The staff of Penn State Hershey Heart and Vascular Institute often receives questions from patients and visitors in the hospital as well as people who visit our booths at health fairs.
My child has chicken pox and is receiving Aspirin for a heart problem. I've been told using Aspirin during viral illnesses like chicken pox could cause Reyes Syndrome. Should I stop the Aspirin?
Though uncommon, Reyes Syndrome has been associated with the use of Aspirin therapy in children during viral illnesses. We do recommend stopping the Aspirin for two weeks during the illness and then restart same dose once the child recovers. (Answer to this question supplied by Mary Lou Box, RN, MSN, Clinical Nurse Specialist, Pediatrics.)
If my child is taking heart medicine, what cold and cough medicines can I give him/her?
Many cold medicines contain stimulants that can affect a child's heart rate, especially in children with heart rhythm problems. The medicines we recommend are Benadryl, plain Dimetapp, or plain Robitussin. Your family doctor, or the child's heart doctor, should check using any other "over-the-counter" medicines. (Answer to this question supplied by Mary Lou Box, RN, MSN, Clinical Nurse Specialist, Pediatrics.)
What does an Echocardiogram show and does it show blockage in the arteries of my heart?
An echocardiogram can help diagnose problems such as "leaky or tight heart valves", enlargement of the heart chambers, poor heart muscle function, etc. No, it does not show blockages in the heart arteries but it can help diagnose areas of a previous heart attack. It can also diagnose many other forms of underlying heart disease as well. (Answer to this question supplied by Steve Stouch, RDCS, Coordinator, Echocardiography Suite.)
I was fit with a mechanical mitral valve in 1991 and, at the time of the operation, told that I might need another valve in approx.15 years. Do the statistics still support this estimate or can I hope that the time period may be longer?
The overall mechanical durability of metal heart valves are greater than that of bioprosthetic valves. While you were told that you may need another valve in 15 years, my experience has been that metal valves last longer than 15 years. Bioprosthetic valves may need to be replaced after 10-15 years. As long as you have been followed by a cardiologist/internist who has been monitoring the valve's function, any problem that occurs will be picked up earlier. You may find your valve will last longer then what was estimated at the time of your operation. A transthoracic or transesophageal echocardiogram is typically used to follow the valve (assess function, measure the transvalvular gradient [the pressure change across the valve], mobility). In addition, fluoroscopy (x-ray of the moving heart) can be used to study the valve and its function if a "disc" valve was used. I recommend you discuss these concerns with your doctor and review the results of the studies with him/her. (Answer to this question supplied by Steven Ettinger, MD.)
I have Mitral Valve Prolapse (MVP). For several years I have occasionally been experiencing heart pains when I lay down to sleep at night. Is this normal for MVP?
The mitral valve prolapse syndrome has become recognized as one of the most prevalent cardiac valvular abnormalities, affecting an estimated 3-5 % of the population. This syndrome is twice as common in women as in men. There are various criteria that are used to make the diagnosis of mitral valve prolapse which include nonspecific and specific findings.
- Physical examination of a patient with MVP demonstrates abnormal heart findings which include a murmur or a mid-systolic click.
- An echocardiogram is routinely performed (a study that images the structure, and motion of the heart) to confirm the diagnosis.
- An ECG (electrocardiogram) may demonstrate abnormal waveforms or patterns.
- Some nonspecific symptoms reported in patients with MVP include: "atypical" chest pain, shortness of breath, fatigue, lassitude, dizziness, syncope (passing out), psychological disturbances, and palpitations.
It is important to confirm how your physician made the diagnosis of MVP, as this will effect whether you receive antibiotic prophylaxis prior to undergoing dental/surgical procedures.
With regards to the symptom of chest pain that you have noted when laying down, while it is unusual for heart pain to last only 1-2 seconds, you should discuss this with your physician. While you may be at risk for developing coronary artery disease, the pain that you are experiencing may not be related to your heart. (Answer to this question supplied by Steven Ettinger, MD.)
My friend is currently in the hospital with pericarditis. He began taking methotrexate for rheumatoid arthritis three weeks ago. He was in the hospital last weekend for pericarditis, took augmentin, got better. He took another methotrexate on Thursday, and is back in the hospital today with pericarditis again (his heart is about the size of four fists). Could his pericarditis be due to the methotrexate?
Methotrexate is a very effective drug in the treatment of rheumatoid arthritis (RA). It is widely used as the initial DMARD (disease modifying antirheumatic drug) for RA - especially for aggressive disease. It has the most predictable benefit of all the DMARDs and is usually the best tolerated- so patients tend to take it longer.
Methotrexate (MTX) is an antifolate agent and is excreted in the urine unchanged. Pre-existing renal or liver disease or alcohol abuse raise concerns about using this agent. Common side effects of this drug include: nausea, diarrhea, alopecia (hair loss). It may also cause bone marrow depression which manifests as a lowering of white blood cells. White blood cells help the body fight infection. Therefore it is recommended that a CBC (complete blood count) be performed every 4-8 weeks. An idiopathic pneumonitis (inflammation of the lungs) may occur in 2-6% of patients on MTX. The initial symptom of the pneumonitis is a non-productive cough. A chest x-ray can be performed to demonstrate the abnormal findings.
While there are many causes for pericarditis, methotrexate (MTX) has not been linked to this disorder. Drugs that have been linked to pericarditis include: hydralazine, procainamide, diphenylhydantoin, isoniazid, phenylbutazone, dantrolene, doxorubicin, and methysergide. Check to see if your father is taking one/several of these medications.
Of note, rheumatoid arthritis may cause pericarditis and so this may be a manifestation of his disease process. As your email describes, your father's heart is dilated and his condition may be related to a myocarditis/pericarditis process. That is, his heart muscle as well as the sac that covers the heart (pericardium) may be inflamed. (Answer to this question supplied by Steven Ettinger, MD.)
What are the warning signs of a stroke?
- Numbness, weakness, or paralysis in the face, arm, or leg, especially on one side of the body
- Sudden blurred or decreased vision in one or both eyes
- Difficulty speaking or understanding simple statements
- Loss of balance or coordination when combined with another sign
- STROKE IS AN EMERGENCY!
(Answer to this question supplied by Marsha Neumyer Assistant Professor of Surgery, Vascular Labs.)
Note: These questions and answers are placed here to provide you with general knowledge and are NOT intended to replace your primary care provider's advice and care. The BEST thing you can do is discuss any and all of your concerns with your health care provider. His/her job is to serve you and help you understand your clinical situation.
