Wednesday, April 16, 2008

HELP! I Can't COPE

Cardiovascular disease remains the leading cause of death and disability in the United States. When a person is diagnosed with heart disease, its effect can be devastating to the individual and the family. If the cardiac event is severe (real or perceived), there is little social support in the home, or this is a first time cardiac event, the individual may find themselves unable to deal with their present circumstances. If this inability to cope goes on without help of support, it can lead to a vicious cycle of emotional turmoil and feelings of helplessness, which are not conducive to the healing process.
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.
Adjusting to a new way of life, saying good bye to the “old” lifestyle can be a difficult transition for many… to help yourself… turn to family, friends, physician for the support you need so you can say to this new lifestyle… “I CAN Cope”

Thursday, April 10, 2008

Coronary Heart Disease (CHD)

CHD is the most common type of heart disease. CHD occurs when the coronary arteries, that supply blood to the heart muscle, become hardened and narrowed due to the plaque buildup. The plaque buildup and the narrowing and hardening of the arteries is called atherosclerosis. Plaques are a mixture of fatty substances including cholesterol and other lipids. Blood flow and oxygen supply to the heart can be reduced or even fully blocked with a growing plaque. Plaques may also rupture and cause blood clots that block arteries.

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

American Heart Association
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

Surgery on the great vessels was followed by the development of closed heart surgery, where a small incision is made (the chest cavity is not opened) and the surgeon blindly worked on the beating heart. It left a great deal to be desired, but had much to offer for great risk. Palliation of severe mitral valve stenosis, which was common in the past due to rheumatic fever, could be accomplished by poking a finger into the (mitral) valve through an incision in the left atrium. If a finger didn't do, a knife was passed through the incision to cut out tissue. Following successful treatment of mitral stenosis, a special cutter for aortic valve stenosis was developed, that maneuvered through an incision in the left atrium, accomplished much the same thing as the surgeon's finger in a stenosed mitral valve.