Heart failure can cause stiff heart
Dear Dr. Roach: A friend of mine has been diagnosed with “stiff heart” and has kind of given up because there is no treatment. Isn’t there something that can be done?
C.L.
Answer: My best guess is that your friend has a type of heart condition called “heart failure with preserved ejection fraction” (HFpEF).
The left ventricle, which is the chamber of the heart that provides oxygenated blood to the body, is indeed stiff, requiring high pressures to fully fill the chamber. The damage to the heart in HFpEF can come from many conditions, including high blood pressure, diabetes, obesity, blockages in the arteries, atrial fibrillation, kidney or lung disease, sleep apnea, and just getting old.
Specific treatment for HFpEF can be frustrating, but medical advances are catching up. New classes of medicines have been shown to improve symptoms.
In people who are obese with HFpEF, the use of semaglutide has been shown to improve their exercise ability and quality of life.
Dear Dr. Roach: Iam just getting over the horrible shingles. It is horrible and debilitating with nerve pain and rash pain after the blisters start to disappear. Once this miserable thing passes (if it ever does), should I get the new and improved shingles vaccine at some point, or am I good to go for a while? I’m 77 and still in basically good health.
H.B.
Answer: Shingles can be miserable, with pain that can persist for weeks or months (or even years).
Unfortunately, people can get shingles more than once, so you should absolutely get the newer, two-dose Shingrix vaccine, which reduces the risk of shingles by as much as 97%. You can get the vaccine as soon as the lesions are all crusted over.
People have asked me about getting a second complete vaccine sequence after getting shingles, despite getting vaccinated with the new vaccine. They also ask about getting the vaccine at an age younger than 50. I can’t answer these as there aren’t good data.
Readers may email questions to: ToYourGoodHealth@med .cornell.edu or mail questions to 628 Virginia Dr., Orlando, FL 32803.