 55% on each contraction, your heart is weakening. This means the heart muscle is becoming too flaccid to pump out sufficient blood  on each contraction.

Eventually as ejection fraction percentage drops, the weakened heart increases shortness of breath (dyspnea) and fluid retention (edema), resulting in the swelling in the feet and legs. At this stage of the game, doctors will typically prescribe strong diuretics such as Lasix (furosemide) however, this is not kind to the heart and it's hard on the kidneys.

As this condition progresses in its usual way with orthodox cardiology, the left ventricle slowly loses its capacity to pump blood out of the left atrium, or when one or more of the heart valves becomes leaky or narrowed (stenotic), the flow of blood backs up into the lungs, otherwise known as pulmonary edema.

From here, the cardiologist enters more drugs, from beta-blockers to calcium channel blockers, further weakening the heart muscle. Simple and naturally sourced b-vitamins could have prevented this calamity. Synthetic, "enriched," b-vitamins that are added to processed foods do not work, in fact they further deplete what little dietary intake exists in these patients.

As mentioned in earlier discussions in Daily Topic, beriberi, a thiamin (vitamin B1) deficiency disease, thought to be long conquered by its fortification in processed foods is still very much alive today. Such a deficiency causes a paralyzing muscle weakness of the heart, meanwhile doctors prescribe drugs that further weaken the heart muscle in an attempt to normalize its rhythm.

With a chronically congested heart, it typically becomes hypertrophic (enlarged) or enters into cardiomyopathy. Shortness of breath, fatigue, and spaciness now become commonplace. The patient says, "now what?" and the typical cardiologist will answer, "More drugs!"

Much more to cover on emergency cardiac medicine in the next Daily Topic.

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