Dr. Fishbein received his undergraduate and medical degrees from the University of Illinois. He completed a residency in anatomic and clinical pathology at Harbor General Hospital/UCLA Medical Center. He is board certified in anatomic and clinical pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Every year in the United States there are about 4,000 people who could benefit
from a heart transplant. Unfortunately, there are only about 2,000 donor hearts
available. Therefore, there is a careful selection process in place to assure
that hearts are distributed fairly and to those who will benefit most from the
donor heart. The heart is just a pump, although a complicated pump. Most
patients require a transplant because their hearts can no longer pump well
enough to supply blood with oxygen and nutrients to the organs of the body. A
smaller number of patients have a good pump, but a bad "electrical conduction
system" of the heart. This electrical system determines the rate, rhythm and
sequence of contraction of the heart muscle. There are all kinds of problems
that can occur with the conduction system, including complete interruption of
cardiac function causing sudden cardiac death.
While there are many people with "end-stage" heart disease with inadequate
function of the heart, not all qualify for a heart transplant. All the other
important organs in the body must be in pretty good shape. Transplants cannot be
performed in patients with active infection,
cancer, or bad diabetes mellitus;
patients who smoke or
abuse alcohol are also not good candidates. It's not easy
to be a transplant recipient. These patients need to change their lifestyle and
take numerous medications (commonly more than 30 different medications). Hence,
all potential transplants patients must undergo psychological testing to
identify social and behavioral factors that could interfere with recovery,
compliance with medications, and lifestyle changes required after
transplantation.
Moreover, needing a heart and being a suitable candidate are not enough. The potential
donor heart must be compatible with the recipient's immune system to decrease
the chance of problems with rejection. Finally, this precious resource, the
donor organ, must be distributed fairly. The United Network for Organ Sharing
(UNOS) is in charge of a system that is in place to assure equitable allocation
of organs to individuals who will benefit the most from transplantation. These
are usually the sickest patients.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Vancomycin-resistant enterococci (VRE) infection is the most common type of infection acquired by patients while hospitalized. Patients at risk for VRE are those who are already ill, and hospitalized, including individuals with diabetes, elderly, ICU patients, kidney failure patients, or patients requiring catheters. Enterococci can survive for months in the digestive tract and female genital tract. Other risk factors for acquiring VRE include those how have been previously treated with vancomycin and combinations of other antibiotics. Treatment of VRE is generally with other antibiotics other than vancomycin. Prevention of VRE can be achieved by proper hand hygiene.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Dilated Cardiomyopathy is a condition where the heart's ability to pump blood is decreased because the heart's main pumping chamber is enlarged and weakened. Symptoms of dilated cardiomyopathy include chest pain, heart failure, swelling of the lower extremities, fatigue, weight gain, fainting, palpitations, dizziness and blood clots.
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
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