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Medical Insider Blog

Treating Cardiac Disease

  • Posted Jun 04, 2009
  • Alan Niederman, MD, FACC, FACP

Angina is what we call the symptom of chest discomfort that is caused by lack of blood flow to the heart muscle.  It has multiple causes but the one that is most common is atheroscelerotic blockages in the heart arteries causing limitation of blood flow.  It can be at rest or exercise because the symptom is a result of  a combination of a person's heart rate and blood pressure.  These same blockages can lead to heart attack in other circumstances. The most common treatment for angina is medication.  These drugs fall into various classes of medication. The oldest is nitroglycerine, which has been in use since 1870 when it was first used by Thomas Bruton in England for the treatment of angina and reported in The Lancet in 1879.  It is only recently that the mechanism of action of nitroglycerine has been understood as an example of how long it takes for science to catch up with the practice of medicine.  Beta-Blockers are a mainstay of treatment.  They were invented by a brilliant Scottish doctor and pharmacologist Dr. James Whyte Black in the late 1950s.  Interestingly, he also invented Cimetidine, which was a new class of drugs to treat stomach ulcers known to most people as Tagamet.  For these and other advances, he was awarded the Nobel Prize for Medicine in 1988.  Beta blockers are used to control both the heart rate and the blood pressure in patients with angina.  This allows the heart to receive sufficient oxygen carrying blood for energy utilization. Calcium channel blockers are medications that have predominantly heart rate slowing or vasodilatation mechanisms of action.  These are commonly used as drugs such as Norvasc, Cardizem, Procardia or Calan.  They lower the heart rate and overall blood pressure much as the Beta Blockers. Next week I will discuss what is probably the most important advance, in atherosclerotic heart disease, the statin drugs.


Blog Dedicated to Research Launched

  • Posted Jun 01, 2009
  • Alan Niederman, MD, FACC, FACP

bright-ideaWelcome to the JMHVRI blog. My purpose in hosting this blog is to be personal and educational. I will strive to bring the practice of cardiology and the groundbreaking research that my colleagues and I do to your attention. We are here for our community as Holy Cross and the Sisters of Mercy have been for over 50 years.

Heart disease is the leading cause of death in the United States for both men and women. Much has been learned over the past years but significant issues still remain. Information is now widely available on the Internet but much of it requires interpretation and some is just incorrect. This site will be a place to discuss these issues and concerns.

The JMHVRI is involved in groundbreaking research. We are the only site in South Florida for some of this work. I will highlight these studies so that you can participate or pass the information on to others who might be in need.

Our research institute is currently working on Adult Stem Cell therapy for the treatment of angina which can not be remedied with medication, surgery or angioplasty and as a treatment for heart failure which is still problematic in spite of all known therapies.

We are working on new therapy to replace Coumadin, as well as a new class of drugs known as Thrombin inhibitors for the treatment of clots. On new ways to treat high cholesterol, on new treatments for heart attacks, on novel drugs for the treatment of congestive heart failure to name just a few of our projects. I will inform you in depth about all these projects and more.

It is an exciting journey and I welcome you to join me.


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About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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