Diseases & Conditions Archive

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Squeezing chest pain isn't always from a blocked artery.

Classic heart attack symptoms—severe pressure, heaviness, or pain in the chest—most often arise from a blockage in a coronary artery that prevents blood from reaching the heart muscle. But a lesser-known condition, called takotsubo cardiomyopathy, can produce the same sudden heart symptoms even when the coronary arteries are clear.

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Research we're watching

People who sleep too much or too little may be more likely to have early signs of heart disease, according to a study of more than 47,000 apparently healthy young and middle-aged adults.

The study volunteers filled out sleep questionnaires and underwent tests to assess the arteries in their hearts and legs. Researchers found that people who slept for nine or more hours per night had more calcium buildup in their heart artery walls and stiffer leg arteries than those who slept seven hours per night. These early signs of heart disease were also more prevalent in people who logged five or fewer hours of sleep per night and in people who reported poor sleep quality.

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Erectile dysfunction is common, but it's not always the problem. A doctor can help you get to the bottom of it.

Erectile dysfunction (ED) is difficulty either getting or maintaining an erection firm and lasting enough for a satisfying sexual encounter. The most common cause is inadequate blood supply to the spongy tissues in the penis that provide rigidity. That's a straightforward "plumbing problem" that can usually be treated with medication. But there are other possible causes, too.

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Calcium is required for good health, and you can obtain most of what you need from common foods.

Calcium builds strong bones—right? In general that's true, because calcium forms the bricks and mortar of bones. That's why you need to take in sufficient calcium from your diet to replace worn-out bone as you age. Being deficient in calcium can weaken bones, leaving them more prone to breaking. Vitamin D is the helpmate to calcium, allowing the body to absorb more of the mineral during digestion.

Ask the doctor

Q. I've had some severe bouts of depression before my periods. I have done my own research and I am willing to try an antidepressant. What dosage of Sarafem or Prozac is usually given to treat this?

A. Selective serotonin reuptake inhibitors (SSRIs) are an excellent option for treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In fact, most physicians now consider them first-line therapy. Many different SSRIs have been studied, including the one you asked about—fluoxetine (Prozac or Sarafem)—and they all appear to be equally effective.

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The raised, tortuous vessels may be controlled with support hose, and they can be eradicated in a quick, outpatient procedure.

Varicose veins are one cardiovascular condition that usually isn't considered serious or life-threatening. Around half of all women have them, and most regard them as a cosmetic annoyance. However, they can be responsible for swollen legs, skin changes, and the development of leg ulcers.

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Research we're watching

An analysis published online Sept. 17, 2015, by the British Journal of Sports Medicine suggests that doing tai chi enhances the quality of life for people with common chronic conditions.

Researchers analyzed data from 33 studies involving nearly 1,600 adults. Most were in their 60s or 70s, and all had one or more chronic conditions: osteoarthritis, breast cancer, heart failure, or chronic obstructive pulmonary disease (COPD). All 290 participants in the breast cancer studies were women. There were 452 women (85% of participants) in the arthritis studies, 76 (16%) in the heart failure studies, and 92 (19%) in the COPD studies.

Q. I've been having abdominal pain that may be due to gallstones. Is surgery the best solution, or are there other things I can try first?

A. The first thing to determine is whether your abdominal pain is in fact due to gallstones. They typically cause pain on the upper right side or in the center of the abdomen just below the breastbone that radiates to the back or right shoulder. The pain is often brought on by eating—especially fatty foods—or may occur at night. Sometimes gallstone pain is accompanied by sweating, bloating, nausea, or vomiting.

If you're "leaning in" by putting in extra hours on the job, you may be gaining gender equality that you don't want—the same stroke risk as your male colleagues. A recent analysis indicates that women who work 55 hours or more per week have a 30% higher risk of having a stroke than those working standard hours, making them just as likely to have a stroke as their male counterparts.

The analysis, published online Aug. 20, 2015, by The Lancet, was conducted by European public health re-searchers. It involved data from over 600,000 women and men enrolled in long-term observational studies in Europe and the United States. It was the first such analysis of the relationship between working long hours and stroke. The researchers noted several factors that might have contributed to the elevated stroke risk, including the additional stress of balancing the extra work hours, inactivity, long periods of sitting, and ignoring stroke warning signs.

Although vitamin D is essential to bone health, a controlled clinical trial published online by JAMA Internal Medicine on Aug. 3, 2015, found that vitamin D supplements didn't build bone in postmenopausal women with blood levels of vitamin D below the 30-ng/mL threshold generally considered necessary for good health. Researchers at the University of Wisconsin randomly assigned 230 women to three groups: one got 800 IU of vitamin D daily and a placebo twice a month; one got a placebo daily and 50,000 IU of vitamin D twice a month; the third got placebos both daily and twice a month. The study lasted a year. The researchers found that neither dose of vitamin D had a significant effect on bone mass, falls, or fractures.

The Wisconsin study may not have used the right doses of vitamin D or lasted long enough to show an effect. One ongoing study, The Vitamin D and Omega-3 Trial (VITAL), is large enough to demonstrate even small-to-moderate benefits of vitamin D supplementation. VITAL is evaluating a 2,000-IU daily dose for five years in 26,000 women and men. The results are expected in 2017. Until then, it's still important to get the recommended daily dose of vitamin D: 600 IU for adults through age 70 and 800 IU for people ages 71 or older