Year End Summary
This week marks the one-year anniversary of this cardiology blog. Now that 2009 has come to an end I’d like to take this opportunity to summarize the best pieces of the previous 52 weeks. It seems every other publication from Time magazine to Mad magazine allows themselves the luxury of taking a week off by recycling a year’s worth of previous material, so I figure “Why not do the same?”
Below you’ll find links to all sorts of useful information and answers to nearly every important question in the world of cardiology.
Does elective coronary stenting decrease your chance of a future heart attack? See the entry from February 18.
What’s the best dose of aspirin for you? June 22
Are women more or less prone to strokes than men and how do they fare when they suffer a stroke? February 11
What causes palpitations in healthy people? August 24
What does “Do Not Resuscitate” (DNR) mean and how does it affect end-of-life care in the hospital setting? March 2
What are the best internet sites for medical information? December 7
What do you do if you have symptoms that no one can figure out? October 19
What can you conclude if you have chest pain that is relieved in the emergency room with a dose of nitroglycerin? April 6
Do we really use rat poison to prevent strokes in humans? February 23
Is marathon running dangerous? October 26
What kind of influence do drug companies have on our prescribing practices? May 11
Should someone with heart problems get the flu shot? October 5
How much sedation are you really going to get with that medical procedure? May 18
What constitutes adequate exercise for your heart? May 26
What’s the latest thing in cardiac imaging and what are the risks? November 23 and January 11
What are the treatment options for atrial fibrillation? December 21
How can you best prepare for your next visit with your doctor so that your important questions will get answered? March 23
Should you limit your peak heart rate when you exercise? June 1
What are the characteristics of a good doctor? September 14
How important is quitting smoking? August 10. What’s the latest on smoking cessation products? July 13
How useful is it to ask your surgeon how many times he or she has performed the procedure you’re scheduled to have? April 20
How can you stay in good shape as you age? August 3 and September 28
What can you and your doctor do to cut your pharmacy expenses? August 17
What’s the latest on the defibrillator ex-president George Bush received to protect his heart from the trauma of his pending divorce? Oh, wait. That wasn’t my blog. That little pearl of scientific insight comes from The Globe. No wonder their readership is bigger than mine.

Eric Van De Graaff, MD is a Heart & Vascular Specialist at CHI Health Clinic.
Jill Ogg-Gress, DNP
Congratulations on a successful year of blogging. I've enjoyed reading your posts and use the information on a frequent basis. Thanks for all of your dedication to the field of cardiology and hard work!
Dr. Van De Graaff
Kate, Thanks for your question about the sizes of cholesterol particles. You’re not alone in your confusion—it’s a complicated matter. When we report the numbers from a lipid panel (total cholesterol, triglycerides, LDL and HDL cholesterol) we don’t make mention of the subtypes of LDL molecules. It turns out that there are many different varieties of LDL, some of which are more atherogenic (causing coronary plaque formation) than others. While it doesn’t cause clotting per se (that’s the job of the platelet cells) the small LDL particles have the ability to induce more disease in the vessel wall than the larger ones. We don’t typically measure LDL particle size because, to be quite honest, we don’t really know what to do with the information. It has taken decades of research and hundreds of thousands of patient volunteers to solidify our current practice which principally targets the LDL number without respect to size. We know that treatment of high LDL with a statin medication is very effective at reducing the risk of stroke and heart attack. We don’t know if treating patients with a higher ratio of small dense LDL particles more aggressively will yield any additional benefit. In the end the answer that most lipid experts will give is that we should stick with what we know best. Target the LDL, watch your diet, don’t smoke, exercise, avoid weight gain, and you’re doing the best that science can offer. Dr. VDG
Arie
Dr. Van De Graaff, I love the blog and felt that I've learned all sorts of practical advice for taking care of my heart. However, you left out some of my favorite highlights: Just what goes into a McBlubber burger? July 27 Which Hollywood action star will ultimately save us from an out-of-control meteor? October 4
Kate Hanlon
Dr Van De Graff I heard a discussion on the radio about the fact that there are two different sizes of lipids in our veins. That some folks have large lipids which, because of their size, do not form clots in our veins and then there are the small ones, which do create clots (as well as other forms of cardiac problems) and that folks need to find out which they have and make sure to take medication if they have the smaller ones. First have you heard of this? If you have what is your opinion? Also what test would I request that my doctor do should I wish to find out what size lipids I have? Thanks!
Joel
Thank you for all the work you've done in this blog. I'm sure it's been difficult but I have thoroughly enjoyed reading them every week. They are well researched and fun to read. Keep up the good work.