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What Covid Means for the Athlete’s Heart

For sports fans across the country, the resumption of the regular sports calendar has signaled another step toward post-pandemic normality. But for the athletes participating in professional, collegiate, high school or even recreational sports, significant unanswered questions remain about the aftereffects of a covid infection.

This story also ran on ESPN. It can be republished for free.

Chief among those is whether the coronavirus can damage their hearts, putting them at risk for lifelong complications and death. Preliminary data from early in the pandemic suggested that as many as 1 in 5 people with covid-19 could end up with heart inflammation, known as myocarditis, which has been linked to abnormal heart rhythms and sudden cardiac death.

Screening studies conducted by college athletic programs over the past year have generally found lower numbers. But these studies have been too small to provide an accurate measure of how likely athletes are to develop heart problems after covid, and how serious those heart issues may be.

Without definitive data, concerns arose that returning to play too soon could expose thousands of athletes to serious cardiac complications. On the other hand, if concerns proved overblown, the testing protocols could unfairly keep athletes out of competition and subject them to needless testing and treatment.

“The last thing we want is to miss people that we potentially could have detected, and have that result in bad outcomes — in particular, the sudden death of a young athlete,” said Dr. Matthew Martinez, director of sports cardiology at Atlantic Health’s Morristown Medical Center in New Jersey and an adviser to several professional sports leagues. “But we also need to look at the flip side and the potential negatives of overtesting.”

With millions of Americans playing high school, college, professional or master’s level sports, even a low rate of complications could result in significant numbers of affected athletes. And that could prompt a thorny discussion of how to balance the risk of a small percentage of players who could be in danger against the continuation of sports competition as we know it.

Limited Impact on Pro Sports

Data released from professional sports leagues in early March provided at least some reassurance that the problem may not be as great as initially feared. Pro athletes playing football, men’s and women’s basketball, baseball, soccer and hockey were screened for heart problems before returning from covid infections. The players underwent an electrical test of their heart rhythms, a blood test that checks for heart damage and an ultrasound exam of their hearts. Out of 789 athletes screened, 30 showed some cardiac abnormality in those initial tests and were referred for a cardiac MRI to provide a better picture of their heart. Five of those, less than 1% of athletes screened, showed inflammation of the heart that sidelined them for the remainder of their seasons.

The researchers compiling the data did not name the players, although some have disclosed their own diagnoses. Boston Red Sox pitcher Eduardo Rodríguez returned to the mound this spring after missing the 2020 season following his covid and myocarditis diagnoses. Similarly, Buffalo Bills tight end Tommy Sweeney was close to returning from a foot injury when he was diagnosed with myocarditis in November.

In the college ranks, many assumed Keyontae Johnson — a 21-year-old forward on the University of Florida men’s basketball team who collapsed on the court in December, months after contracting covid — might have developed myocarditis. The Gainesville Sun reported that month he had been diagnosed with myocarditis, but his family issued a statement in February saying the incident was not covid-related and declined to release additional details.

Consequences Still Unclear

Doctors still don’t know how significant those MRI findings of myocarditis may be for athletes. Tests looking for rare medical events often generate more false positives than true positives. And without comparing the results with those of athletes who didn’t have covid, it is hard to determine what changes to attribute to the virus — or what may just be an effect of athletic training or other causes.

Training significantly changes athletes’ hearts, and what might look concerning in another patient could be perfectly normal for an elite athlete. Many endurance athletes, for example, have larger than average left ventricles and pump out a lower percentage of blood with each contraction. That would be a warning sign for patients who aren’t highly trained athletes.

“You can definitely have what we call the gray zone, where extreme forms of athletic cardiac remodeling can actually look a little bit like pathology,” said Dr. Jonathan Kim, a sports cardiologist at Emory University in Atlanta. “Covid has introduced a new challenge to this. Is it because they’re a cross-country runner or is it because they just had covid?”

Moreover, myocarditis is generally diagnosed based on symptoms — chest pain, shortness of breath, heart muscle weakness or electrical dysfunction — and then confirmed by MRI. It isn’t clear whether MRI findings that look like myocarditis in the absence of those symptoms are just as concerning.

“They have normal physical exams. They have normal cardiograms. Nothing else is going on,” said Dr. Robert Bonow, a cardiologist at Northwestern University and editor of JAMA Cardiology. “But when you order an MRI as part of a research study, you start seeing very subtle changes, because the MRI is very sensitive.”

Were they finding “abnormalities” simply because they were looking? Even in patients who die of covid, the rate of myocarditis is very low, Bonow said.

“So what’s going on with the athletes? Is it something related to the fact that they had an infection, or is it something which is very nonspecific, related to covid but not damage to the heart?” he said. “There’s still a great deal of uncertainty.”

Sports cardiologists involved in the pro sports data collection and in writing screening guidelines for athletes said the fact that players were able to resume their seasons without serious heart complications suggests the initial concern was overblown. Of the players who had mild or asymptomatic cases of covid, none was ultimately found to have myocarditis, and none experienced ongoing heart complications through 2020. Many completed their 2020 season and have already started their next one.

“We overcalled it,” Martinez said. “It shows what our guidelines reflected: The prevalence of cardiac disease in this condition is unusual in the athletic population.”

Falling Through the Cracks

Those screening guidelines, published by a group of leading sports cardiologists in October, call for cardiac tests only for athletes with moderate or severe covid symptoms. Athletes with asymptomatic cases or those with mild symptoms that have gone away can return to play without the additional testing. The National Federation of State High School Associations and the American Medical Society for Sports Medicine have put out similar guidelines for high school athletes.

But that approach would not flag players such as Demi Washington.

Washington, a 19-year old sophomore on Vanderbilt’s women’s basketball team, had a rather mild case of covid. She had shared a meal with two teammates, one of whom later turned out to be infected. Seven days into a two-week quarantine in a hotel off campus, Washington also tested positive, and had to isolate with a stuffy nose for an additional 10 days. She waited for her symptoms to get worse, but they never did.

“It felt like allergies,” she said.

But when her symptoms cleared and she returned to practice, the university required her to undergo several tests to ensure the virus had not affected her heart. The initial tests raised no concerns. An MRI, though, showed acute myocarditis.

Her season was over, but, more importantly, Washington, an athlete in prime physical condition, faced the possibility of losing her life. She learned about Hank Gathers, a 23-year-old Loyola Marymount basketball star who collapsed during a game in 1990 and died within hours. His autopsy confirmed an enlarged heart and myocarditis.

“That really put me on the edge of my seat,” Washington said. “I was like, ‘OK, I have to take this seriously, because I don’t want to end up like that.’”

For months, she had to keep her heart rate under 110 beats per minute. Before, she ran 5 miles a day. With the myocarditis diagnosis, she had to wear a heart monitor, and even a brisk walk could push her above that threshold.

“One time I was walking to the gym and I might have been walking a little fast,” Washington recalled. “My chest got really, really tight.”

By mid-January, however, another MRI showed the inflammation had cleared, and she has since resumed working out.

“I’m so grateful that Vanderbilt does the MRI, because without it, there’s no telling what could have happened,” she said.

She wondered how many other athletes have been playing with myocarditis and didn’t know it.

Cases like Washington’s raise questions about how aggressively to screen. Her condition was found only because Vanderbilt took a much more conservative approach than that recommended by current guidelines: It screened all athletes with cardiac MRIs after they had covid, regardless of the severity of their symptoms or their initial cardiac tests.

Of the 59 athletes screened post-covid, the university found two with signs of myocarditis. That’s just over 3%.

“Is the current rate of myocarditis that we’re seeing high enough to warrant ongoing cardiovascular screening?” asked Dr. Daniel Clark, a Vanderbilt sports cardiologist and lead author of an analysis of the school’s screening efforts. “Five percent is too much to ignore, in my opinion, but what is our societal threshold for not screening highly competitive athletes for myocarditis?”

Even though myocarditis is rare, studies have found that noncovid-related myocarditis causes up to 9% of sudden cardiac deaths among athletes, said Dr. Jonathan Drezner, director of the University of Washington Medicine Center for Sports Cardiology, who advises the NCAA on cardiac issues. Thus covid adds a new risk. The NCAA alone reports more than 480,000 athletes. To provide a sense of scale: If all of them got covid and even 1% were at risk of heart problems, that’s 4,800 athletes.

Waiting for More Data

Doctors are now waiting for the release of data pooled from thousands of college athletes screened after having covid last year. The American Heart Association and the American Medical Society for Sports Medicine have created a national registry to track covid cases and heart disease in NCAA athletes, with more than 3,000 athletes enrolled, while the Big Ten conference is running its own registry.

That registry data may eventually help parse who is most at risk for heart complications, target who needs to be screened and improve the reliability of the tests. Doctors may discover that some symptoms are better indicators of risk than others. And down the road, genetic testing or other types of tests could identify who is most vulnerable.

But will smaller schools have the resources and know-how to screen all their athletes?

“How about all the junior colleges, all the Division III programs, the Division II programs?” Martinez said. “A lot of them are saying, ‘Look, forget it. If we have do all this extra testing, we can’t do it.’”

He said the new pro sports data should reassure those colleges and even high schools, because the vast majority of young, healthy athletes who contract covid generally have mild or asymptomatic infections, and won’t need further testing.

The same guidelines apply to recreational athletes. Those with mild or asymptomatic covid can slowly resume exercising once their symptoms resolve without much concern. Those with moderate or severe cases should talk to their doctors before returning to sports.

Concerns for Small Schools

Large, wealthy universities like Vanderbilt have cutting-edge medical facilities with the resources and expertise to properly interpret cardiac MRIs. Smaller schools could struggle to get their athletes screened.

“There’s only a small number of centers around the country that have the true expertise to be able to effectively do cardiac MRIs on athletes,” said Dr. Dermot Phelan, a sports cardiologist with Atrium Health in Charlotte, North Carolina. “And the reality is that those systems are already stretched trying to deal with normal clinical data. If we were to add a huge population of athletes on top of that, I think we would stretch the medical system significantly.”

Some schools with limited resources for testing could decide to bench athletes recovering from moderate or severe covid rather than risk a devastating event. Others could allow athletes to resume playing once they’ve recovered, and then monitor them for signs of cardiac complications. Many NCAA schools added automated external defibrillators after Gathers’ death in case an athlete collapses during a game or practice.

“You think about all the 100,000 high school athletes out there whose parents are concerned: Do they even have access to anyone who knows something about this? On the other hand, they’re younger people who don’t get really sick with covid,” said Dr. James Udelson, a cardiologist with Tufts Medical Center in Boston. “There’s a concern about how much we don’t know.”

Legal Issues

Some schools may also worry about the liability of allowing players to return after a covid infection if they can’t get the proper cardiac screening.

“No matter what precautions a college or university takes in that regard, they can always be sued,” said Richard Giller, an attorney with the Pillsbury Winthrop Shaw Pittman law firm in Los Angeles. “The real question is, do they have liability? I think that’s going to depend on a number of factors, not the least of which is who recommended that student athletes who contracted covid-19 return to play.”

He recommends that colleges not rely solely on doctors affiliated with the university but have student athletes see their own private physicians to make return-to-play decisions. Teams may also ask players to sign waivers to the effect that if they return to play after a covid infection, they might face cardiac complications.

Some colleges asked students to sign waivers absolving the school if a player contracted covid. But the NCAA ruled that schools couldn’t make those waivers a requirement to play.

Doctors don’t know what might happen over the long run. With barely a year’s worth of experience with covid, it’s not clear whether the myocarditis seen on MRIs will resolve quickly, or whether there might be lingering effects that cause complications years later.

That leaves many concerned about what we still don’t know about covid and the athlete’s heart, as well as the handful of cases that might elude detection.

“You can take a cohort of athletes and put them through every single cardiac test and come out the other end, and one of them will die someday,” Phelan said. “The reality is there’s nothing we can do to be 100% guaranteed.”

ESPN’s Paula Lavigne and Mark Schlabach contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

What Covid Means for the Athlete’s Heart published first on https://nootropicspowdersupplier.tumblr.com/

[stephenmccull]

What Covid Means for the Athlete’s Heart

For sports fans across the country, the resumption of the regular sports calendar has signaled another step toward post-pandemic normality. But for the athletes participating in professional, collegiate, high school or even recreational sports, significant unanswered questions remain about the aftereffects of a covid infection.

This story also ran on ESPN. It can be republished for free.

Chief among those is whether the coronavirus can damage their hearts, putting them at risk for lifelong complications and death. Preliminary data from early in the pandemic suggested that as many as 1 in 5 people with covid-19 could end up with heart inflammation, known as myocarditis, which has been linked to abnormal heart rhythms and sudden cardiac death.

Screening studies conducted by college athletic programs over the past year have generally found lower numbers. But these studies have been too small to provide an accurate measure of how likely athletes are to develop heart problems after covid, and how serious those heart issues may be.

Without definitive data, concerns arose that returning to play too soon could expose thousands of athletes to serious cardiac complications. On the other hand, if concerns proved overblown, the testing protocols could unfairly keep athletes out of competition and subject them to needless testing and treatment.

“The last thing we want is to miss people that we potentially could have detected, and have that result in bad outcomes — in particular, the sudden death of a young athlete,” said Dr. Matthew Martinez, director of sports cardiology at Atlantic Health’s Morristown Medical Center in New Jersey and an adviser to several professional sports leagues. “But we also need to look at the flip side and the potential negatives of overtesting.”

With millions of Americans playing high school, college, professional or master’s level sports, even a low rate of complications could result in significant numbers of affected athletes. And that could prompt a thorny discussion of how to balance the risk of a small percentage of players who could be in danger against the continuation of sports competition as we know it.

Limited Impact on Pro Sports

Data released from professional sports leagues in early March provided at least some reassurance that the problem may not be as great as initially feared. Pro athletes playing football, men’s and women’s basketball, baseball, soccer and hockey were screened for heart problems before returning from covid infections. The players underwent an electrical test of their heart rhythms, a blood test that checks for heart damage and an ultrasound exam of their hearts. Out of 789 athletes screened, 30 showed some cardiac abnormality in those initial tests and were referred for a cardiac MRI to provide a better picture of their heart. Five of those, less than 1% of athletes screened, showed inflammation of the heart that sidelined them for the remainder of their seasons.

The researchers compiling the data did not name the players, although some have disclosed their own diagnoses. Boston Red Sox pitcher Eduardo Rodríguez returned to the mound this spring after missing the 2020 season following his covid and myocarditis diagnoses. Similarly, Buffalo Bills tight end Tommy Sweeney was close to returning from a foot injury when he was diagnosed with myocarditis in November.

In the college ranks, many assumed Keyontae Johnson — a 21-year-old forward on the University of Florida men’s basketball team who collapsed on the court in December, months after contracting covid — might have developed myocarditis. The Gainesville Sun reported that month he had been diagnosed with myocarditis, but his family issued a statement in February saying the incident was not covid-related and declined to release additional details.

Consequences Still Unclear

Doctors still don’t know how significant those MRI findings of myocarditis may be for athletes. Tests looking for rare medical events often generate more false positives than true positives. And without comparing the results with those of athletes who didn’t have covid, it is hard to determine what changes to attribute to the virus — or what may just be an effect of athletic training or other causes.

Training significantly changes athletes’ hearts, and what might look concerning in another patient could be perfectly normal for an elite athlete. Many endurance athletes, for example, have larger than average left ventricles and pump out a lower percentage of blood with each contraction. That would be a warning sign for patients who aren’t highly trained athletes.

“You can definitely have what we call the gray zone, where extreme forms of athletic cardiac remodeling can actually look a little bit like pathology,” said Dr. Jonathan Kim, a sports cardiologist at Emory University in Atlanta. “Covid has introduced a new challenge to this. Is it because they’re a cross-country runner or is it because they just had covid?”

Moreover, myocarditis is generally diagnosed based on symptoms — chest pain, shortness of breath, heart muscle weakness or electrical dysfunction — and then confirmed by MRI. It isn’t clear whether MRI findings that look like myocarditis in the absence of those symptoms are just as concerning.

“They have normal physical exams. They have normal cardiograms. Nothing else is going on,” said Dr. Robert Bonow, a cardiologist at Northwestern University and editor of JAMA Cardiology. “But when you order an MRI as part of a research study, you start seeing very subtle changes, because the MRI is very sensitive.”

Were they finding “abnormalities” simply because they were looking? Even in patients who die of covid, the rate of myocarditis is very low, Bonow said.

“So what’s going on with the athletes? Is it something related to the fact that they had an infection, or is it something which is very nonspecific, related to covid but not damage to the heart?” he said. “There’s still a great deal of uncertainty.”

Sports cardiologists involved in the pro sports data collection and in writing screening guidelines for athletes said the fact that players were able to resume their seasons without serious heart complications suggests the initial concern was overblown. Of the players who had mild or asymptomatic cases of covid, none was ultimately found to have myocarditis, and none experienced ongoing heart complications through 2020. Many completed their 2020 season and have already started their next one.

“We overcalled it,” Martinez said. “It shows what our guidelines reflected: The prevalence of cardiac disease in this condition is unusual in the athletic population.”

Falling Through the Cracks

Those screening guidelines, published by a group of leading sports cardiologists in October, call for cardiac tests only for athletes with moderate or severe covid symptoms. Athletes with asymptomatic cases or those with mild symptoms that have gone away can return to play without the additional testing. The National Federation of State High School Associations and the American Medical Society for Sports Medicine have put out similar guidelines for high school athletes.

But that approach would not flag players such as Demi Washington.

Washington, a 19-year old sophomore on Vanderbilt’s women’s basketball team, had a rather mild case of covid. She had shared a meal with two teammates, one of whom later turned out to be infected. Seven days into a two-week quarantine in a hotel off campus, Washington also tested positive, and had to isolate with a stuffy nose for an additional 10 days. She waited for her symptoms to get worse, but they never did.

“It felt like allergies,” she said.

But when her symptoms cleared and she returned to practice, the university required her to undergo several tests to ensure the virus had not affected her heart. The initial tests raised no concerns. An MRI, though, showed acute myocarditis.

Her season was over, but, more importantly, Washington, an athlete in prime physical condition, faced the possibility of losing her life. She learned about Hank Gathers, a 23-year-old Loyola Marymount basketball star who collapsed during a game in 1990 and died within hours. His autopsy confirmed an enlarged heart and myocarditis.

“That really put me on the edge of my seat,” Washington said. “I was like, ‘OK, I have to take this seriously, because I don’t want to end up like that.’”

For months, she had to keep her heart rate under 110 beats per minute. Before, she ran 5 miles a day. With the myocarditis diagnosis, she had to wear a heart monitor, and even a brisk walk could push her above that threshold.

“One time I was walking to the gym and I might have been walking a little fast,” Washington recalled. “My chest got really, really tight.”

By mid-January, however, another MRI showed the inflammation had cleared, and she has since resumed working out.

“I’m so grateful that Vanderbilt does the MRI, because without it, there’s no telling what could have happened,” she said.

She wondered how many other athletes have been playing with myocarditis and didn’t know it.

Cases like Washington’s raise questions about how aggressively to screen. Her condition was found only because Vanderbilt took a much more conservative approach than that recommended by current guidelines: It screened all athletes with cardiac MRIs after they had covid, regardless of the severity of their symptoms or their initial cardiac tests.

Of the 59 athletes screened post-covid, the university found two with signs of myocarditis. That’s just over 3%.

“Is the current rate of myocarditis that we’re seeing high enough to warrant ongoing cardiovascular screening?” asked Dr. Daniel Clark, a Vanderbilt sports cardiologist and lead author of an analysis of the school’s screening efforts. “Five percent is too much to ignore, in my opinion, but what is our societal threshold for not screening highly competitive athletes for myocarditis?”

Even though myocarditis is rare, studies have found that noncovid-related myocarditis causes up to 9% of sudden cardiac deaths among athletes, said Dr. Jonathan Drezner, director of the University of Washington Medicine Center for Sports Cardiology, who advises the NCAA on cardiac issues. Thus covid adds a new risk. The NCAA alone reports more than 480,000 athletes. To provide a sense of scale: If all of them got covid and even 1% were at risk of heart problems, that’s 4,800 athletes.

Waiting for More Data

Doctors are now waiting for the release of data pooled from thousands of college athletes screened after having covid last year. The American Heart Association and the American Medical Society for Sports Medicine have created a national registry to track covid cases and heart disease in NCAA athletes, with more than 3,000 athletes enrolled, while the Big Ten conference is running its own registry.

That registry data may eventually help parse who is most at risk for heart complications, target who needs to be screened and improve the reliability of the tests. Doctors may discover that some symptoms are better indicators of risk than others. And down the road, genetic testing or other types of tests could identify who is most vulnerable.

But will smaller schools have the resources and know-how to screen all their athletes?

“How about all the junior colleges, all the Division III programs, the Division II programs?” Martinez said. “A lot of them are saying, ‘Look, forget it. If we have do all this extra testing, we can’t do it.’”

He said the new pro sports data should reassure those colleges and even high schools, because the vast majority of young, healthy athletes who contract covid generally have mild or asymptomatic infections, and won’t need further testing.

The same guidelines apply to recreational athletes. Those with mild or asymptomatic covid can slowly resume exercising once their symptoms resolve without much concern. Those with moderate or severe cases should talk to their doctors before returning to sports.

Concerns for Small Schools

Large, wealthy universities like Vanderbilt have cutting-edge medical facilities with the resources and expertise to properly interpret cardiac MRIs. Smaller schools could struggle to get their athletes screened.

“There’s only a small number of centers around the country that have the true expertise to be able to effectively do cardiac MRIs on athletes,” said Dr. Dermot Phelan, a sports cardiologist with Atrium Health in Charlotte, North Carolina. “And the reality is that those systems are already stretched trying to deal with normal clinical data. If we were to add a huge population of athletes on top of that, I think we would stretch the medical system significantly.”

Some schools with limited resources for testing could decide to bench athletes recovering from moderate or severe covid rather than risk a devastating event. Others could allow athletes to resume playing once they’ve recovered, and then monitor them for signs of cardiac complications. Many NCAA schools added automated external defibrillators after Gathers’ death in case an athlete collapses during a game or practice.

“You think about all the 100,000 high school athletes out there whose parents are concerned: Do they even have access to anyone who knows something about this? On the other hand, they’re younger people who don’t get really sick with covid,” said Dr. James Udelson, a cardiologist with Tufts Medical Center in Boston. “There’s a concern about how much we don’t know.”

Legal Issues

Some schools may also worry about the liability of allowing players to return after a covid infection if they can’t get the proper cardiac screening.

“No matter what precautions a college or university takes in that regard, they can always be sued,” said Richard Giller, an attorney with the Pillsbury Winthrop Shaw Pittman law firm in Los Angeles. “The real question is, do they have liability? I think that’s going to depend on a number of factors, not the least of which is who recommended that student athletes who contracted covid-19 return to play.”

He recommends that colleges not rely solely on doctors affiliated with the university but have student athletes see their own private physicians to make return-to-play decisions. Teams may also ask players to sign waivers to the effect that if they return to play after a covid infection, they might face cardiac complications.

Some colleges asked students to sign waivers absolving the school if a player contracted covid. But the NCAA ruled that schools couldn’t make those waivers a requirement to play.

Doctors don’t know what might happen over the long run. With barely a year’s worth of experience with covid, it’s not clear whether the myocarditis seen on MRIs will resolve quickly, or whether there might be lingering effects that cause complications years later.

That leaves many concerned about what we still don’t know about covid and the athlete’s heart, as well as the handful of cases that might elude detection.

“You can take a cohort of athletes and put them through every single cardiac test and come out the other end, and one of them will die someday,” Phelan said. “The reality is there’s nothing we can do to be 100% guaranteed.”

ESPN’s Paula Lavigne and Mark Schlabach contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

What Covid Means for the Athlete’s Heart published first on https://smartdrinkingweb.weebly.com/

[phawareglobal]

Stephanie Volino - phaware® interview 242

Pulmonary hypertension caregiver Stephanie Volino discusses her daughter Anna's road to a PH diagnosis following the loss of her other daughter, Sophia, who passed away from pulmonary hypertension after one week of finding out that she had this horrific disease.

My name is Stephanie Volino. I am a caregiver of a young lady, Anna Volino, who has pulmonary hypertension, since she was four years old. I am also a caregiver of a little two year old girl, Sophia-Lyn Volino, who passed away from pulmonary hypertension after one week of finding out that she had this horrific disease.

The first time we heard pulmonary hypertension was when my daughter Sophia was born in August of 2005. Her umbilical cord was wrapped around her neck and I had to stop mid-push to allow the doctor to unwrap the cord and then when she finally did come out and they cut her cord, they realized her breathing was labored so they whisked her away very quickly and she was put into the NICU on oxygen and the doctor said that it was “like a pulmonary hypertension.”

They really didn't make it sound like a huge deal, that it was just like, “Oh, you know, this will get rectified after a few days on oxygen.” She did a test in her car seat, where she had to be hooked up to oxygen monitors and heart monitors and she passed with flying colors. They said "you're good to go, you can go home" and we gave the nurses and doctors hugs and we left and we went on our merry way and we had our beautiful family of four because my daughter Anna was born in 2003, so she was two years old and we had a newborn.

We took her home and life proceeded as normal. She was a really good baby. She ate, she slept, she produced a lot of dirty diapers. Anna was a little mommy to her. She always wanted to read to her and show her how to roll over and do all that big sister stuff. Then around four months of age, just like her sister, because Anna at four months of age just went blue a little bit. They started holding their breath. Like we did with Anna, we brought Sophia to the hospital. They put her on oxygen, they checked her saturation level. They wanted to admit her. Her coloring was still off. They did a series of tests and then a few days later we went home. They said to follow up with our pediatrician, which we did. Then everything was cleared. She was fine. We just thought it was a strange coincidence that both girls did this around the same time, four months of age.

We followed through with the doctors. We did everything as parents that we thought we should do and then when they medically cleared them both we thought that everything was fine.

In the spring of 2007, she started spitting up her food a little bit, so we brought her to the doctor because we were a little concerned. We thought maybe she had a food allergy. Our doctor thought maybe it was just acid reflux so he gave her pepsin. We were giving her the pepsin and it was still happening frequently, that she was spitting up. All of a sudden it was her two year check-up and when I went back, the night before, she had a violent episode where she projectile vomited straight across the table. I looked at my husband and we knew something was off . She was just limp in my arms and that was at the forefront of our conversation the next day with the pediatrician.

I said "I don't think the pepsin is working that well and maybe we should do further testing". He agreed. The doctor said "let's do an endoscopy, we're just going to put her under general anesthesia and take a snip of that tissue and see what it is". So we took her in the next day. It seemed normal enough, to be an in and out procedure, very quick, but he came out and he said when they put her under, she went blue and they rushed a cardiologist in to revive her. That's where our story with pulmonary hypertension really started.

The doctors at Staten Island University Hospital sent us from there to Cornell then onto New York Presbyterian Stanley Morgan Children’s Hospital. This happened all in the same day, and that's when, when we finally met Dr. Erika Berman Rosenzweig at the children's hospital. We were there for a week. They did tests. They had her on oxygen and then she went [to get a right heart] catheterization on September 19th 2007. She made it out of the catheterization, but Dr. Berman came out and said she had severe pulmonary hypertension, that the right side of her heart was enlarged. Her pressures where like 130 and they were trying out medications on her and she just couldn't handle it. Then that night, she spiked 107 fever and they had her on ice. They had us in the room and she began to crash and they worked on her and worked on her and then she just didn't make it.

We went back to the children's hospital with Anna. They checked her out. They said she had a tiny hole in her heart, but after all that we went through, that we really didn't have to address it at the moment, that we could just wait and do it within time. Dr. Berman also said that normally kids would get something like that taken care of around Anna's age, which was she was four at the time, because it was less traumatic to just do it, get it over with, than doing it when they got older.

We took all that into consideration. We said we were going to wait for little while. Then just a little time passed, a couple of months. Actually, she was getting ready to go into kindergarten, and I'd just registered her for kindergarten and then I thought to myself, “let me talk to [my husband] Joe about this, about getting that hole taken care of before she started kindergarten.” We didn't have to wait until she got older and she wouldn't have to panic because her sister died from a heart related disease. Even though it was something completely different, we didn't want her to worry about it.

We decided to go to a cardiologist in Morristown. He saw a blip on the screen when he did her tests and he said we had to go back to Dr. Berman. We were still in that numb state. We were traumatized. We were angry. We were upset. Our head was still spinning. It wasn't fully sinking in, because it was such a whirlwind when Sophia was diagnosed, 7 days until she passed. So we were still trying to figure it all out and what ground we stood on, because it didn't even feel like we had any ground to stand on and then we had this little girl.  That was the reason that I think, we survived initially, because we did have her at home and we were still parents and we had to raise her and then all of a sudden with the doctor saying “you have to go back” it was just shocking. I didn't know what to think, I just couldn't believe this was all happening again.

I've constantly felt choked up, like I couldn't breathe because it was unbelievable that we went through this one time and we were so young, early 30's and life was ahead of us and we lost one daughter and now somebody's telling me that my other daughter’s life might be in peril. It was an incredibly tough time to get through.

We repeated the same steps. She went into the catheterization and her diagnosis was much milder than Sophia's. They were almost at the opposite end of the spectrum, so to say. Even though she was diagnosed with pulmonary hypertension and we were devastated over that, we were just so elated that she was alive and that we got to take her home and take care of this. So we just put our best foot forward and we kept moving right along.

Doing the blood work every month was a struggle, she didn't want to go, she didn't want to get the blood work done. Then one day, miraculously, one of the phlebotomists said "let's sing happy birthday while I stick the needle in and you can blow out the candle when the needle goes in.” She sang happy birthday and he said "OK, now blow out your candle." She blew on her arm and in went the needle and it was like, we did that every time ever since, because that was like our little miracle for the moment because then she wasn't crying or screaming and I didn't have to hold her down. Then we would trek into the hospital, into New York quarterly to get her checked and when we would get her right heart caths done, every time without fail, these nurses would try and put us in the same recovery room that Sophia was in and Joe and I just couldn't do it.

I don't even know if I can say it shouldn't have made a difference, but it definitely did make a difference. Every time Joe would say, "I'm sorry," and explain the story. Then they would look at us, "Oh, oh, oh," because they have so many patients and everything. Maybe that was Sophia's way of saying “I'm here for my sister,” because we always considered her after that as Anna's guardian angel. I mean, without Sophia and her diagnosis and everything that happened, I don't know if we would have figured this out in Anna for a very long time, because her case was mild. God know where we would be or when we would have found out or how we would have found out. So Sophia, after she passed, was always looked at as Anna's guardian angel.

For a four year old to face all that she had to and then to face her own diagnosis and take medicine and go into the hospital and get picked and prodded and poked at and do all that, I look at her in awe for all that she's been through.

We look at it from the perspective of, we just try to keep moving on and look at it in a positive way and we wouldn't be here today without the doctors and everybody that's fighting for pulmonary hypertension and looking to cure this horrific disease. One day children like Sophia, they will survive. Every single one of them will. Those doctors are their super heroes. They fight every day for these kids. They really do. They will win. We will all win because of them, and because of our community.

Children like Anna are thriving today. When we first started out there were maybe three medications and now there's so many more, so much more we know. 10 years later, 12 years later, we just have to keep moving forward and supporting each other and supporting them. We're very appreciative of them, we put our trust and hope in them every day.

I'm Stephanie Volino and I'm aware that I'm rare.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials @antidote_me 

Listen and View more on the official phaware™ podcast site

[randybenedict]

Edwards Lifesciences, Bay Labs ink cardio-focused collab AI-dev deal

Edwards Lifesciences’ (NYSE:EW) and  cardiovascular artificial intelligence medtech firm Bay Labs, have inked a multi-faceted collaborative cardiovascular-focused development deal, Bay Labs said today.

San Francisco-based Bay Labs said that the partnership involves multiple initiatives including the development of new AI-powered algorithms in Bay Labs’ EchoMD software suite and the integration of EchoMD algorithms into Edwards’ CardioCare quality care navigation platform, as well as support for ongoing clinical studies.

“Our vision is to improve patient care throughout the continuum from disease detection to appropriate intervention. Working with Edwards to deploy Bay Labs’ AI software with deep learning technology into clinical settings has the potential to derive quality improvements and to increase the accuracy of timely heart disease detection,” Bay Labs co-founder & CEO Charles Cadieu said in a prepared statement.

Bay Labs said that it has already integrated EchoMD algorithms into the CardioCare platform for investigational use to “retrospectively analyze echocardiograms,” and added that it believes that integration of the existing and future algorithms could improve quality and increase heart disease detection.

“It is unfortunate that patients suffering from severe aortic stenosis frequently do not receive a proper diagnosis, for a variety of reasons. The value of Bay Labs’ technology is in providing help for these patients to be appropriately diagnosed and successfully find their way to proper treatments,” Edwards strategy & corp dev corporate VP Don Bobo said in prepared remarks.

Earlier this month, Edwards Lifesciences launched a pivotal trial of its Pascal mitral valve repair system, with the first procedure being performed at Atlantic Health System’s Morristown Medical Center.

The post Edwards Lifesciences, Bay Labs ink cardio-focused collab AI-dev deal appeared first on MassDevice.

from MassDevice https://ift.tt/2UxMoNN

[newstfionline]

Why we’re exhausted: Stress and social media are taking their toll

Bill Ervolino, USA Today, Oct. 9, 2017

Marie Sullivan says that she knew something “wasn’t quite right” during a doctor visit, five years ago.

“I thought I might be anemic, but the results of my annual physical were fine,” the Paramus, N.J., resident recalls. “All my numbers were in the normal range. The blood work turned up nothing. I said to my doctor, ‘Are you sure? What’s wrong with me?’”

Her doctor told Sullivan, “You’re getting older.” But Sullivan, 60, wasn’t buying it. “I’m not that old,” she says. “I used to have tons of energy. I know you slow down as you age, but I’m physically exhausted all the time. And I know I’m not the only person who feels this way.”

Exhaustion. Weariness. Fatigue. Whichever phrase you prefer, recurring tiredness seems to be the new normal for a growing number of people, regardless of their age or background.

Causes range from illnesses such as anemia, depression, hypothyroidism, diabetes and heart disease to the increasing overuse of technology and its implications on our mental well-being.

Yes, Facebook, Twitter and Instagram can wear you out, says Dr. Patricia Bratt, a therapist and psychoanalyst with offices in Livingston and New York City.

“Social media can run the gamut from being fabulously uplifting to being totally depressing and exhausting,” says Bratt, who is also the director of trauma and resilience studies at the Livingston, N.J.-based Academy of Clinical and Applied Psychoanalysis. “And this applies to all ages.”

Bratt works with young adults who check their social media constantly--at all hours of the day and night--and they all complain about being tired.

“It impacts their sense of themselves and their identities and makes them anxious,” she says. “Social media has created a new sense of impulsivity and urgency, it can make them feel overwhelmed by what is happening in the world, and all of these factors can be fatiguing and can impact how they sleep.”

Sleep apnea and poor diet are other common culprits of fatigue. And then there is the most obvious cause of all: not enough sleep, which often goes hand in with overwork.

In July, a survey conducted by the National Safety Council found that 97% of Americans have at least one of the leading risk factors for fatigue, which include working at night or in the early morning, working long shifts without breaks and working more than 50 hours per week. Forty-three percent of respondents said they do not get enough sleep to think clearly at work, make informed decisions and be productive.

Three years ago, Dominick “DJ” DeRobertis of Pearl River in Rockland County, N.J., was one of those people. Now 39, DeRobertis works in the construction industry. He drives trucks, operates other heavy machinery and was having problems staying awake.

“I was sleeping two, three hours a night, waking up frequently and was always tired at work,” DeRobertis recalls. “I was taking these 15-minute power naps every two hours. It was bad. Then I put on some weight, and that just made it worse.”

Larry Rodriguez of Fort Lee had a similar complaint. A toll collector on the George Washington Bridge, he suffered from sleep apnea as well as shortness of breath, which he attributed, in part, to his work. “The hours, the fumes ... I would wake up tired and I’d be tired all day,” Rodriguez says. “Then, I’d leave work and take a nap as soon as I got home.”

Both Rodriguez and DeRobertis took part in studies at the Sleep Center at Holy Name Medical Center in Teaneck and were diagnosed with sleep apnea.

Rodriguez now sleeps with a machine called a CPAP (continuous positive airway pressure), which delivers a steady stream of pressurized air into his airways. “And the results were immediate,” he says. “I still like a nap once in a while, but I’m not a zombie anymore.”

DeRobertis uses a variation on the CPAP called a BPAP (bilevel positive airway pressure) machine, which has an additional pressure setting. (The BPAP is used for patients who need to get more air in and out of their lungs while they sleep.)

“I can’t recommend it highly enough,” DeRobertis says of the BPAP. “It changed my life. I don’t have that constant tiredness anymore.”

While sleep apnea is relatively easy to diagnose, other forms of chronic fatigue are not.

Dr. Maria Vila, a physician at Atlantic Health System’s Chambers Center for Well Being in Morristown, N.J., says fatigue is one of the most common complaints among her patients. And, no, she doesn’t think “You’re getting older” is a particularly helpful diagnosis.

“I hear this all the time,” Vila says. “Patients are told, ‘You’re getting older ... you’re a woman .. you’re menopausal ...’ and so on. That’s not what we do here. I start by looking at the patient’s history, their diet, exercise, sleep patterns and stress levels. Then I move on to blood tests. Almost everyone says they were told that their blood tests were ‘normal.’ But I’m not looking for normal. I’m looking for optimal.

“We look at the biochemical processes in your body,” Vila continues. “Is there a vitamin deficiency? We can test for that. Do you have elevated cortisol levels? Remember: Elevated cortisol can your affect your thyroid. What about food sensitivities? Dehydration? All of these things can cause fatigue and we address all of them, without medications. We use supplements, lifestyle changes, stress relief, massage, yoga ... until those numbers come up. Again, we don’t want normal, we want optimal.”

Gary Schulman, a certified fitness trainer from Oradell, N.J., who works with clients coping with chronic diseases, including diabetes and arthritis, also favors a natural approach to fatigue and warns that people living with stress should not ignore it.

“People say stress can kill you, and they’re right,” Schulman says. “In today’s society, most people are on this disease continuum that I call stress without recovery. They’re dealing with stress from relationships, jobs, the toxins they put on their skin, the toxins they eat. And if they continue on that course, it eventually leads to chronic disease, thyroid problems, high blood pressure and more.”

Schulman says that every out-of-shape client who comes to him complains of recurring tiredness. His recovery plan: cardio workouts with some resistance training (beginning at a rate the client can handle), breathing exercises and stress management. As for diet, he urges clients to eliminate refined sugars and processed foods and limit or eliminate wheat products and refined carbs.

“Even if you’re not gluten-intolerant, it can cause inflammation and you’ll feel better without it,” Schulman says of the composite of proteins found in wheat. “As for sugar, the more you consume, the worse you’re going to feel and look.”

Dr. Vila isn’t quite as strict. “I don’t do everything right,” she says, “and I don’t expect people to do everything right. But diet-wise, if you can do 80% good and 20% bad, that’s a good place to start.”

Other causes of fatigue? Dr. Theophanis A. Pavlou, a pulmonologist focused on sleep medicine at the Sleep Center in Teaneck, N.J., deals regularly with sleep apnea patients. “But we also look for related disorders such as hyperthyroidism and hypersomnolence, which is a recurring desire to fall asleep,” he says.

And what about fatigued folks who don’t have sleep apnea, vitamin deficiencies or diet problems, but do have sleepless nights and a lack of energy during the day?

“We’re living in a very complex society,” says Dr. Carlos Rueda, chairman of behavioral health services at St. Joseph’s Healthcare System in Paterson, “and this causes all kinds of problems. We are dealing with perceived threats from everywhere, economic uncertainty, and we are in constant state of fight and flight. And, of course, people are constantly receiving stimuli from their computers and their phones. You need this if you want to stay competitive but this is also creating constant stress that disrupts sleep and disrupts your circadian rhythm.”

Dealing with these stresses, Rueda says, requires time management skills and re-learning how to relax. “Set a time, say 8 p.m. or 9 p.m., when you turn off your computer and TV screens,” he suggests. “We aren’t supposed to be receiving and processing information 24/7. Stop. Take a pause. You want to sleep better? Go sit under a tree and read a book.”

[cardiologyassociatesofmorrist]

Choose New Jersey Cardiology Associates Heart Failure Center for your Heart Care.

Looking for the best heart treatment? If yes then visit New Jersey Cardiology Associates Heart Failure Center. Our specialized team offers comprehensive, cutting-edge treatments for heart failure, ensuring personalized care and support for your cardiac health. Trust our expertise to guide your journey towards a healthier heart. Contact us today today!

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Discover comprehensive heart disease diagnosis in Morristown! Our advanced facilities and expert cardiologists ensure accurate assessments for effective treatment. Your heart health matters – trust us for precise diagnosis and care.

[cardiologyassociatesofmorrist]

Discover the essentials of maintaining heart health as you age in our recent blog. As we grow older, understanding the changes in the cardiovascular system becomes pivotal. The article delves into the structural and functional shifts in the aging heart, offering insights into minimizing risks through lifestyle modifications like regular exercise, balanced nutrition, blood pressure and cholesterol management, weight control, and stress reduction. Embracing these practices nurtures heart health, enabling a vibrant and fulfilling life, regardless of age. To know more, visit us

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Struggling to recover from heart attacks or cardiac surgeries? If yes, then read our blog on 'The Benefits of Cardiac Rehabilitation after a Heart Attack or Surgery' and get tips to enhance your cardiovascular fitness, emotional well-being, and long-term heart health.

[cardiologyassociatesofmorrist]

Discover the Best Cardiologists in Morristown for Precise Heart Disease Diagnosis! Our latest blog unravels the diagnostic journey, revealing key methods employed by top-notch cardiologists. Empower yourself with knowledge and entrust your heart to the experts.

[cardiologyassociatesofmorrist]

Cardiology Patient Education Morristown

Looking for precise diagnosis, treatment, and prevention of your heart disease? If yes, then visit us to access comprehensive cardiology patient education in Morristown. Attend our seminars, and expert-led sessions to enhance your understanding of cardiovascular conditions & treatment. To know more visit us.