Tag Archives: Heart Disease


PHM0515PF11SCAD stands for Spontaneous Coronary Artery Dissection, a form of heart disease that is rare but is the cause of heart attacks in younger women, pregnant women, and women you are not a typical risk for heart disease.

After Robert’s wife died from the condition, he became a supporter of research into this little known topic and as a result, they are starting to get funding and research that is shedding light on this condition.

Read more about Robert’s efforts and the latest research on this topic, covered in Phoenix Magazine>>>>>HERE<<<<


medications-342487_1280 copyNSAID medications are commonly prescribed and used as over-the-counter pain relief treatments.

Non Steroidal Anti Inflammatory Drugs are non-aspirin pain relievers that include over-the-counter Advil (Ibuprofen), Aleve (Naprosyn), and a host of prescriptions medications like Celebrex, Voltaren (Diclofenac), and long list of additional medications in this class.  Aspirin, although technically in this grouping, is excluded, as is Tylenol (Acetominophen).  The entire list is >>>>HERE<<<<

Ever since the early 2000’s, when Vioxx was removed from the US due to a connection with increased heart attack risk, the entire group of these NSAID medications has come under scrutiny for the risks they may pose for the heart and blood vessels.   Many studies have been done, primarily looking at large data sets in retrospect, and they have concluded the following, which are the important ‘take home’ points:

1.  NSAID medications do statistically increase the risk of heart attack when used regularly, even for a short time (a week or more)

2.  Some NSAID medications appear to pose lower risk (Aleve/Naprosyn….lowest risk).   Celebrex and Diclofenac appear to be higher risk in this group.

3.  NSAID medications should only be used if they provide significant clinical benefit, and should not be taken routinely if they are of questionable value.

4.  Combining NSAID medications with aspirin will reduce the heart risks involved, but does lead to an increase in stomach ulcers.  Prevention strategies with PPI medications (Prilosec and similar) is worth considering if this combination is used.

Read more >>>>HERE<<<<   &  >>>>>HERE<<<<



robert alicoRobert Alico is a patient of ours who is making a difference through his commitment to  fund research into an little known condition called SCAD …Spontaneous Coronary Artery Dissection.   Through his effort, Robert has been begun this much needed discussion, brought about awareness, and provided funds to promote research.   Below….is his open letter to the Scottsdale Community and our patients:


SCAD Research, Inc. is a Scottsdale based 501 (C) (3), non-profit that is incorporated in Arizona, however, it is helping patients and doctors all over the world.

SCAD stands for Spontaneous Coronary Artery Dissection, which is a cause of heart attack and death.

SCAD occurs at a ratio of about 80% women and 20% men. It is the number one cause of heart attack in pregnant women and the number one cause of heart attack in women age 40 and under. Heart attacks caused by SCAD have also increased in frequency in women during menopause.

Not long ago SCAD was unofficially known as “ sudden death heart attacks “ because approximately 50% of SCAD heart attack sufferers die from their first SCAD heart attack.

SCAD Research, Inc. was started by Scottsdale resident Bob Alico and his family after the death of his wife Judy, at age 51 and with no known risk factors for heart attack, to SCAD on January 4, 2011.   After Judy’s passing, Bob and his family set out to find out about the causes of SCAD and to join any efforts to bring awareness and funding to research into the causes, treatment and possible cure for SCAD.   Judy’s family did not want any other family to suffer the way they did from this virtually unknown, under diagnosed and virtually unknown and definitely undetectable cause of heart attack and death.

In their family’s search it was found that the most current and advancing research into SCAD was being done at Mayo Clinic in Rochester, MN, under the direction of cardiologist Dr. Sharonne Hayes. After several phone conversations with Dr. Hayes, Judy’s family started SCAD RESEARCH, INC. and it was decided that they would work to bring awareness and much needed funding to the most promising SCAD research they could find and that was at Mayo Clinic in Rochester, MN.

Since funding started to be sent to Dr. Hayes and her research team discoveries have started to occur, albeit small in comparison to the large population affected, none the less progress is being made. Just one example is that we now know that we have SCAD heart attacks that have occurred in people as young as 18 years old and up to 80 years old. Last year we had a 19 year old female go into instant cardiac arrest on a ski hill in Colorado just after Christmas, 2013. With the help of the local ski patrol, hospitals in Vail and Aurora, Colorado, and electronic communications with Dr. Hayes at Mayo, Rochester, as a result this young college student survived this SCAD heart attack. SCAD reoccurs in about 17% of all SCAD patients.

The photo of the check you see was the 2014 donation to Mayo Clinic, Rochester, MN, from SCAD RESEARCH, INC. and to date the nonprofit has donated over $135,000.

You can find out more about SCAD RESEARCH, INC. by going to www.scadresearch.org and you can find it on FaceBook, if you do please give it a “ like. “


1904009001_37_13_350No…not the Green Bay Packers that Barb and all of our Wisconsiners love so much…it’s Milton Packer, MD.

Dr. Packer is a renowned researched on heart failure, a disease in which the heart cannot pump effectively to provide circulation throughout the body.  He, and a team of scientists at Novartis have developed a combination medication that provides at 20% improvement over current medication approaches.   That is a major advance and amounts to a huge statistical improvement in both quality of life, and prevention of death and hospitalization.

The medication will be available in 2015 if goes as planned with the FDA.  Expected to be pricey, coverage is virtually assured by insurance and Medicare, given the cost savings that will arise from reduced hospitalization for heart failure, the most costly disease among Medicare-age patients.

Read more >>>>>>>HERE<<<<<.


apple cutI think I’m like most people….in that I have a feeling about most of the foods I eat.   What I mean by that is not….oh, this is tasty….but rather that I have a feeling about whether I’m eating healthy or not.  If I eat a burger….I feel like ‘that’s not good for me’, while if I eat some oatmeal….I feel…”I’m being healthy.”

Our relationship with food is a curious one, and to be honest, I suspect most people in the U.S. have issues with their food choices much of the time.

With this in mind, the latest research that is returning fat and meat to the diet, as healthy choices, is both reassuring and a bit concerning.

Reassuring, for me, as a meat-eater…..giving me cover and making me feel ‘not so bad’ about the choices I make, but disconcerting in that it calls into question all of what we have been told by ‘the experts’ over the past few decades.

Books like Salt, Sugar, Fat....which was popular last summer, and which I commented on previously here in my blog, showed the issues with processed food.   Now, the upcoming book   that looks at meat and fat…. “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet,”  and reasserts that these are healthy and good to resume in our diets.

Why we have changed our minds on these topics, is elucidated in this article from the Wall Street Journal, but I think that the best advice for your diet, came from Aristotle, the great Greek Philosophy.  To shoot for ‘the golden mean’ and to find balance in all things, diet included.

See more on diet, here in my video about Ancel Keys and the Mediteranean Diet.




dreamstime_l_17339305Statins (Lipitor, Crestor & others)  are effective, safe, and have been shown to prevent heart attacks and strokes.  Now, a new competitor is potentially coming to market, as it continues to show promise in lowering bad (LDL) cholesterol by 50-66%.  This group of medications are called anti-PSCK9 agents  & include Amgen’s evolocumab, alirocumab from Sanofi and Regeneron and Pfizer’s bococizumab.

These are injectible medications, they are showing promise and safety.  Further studies will confirm if they prevent heart attacks and strokes, and if they do so, they will offer an alternative agent for patients with heart disease, and in particular will be available for those are are unable to tolerate statins due to muscle or liver issues.

Read more  >>>>>HERE.


dreamstime_l_5740056That simple admonition, best captures my sense of the ‘science’ of diet and how to eat properly for your health.    There are advocates for every  type of diet….low calorie, low fat, low sugar.  All have their advocates and their detractors, and all have some supportive research as backing, but there will be NO definitive answer to this question.

A recent study cited in the NY Times was brought to my attention by a patient, and this study showed that saturated fats, long the villian of the American diet, have now been given some cover.    In a article in the ANNALS OF INTERNAL MEDICINE  >>>HERE<<<   did not find an association between heart disease and saturated fat consumption, nor did they find a reduced level of heart disease in those who has unsaturated or monounsaturated fats.

While this is good news for those of use who like our burgers, it just shows that the complex connection between diet and health is so multifaceted, that eating with moderation, both those items claimed to be ‘healthy’ and those unhealthy, will likely yield a fine, and long life.   Keep your processed foods to a minimum, eat appropriate portions, exercise (don’t forget that….#1 KEYS recommendation), and keep your weight from ballooning and you’ll stay healthy.



heartstethatscopeCoronary artery disease remains very common,  with management during an acute episode of chest pain clearly favoring intervention with balloon treatment, stenting, or other aggressive therapies.  But for patients with stable disease, there is more controversy

If a person has stable coronary artery disease (no chest pain) but testing demonstrates are area of reduced blood flow, is it necessary to treat them with stenting, or best to manage with medications.   Often, when the cardiologist sees reduced bloodflow to an area of heart muscle, he gets something that my cardiology friend likes to call the ‘cardio-stenotic reflex’–this  is a reflexive need to improve the blood supply by placing a coronary stent.

This recent recent JAMA study showed that medication treatment in these ‘stable’ situations is equal to placing coronary stents to improve blood flow, as demonstrated in 5 year follow-up of over 5,000 patietns.







good news 2This weeks Sunday New York Times had a great article titled “Why Everyone Seems to Have Cancer” and the summary is….as we live longer and reduce the greatest killer of people, HEART DISEASE, Cancer comes to dominate as the major cause of death.

The statistics clearly show reductions in premature death from heart disease and stroke, as well as reductions in death from cancer; only cancer death reductions are less than those seen in heart disease.  Why that is, is the source of great interest, but mostly has to do with the great strides in prevention of heart disease with diet, exercise, and cholesterol medications….and improved treatment of acute illness from stenting, balloon treatments, acute management in the intensive care unit.

Cancer deaths have declined since 1990, mostly due to reduced lung cancer cases, but also as the result of great strides in specific types of childhood and adult cancers, as well as incremental improvements in a whole host of common cancers.

So….the statistics clearly show we are making strides in treating cancer.  Let’s recognize our success but focus on further improvements in the future.


VITRUVIAN MANRemember “Hans and Franz?”…from Saturday Night Live.   Two muscle-heads who want to ‘PUMP YOU UP’

Well….this was just the start of the hormone craze that has had a wide-range of influences in society, from Major League Baseball scandals, to issues in the local High School locker-rooms, and with the expanding advertising during football season for testosterone supplements, the issue is growing more influential.

A recent study from the NIH (National Institutes of Health) has questioned the heart safety of testosterone supplementation, when some initial reports showed a 30% increased in heart risk for patients with heart disease taking testosterone supplementation.  The men without hormone, had a 20% change of heart issues developing over a six year time-frame, but those on testosterone had a 26% incidence.  A total of 6% more or 30% greater (statistics…!)

Although a study of interest and not conclusive as an indictment of testosterone, it does raise the question of the potential side-effects of this type of therapy and that this should also come into consideration when you are deciding if testosterone is something you want to manipulate.

More will be developing on this topic, and to hear some information from a urologist on this topic, see my video interview with Dr. Bernie Gburek.  Start at minute 34 if you want to see him discuss testosterone therapy….HERE IS THE LINK