Dear Dr. Roach: Can you tell me how WPW syndrome is detected? Sometimes my heart beats fast and wobbly. My whole chest sometimes goes up and down. I went to a cardiologist. My stress test was good. My echocardiogram was good. Does my heart have to be in the throes of beating off track for the doctor to detect WPW syndrome?
T.Y.
“WPW” is Wolf-Parkinson-White syndrome, a common (one in 100) heart condition in which the electrical impulse coming from the heart’s pacemaker in the atria takes an alternate pathway to the ventricles of the heart.
Normally, the electrical stimulus travels down a pathway so that it arrives in the ventricle precisely when needed. However, in WPW syndrome, the impulse comes too quickly down the alternate path. Occasionally, this leads to a big problem, because the electrical impulse can travel back up the normal path and down the fast path again, over and over, causing an extremely rapid heart rate.
WPW usually is found on a routine EKG. There are cases where it can’t be seen, in which case a stress test is often diagnostic. But there are more causes for fast heartbeats.
Your cardiologist has done both the echo and the stress test. If you keep having symptoms, you could wear a device that records your heartbeats continuously for 24 to 48 hours, called a Holter monitor, or an event monitor for even longer times. Speak to your cardiologist.
WPW can be treated with medication, but is more frequently treated with radiocatheter ablation, where the extra pathway is destroyed with radio waves. Not everyone with WPW needs treatment.
Dear Dr. Roach: German and Swiss researchers followed 24,000 adults for 11 years. They found regular users of calcium supplements had an 86 per cent increased risk of heart attack. I’ve been taking supplements for years. Should I be concerned?
V.A.
Three papers looking at calcium and heart-disease risk have been published in the past year. Two showed no benefit or evidence of harm, and one showed evidence of benefit. I carefully read the German study you cite, and the 86 per cent apparent risk almost disappears when you look at the data regarding the cumulative effects of supplementation.
New data always should be reviewed with caution, especially if it overturns accepted scientific wisdom. I don’t think calcium supplementation is likely to cause a large increase in heart risk. On the other hand, it isn’t likely to cause a large benefit, so consider why you are taking it. For people with osteoporosis, the benefits clearly outweigh the risks. For everyone else, getting all the calcium you need from food may be best.
