Dr. Grace J. Noh, MD

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

Most people with hemophilia have a family history of the disorder, though about 30% do not. The most common forms are hemophilia A (classic hemophilia) and hemophilia B (Christmas disease). Hemophilia A and B share certain characteristics, but different genes are involved. Acquired hemophilia is very rare and has been linked to autoimmune conditions, cancer, and multiple sclerosis.

Hemophilia may be diagnosed using a blood test. If there is family history of the disorder, testing may be done prenatally. Treatment involves regular intravenous replacement of clotting factors, which may be produced in a laboratory (recombinant) or come from blood donors. For people with milder forms of the disease, a hormone called desmopressin may stimulate the body to produce clotting factors. Other drug therapies include medications that help slow the breakdown of blood clots and medications that are applied directly to the wound to promote clotting.

Living with hemophilia can be challenging, but simple things may help prevent excessive bleeding. For example, choosing activities like walking or swimming over contact sports can prevent injuries and strengthen muscles while protecting the joints. Chances for bleeding may also be reduced by making sure that children wear helmets and elbow pads during activities like bicycle rides.

Hydrocephalus is most often treated with an implanted device called a shunt. A shunt is a long, thin tube that is used to drain excess fluid. One end is placed within the brain. The tube runs under the skin, along the neck behind the ear, and to another part of the body where the fluid can be reabsorbed. Most often this is the abdomen, but the chest or other areas can also be used. Shunts have a valve that allows doctors to monitor and control the pressure within the brain. Insertion of a shunt is a surgical procedure that takes one to two hours. Incisions are made in the head and the abdomen, and the shunt is threaded into place before the openings are stitched closed.

In cases where hydrocephalus is caused by a blockage, a procedure called endoscopic third ventriculostomy, or ETV, may be performed. During this procedure, a surgeon makes a dime-sized hole in the skull and uses a thin tube with a camera on the end (called an endoscope) to see inside the brain. The surgeon punctures a hole in the floor of the third ventricle, a fluid-filled space within the brain. The hole provides an opening for cerebrospinal fluid to flow around the blockage, normalizing pressure. The entire procedure usually takes less than an hour and patients can often go home the following day. ETV can provide a permanent and safe alternative to a shunt, but it is only useful for patients whose hydrocephalus is caused by a blockage.