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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • March 01, 2019

    By MedStar Health

    Deliya Wesley was awarded the SPIRIT of Excellence Award for the fourth quarter of 2018 at a presentation at University Town Center (UTC) offices. Deliya is the Research Scientist for Health Equity at MedStar Health Research Institute. Nominated by Angela Thomas, DrPH, MPH, MBA, Assistant Vice President, Healthcare Delivery Research at MHRI, the award was presented by Mary Anne Hinkson, Vice President of Research Operations.

    Deliya was recognized for her commitment to the organization and her tremendous leadership. Deliya’s dedication goes beyond writing proposals, managing contracts, leading projects, collaborating with others, and writing publications. She is a great team player and treats all of her colleagues with integrity and respect.

    “Deliya’s ability to integrate quickly and effectively into any team, promote the value of her research, and contribute significantly ultimately led to her receiving a contract from AHRQ that’s over $1M and includes collaborators from Georgetown University, Sports Medicine, Human Factors, and many others!”

    The SPIRIT Award is given to recognize and reward one associate (management or non-management) each quarter, who excels in Service, Patient First, Integrity, Respect, Innovation, and Teamwork. Nomination submissions for the second quarter of 2019 are due by May 15. Learn more on the SPIRIT StarPort page or contact MHRI-HR@medstar.net

  • February 28, 2019

    By Daniel James Dooley, MD

    Aspirin has long been used as a therapy to reduce the risk of stroke, heart attacks, and heart disease. But research released in September 2018 as part of the ASPREE (Aspirin in Reducing Events in the Elderly) study has left many patients questioning if aspirin should be part of their heart health strategy.

    The answer is not straightforward because the risks and benefits vary for each patient. It’s important for patients and their doctors to talk about these findings and how they might affect their individualized treatment plan.

    First, let’s learn more about the new research, and then we’ll look at who may benefit from taking aspirin daily.

    Research Shows Aspirin Therapy Isn’t Always Safe

    The ASPREE trial found that daily aspirin use did not improve the lifespan of patients who were 65 or older. The trial involved monitoring elderly patients in Australia and the U.S. who were in relatively good health with no heart disease at the beginning of the study.

    The trial’s results, published in The New England Journal of Medicine, suggest that aspirin use did not:

    • Prolong survival without major disabilities
    • Result in lowered risk for heart disease in healthy older adults

    In addition, ASCEND—a separate study published in August 2018—found that the increased bleeding risks of daily aspirin use outweighed the heart and vascular benefits of daily aspirin use in patients 40 and older with diabetes, which is a well-known risk factor for heart disease.

    In ASPREE’s conclusion, the authors state that the results were unexpected and should be interpreted with caution. The study also highlights that additional research is needed to confirm or refute the findings. It is important to remember the patients involved in the ASPREE study were using aspirin for preventing a first heart attack or stroke. This study did not include patients with a previous history of heart attack or stroke.

    Weighing the Risks and Benefits of Aspirin Therapy

    Many heart attack and stroke survivors take aspirin daily to lower the chance of having an additional heart attack or stroke. This is called secondary prevention. According to the American Heart Association, the evidence is clear that a daily low-dose aspirin is beneficial for this group of patients.

    For patients without a history of prior heart attack or stroke, it is important to look at the individualized risks and benefits. If you have experienced peptic ulcer disease, gastric ulcers, or bleeding episodes related to the gastrointestinal tract, daily aspirin use to lower cardiovascular risk should generally be avoided for primary prevention. Patients with other conditions that may raise the risk of bleeding problems, such as kidney failure requiring dialysis, may also be at a higher risk for bleeding complications. These medical conditions are among those that should be carefully considered when deciding on whether aspirin should be used as a primary prevention strategy.

    On the other hand, if you’ve been taking aspirin daily and it’s working as part of your overall heart health strategy, it may be reasonable to continue taking aspirin. The overall strategy to reduce your cardiovascular risk should also include:

    • Eating a healthy diet
    • Getting enough physical activity
    • Maintaining a healthy weight
    • Not smoking or using other forms of tobacco

    Patients who effectively reduce their risk of heart or vascular disease often use a variety of these strategies. Individuals who are most successful in reducing their cardiovascular risk often make significant lifestyle changes in many areas.

    Whether you take aspirin daily or you’re considering adding aspirin to your health strategy, talk to your doctor about whether aspirin therapy is right for you.

    Call 202-877-3627 or click below to request an appointment with a cardiologist to discuss whether you should be on aspirin therapy to reduce your risk of having a heart attack or stroke.

    Request an Appointment

  • February 26, 2019

    By Allen J. Taylor, MD

    We’ve long known that people who eat a healthy diet—which, from a heart health perspective, is low in fat and high in fruits and vegetables—are less likely to develop heart disease. However, with so many ideas online and from well-meaning friends and family, it can be difficult to make the right choice.

    But it doesn’t have to be confusing. For optimal heart health, the best option is the Mediterranean diet, which emphasizes the consumption of:

    • Fruits
    • Vegetables
    • White meat
    • Beans
    • Nuts
    • Olive oil (for supplementation)
    • Wine (occasionally)

    It’s really less of a “diet” than a daily decision to make healthier food and beverage choices. Most people find it easier to sustain than fad diets, such as Atkins or the ketogenic diet, because there is no calorie counting and no severe restrictions. The Mediterranean diet is an evidence-based way to reduce the risk of heart disease, and it often carries the added benefits of increased energy and weight loss.

    LISTEN: Dr. Allen J. Taylor discusses heart-healthy diets in the Medical Intel podcast.

    Why the Mediterranean Diet?

    The Mediterranean diet has been rigorously studied in people with and without heart disease. For example, the PREDIMED study examined about 7,500 individuals without heart disease who were asked to eat either a Mediterranean diet or an otherwise high-quality American diet consisting of low-fat dairy products, pasta, rice, fish, fruits, and vegetables.

    When the two groups of participants were compared, the diet led to impressive results in those who followed the Mediterranean diet, including nearly a 20 percent lower risk for heart events and a 30 percent reduction in heart disease risk.

    Another great thing about the Mediterranean diet is that, while it discourages things such as soda, commercial baked goods and sweets, spread fats, and red meats, it doesn’t say to never have them. For example, if you are tempted to buy a sweet treat while standing in line at the coffee shop, it’s fine to indulge once in a while. Some diets prohibit these foods, which can discourage patients and lead them to drop the diet altogether.

    The #MediterraneanDiet not only is great for #hearthealth, but is relatively easy to follow. While it discourages soda and sweets, it doesn’t say to never indulge. Learn more. https://bit.ly/2Nv6xkH via @MedStarWHC

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    Mediterranean Diet vs Other Diets

    Weight loss is the goal of many of today’s popular diets. The problem is that many of these diets is that while people often can lose weight quickly, it tends to come right back when the diet ends. And, frankly, we don’t always know the safety of fad diets, such as how they may affect a person’s cholesterol and blood pressure.

    Among the most popular fad diets today is the ketogenic diet, which emphasizes avoiding carbohydrates and eating mostly proteins and vegetables. In the short-term, people often lose water weight quickly, and then the weight loss tails off. If you really want to follow an evidence-based diet to reduce heart risk and control your weight, choose the Mediterranean diet.

    That said, the focus of the Mediterranean diet is more about heart disease prevention than weight loss. A smaller waist often is happy byproduct. Mathematically, weight loss can be equated to calories in, calories out through food intake and exercise. There are some great, free health apps, such as MyFitnessPal, to help make these calculations. Many patients use them to show us how they’ve identified unhealthy foods that were regularly a part of their diet, and changed their diets to eliminate those foods, which resulted in weight loss.

    What Should Patients Ask Their Doctor?

    It’s important that patients mention their goals when discussing diet options with their doctor, who can recommend different diets to lose weight or improve heart health. For example, to improve blood pressure, the doctor might recommend the DASH (Dietary Approaches to Stop Hypertension) diet, which reduces sodium and increases potassium and magnesium. Cholesterol, unfortunately, is fairly unresponsive to diet alone, so we usually have to rely on medication as well to keep cholesterol at a healthy level.

    A week doesn’t go by where I’m not in the hospital talking to patients about the Mediterranean diet. I hand out copies of the PREDIMED study and summaries of the diet so they can decide on their own whether they want to follow it. Of all the diets out there, the Mediterranean diet is best for reducing heart disease risk.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment

  • February 25, 2019

    By Nicholas Paivanas,MD

    We all know that cold weather can contribute to many common health conditions, such as colds or the flu. However, a new study shows that more serious health complications also can arise—such as heart attacks.

    In November 2018, the journal JAMA Cardiology published a study that examined the relationship between cold weather and heart attacks. Researchers looked at incredibly detailed data from a 15-year period in Sweden using the country’s online cardiac registry, Swedeheart, along with information from the Swedish government’s weather institution. They found that days with below-freezing temperatures had the country’s highest incidence of heart attacks. Days with high wind speeds and shorter durations of sunshine were also associated with a higher risk of citizens having heart attacks.

    When I look at this study and its results, I see two areas of potential risk for patients: the actual effects cold temperatures have on the body and people’s activity levels after a sudden winter storm. Both of these factors can combine with tragic results in patients who aren’t properly prepared.

    How Cold Affects the Body and Heart

    Cold temperatures affect the body in many ways that can increase your heart attack risk. For example, cold causes the body’s blood vessels to constrict, or narrow, especially in the arms and legs. This is called peripheral vasoconstriction, and it’s a phenomenon that allows the body to conserve its core heat for as long as possible by restricting blood flow to the areas farthest from the heart. However, this constriction of the blood vessels causes your blood pressure to increase, which can put added stress on the heart, as it has to force blood throughout your body against higher pressure.

    Additionally, colder temperatures cause your blood’s platelets to stick together more than normal. While platelets typically clump together to form clots that help seal bleeding wounds, cold weather can increase your risk for a dangerous blood clot to form inside your body. Also, if you have a buildup of plaque (a hard substance made of fat, cholesterol, calcium, and other substances in your blood) in your arteries, the colder air could increase the risk of that plaque rupturing, which can lead to a heart attack.

    All of these factors cause your heart to work harder to pump the exact same amount of blood. Logically, that means people should scale back on their physical exertions during cold weather to take it easy on their hearts.

    The Risk from People’s Reactions to Cold Weather

    Unfortunately, many people actually increase their physical exertion in the cold, not decrease it, which can dramatically increase their heart attack risk.

    Much of the increased physical activity we see relating to cold weather comes from shoveling snow. Most folks don’t realize how stressful shoveling the driveway or walks will be, as their frame of reference is what they were doing in the yard last spring, summer, or fall. Shoveling is a deceptively extreme exertion that many people aren’t used to, especially if they’re not already exercising regularly or otherwise lowering their risk of heart disease. On top of this, most people are driven by completion of the task at hand rather than their body’s signals to rest and take a break. In just a couple hours of shoveling, some people can double or triple their usual daily activity levels.

    I attended medical school here at Georgetown, but did my post-graduate medical training in Rochester, N.Y.—an area that routinely sees more than 100 inches of snow during the winter. After a big snowstorm, my colleagues and I would often wonder if we would get a patient in the hospital who had suffered a heart attack after shoveling snow, and we often did. Essentially, if people aren’t getting much exercise on a regular basis, and then they’re shifting into high gear to shovel out driveways and sidewalks after a massive snowstorm, they’re putting their hearts through an extreme stress test. Unfortunately, in many cases, they’re failing that test by having heart attacks.

    #Cold temperatures make your #heart work harder to pump the same amount of blood. Scale back on #shoveling #snow and other cold-weather activities to protect yourself. https://bit.ly/2NtJmae via @MedStarWHC

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    One interesting item I noticed in the Swedeheart study was that there was a greater increase in heart attacks relating to cold weather in places where the weather changed from warm to cold. In places where it’s always cold, people seemed to tolerate it better, whether their bodies have adapted to the temperatures or whether they’ve adapted their behaviors to the weather.

    Whose Hearts are Most at Risk from the Cold?

    There are three main levels of heart attack risk relating to the cold and snow. The first level includes people who have been under a doctor’s care for some time for heart disease, heart failure, high blood pressure, high cholesterol, or other heart-related issues, as well as those who have had a heart attack in the past. I put these patients in the lowest risk level because, they’re taking care of themselves —that is, taking their medications, controlling their risk factors, and generally protecting themselves.

    The next level up includes people who have recently been diagnosed with heart problems and who are still working with their doctors to optimize their treatment plans. These patients are vulnerable because they may not have a risk factor fully controlled yet, such as their high blood pressure, which can skyrocket after a hard session of shoveling snow or other strenuous activity in the cold.

    The people who are at greatest risk are those who never see the risk coming. They’re the people who feel good at rest, but have unknowingly developed severe narrowing in an artery. If they decide to go shovel snow when it’s 20 degrees, the stress on their blood vessels can cause a blockage to rupture, and then they suffer a heart attack. That can be a life-threatening emergency, especially if they’re outside alone.

    How to Protect Your Heart from the Cold

    The best overall protection for your heart is to take steps to reduce or eliminate major risk factors for heart disease. These steps include:

    • If you smoke, stop: The Pulmonary Services department at MedStar Washington Hospital Center can help you quit
    • Get enough exercise: The American Heart Association recommends at least 2.5 hours of vigorous exercise per week, which works out to 30 minutes a day, five days a week
    • Eat a heart-healthy diet: Consume everything in moderation! Make sure you’re getting a variety of fruits and vegetables, whole grains, low-fat dairy, and other healthy choices, and limit red meats and sweets

    If you have high blood pressure and monitor your blood pressure numbers at home, watch your numbers after you’ve been active in the cold. Don’t let them rise too high without taking a break.

    While you’re in the cold, pay attention to what you’re doing and how tired you are. Make a conscious effort to limit your activity levels to less than what you normally would do in moderate or warm temperatures. If you must shovel snow, make sure someone knows where you are and can either share the workload or check on you from time to time.

    Finally, watch for symptoms that could indicate a heart attack. These symptoms can include:

    • Chest pain, discomfort, or pressure
    • Pain in other areas of the body, such as the back, neck, or jaw
    • Fatigue, lightheadedness, or dizziness
    • Nausea, indigestion, heartburn, or pain in the abdomen
    • Shortness of breath

    If you notice any of these symptoms, call 9-1-1 right away.

    Frigid weather can be dangerous for your heart. If you’re at risk for heart disease, get checked out by your primary care doctor or a cardiologist. And when the cold and snow strike, take it slow, don’t overexert yourself, and stay safe out there.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment

  • February 21, 2019

    By Stephanie Jacobs, MD

    The problem of obesity continues to grow in the U.S., which means more women are becoming pregnant while they are carrying excess weight. According to data from the March of Dimes, 22.8 percent of women of childbearing age in Washington, D.C., are obese.

    Just for women: Learn your personal risk for heart disease.

    Take our Quiz

    Pregnancy is a strain on the hearts of women who are at a healthy weight—obesity compounds these cardiovascular risks. However, cardiologists can help women reduce their risk for dangerous heart conditions before, during, and after pregnancy.

    Before Pregnancy: Proactive Heart Care for Women at Risk

    The best-case scenario is that women with obesity see a cardiologist before they become pregnant. We can start making a plan to reduce a woman’s risk for obesity-related heart disease during pregnancy well in advance, such as:

    • Adjusting the type or dosage of current medications
    • Nutritional guidelines to reduce the risk of heart disease, such as the DASH diet (Dietary Approaches to Stop Hypertension)
    • Regular cholesterol checks by their primary care doctor
    • Ways to reduce high blood pressure if necessary
    • Whether they’re active and, if not, how to start a heart-healthy exercise routine

    These healthy steps can reduce women’s risks for heart attacks and strokes before pregnancy places added stress on their hearts.

    Think of pregnancy like an elective surgery. Before scheduling your procedure, we would look at the guidelines for who is a good candidate and make adjustments to improve your chances of a good outcome before the day of your surgery. The same basic principle applies to pregnancy. A cardiologist can help you take healthy steps ahead of time to improve your chances of a healthy, lower-risk pregnancy for you and your baby before you ever become pregnant.

    During Pregnancy: What’s Normal and What Isn’t

    So many heart condition symptoms are easy to brush off as “normal” pregnancy symptoms, such as heartburn or fatigue. However, certain symptoms should be red flags that a woman’s heart health is at risk, particularly if she is obese.

    For example, it can be tough for pregnant women to catch their breath sometimes, and that can be normal, especially in the third trimester, with the growing baby pushing up against the lungs. But shortness of breath could be a sign of a pulmonary embolism—a potentially fatal condition—if it comes with the following symptoms:

    • Bluish skin around the lips or fingers
    • Chest pain
    • Rapid pulse

    A cardiologist can help women with obesity identify what is normal and when it’s time to get help. We provide guidelines to all obese women who are pregnant and at risk for potential heart problems that can be fatal for both mom and baby.

    #Pregnant women who also are #obese should talk to a #cardiologist about warning signs for potentially serious complications. https://bit.ly/2Nqv4Yh via @MedStarWHC
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    After Pregnancy: Continuing Heart Care for New Moms

    Unfortunately, the risks of obesity during pregnancy don’t necessarily stop once the baby is born. Moms who develop obesity-related heart conditions while they are pregnant often need help managing them after delivery. We are seeing more of these issues in the “fourth trimester,” or that critical time after pregnancy in which the body is transitioning to its new post-baby status.

    Depending on how serious a woman’s heart-related risks were during her pregnancy, a cardiologist is sometimes the first doctor she sees after leaving the hospital—even before she goes back to her Ob/Gyn for her six-week checkup. Gestational diabetes, a type of diabetes that develops during pregnancy, can cause dangerous complications for the heart. A 2017 study in the medical journal JAMA Internal Medicine found that women with a history of gestational diabetes during pregnancy had a 43 percent greater risk for heart attack or stroke over their lifetimes compared to women who never developed gestational diabetes. Women who had gestational diabetes during their pregnancies also are 10 times more likely to develop type 2 diabetes within 10 years after delivery, so it’s something many women have to consider long after their babies arrive.

    Peripartum cardiomyopathy, a rare form of heart failure, can develop during the last month of pregnancy or up to five months after delivery, and it can lead to decreased blood flow to the body’s vital organs. Obesity is a major risk factor for peripartum cardiomyopathy, and patients with severe cases might require a heart transplant or a left-ventricular assist device (LVAD).

    Women who develop peripartum cardiomyopathy can be some of the hardest for me to treat personally. Though it’s possible for us to manage the disease and help women live normal lives afterward, some women sustain such damage to the heart that we have to advise them against becoming pregnant again. When a woman has an idea of what her family will look like, and I have to tell her that her plans have to change, it can be devastating for her.

    The heart-related consequences of pregnancy can linger for a lifetime, particularly for women who are obese. With focus, drive, and support from a cardiologist, you can make the healthy lifestyle changes needed to protect your heart during and after pregnancy.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment

  • February 19, 2019

    By Toby Rogers, MD

    Aortic stenosis, a common condition in older adults, is caused by the progressive narrowing of the aortic valve, the main heart valve through which blood flows from the heart to the rest of the body. As the valve gets progressively tighter over time, people can begin to experience symptoms—especially when they’re walking or being active. The most common symptoms include:

    • Shortness of breath
    • Chest pain
    • Dizziness

    In the past, the only treatment for aortic stenosis was open-heart surgery, which involves putting patients to sleep, stopping their heart, making an incision in the chest, removing the old heart valve, and sewing in a new one. Now, a technique called transcatheter aortic valve replacement (TAVR), allows doctors to replace the narrowed heart valve through a small catheter inserted through the groin without the need for general anesthesia.

    Initially only available to people who were too ill to undergo open-heart surgery due to underlying health conditions of the kidneys, lungs, or liver for example, clinical trials have shown that TAVR is a good treatment for most—if not all—patients with aortic stenosis.

    LISTEN: Dr. Rogers discusses TAVR for aortic stenosis in the Medical Intel podcast.

    How TAVR Works

    TAVR begins with patients receiving sedation that makes them feel relaxed and sleepy. Doctors introduce the new heart valve through the artery in the groin and position it inside the heart, using X-ray and ultrasound to precisely position the new valve inside the old narrowed valve. Then, the new heart valve is implanted inside the old valve, opening and closing with every heartbeat.

    Because TAVR is less invasive than open-heart surgery, the recovery after TAVR is much faster. Patients typically go home in two to three days, compared to a week for surgery. Of course, every patient is different, however. Most patients go home to recover, but others may require rehab after the procedure to rebuild their physical strength.

    Related reading: TAVR is used for high-risk aortic stenosis patients. Why not everyone?

    A TAVR Success Story

    We saw one patient who had successful open-heart surgery 10 years prior to replace a valve. However, prosthetic heart valves don’t always last a lifetime, and his replacement heart valve started getting tight again. Initially, he was worried about the idea of undergoing open-heart surgery again—until he learned about TAVR. He underwent TAVR, received a new heart valve, and went home the next day. Today, he continues to be overjoyed with the results.

    People with #aorticstenosis, a narrowed or tight #heart valve, now can use #TAVR, a minimally invasive procedure that doesn’t require general anesthesia and is much less invasive than open-heart surgery. via @MedStarWHC

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    Preparing for TAVR does require patients to undergo a number of scans and tests, so doctors can carefully plan the procedure. We typically perform these tests a few weeks before the actual TAVR procedure. Most patients will come into the hospital the night before the procedure to ensure they are ready for surgery the next day.

    Expert Care at MedStar Heart & Vascular Institute

    The team of cardiologist and cardiac surgeons at MedStar Heart & Vascular Institute at MedStar Washington Hospital Center were part of the first wave of U.S. hospitals to perform TAVR more than 10 years ago. Today, our experts have performed almost 2,000 of these procedures. We’re also very active in research, which allows us to offer patients access to the latest treatments and technologies.

    In 2016, we received approval from the Food and Drug Administration (FDA) to launch the first-of-its-kind clinical trial in the United States to evaluate whether TAVR is a good treatment option for younger low-risk patients, who would currently be recommended to undergo surgery for aortic stenosis. The results of the trial, published online in last year’s Journal of the American College of Cardiology, showed no deaths or disabling strokes within 30 days of undergoing the procedure for 200 low-risk patients who participated in the study. These results provide a strong signal that is just a matter of time until TAVR is approved for general use.

    To determine if TAVR is right for you, call 202-877-3627 or click below to make an appointment with a heart valve specialist.

    Request an Appointment