Tuesday, October 7, 2008
Congenital heart disease
Monday, August 25, 2008
HEART STATISTICS
- Coronary artery disease is the single largest cause of morbidity amongst all diseases so much so that it has been classified as having reached pandemic proportions by none less than the WHO (World Health Organisation).
- Over 7,0000,000 Indians have heart related diseases
- 1 in 3 adults, both men and women, has some form of cardiovascular disease.
- In 90% of adult victims of sudden cardiac death, two or more major coronary arteries are narrowed or blocked.
- Brain death and permanent death start to occur in just 4-6 minutes after someone experiences cardiac arrest.
- The cardiac 64 CT scan provides 3D images of the heart so detailed that the heart disease can be detected at a very early stage.
Monday, July 28, 2008
Effects of Heavy Drinking on Heart Health Differs Between Genders
Sunday, June 29, 2008
Low vitamin D level may up death risk
Monday, June 23, 2008
Risk Factors Of Ischemic Heart Disease
heart attack (myocardial infarction)-when a part of heart muscle is permanently damaged or actually dies because there’s not enough oxygen.
unstable angina-is an intermediary between myocardial infarction and stable angina.It’s manifestation is a severe chest pain that lasts more than stable angina and it doesn’t respond very well to medication.
angina-is a chest discomfort which occurs when the coronary vessels receive an inadequate blood flow.
atherosclerosis-occurs when fatty material deposite into the arteries walls. This can lead to a blockage of the arteries.
Other risk factors for Ischemic Heart Disease are:
hypertension (high blood pressure)- blood pressure can vary with activity and with age, but a healthy adult who is resting generally has a systolic pressure reading between 120 and 130 and a diastolic pressure reading between 80 and 90 (or below).
diabetes-heart problems are the leading cause of death among people with diabetes, especially in the case of non-insulin-dependent diabetes also known as Type II diabetes.
high blood cholesterol-cholesterol is a fat-like substance carried in your blood.It can be found in all of your body's cells. The liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs,and other similar products).
obesity and overweight- extra weight leads to increased total cholesterol levels, high blood pressure, and an increased risk of coronary artery disease. Obesity increases your chances of developing other risk factors for heart disease, especially high blood pressure, high blood cholesterol, and diabetes.
smoking- It’s well known that smoking increases the risk of lung cancer, but few people know that it also increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms and legs). Smoking also raises blood pressure, which increases the risk of stroke in people who already have high blood pressure.
birth control pills-At the beginning birth control pills contained high levels of estrogen and progestin, and taking these pills increased the chances of heart disease and stroke, especially in women older than 35 who smoked. In our days the dose of hormones contained in these pills has been lowered and they are considered safe for women younger than 35, who do not smoke or have high blood pressure.
physical inactivity- people who exercise regularly have a lower risk of heart attack than people who are not active. Exercise burns calories, may lower blood pressure and helps to control cholesterol levels and diabetes. In addition to this exercise makes the arteries more flexible and strengthens the heart muscle.
Wednesday, June 4, 2008
High cholesterol
High cholesterol, high blood pressure and heart disease are among the most common high-risk conditions facing Americans today. The good news is that by making simple lifestyle changes you can significantly reduce your risk.
The Healthy Heart Program is designed to help you take small steps today that can lead to long-term results. The program provides:
Basic information about cholesterol and heart disease
A personalized meal plan with healthy, great-tasting recipes
Tips on "superfoods" that have been proven to fight heart disease
Advice on reducing your stress and ways to think healthy
Scientific advice on nutrition, supplements, wellness and fitness
Each week your homepage will provide you with an achievable goal, and a To-Do List of action items to help you make it happen. Regular e-mails will remind you to stay on track. When you've completed your program you can choose a new one or maintain your progress with Your Healthy Living Program, which gives you personalized resources based on your interests and continued access to all your tools and trackers.If you're not sure if this program is right for you, print this page and review it with your healthcare provider.
Thursday, May 1, 2008
Health - Conditions - Drugs and surgery
Heart surgery
Sometimes medication can't control all the symptoms of heart disease. Surgery may be needed to open or replace the blocked arteries, repair damaged valves or simply keep the patient alive.
Common operations for heart disease include:
Coronary angioplasty, or percutaneous transluminal coronary angioplasty (PTCA) to give it its full technical name, is used to treat coronary heart disease.
It involves passing a long, thin, hollow tube or catheter up into the coronary arteries, under x-ray guidance, from an artery in the groin or arm (under local anaesthetic.) A device on the tube is then used to unblock the artery, and stretch the artery walls so that more blood and oxygen can flow to the heart muscle.
Angioplasty may be recommended if angina cannot be controlled with drugs, if angina is limiting a person's life, or when a person gets angina just sitting in a chair at rest.
PCTA may be performed as an emergency when someone is having a heart attack. If carried out soon enough it can open the blocked coronary artery before permanent damage is done to the heart muscle. But it can only be performed in a specialist hospital, so it's not an option for most people having a heart attack.
Types of angioplasty
Balloon angioplasty, often known simply as balloon treatment, was the first type of angioplasty. On the end of the tube or catheter is a small, sausage-shaped balloon. The balloon is inflated in the blocked artery, compressing the fatty build-up (atheroma) against the artery walls. The surgeon then deflates the balloon and removes it.
Another common type of angioplasty involves inserting a short stainless steel mesh tube, called a stent, at the same time as the balloon. As the balloon is deflated, the expanded stent is left in place to help keep the artery open.
This method helps to prevent the problem of reblockage (restenosis), which affects around a third of people following conventional balloon treatment.
Recently, doctors have begun to use stents that incorporate drugs to help prevent reblockage.
Doctors are also trying a number of newer ways to perform angioplasty. They're using devices to cut or drill out fatty deposits, vaporise them with a laser, or blast them with ultrasound.
But, as yet, these techniques haven't been proven to be better than the standard balloon or stent method. While they're being tested and developed in some centres in the UK, they're not routinely available.
Coronary bypass surgery
Coronary bypass surgery, medically known as coronary artery bypass graft or CABG (pronounced 'cabbage'), is an operation in which a blood vessel from another part of the body is grafted between the aorta (the main artery leading from the heart) and the coronary artery, or arteries, to bypass blockages and restore blood flow to the heart muscle.
A bypass can be done on each of the four coronary arteries if necessary, hence the terms single, double, triple or even quadruple graft, depending on how many arteries are bypassed. The operation can be done using conventional surgical techniques or by keyhole surgery (microsurgery).
While many people find this sort of surgery hugely improves their health, it's not without considerable risks.
CHD can frequently be controlled with drugs alone, but if the blood vessels have become severely narrowed, or if drug treatment is unable to control symptoms, surgery may be needed to open up or replace the blocked arteries.
Valve replacement
Diseased heart valves can be repaired or replaced with either mechanical valves or biological valves (made from human or animal tissue). Mechanical valves may last longer but usually require a person to take anticoagulant medicines because there is an increased risk of clots forming.
Wednesday, April 16, 2008
HELP! I Can't COPE
Several studies have show the fear, anxiety and depression are the most common responses to one’s heart disease upon returning home from a hospitalized event. It should be noted that depression is not just simply “feeling down or sad” but an accumulation of various symptoms which would lead to the diagnosis of depression by a physician. Many feelings of despair and hopelessness in the initial phases of any illness can be normal. The human spirit also sustains a “blow” when an illness strikes and requires time to heal. For instance, when a heart attack occurs, it takes the heart muscle approximately 5-8 weeks to recover, but studies show it takes about 8-12 weeks to emotionally recover!
The grieving process consists of anger, fear, denial, and finally acceptance. Negative feelings after a major medical event (such as a heart attack or open-heart surgery) is likely due to the grieving process, which is a normal and natural method of coping. In these cases, the individual is grieving over the loss of the previous state of health. It is necessary to complete the grieving process to move on to accepting one’s current state of health and new stage in life. By the time the individual and family feel more comfortable to plan for the future, the grieving process has been completed. Everyone completes this cycle in a different time frame.
Some signs of inappropriate coping are daily; loss of interest or pleasure in all or most activities, significant weight loss or weight grin, insomnia or excessive sleeping, fatigue or loss of energy, feelings or worthlessness or excessive or inappropriate guilt, diminished ability to think or concentrate, sudden unexplained outbursts of crying, recurrent thoughts of death (not just fear of dying), and/or a specific suicide plan. Those who are angry and irritable may also not be adapting well.
Not all of these symptoms can always be attributed to maladaptive coping mechanism or depression. For instance, someone who has congestive heart failure will, because the nature of his or her illness chronically fell fatigues, sleep a lot and may have excessive weight loss. Some cardiac medications can also bring on some of these symptoms. To help in assisting one through the coping stages of an illness it is important that the individuals get concise, informative facts about their illness. A course of rehabilitation and expectations should be mapped out so that the patient does not place unrealistic expectations on him/herself causing frustration and helplessness when those unrealistic expectations are not met. Cardiac rehabilitation programs are specifically set up to aid the individual to realize their full potential following a cardiac event. As a patient, you should ask and insist on obtaining coping/rehab information. Having written information is very helpful so it can be referred back to from time to time if necessary. Additionally, it is important to involve family or other support persons to help you recovery. A speedy and effective recovery is difficult if it’s done solo. If you don’t have family or friends who can help, agencies like the Senior friendship Center or home health Agencies may be able to lend assistance or offer other resources for help. There are many support groups for various cardiac problems, which are free and very beneficial.
It’s important to establish good communications with your physician or his/her nurse. They are resources available to your to whom you may voice your concerns regarding the symptoms you may be having or to reinforce any education you may have received. Any hobbies practiced previous to the cardiac event should be resumed as soon as cleared by the physician. Resist the temptation to sleep during the day for any length in time. A good nights sleep is essential to cope with tomorrow’s problems! Of course for some individuals these simple suggestions may not be enough and especially for those who have thoughts of harming themselves, professional help should be strongly considered.
Thursday, April 10, 2008
Coronary Heart Disease (CHD)
CHD can lead to a heart attack. Angina can also occur. Angina is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. Over time, CHD can weaken the heart muscle and lead to heart failure, a serious problem where the heart cannot pump blood the way that it should. Also, irregular heart beats, called arrhythmias, can develop.
The most common symptom of CHD is angina. In some people the first sign of CHD is a heart attack. Doctors can assess a patient’s risk status by checking several factors, including blood pressure, blood cholesterol and glucose, history of heart disease, and other factors. Doctors can perform several tests to assess CHD in patients who are at high risk or have symptoms. These may include one or more of these tests:
ECG or EKG (electrocardiogram), which measures the electrical function and the rate and regularity of your heartbeat.
Echocardiogram, which creates a picture of the heart.
Exercise stress test, to measure how well the heart pumps at greater than usual workloads when it needs more oxygen.
- Chest x–ray, a picture of the organs and structures inside the chest.
- Cardiac catheterization, a thin, flexible tube is passed through an artery in the groin or arm to reach the coronary arteries.
- The tube lets your doctor check the inside of your arteries to see if there is any blockage. Your doctor also can measure the pressure and blood flow in the heart's chambers, collect blood samples from the heart, and examine the arteries of the heart by x–ray.
- Coronary angiography, which is usually performed along with cardiac catheterization. A dye is injected through the catheter into the coronary arteries.
- The doctor can then take an x–ray to see the flow of blood through the heart and check for blockages.
For persons with CHD, treatment will involve addressing those factors that put them at risk for CHD and heart attack. The doctor may recommend lifestyle changes to help reduce risk. Medicines and medical treatments may be needed. Medicines are available to treat high blood cholesterol, high blood pressure, irregular heart beats, blood flow, and other potential problems. Some advanced treatments and surgical procedures may be used to help restore blood flow to the heart muscle.
In principle, all people can take steps to lower their personal risk of heart disease and heart attack by addressing their risk factors. People who already have heart disease especially need to control their risk factors.
Friday, April 4, 2008
TOP Websites
Information and education about heart and stroke disease.
http://www.americanheart.org/
Heart and Stroke Foundation of Canada -
Heart Disease, Stroke The Foundation is committed to keeping your doctor informed of the latest developments in prevention and management of heart disease and stroke.
...http://ww2.heartandstroke.ca/
British Heart Foundation Home
Charity fighting heart and circulatory disease. The BHF funds research, education and life-saving equipment and helps heart patients.
http://www.bhf.org.uk/
Women Heart Disease, Heart Attacks, Coronary, Cardiac Health
Continue to our web site. New website coming in summer 2008! WomenHeart logo. omenHeart is a nationwide community of women with heart disease
http://www.womenheart.org/
Wednesday, April 2, 2008
Closed heart surgery
Tuesday, March 25, 2008
Weightlifting Death Risk
Scientists are calling for widespread heart screening of people before they begin weight training. That's based on new evidence that lifting more than half your body weight could put you at risk of sudden death, as this ScienCentral News video explains.
"They wanted let me go home ... They gave me the option to stay but said 99 percent I'd be fine to go home ... They wanted me to come back the following day for a stress test," Bill Linski recalls. He was only 21 years old and in great shape from his 6-day-a-week gym workouts when intense chest pains sent him to his local hospital emergency room. Luckily, he let his mom decide. She thought he should stay.
It turned out that pumping iron earlier that day had pumped up Linski's blood pressure, which caused a tear in his aorta, the heart's main artery. He was airlifted to Yale New Haven Hospital where surgeon John Elefteriades performed lifesaving surgery.
Sadly, Elefteriades says similar scenarios all too often end in the death of a healthy young man. "A problem and a tragedy arises in the fact that it's uncommon for physicians to think of an internal tear of the aorta in healthy young athletes," Elefteriades says.
In 2003, he and his team wrote in the Journal of the American Medical Association that they'd noticed a pattern: five young patients, including Linski, with torn aortas following heavy lifting. All had a previously undetected aneurysm, or enlargement of the aorta.
Now, they report even stronger evidence of this association in the journal Cardiology, where they've documented that link in 31 patients.
"Of the 31 patients," says Elefteriades, "10 of them are dead."
He's grateful to family members who contacted him and allowed him to investigate the deaths of their loved ones. "Through the generosity of families who shared their stories with me ... I've heard the most tear-wrenching accounts," he says.
His team's new recommendations are based solely on trying to prevent such terrible losses, he says. "For heavy strength training involving weight lifting or similar activities like pushups, we're recommending screening for unknown or undetected aortic aneurysm."
Elefteriades says that includes people who do heavy lifting on the job, and that the team defines heavy lifting as more than half your body weight.
The screening test they recommend is a heart echo exam, technically called transthoracic echocardiography, also commonly called a heart ultrasound. It's "a very simple test which is painless, it's fun to have and relatively inexpensive," he says.
Monday, March 24, 2008
Excretory System: Poison Protection
Hidden throughout your body are dangerous poisons that must be removed in order for it to survive. The process of excretion involves finding and removing waste materials produced by the body. The primary organs of excretion are the lungs, kidneys, and skin. Waste gases are carried by blood traveling through the veins to the lungs where respiration takes place. Dead cells and sweat are removed from the body through the skin which is part of the integumentary system. Liquid waste is removed from the body through the kidneys. Located beside the spine in your back within your ribcage, the kidneys are small (about 10 centimeters long) reddish-brown organs that are shaped like beans. During circulation, blood passes through the kidneys in order to deposit used and unwanted water, minerals, and a nitrogen-rich molecule called urea. The kidneys filter the wastes from the blood, forming a liquid called urine.
The kidneys funnel the urine into the bladder along two separate tubes called ureters. The bladder stores the urine until muscular contractions force the urine out of the body through the urethra. Each day, your kidneys produce about 1.5 liters of urine. All of it needs to be removed from your system. This occurs through urination. If your kidneys are diseased and not working properly, the buildup of waste in your system will eventually lead to death. Some kidney diseases can be treated with medication. Severe kidney diseases require more intense treatment. One treatment is called dialysis.
The patient's blood is pumped through a dialysis machine which filters the waste from the blood and returns the clean blood. A dialysis patient has to spend nearly sixty hours each week attached to the machine. The most radical treatment for kidney disease is a kidney transplant. Healthy people can live comfortably with only one kidney. Therefore, their other kidney can be donated to a person with kidney disease. The donor and patient must have very similar genetic structures in order for the patient to accept the new kidney without complications. The patient also receives anti-rejection drugs. During a kidney transplant operation, the healthy kidney is placed in the abdomen of the patient and attached to the blood vessels and bladder. The patient's original kidneys are not removed.
Thursday, March 20, 2008
Pulmonary Circulation: It's All in the Lungs
The left ventricle's contraction forces the blood into the aorta and the blood begins its journey throughout the body.
The one-way valves are important for preventing any backward flow of blood. The circulatory system is a network of one-way streets. If blood started flowing the wrong way, the blood gases (oxygen and carbon dioxide) might mix, causing a serious threat to your body. You can use a stethoscope to hear pulmonary circulation. The two sounds you hear, "lub" and "dub," are the ventricles contracting and the valves closing.
Owning a cat 'cuts heart attack or stroke risk by third'
Whether it's a frisky kitten or a tubby tabby, a cat at home could cut your heart attack or stroke risk by almost a third, according to a new study.
A team of international researchers has found that owning a cat helps in relieving stress and anxiety, which is known to help protect against cardiovascular problems by lowering blood pressure and reducing the heart rate.
"The logical explanation may be that cat ownership relieves stress and anxiety and subsequently reduces the risk of heart disease," 'The Daily Telegraph' quoted lead author Prof Adnan Qureshi of the Minnesota University as saying.
According to the researchers, one reason could be that stroking the pet could cut the level of stress-related hormones in the blood.
The team came to the conclusion after analysing a data of 4,435 adults, aged between 30 and 75, about half of whom owned a cat. Subsequently, the team tracked rates of death from all causes, including heart and stroke.
The cat owners "appeared to have a lower rate of dying from heart attacks" over 10 years of follow-up compared to feline-free folk, Prof Qureshi said, adding the magnitude of the effect -- a 30 per cent reduction in heart attack risk -- "was a little bit surprising".
Cat owners were still found to have a much reduced chance of developing strokes or heart attacks when the team took factors known to trigger heart disease, including high cholesterol levels, smoking and diabetes, into consideration.
"We certainly expected an effect, because we thought that there was a biologically plausible mechanism at work. But the magnitude of the effect was hard to predict," Prof Qureshi said.
Tuesday, March 18, 2008
Respiratory System: Oxygen Delivery System
The oxygen then passes through the larynx (where speech sounds are produced) and the trachea which is a tube that enters the chest cavity. In the chest cavity, the trachea splits into two smaller tubes called the bronchi. Each bronchus then divides again forming the bronchial tubes. The bronchial tubes lead directly into the lungs where they divide into many smaller tubes which connect to tiny sacs called alveoli. The average adult's lungs contain about 600 million of these spongy, air-filled sacs that are surrounded by capillaries. The inhaled oxygen passes into the alveoli and then diffuses through the capillaries into the arterial blood. Meanwhile, the waste-rich blood from the veins releases its carbon dioxide into the alveoli. The carbon dioxide follows the same path out of the lungs when you exhale.
The diaphragm's job is to help pump the carbon dioxide out of the lungs and pull the oxygen into the lungs. The diaphragm is a sheet of muscles that lies across the bottom of the chest cavity. As the diaphragm contracts and relaxes, breathing takes place. When the diaphragm contracts, oxygen is pulled into the lungs. When the diaphragm relaxes, carbon dioxide is pumped out of the lungs.
Monday, March 17, 2008
Respiratory System: Oxygen Delivery System
Respiration is achieved through the mouth, nose, trachea, lungs, and diaphragm. Oxygen enters the respiratory system through the mouth and the nose. The oxygen then passes through the larynx (where speech sounds are produced) and the trachea which is a tube that enters the chest cavity. In the chest cavity, the trachea splits into two smaller tubes called the bronchi. Each bronchus then divides again forming the bronchial tubes. The bronchial tubes lead directly into the lungs where they divide into many smaller tubes which connect to tiny sacs called alveoli. The average adult's lungs contain about 600 million of these spongy, air-filled sacs that are surrounded by capillaries. The inhaled oxygen passes into the alveoli and then diffuses through the capillaries into the arterial blood. Meanwhile, the waste-rich blood from the veins releases its carbon dioxide into the alveoli. The carbon dioxide follows the same path out of the lungs when you exhale.
The diaphragm's job is to help pump the carbon dioxide out of the lungs and pull the oxygen into the lungs. The diaphragm is a sheet of muscles that lies across the bottom of the chest cavity. As the diaphragm contracts and relaxes, breathing takes place. When the diaphragm contracts, oxygen is pulled into the lungs. When the diaphragm relaxes, carbon dioxide is pumped out of the lungs.
Saturday, March 15, 2008
Circulatory System: The Circle of Blood
On average, your body has about 5 liters of blood continually traveling through it by way of the circulatory system. The heart, the lungs, and the blood vessels work together to form the circle part of the circulatory system. The pumping of the heart forces the blood on its journey.
The body's circulatory system really has three distinct parts: pulmonary circulation, coronary circulation, and systemic circulation. Or, the lungs (pulmonary), the heart (coronary), and the rest of the system (systemic). Each part must be working independently in order for them to all work together.
Friday, March 14, 2008
Men and Heart Disease Statistics
- In 2002, over 340,000 men died from heart disease.
- Heart disease is the leading cause of death in men.
- A man's average age for a first heart attack is 66 years old.
- Between 70 percent and 89 percent of sudden cardiac incidents occur in men.
- 50 percent of men who have a heart attack before the age of 65 die within eight years.
- Men suffer heart attacks on average, ten years earlier than women.
- 50 percent of men who have died from a heart attack exhibited no previous symptoms.
- Men who are clinically depressed have a higher risk of heart disease and heart attack then men who are not depressed.
Wednesday, March 12, 2008
Tuesday, March 11, 2008
Heart disease after Hodgkin's lymphoma treatment
Every day, another woman becomes a fatal statistic to heart disease. Here are some quick facts about heart disease and its effect on women:
-Heart disease is the number one killer of women.
-8 million women in the United States have some form of heart disease.
-Every 34 seconds a woman dies from a heart related disease
-Women who have reached menopause are two to three more times likely to develop coronary artery disease than those who have not reached menopause.
-6 million women in the United States have had a heart attack or experienced angina. -31,837 women each year die from congestive heart failure.
-Heart disease takes more lives than the next eight on list for top killers of women, including breast cancer. -267,000 women will die from a heart attack this year.
-Women who smoke have a chance of having a heart attack 19 years before women who do not smoke.
Friday, March 7, 2008
Congestive Heart Failure
Congestive heart failure is another type of heart disease. It is, simply put, when a persons heart fails. It is the most common reason for the elderly to be hospitalized. Congestive heart failure often is a result of another type of heart condition.
It occurs when the heart is not able to pump out enough blood from its chambers to meet the body's needs. Congestive heart failure can also occur when a persons heart chambers become stiff, which doesn't allow the heart to relax and thus fill with blood.
There are several symptoms to congestive heart failure. The symptoms are determined by which side of the heart may be failing. Often, the symptoms of congestive heart failure are from the congestion that occurs when fluid backs up into the lungs and pushes into the surrounding tissues.
Symptoms of heart failure on the left side of the heart may be as follows: tiredness, shortness of breath, difficulty breathing; especially when sleeping, wheezing, and weight loss. Symptoms of heart failure on the right side of the heart may result in the following: tiredness, fluid in the feet, legs and abdomen, enlargement of the liver, and weight gain that is unintentional due to water retention. A doctor should be contacted immediately when a person has any of the above symptoms.
Wednesday, March 5, 2008
Body Weight Contributes to Heart Disease
Being overweight can contribute to the development of heart disease. The heart has to work harder in people that carry more weight than those who are slim. This puts a strain on the heart of the overweight person. Someone who is overweight may also have a higher bad cholesterol level, higher blood pressure and an increased risk of diabetes.
Having high blood pressure or high cholesterol increases the chances of developing heart disease. To lessen your risk of heart disease due to weight, it is important to know your BMI, or your body mass index. BMI is calculated using your height and weight.
Doctors often use it to determine if one is overweight or underweight. To figure BMI you must divide your weight in pounds by 2.2. You then must multiply your height in inches by .0254. When this is done, you divide your pounds by inches to get your BMI.
A BMI higher than 30 would be considered obese. Being obese puts you at risk for heart disease. Being overweight is classified as anything from 25 to 30. People who are overweight are also at an increased risk for heart disease. A normal BMI is from the 18.5 to 24.9 range.
Exercise and diet can help you lose weight; it can also help reduce your chance of developing heart disease due to obesity.
Tuesday, March 4, 2008
Blood Pressure Contributes to Heart Disease
Blood pressure is often called a "silent killer", because many people are unaware they suffer from high blood pressure. High blood pressure can lead to stroke and heart attack. People need to have their blood pressure monitored on a regular basis by a physician.
High blood pressure often causes an increase pressure on the kidneys and the heart to work harder. This then increases the risk of heart attack, stroke and even kidney disease. A normal blood pressure is considered to be 120/80 and lower. High blood pressure is considered to be 140/90 and higher.
Blood pressure can be controlled through exercise, weight loss and diet. There are times when medication is required to help decrease blood pressure. Reducing your blood pressure results in less chance of developing heart disease.
Monday, March 3, 2008
Cholesterol Contributes to Heart Disease
Many people don't know what cholesterol is let alone know what their cholesterol levels may be. One thing that is known is: having high cholesterol can contribute to heart disease. When fatty deposits filled with bad cholesterol build up on your arteries, it can cause a lack of blood flow and oxygen to your heart. This can result in heart disease.
A person's total cholesterol level should be lower than 200 mg/dl. Your LDL (this is the bad cholesterol in your blood) should be less than 70 mg/dl if you have an existing heart disease. Your LDL level should be less than 100 mg/dl if you are at risk for heart disease and it should be no higher than 130 mg/dl if you have no risk factors.
It is important to raise your good cholesterol (HDL) and lower your bad (LDL). A goal for good cholesterol (HDL) is 40 mg/dl, and anything higher is wonderful. People at risk for heart disease, and even those not at risk, should have their cholesterol levels checked regularly. By simply changing your diet and exercising, you can lower your cholesterol.
Sunday, March 2, 2008
Heredity and Heart Disease Risk
Heredity is one cause of heart disease that someone cannot change. Many times heart disease is genetic and passed on from parent to child.
Children who have parents that have heart disease are more likely to develop heart disease themselves. Many times when heart disease is prevalent in families, it is also compounded with other risk factors.
It is always important for a family with a high risk factor of heart disease to treat and control any risk factors that may present themselves. Seeing a doctor regularly for check-ups and heart checks is important in helping to control any heart disease that runs in families.
The more a person knows about the heart disease that may run in their family, the more a person can do to help minimize the risks of developing it. Obviously, doctors cannot do anything about what is in someone's genes, but the more information a person can share with his or her doctor about a hereditary heart disease, the more a doctor can do more to develop strategies that may help that person in the future.
Saturday, March 1, 2008
Preventing Heart Disease, Heart Attack through Stress Management
- People who have “hurry sickness” can be cured-and heal their hearts. Try to substitute sympathy for irritation.
- Some 70 percent of those who were hostile were found to have clogged arteries. Learn what pushes your buttons and reconstruct a healthy response.
More Advice For Preventing and Managing Heart Disease, Heart Attack
- Get two cholesterol readings when necessary to avoid errors
- Getting up on the treadmill and monitoring your heart can show if it is getting enough oxygen during exercise
- A new test may identify people with a family history of high cholesterol
- An array of drugs help your heart behave normally.
- An aspirin a day may keep blood clots at bay. A new device is now available to scrape away plaque from narrowed arteries
Friday, February 29, 2008
Preventing Heart Disease, Heart Attack through Physical Exercise
- Studies show you don’t have to work up a sweat to keep your cholesterol in check. Walking is no strain, all gain, exercise for your heart.
- Regular activities that burn 2,500 calories a week may cut your heart attack risk in half
- Patients who regularly exercise may greatly improve their chances of avoiding a heart attack
- Exercise is a new lease on life, even for those with a family history of heart disease
Thursday, February 28, 2008
What is the need for cardiac CT
- “Screening” is a widely accepted strategy to combat CAD for early detection of stenosis of the coronary artery lumen.
- Exclusion of stenosis in non- symptomatic high risk patients.
- Prior to major (non-cardiac) Surgery.
- Atypical (unstable) chest pain.
- Refractory chest pain with doubtful coronary origin.
- Non-conclusive stress tests.
- As a substitute to conventional coronary angiography prior to percatareous coronary intervention and in high risk patient like aortic disease.
- Adjuvant to coronary Angio for Plaque characterization ,Complicated coronary intubation., Total coronary occlusion.
- Follow-up in -Percutaneous coronary intervention-Bypass Surgery.
- Evaluation of coronary anomalies.
- Evaluation of chest pain at emergency department.
- Evaluation of lifestyle, dietary or pharmacological interventions on progression /regression of coronary atherosclerosis.
Tuesday, February 26, 2008
Heart-Lung Machines
by Allison J.
Definition
The heart-lung machine is medical equipment that provides cardiopulmonary bypass, or mechanical circulatory support of the heart and lungs. The machine may consist of venous and arterial cannula (tubes), polyvinyl chloride (PVC) or silicone tubing, reservoir (to hold blood), bubbler or membrane oxygenator, cardiotomy (filtered reservoir), heat exchanger(s), arterial line filter, pump(s), flow meter, inline blood gas and electrolyte analyzer, and pressure-monitoring devices. Treatment provides removal of carbon dioxide from the blood, oxygen delivery to the blood, blood flow to the body, and/or temperature maintenance. Pediatric and adult patients both benefit from this technology.
Purpose
In the operating room , the heart-lung machine is used primarily to provide blood flow and respiration for the patient while the heart is stopped. Surgeons are able to perform coronary artery bypass grafting (CABG), open-heart surgery for valve repair or repair of cardiac anomalies, and aortic aneurysm repairs, along with treatment of other cardiac-related diseases.
The heart-lung machine provides the benefit of a motionless heart in an almost bloodless surgical field. Cardioplegia solution is delivered to the heart, resulting in cardiac arrest (heart stoppage).
The heart-lung machine is invaluable
In critical care units and cardiac catheterization laboratories, the heart-lung machine is used to support A heart-lung machine. ( Photograph by Albert Paglialunga. Phototake NYC. Reproduced by permission. ) and maintain blood flow and respiration. The diseased heart or lung(s) is replaced by this technology, providing time for the organ(s) to heal. The heart-lung machine can be used with venoarterial extracorporeal membrane oxygenation (ECMO), which is used primarily in the treatment of lung disease. Cardiopulmonary support is useful during percutaneous transluminal coronary angioplasty (PTCA) and stent procedures performed with cardiac catheterization. Both treatments can be instituted in the critical care unit when severe heart or lung disease is no longer treatable by less-invasive conventional treatments such as pharmaceuticals, intra-aortic balloon pump (IABP), and mechanical ventilation with a respirator.
Use of this treatment in the emergency room is not limited to patients suffering heart or lung failure. In severe cases of hypothermia, a patient's body temperature can be corrected by extracorporeal circulation with the heart-lung machine. Blood is warmed as it passes over the heat exchanger. The warmed blood returns to the body, gradually increasing the patient's body temperature to normal.
Tertiary care facilities are able to support the staffing required to operate and maintain this technology. Level I trauma centers have access to this specialized treatment and equipment. Being that this technology serves both adult and pediatric patients, specialized children's hospitals may provide treatment with the heart-lung machine for venoarterial ECMO.
Description
The pump oxygenator had its first success on May 6, 1953. Continued research and design have allowed the heart-lung machine to become a standard of care in the treatment of heart and lung disease, while supporting other non-conventional treatments.
Foreign surfaces of the heart-lung machine activate blood coagulation, proteins, and platelets, which lead to clot formation. In the heart-lung machine, clot formation would block the flow of blood. As venous and arterial cannulas are inserted, medications are administered to provide anticoagulation of the blood which prevents clot formation and allows blood flow through the heart-lung machine.
Large vessels (veins and arteries) are required for cannulation, to insert the tubes (cannulas) that will carry the blood away from the patient to the heart-lung machine and to return the blood from the heart-lung machine to the patient. Cannulation sites for venous access can include the inferior and superior vena cava, the right atrium (the upper chamber of the heart), the femoral vein (in the groin), or internal jugular vein. Oxygen-rich blood will be returned to the aorta, femoral artery, or carotid artery (in the neck). By removing oxygen-poor blood from the right side of the heart and returning oxygen-rich blood to the left side, heart-lung bypass is achieved.
The standard heart-lung machine typically includes up to five pump assemblies. A centrifugal or roller head pump can be used in the arterial position for extracorporeal circulation of the blood. The four remaining pumps are roller pump in design to provide fluid, gas, and liquid for delivery or removal to the heart chambers and surgical field. Left ventricular blood return is accomplished by roller pump, drawing blood away from the heart. Surgical suction created by the roller pump removes accumulated fluid from the general surgical field. The cardioplegia delivery pump is used to deliver a high potassium solution to the coronary vessels. The potassium arrests the heart so that the surgical field is motionless during surgical procedures. An additional pump is available for emergency backup of the arterial pump in case of mechanical failure.
Monday, February 25, 2008
Nutrition: Diet and Heart Disease
Being Thin Is Not Necessarily the Solution
RMR
How important a factor is dietary fat intake in the development of coronary artery disease? Put another way, if a person has a high fat diet but stays relatively thin will their arteries be okay?AHLYou can't tell by looking at someone whether they are of a desirable body weight or overweight, or their risk of developing heart disease. Each person is different.First, you have to know how much fat (lipid) is in your blood (see Table 1 below for more detail). Most physicians do this blood test every time you have a check-up or annual medical exam. The most important factor affecting blood cholesterol levels is how much saturated fat and cholesterol you eat.
Risk Factors Vary with the Individual, but They Do Add Up
RMR
What risk factors affect your blood lipid levels? Alice, you mentioned the various risk factors for coronary artery disease and I wonder if you would list them in order of importance as a review and, secondly, could you review the main sources of saturated fats in our diet and the mechanism whereby saturated fats give rise to elevated cholesterol levels?
AHL
The significant risk factors are hypertension, family history of cardiovascular disease, current cigarette smoker, hypertension, low HDL cholesterol (the good cholesterol) and diabetes. Although not considered independent risk factors, obesity and physical inactivity should also be taken into consideration. No one risk factor is more important than another (see Table 2 below).
Major Sources of Saturated Fat in the Diet
AHL
The American Heart Association (AHA) and the National Cholesterol Education Program (NCEP) have issued recommended guidelines, Step 1 and Step 2 they're called, for the dietary treatment of too much cholesterol Table 3. The patient should be first counseled to follow a Step 1 diet. If a patient is already on a Step 1 diet, or an acceptable response is not achieved, the patient should be advised to follow a Step 2 diet by further decreasing their saturated fat intake to 7% of calories and their cholesterol intake to 200 mg/day. For this strategy to be effective, you'll probably require the help of a registered dietitian. Usually, decreasing the total fat content of the diet is easier to do than decreasing the saturated fat content. In order to decrease effectively the saturated fat content, it is important to know its major sources. These include animal fats such as meat and full fat dairy products and, depending on one's tastes, a few selected plant oils (Table 7). The plant oils, frequently termed tropical oils, include coconut oil, palm oil, palm kernel oil and cocoa butter and contain a fair amount of saturated fat. However, they do not tend to be used in high levels in the United States.For Americans with high blood lipid levels, the focus should be on decreasing full fat dairy products and meat. Many non-fat, reduced-fat and low-fat dairy products are now available. To reduce the intake of saturated fat from meat, buy cuts of meat with the least amount of visible fat; trim meat of excess fat; with poultry, remove the skin before eating; and, of course, cut down on the size portion of meat actually consumed.
The other potential source of animal fat can come from cooking, as discretionary fat is added during food preparation. We recommend that individuals switch from animal fats such as lard or butter to vegetable oils.The other dietary factor which elevates blood cholesterol levels is dietary cholesterol.
Major sources of dietary cholesterol are eggs and animal fats (both dairy and meat). By decreasing the consumption of animal fat, in addition to saturated fat, dietary cholesterol intake should also decrease.
Heart attack : BBC News Friday, 23 June, 2000
A heart attack occurs when blood flow to part of the heart is blocked, often by a blood clot, causing damage to the affected muscle.
This is usually caused by atherosclerosis - hardening of the artery walls. The clot, often caused by rupturing or tearing of plaque in an artery is sometimes called a coronary thrombosis or a coronary occlusion.
A heart attack, also known as myocardial infarction, can also occur when a coronary artery temporarily contracts or goes into spasm, decreasing or cutting the flow of blood to the heart.
An unexpected and abrupt heart attack occuring soon after the onset of symptoms can result in sudden death.
It accounts for about half of all coronary heart disease deaths and can be caused by nearly all types of heart disease.
Three main symptoms of a heart attack:
1. Pressure or pain in the centre of the chest, lasting more than a few minutes or going away and coming back
2. Pain spreading to the shoulders, neck or arms
3. Chest discomfort combined with light-headedness, fainting, sweating, nausea or shortness of breath
Other common warning signs of heart attack include unusual chest, stomach or abdominal pain, nausea or dizziness, shortness of breath or difficulty breathing, unexplained anxiety, weakness or fatigue, palpitations, cold sweat or paleness.
Anybody experiencing these symptoms should call an ambulance immediately, but should not try to drive themselves to hospital, as complications can begin to occur before they get there.
Most people do have time to get to hospital and be treated before collapsing, but they do need to act quickly.
Some people wait for hours or even days before seeking help - they are the ones that get into trouble.
After a heart attack
Diagnosis of a heart attack usually involves a clinical examination, an electrocardiogram, heart rhythm monitoring and blood tests.
Echocardiograms or angiograms will detect the extent of damage to the heart.
Immediately after a heart attack, clot-busting drugs will be used to restore blood flow. Aspirin, to aid blood flow, and beta-blockers, to ease the heart's work rate, may also be used.
In the days or weeks after a heart attack, surgery - either angioplasty or coronary artery bypass surgery - may be performed.
http://news.bbc.co.uk/2/hi/health/medical_notes/g-i/764015.stm
Sunday, February 24, 2008
Friday, February 22, 2008
Thursday, February 21, 2008
Heart Transplant Surgery
Also called: Cardiac Transplantation, Artificial Heart Transplantation
- Summary- About heart transplants- While waiting- Before the procedure- During the procedure- After the procedure- Benefits and risks- About organ donations- Recent advances- The waiting list- Questions for your doctor
Reviewed By: Larry W. Stephenson, M.D., FACC, FCCP, FACS
Test Your Knowledge
-
Heart Failure Quiz
Quizzes A-Z
Summary
A heart transplant is an open-heart surgery in which a severely diseased or damaged heart is replaced with a healthy heart from a recently deceased person. Heart transplantation has made great strides over the years. Today, more than 85 percent of heart recipients will live at least another year and more than 70 percent will live another five years. However, patients continue to face a lengthy waiting list to receive a donor heart. Researchers are working to develop equipment to improve the health and comfort for patients waiting for a donor heart and, ideally, to develop a mechanical heart that could permanently solve the shortage problem.
People who receive a heart transplant can expect to spend 10 days to two weeks in the hospital. The medical team will join them in the fight to keep the new heart free from either infection or rejection by the body. After being discharged from the hospital, patients must continue to take their medications and keep their follow-up appointments. There are many changes that come with having a new heart and depression is not uncommon. The support of family and friends during this difficult time is an important part of recovery.
Tetralogy of Fallot / TOF
Tetralogy of Fallot / TOF is a cardiac anomaly that refers to a combination of four related heart defects that commonly occur together. The four defects include:
Pulmonary stenosis (narrowing of the pulmonary valve and outflow tract or area below the valve, that creates an obstruction (blockage) of blood flow from the right ventricle to the pulmonary artery
Ventricular septal defect / VSD
Overriding aorta (the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle as occurs in normal hearts)
Right ventricular hypertrophy (thickening of the muscular walls of the right ventricle, which occurs because the right ventricle is pumping at high pressure)
A small percentage of children with tetralogy of Fallot may also have additional ventricular septal defects, an atrial septal defect / ASD or abnormalities in the branching pattern of their coronary arteries. Some patients with tetralogy of Fallot have complete obstruction to flow from the right ventricle, or pulmonary atresia. Tetralogy of Fallot may be associated with chromosomal abnormalities, such as 22q11 deletion syndrome.
The pulmonary stenosis and right ventricular outflow tract obstruction seen with tetralogy of Fallot usually limits blood flow to the lungs. When blood flow to the lungs is restricted, the combination of the ventricular septal defect and overriding aorta allows oxygen-poor blood ("blue") returning to the right atrium and right ventricle to be pumped out the aorta to the body.
This "shunting" of oxygen-poor blood from the right ventricle to the body results in a reduction in the arterial oxygen saturation so that babies appear cyanotic, or blue. The cyanosis occurs because oxygen-poor blood is darker and has a blue color, so that the lips and skin appear blue.
The extent of cyanosis is dependent on the amount of narrowing of the pulmonary valve and right ventricular outflow tract. A narrower outflow tract from the right ventricle is more restrictive to blood flow to the lungs, which in turn lowers the arterial oxygen level since more oxygen-poor blood is shunted from the right ventricle to the aorta.
Tetralogy of Fallot is most often diagnosed in the first few weeks of life due to either a loud murmur or cyanosis. Babies with tetralogy of Fallot usually have a patent ductus arteriosus at birth that provides additional blood flow to the lungs, so severe cyanosis is rare early after birth.
As the ductus arteriosus closes, which it typically will in the first days of life, cyanosis can develop or become more severe.
The degree of cyanosis is proportional to lung blood flow and thus depends upon the degree of narrowing of the outflow tract to the pulmonary arteries.
Rapid breathing in response to low oxygen levels and reduced pulmonary blood flow can occur. The heart murmur, which is commonly loud and harsh, is often absent in the first few days of life.
The arterial oxygen saturation of babies with tetralogy of Fallot can suddenly drop markedly. This phenomenon, called a "tetralogy spell," usually results from a sudden increased constriction of the outflow tract to the lungs so that pulmonary blood flow is further restricted. The lips and skin of babies who have a sudden decrease in arterial oxygen level will appear acutely more blue.
Children having a tetralogy spell will initially become extremely irritable in response to the critically low oxygen levels, and they may become sleepy or unresponsive if the severe cyanosis persists. A tetralogy spell can sometimes be treated by comforting the infant and flexing the knees forward and upward. Most often, however, immediate medical attention is necessary.
How is tetralogy of Fallot Diagnosed?
When a newborn baby with significant cyanosis is first seen, they are often placed in supplemental oxygen. The increased oxygen improves the child's oxygen levels in cases of lung disease, but breathing extra oxygen will have little effect on the oxygen levels of a child with tetralogy of Fallot.
Failure to respond to this "hyperoxia test" is often the first clue to suspect a cyanotic cardiac defect. Infants with tetralogy of Fallot can have normal oxygen levels if the pulmonary stenosis is mild (referred to as "pink" tetralogy of Fallot). In these children, the first clue to suggest a cardiac defect is detection of a loud murmur when the infant is examined.
Once congenital heart disease is suspected, echocardiography can rapidly and accurately demonstrate the four related defects characteristic of tetralogy of Fallot.
Cardiac catheterization is occasionally required to evaluate the size and distribution of the pulmonary arteries and to clarify the branching patterns of the coronary arteries. Catheterization can also demonstrate whether patients have pulmonary blood flow supplied by an abnormal blood vessel from the aorta (aortopulmonary collateral).
What are treatment options for tetralogy of Fallot?
Once tetralogy of Fallot is diagnosed, the immediate management focuses on determining whether the child's oxygen levels are in a safe range. If oxygen levels are critically low soon after birth, a prostaglandin infusion is usually initiated to keep the ductus arteriosus open which will provide additional pulmonary blood flow and increase the child's oxygen level. These infants will usually require surgical intervention in the neonatal period. Infants with normal oxygen levels or only mild cyanosis are usually able to go home in the first week of life. Complete repair is usually done electively when the children are about six months of age, as long as the oxygen levels remain adequate. Progressive or sudden decreases in oxygen saturation may prompt earlier corrective repair. Surgical correction of the defect is always necessary. Occasionally, patients will require a surgical palliative procedure prior to the final correction. Corrective repair of tetralogy of Fallot involves closure of the ventricular septal defect with a synthetic Dacron patch so that the blood can flow normally from the left ventricle to the aorta. The narrowing of the pulmonary valve and right ventricular outflow tract is then augmented (enlarged) by a combination of cutting away (resecting) obstructive muscle tissue in the right ventricle and by enlarging the outflow pathway with a patch. In some babies, however, the coronary arteries will branch across the right ventricular outflow tract where the patch would normally be placed. In these babies an incision in this area to place the patch would damage the coronary artery so this cannot safely be done. When this occurs, a hole is made in the front surface of the right ventricle (avoiding the coronary artery) and a conduit (tube) is sewn from the right ventricle to the bifurcation of the pulmonary arteries to provide unobstructed blood flow from the right ventricle to the lungs.
What are the results of treatment for tetralogy of Fallot?
Survival of children with tetralogy of Fallot has improved dramatically over recent decades. In the absence of confounding risk factors, more than 95 percent of infants with tetralogy of Fallot successfully undergo surgery in the first year of life. Surgical repair is more difficult when the pulmonary arteries are critically small or when the lung blood flow is supplied predominantly by aortopulmonary collaterals.Most babies are fairly sick in the first few days after surgery, since the right ventricle is "stiff" from the previous hypertrophy (thickness) and because an incision is made into the muscle of the ventricle, making the muscle temporarily weaker. This right ventricular dysfunction usually improves significantly in the days following surgery. Patients may also have rhythm problems after surgery. An abnormally fast rhythm (called junctional tachycardia) may occur and may require treatment with medication or the use of a temporary pacemaker. This abnormal rhythm is usually temporary and the rhythm generally will return to normal as the right ventricle recovers. Patients are also at risk for slow heart rates after surgery due to heart block. Heart block may be caused by injury to or inflammation of the conduction system in the heart. In many patients, the conduction improves and normal rhythm returns. Rarely, a permanent pacemaker may be necessary. Since a normal circulation is produced by the tetralogy of Fallot repair procedure, long-term cardiac function is usually excellent.However, the repair does usually leave the child with a leaky (insufficient) pulmonary valve. In this situation, after the right ventricle pumps blood out to the pulmonary arteries, some of the blood will flow back into the right ventricle. This creates extra volume in the right ventricle forcing it to work harder and become dilated.In a small percentage of children, this pulmonary insufficiency can lead to diminished function of the right ventricle. Symptoms of fatigue, especially with exercise, may develop. In these cases, replacement of the pulmonary valve is often recommended. Patients who have had repair of tetralogy of Fallot can also redevelop a narrowing at the outflow area or in the branch (left or right) pulmonary arteries, which will cause the right ventricle to pump at abnormally high pressures. If these problems occur, surgical intervention to further widen the outflow tract or pulmonary arteries may be necessary. Narrowing the pulmonary arteries can sometimes be treated without surgery, with balloon dilation of the vessels during cardiac catheterization.
Long-term follow-up with a cardiologist to detect recurrent or new problems as early as possible is essential. Follow-up visits in the cardiology clinic usually consist of a physical examination, periodic echocardiography, and sometimes an exercise stress test or Holter evaluation as a child reaches the teenage and adult years.
Congenital Heart Disease
Congenital Heart Disease (CHD)
What is congenital heart
disease (CHD)?
Congenital heart disease (CHD) is malformation of the heart or the large blood
vessels near the heart. "Congenital" speaks only to time, not to causation. It
means "born with" or "present at birth."
Alternative names for CHD
include: congenital heart defect, congenital heart malformation, congenital
cardiovascular disease, congenital cardiovascular defect, and congenital
cardiovascular malformation.
How
common is congenital heart disease?
Congenital heart disease is the most frequent form of major birth defects in
newborns affecting close to 1% of newborn babies (8 per 1,000). This figure is
an underestimate since it does not include some common problems, namely:
Patent ductus arteriosus in
preterm babies (a temporary condition)Bicuspid (two cusps) aortic
valve (the aortic valve usually has three cusps or flaps)
Mitral valve prolapse (drooping of a heart valve)Peripheral pulmonary sten
When is the diagnosis of
congenital heart disease (CHD) usually made?
Although all types of CHD (by definition) are present at birth and therefore
were present before birth, few cases of CHD come to light until birth or
beyond. The diagnosis of CHD is made by one week of age in 40-50% of cases.
And 50-60% of all cases is diagnosed within the newborn period (the first
month of life after birth). The remaining cases are not diagnosed until
after that time.
Why are most cases of CHD
not a problem before birth?
The circulation of blood in the fetus (the fetal circulation) differs from
that after birth. The fetal circulation derives oxygen and nutrients from
the mother through the placenta. The fetal circulation also has important
communications (shunts) between the upper heart chambers and the great blood
vessels near the heart. Consequently, most types of CHD are well tolerated
during fetal life. Even such a severe form of CHD as left heart hypoplasia
(in which the entire left side of the heart is underdeveloped) is
compensated for by the fetal circulation.
The fetal circulation:
The three major features of the fetal circulation are:
The maternal circulation
through the placenta brings oxygen and nutrients to the fetus and
removes carbon dioxide from the fetal circulation.The foramen ovale is a
hole located in the septum (wall) between the two upper heart chambers
(the right and left atria). The foramen allows blood to shunt from the
right atrium to the left atrium.Another shunt, the ductus
arteriosus, allows deoxygenated blood to flow from the pulmonary artery
into the aorta and through it to the body.
The circulation after
birth: The placenta is removed and the lungs have to take over
oxygenating the blood. Major circulatory changes occur after birth.
These changes include:
The maternal circulation
can no longer bring oxygen and remove carbon dioxide from the baby's
circulationThe foramen ovale closes
(or is restricted) and can no longer act as a shunt between the two
atria (the two upper chambers) of the heartThe ductus arteriosus
closes and no longer provides a communication between the pulmonary
artery and aorta
Once these changes occur, the
fetal circulation is a thing of the past and the full impact of various
congenital heart defects is felt. These defects become evident, cause signs
and symptoms and so may be diagnosed. Further changes occur in the
cardiovascular system during infancy and childhood as, for example, in the
pressure relationships between the right and left ventricles. These changes
serve to bring more cases of CHD to light.
What causes congenital
heart defects?
Congenital heart disease can have diverse causes. The causes include
environmental factors (such as chemicals, drugs or infections), certain
maternal diseases, chromosome abnormalities, genetic diseases, and unknown
(idiopathic) factors.
Environmental factors
sometimes are at fault. For example, if a mother catches German
measles (rubella) during pregnancy, the infection can impair the
development of her unborn baby's heart (and other organs). If the mother
consumes alcohol during pregnancy, the fetus can suffer from
fetal alcohol syndrome (FAS) including CHD.
Exposure to certain
medications during pregnancy can also cause CHD. An example is retinoic acid
(brand name Accutane) which is used for
acne.
Other examples are anticonvulsant drugs, specifically the hydantoins (such
as Dilantin) and valproate.
Certain diseases in the
mother can increase the risk of developing CHD in the fetus. The infants of
women with
diabetes mellitus, especially those women under less than optimal blood
glucose control during pregnancy, are at increased risk for CHD. And
women who have the genetic disease
phenylketonuria (PKU) and do not stay on their special diet during
pregnancy tend also to have babies with CHD (and many other problems as
well).
Chromosome disorders can
cause congenital heart disease. (The chromosomes contain the genetic
material, the DNA, with each person normally having 46 chromosomes, 23
chromosomes from each parent). About 3% of all children with CHD have a
detectable chromosome abnormality.
A common chromosome
abnormality causing CHD is Down's syndrome (trisomy 21, that is, an extra
chromosome # 21. About half of children with
Down syndrome have CHD.
Other autosomal (non-sex)
chromosome abnormalities associated with CHD include trisomy 13 (Patau
syndrome) and trisomy 18 (Edwards syndrome). Although less common than Down
syndrome, these trisomies carry an even higher risk of CHD.
A sex chromosome abnormality
with only one X chromosome (45,X) causes
Turner syndrome and a 40% risk of CHD.
Genetic factors can cause CHD.
About 5% of CHD babies have an identifiable genetic disease. Genetic
diseases associated with an increased risk of CHD include Apert syndrome,
Carpenter syndrome, Conradi syndrome, Crouzon syndrome, cutis laxa, Cornelia
de Lange syndrome, Ellis-van Creveld syndrome, Holt-Oram (cardiac-limb)
syndrome, Kartagener syndrome, Meckel-Gruber syndrome,
Noonan syndrome Pallister-Hall syndrome, Rubinstein-Taybi syndrome,
Scimitar syndrome, Smith-Lemli-Opitz syndrome, thrombocytopenia-absent
radius (TAR) syndrome, Treacher Collins syndrome, and Williams syndrome,
etc. (The point here is not for you to learn all the entities just listed
but to know that there are many genes capable of contributing to CHD).
Idiopathic: in the
majority of children with CHD, the cause of the CHD is totally unknown. It
is idiopathic (cause unknown).A number of syndromes of unknown origin are
associated with CHD including:
Alagille syndrome (arteriohepatic
dysplasia)Asplenia syndrome (no
spleen)CHARGE association
(CHARGE is an acronym for Coloboma, Heart, Atresia choanae, Retardation,
Genital anomalies, and Ear anomalies)CHILD association (CHILD
is an acronym for Congenital Hemidysplasia, Ichthyosiform erythroderma,
and Limb Defects)DiGeorge sequence
FAVS spectrum (FAVS is an
acronym for Facio-Auriculo-Vertebral Spectrum)Mullibrey nanism (Mullibrey
is an acronym for MUscle, Liver, BRain, and EYe)Polysplenia syndrome
(multiple spleens)VATER association (VATER
is an acronym for Venticular septal defect or Vertebral defect, Anal,
TracheoEsophageal, and Renal anomalies)
What Are the Signs of Heart Disease?
You know how important your heart
is, so it's no wonder people worry when they hear someone has heart problems.
Heart disease, also called
cardiovascular (say: kar-dee-oh-vas-kyoo-lur) disease, mainly
affects older people and means that there are problems with the heart and blood
vessels.
You might know someone who has
cardiovascular disease because 61 million Americans have some form of it. This
disease includes a variety of problems, including high blood pressure, high
blood cholesterol, hardening of the arteries, chest pain, heart attacks, and
strokes.
What Is Heart Disease?
The
heart is the
center of the cardiovascular system. Through the body's blood vessels, the heart
pumps blood to all of the body's cells. The blood carries oxygen, which the
cells need. Cardiovascular disease is a group of problems that occur when the
heart and blood vessels aren't working the way they should.
Here are some of the problems
that go along with cardiovascular disease:
Arteriosclerosis
(say: ar-teer-ee-oh-skluh-row-sus). Also called hardening of
the arteries, arteriosclerosis means the arteries become thickened and are no
longer as flexible.Atherosclerosis
(say: ah-thuh-row-skluh-row-sus). People with atherosclerosis
have a buildup of cholesterol and fat that makes their arteries narrower so
less blood can flow through. Those deposits are called plaque.Angina (say:
an-jy-nuh). People with angina feel a pain in the chest that
means the heart isn't getting enough blood.Heart attack.
This is when a blood clot or other blockage cuts blood flow to a part of the
heart.Stroke. when
part of the brain doesn't get enough blood due to a clot or a burst blood
vessel.
How Do You Get Heart Disease?
Heart disease is not contagious —
you can't catch it like you can the flu or a cold. Instead, there are certain
things that increase a person's chances of getting cardiovascular disease.
Doctors call these things risk factors.
Some of these risk factors a
person can't do anything about, like being older and having other people in the
family who have had the same problems. But people do have control over some risk
factors — smoking, having high blood pressure, being overweight, and not
exercising can increase the risk of getting cardiovascular disease.
What Are the Signs of Heart
Disease?
Many people do not realize they
have cardiovascular disease until they have chest pain, a heart attack, or
stroke. These kinds of problems often need immediate attention and the person
may need to go to the emergency department of a hospital.
If it's not an emergency and a
doctor suspects the person could have cardiovascular disease, the doctor can do
some tests to find out more about how the heart and blood vessels are working.
These tests include:
Electrocardiogram
(say: eh-lek-tro-kar-dee-uh-gram). This test records the
heart's electrical activity. A doctor puts the patient on a monitor and
watches the machine to see the heart beat and determine if it's normal.Echocardiogram
(say: eh-ko-kar-dee-uh-gram). This test uses sound waves to
diagnose heart problems. These waves are bounced off the parts of the heart,
creating a picture of the heart that is displayed on a monitor.Stress test.
For this test, the person exercises while the doctor checks the
electrocardiogram machine to see how the heart muscle reacts.Catheterization
(say: kah-thuh-tuh-ruh-zay-shun). This test uses a long, thin
tube that is inserted into the patient's body to inject a special dye. It can
locate narrowed areas in arteries due to plaque buildup and find other
problems.Carotid (say:
kuh-rah-tid) artery scan. This test uses sound waves to check
for blockages in the carotid artery, a large blood vessel in the neck that
supplies blood to the brain.
If the doctor finds that a
patient has cardiovascular disease, he or she will talk with the patient about
how stopping smoking, losing weight, eating a healthy diet, and getting exercise
can help. The person also may need to take medicine, have surgery, or both.
There are different surgeries for
the heart and blood vessels. These include:
Angioplasty
(say: an-jee-uh-plas-tee). This opens a blocked vessel by
using a balloon-like device at an artery's narrowest point. The doctor may
also insert a stent, which is a tiny, stainless steel tube that props the
vessel open and makes sure it stays clear.Atherectomy
(say: ah-thuh-rek-tuh-mee). This involves cutting the plaque
out of an artery, so blood can flow freely.Bypass surgery.
This involves taking part of an artery or vein from another part of the body
(like the arm or leg) and using it to channel blood around a blocked area in
an artery.Pacemakers. A
pacemaker is a small electronic device that's put inside the body to regulate
the heartbeat.Valve replacement.
If a heart valve is damaged or isn't working, a surgeon can replace it.Carotid endarterectomy
(say: en-dar-tuh-rek-tuh-me). During this procedure, a
surgeon removes plaque deposits from the carotid artery to prevent a stroke.
If someone you know is getting
one of these operations, you might feel worried. The good news is that these
surgeries can help prevent heart attacks, strokes, and other problems. The
amount of time the person will need to spend in the hospital will vary,
depending on the operation and the person's health. The person may be tired and
worn out after the surgery, but you can help by making a "Get Well" card and
paying a visit.
Can Kids Get Heart Disease?
Kids usually don't have any
symptoms of heart and blood vessel problems. But by starting heart-healthy
habits right now, kids can reduce the chance they will ever need to worry about
cardiovascular disease.
So what should you do? Don't
smoke, for one. And be sure to eat healthy, exercise, and maintain a healthy
weight. Your heart and blood vessels will thank you later!
