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Category Archives: Medical Issues

Yes, You Can Die From A Broken Heart

The term “broken heart” is well known to everyone. From Romeo and Juliet, to shattered romances, to many a teenager’s angst, a broken heart seems to be part of life. Everyone’s been there. But can you die from a broken heart? You bet.

In a very unusual medical condition known as Takotsubo’s Cardiomyopathy, dying from a broken heart can actually occur. Takotsubo is a Japanese octopus trap and is shaped like a dilated and damaged left ventricle as happens in a cardiomyopathy.

Takotsubo Pot and LV

Cardiomyopathy is a big word but when broken down into its components is fairly easy to understand. Cardio means heart, myo means muscle, and opathy means disease. So a cardiomyopathy is a disease of the heart muscle. It often results from coronary artery disease where multiple heart attacks (myocardial infarction or MI) have occurred, damaging the muscle severely. It also can occur after viral infections, certain meds and drugs that are toxic to the myocardium, odd diseases like amyloidosis, some members of the disease group we call autoimmune disorders, and other maladies.

We analyze the pumping function of the heart in many ways. Echocardiograms, CT and MRI angiograms, and with a ventriculogram done as part of a cardiac catheterization procedure. Here a catheter is passed through an artery and into the left ventricle—the heart’s main pumping chamber—and contrast material is injected while a digital video is made. A normal ventriculogram shows the heart squeezing in tightly as the heart muscle contracts.

Normal LVgram

An abnormal one, such as is seen in a cardiomyopathy, will show diminished “squeezing” during the contraction phase (systole) of the cardiac cycle.

CMP LVgram

An odd form of cardiomyopathy is Takotsubo’s Cardiomyopathy. In this circumstance, extreme emotional upset changes the physiology of the heart muscle in some fashion and leads to it being “stunned” or damaged. The actual mechanism for how this happens is not known but the result is a significant weakness of the heart muscle, which, in turn, can lead to heart failure and death. It is not common, but it is real.

This is likely what happened to Joanie Simpson and perhaps the famous actress Debbie Reynolds.

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Metal Pica: Hmmm, That’s Good—-Or Not

 

Pica is the persistent and compulsive eating of substances that have no nutritional value. Things like dirt (geophagia) or rocks (lithophagia), ice (pagophagia), paint chips, hair (trichophagia), paper (Xylophagia), metal, almost anything.

In the South, clay pica, more so in the past than now, still occurs. Red clay dirt is seen as having health benefits. It doesn’t, and in fact, the clay can bind iron, remove it from the body, and lead to significant anemia.

X-Ray of Geophagia

And oddly, ice pica can be a sign of iron-deficiency anemia. If someone says they feel the need to munch on ice constantly, a search for anemia is in order.

Metal pica is not common but cases do pop up from time to time. Kids swallow coins and paper clips and pieces of aluminum foil because kids do goofy stuff. But some people consume metallic objects in large amounts and, as should be obvious, this has significant health concerns. I mean, a belly full of metal can’t be good.

Such is the case with a 52-year-old man from whom surgeons removed over 100 pieces of metal.

 
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Posted by on March 19, 2018 in Medical Issues

 

The Mystery of Chopin’s Heart

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Did Frederic Chopin die from Tubercular Pericarditis? And what the heck is that anyway?

Pericarditis is an inflammation has occurred of the pericardium, the sac that contains the heart. Most often it is due to a viral infection but there are many others causes. One of the worst is tuberculosis (TB).

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Tubercular Thickening of the Pericardium

 

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X-Ray Showing Thickened Pericardium
(White ring around heart shadow)

Tuberculosis has wreaked havoc in humans for centuries. It has been found in Egyptian mummies and has devastated entire populations. Treatment didn’t appear until the 20th century and in recent years new, more malignant forms have appeared. Even after several millennia, it remains a difficult medical problem.

It attacks the lungs and slowly destroys the tissues, leading to cough, fatigue, weight loss, and muscle wasting—-the reason it was called “the consumption.” It, at times, literally consumed the sufferer.

When it spreads to the heart, particularly the pericardium, it can quickly become deadly. A thick viscous fluid collects in the pericardial sac, compresses the heart, and interferes with its function as a pump. This fluid can also solidify into a leathery trap around the heart so that even survivors of the initial infection can suffer severe, long-term problems that we term constrictive pericarditis—-the encasement restricts cardiac filling and thus effects pumping.

Recent studies suggest that this is what happened to Chopin. His heart took a strange and convoluted journey. He had requested that at his death that his heart be removed and returned to his native Warsaw, Poland. When he died in Paris in 1849, his heart was indeed removed, placed in a crystal jar, and encased in a stone pillar at the Holy Cross Church in Warsaw. In a recent examination, researchers found evidence that suggested he had suffered from TB pericarditis.

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Holy Cross Church

 

Getting Lost in Your Own Home

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What if you couldn’t navigate your own home? What if your child is calling for you in another room, but you can’t figure out how to get there? You just might have Developmental Topographical Disorientation (DTD). Some resort to making detailed maps of their home just to navigate life.

An odd neurological condition for sure.

The Atlantic article: https://www.theatlantic.com/health/archive/2015/05/when-the-brain-cant-make-its-own-maps/392273/

New Scientist article: https://www.newscientist.com/article/dn25578-mindscapes-the-woman-who-gets-lost-in-her-own-home/?full=true&print=true#.U4neU16aGzA

Medical Daily article: http://www.medicaldaily.com/getting-lost-what-happens-when-brains-gps-mapping-malfunctions-245400

 
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Posted by on January 11, 2018 in Medical Issues

 

Peanut Butter Can Kill You

 

Peanut butter can be deadly. If you’re allergic to peanuts.

Our immune system protects us from all sorts of bad things – – bacteria, fungi, and viruses. Our bodies recognize these foreign invaders and the immune system immediately goes to work manufacturing antibodies against the intruders. These antibody signal for help and pretty soon white blood cells show up along with their buddies known as mast cells. These cells release an array of chemicals that help damage the invaders, which are then consumed by the white blood cells. And life goes on.

But sometimes the immune system overreacts. It produces a massive amount of chemicals that can cause a drop in blood pressure, a tightening of the bronchial tubes, a leaking of fluids within the tissues and, most deadly, the lungs. We call this overwhelming reaction anaphylaxis. It is typically immediate and severe.

Such a reaction happened to Miriam Ducre-Lemay. She was allergic to peanuts. Her boyfriend had apparently eaten a peanut butter sandwich and had given her a good night kiss. Then everything went off the rails. She suffered an acute anaphylactic reaction and by the time paramedics arrived it was too late. This illustrates that it only takes a very small amount of an antigen (in this case the peanut oils in the peanut butter) to initiate a severe anaphylactic reaction.

 

In the 1800s, Wagon Train Travel Could Be Deadly

Wagon Train

Many brave souls headed West during the 1800’s, often by wagon train. They fought weather, disease, starvation, hostile folks of all types, and potentially deadly injuries. Medicine was crude, basically non-existent, and many died along the way.

Check out my latest Q&A on the Suspense Magazine Blog:

Could Death From Bleeding Be Delayed For Several Days After a Frontier Wagon Wheel Accident?

Read the answer and listen to the expanded audio information here:

http://suspensemagazine.com/blog2/2017/07/01/could-death-from-bleeding-be-delayed-for-several-days-after-a-frontier-wagon-wheel-accident/

This was one of the many clever questions included in my first Q&A book—MURDER & MAYHEM

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Is Truly Autonomous Robotic Surgery Far Off?

Robot Surgery

You’ve probably heard of robotic surgery. Sure sounds cool and very much like Star Trek. I mean, Bones could do this in his sleep. Right?

But robotic surgery in its current iteration is actually more “remote” surgery. It’s still performed by a surgeon but he sits across the room from the patient at a console where he manipulates handles that in turn do the surgery. A series of lights, cameras, and instruments are inserted through cannulae into the patient, and the surgeon manipulates the instruments under visual guidance and performs the procedure not unlike he would if he were standing next to the patient. This is very expensive equipment as you might imagine.

But, distance can prove a problem here. Time lag is never a good thing in surgery. The surgeon needs everything to happen in real time, particularly if an emergency arises or things go wrong. There is no time for delay under these circumstances.

Think about space travel. Let’s say, that a colony is being constructed on Mars. The initial explorers would be few in number and would have skills more related to space travel and geology and other scientific endeavors. Having a surgeon and a well-equipped operating room might not be possible. Not to mention, most surgeons are not trained to do all procedures – – or at least they are not comfortable with doing them. Robotic surgery could eliminate this problem. But not in its current form. For example, what if a surgeon is performing a gallbladder removal using a robotic device? The patient is on Mars; the surgeon is on Earth. The time lag for instructions to travel the roughly 250,000,000 miles back and forth would be daunting. Currently, communication with the various Rovers that are roaming around the red planet pass through one or more satellite systems and can take anywhere from three or four minutes up to 20 or 25 minutes. In surgery, such delay could prove catastrophic.

The solution, of course, is a completely autonomous robotic surgeon. One that can perform the surgery – – from skin to skin as surgeons like to say – – on its own. One that does not require any ongoing instructions or feedback. One that “sees” what is needed and performs all the needed tasks to complete the surgical procedure. Very heady stuff.

But such research is ongoing right now. A system known as the Smart Tissue Autonomous Robot (STAR) is in development. It’s in its beginning stages and therefore still fairly crude but it is a step in the right direction.

In my second Dub Walker thriller, Hot Lights, Cold Steel, the arena of robotic surgery in the hands of a megalomaniac is in play. Dub and crew, of course, must uncover what is going on and track down the culprits.

 

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