10 Steps to Protect Against Hypertrophic Cardiomyopathy

Click on Image for FoxNews.com Posting

By Dr. Robert Tozzi

Published February 11, 2013

FoxNews.com

As if it were yesterday, I recall the death of 18-year-old Ben Breedlove, who suffered from hypertrophic cardiomyopathy (HCM), an ailment in which I specialize as a pediatric cardiologist.

I have seen it rob too many young people unnecessarily of a long and fulfilling life.

Here are 10 steps to protect your children, family members and anyone you love against the ravages of hypertrophic cardiomyopathy:

1. Remember that statistically if one member of your family has been diagnosed with HCM, then one-half of your family members are at risk for developing this disease. Evaluation of first-degree relatives on a regular, repetitive basis can go a long way towards correct diagnosis and effective treatment. It is imperative to extend this medical information to as many relatives as possible. Try to make the effort to contact others, even if you are estranged from them. Remember to breed love.

2. Always remember that hypertrophic cardiomyopathy is a sneaky disease: It is many times missed or misdiagnosed. Common diseases that are confused with HCM are asthma, mitral valve prolapse, anxiety, coronary artery disease and an athletic heart.

3. Be aware of symptoms that require prompt medical attention:
• Chest pain with exercise or simple activities such as walking.
• Passing out is a very important symptom that requires prompt medical attention.
• Shortness of breath, lightheadedness, and extreme tiredness are other symptoms of HCM.

4. Avoid circumstances that increase your risk:
• Avoid hot weather and dehydration.
• Be aware of the need for vigorous fluid resuscitation during infections or gastroenteritis or exercise.
• Avoid burst of activity.
• Avoid isometric activity.

5. With hypertrophic cardiomyopathy in humans, the lining of the blood vessels in the heart tends to be affected. Unfortunately, this is not just limited to the heart, but also involves the blood vessels networked to other organs throughout the body:
• Foods that improve the lining of your blood vessel include nuts, seeds, dark chocolate, fruits and vegetables.
• Prolonged periods of walking help revitalize the lining of your blood vessels.
• Foods that decrease the function of the lining of blood vessels include sugary drinks (soda), high salt, high fat, high sugar, high fructose corn syrup, and even high protein. Life is about balance and a balanced diet.

6. Beware of diseases or circumstances that can worsen hypertrophic cardiomyopathy, or cause it to progress faster:
• Sleep apnea, diabetes, obesity, hypertension, rapid weight gain and hypercholesterolemia.
• Steroids, including drugs like prednisone, anabolic steroids, and testosterone can aggravate the condition. The use of growth hormones or supplements that increase growth hormone or testosterone levels may also accelerate HCM.

7. Avoid drugs that can increase your risk of having a bad event:
• Avoid stimulants and decongestants.
• Avoid alcohol consumption as its diuretic effect can lead to decreased blood volume.
• If you are on a blood-thinner (e.g., Coumadin), remember to have your blood checked monthly.

• For any abrupt new onset of neurologic symptoms, such as muscle weakness, severe headache, or change in vision, seek prompt, urgent medical attention.

8. Once diagnosed with HCM, you are restricted from competitive sports and extremes of exercise, such as avoiding heavy lifting.

9. If you are on a beta blocker for HCM, it is imperative that it is taken daily. Missing a dose results in a rebound effect that can make your heart rate increase and put you at an increased risk.

10. Enjoy life, keep active and eat healthy. Most people with HCM have a normal life expectancy.

Dr. Robert J. Tozzi is Chief of Pediatric Cardiology and the Founding Medical Director of The Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at the Hackensack University Medical Center in New Jersey. He is the co-author of several papers published in refereed research journals, and he has lectured extensively in his field at numerous professional conferences. To learn more, visit his website at DRTOZ.com.
Read more: http://www.foxnews.com/health/2013/02/08/10-steps-to-protect-against-hypertrophic-cardiomyopathy/#ixzz2KheuMOYG

 

Teen & Young Adult Health: Topics & Resources

Welcome to the section of HealthConnection where visitors can find links, articles, videos and other resources on topics concerning Adolescent  and Young Adult Health. Please feel free to send me questions and inquiries at roberttozzi@ymail.com

 

 

Dr. Robert Tozzi Offers His “Second Opinion” on the Dangers of Energy Drinks
With Dr. Manny Alvarez, FoxNews.com, March 22, 2012
(click graphic below to view video segment)

Dr. Tozzi’s Top 10 Reasons Why Energy Drinks are a Health Hazard

1. The marketing of fortified energy drinks relies to a great degree on predatory and deceptive advertising. The companies that distribute these drinks prey on the ignorance of youth. Energy drinks do not fall into the same category of “refreshments” as juice, coffee or soda.

2. Energy drinks increase the body’s demand for oxygen, while decreasing blood volume (high osmolality) and the ability to bring blood flow to muscles and organs.

3. Consumption of one 8 oz. can of energy drink provides the total recommended daily allotment of sugar. The result is increased insulin levels and the promotion of obesity and dental cavities.

4. Use of energy drinks promotes a culture of drugs, not health – and can be the gateway to other forms of stimulant/drug use.

5. Energy drinks pose the potential for multiple caffeine-induced DSM-IV psychiatric disorders. The four disorders include:
-Caffeine intoxication
-Caffeine-induced anxiety disorder
-Caffeine-induced sleep disorder
-Caffeine-related disorder not otherwise specified

6. Energy drinks may be lethal when consumed by a child with an underlying undiagnosed cardiac condition.

7. When energy drinks are mixed with other medications or nutritional supplements, increased toxicity occurs. Combining these drinks with medications for ADHD, asthma or heart disease may be lethal.

8. Use of energy drinks with alcohol gives a misguided sense of not being intoxicated. The result is excessive consumption of alcohol and caffeine.  This increases the risk of injury, abuse and death.

9. Regular consumption of energy drinks increases risk of MI (heart attack) or stroke by decreasing endothelial function and increasing platelet aggregation.

10. Toxic levels of caffeine may cause seizures, arrhythmias or death.

Energy Drink Dangers

Dr. Tozzi appears with Dr. Manny Alvarez on Health Talk at FoxNewsHealth.com, Nov. 17, 2010, to discuss how dangerous these caffeinated beverages can be (click on the blue link to view video at FoxNews.com): http://video.foxnews.com/v/4423504/

FROM:  Parentdish

The Most Dangerous Game: Young Athletes Taking Energy Boosters

sports drinks

When an 11-year-old patient developed an irregular heartbeat after eating what he told me was “candy” before a soccer game, it occurred to me that there might be something else at play here.

This intelligent and astute patient said his soccer coach had distributed “candy” to the team to give them a boost of energy and help them play better.

Considering that this particular patient had undergone open-heart surgery just months before coming to my office with an arrhythmia, I knew I had to investigate further.

It turns out the “candy” my patient was referring to are Black Cherry CLIF SHOT BLOKS, made by CLIF Bar & Company, and marketed as a nutritional supplement to replace carbohydrates and electrolytes during activity.

One serving contains 50 mg of caffeine, which is about the equivalent of half a cup of coffee or one shot of espresso.

Yes, it is true that this patient was at increased risk because of his heart surgery to close a hole in the wall of the lower heart chamber — a common heart defect that only occasionally requires surgical repair.

But children with a history of heart disease are not the only ones at risk for the occurrence of a cardiac event while taking stimulants. Some children have undiagnosed heart conditions, making them more vulnerable to the effects of exercise and stimulants.

CLIF SHOT BLOKS are targeted towards endurance athletes, like cyclists and marathon runners that need to replace nutrients lost during physical activity and get a little boost of energy to keep them going. The small amount of caffeine they contain may seem safe, but in the wrong hands, these chewy treats can be confused with candy — as evident with my young patient.

What concerns me most about this kind of confusion is the potential for children to unknowingly consume multiple servings. Exposure to excessive amounts of caffeine can be toxic, and can result in arrhythmias, seizures and even death.

CLIF SHOT BLOKS not only deliver the stimulant, they also contain undiluted sugar, salt and potassium, so the manufacturer suggests taking them with enough water to prevent dehydration.

A healthier alternative for kids, such as Gatorade or Powerade, contains salt, sugar and potassium in safe concentrations. But these drinks should be consumed only to replenish fluid lost during physical activity.

Sports drinks contain large amounts of sugar, so using them in place of daily water consumption can increase the risk of dental problems and help fuel the obesity epidemic.

According to a recent report published in the journal Pediatrics, experts are urging kids and teens to avoid energy drinks and only consume sports drinks in limited amounts.

The researchers from the American Academy of Pediatrics say that children should never drink energy drinks because they contain caffeine and other stimulants that put stress on the body.

Most energy drinks and supplements also contain vitamins and herbal extracts that are not well researched or regulated, and we just don’t know enough about the potential side effects.

From soda to energy drinks to caffeine-laced chews, our children are being exposed to exceptionally high levels of stimulants, all in an attempt to improve performance.

The reality is, when these products are consumed during physical activity, they can be extremely dangerous. The combination of a stimulant in the face of dehydration is a recipe for disaster.

I thought I was asking all the right questions when a child presents with palpitations: Are you on any prescription stimulants, any weight-loss medications, protein or supplement drinks? Do you drink coffee, soda or energy drinks?

It never occurred to me that my interview must now include seemingly innocent “candy.”

This article was originally published by FoxNews.com by Dr. Robert J. Tozzi. Dr. Robert J. Tozzi is the chief of pediatric cardiology and founder of the Pediatric Center for Heart Disease at Hackensack University Medical Center in Hackensack, New Jersey. He is also the director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center and a Fox News contributor.

 

 

FROM: Chicagonow.com

Pediatric Cardiologist Dr. Robert J. Tozzi Dismisses Genetic Test Claims as Fantasy

By Kirk Mango, July 6, 2011 at 9:10 am

In a post last March titled, Attention Sports Parents, Genetic Tests To Determine Sports Superstardom Are Here!!!, I highlighted the new genetic tests available that artfully claim to determine predisposition to athletic prowess, thus, possible athletic stardom. It was in that post I raised my concerns over such testing and the possible consequences that may result.

Any successful athlete will tell you that having any amount of athleticism is only a small piece of the complicated puzzle to athletic success, no matter what level one is seeking to reach. In fact, there is some evidence out there that suggests one’s talent is something that can actually be developed. You don’t have to take my word for it, check this site out regarding the book the Talent Code.

That link alone demonstrates how much more there is to succeeding in sports than what most people are commonly aware of, and it supports the idea that genetic tests for determining said athletic success fall far short of their inferred claims.

My thoughts on all of this are further supported by Pediatric Cardiologist Dr. Robert J. Tozzi as reported in his most recent piece, Predicting Kids’ Athletic Future With At-Home Genetic Testing. In it Dr. Tozzi refers to the anecdotal claims of one genetic testing company as “pure fantasy,” this all based on information he pulled off their website and listed in his article. In addition he states that these companies are “misleading the public into believing that there is value in obtaining genetic testing to see what sports may be best for their child.”

I am certainly one who agrees with Dr. Tozzi and don’t really see much of an upside to genetic testing for athleticism. On the contrary, I think the likelihood of having more bad than good come out of all this is a real possibility.

 

Video: Don’t Believe Everything That’s In Your Head!

 

Wednesday, June 15, 2011
BY JODI WEINBERGER
OF SUBURBAN NEWS
Waldwick Suburban News

Waldwick– The second round of cardiac screenings for high school freshmen again proved to be lifesaving.

Ing Group Inc., the marketing company for the Gregory M. Hirsch Memorial Foundation, announced last week that out of the 94 freshman screened at the high school in March, two students are now under the care of physicians as a result of the tests.

Freshmen in Waldwick were the first in the state last year to receive the free testing through the high school. Out of the 64 who participated in 2010, one student required major follow-up, officials reported.

The testing was inspired by the tragic passing of Sean Fisher, a 13-year-old Waldwick boy who died from an undetected heart condition during football practice in 2008.

Sheila Fisher, Sean’s mother, said in an interview Thursday, June 9, that it was “phenomenal” to hear that students have been helped.

The screenings are sponsored by the Gregory M. Hirsch Memorial Foundation, The Sean Fisher Memorial Foundation, Gift of Life American and CardiacScan Imaging Services.

According to a release, the screening program was developed by Dr. Robert J. Tozzi, the director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at Hackensack University Medical Center and Kerri Winans Kaley, founder of CardiacScan Imaging Services.

The release said that one of the most common cases of cardiac death is hypertrophic cardiomyopathy, a genetic disease in which the heart muscle becomes abnormally thick, making it harder to pump blood throughout the body. Most people have few, if any, symptoms of this disease, it said. Some people experience shortness of breath when exercising, chest pain, fainting, dizziness, fatigue, or abnormal heart rhythms.

High school principal Kevin Carroll did not return calls June 9 or 10.

E-mail: weinberger@northjersey.com

FROM: FoxNews.com

Are Cell Phones Putting Kids in Danger?

Written By

Published June 01, 2011

FoxNews.comHolding-Cell-Mobile-Smart-Phone

Technology has provided innovation beyond what previous generations could have imagined, but at what expense?

The age at which kids are learning how to use technology is getting younger and younger. Earlier this year, a survey by online security company, AVG, found that more children ages 2-5 knew how to work a smart phone application than tie their shoes. And now, experts are saying that cell phones may be a real danger to our children’s health.

Preliminary results of a 10-year, $30 million research project by the International Agency for Research on Cancer recently revealed that there is data to support what researchers have feared for years – cellphones may cause cancer.

Western culture has been responsible for the proliferation of many diseases like obesity, hypertension, heart disease and diabetes. Studies show that the amount of time Americans spend on computers or watching television is related to the amount of disease seen in this country. The use of electronics to aid social networking has been related to anxiety and depression.

At this stage in the game, technology is largely unavoidable, and odds are – you need it to function in your daily life. So what is a parent to do?

Here are some tips to help keep your kids safe:

1) Turn off electronics in your home.
2) Do not give your baby or child your cellphone to keep them busy. If you do, make sure you turn it off first.
3) Limit your children’s cellphone use.
4) Buy hands-free adaptors for your kids to use when talking on their cellphones
5) Turn off your cellphone when not using it. When it is on, keep it off your body.
6) Promote dinner time with face to face conversation.
7) Take a walk or a hike with your child to encourage physical activity.
8) Read to your children.

Technology will continue to advance rapidly, but the key is to be smart and remember to unplug yourself and your family from time to time.

Dr. Robert J. Tozzi is the chief of pediatric cardiology and founder of the Pediatric Center for Heart Disease at Hackensack University Medical Center in Hackensack, New Jersey. He is also the director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center and a Fox News contributor.

 

FROM: FoxNews.com

Death on a Playground: Anthony’s Story

Written By
Published June 24, 2011
FoxNews.comAnthony_Cole_Wolff_Parkinson_White_SyndromeCourtesy: Cole Family

One ordinary day on a playground, a 12-year-old boy announces to his friends, “I have no pulse.” He then collapses to the ground in an apparent full cardiac arrest.

More than a decade ago, this tragic scenario played out for real.

Anthony Cole’s heart had stopped beating, and he was considered clinically dead. The boy was airlifted to Cincinnati Children’s Hospital. On the way, he had 13 electrical shocks applied to his chest in a desperate attempt to revive him. Miraculously, his heart was shocked back into its beating state; but by that time, severe, irreversible brain damage had occurred.

This preventable and treatable cardiac arrest left Anthony in a coma for more than a year. Once he was out of the coma, he was left with severe handicaps that would require a lifetime of special care.

The cardiac condition that caused this tragedy is called Wolff-Parkinson-White Syndrome (WPW). Simply described, the syndrome involves an extra piece of muscle woven into the overall mass of heart tissue that creates an electrical short circuit. In some individuals, this condition is benign – in others it can lead to palpitations or tachycardia – but, in a few, as in Anthony’s case, it can be deadly, leading to sudden and unexpected full cardiac arrest.

In the most recent large-scale school screenings, this condition has been identified in up to one child per 100-1,000. The good news is that WPW is now 100 percent curable. A simple procedure, called an ablation, is used to remove the excess heart muscle, which removes all future risk of sudden death.

But how can you detect a disease that may have no symptoms, even right up to last second, just before the onset of cardiac arrest? A simple EKG can make the diagnosis.

Anthony’s parents have chronicled his story in their book “Resurrecting Anthony.” I had the pleasure to meet with this heroic couple during an interview on FoxNews.com Live. The following is an excerpt from an e-mail that Anthony’s mother, Linda Cole, sent me after the show:

“Dear Dr. Tozzi,
It was such a pleasure meeting you and your wife on Tuesday at Fox. I am quite excited that you are pursuing cardiac screening for children. This would save many families much needless heartache. I also believe that it would save Medicaid dollars in the long run. If nothing else, I hope that parents can at least be educated and given the option of paying for an EKG…”

Anthony’s mom is right. This tragedy could have been avoided in two ways:

1. Required early cardiac screening for children.
2. Rapidly available automated external cardiac defibrillator units at all schools, playgrounds, athletic fields and public places in general.

The alternatives are starkly defined.

By using established EKG technology, which costs about $40 per patient, physicians can diagnose and cure virtually all detected incidences of the bad form of WPW in young children, who will go on to lead normal, productive lives.

Tragedies like Anthony’s, which can result in subsidized health care costs mounting into the hundreds of thousands over a lifetime, can become, literally, a thing of the past.

Dr. Robert J. Tozzi is the chief of pediatric cardiology and founder of the Pediatric Center for Heart Disease at Hackensack University Medical Center in Hackensack, New Jersey. He is also the director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center and a Fox News contributor.

 

PBS: Caucus NJ with Steve Adubato. Hypertrophic Cardiomyopathy (HCM) part1

PBS: Caucus NJ with Steve Adubato. Hypertrophic Cardiomyopathy (HCM) part2

Sudden Cardiac Death Screenings For Freshman Class

By Press Release   Monday, February 28, 2011, 03:53 PM EST

Printed: The Paramus Post

As American Heart Health Awareness Month comes to a close, think about preventing sudden cardiac death in children and young adults. One of the most common causes of sudden cardiac death is hypertrophic cardiomyopathy (HCM). HCM is a genetic disease in which the heart muscle becomes abnormally thick, making it harder to pump blood throughout the body. Most people have few, if any, symptoms of this disease. Some people experience shortness of breath when exercising, chest pain, fainting, dizziness, fatigue, or abnormal heart rhythms (arrhythmias).

Early detection and treatment saves lives! For the second year, The Gregory M. Hirsch Memorial Foundation (GMHMF) in conjunction with Waldwick High School will be conducting screenings on Monday, March 21. Last year three students were identified who required follow-up care. One student’s case was serious. Thanks to early detection, these students are now under the care of their physician and have the opportunity to lead strong, productive lives.

This innovative screening program was developed by Kerri Winans Kaley, of Huntington, NY, founder of CardiacScan Imaging Services and GMHMF trustee along with Robert J. Tozzi, M.D., FACC, of Ridgewood, director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center, a division of the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center (HUMC).

Freshman students at Waldwick High School may take advantage of this free screening. This year’s screening is sponsored by GMHMF, The Fischer Foundation, Gift of Life America and CardiacScan Imaging Services. Parents of other area students may contact the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at (201) 487-7617 to arrange for a private screening session, which costs $265.
“Screenings are the only way to know if your child has HCM,” said Fred C. Hirsch, GMHMF Founder. “They are painless and take about 30 minutes. A fraction of time, compared to a lifetime of grief in losing your child.”

GMHMF is working with other area non-profit organizations to defray the costs so that every freshman high school class in Bergen County can be screened.

Prevent sudden cardiac arrest; save your child’s life!

GMHMF is dedicated to preventing sudden cardiac death in children and young adults by better understanding its causes, identifying at-risk individuals and families, and offering those families state-of-the-art treatment and support. All etiologies of sudden cardiac death will be investigated including hypertrophic cardiomyopathy (HCM), which is responsible for the vast majority of these devastating losses. For more information, please visit www.gmhmfoundation.org.

The Gregory M. Hirsch Hypertrophic Cardiomyopathy Center, a division of the Joseph M. Sanzari Children’s Hospital at HUMC is committed to providing individualized care, treatment, and support to patients and families with HCM. It is the first facility established in the area to screen families for HCM. For more information, please visit www.humc.com/hirsch.

 

The Top 10 Reasons Why School Sports are Unhealthy

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I believe that high school sports, and behaviors related to school athletics, are fostering obesity, eating disorders and illness in America. Here is my Top 10 List of reasons why school sports are – counter-intuitively – leading to bad habits and worse health for America’s young people.

1)    Rapid weight-gain in childhood is associated with life-long obesity and heart disease. Bad behaviors that are associated with school athletics include bulking up for football, dropping and gaining weight for wrestling, and ultra-thin eating habits, leading to anorexia in young gymnasts.

2)    The concept that, “You’re an athlete – you’re working out, so you can eat whatever you want to eat,” promotes consumption of junk foods, which also extends to the spectators who consume junk foods sold at sporting events.

3)    Teaching the concept that endurance and intense aggressive training is a healthy lifestyle – “no pain, no gain” – reduces the likelihood that voluntary athletic behavior will continue into adulthood.

4)    If “winning isn’t everything, it’s the only thing” as the goal in sports participation, then inevitably there will be many losers. Ultimately this concept becomes a psychological negative when one thinks of health and its relationship to exercise.

5)    Lengthy afterschool practice sessions, combined with late-evening competition in Junior Varsity team sports, leads to missed hours of sleep, a drop in metabolism and a propensity toward obesity.

6)    Head injuries in soccer and hockey, as well as football concussions, are becoming a common cause of extended illness in young people.

7)    Repetitive damage to joints results in long-term disability, including back, knee and hip disease.

8)    This results not only in limiting one’s ability to ambulate as an adult, but subsequently results in weakened cardio-pulmonary function due to a lack of mobility, thereby increasing the likelihood of obesity, hypertension, diabetes, heart disease and stroke.

9)    Sadly, school athletics encourage the culture of drugs:  Taking stimulants for added stamina, including energy drinks such as Red Bull, often leads to the accepted use of steroids and other harmful and/or prohibited substances.

10) The overriding concept that winning is the most important part of the game is perhaps the umbrella theme promoting all the other unhealthy behaviors that affect today’s young athletes.