Shown is the back of a female patient with a doctor who is using a stethoscope to listen to her lungs. (Photo credit: Wikipedia)
It’s great to know that what a doctor can hear/feel in the physical exam of a patient with advanced heart failure is the best predictor of how well that patient will fare.
Despite the development of continually more sophisticated diagnostic tools, it’s comforting to know that the best guide to a patient’s prognosis is the doctor’s careful listening to and observation of four important indicators: 1) distended jugular venous distention, 2) a third heart sound, 3) rales (crackles) in the lungs, and 4) peripheral edema (swelling in the legs and ankles).
I am grateful that most doctors have some training in how to present bad news to a patient. As one of their duties, that’s gotta suck. But the hope is that patient and doctor have developed a respectful, caring relationship along the way.
It’s a long way off from availability, but isn’t it nice to know that some researchers who were looking for something else entirely – isn’t that how half our best discoveries are made? – have found a molecule that might be able to tell us with a simple blood test if we’ve got coronary artery disease (CAD). CAD is responsible for heart attacks and strokes and is the number one cause of death in the United States, according to an article in MedNewsToday.com.
Up til now, most people have no idea they have CAD (also known as atherosclerosis and, to many folks, just plain old heart disease) until they have a heart attack. Many felt fine and noticed no warning symptoms. Then suddenly, they’re in the hospital and terrified.
Researchers noticed the molecule – malondialdehyde-acetaldehyde (MAA) – because it showed up where there was inflammation while they were investigating arthritis and liver disease.
While a blood test isn’t totally non-invasive, it’s a darn sight less so than nasty tests like angiograms and catheterizations. So here’s hoping they can hurry this research along. Once it’s developed, people will know ahead of time that they have to make diet and lifestyle changes to avoid a heart attack.
But I guess we already hear that all the time, and yet it doesn’t hit home to many. Maybe this test will come to serve as a less drastic wake-up call.
Image via Wikipedia
If you find yourself not being able to breathe very well—gasping or huffing and puffing on slight exertion or on lying down—your doctor can go down a number of different routes to find out what the problem is. Since I know from personal experience they don’t necessarily go down the right road, even when they keep reaching dead ends on the ones they do pursue, this could be a good thing for you to know yourself.
If you already know you have heart trouble, your doc will probably look down that route first. And now there’s a way for even your internist to tell if your troubled breathing might be due to congestive heart failure rather than to a respiratory or other issue. A simple blood test for BNP (B-type natriuretic peptide) can tell whether you have much higher levels than someone who’s breathing trouble is lung- or other-related. Any doctor can read the test–doesn’t have to be a cardiologist. And even happier, the BNP test can be done quickly–as in emergency room speed–so docs can treat for the right thing right away.
Earlier treatment can vastly improve quality of life and potentially extend a patient’s lifespan. It can also mean savings in treatment costs over the course of the condition. So it’s good news for hospitals as well as for patients.
Well, I guess it’s never too early to learn the truth if docs can give you medications to ease the symptoms. Plus, it gives you more time to decide if there’s anything you want to get done before your number’s up.