Latest / Morning Medical with Dr. Chow / Diastolic Heart Failure, Sunburn Prevention, and Strawberry Health Insights

Transcript

Diastolic Heart Failure, Sunburn Prevention, and Strawberry Health Insights · Morning Medical with Dr. Chow

• 0:00
  Welcome to another episode of Morning Medical with Dr.
• 0:02
  Chow.
• 0:03
  I'm your host, Dr.
• 0:05
  Chi-Ming Chow.
• 0:07
  Today, we're diving into a topic that's crucial for understanding certain types of heart
• 0:12
  failure – specifically, diastolic heart failure.
• 0:15
  This condition is often misunderstood, so let's take a closer look at what it is, what causes
• 0:20
  it, and how it can be managed.
• 0:25
  Diastolic heart failure occurs when the left ventricle of your heart becomes stiff and
• 0:30
  bulky, making it difficult for your heart to fill up with enough blood.
• 0:35
  This means that less blood is pumped out to the rest of your body.
• 0:40
  It's a serious condition, but the good news is that once it's diagnosed, there are meaningful
• 0:45
  steps you can take to manage it.
• 0:48
  To get a better understanding, let's compare diastolic heart failure to systolic heart
• 0:53
  failure.
• 0:54
  In diastolic heart failure, the left ventricle is rigid, whereas in systolic heart failure,
• 0:59
  the left ventricle becomes limp and can't pump hard enough to push out a healthy amount of
• 1:04
  blood.
• 1:06
  So, what causes diastolic heart failure?
• 1:09
  Aging is the most common cause, as our hearts and blood vessels naturally stiffen over time.
• 1:15
  Other contributing factors include high blood pressure, diabetes, coronary artery disease,
• 1:21
  obesity, chronic kidney disease, sleep apnea, and atrial fibrillation.
• 1:27
  Each of these conditions puts extra strain on the heart, leading to the thickening or
• 1:31
  enlargement of the heart muscle.
• 1:34
  Symptoms of diastolic heart failure can vary but often include shortness of breath, fatigue,
• 1:40
  swelling in the feet, ankles, legs, or abdomen, and a lasting cough or wheezing.
• 1:46
  You might also experience a fast or irregular heartbeat, dizziness, confusion, increased
• 1:52
  nighttime urination, nausea, or a lack of appetite.
• 1:57
  Diagnosing diastolic heart failure typically involves a physical exam and a review of your
• 2:02
  health history.
• 2:04
  Doctors will look for symptoms like shortness of breath and swelling, and may conduct tests
• 2:08
  such as echocardiograms, blood tests, electrocardiograms, chest X-rays, or stress
• 2:15
  tests to get a clearer picture of your heart's function.
• 2:18
  While there's no easy cure for diastolic heart failure, proper management can significantly
• 2:23
  improve symptoms and quality of life.
• 2:26
  Treatment plans often include lifestyle changes like reducing sodium intake, eating more fresh
• 2:31
  foods, regular exercise, quitting smoking, and limiting alcohol.
• 2:36
  It's also important to manage other health issues like diabetes or high blood pressure.
• 2:42
  Medications may also be part of the treatment strategy.
• 2:46
  Common options include diuretics to reduce swelling, mineralocorticoid receptor
• 2:51
  antagonists, blood pressure medications, and SGLT2 inhibitors, which are usually used for
• 2:56
  diabetes but can also improve heart function.
• 3:01
  Preventing diastolic heart failure involves maintaining a heart-healthy lifestyle.
• 3:05
  This means following a balanced diet, staying physically active, managing stress, and
• 3:12
  avoiding excessive alcohol and tobacco.
• 3:15
  Regular check-ups with your doctor are key to catching any issues early and keeping your
• 3:19
  heart in good condition.
• 3:22
  In summary, if you have diastolic heart failure, the left ventricle of your heart
• 3:26
  doesn't fill with enough blood to meet your body's needs.
• 3:30
  Although there's no cure, medications and lifestyle changes can help you manage symptoms
• 3:34
  and lead an active life.
• 3:36
  Many people with this condition live full, satisfying lives by following their doctor's
• 3:40
  advice and making healthy choices.
• 3:44
  Sunburn is a common skin injury that occurs when your skin is exposed to excessive
• 3:49
  ultraviolet rays from the sun.
• 3:51
  Despite numerous health warnings, many people still experience sunburn at least once a year.
• 3:57
  This is particularly concerning because repeated sunburns can lead to more serious skin
• 4:01
  conditions, including skin cancer.
• 4:04
  The cause of sunburn is straightforward: when your skin is exposed to the sun for too long,
• 4:09
  it burns, becoming red and irritated.
• 4:12
  Underneath this visible damage, ultraviolet rays can penetrate deep into the skin, altering
• 4:17
  your DNA and accelerating skin aging.
• 4:20
  Over time, this can increase the risk of skin cancers, including melanoma.
• 4:25
  There are three types of ultraviolet light: UVA, UVB, and UVC.
• 4:31
  While UVC light doesn't reach the Earth's surface, UVA and UVB rays do and are
• 4:38
  responsible for skin damage.
• 4:40
  Infants and children are particularly sensitive to these rays, making it crucial to protect
• 4:44
  their skin from sun exposure.
• 4:47
  Sunburns can vary in severity.
• 4:50
  A first-degree sunburn affects only the outer layer of the skin, usually healing within a
• 4:55
  week.
• 4:55
  A second-degree sunburn is more severe, damaging the middle layer of skin and
• 5:00
  potentially causing blisters.
• 5:02
  These can take several weeks to heal.
• 5:05
  A third-degree sunburn, although rare, affects all layers of the skin and requires immediate
• 5:10
  medical attention.
• 5:13
  Signs of sunburn include red, painful skin, which can swell and blister.
• 5:18
  Severe cases might even cause systemic symptoms like fever, chills, nausea, and weakness,
• 5:25
  resembling flu-like symptoms.
• 5:27
  As the skin begins to heal, it often peels and itches.
• 5:32
  To alleviate sunburn symptoms, you can apply cold compresses or take cool baths to soothe
• 5:37
  the skin.
• 5:39
  Creams or gels containing menthol, camphor, or aloe vera can help relieve pain and
• 5:45
  inflammation.
• 5:46
  Over-the-counter hydrocortisone cream and nonsteroidal anti-inflammatory drugs such as
• 5:52
  ibuprofen can also be effective.
• 5:55
  It's important to stay hydrated and avoid further sun exposure until the burn heals.
• 6:01
  In some cases, sunburn requires a doctor's attention, especially if you experience a high
• 6:07
  fever, severe pain, blisters covering a large area of your body, or signs of infection.
• 6:13
  Additionally, if you notice changes in any moles or skin lesions, it's important to
• 6:18
  consult a healthcare professional, as these could be early signs of skin cancer.
• 6:24
  Repeated sunburns can lead to complications such as premature skin aging, eye problems like
• 6:29
  cataracts, and an increased risk of precancerous lesions and skin cancer.
• 6:35
  It's crucial to take sunburn seriously and protect your skin.
• 6:39
  Preventing sunburn involves several strategies.
• 6:42
  Avoid the sun during peak hours, typically between 10 a.m.
• 6:46
  and 4 p.m., seek shade, and wear protective clothing like hats and long sleeves.
• 6:51
  Applying a broad-spectrum sunscreen with a sun protection factor of at least 30 is essential.
• 6:57
  Remember to reapply sunscreen every two hours, or more often if you're swimming or sweating.
• 7:04
  Some medications can increase your skin's sensitivity to the sun, so it's important to
• 7:09
  discuss any prescriptions with your doctor to ensure you're taking the necessary precautions
• 7:13
  to protect your skin.
• 7:16
  Today, we're delving into a popular wellness trend that's been making waves on social media
• 7:22
  – it's called "sleepmaxxing." You might've come across this term if you're active online, as
• 7:27
  it's been touted as the ultimate way to achieve a perfect night's sleep.
• 7:32
  But what does sleepmaxxing really entail, and does it actually work?
• 7:37
  Let's break it down.
• 7:39
  The concept of sleepmaxxing involves a variety of strategies aimed at optimizing your sleep
• 7:45
  experience.
• 7:47
  These include keeping your mouth closed while you sleep, avoiding liquids a few hours before
• 7:51
  bedtime, taking a shower right before hitting the sheets, eating a kiwi shortly before bed,
• 7:58
  setting your bedroom to a cooler temperature, ensuring a dark and quiet environment, using a
• 8:03
  white noise machine, and incorporating certain supplements into your routine.
• 8:09
  Dr.
• 8:10
  Laxminarayan Prabhakar, a sleep medicine fellow at Long Island Jewish Medical Center, shared
• 8:16
  some insights on this trend.
• 8:17
  He believes that many of these strategies can indeed be beneficial.
• 8:21
  However, he cautions that some supplements, like melatonin, are not primarily meant to
• 8:26
  enhance sleep efficiency.
• 8:28
  Instead, they're typically used to help people with sleep disorders or those traveling across
• 8:34
  time zones to adjust their circadian rhythm.
• 8:38
  Interestingly, recent research has suggested a potential link between long-term melatonin use
• 8:43
  and cardiovascular risks.
• 8:45
  This highlights the importance of a nuanced and patient-specific approach to sleep improvement
• 8:50
  rather than a one-size-fits-all method like sleepmaxxing.
• 8:55
  When it comes to white noise machines, Dr.
• 8:58
  Prabhakar notes that while they might help some individuals sleep better, others might prefer
• 9:03
  complete silence.
• 9:05
  Similarly, keeping your mouth shut during sleep might reduce snoring, benefiting your partner
• 9:11
  more than yourself.
• 9:12
  And while there is some limited data suggesting that eating kiwi might improve sleep
• 9:16
  efficiency, it's not conclusive.
• 9:20
  Taking a shower before bed can be beneficial by increasing peripheral blood flow, which helps
• 9:25
  cool the body down more quickly, aiding in falling asleep.
• 9:29
  Yet, beyond these measures, some people invest in expensive beds and pillows to address sleep
• 9:34
  issues, regardless of their awareness of the sleepmaxxing trend.
• 9:39
  An interesting point is that a search for "sleepmaxx" and "sleepmaxxing" in PubMed,
• 9:45
  PsycNet, and Google Scholar yielded no results.
• 9:49
  This doesn't mean that some influencer-recommended strategies lack
• 9:52
  evidence, but rather that the concept of sleepmaxxing as a defined package hasn't been
• 9:57
  scientifically studied.
• 9:59
  Some strategies, like taping one's mouth shut during sleep, lack scientific evidence.
• 10:05
  Dr.
• 10:06
  Prabhakar emphasizes that improving sleep often involves cognitive behavioral therapy for
• 10:11
  insomnia.
• 10:12
  This might include creating a calm, quiet, dark, and cool sleeping environment, avoiding
• 10:17
  screen time in bed, steering clear of late dinners, and setting consistent sleep and wake
• 10:22
  times tailored to whether you're a night owl or an early bird.
• 10:26
  While sleepmaxxing might not be the ultimate solution for optimal sleep, it does reflect a
• 10:31
  growing interest in sleep improvement, which is a positive trend.
• 10:36
  Dr.
• 10:37
  Prabhakar advises consulting a physician if you have sleep concerns, as they can guide you
• 10:42
  toward evidence-based treatment approaches.
• 10:45
  One of the significant challenges physicians face is combating misinformation.
• 10:50
  Dr.
• 10:51
  Prabhakar points out that part of their role is to steer patients away from misinformation and
• 10:56
  toward more scientifically-backed methods for improving sleep.
• 11:01
  Today, we're diving into an exciting development in the treatment of heart failure
• 11:06
  with reduced ejection fraction.
• 11:09
  A polypill that combines three of the four mainstays of treatment has shown promising
• 11:13
  results in improving cardiac function and reducing the risks of serious medical events.
• 11:19
  This was reported in a randomized trial presented at the American Heart Association
• 11:23
  annual meeting.
• 11:25
  The trial included 212 patients who were unable to reach their target medication doses.
• 11:31
  By switching their treatment to a once-daily polypill, there was a significant improvement
• 11:36
  in the primary endpoint of left ventricular ejection fraction from baseline to six months.
• 11:42
  Specifically, patients in the polypill group saw their ejection fraction improve from 29.7%
• 11:48
  to 39.9%, compared to 28.9% to 36.5% in the control group receiving enhanced usual care.
• 11:59
  Dr.
• 12:00
  Ambarish Pandey from the University of Texas Southwestern Medical Center in Dallas
• 12:05
  highlighted that polypill patients experienced 60% fewer heart failure hospitalizations,
• 12:12
  emergency visits, and deaths.
• 12:14
  He noted that managing multiple separate pills can be challenging for patients, particularly
• 12:19
  in heart failure, where complex and individualized medication regimens are common.
• 12:25
  The polypill includes the beta-blocker metoprolol succinate, a ten-milligram dose of
• 12:31
  empagliflozin, which is an SGLT2 inhibitor, and a twelve-and-a-half-milligram dose of
• 12:36
  spironolactone, a mineralocorticoid receptor antagonist.
• 12:40
  Dr.
• 12:41
  Carolyn Lam from Duke-National University of Singapore, who wasn't involved in the study,
• 12:46
  pointed out that while the results are encouraging, the polypill lacks the fourth
• 12:50
  commonly used medication, sacubitril/valsartan, which requires twice-daily dosing.
• 12:58
  Dr.
• 12:59
  Lam emphasized the importance of adherence to guideline-directed medical therapy, noting that
• 13:05
  the polypill significantly improved adherence rates.
• 13:08
  Patients taking the polypill reached an adherence rate of 79.3% compared to 54.3% with
• 13:16
  enhanced usual care.
• 13:18
  Adherence to optimal doses of guideline-directed medical therapy also
• 13:22
  improved significantly at one, three, and six months with the polypill.
• 13:29
  The trial, known as POLY-AF, was an open-label study conducted at two centers in Dallas,
• 13:36
  enrolling patients with heart failure with reduced ejection fraction who were not
• 13:41
  achieving their target doses of guideline-directed medical therapy.
• 13:45
  Participants were randomized to receive either the polypill or the enhanced standard of care
• 13:50
  treatment, which included the same medications separately.
• 13:55
  At the start of the trial, participants underwent cardiac MRI and echocardiography,
• 14:00
  which were repeated six months later.
• 14:02
  The average age of participants was 53.5 years, with 22% being women.
• 14:09
  Most participants were Black or of Hispanic ethnicity, and a majority had new-onset heart
• 14:15
  failure at the time of enrollment.
• 14:18
  Beyond improvements in heart function, patients taking the polypill also reported feeling
• 14:23
  better, scoring 8.5 points higher on the Kansas City Cardiomyopathy Questionnaire, a measure of
• 14:28
  quality of life, compared to those receiving enhanced usual care.
• 14:33
  Dr.
• 14:34
  Pandey mentioned that the next steps in the development of the polypill will be multicenter
• 14:40
  studies to assess long-term mortality, morbidity outcomes, cost-effectiveness, and
• 14:46
  implementation strategies.
• 14:48
  This polypill represents a significant step forward in addressing the challenges of
• 14:53
  polypharmacy, particularly for elderly patients with multiple comorbidities.
• 15:00
  Strawberries are a beloved summer fruit, often found in a variety of dishes ranging from
• 15:05
  yogurt to desserts and salads.
• 15:08
  They're an excellent choice for those looking to manage their blood sugar levels, as they're
• 15:12
  a low-glycemic food.
• 15:15
  This means they have minimal impact on blood glucose levels.
• 15:19
  While June is typically the best time for picking fresh strawberries, they're available
• 15:23
  in supermarkets throughout the year.
• 15:26
  Whether consumed raw or cooked, strawberries add a delightful flavor to both sweet and
• 15:31
  savory recipes.
• 15:33
  Despite being a member of the rose family, strawberries aren't technically fruits or
• 15:37
  berries.
• 15:39
  They're actually the enlarged receptacle of a flower.
• 15:42
  These delightful red fruits are cultivated in temperate regions across the globe, including
• 15:47
  South America, North America, Asia, and Europe, making them one of the world's most popular
• 15:52
  berry fruits.
• 15:54
  Nutritionally, strawberries are a powerhouse.
• 15:58
  They're low in calories and sugar compared to other fruits like apples and bananas.
• 16:03
  They pack a punch with fiber and essential nutrients, including high levels of
• 16:08
  antioxidants known as polyphenols.
• 16:12
  These antioxidants help protect cells and tissues in the body by neutralizing free
• 16:17
  radicals, potentially lowering inflammation and reducing the risk of various health conditions.
• 16:24
  Strawberries are particularly rich in vitamin C, providing more of this vitamin per serving
• 16:29
  than an orange.
• 16:30
  They're also a good source of manganese, potassium, calcium, iron, folate, and
• 16:35
  magnesium.
• 16:37
  The antioxidants found in strawberries, such as anthocyanins, not only give them their vibrant
• 16:44
  red color but also increase as the fruit ripens, boosting their health benefits.
• 16:50
  The health benefits of strawberries are extensive.
• 16:53
  They can improve insulin sensitivity in nondiabetic adults, making them a smart choice
• 16:59
  for managing glucose levels.
• 17:01
  Their anti-inflammatory properties may also help protect the skin from damage, particularly
• 17:07
  from ultraviolet A radiation, and may aid in managing conditions like osteoarthritis by
• 17:12
  reducing pain and swelling.
• 17:15
  Strawberries are also associated with a lowered risk of cardiovascular disease.
• 17:19
  They may help improve heart health by lowering blood fats known as triglycerides, as well as
• 17:24
  total and LDL cholesterol.
• 17:27
  Regular consumption can support healthy blood vessel function and lower blood pressure,
• 17:31
  contributing to overall cardiovascular wellness.
• 17:35
  In addition to heart health, strawberries promote better gut health due to their fiber
• 17:40
  content, which aids digestion and acts as a prebiotic, feeding beneficial gut bacteria.
• 17:46
  A healthy gut microbiome can enhance the body's utilization of antioxidants like anthocyanins,
• 17:52
  reinforcing the fruit's health benefits.
• 17:56
  There's also evidence suggesting that strawberries might lower the risk of certain
• 18:00
  cancers.
• 18:01
  Antioxidants in strawberries could slow cancer cell growth, although more research is needed
• 18:07
  to fully understand the mechanisms at play.
• 18:10
  Additionally, the consumption of antioxidant-rich fruits like strawberries has
• 18:15
  been linked to slower cognitive decline and a reduced risk of Alzheimer's disease.
• 18:22
  While strawberries are generally safe for most people, some individuals might experience
• 18:26
  allergic reactions, particularly those allergic to birch pollen.
• 18:31
  This is known as oral allergy syndrome and can cause symptoms such as itching or swelling of
• 18:36
  the lips, mouth, or throat.
• 18:40
  To maximize the benefits of strawberries, it's important to choose medium-sized, firm, and
• 18:45
  deep red berries, as they don't ripen after being picked.
• 18:49
  Storing them properly in the refrigerator and using them in a variety of recipes can help you
• 18:54
  enjoy their taste and nutrition throughout the year.
• 18:59
  Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is a condition that can
• 19:06
  significantly disrupt daily life.
• 19:09
  Unfortunately, there's no cure for this syndrome, and no medications have been approved
• 19:14
  by the United States Food and Drug Administration specifically for its treatment.
• 19:19
  However, managing symptoms is possible with a combination of over-the-counter and
• 19:24
  prescription medications, tailored to individual needs.
• 19:29
  One of the common challenges faced by individuals with chronic fatigue syndrome is
• 19:33
  sleep problems.
• 19:34
  Many people with this condition struggle with sleep disorders, which can exacerbate fatigue.
• 19:40
  To improve sleep quality, doctors typically recommend establishing good sleep hygiene
• 19:45
  first.
• 19:46
  This includes maintaining a consistent bedtime and wake time, ensuring the bedroom is quiet,
• 19:51
  dark, and cool, and avoiding electronics before bed.
• 19:55
  If these measures aren't sufficient, over-the-counter sleep aids such as
• 19:59
  antihistamines might be recommended, though they can cause daytime drowsiness.
• 20:05
  For those who need further assistance, prescription sleep medications may be
• 20:09
  prescribed.
• 20:10
  These include options like eszopiclone, ramelteon, zaleplon, and zolpidem, which are
• 20:16
  intended for short-term use to help regulate sleep patterns.
• 20:20
  Other medications, such as amitriptyline, benzodiazepines, and certain antidepressants,
• 20:27
  might be used to help individuals fall asleep or stay asleep.
• 20:32
  It's crucial to weigh the benefits and potential side effects of these medications
• 20:36
  with your doctor, as they can sometimes mimic the symptoms of chronic fatigue syndrome.
• 20:42
  Stimulants are another class of medications sometimes used to address fatigue and cognitive
• 20:47
  issues in chronic fatigue syndrome.
• 20:50
  These stimulants, often used for attention-deficit hyperactivity disorder, can
• 20:54
  provide energy and improve focus.
• 20:57
  However, they carry the risk of worsening the condition by leading to a cycle of overexertion
• 21:03
  followed by crashes.
• 21:05
  Additionally, these medications can be addictive and may cause irritation or
• 21:10
  agitation, especially in standard doses.
• 21:14
  It's important that they are prescribed and monitored by a healthcare provider familiar
• 21:19
  with their use in chronic fatigue syndrome.
• 21:22
  Pain management is also a key component of treating chronic fatigue syndrome, as many
• 21:28
  patients experience headaches, migraines, and muscle or joint pain.
• 21:31
  Over-the-counter pain relievers like acetaminophen, aspirin, and ibuprofen are
• 21:37
  commonly used.
• 21:39
  If these aren't effective, stronger prescription medications or tricyclic
• 21:44
  antidepressants, which can help with chronic pain, may be considered.
• 21:50
  In some cases, referral to a pain specialist might be necessary for more targeted
• 21:55
  management.
• 21:57
  Orthostatic intolerance, which includes symptoms like dizziness and rapid heart rate
• 22:02
  upon standing, is another symptom that can affect those with chronic fatigue syndrome.
• 22:08
  Medications such as fludrocortisone, midodrine, and propranolol can be used to manage these
• 22:14
  symptoms.
• 22:15
  It's important to discuss these symptoms with a healthcare provider to determine the most
• 22:19
  appropriate treatment.
• 22:22
  Depression is a common comorbidity in chronic fatigue syndrome, affecting about half of those
• 22:27
  diagnosed.
• 22:29
  Antidepressants may be prescribed to help manage depression, but it's important to choose
• 22:33
  ones that minimize side effects that could worsen chronic fatigue syndrome.
• 22:39
  Options include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake
• 22:45
  inhibitors, and other classes like tricyclic antidepressants.
• 22:49
  Additionally, talk therapy, such as cognitive behavioral therapy, can be a valuable tool in
• 22:55
  managing both depression and chronic fatigue syndrome.
• 22:59
  Research is ongoing into experimental medications that might help manage chronic
• 23:03
  fatigue syndrome symptoms.
• 23:06
  Some of these include Ampligen, low-dose naltrexone, and rituximab.
• 23:11
  Studies are also exploring the potential benefits of antivirals, neuromodulators, and
• 23:17
  other innovative approaches.
• 23:19
  While these are not yet widely available treatments, they offer hope for future
• 23:23
  management options.
• 23:25
  In conclusion, while chronic fatigue syndrome remains a challenging condition to treat, there
• 23:30
  are various strategies and medications that can help manage its symptoms.
• 23:35
  It's essential to work closely with your healthcare provider to tailor a treatment plan
• 23:40
  that addresses your specific symptoms and improves your quality of life.
• 23:45
  Thank you for joining me on this episode of Morning Medical with Dr.
• 23:48
  Chow.
• 23:49
  Stay well, and I'll see you next time as we continue to explore the latest in medical and
• 23:55
  health news.