DEAR DR. DONOHUE: A friend in his late 40s thought he had the flu and called his doctor for medicine. Later he had trouble breathing and went to the emergency room, where they said he was having a heart attack. Several hours later, he passed away. An autopsy showed that a virus had attacked his heart. I know there are many types of viruses, but what kind did he have? How does a person get this kind of virus? If it had been found in time, could something have been done to stop it? — R.R.
ANSWER: Your friend had myocarditis, an inflammation of the heart. Viruses are one cause of it. The virus most often involved is the Coxsackie virus, named after the New York town where it was first identified.
Myocarditis can be so mild that it produces no symptoms. Or it can be so overwhelming that it is fatal. It occurs at any age. Often, a respiratory infection (even a common cold) or a gastrointestinal disorder (stomach flu) might precede it. A young person — and your friend is considered young — struggling to breathe puts the doctor on alert to suspect that a failing heart is responsible and that a viral infection of the heart could be the cause.
Coxsackie viruses are transmitted from one person to the next through respiratory droplets or from foods, hands or utensils contaminated with the virus.
We have no medicine that kills this virus. Most of the time, none is needed, since nearly all Coxsackie infections are minor troubles. In cases like your friend’s, medicines to keep the heart beating forcefully usually can tide a person over the dangerous period of heart failure.
Your friend’s story is tragic.
The booklet on congestive heart failure describes the more common kinds of it, not the kind due to viral infections. Readers can order a copy by writing: Dr. Donohue — No. 103W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the reader’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am 90 years old. About three years ago I developed foot drop. A neurologist diagnosed the condition. My general health is good, considering my age. This foot drop has become debilitating. Is there anything I can do to take care of it? —M.S.
ANSWER: Foot drop isn’t really a diagnosis. It’s an observation of what’s happened to your foot. You cannot raise the front part of your foot off the ground when you take a step. The drooping foot makes it hard to walk. You have to lift the leg very high so the foot clears the ground. Finding out what made the foot drop is going to be your diagnosis.
Nerve damage, back problems, stroke, diabetes and muscle illnesses are some of the causes of foot drop, and they are the actual diagnosis. Many times, the problem is nerve malfunction. Quite often, health cannot be restored to the nerve, but things can be done. One of those things is a lightweight brace that keeps the foot from flopping downward when you take a step.
DEAR DR. DONOHUE: Public speaking panics me. My job requires that I do lots of public speaking. In spite of the fact that I am called on to perform often, it doesn’t get any easier for me. In fact, I think it’s gotten worse.
My sister has a similar problem. Her doctor gave her a medicine that makes her actually relish getting up and addressing a crowd. Do you know the name of the drug? -- S.S.
ANSWER: I’m pretty sure it’s Inderal (propranolol). It has many medical uses, like regulating the heartbeat, controlling blood pressure and abolishing certain tremors.
It also controls the signs of stage fright. Many professional musicians have to use it before their performances. It’s a prescription drug, so your doctor has to agree to its use. Limit taking it to those occasions when you have to speak in public. It’s not habit-forming. It’s not a narcotic. It’s not a tranquilizer.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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