DEAR DR. DONOHUE: I have been diagnosed with atrial flutter. I am shocked to find myself with a heart problem. For the past 20 years, I have followed a very healthy lifestyle. I exercise every single day. I eat carefully and take little meat. I have never been overweight. My blood pressure is normal. I have never smoked. What’s the point of living this kind of life if one can still get atrial flutter, a serious heart condition for which I have to take the dangerous blood thinner Coumadin? – P.M.
ANSWER: Thousands of people ask that same question every day. Not all illnesses, including heart ills, are preventable. Without leading the kind of life you have led, you could have developed an untreatable heart condition. Atrial flutter is treatable and shouldn’t shorten your life. It’s not always preventable.
It’s a heart-rhythm disturbance where the atria, the two upper-heart chambers, beat around 300 times a minute. The two lower-heart chambers, the blood-pumping chambers – the ventricles – beat about one-half to one-third that rate.
The object of treatment is to restore a normal heartbeat or to slow the abnormal heartbeat to a reasonable pace. Sometimes a jolt of electricity can accomplish that end. Or a temporary pacemaker can often override the fast heartbeat and permit the heart’s natural pacemaker to resume control of the heart. Heart doctors can destroy patches of heart tissue that are generating the fast heartbeat. The procedure is called ablation therapy, and it is done with a special catheter inched into the heart through a distant blood vessel.
If none of these is applicable to you, heart medicine can slow the heartbeat. Coumadin is prescribed to prevent clot formation in the atria. Those clots might find their way to brain arteries and cause a stroke.
A person with a normal heart in all other respects who develops atrial flutter has a favorable prognosis. I wouldn’t be surprised if your healthy living has put you in that category. Atrial flutter is not the same as atrial fibrillation, the more common heartbeat disturbance.
DEAR DR. DONOHUE: I had a heart attack 10 years ago and then bypass surgery. Now, after a heart catheterization, the doctor showed me that my bypass is blocked. He dismissed me without further treatment after a stress test. I have talked to knowledgeable people, including one doctor, who says this is impossible. Do I need further treatment? – E.D.
ANSWER: Bypass grafts do block up in some people. Your doctor owes you the courtesy of clearing up the issue of further treatment – unblocking the blocked artery with angioplasty or undergoing a second bypass. It could be that your heart has sprouted new blood vessels that have taken over for the blocked vessel. Perhaps your stress test showed your heart gets enough blood when you are working at your maximum.
Even if you have no symptoms and even if your stress test is normal, demand an explanation from the doctor.
The booklet on heart attacks explains this common problem and its treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: You mentioned involuntary eyelid closing without mentioning its cause or treatment. My wife has this condition, and I would appreciate your providing the answers we need. – H.E.
ANSWER: The condition is blepharospasm (BLEFF-uh-row-SPAZ-um) – uncontrollable, rapid eyelid blinking that virtually blinds a person. Or the eyelids can be locked tightly closed. The cause is a disruption in the brain center that controls eyelid muscles. Botox injections, by weakening eyelid muscles, can often stop the blinking. Medicines can also be prescribed.
Your wife should see a neurologist or an ophthalmologist (an eye doctor).
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com
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