Medical Tests & Procedures Archive

Several new technologies and medications that may benefit the heart are moving into cardiology care.

As regular readers of the Heart Letter know, our features tend to focus on lifestyle advice and currently available therapies for heart disease. As the new decade begins, we're also looking to the future. Editor in Chief Dr. Deepak L. Bhatt selected five promising new developments in cardiovascular research that you may be hearing more about in the coming years.

1. Digital stethoscopes

First developed more than 200 years ago, the instrument doctors use to listen to the heart and lungs has undergone some high-tech improvements in recent years. The latest digital stethoscopes feature specialized microphones and sensors that filter, buffer, and amplify sounds from the heart. The sounds are then converted to a digital signal and sent wirelessly to a smartphone, where the patterns can be visualized and further analyzed. Some models are so sensitive they can detect turbulent blood flow in the arteries of the heart, possibly enabling doctors to detect coronary artery disease. Studies assessing that potential use are currently under way.

They often lead to follow-up appointments and more testing.

Modern medical imaging saves lives: it can find a blocked artery, a bulging blood vessel, or a suspicious mass. But many times, an x-ray, CT scan, MRI scan, or ultrasound exam looking for one kind of problem can reveal an anomaly that's unrelated and unexpected. Such incidental findings can lead to more testing, more medical bills, and a great deal of anxiety.

"Frequently radiologists will point out something and say it's probably benign, but recommend an MRI. Once you've been told something might be abnormal, you might feel nervous until you know what it is," says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

The once-a-year appointment can reveal vital health information for both you and your doctor.

It's usually covered by your health insurance, it doesn't take much time, and it's a great way to learn about your present and future health.

While men often call it the yearly physical, the annual ritual is better named a wellness visit or preventive health appointment. Whatever you call it, men should still have one every year as it remains an important part of primary care, according to Dr. Asaf Bitton, executive director of Ariadne Labs and primary care physician at Harvard-affiliated Brigham and Women's Hospital.

Here is what men need to know to minimize discomfort of a prostate biopsy and get the best results.

What Is It?

A heart transplant is surgery in which a patient with a life-threatening heart problem receives a new, healthy heart from a person who has died. In a heart transplant, the patient who receives the new heart (the recipient) is someone who has a 30 percent or greater risk of dying within 1 year without a new heart. Although there is no absolute age limit, most transplants are performed on patients younger than 70 years old.

The person who provides the healthy heart (the donor) is usually someone who has been declared brain dead and is still on life-support machinery. Heart donors are usually younger than 50, have no history of heart problems, and do not have any infectious diseases.

What Is It?

A heart-lung transplant is surgery for someone with life-threatening heart and breathing problems. Surgeons remove the damaged heart and lungs and replace them with a healthy heart and lungs from a person who has died.

The person receiving the new heart and lungs (the recipient) is someone with a high chance of dying within one to two years without a transplant. The person providing the healthy heart and lungs (the donor) is someone who is brain dead, but still on life-support machinery.

What Is It?

In lung transplant surgery, someone with life-threatening respiratory problems is given one or two healthy lungs taken from a person who has died. If one lung is transplanted, the procedure is called a single-lung transplant. If both lungs are transplanted, it is a bilateral or double-lung transplant.

Lungs for transplantation usually come from young, healthy people who have had severe brain damage because of trauma or cardiac arrest (a stopped heart). Their lungs and other organs are maintained with life-support machinery.

News briefs

About half of all people in the United States living with a diagnosis of HIV (human immunodeficiency virus) are age 50 or older. But new data from the CDC suggest most Americans have never been tested for the virus (which causes AIDS, the late-stage phase of HIV infection). According to the June 28, 2019, Morbidity and Mortality Weekly Report, less than 40% of people in the United States have had an HIV test, even though the CDC recommends routine testing at least once for everyone age 13 to 64. The CDC notes that older adults sometimes aren't tested for HIV because they don't consider themselves at risk for infection or because their health care providers don't offer them the test. Older people may also mistake late-stage HIV symptoms, such as weight loss and frequent illness, for signs of normal aging. Those symptoms occur because HIV attacks the body's immune system. But a delay in diagnosis allows the virus to cause more damage. That's unfortunate, since medications can keep the infection from progressing.

If you haven't had an HIV test, talk to your doctor about whether it's right for you, no matter your age, especially if you are sexually active or have had more than one sex partner.

Research we're watching

With some smartphones, you can unlock the phone simply by showing your face. One day, a short video of your face may do far more — maybe even measure your blood pressure.

That's the premise of a novel smartphone-based technology described in the August issue of Circulation: Cardiovascular Imaging. For the study, researchers took two-minute videos of 1,328 Chinese and Canadian adults, using an iPhone equipped with transdermal optical imaging. The software measures blood pressure by detecting blood flow changes in a person's face. When compared with readings taken using a traditional blood pressure cuff, the video blood pressure readings were about 95% accurate.

Active surveillance and watchful waiting are the most conservative — and increasingly popular — approaches to prostate cancer management. Is one of these right for you?

Over the years, the outcome for prostate cancer has turned out to be better than expected for many men.

While prostate cancer is quite common, the risk of dying from the disease is low, even without treatment. In fact, most diagnosed men will die from something else, like heart disease. Even so, prostate cancer remains the second leading cause of cancer deaths (after lung cancer) in men, according to the American Cancer Society.