Here are some tips from the Lown Cardiovascular Center on how to reduce stress in easy, enjoyable ways that don't take much time or cost money.
In Practice
Joe G. recently visited the Lown Cardiovascular Center concerned about periods of breathlessness. A 60-year-old computer programmer, for the past several years Joe had successfully managed his cardiovascular risk factors--hypertension, diabetes, and high cholesterol--with medication and lifestyle. "This time, he was ten pounds heavier than six months earlier," Dr. Brian Bilchik, Co-Director of the Lown Center, recalls.
In Practice
This pearl derives from work on the Lown Ganong Levine Syndrome (LGL) carried out in 1950. The study characterized patients with abbreviated A-V conduction and paroxysms of atrial tachyarrhythmias...
Clinical Pearl
It needs to be recalled that the numerous circulatory and hormonal adaptations during the pregnant state simulate the clinical presentations associated with congestive heart failure...
Clinical Pearl
Angina pectoris is a stereotypical discomfort with a uniquely distinguishable pattern comprehended only by a carefully taken history...
Clinical Pearl
I encourage patients with angina to take nitroglycerin freely. This is contrary to the prevailing culture in medicine...
Clinical Pearl
Massaging or pressing on the carotid sinus bulb on either side of the neck to diagnose angina pectoris is neither appreciated nor practiced by cardiologists...
Clinical Pearl
Nitroglycerin is a true wonder drug. When it is taken properly, it can help patients with angina achieve the goal of a pain-free life with little or no limitations...
In Practice
When the latest costly equipment is located conveniently nearby, motivation to utilize it affects both patient and physician on many levels. Two recent clinical encounters involving the same patient illustrate the dilemma created by easy access to cardiac procedures and a bias for using them...
Clinical Encounter
I saw two patients recently who exemplify the powerful changes that individuals can make in their lives with education and encouragement from a physician. By helping patients understand that their bodies can, on their own, produce the most powerful drugs necessary for a healthy heart, we can be the catalysts for them taking a more proactive role in their physical wellbeing...
Clinical Encounter
"Please take off your socks" is one sentence all patients with diabetes need to (but rarely) hear. Diabetic neuropathy is common, occurring in 32% of type 2 diabetics, and it is a major contributor to lower limb amputation...
In Practice
When I started to practice, the predominant method of imparting information to patients followed paternalistic models; the doctor had all the answers, and he or she imparted information in a top-down model that was prescriptive and left no space for a patient's input, ambivalence, or questions...
In Practice
My patient was apologetic for calling me at home late one evening on a weekend--something he had never done in the 30 years that I have cared for him. "I won't keep you long, but I'm disabled and don't know where to turn," he began. He then asked for the name of an orthopedist...
Clinical Encounter
Although dietary recall is a quicker way to obtain dietary information, we find that the food diary more accurately reflects the details of a diet over several days or a week...
In Practice
"Before utilizing new, death-defying technology, numerous questions need to be answered. If death can be postponed, how long is the deferral? Will the extra time be a mere extension of misery? Will living remain purposeful? At what individual, social, and economic cost will the extra time be purchased?...The bottom line is that scientific medicine has lengthened and improved life but, by the same token, worsened death"...
In Practice
"A doctor...confronts a single, singular individual. There is never any certainty as to where the individual fits on the normal statistical curve....The doctor, loyal to his or her calling, craves certainty while immersed in doubt. Yet doubt cannot delay the urgency to treat and the necessity to heal..."
In Practice
