After heart surgery: Answers to patients’ frequent questions

taste 320x320Many patients come to me with questions about what they should expect in the days and months following heart surgery. Overall, no two heart patient experiences will be the same, but there is general information you should be aware of when recovering from surgery.

“I’ve noticed a loss or change in my sense of taste after heart surgery. Is this normal?”

This is likely due to a combination of factors, including:

  • Your age
  • Length of the bypass procedure
  • Tubing used for the bypass machines
  • Your response to the anesthesia
  • Your response to the cardiac medications, many of which may be new to you

The good news is that if you’ve experienced a loss or change in your sense of taste after heart surgery, it usually resolves itself within several weeks. It is rare for this to occur and be a permanent issue.

Remember, it is important for heart patients to maintain a nutritional food plan following surgery as their body heals. Food should be low in sodium and low to moderate in fat. It’s also important to eat enough protein to heal after surgery. Foods that are high in protein and low in salt, saturated fat and trans fats include fresh skinless chicken (not injected with salt or broth), fresh or frozen fish, lean beef, pork or lamb, skim milk and fat-free yogurt. Cultured foods like yogurt also contain “probiotics,” which help restart your digestive tract after your operation. Continue reading

Tailgating and alcohol: Information to take to heart

Why does my heart race after drinking?

Tailgating and alcohol

Before you head out to your next tailgate party, make sure you’re aware of the dangers of excessive alcohol consumption.

It’s football season, and with it comes the fun of tailgating … and often an increase in alcohol consumption. Dr. Kenneth Tobin, clinical assistant professor for the Department of Internal Medicine and director in the Chest Pain Center at the University of Michigan, says patients often ask questions about alcohol and heart health, including: “Why does my heart race after drinking alcohol?” Dr. Tobin discusses this question and other alcohol/heart health issues here–information about tailgating and alcohol you can take to heart this football season. Continue reading

Advantages of warfarin and Coumadin alternatives

All drugs have both advantages & drawbacks based on individual medical needs

Anticoagulants like Coumadin or Jantoven are prescribed to prevent the formation of blood clots.

Three new drugs were recently approved as warfarin and Coumadin alternatives.

Up until recently, when physicians treated patients for thromboembolism (blood clots) or patients who might be at risk for the development of a blood clot, the only oral drug available was warfarin. Warfarin (brand names Coumadin or Jantoven) has been around for years, and when used appropriately is a safe treatment plan for reducing the risk of stroke and blood clots. Like any medication, there are always potential side effects or risks. Also, like any medication, those risks are weighed against its potential benefits, thereby allowing a treating physician to make the most appropriate treatment plan for an individual patient.

Warfarin drawbacks

There are four main drawbacks to taking Coumadin or Jantoven:

  1. Regular blood draws are required to be sure the right dose is being administered (every patient’s dose is specific to their body’s response to the drug).
  2. There are many potential drug interactions with warfarin that may lead to either an increase or decrease in its blood levels.
  3. All the cruciferous vegetables (those foods high in Vitamin K, such as cauliflower, cabbage and broccoli) counteract warfarin, making dietary guidelines for anticoagulants very important.
  4. There is a narrow therapeutic index for warfarin, which, in some patients, may lead to very difficult warfarin dosing. If the blood level is too low it will not be effective and if it is too high, there is an increased chance of bleeding.

Continue reading

What stress tests can and can’t predict

Answering two most frequently asked questions about stress tests

If you have chest pain or other symptoms of heart disease, you may be asked to complete a stress test stresstest.fwso your doctor can help determine the right treatment plan. Patients are often curious about how to interpret the results of a stress test or what the results may indicate. Let’s break down the two stress test related questions I most often receive: Continue reading

An aspirin a day … is it right for you?

Clearing the air on who benefits from a daily aspirin

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If you’ve had a heart attack, you should be taking a low-dose aspirin a day.

Aspirin is truly a wonder drug when it comes to coronary artery disease (CAD). But what about the Food and Drug Administration’s recently released statement saying an aspirin a day is only for a select few?

In medicine, we define our treatments for CAD as primary and secondary prevention measures.

Primary prevention

Patients who have never had a heart attack or do not have any formal diagnosis of CAD fall into what we refer to as the primary prevention group. In this group, we commonly further subdivide patients into low and high risk for developing CAD. The more risk factors a patient has (family history, diabetes, hypertension, high cholesterol), the higher his or her lifetime risk is for having a heart attack. Patients older than 50 who are at high risk for developing CAD might benefit from taking 81 mg of aspirin every morning.

Secondary prevention

Patients who have already had a heart attack or have been diagnosed with CAD fall into the secondary prevention category. In this group, our goal is to prevent a second cardiac event. Ideally, everyone in this group should be taking an aspirin a day. The current recommended dose is one or two baby aspirin (81 or 162 mg every morning). A higher aspirin dose (325 mg) doesn’t necessarily reduce the risk of another heart attack, but instead potentially increases a patient’s bleeding risk.

No “one size fits all”

It is difficult to come up with a blanket statement for all patients with respect to aspirin, as it also depends on a patient’s bleeding risk as well as other factors. If a patient has had a heart attack (and there are no contraindications for using aspirin), I encourage him or her to take 81 mg of aspirin every morning.

For the primary prevention group of patients (if there is no increased risk associated with taking aspirin, the patient has multiple cardiac risk factors and is age 50 or older), I prescribe 81 mg of aspirin every morning.

For all patients, I encourage you to discuss aspirin use with your doctor before starting. Finally, aspirin should be taken after breakfast to decrease stomach irritation.

Take the next step:

  • To make an appointment to discuss your need for treatment, contact us toll-free at 888-287-1082 or email us at 


tobin_kenneth 150x150Dr. Kenneth Tobin is a clinical assistant professor for the Department of Internal Medicine and director in the Chest Pain Center at the University of Michigan. His specialty is cardiology, with clinical interests in the association of patent foramen ovale and stroke, patent foramen ovale and migraine, preventive cardiology and echocardiography.



Frankel-informal-vertical-sigThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at







Men’s heart health tips

Develop good habits early for a healthy heart later in life

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Adopting healthy habits at a young age can pay off as you age.

As we age, the stakes get higher for coronary artery disease (CAD). A man in his 70s has a higher risk of developing CAD than a man in his 20s. But CAD does not occur overnight.

Even at 20 years old, you can affect what happens to you and your heart health when you are older. Having an appropriate health maintenance exam to define your risk of diabetes, high cholesterol levels, high blood pressure and other cardiac risk factors is very important for heart health.

The role genetics plays

The single biggest risk factor for developing CAD is genetics. A person (man or woman) who has a family history of early-age CAD (usually defined as 55 or younger) needs to be extremely diligent about his or her heart health.

Even though you can’t change genetics, there are certain genetic risk factors that can be modified — and the earlier you start, the better. Continue reading