Cardiac Care News and Events - Baptist Health System

Senior Aids for Seniors & Seniors with Dementia

Sun, 03 Aug 2008 00:00:00 GMT

Sleeping Aids for Seniors and Seniors With Dementia: Melatonin and Zolpidem

Poor sleep habits can have a negative impact on your thought process, heart health, and overall wellness. About 67% of US seniors reported difficulty in getting proper sleep. They are more likely to experience problems because of changes in medication, health issues, and lifestyle. Dementia disorders can also decrease sleep ability. Current sleep treatments include lifestyle changes, medication, and supplements. A common sleep supplement is melatonin. It is a hormone made in our brains that triggers our wake and sleep cycles. Pharmacological treatment and melatonin are common approaches to managing sleep issues, but there are safety concerns.

Two recent studies reviewed these approaches for elderly recipients. Researchers at the Sleep Medicine and Research Center at St John's and St Luke's Hospital reviewed the effects of a drug called zolpidem. In the study, published in the American Journal of Geriatric Psychiatry, zolpidem did show promising results in helping seniors achieve a more effective sleep. Researchers at the Netherlands Institute for Neuroscience reviewed the benefits of melatonin and the effect of environmental light in elderly with dementia. In this study, published in the Journal of the American Medical Association, melatonin did help with sleep but increased withdrawn dementia-related behavior. The results improved when given in combination with a bright light environment.

About the Studies

The zolpidem study was a randomized control study. It involved 205 patients aged 65-87 years. They were split into two groups. One group received zolpidem (6.25 mg extended release) every night. The second group received a placebo.

Baseline measurements were taken for both groups. At the end of 21 days, compared to the placebo group, the group that took the zolpidem reported:

24.01 more minutes in total sleep time
An average of one fewer awakenings per night
14.82 minutes more sleep before experience an awakening

In general, the zolpidem group reported a better overall sleep. Negative reports (eg, headache, dizziness, somnolence, nasopharyngitis) were about the same for both groups.

The melatonin study involved 189 elderly patients, 87% had dementia. All participants resided in assisted care facilities. The patients were randomly assigned to one of the following groups:

Melatonin and exposure to bright light
Melatonin and dim light exposure
Placebo and bright light
Placebo and dim light

Melatonin did help to improve onset of sleep and sleep duration by 27 minutes. However, it did cause unwanted side effects of increased withdrawn and depressive behavior in patients. The good news is the bright light therapy was linked to improvement of cognitive deterioration and depressive symptoms, and increased functional abilities and activities of daily living.

The combination of these two therapies seemed to produce the best results. There were decreases in nighttime restlessness, agitation, and aggression. The bright light environment seemed to counteract negative effects of the melatonin.

How Does This Affect You?

Adequate sleep is important to everyone's overall health. Sleep solutions need to complement any current medical support you may have. Although both zolpidem and melatonin with bright light therapies showed positive outcomes it is important to understand the possible side effects as well.

Pharmacological drugs and supplements can both have significant adverse effects. Research continues to understand the benefits and risks of both. This study has revealed a caution against using melatonin for dementia patients because of the negative side effects. Talk to your doctor if you or someone you are caring for is having difficulty sleeping. Together you can develop a plan that may include lifestyle changes or medical interventions.

RESOURCES:

American Family Physician
http://www.aafp.org/

National Sleep Foundation
http://www.sleepfoundation.org/

REFERENCES:

Riemersma-van der Lek RF, Swaab DF, Twisk J, et al. Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial. JAMA. 2008 Jun 11;299(22):2642-55.

Walsh JK, Soubrane C, Roth T. Efficacy and safety of zolpidem extended release in elderly primary insomnia patients. AM J Geriatr Psychiatry. 2008 Jan;16(1):44-57.

Last reviewed July 2008 by Larissa J. Lucas, MD

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Understanding Chest Pain

Wed, 20 Aug 2008 00:00:00 GMT

Free Seminar Explains the Many Causes of Chest Pain

Chest pain is a frightening symptom and one of the most common reasons people wind up in the emergency room. Many people believe chest pain means they are having a heart attack, but there are many causes of chest pain, only some of them serious. Dr. Dwarakraj Soundarraj will host a free seminar - "Understanding Chest Pain" on Tuesday, September 9th at Southeast Baptist Hospital. Attendees will learn the various causes of chest pain and what to do if they experience symptoms. Registration is required. Call (210) 297-3738 to reserve your seat.

Come to this free dinner seminar and learn how lifestyle changes can improve your health, and maybe save your life.�Led by Board-certified Cardiologist Dwarak Soundarraj, M.D.

When:
Thursday, September 9, 2008

Time:
5:30 p.m. Dinner
6:00 p.m. Presentation

Where:
Conference Room #2
Southeast Baptist Hospital
4214 E. Southcross
San Antonio, Texas 78222
Maps & Directions

Dr. Dwarak Soundarraj is a member in good standing of the medical staff at Southeast Baptist Hospital. Physicians are independent contractors who are neither employees nor agents of Southeast Baptist Hospital or of Baptist Health System and, as a result, Baptist Health System is not responsible for the acts of Dr. Soundarraj in his medical practice.

You Can Save a Life...Learn CPR

Wed, 16 Jul 2008 00:00:00 GMT

Parents, adults and children 12 years of age and older are invited to this FREE Cardiopulmonary Resuscitation (CPR) class, presented by the Harper's Embrace LifeSaver Program.

FREE!FREE!FREE!FREE!FREE!FREE!FREE!
Hosted by Baptist Medical Center
You must R.S.V.P. by October 15
Saturday, October 18
10 a.m. -1 p.m.

Baptist Medical Center, Cafeteria A & B
111 Dallas Street

Space is limited. Free parking at Dallas Street garage.

Register by phone at 210-804-4357 (HELP) or online at Harper's Embrace
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Harper's Embrace LifeSaver Program (H.E.L.P.) is committed to teaching
Cardiopulmonary Resuscitation (CPR), FREE, to people in all areas of San Antonio.
The H.E.L.P. courses are taught by CPR-certified volunteers providing you with
instructional and hands-on practice within a small classroom environment.

What Does Your Family History Mean For Your Health?

Wed, 30 Jan 2008 00:00:00 GMT

Try the latest online health tool- our new Family Tree Risk Calculator.� The calculator is designed to help you learn more about what impact the health of your family members can mean to your vascular health.

This tool was developed for educational purposes only and is not intended nor should be a substitute for medical advise.

Cardio Services at Baptist Medical Center

Tue, 29 Jan 2008 00:00:00 GMT

Baptist Medical Center offers quality cardiovascular care and�is considered the "heart" of San Antonio's healthcare system in downtown San Antonio.��

Baptist Medical Center Cardiac Services:

The first hospital in San Antonio to offer minimally invasive, robotically assisted cardiac capabilities.
A recently upgraded heart catheterization lab offering the latest in bi-plane, flat-screen imaging technology as well as dedicated rooms for post-surgical recovery.
The Vascular Institute of San Antonio
Baptist Medical Center has an Accredited Chest Pain Center designation by the Society of Chest Pain Centers.

It's no wonder that some of the best cardiologists in San Antonio treat their patients at Baptist Medical Center.

Learn more about Baptist Health System's Cardiovascular Services

111 Dallas Street
San Antonio, Texas 78205-1230
Maps & Directions

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Follow Your Heart To Baptist

Tue, 29 Jan 2008 00:00:00 GMT

Cardiovascular care is at the heart of what we do, and it's just one reason why so many families trust us to care for their loved ones.

We offer the following services:

Cardiac catheterization labs
Cardiac education services
Cardiothoracic surgery
Electrophysiology study capabilities
Non-invasive cardiology
Peripheral vascular surgery
Peripheral cardiovascular studies
Robotically-assisted heart surgery
Specialized intensive care and telemetry units

Chest Pain Center Accredited

The Society of Chest Pain Centers has granted the designation of Accredited Chest Pain Center to each of the five hospitals in the Baptist Health System. Baptist Medical Center, North Central Baptist Hospital, Northeast Baptist Hospital, Southeast Baptist Hospital and St. Luke's Baptist Hospital received full accreditation status from the Accreditation Review Committee on November 3, 2005.

They are the first, and currently only, accredited Chest Pain Centers in San Antonio, and are among fewer that 180 in the nation.

Learn more about our Cardiovascular Services

Follow Your Heart to St. Luke's Baptist Hospital

Tue, 04 Sep 2007 00:00:00 GMT

San Antonio's top cardiologists and cardiac surgeons trust St. Luke's Baptist Hospital with their patients, from minimally invasive, robotically assisted heart surgery to cardiac catheterization labs.

Cardiac Services

A state-of-the-art Cardiac Catheterization Lab providing the diagnosis and treatment of heart conditions.
Peripheral vascular surgery
Acute Rehabilitation Unit
Robotically assisted cardiac capabilities
St. Luke's Baptist Hospital has an Accredited Chest Pain Center designation by the Society of Chest Pain Centers.

St. Luke's Baptist Hospital has far exceeded emergency cardiac care standards with its 'Heart Alert' program. The national benchmark is 90 minutes from the time a patient suffering a heart attack arrives at the hospital to the time the patient's heart is reperfused in the cath lab. St. Luke's Baptist Hospital is averaging below 70 minutes, one of the best in San Antonio.

Learn more about Baptist Health System's Cardiovascular Services

St. Luke's Baptist Hospital
7930 Floyd Curl Drive
San Antonio, Texas
78229-3950
Maps & Directions

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Call (210) 297-7005 for more information.

Cardio Services at Northeast Baptist Hospital

Tue, 29 Jan 2008 00:00:00 GMT

The beautiful, modern Cardiovascular Center at Northeast Baptist Hospital offers excellence in cardiovascular care with comprehensive heart programs.

Cardiac Services:

A Cardiovascular Center dedicated solely to the prevention and treatment of heart disease and staffed by cardiac care health professionals.

64-slice Computed Tomography (CT) scanner technology that provides your physician a detailed visualization of the heart's arteries.

Northeast Baptist Hospital has an Accredited Chest Pain Center designation by the Society of Chest Pain Centers.

Northeast Baptist has far exceeded emergency cardiac care standards with its "Heart Alert" program. The national benchmark is 90 minutes from the time a patient suffering a heart attack arrives at the hospital to the time the patient's heart is reperfused in the cath lab.
Northeast Baptist Hospital is averaging 46 minutes: the best in San Antonio.

Learn more about Baptist Health System's Cardiovascular Services.

8811 Village Drive
San Antonio, Texas 78217-5440
Map & Directions

Call (210) 297-7005 for more information.

What is a Heart Valve Replacement?

Tue, 11 Mar 2008 00:00:00 GMT

Definition

This is a surgical procedure to replace a damaged heart valve. The heart's four valves, which open and tightly close, allow blood to flow from one chamber to another and also allow blood to leave the heart through the large blood vessels. Usually only one valve is replaced at a time, but at times one or more valves have to be replaced. Heart valves are either mechanical (metal and plastic), such as a St. Jude valve, or made of tissue. Tissue valves most commonly come from a pig (porcine valve) or a cow (bovine valve), but they may also be supplied by a human donor or even manufactured from your own tissues.

Aortic Valve Replacements: Mechanical vs. Tissue

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Parts of the Body Involved

Heart and chest

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Reasons for Procedure

This procedure is done to repair:

Congenital valvular defects
Narrowed, stiff valves that obstruct the free flow of blood
Loose, leaky valves that allow blood to flow the wrong way through the heart
Infected heart valves
Infected or diseased tissue or mechanical valves

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Risk Factors for Complications During the Procedure

Pre-existing heart or lung condition
Advanced age
Recent or chronic illness
Stroke
Kidney or liver failure
Recent infection
Poor dental care

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What to Expect

Prior to Procedure

Your doctor will likely do the following:

Physical exam
Echocardiogram-a test that uses sound waves to visualize functioning of the heart, including the valves
X-ray-a test that uses radiation to take a picture of structures inside the body
Electrocardiogram (ECG, EKG)-a test that records the heart's activity by measuring electrical currents through the heart muscle
Cardiac catheterization (possibly)-the insertion of a tube-like instrument into the heart through an artery (usually in the leg) to detect problems with the heart and its blood supply. It can also accurately define the valve problem.
Have blood ready for surgery

In the days leading up to your procedure:

Do not take aspirin or other anti-inflammatory drugs for two weeks before surgery, unless told otherwise by your doctor.
Stop all blood thinners a week before surgery.
See a dentist and get your teeth checked out.
Arrange for a ride to and from the hospital.
Arrange for help at home after returning from the hospital.
The night before, eat a light meal and do not eat or drink anything after midnight, unless told otherwise by your doctor.

During Procedure

IV fluids, oxygen, anesthesia, and diversion of blood circulation through a heart-lung machine

Anesthesia

General

Description of the Procedure

The surgeon cuts through the skin and breastbone, opens the chest, and connects your heart to a heart-lung machine. This machine takes over the functions of the heart and lungs during the operation.

The surgeon stops the heart, makes an incision, and removes the damaged valve. The new valve is stitched into place and checked to make sure it opens and closes properly. The incision in the heart is closed and the heart restarted. Once the heart is working fine, you will be removed from the heart-lung machine and your chest will be closed with wires. The skin will be closed with absorbable sutures.

After Procedure

You'll be closely monitored in the intensive care unit with the help of the following devices:

Heart monitor
Breathing tube until you can breathe independently, then an oxygen mask
Chest tubes to drain accumulated fluids from the chest
A line into an artery in your arm to measure pressure
A tube through your nose and into the stomach (a nasogastric tube) to keep the stomach drained of accumulated fluids and gas
Bladder catheter

How Long Will It Take?

3-5 hours, depending on how many valves are being replaced

Will It Hurt?

Anesthesia prevents pain during surgery. You may experience some pain during recovery, but will be given pain medication to relieve the discomfort.

Possible Complications

Infection
Blood clots around the valve, which can cause a stroke, kidney damage, or damage to the extremities
New valve does not work properly
Sac around the heart may become inflamed and painful
Excessive bleeding
Pneumonia
Phlebitis (blood clots of a vein)
Anesthesia-related problems
Infection of breast bone
Death

Average Hospital Stay

2-5 days-The first day is usually spent in an intensive care unit. Over the next few days, all the lines and tubes are removed. As you start to walk and eat a regular diet, you may be sent for rehabilitation therapy

Postoperative Care

Breathe deeply and cough 10-20 times every hour.
Two to three days after surgery, you may be able to walk with help.
You may be started on anticoagulant medications (blood thinners) to prevent blood clots from forming around the valve. If you have a tissue valve, you will not require a blood thinner after surgery. But, if you have a mechanical valve, you will be placed on a blood thinner for the rest of your life.
Only take medications approved by your doctor.

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Outcome

The surgical site in your breastbone heals in 4-6 weeks. Once recovery from the surgery is complete, you should be able to return to your normal activities.

Depending on the type of valve you receive, you may need to take anticoagulant medication for the rest of your life. You will need to take antibiotics before some dental and surgical procedures to decrease the risk of infection.

�

Call Your Doctor If Any of the Following Occurs

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Cough, shortness of breath, chest pain, or severe nausea or vomiting
Coughing up blood
Rapid heart rate
Sudden headache or feeling faint
Problems with vision or speaking
Numbness or weakness on one side
Inability to urinate
Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain

�RESOURCES

American Heart Association
http://www.americanheart.org/presenter.jhtml?identifier=1200000

National Library of Medicine
http://www.nlm.nih.gov/

�CANADIAN RESOURCES

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/Page.asp?PageID=24

University of Ottawa Heart Institute
http://www.ottawaheart.ca/UOHI/Welcome.do

REFERENCES:

Cecil Textbook of Medicine. 21st ed. WB Saunders Co, 2000.

Society of Thoracic Surgeons website. Available at: http://www.sts.org/.

Cardio Services at North Central Baptist Hospital

Tue, 04 Sep 2007 00:00:00 GMT

The Cardiovascular Center at North Central Baptist Hospital brings you highly trained physicians, compassionate nurses who specialize in cardiac care and state-of-the-art technology.

In our Accredited Chest Pain Center our emergency room staff have been specifically trained to evaluate, diagnose and treat chest pain quickly, saving time and lives.

The Cardiovascular Center at North Central Baptist Hospital also provides:

2 new interventional cardiac catheterization labs for diagnosis and treatment of artery blockage
New 10-bed Cardiac Intensive Care Unit
New 31-bed Progressive Cardiac Care Unit
New 9-bed Outpatient Cardiovascular Care Unit
New state-of-the-art operating suite dedicated to open heart surgery
Cardiac education to help you with your treatment plan after you leave the hospital

When chest pain strikes, the Cardiovascular Center at North Central is here to provide your family with high quality care.

Learn more about Baptist Health System's Cardiovascular Services

North Central Baptist Hospital
520 Madison Oak Drive
San Antonio, Texas 78258-3912
Maps & Directions

Call (210) 297-7005 for more information.