Barry M. Massie

Caring.com Expert

About

Barry M. Massie is professor of medicine at the University of California, San Francisco, and chief of cardiology at the San Francisco V.A. Medical Center. Susan E. Ammon is a nurse practitioner at the San Francisco V.A. Medical Center Heart Failure Clinic.

Recently Published on Caring.com

  1. Thursday August 27, 2009

    1. What does "end stage" congestive heart failure mean for my mother?

      Answer - Heart failure is a serious condition -- but it's also one that can be treated with considerable success. I don't like the term "end stage" because many patients improve even if their overall heart function is poor. I've had patients who were labeled this way who have done well for years.

  2. Sunday November 18, 2007

    1. Can Coenzyme Q10 raise my mother's ejection fraction?

      Answer - There have been quite a few studies of CoQ10 and heart failure, but none of the best-designed ones have shown any benefit from this expensive treatment. Unlike CoQ10, many of the medicines prescribed for heart failure have shown clear benefits in prolonging survival, preventing hospitalization, and relieving symptoms...

    2. Can exercise improve ejection fraction?

      Answer - Cardiac rehabilitation may not play a major role in raising your mother-in-law's EF, but it should improve her quality of life and her ability to be active. EF is a helpful marker for physicians, but it isn't the be-all and end-all of rehabilitation. Some patients feel good and remain active in spite of having a low EF...

    3. Is dad's back pain from heart failure medication?

      Answer - We've never seen back pain due to a diuretic, so it's unlikely that your father's pain is linked to that medication. Patients often attribute new symptoms to their medications, but there are actually many causes for back pain, some of which can be serious. Your father needs to be evaluated by his doctor...

    4. Can you overcome fatigue from medication?

      Answer - Many of the medicines that improve heart function and survival in heart failure patients also lower blood pressure. All three of the medicines your mother is taking are often used to treat high blood pressure. In patients with heart failure and a low EF, this can lead to a difficult balancing act...

  3. Thursday September 20, 2007

    1. How can I tell if my mother's having an angina episode or a heart attack?

      Answer - Angina (chest pain) and heart attacks stem from the same cause -- a lack of blood flow and oxygen to the heart due to narrowed or blocked blood vessels. The difference lies in severity and duration.

    2. Is aspirin necessary to treat heart disease?

      Answer - Yes. Aspirin may prevent blood clots from forming in the arteries of the heart, the primary cause of heart attacks in patients with coronary heart disease. I recommend taking a baby aspirin (81 mg) -- higher doses aren't more effective and cause more side effects such as bleeding.

    3. How can I keep my father from overexerting himself after his heart attack?

      Answer - This is a difficult problem that often causes real conflicts. The best approach would be for the two of you to visit his physician together so that you can discuss what levels of activity are appropriate.

  4. Wednesday September 19, 2007

    1. What is giving my father more frequent heart palpitations?

      Answer - There are a number of possible causes. Sometimes palpitations (feeling the heartbeat) are the result of anxiety and have nothing to do with a heart abnormality. Palpitations can also be caused by irregular heartbeats, which may feel like extra beats or skipped beats. Even though this is common and usually isn't serious, it can still be worrisome...

    2. Is a "racing heart" normal for someone with heart disease after a bypass?

      Answer - It's not uncommon, but that doesn't mean it's nothing to be concerned about. Your mother's symptoms should be reported to her physician immediately.

    3. Is Discomfort After Angioplasty Normal?

      Answer - It's not unusual to have brief episodes of chest pain in the first few hours after an angioplasty, but any sustained or recurrent chest pain, pressure, or discomfort should be reported to your father's physician. Prolonged symptoms may mean that the stent -- a small tube placed inside an artery to keep...

    4. How can I convince Dad to stop smoking?

      Answer - It's very unlikely that your father doesn't know he shouldn't be smoking, and it rarely helps to nag. Ideally, someone other than a family member, such as his physician or maybe even a close friend, should take the lead. Family dynamics may make it difficult for you to get through to him, but someone more detached might deliver the message clearly... 1 Comment

  5. Tuesday September 18, 2007

    1. Can heart bypass surgery change someone's personality?

      Answer - Heart surgery -- or even receiving a diagnosis of heart disease -- can change someone's personality, pretty much like any psychological trauma. Sometimes there can be changes in the brain related to the surgery that cause personality changes, but more often it's just the shock of recognizing that you have a serious condition... 1 Comment