What is pitting edema and what can be done about it?

Peripheral Edema is a swelling, usually of the legs, due to excessive fluid in the tissues. Standing for an extended period of time or sitting with your legs left hanging for prolonged period of time, especially in hot weather, causes excess fluid accumulation in your legs and ankles.

I may have Marfan's syndrome. Is it risky?

Hi Dr T, I am a 16 year old girl who was just at the cardiologist today. He suggested that I may have Marfan's syndrome. What does it mean?

Marfan Syndrome is a genetic disorder of the connective tissue in your body. The damage caused by Marfan syndrome can be mild or severe. The most serious effects of Marfan syndrome can be life-threatening. People with Marfan syndrome are usually tall and thin, with disproportionately long arms, legs, fingers and toes. Patients sometimes also have “arachnodactyly”, which means "spider-like fingers", since one of the characteristic signs of the disease can include very long fingers and toes.

I have a Depressed Sternum

Hi Dr T, What exactly is this and what problem does this cause?

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  • Is there a risk to two different pulses in my neck?

    Hi Dr T, Sometimes when I feel my neck pulse, it feels like the right and left side are pumping at different rates, is this normal? I also get some twitches on the left side ocasionally.

    Not knowing anything else about you, the best way to go ahead and assess whether you are at risk for cardiovascular disease or stroke. Ask yourself the following:

    The risk of Niacin therapy and niacin in the news

    I experienced an MI in 1999 and have been fine since then. I take 20mg of simvastatin and 1500mg of plain niacin. The niacin has brought my HDL and triglycerides to desirable levels. It has also lowered my LDL more than the statin alone. Now comes the study which found no benefit with Niaspan. Do you think that it would be wise for me to consider dropping the niacin and increasing the simvastatin? I definitely want to address the risk factors aggressively and have been doing so to the best of my ability. Thank you for your generous help.  

    I was just planning to write about this, so your question is very timely!
    You are referring to the AIM-HIGH trial: A trial of high-dose extended-release niacin (Niaspan, Abbott) given in addition to statin therapy in patients with a history of cardiovascular disease, high triglycerides, and low levels of HDL cholesterol has been halted prematurely, 18 months ahead of schedule, because niacin offered no additional benefits in this patient population.

    In itch and cough in my chest

    "I am 18, 5'11", Korean American, and have a normal heart except when I expel air forcibly. (longer tones and higher pitches) The cough feels like an itch in my chest, rather than my throat, and cough drops do not help. The chest movements are the biggest source of concern, as a doctor has told me that the heart sounds are no danger, but I'd appreciate a second opinion. I do not have insurance, and I need my full vocal and physical capabilities as soon as possible. Thank you for your time

    Some questions to you:
    1): What does this mean, "I need my full vocal and physical capabilities as soon as possible"?
    2): What do you mean, hiccup, belch, cough, sing, talk? Is it productive (sputum etc.)?
    3): Do you have any trouble breathing, and if so, when?
    4): Is it worse when you take a deep breath?
    5): Where is this itch, is it new, how long has this been going on?

    Duchenne's Muscular Dystrophy and heart disease

    I have a 19 year old son with Duchenne's Muscular Dystrophy. He also has Supraventricular tachycardia.  He has under gone an atrial flutter ablation and still has arrhythmias.  He is not on any heart medication.His latest EKG showed RSR rime in V1, non specific T wave changes and sinus rhythm. His heart rate is 100bpm. When he has palppitations his heart reate will increase to 110- 140 bpm. My question is how will this impact my son's heart, especially with having muscular dystrophy?  Will this create a strain on his heart? Thank you for your time in answering this question.

    Patients with Duchenne's Muscular Dystrophy are at a high risk for both arrhythmias and heart failure and should be followed (and treated) agressively.

    What is a Myoview stress test

      What is a test that is called Non Congenital and stress Exercise Myoview is this one test or 2 different ones. This is what I need to get but I want to know is it painful? or does it hurt any at all and how is it done? thank you

    It is an exercise stress test that will test you for the presence of coronary artery disease. More specifically, it includes imaging of your heart, and is called a MIBI, Cardiolite, Myoview or Thallium stress test.

    A teaching moment

    This morning one of my readers gave me low rating: he had asked for advice about his heart pounding in his heart at night after heavy drinking. My advice included to stop (among many other things), but since he "already knew that", the rest of my consultation was useless to him. 

    Could I have a thoracic outlet syndrome

    37 year old female with pain in upper left arm sensitive to touch and collarbone -some swelling in lower forearm had since last august had various tests eventually had MRI which showed 50 % stenosis of subclavian artery - but my consultant doesnt think it is related to the pain i am having please advise its taken 8 months for a diagnosis and now i have one nothing is to be done except a referral to a pain clinic. I am left handed and my life is really becoming affected i work full time as a teacher. 

    It is  correct to say that a 50% blockage is not enough to affect the blood flow to your arm - at rest! The question whether this caused by a
    atherosclerotic blockage within the artery or by compression on the outside, something sometimes associated with a "thoracic outlet syndrome" which may involve the nerve supply as well as the arterial and/or venous return to and from your arm respectively.

    The nerves and vessels travel between muscles in the neck called the scalene muscles and over the top of the rib cage. The thoracic outlet
    is this opening between the scalene muscles and the rib cage. The nerves and blood vessels then go under the collarbone (also known as
    the clavicle), through the armpit (the axilla), and down the arm to the hand.



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