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Is Turbulence Good For The Heart?

It’s hard to believe that turbulence could be a good thing for the heart. Consider how the word turbulent is defined: “Characterized by conflict, disorder, or confusion; not controlled or calm.” Those traits don’t sound very heart-healthy. But when it comes to heart rhythm, it turns out that a turbulent response — to a premature beat — is better than a blunted one. The more turbulent the better.

No, you haven’t missed anything, and turbulence isn’t another of my typos. Until [recently], heart rate turbulence was an obscure phenomenon buried in the bowels of heart rhythm journals.

What Is Heart Rate Turbulence (HRT)?

When you listen to the heart of a young physically-fit patient, you are struck not just by the slowness of the heartbeat, but also by the variability of the rhythm. It isn’t perfectly regular, nor is it chaotic like atrial fibrillation (AF). Doctors describe this — in typical medical speak — as regularly irregular: The heart rate increases as the patient inhales and slows as he or she exhales. This variability occurs as a result of the heart’s responsiveness to its environment. The more robustly and quickly the heart responds, the healthier it is.

HRT seeks to measure how quickly and vigorously the heart rate reacts in response to a single premature beat from the ventricle — a premature ventricular contraction (PVC).  Normally after a PVC, the heart rate speeds for a few beats, and then slows back to baseline over the next 10 beats. The healthy heart responds with a more intense rise in heart rate and a quicker return to baseline. Using simple measurements of heart rate from a standard 24-hour electrocardiogram (ECG) monitor, a propriety software program averages many of these responses and comes up with a measurement of turbulence onset and turbulence slope. Read more »

*This blog post was originally published at Dr John M*

Are Plastic Products Safe? Ask Chemistry Professor, Joe Schwarcz, Ph.D.

Have you heard the new urban legend about plastic products? A growing number of celebrities and websites have been fueling a plastic paranoia, striking fear in the hearts of parents, fitness buffs, and microwave container users. Concerns reached such a fever pitch that I wondered if there may be something to this buzz: Can certain plastics harm our bodies or even cause cancer?

But like the buzz surrounding vaccines and autism (there is NO link between the two), plastiphobia (as I like to call it) is not backed by any clear evidence of human harm. Chemist, Dr. Joe Schwarcz of McGill University (who has no financial ties to plastics manufacturers, by the way) has reviewed the scientific literature and has found plastics to be an extremely unlikely candidate for human injury. (Well, unless you hit someone over the head with a water bottle.) Dr. Schwarcz reviewed plastics safety in a live health chat on December 8th. You can review the entertaining conversation here.

Plastiphobia has fueled an entire industry of plastic-free baby bottles and “microwave safe” containers. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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