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  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

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  • 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

  • February 15, 2019

    By Allen J. Taylor, MD

    Heart disease is the No.1 cause of death in the U.S.—so plenty of traditional prevention tips exist, ranging from the Mediterranean diet  to exercising regularly. However, a 2019 study published in the Journal of the American College of Cardiology (JACC) suggests that getting enough quality sleep also should be a priority.

    People who uninterruptedly sleep between seven and eight hours had overall healthier heart profiles compared to those who slept less than six hours a night, according to the study. Let’s discuss how the study was done, more results that it found, and ways you can improve your sleep.

    What the Data Say

    The study examined nearly 4,000 bank employees in Spain who were an average of 46 years old and had no history of heart disease. The participants were divided into four groups based on their sleep duration:

    • Less than six hours
    • Six to seven hours
    • Seven to eight hours
    • More than eight hours

    All participants wore an actigraph, a small device that continuously measured the length and quality of sleep for seven days, and then underwent 3D heart ultrasound and cardiac CT scans to look for heart disease.

    When traditional heart disease risk factors were considered, participants who slept less than six hours were 27 percent more likely to have atherosclerosis throughout the body compared to those who had high-quality sleep for seven to eight hours. Atherosclerosis is the buildup of fats, cholesterol, and other substances in the artery walls, which can restrict blood flow, causing serious problems, including heart attack, stroke or even death. Meanwhile, individuals who had poor-quality sleep—because they woke up during the night or moved a lot during sleep—were 34 percent more likely to have atherosclerosis compared to those who had a good night’s sleep.

    People who slept less than 6 hours a night were 27% more likely to have #atherosclerosis than those who report high-quality #sleep for 7 to 8 hours, according to a new study published in @JACCJournals. bit.ly/2GLjYeM via @MedStarWHC @TaylorMHVIcard

    Click to Tweet

    People who reported poor sleep quality also were more likely to be associated with most heart disease risk factors, the study found, which suggests that sleeping poorly might be a signal that other areas of your heart health could use attention. These risk factors include:

    • Bad cholesterol levels, or high LDL (bad cholesterol) and low HDL (good cholesterol)
    • Being overweight
    • Drinking alcohol
    • High blood pressure
    • High blood sugar
    • More inflammation in the body
    • Smoking cigarettes

    Tips to Improve Sleep

    The first step people can take to improve their sleep is continuously measuring it, so that they know how often it is getting interrupted. Several at-home options exist, such as using an Apple watch, Fitbit, Polar Sleep device, or certain phone apps. Seeing sleeping patterns first-hand helps people understand how much quality of sleep they truly get, as what they perceive as good sleep isn’t always so.

    Some other ways to improve sleep quality include:

    • Avoid drinking too much before bed: Having to get up and go to the bathroom in the middle of the night interrupts your sleep
    • Avoid sleep aids: These can help people sleep better for a few nights, but data show that, in the long run, they often reduce high-quality sleep
    • Don’t drink coffee before bed: Coffee can cause sleep disturbance, so I always suggest that patients avoid consuming it three to six hours before bed
    • Have the room at a comfortable temperature: Somewhere around 67 degrees is a good temperature to sleep—it’s important to avoid getting too hot or cold at night
    • If you snore, talk to your doctor: Regularly snoring is a symptom of sleep apnea, which consistently disrupts sleep
    • Limit noises: Even a loud heater or clanking radiator could be hurting people’s sleep without them knowing it

    Do you have any strategies that help you get a good night’s sleep? Tell us about them on our Facebook or Twitter page.


    As poor-quality sleep is associated with higher heart disease risk, it’s important that individuals aim to consistently get a good night’s rest. And never trust your own judgment for how good your sleep is—that’s what the measuring devices are for.

    Are you worried about how your lack of sleep may be affecting your heart health?  Call 202-877-3627 or click below to request an appointment with a cardiologist.

    Request an Appointment

  • February 14, 2019

    By Stephanie Jacobs, MD

    The world of medicine has historically been dominated by men. But an August 2018 study published in the Proceedings of the National Academy of Sciences suggests that women who have heart attacks might have better outcomes when they are treated by female doctors. Researchers examined data on patients who were admitted to Florida hospitals with heart attacks between 1991 and 2010. They found a lower mortality rate among female patients who were admitted by female emergency department (ED) doctors as compared to male doctors.

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

    Take our Quiz

    Studies like these often raise questions in the minds of readers and prospective patients:

    • Are female doctors more in tune with how heart disease can affect women?
    • Are male doctors not aware of female patients’ needs?
    • Should women request female doctors?

    While valid concerns, these findings don’t address the major factors involved with women’s emergency heart care outcomes from female or male doctors. It’s not a battle of the sexes. The outcomes for women who have heart attacks depend on a number of factors, including an understanding of women’s heart attack symptoms, the team of providers involved, the trust women have in their doctors, and the culture of knowledge-sharing among doctors.

    A Modern Understanding of Heart Attack Symptoms in Women

    One big problem I have with this study is that doctors today have a better understanding of women’s heart attack symptoms than we did in the 1990s. We have all seen men in movies or TV shows who clutch their chest and fall to the ground with a heart attack, but women might have more subtle symptoms, such as:

    • Back, chest, or abdominal pain or pressure
    • Dizziness, lightheadedness, or fainting
    • Fatigue
    • Shortness of breath

    I suspect that if the same study were repeated with doctors today, researchers would get much different results. More doctors nowadays are trained in women’s heart attack symptoms, as well as what a patient’s symptoms might point to if they aren’t having a heart attack.

    A limitation of this study is that they only studied ED doctors. Without a doubt, ED doctors are crucial in emergency cases such as heart attacks. Their experience is key in deciding if a patient is rushed into emergency surgery, admitted to the hospital for observation, or sent home with orders to follow up with their regular doctor.

    But the ED doctor is only one person involved in a patient’s care. If the patient is admitted, they might see a number of medical professionals, including:

    For example, a patient in her 40s came into the ED who was obese and had Type 1 diabetes. She complained of pain she described as indigestion—a symptom that could indicate a heart attack. Her test results were not very unusual, so the male ED doctor called me to come take a look. The patient’s body language when she experienced chest and stomach pain right in front of me absolutely resembled a heart attack. I called the interventional cardiologist on duty, a male, and suggested additional testing so we could know for sure. It turned out the patient had a 90 percent blockage in one of her arteries, reducing blood flow to the heart, which could have been life-threatening. But thanks to our teamwork, the patient recovered the next day with no damage to her heart.

    Women who are having a #heartattack can have much different symptoms than men. A team approach to #hearthealth is critical for good outcomes. https://bit.ly/2If8BOC via @MedStarWHC
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    And women also are more aware of the symptoms of a heart attack and their own risk factors. That’s due at least in part to awareness campaigns started within the last two decades. In fact, in February 1997, MedStar Washington Hospital Center launched one of the nation’s earliest campaigns to educate women – and their doctors – about the fact that heart disease affects both men and women. The hospital’s initiative gained national attention by shining a light on a widespread lack of understanding of heart disease in women, particularly among primary care physicians, and by raising awareness of women’s often subtle heart disease symptoms.

    Then, in the early 2000s, the American College of Cardiology began to spread awareness of the fact that heart disease, including heart attack, are the No. 1 killer of both men and women in the U.S. And in 2004, the American Heart Association created its Go Red for Women campaign to raise awareness of women’s risks for heart disease and strokes. MedStar Cardiology Associates doctors are actively involved with the Go Red for Women campaign.

    It’s vital for doctors to know the science behind treating a woman who’s having a heart attack. But equally important is the relationship doctors and patients have with one another.

    The Importance of the Doctor-Patient Relationship

    Just like any personal or professional relationship, a good doctor-patient relationship depends on key factors:

    • Mutual respect
    • Open communication
    • Similar goals

    The medical profession used to be very patriarchal. The doctor gave a diagnosis and treatment plan, and the patient complied. Now, the relationship ideally is more about shared decision-making. We have a conversation about your concerns and symptoms, test to confirm or eliminate theories, and decide together the best course of action. Providers who haven’t updated how they relate to patients can be very off-putting to anyone—not just women.

    In the outpatient setting, patients can select a doctor based on the traits that matter to them. You can search for a particular cardiologist at MedStar Heart & Vascular Institute based on a number of factors, including:

    • Gender
    • Language(s) spoken
    • Specialty

    I have patients who prefer to see a female doctor. There are patients who prefer to see a male doctor, and I don’t take that personally. The important thing is that you see a doctor to whom you can relate. If you don’t, you may be less likely to be honest about your symptoms or listen to their recommendations.

    The Heart of the Matter: Share What Works

    My great worry about studies like the one of the Florida ED doctors is that women will say, “I only want a female doctor to see me,” when they are really saying they want a doctor who will listen to them, communicate, and practice evidence-based medicine.

    At MedStar Cardiology Associates, we identify the qualities that could lead female doctors to better outcomes with female patients and employ doctors who naturally exhibit those qualities and teach them to those who don’t. Because of this approach, we have doctors of many genders, ages, and ethnicities who work together in patient care. This diversity helps us share knowledge and learn from one another, which ultimately benefits our patients.

    In fact, the idea of continual learning and sharing knowledge was measured in the study of the Florida ED doctors. The researchers noted that female patients had better outcomes when treated by male doctors if those doctors either treated more female patients or worked with more female doctors. Experience levels, rather than gender differences, are key in female patients’ outcomes after a heart attack.

    Women, Take Care of Yourselves

    As a mother of five children, I understand that women often take on the role of the family caregiver. We get caught up in caring for our families, providing for a sick or elderly friend, or any of a thousand things we have to balance every day. When something’s wrong with ourselves, we might say, “I don’t have time for that now. If it still hurts tomorrow, I will go get checked out.”

    But heart attack symptoms can’t wait until tomorrow. And when seconds count, follow your instincts and get help right away. Your doctor, male or female, will provide the emergency care you need.

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

    Request an Appointment

  • February 13, 2019

    By MedStar Health

    Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs) are on the rise in the United States. According to 2018 data from the Centers for Disease Control and Prevention (CDC), STD cases have spiked each year from 2013 to 2017.

    We see patients of all ages at MedStar Health who have STDs—some of whom visit us specifically for an STD test, while others have symptoms that lead us to test for STDs. The primary reasons individuals get STDs include:

    • Being with a new partner
    • Having multiple partners
    • Having a history of STDs, resulting in a higher likelihood to later develop a new STD

    STDs often have no symptoms and can have serious consequences, especially if left untreated. As a result, it’s important that people know and understand what the most common STDs are, understand ways to prevent them, and get tested regularly if they are sexually active.

    Being with a new partner, having multiple partners, and having a history of STDs increase your risk of getting an #STD. Learn which are the most common and why treatment is important via @MedStarHealth
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    The Most Common STDs

    Below is an overview of the STDs that we see the most—in no particular order—and the risk of leaving them untreated.

    1. HPV

    HPV is the most common STD in the U.S., affecting about 79 million Americans—most of whom are in their late teens and early 20s. In about 90 percent of cases, HPV goes away on its own and has no symptoms. But in rare cases, it can cause health problems such as genital warts and cancers, including cervical cancer and cancers involving the penis, vulva, vagina, anus, or back of the throat.

    1. Chlamydia

    Chlamydia is a type of bacteria that typically affects the genital area, anus, eyes, and throat. While most people with chlamydia don’t have symptoms, they can experience:

    • An increase in vaginal discharge
    • Pain when urinating
    • Pain during sex
    • Pelvic pain
    • A white, cloudy discharge from the penis
    • Pain or swelling in the testicles

    Chlamydia affects a reported 1.7 million men and women each year in the U.S., nearly half between the ages of 15 and 24. If left untreated, chlamydia can lead to chronic pelvic pain for women and make it difficult or impossible to have children.

    1. Gonorrhea

    Gonorrhea affects about 820,000 new people each year in the U.S., 570,000 of whom are between the ages of 15 to 24. Gonorrhea occurs when bacteria infects the mucous membranes of the mouth, throat, eyes, rectum, and reproductive tract (the uterus, fallopian tubes, and cervix in women, and the urethra in women and men). Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner.

    In most cases, gonorrhea has no symptoms. When left untreated, the disease can spread to the uterus fallopian tubes in women and cause pelvic inflammatory disease. In rare cases, it can lead to infertility in men and miscarriage or preterm labor in pregnant women.

    1. Trichomoniasis

    Trichomoniasis is caused by infection with a protozoan parasite called Trichomonas vaginalis. The parasite spreads from one person to another during sex. Most people with trichomoniasis, which affects about 3.7 million Americans, are asymptomatic. However, when symptoms do arise, they can include:

    • Discomfort with urination
    • A change in vaginal discharge
    • Itching or irritation inside the penis
    • Discharge from the penis

    In some cases, trichomoniasis can cause genital inflammation, which increases an individual’s chances of getting infected with HIV. If left untreated, trichomoniasis can last for months or years.

    1. Syphilis

    Syphilis is an STD that causes round, painless sores on the genital area, anus, and sometimes on the lips and mouth. If left untreated, syphilis can lead to serious problems, such as brain damage, paralysis, and blindness.

    1. Herpes

    Herpes comes in two forms: genital and oral. In each case, herpes causes you to develop blister-like red sores on the skin, which can be spread through sexual contact, kissing, or sharing cups. In many cases, it takes anywhere from one to three weeks for sores to begin appearing. Oral herpes affects more than 50 percent of Americans, while about 12.5 percent of people ages 14 to 49 have genital herpes.

    While the biggest problem we see in patients who have untreated herpes is pain, open sores also can lead to an increased risk of other infections.

    1. HIV/AIDS

    HIV is a virus that hurts your immune system by destroying cells that fight disease and infection. As a result, you become more prone to develop infections and certain cancers. HIV, which affects about 1.1 million Americans, eventually leads to AIDS after many years, although medication can significantly slow the process. HIV typically spreads through unprotected sex or by sharing drug needles. It can take years for symptoms to arise, which can include:

    • Fatigue
    • Flu-like symptoms
    • Swollen glands

    Since HIV develops into AIDS more quickly when left untreated, symptoms can become more severe and the risk of developing life-threatening infections and cancers increases.

    Diagnosing and Treating STDs

    Because so many STDs exist, there are a variety of ways to test for them. However, in most cases, we can make a diagnosis by examining a patient’s:

    • Blood work
    • Penile or vaginal discharge
    • Urine

    It’s imperative that patients who are sexually active get screened for STDs regularly. In many cases, getting screened once per year for all STDs is a good idea. You can view guidelines from the Centers for Disease Control and Prevention (CDC), which suggest how often you should get screened for common types of STDs. Make sure to speak to your primary care doctor to create a screening plan that makes sense for you.

    In most cases, STDs can be cured with medication—especially in the early stages. However, certain kinds of HPV, genital herpes, and HIV can be managed but not cured. Make sure to have a discussion with your doctor about which treatments would work best for you, if you’re diagnosed with an STD.

    Preventing STDs

    The most reliable way to prevent STDs is to be in a long term mutually monogamous relationship with an uninfected partner, or to abstain from sexual activity. Avoiding injection drugs also is important, as certain STDs, such as HIV, can be transmitted through the use of needles.

    As STDs are on the rise, there’s no better time to begin implementing prevention strategies and undergoing more frequent screenings, if necessary.

    Have you been tested lately for sexually transmitted diseases? If not, stop by one of our 14 MedStar Health Urgent Care locations. Click below to find out more and check in online for an appointment.

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  • February 12, 2019

    By Valeriani R. Bead, MD

    Relaxing is an important part of life—even for the heart. When the heart has trouble relaxing between beats, the left chamber (left ventricle) can’t completely refill with blood. This results in higher pressure in the heart, fluid build-up in the lungs, thickening of the ventricles, and ultimately, diastolic heart failure.

    Diastolic heart failure is responsible for about two-thirds of the heart failure cases. Some of the most common symptoms of diastolic heart failure include:

    • Fatigue
    • Irregular or abnormal heartbeat
    • Lightheadedness or fainting
    • Shortness of breath

    Although diastolic heart failure isn’t curable, treatment can help relieve symptoms and improve the way the heart pumps. In fact, we’ve treated patients who went from being extremely fatigued and unable to exercise to regular physical activity in less than a year.

    LISTEN: Dr. Valeriani Bead discusses diastolic heart failure in the Medical Intel podcast.

    How is Diastolic Heart Failure Diagnosed?

    To make a diagnosis, a cardiologist has a conversation with a patient about their symptoms and follows it up with a physical exam. An echocardiogram, or an imaging test that shows a visual image of the heart, meanwhile, might be needed to rule out other conditions, as well as a stress test to show how blood is flowing through the heart during exercise.

    Blood tests or a cardiac catheterization procedure—when a thin tube is inserted into the heart to see how it’s functioning— also is needed at times to determine whether a patient’s arteries have any blockages or to examine cholesterol levels.

    How is Diastolic Heart Failure Treated?

    Treatment for diastolic heart failure always begins with lifestyle modifications, such as quitting smoking, increasing physical activity, and having a healthy diet. We then offer treatment to control factors that can contribute to stiffening of the heart, which includes high blood pressure, diabetes, and high cholesterol.

    The medications we use include:

    • Beta blockers, which slow the heart rate to allow it to function better
    • Calcium channel blockers, which help reduce the stiffness of the heart
    • Diuretics, which help reduce fluid accumulation. If those medications aren’t sufficient, sometimes we’ll recommend surgery to open blocked or narrowed blood vessels.

    Lifestyle modifications are first-line treatment for diastolic #heartfailure, says Dr. Valeriani Bead. Discover what other treatments can help patients relieve symptoms. https://bit.ly/2IctR7M via @MedStarWHC #HeartMonth

    Click to Tweet

    A treatment success story

    One middle-aged patient we treated was experiencing shortness of breath, which prevented her from doing her Zumba exercises. When she experienced swelling in her legs and a “flooding” sensation in her heart, she decided to seek medical attention.

    After she told us about her symptoms, she underwent an electrocardiogram (EKG), which showed an abnormal heart rhythm. Her lungs were clear and her heart sounded good (with the exception of a few skipped beats), but her blood pressure was too high. As a result, we prescribed medications to control her blood pressure and reduce the fluid in her legs, and we discussed following a healthier diet.

    When she saw us a couple of weeks later, we did an echocardiogram of her heart. It showed that her heart was strong; however, by using certain diagnostic techniques, we could tell that it was becoming a little stiff and thick from her long-standing high blood pressure. As the patient continued taking her medications and eating a healthier diet, her heart began to heal. She was back to doing Zumba in just eight weeks, and after six months, she was teaching Zumba classes!

    Who is Most at Risk for Diastolic Heart Failure?

    Individuals who are at a higher risk for diastolic heart failure include people 65 and older, women, and people with:

    • Clogged arteries: When arteries are clogged, blood flow to the heart can be impacted.
    • Diabetes: The disease is thought to lead to stiffening of the heart because of excess glucose in the blood that “starches” the heart muscle.
    • Heart valve problems: If the aortic valve narrows, the left ventricle may thicken or harden.
    • High blood pressure: Chronic hypertension increases pressure in the left ventricle.

    MedStar Heart & Vascular Institute offers cardiology patients advanced care in a compassionate environment. We provide treatments that are supported by clinical trials and the latest information in the medical field. Additionally, patients with diastolic heart failure and other specific conditions have the benefit of seeing a wide range of specialists who treat these conditions every day.

    Symptoms of diastolic heart failure can be easy to overlook at times. However, seeking medical attention is critical in order to receive the proper treatment.

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

    Request an Appointment

  • February 08, 2019

    By MedStar Health

    Good physicians learn a great about their patients’ condition through observation, and skin is often the most revealing attribute of all.

    “Dermatology is sometimes called an ‘old-school’ field, because you rely a lot on visual examinations to make a diagnosis,” explains Sanna Ronkainen, MD, a board-certified dermatologist at MedStar Washington Hospital Center and MedStar Georgetown University Hospital. “But skin can also provide valuable clues about what else is going on in the body.”

    Collaboration is Key

    Along with treating common conditions such as psoriasis and eczema, Dr. Ronkainen frequently collaborates with colleagues in other disciplines, to care for patients whose skin may be affected by HIV, infectious diseases, and malignancies such as cutaneous lymphomas.

    “I get to be involved with a patient throughout the course of treatment,” she says. “I always enjoy following their progress, even after my role is pretty much complete.”

    Why Medicine?

    The opportunities for professional and patient interaction helped steer the Washington, D.C., native toward a career in medicine.

    "I liked science, but couldn’t see myself working in a lab most of the time,” Dr. Ronkainen recalls.

    After graduating from Georgetown University School of Medicine, she completed her internal medicine/dermatology residency at the University of Minnesota, where she was the program’s chief resident. The opportunity to return home in 2018 was too good to pass up.

    “I love D.C., and liked the Hospital Center, its range of services, and the broad patient population,” she says. “It also helped that my husband is a neurology resident here.”

    Exciting Year Ahead

    This coming year will be particularly eventful for Dr. Ronkainen. Along with the arrival of her first child, she’ll help launch a new Hospital Center clinic that integrates dermatology and oncology services for cutaneous lymphomas.

    "The two areas frequently overlap,” she says. For example, certain cancer treatment regimens have skin-related side effects.

    "As we take on cases, we hope to collect data for researching the effectiveness of specific treatments to counteract those effects, and improve the patients’ quality of life,” she adds.

    These new professional and family responsibilities will likely sideline Dr. Ronkainen from indulging in her passion for travel, which has included exploring her family’s Finnish roots, and those of her husband in England, and caring for patients in Botswana, under a Resident International Grant from the American Academy of Dermatology.

    What won’t change, though, is being able to interact with and help patients.

    “There’s nothing better than seeing them after a few months, and hearing how happy they are with the improvement in their skin condition,” Dr. Ronkainen says.