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[HEADLINE: Why I needed a heart attack to save my life (UK)]
Author: Tim Stewart (---.dsl.dytnoh.ameritech.net)
Date: 11-27-02 04:08
Copyright 2002 Associated Newspapers Ltd.
DAILY MAIL (London)
November 26, 2002
SECTION: Pg. 46
LENGTH: 929 words
HEADLINE: Why I needed a heart attack to save my life
BYLINE: Martyn Halle
BODY:
AN injection to provoke a heart attack is the latest weapon in the war
against heart disease. The treatment involves giving the heart a shot of pure
alcohol, and has been pioneered by a British doctor.
It is used for hypertrophic congestive cardiomyopathy, a thickening of the
heart muscle which reduces blood flow between the chambers.
The condition, which affects one in 500 people, is particularly linked to
young athletes, for whom it is the most common cause of sudden death.
This is because long-term sports training can lead to thickening of the
heart wall, making it harder for blood to flow at a normal pressure, so
increasing the risk of a heart attack in someone who already suffers from
cardiomyopathy.
Sadly, many young athletes who die from the condition collapse unaware they
have an abnormality, because it has remained undiagnosed.
Until recently, the only way to treat the condition was to use open-heart
surgery to cut away the thickening wall so the blood could pass easily again.
This was not without risk, was expensive, and involved a twoweek stay in
hospital.
With the new injection, the patient stays awake under local anaesthetic and
can go home a day after treatment. It is also much safer.
The procedure was developed by Professor Ulrich Sigwart, who used to work at
London's Royal Brompton Hospital. He discovered that scarring caused when
someone has a heart attack actually reduced the presence of thickened muscle and
increased blood flow in the heart.
The treatment is so specialised that only a handful of cardiologists in the
UK have sufficient skill to carry it out. Professor Sigwart regularly returns to
the UK from a hospital in Switzerland to treat patients.
'You have to be careful because you are dealing with 100pc alcohol. The aim
of the treatment is to keep it in the heart,' he says.
'If it escapes into the rest of the body, it can kill a patient or at the
very least make them seriously ill.
'But younger patients, in particular, aren't keen on having open-heart
surgery and this is now a viable option for some.' Results of an eight-year
study of patients treated using the alcohol method were published in the New
England Journal of Medicine recently and showed that it was as good if not
better than surgery in providing longterm relief.
PROFESSOR Sigwart estimates that around 30 pc of patients who require
surgery would benefit from the procedure. It involves inserting a catheter into
a groin artery and then feeding it up through the aorta - the largest blood
vessel - into the heart. A second catheter is then fed inside to deliver the
alcohol.
The direct effect of injecting a toxic substance into the heart could be to
stop it. So to ensure it continues to beat during the heart attack, a temporary
pacemaker is inserted first.
'It is relatively painless, although some patients report a twinge as the
injection reaches the heart and causes the attack,' says Professor Sigwart.
'It damages a section of the heart and kills off the excess muscle, causing
a small, localised and highly specific area of heart damage in the target
region.
'As the muscle dies it is gradually transformed over a period of weeks into
scar tissue, which causes it to shrink back and reduce the obstruction.' Alan
Harris, a 43-year-old design engineer, recently had the alcohol treatment at the
Royal Brompton. He says: 'I was diagnosed with cardiomyopathy 17 years ago when
I went for a health check-up for a new job.
'I was told I had a heart murmur which needed investigating and the
cardiologist I saw told me I had cardiomyopathy.
'Because I was otherwise fit and healthy, they decided to monitor me and it
wasn't until seven years ago that I started getting symptoms that required more
attention.
'They had put me on drugs to thin my blood and boost the flow through the
heart. But my heart beat became erratic.' This condition can lead to heart
attacks and strokes, so doctors have to consider other treatments if it cannot
be controlled by drugs.
'It wouldn't go away except after lengthy rest, so eventually it was decided
that I should have a treatment called cardioversion,' says Alan.
This is a simple procedure. It is performed to correct a fast or chaotic
heart rhythm after medications fail.
It sends an electrical shock to the heart through the chest wall, which
momentarily stops the heart and its irregular rhythm.
This usually disrupts the abnormal stimulus and allows the heart's normal
rhythm to take over.
Alan, who lives in Barton on Sea, Hampshire, with his wife Amanda, 43, had
two treatments using cardioversion without success.
'My condition was worsening and it was a choice between open-heart surgery
and this new technique to reduce the thickening of the heart muscle,' he says.
'It was almost painless. I felt a sharp twinge in my chest ever so briefly - as
the alcohol went into the heart - but then everything was fine.
'The doctors were reassuring and I knew my heart would continue to beat
because of the pacemaker. The treatment lasted only half an hour and I was home
after two days.
'Since the operation I've felt a lot better. I used to get out of breath
going upstairs. Now I am able to cope without a problem.
'I am also allowed to exercise, which my condition wouldn't allow before the
operation.
Cardiomyopathy doesn't go away and it is possible for heart muscle to
thicken again, but the evidence so far is that patients having alcohol treatment
are less likely to need a repeat procedure.
GRAPHIC: ALAN HARRIS: REVOLUTIONARY TREATMENT WAS ALMOST PAINLESS
LOAD-DATE: November 27, 2002
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
[Re: HEADLINE: Why I needed a heart attack to save my life (UK)]
Author: Linda, Bd of Directors (---.wmnsmd.adelphia.net)
Date: 11-27-02 06:27
Tim, Thanks for being a watchdog for much of the recent publications. How do you pick up so many of them? If these things go on the message board, it offers a chance for all to comment, ask questions, and clarify issues. We must all remember how very important it is to be very specific to each person's condition and needs for treatment. No treatment is without risk, and the person performing the treatment is key to success. We must be cautious to remember that the muscle thickness is only one part of HCM and removing the thickness still leaves the underlying problem of muscle function/dysfuction. Remember also, how often we see retractions to what was thought to be the perfect med/treatment at the time. Time and study will continue to help us discover the best options with the least risk. Meanwhile, let's all remember - ask questions specific to our own situation, discover all options, be realistic about expectations. Once again, if it sounds too good to be true, it probably is. These articles profile one person who was selected very carefully, and can mislead one to think it is an option for all. For anyone interested in obtaining more info on this procedure, please contact the HCMA office and you will be provided with the latest and most accurate information available. Lisa is in constant contact with the experts. Linda
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
[Re: HEADLINE: Why I needed a heart attack to save my life (UK)]
Author: Erica (---.biz.dsl.gtei.net)
Date: 11-27-02 06:31
It was mentioned in an earlier posting that an update was provided about the procedure (ablation) at AHA. It was also mentioned that this update would be posted in the next newsletter! Any idea when it will reach our mailboxes? Looking forward to reading all that was learned about HCM at the AHA! : )
~ Erica
Author: Tim Stewart (---.dsl.dytnoh.ameritech.net)
Date: 11-27-02 04:08
Copyright 2002 Associated Newspapers Ltd.
DAILY MAIL (London)
November 26, 2002
SECTION: Pg. 46
LENGTH: 929 words
HEADLINE: Why I needed a heart attack to save my life
BYLINE: Martyn Halle
BODY:
AN injection to provoke a heart attack is the latest weapon in the war
against heart disease. The treatment involves giving the heart a shot of pure
alcohol, and has been pioneered by a British doctor.
It is used for hypertrophic congestive cardiomyopathy, a thickening of the
heart muscle which reduces blood flow between the chambers.
The condition, which affects one in 500 people, is particularly linked to
young athletes, for whom it is the most common cause of sudden death.
This is because long-term sports training can lead to thickening of the
heart wall, making it harder for blood to flow at a normal pressure, so
increasing the risk of a heart attack in someone who already suffers from
cardiomyopathy.
Sadly, many young athletes who die from the condition collapse unaware they
have an abnormality, because it has remained undiagnosed.
Until recently, the only way to treat the condition was to use open-heart
surgery to cut away the thickening wall so the blood could pass easily again.
This was not without risk, was expensive, and involved a twoweek stay in
hospital.
With the new injection, the patient stays awake under local anaesthetic and
can go home a day after treatment. It is also much safer.
The procedure was developed by Professor Ulrich Sigwart, who used to work at
London's Royal Brompton Hospital. He discovered that scarring caused when
someone has a heart attack actually reduced the presence of thickened muscle and
increased blood flow in the heart.
The treatment is so specialised that only a handful of cardiologists in the
UK have sufficient skill to carry it out. Professor Sigwart regularly returns to
the UK from a hospital in Switzerland to treat patients.
'You have to be careful because you are dealing with 100pc alcohol. The aim
of the treatment is to keep it in the heart,' he says.
'If it escapes into the rest of the body, it can kill a patient or at the
very least make them seriously ill.
'But younger patients, in particular, aren't keen on having open-heart
surgery and this is now a viable option for some.' Results of an eight-year
study of patients treated using the alcohol method were published in the New
England Journal of Medicine recently and showed that it was as good if not
better than surgery in providing longterm relief.
PROFESSOR Sigwart estimates that around 30 pc of patients who require
surgery would benefit from the procedure. It involves inserting a catheter into
a groin artery and then feeding it up through the aorta - the largest blood
vessel - into the heart. A second catheter is then fed inside to deliver the
alcohol.
The direct effect of injecting a toxic substance into the heart could be to
stop it. So to ensure it continues to beat during the heart attack, a temporary
pacemaker is inserted first.
'It is relatively painless, although some patients report a twinge as the
injection reaches the heart and causes the attack,' says Professor Sigwart.
'It damages a section of the heart and kills off the excess muscle, causing
a small, localised and highly specific area of heart damage in the target
region.
'As the muscle dies it is gradually transformed over a period of weeks into
scar tissue, which causes it to shrink back and reduce the obstruction.' Alan
Harris, a 43-year-old design engineer, recently had the alcohol treatment at the
Royal Brompton. He says: 'I was diagnosed with cardiomyopathy 17 years ago when
I went for a health check-up for a new job.
'I was told I had a heart murmur which needed investigating and the
cardiologist I saw told me I had cardiomyopathy.
'Because I was otherwise fit and healthy, they decided to monitor me and it
wasn't until seven years ago that I started getting symptoms that required more
attention.
'They had put me on drugs to thin my blood and boost the flow through the
heart. But my heart beat became erratic.' This condition can lead to heart
attacks and strokes, so doctors have to consider other treatments if it cannot
be controlled by drugs.
'It wouldn't go away except after lengthy rest, so eventually it was decided
that I should have a treatment called cardioversion,' says Alan.
This is a simple procedure. It is performed to correct a fast or chaotic
heart rhythm after medications fail.
It sends an electrical shock to the heart through the chest wall, which
momentarily stops the heart and its irregular rhythm.
This usually disrupts the abnormal stimulus and allows the heart's normal
rhythm to take over.
Alan, who lives in Barton on Sea, Hampshire, with his wife Amanda, 43, had
two treatments using cardioversion without success.
'My condition was worsening and it was a choice between open-heart surgery
and this new technique to reduce the thickening of the heart muscle,' he says.
'It was almost painless. I felt a sharp twinge in my chest ever so briefly - as
the alcohol went into the heart - but then everything was fine.
'The doctors were reassuring and I knew my heart would continue to beat
because of the pacemaker. The treatment lasted only half an hour and I was home
after two days.
'Since the operation I've felt a lot better. I used to get out of breath
going upstairs. Now I am able to cope without a problem.
'I am also allowed to exercise, which my condition wouldn't allow before the
operation.
Cardiomyopathy doesn't go away and it is possible for heart muscle to
thicken again, but the evidence so far is that patients having alcohol treatment
are less likely to need a repeat procedure.
GRAPHIC: ALAN HARRIS: REVOLUTIONARY TREATMENT WAS ALMOST PAINLESS
LOAD-DATE: November 27, 2002
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
[Re: HEADLINE: Why I needed a heart attack to save my life (UK)]
Author: Linda, Bd of Directors (---.wmnsmd.adelphia.net)
Date: 11-27-02 06:27
Tim, Thanks for being a watchdog for much of the recent publications. How do you pick up so many of them? If these things go on the message board, it offers a chance for all to comment, ask questions, and clarify issues. We must all remember how very important it is to be very specific to each person's condition and needs for treatment. No treatment is without risk, and the person performing the treatment is key to success. We must be cautious to remember that the muscle thickness is only one part of HCM and removing the thickness still leaves the underlying problem of muscle function/dysfuction. Remember also, how often we see retractions to what was thought to be the perfect med/treatment at the time. Time and study will continue to help us discover the best options with the least risk. Meanwhile, let's all remember - ask questions specific to our own situation, discover all options, be realistic about expectations. Once again, if it sounds too good to be true, it probably is. These articles profile one person who was selected very carefully, and can mislead one to think it is an option for all. For anyone interested in obtaining more info on this procedure, please contact the HCMA office and you will be provided with the latest and most accurate information available. Lisa is in constant contact with the experts. Linda
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
[Re: HEADLINE: Why I needed a heart attack to save my life (UK)]
Author: Erica (---.biz.dsl.gtei.net)
Date: 11-27-02 06:31
It was mentioned in an earlier posting that an update was provided about the procedure (ablation) at AHA. It was also mentioned that this update would be posted in the next newsletter! Any idea when it will reach our mailboxes? Looking forward to reading all that was learned about HCM at the AHA! : )
~ Erica