Acupuncture in Patients with Valvular Heart Disease and Prosthetic Valves

Practice recommendations for physiotherapists in Canada managing adverse events associated with acupuncture

In Canada, acupuncture is a regulated medical practice that involves inserting thin needles at specific points on the body to alleviate pain and other health conditions. Acupuncture is a controlled act in physiotherapy practice. Therefore, physiotherapists who incorporate acupuncture into their practice should have the necessary education and roster this controlled act with the regulatory college in their province. Although acupuncture can be helpful, potential complications can arise, ranging from minor bruising to life-threatening conditions such as pneumothorax and cardiac tamponade. This article provides information on the potential adverse effects of acupuncture and provides recommendations for physiotherapists regarding prevention and management of any incidents that may arise during treatment.

Integrative Medicine and Cardiovascular Disorders

Integrative medicine (IM) has developed an increasingly significant role in health care worldwide, including cardiovascular diseases (CVD). This review describes the commonly used IM in CVD, with particular attention placed with dietary supplements and mind-body therapies. More rigorous research continues to be needed to determine the mechanisms and efficacy of IM cardiovascular morbidity and mortality. Health care providers will need to develop skills in open communication and nonjudgmental dialogue around IM use in discussing treatment plans with their patients.

Electro-acupuncture therapy in a patient with a total artificial heart

Interaction between the electrical system of implanted cardiovascular devices and electrical stimulation of acupuncture points (electro-acupuncture) can be life-threatening. As a result, there is reluctance to use this modality in patients who have been implanted with any cardiac device. A patient with a total artificial heart was successfully treated with electro-acupuncture for inflammatory arthritis without any adverse events. This case illustrates the safety of electro-acupuncture in patients with a total artificial heart.

Complementary medicine in chronic cancer care

Although advancements in cancer care have led to increased cure rates and survival times, those coping with the long-term sequelae of a cancer diagnosis often report high levels of distress, poor health-related quality of life, and unmet psychosocial needs. The shortcomings of the conventional biomedical system at sufficiently addressing these chronic illness issues are a primary reason that many patients turn to complementary and alternative medicine (CAM). Although patients usually use such treatments in addition to conventional care, they often do not discuss doing so with their conventional physicians, who are perceived as being unreceptive to the topic. Physicians may feel uninformed about CAM treatments, especially given the relatively small amount of data on the topic available in the medical literature. This article reviews a few CAM modalities commonly used by cancer survivors and those with chronic cancer illness, with a particular focus on familiarizing physicians with treatments that may potentially complement regular oncologic care by decreasing stress and enhancing health-related quality of life.