Netherlands Heart Journal

Cigarette smoking has declined over the last years in modern countries. On the contrary, waterpipe smoking has increased, especially among young people visiting waterpipe bars. Unfortunately, most waterpipe smokers seem to know little about the possible cardiovascular and other health consequences of waterpipe smoking. To describe by narrative literature review the known adverse consequences for the human body caused by smoking the waterpipe compared with the consequences of smoking normal cigarettes. Also, to get a picture of public awareness of these consequences as deducted from the literature and a small new survey in the Netherlands. Tobacco smoking is associated with serious adverse (cardiovascular) health effects, and there is no evidence that these effects are less serious if a waterpipe is used. The increasing use together with the limited amount of awareness and attention for the possible health consequences of smoking the waterpipe is worrisome. Especially considering the increasing acceptance and use of the waterpipe among the youth. Therefore we recommend more systematic research into the possible health hazards of waterpipe smoking. In the meantime education campaigns and materials are needed to raise public awareness on the possible health risks of waterpipe use.

Pregnant women with heart disease often have an increased risk of maternal cardiovascular and offspring complications. The magnitude of these risks varies depending on the type and severity of the underlying disease. Therefore risk assessment should be performed before pregnancy. This can be accomplished by taking into account predictors and risk scores that have been developed in large populations of pregnant women with heart disease, as well as by consulting disease-specific pregnancy literature. A system that integrates all available knowledge about the risk of pregnancy is the adapted World Health Organisation risk classification. The safety of pregnancy for women with heart disease can be enhanced by adequate risk assessment and counselling.

>Hypertrophic cardiomyopathy (HCM) is a common hereditary disease, with a prevalence of 1:500 in the general population. 1,2 HCM is clinically diagnosed by the presence of – often asymmetrical – left ventricular (LV) hypertrophy in the absence of a disease likely to cause this hypertrophy, such as diabetes mellitus, hypertension and/or aortic valve stenosis.

Muscle overlying of an epicardial coronary artery is termed a myocardial bridge. The frequency of myocardial bridging reported in angiographic studies varies from 0.5 to 16%.1 Myocardial bridging is usually confined to the left anterior descending coronary artery. A myocardial bridge of the branches of the right coronary artery is very rare.