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
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.

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”

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.

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/

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.

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.

Strong Evidence
"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.

Excretory System: Poison Protection

If you knew there was poison hidden in your house, you would surely do everything possible to find and remove that poison. If you didn't, you and your family would slowly die. How would you find it? How would you remove it? You would probably figure out a system of searching and removing. That would be an excretory system. Your body does the same thing every day.
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.