The event includes a rockin’ silent auction and an after-show by The Black and White Years (11:30pm). Ten bands sponsored by Austin-area companies will vie for celebrity judges’ votes, the audience’s favor and grand prizes. Come on out and cheer them on!

Band sponsors include LIVESTRONG, Seton Family of Hospitals, Heart Clinic of Austin, Bazaarvoice, Ascendant Technologies, GSD&M Idea City, C3 Presents, Cirrus Logic and H-E-B.

Judges for the April 28 contest and Showdown concert include Amy Corbin, ACL Music Festival booker from C3 Presents, and Adrian Quesada of the GRAMMY award-winning Grupo Fantasma.

April 28, 2011
Doors open at 6pm. $5 before 10pm, $10 after 10pm.
Antone’s 213 W 5th St Austin, TX, 78701-2910

Reason for Test

• One of the most useful and accurate tools in diagnosing cardiovascular problems.
• Can detect where arteries are narrowed or blocked.
• Can measure blood pressure within the heart and oxygen in the blood.
• Can evaluate heart muscle function.
• Helps determine best course of treatment.

As Cardiologists we are sometimes asked to evaluate a pattern called “Early Reoplarization” where there is “ST segment elevation” that can mimic a pattern seen during heart attacks. Patients with this “Early Repolarization” pattern usually feel fine and sometimes undergo testing to confirm that they do not have any obvious heart disease. This can include ECHO and Stress Testing.

In the past patients with this EKG pattern were re-assured after they had normal testing. Research published by Tikkanen et al. in the New England Journal of Medicine suggests that this may not be enough. These researchers looked at over 10,000 patients and found that SOME patients with this EKG pattern where at higher risk for death from cardiac causes. Their conclusion-

… our community-based study shows that J-point elevation in the inferior leads on standard electrocardiography is not an innocuous finding in middle-aged subjects. Future clinical and experimental studies should focus on understanding the exact mechanisms and reasons for this pattern and ultimately on devising strategies to prevent premature death from cardiac causes in subjects with this pattern.”

(Nov. 19th, 2009 NEJM)

What do you do if you have this EKG pattern?

Discuss it with your physician.

If you have had symptoms of palpitations or feelings that you might or have passed out then further evaluation and testing may be appropriate.

This weekend the Heart Clinic of Austin sponsored 6 riders who raised $1000 to help a young local woman who is suffering from Cancer.

Nathan Ward organized the fund drive and deserves a lot of credit for  a great turn out. Raquel and her Mom led the bikers riding in a convertible Mini Cooper as they completed the 8 mile course in Zilker park. Funds raised are going directly to Raquel and her family to help them meet expenses.

It is not too late to help. Donations of any size are welcome. Contact Nathan Ward via ride4raquel@gmail.com if you can help.

We are not in this alone.

The AP(8/31, Cheng) reports that “working up a sweat may be even better than angioplasty for some heart patients,” according to research presented at the European Society of Cardiology meeting. The AP adds, “An angioplasty ‘only opens up one vessel blockage,’ said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology.” According to Dr. Cannon, “Exercise does a lot more than fixing one little problem.”

MedPage Today(8/30, Fiore) reported that the new “data…come from a continuation of a pilot study first reported in 2004 in Circulation. That study of 101 male patients found that after one year, 88 percent of patients who exercised had event-free survival compared with 70 percent of stented patients.” The new “data…reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home.” Participants “with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had percutaneous coronary intervention.” The researchers said that “after four years, 70 percent of patients in the exercise program had event-free survival…compared with 50 percent of stented patients.”

Wanted to share this information from the current issue of ACC CV News Digest

The concern is that taking both Prilosec and Plavix may reduce the ability of Plavix to work. At the Heart Clinic of Austin we recently had a roundtable discussion with other local physicians to discuss how best to proceed. Based on this discussion and on a review of the available information the Heart Clinic recommends-

1. DO NOT STOP YOUR PLAVIX

2. Consider changing from Prilosec to either another “PPI” (eg. Protonix) or to a different class of medicine (eg. Pepcid). You need to make this decision in conjunction with the physician who prescribed Prilosec. We are here to help. If you want to discuss this issue with us make an appointment and we will help determine the best strategy for you.

3. At the Heart Clinic we are continuing patients at high risk for GI bleed on PPI, but changing from Prilosec to Protonix which is available by prescription. We are changing low risk patients to Pepcid. For those patients “in between” we are making decisions on a case by case basis.

We can all expect to see an increasing number of these warnings as the number of prescribed medications increases and as our ability to identify potential interactions improves. The key is communication. Do not hesitate to contact us if you have concerns about interactions between the medications that you take.

I believe that every person, regardless of current or pre-existing conditions, risk of future disease or ability to pay, should be covered by health insurance. But for universal coverage to be successful, we have to put enough money into the system on one side, and control healthcare costs on the other. To fund healthcare, everyone – even the poorest- need to pay something in order to have a stake. But to control costs, it will be important to limit (and even deny) certain types of care.

We should focus our medical efforts and dollars on treatments that work – vaccination of children, certain cancer screenings, proven primary care measures (controlling blood pressure and cholesterol, encouraging exercise) and on interventions proven to extend or to improve life. Too many of our health dollars go for unnecessary hospitalizations and treatments.

A good example of wasted money is the admission of patients with unexplained chest pain to hospitals for “observation”. If you are over 40, develop an unexplained pain in the chest and go to a hospital emergency room, you are likely to be admitted to the hospital and run through a battery of tests. This admission to the hospital comes AFTER lab work and ECG show that you are NOT having a heart attack. During your stay nothing much will happen (you are being observed) and once you have a stress test the following day you will go home. You and your insurance company will then receive a very large bill. It will likely be more that $10,000.

Unless your stress test or observation is “positive” for heart disease, you will not see a Cardiologist and are likely to be sent home the following day with no explanation of what caused your chest pain in the first place.

If, however,  you come to an outpatient clinic, you can usually be seen and evaluated by a cardiovascular specialist AND have your stress testing done for less than 10% of  the cost of the hospital stay. Not only is it less expensive, but it can usually be completed in less than 2 hours. Best of all, you have a physician to talk to and to return to for continued care if further tests or referrals are needed.

Seeing a Cardiologist rather than a Hospital for your symptoms can be cost effective!

I find it interesting that the results are similar to those seen in the 1950s, when scientists sought to evaluate the effect of exercise on the risk of heart attack. One famous study looked at the rate of heart attacks in men working on London’s double decker buses. Each bus had two men – one who drove the bus and a second who walked around collecting the fare. One worker essentially sat (driving) sedentary for the whole shift while the other walked constantly. The bus workers had the same rates of smoking and other risk factors for heart attack, so the major difference between the two groups was the exercise that the fare collectors got on the job. Guess what – when you looked at the rate of heart attacks in the two groups, fare takers had 50% fewer heart attacks compared to the bus drivers. Like Statin drugs, exercise protects against heart attack.

So how do I put this all together?

I exercise.

And I take a Statin.

St. David’s Cardiologists and Chinese Cardiologist Have Heart-to-Heart Talk via Video
Over the past three years, St. David’s North Austin Medical Center cardiologist Dr. Jeffery Michel and Dr. Jia-an Wang, a cardiologist with the Heart Center in Hang Zhou, China, have shared best practices on treating patients with cardiovascular disease through yearly visits and monthly conference calls. On March 25, both cardiologists will hold their first video conference to each discuss a patient case at St. David’s North Austin Medical Center.

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