Monday 13 July 2015

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The heart is a very important organ in our body, despite its being basically a glorified pump. It is responsible for the circulation of blood around the body, which transfers oxygen into the body and carbon dioxide back out.

The heart beats at a steady rate, which increases with increased activity. However, there are many diseases or disorders which can disrupt, or even stop the heart altogether.

This site contains the compilation of 8 common heart diseases of varying degrees of severity. All of them are harmful, and most of them can lead to heart failure.

In the case of experiencing a good portion of the mentioned diseases, it is advisable to consult with your doctor for further diagnosis.


REFERENCE :

OUR BRAIN :)

HEART ATTACK



Definition :

Heart attack refers to blockage of blood flow to the heart caused by atherosclerosis or thrombosis. Also known as myocardial infarction, where myo means muscle, cardial means heart, and infarction means death of tissue.






Signs of Heart Attack :

  • Discomfort or heaviness in the chest.
  • Discomfort spreading to the back, jaw, arms, limbs.
  • Bloated, fullness or have a choked feeling.
  • Extreme weakness, fatigue.
  • Abnormal heartbeat.



CAUSES :

A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks.
During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery.
Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection).




RISK FACTORS :


  • Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women.
  • Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack.
  • High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more.
  • High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) lowers your risk of heart attack.
  • Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes — not producing enough insulin or not responding to insulin properly — causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack.
  • Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk.
  • Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure.
  • Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however.
  • Stress. You may respond to stress in ways that can increase your risk of a heart attack.
  • Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.
  • A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.
  • A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack.


  • DIAGNOSIS :

    • ECG . The ECG (also known as EKG or electrocardiogramcan tellhow much damage has occurred to your heart muscle and where ithas occurred. In addition, your heart rate and rhythm can bemonitored.
    • Blood tests. Blood may be drawn to measure levels of cardiac enzymes that indicate heart muscle damage. These enzymes are normally found inside the cells of your heart and are needed for their function. When your heart muscle cells are injured, their contents -- including the enzymes -- are released into your bloodstream. By measuring the levels of these enzymes, the doctor can determine the size of the heart attack and approximately when the heart attack started. Troponin levels will also be measured. Troponins are proteins found inside of heart cells that are released when they are damaged by the lack of blood supply to the heart. Detecting troponin in the blood may indicate a heart attack.
    ELECTROCARDIOGRAM (Heart Attack)




    ECHOCARDIOGRAPHY OF HEART ATTACK
  • Echocardiography. Echocardiography is an imaging test that can be used during and after a heart attack to learn how the heart is pumping and what areas are not pumping normally. The "echo" can also tell if any structures of the heart (valves, septum, etc.) have been injured during the heart attack.
  • Cardiac catheterization.Cardiac catheterization, also called cardiac cath, may be used during the first hours of a heart attack ifmedications are not relieving the ischemia or symptoms. The cardiac cath can be used to directly visualize the blocked artery and help your doctor determine which procedure is needed to treat the blockage.



  • TREATMENT :


    Drugs or surgery are normally used to treat heart attacks!
    Drugs used during a heart attack may include:
    • Aspirin to prevent blood clotting that may worsen the heart attack
    • Other antiplatelets, such as Brilinta, Effient, or Plavix, to prevent blood clotting
    • Thrombolytic therapy ("clot busters") to dissolve any blood clots in the heart's arteries
    • Any combination of the above

    ALTERNATIVE TREATMENTS :
    During or shortly after a heart attack, you may go to the cardiac cath lab for direct evaluation of the status of your heart, arteries, and the amount of heart damage. In some cases, procedures (such asangioplasty or stents) are used to open up your narrowed or blocked arteries.

    If necessary, bypass surgery may be performed in the days following the heart attack to restore the heart muscle's supply of blood.
    Treatments (medications, open heart surgery, and interventional procedures, like angioplasty) do not cure coronary artery disease. Having had a heart attack or treatment does not mean you will never have another heart attack; it can happen again. But, there are several steps you can take to prevent further attacks.

    STATISTICS :
    • In 2008, over 616,000 people died of heart disease.
    • In 2008, heart disease caused almost 25% of deaths—almost one in every four—in the United States.
    • Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2008 were in men.
    • Coronary heart disease is the most common type of heart disease. In 2008, 405,309 people died from coronary heart disease.
    • Every year about 785,000 Americans have a first coronary attack. Another 470,000 who have already had one or more coronary attacks have another attack.
    • In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of health care services, medications, and lost productivity.

    REFERENCE :




    PERIPHERAL ARTERY DISEASE  

        


    DESCRIPTION

    Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.When you develop peripheral artery disease (PAD), your extremities — usually your legs — don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (intermittent claudication).Intermittent claudication symptoms include muscle pain or cramping in your legs or arms that's triggered by activity, such as walking, but disappears after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.The severity of intermittent claudication varies widely, from mild discomfort to debilitating pain. Severe intermittent claudication can make it hard for you to walk or do other types of physical activity.


    Peripheral artery disease symptoms include:

    ·         Painful cramping in your hip, thigh or calf muscles after activity, such as walking or climbing stairs (intermittent claudication)


    ·         Leg numbness or weakness



    ·         Coldness in your lower leg or foot, especially when compared with the other side


    ·         Sores on your toes, feet or legs that won't heal
    ·         A change in the color of your legs


    ·         Hair loss or slower hair growth on your feet and legs


    ·         Slower growth of your toenails


    ·         Shiny skin on your legs


    ·         No pulse or a weak pulse in your legs or feet


    ·         Erectile dysfunction in men




    CAUSES

    Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, fatty deposits (plaques) build up in your artery walls and reduce blood flow.
    Although the heart is usually the focus of discussion of atherosclerosis, this disease can and usually does affect arteries throughout your body. When it occurs in the arteries supplying blood to your limbs, it causes peripheral artery disease.



    TESTS AND DIAGNOSIS


    Some of the tests your doctor may rely on to diagnose peripheral artery disease are:
    ·         Physical exam. Your doctor may find signs of PAD during a physical examination, such as a weak or absent pulse below a narrowed area of your artery, whooshing sounds (bruits) over your arteries that can be heard with a stethoscope, evidence of poor wound healing in the area where your blood flow is restricted, and decreased blood pressure in your affected limb.



    ·         Ankle-brachial index (ABI). This is a common test used to diagnose PAD. It compares the blood pressure in your ankle with the blood pressure in your arm. To get a blood pressure reading, your doctor uses a regular blood pressure cuff and a special ultrasound device to evaluate blood pressure and flow. You may walk on a treadmill and have readings taken before and immediately after exercising to capture the severity of the narrowed arteries during walking.
    ·    Ultrasound. Special ultrasound imaging techniques, such as Doppler ultrasound, can help your doctor evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.
    ULTRASOUND

    ·         Angiography. By injecting a dye (contrast material) into your blood vessels, this test allows your doctor to view blood flow through your arteries as it happens. Your doctor is able to trace the flow of the contrast material using imaging techniques, such as X-ray imaging or procedures called magnetic resonance angiography (MRA) or computerized tomography angiography (CTA). Catheter angiography is a more invasive procedure that involves guiding a catheter through an artery in your groin to the affected area and injecting the dye that way. Although invasive, this type of angiography allows for simultaneous diagnosis and treatment — finding the narrowed area of a blood vessel and then widening it with an angioplasty procedure or administering medication to improve blood flow.
    ·         Blood tests. A sample of your blood can be used to measure your cholesterol and triglycerides and to check for diabetes.




    TREATMENTS

    Medications

    ·         Cholesterol-lowering medications. You may take a cholesterol-lowering drug called statin to reduce your risk factor of heart attack and stroke. The goal for people who have peripheral artery disease is to reduce low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, to less than 100 milligrams per deciliter (mg/dL), or 2.6 millimoles per liter (mmol/L). The goal is even lower if you have additional major risk factors for heart attack and stroke, especially diabetes or continued smoking.
    ·         High blood pressure medications. If you also have high blood pressure, your doctor may prescribe medications to lower it. The goal of this therapy is to reduce your systolic blood pressure (the top number of the two numbers) to 140 millimeters of mercury (mm Hg) or lower and your diastolic blood pressure (the bottom number) to 90 mm Hg or lower. If you have diabetes, your blood pressure target is under 130/80 mm Hg.
    ·         Medication to control blood sugar. If you also have diabetes, it becomes even more important to control your blood sugar (glucose) levels. Talk with your doctor about what your blood sugar goals are and what steps you need to take to achieve these goals.
    ·         Medications to prevent blood clots. Because peripheral artery disease is related to reduced blood flow to your limbs, it's important to reduce your risk of blood clots. A blood clot can completely block an already narrowed blood vessel and cause tissue death. Your doctor may prescribe daily aspirin therapy or another medication that helps prevent blood clots, such as clopidogrel (Plavix).
    ·         Symptom-relief medications. The drug cilostazol (Pletal) increases blood flow to the limbs both by preventing blood clots and by widening the blood vessels. It specifically helps treat symptoms of claudication, such as leg pain, for people who have peripheral artery disease. Common side effects of this medication include headache and diarrhea. An alternative to cilostazol is pentoxifylline (Trental); however, it's generally less effective. But, side effects are rare with this medication

        In some cases, angioplasty or surgery may be necessary to treat peripheral artery    disease that's causing intermittent claudication:

    ·         Angioplasty. In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow.     Your doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.
    ·    
    • Bypass surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a blood vessel made of synthetic fabric. This technique allows blood to flow around — or bypass — the blocked or narrowed artery.
    • Thrombolytic therapy. If you have a blood clot blocking an artery, your doctor may inject a clot-dissolving drug into your artery at the point of the clot to break it up.


    ·         Supervised exercise program. In addition to medications or surgery, your doctor may prescribe a supervised exercise training program to increase the distance you can walk pain-free. Regular exercise improves symptoms of PAD by a number of methods, including helping your body use oxygen more efficiently.

    EXTRA INFORMATION : http://www.cdc.gov/DHDSP/data_statistics/fact_sheets/fs_PAD.htm

    REFERENCE:


    Sunday 12 July 2015

    Congenital Heart Disease 

    Congenital heart disease is when you are born with malformations of the heart’s structures. Congenital heart disease is a broad term and examples are holes in the heart, abnormal valves, and abnormal heart chambers.


    CLUBBED FINGERNAILS

    General signs of congenital heart disease can include:


    • ·    Excessive sweating
    • ·         Extreme tiredness and fatigue      
    • Poor feeding
    • ·         Rapid heartbeat
    • ·         Rapid breathing
    • ·         Shortness of breath
    • ·         Chest pain
    • ·         A blue tinge to the skin (cyanosis)
    • ·         Clubbed fingernails

    CYANOSIS
     


















    Causes and risk factors 

    If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don’t know why congenital heart defects occur.
    Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect.Children who has genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects. Besides, smoking during pregnancy also has been linked to several congenital heart defects. Other than that, this may be the result of the genes you inherited from your parents or adverse exposure to certain elements while still in the womb, such as some medicines or too much alcohol.


    There are some factors that are associated with an increased chance of having congenital heart disease. These risk factors include:

        ·         Genetic or chromosomal abnormalities in the child, such a Down syndrome
    ·         Taking certain medications or alcohol or drug abuse during pregnancy
    ·         Maternal viral infection, such as rubella ( German measles ) in the first trimester or pregnancy
    ·        
    The risk of having a child with congenital heart disease may double if a parent or a sibling has a congenital heart defect.






    Tests to diagnose a congenital heart disease 

       ·         Fetal echocardiogram
    ·         Echocardiogram
    ·         Electrocardiogram
    ·         Chest X-ray
    ·         Pulse oximetry
    ·        
    Cardiac catheterization



    Treatment - Pharmacology 

    To treat complications and relive symptoms:

    ·         Diuretics lower the amount of extra fluid in the body
    ·         Digoxin increases the strength of the heartbeats
    ·         Vasodilators widen blood vessels so blood can flow more easily
    ·         Antiarrhythmics treat and prevent irregular heartbeats

    To treat a certain defect

    ·         Prostaglandins and prostaglandin inhibitorshelp keep open or close a fetal blood vessel, called the ductus arteriosus, that normally closes at birth

    To prevent problems

    ·         Antibiotics before certain dental and surgical procedures help prevent endocarditis in some people
    ·         Blood thinners, such as aspirin or anticoagulants - lower the risk of blood clots in the heart or in blood vessels



    Extra Information – Statistic 


    The Baltimore-Washington Infant Study is a regional epidemiologic study of congenital heart disease. Among infants born in the study area in 1981 and 1982, 664 had a diagnosis of congenital heart disease confirmed in the first year of life by echocardiography, cardiac catheterization, cardiac surgery, or autopsy. The prevalence rate was 3.7/1,000 livebirths for all cases and 2.4/1,000 livebirths for cases confirmed by invasive methods only. Diagnosis-specific prevalence rates of congenital heart disease are compared with those of eight previous case series. Changing diagnostic categorizations in the time span covered and methodological differences resulted in great variation of the data. However, the data of the New England infant Cardiac Program which used the same case discovery methods showed similar occurrences of major morphologic abnormalities, suggesting that these are stable basic estimates in the eastern United States. For all case series, the rate of confirmed congenital heart disease was approximately 4/1,000 livebirths over the 40-year time span.




    REFERENCE