Aneurysm

Aneurysm is the swelling in the walls of blood vessels especially arteries. The swelling and widening of blood vessels causes them to weaken over time and they can rupture. The most commonly observed causes of aneurysm are congenital defects, uncontrolled high blood pressure and atherosclerosis (growing of fatty deposits in arteries). Aneurysm is usually classified by shape, size and location of the bulge. It is most common in arteries at the base of the brain referred as brain or cerebral aneurysm, and in aortic arteries known as abdominal aortic aneurysm. Although aneurysm can occur at any age it is most commonly observed in adults than children. Women are also found slightly more susceptible than men in this regard.

Aortic Aneurysm:

Aorta is the main artery that supplies blood from heart to the rest of the body. Aneurysm can develop anywhere in the aorta but they are most commonly found in aorta with in the abdominal region below the kidneys. The majority of aneurysms which actually start in the abdominal path of aorta eventually extend up to iliac arteries. It may occur in the chest near the heart as well (thoracic aortic aneurysm). The aortic aneurysm usually does not show any symptoms. Mild to moderate symptoms of aneurysm can sometimes be seen though. Pain in the effected area is a common symptom. One of the main causes of aortic aneurysm is smoking. The smokers over 60 years of age seem to have atherosclerosis. It has to be stopped immediately as it increases the risk of aneurysm's widening.

Treatment:

To treat the aortic aneurysm a procedure known as stenting is performed. After locating the position of the bulge, an X-ray guided polyester tube (stent-graft) is passed through a small cut in upper thigh leading to aorta. Now the blood instead of flowing through the damaged artery flow through the stent-graft and eliminates the chance of rupture.

Brain Aneurysm:

Brain Aneurysm usually originates from the base of the brain where the larger arteries combine. This area is known as circle of willis. The causes of brain aneurysm are generally genetic disorders which includes connective tissue disorders, polycystic kidney disease or some circulatory disorder. Patient having brain aneurysm may be found having the symptoms such as excruciating headache, problem with vision, thinking and decrease in concentration level, difficulty in speech and perception, pain in neck or eye and extreme tiredness.

Treatment:

Surgical clipping and coil embolization are methods usually applied for the treatment of brain aneurysm. Patient has to go through some test to get the right diagnosis after which the doctor will determine the method of treatment that is best suited to repair the blood vessel.

Enlarged Heart in Children

By Batul Nafisa Baxamusa

Enlarged heart in children is not a disease in itself, but a very rare symptom of other underlying medical conditions. This article will cover all the information you need to know more on its causes.

Cardiomegaly is the medical term for enlarged heart in children. It refers to the enlarged heart size seen on an X-ray, a sign that shows the heart is an overworked organ. It is usually a symptom of some underlying disease or something that alters the functioning of the heart. Adults can develop cardiomegaly due to stress on the working of the body, pregnancy or a heart disease like weakening of the muscles of the heart, coronary artery disease, heart valve problems or abnormal heart rhythms.

What is an Enlarged Heart?

Enlarged heart or cardiomegaly as mentioned is not a disease in itself. It is a condition where one observes enlargement of the heart on a chest X-ray. It is related to the disease of the heart muscles, that is, myocardium. There are different types of cardiomyopathies. These include primary that involves ailments of the heart. Secondary that involves some other disease or toxins that affect other organs as well as heart. Let us see what causes cardiomegaly in children.

Causes of Enlarged Heart in Children

High stress levels on the heart causes it to enlarge as the chambers grow and allow more blood to be processed. Thus, depending on the nature of enlargement, the heart is stretched more than its limit. A swelling in the heart in children may also lead to death. Cardiomegaly is also called hypertrophic heart. When the left ventricle of the heart gets enlarged, it is called left ventricular hypertrophy. The causes of an enlarged heart like ventricular hypertrophy is due to some disease or condition that causes extra stress on the left ventricle. The left ventricle is the main chamber for pumping in the heart.

One of the causes can also be due to cardiomyopathy. In cardiomyopathy, the heart is prevented from pumping enough blood. This causes deficiency of blood requirement within the body, leading to a condition called congestive heart failure. There can be an increase in blood pressure in the lungs and it can lead to a condition called pulmonary hypertension.

At times pericarditis can also lead to this condition. The sac surrounding the heart, that is, pericardium gets irritated and starts swelling. The child will complain of a sharp pain in the left side or the center of the chest. Fever, dry cough, shortness of breath and fatigue are common signs. Pericarditis may last for a few weeks or may become a chronic condition that lasts as long as 6 months or beyond. Other than that, myocarditis, that is inflammation of the heart wall can also lead to cardiomegaly. It is generally due to a reaction to certain chemicals, infection, medications as well as radiation.

The main causes due to cardiomyopathy is viral infection. It is generally an overreaction of the immune system to a viral infection. This virus is commonly found to be the Coxsackievirus B (CVB). Bacterial infection, like endocarditis can also lead to enlargement of the heart in children. This condition is generally treated with the help of aggressive antibiotic medications.

Many times, it may be due to congenital heart diseases, nutritional deficiency, fast heart rhythms or even due to chemotherapy for treating cancers in children. Cardiomyopathy can also be due to genetic disease or have no known cause.

Types of Cardiomyopathy Causing Enlarged Heart

There are a few types of cardiomyopathy that causes dilation of the heart. The following are some of the causes:

Dilated or Congestive Cardiomyopathy

The most common type of cardiomyopathy that causes the heart to enlarge and stretch that makes it weak and pump blood inefficiently. This disease may also cause other conditions like irregular heart rhythms leading to arrhythmia or dysrhythmia, increased chances of developing blood clots and congestive heart failure. Many infections, especially viral infections may also cause an inflammation of the heart muscles or myocarditis that causes cardiomyopathy. Chemotherapy that is given for treating cancers also leads to dilated cardiomyopathy. Many times, 20% of the children suffering from this condition have someone in the family with cardiomyopathy, making it a type of hereditary disease.

As explained earlier, the blood flow to the various parts of the body is decreased in cardiomyopathy. Thus, the body begins to conserve nutrients in the essential organs like brain, kidneys, etc. by lowering the supply of these essentials nutrients to skin and muscles. There are many symptoms of dilated cardiomyopathy that are commonly seen in children. However, not all children exhibit these symptoms. The symptoms due to dilated cardiomyopathy include:

Ashen skin color or pale color

Sweaty skin

Rapid heart rate

Increased rate of breathing

Shortness of breath

Fatigue

Irritability

Chest pain

Slow growth

Vomiting

Abdominal pain

The treatment of dilated cardiomyopathy is based on the child's age and overall health of the child. The progress of the disease and the tolerance to specific therapies, medications and procedures by the child also plays an important role. The doctor may try to help the heartbeat more effectively and decrease the stress on the heart with the help of certain medications. He may also prescribe drugs that prevent clots, inflammation and irregular heartbeats. The enlarged heart in children due to dilated cardiomyopathy may improve with improvement in the viral infection. However, it may also worsen and transplantation of the heart may be considered.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy; also known by other medical terms like hypertrophic obstructive cardiomyopathy (HOCM), asymmetric septal hypertrophy (ASH), or idiopathic hypertrophic subaortic stenosis (IHSS), is a rare disease. In this condition, the muscular mass of left ventricles become larger than normal or the septum between the two ventricles is enlarged. This causes obstruction in the flow of blood from the left ventricle, leading to abnormalities.

One of the mitral valve separating the left atrium and left ventricle may get affected by the thickened septal wall. This leads to a leaking mitral valve. Thus, the blood moves backward from the left ventricle into the left atrium instead of flowing in the forward direction into the body. The causes of enlarged heart due to hypertrophic cardiomyopathy is mostly due to hereditary conditions. The symptoms due to hypertrophic cardiomyopathy are:

Dizziness

Pain in chest

Abnormal heart rhythms

Fainting spells

The course of treatment and medications given to treat this condition due to hypertrophic cardiomyopathy are similar to dilated cardiomyopathy. The treatment of hypertrophic cardiomyopathy may also include surgery. The surgical procedures may involve placing an artificial pace maker, removal of a part of the enlarged muscle or heart transplantation.

If you observe anything out of the unusual with your child's health, consult a doctor immediately. It is very important to trust your parental instincts and take immediate action to ease it. Your child's doctor knows what's best for your child. Follow medical advice and take some utmost care of your child and his/her heart health.

Congestive Heart Failure

By Rita Putatunda

Congestive heart failure is a condition, wherein, the heart loses its capacity to pump enough blood, which leads to retention of fluid in the body.

Congestive heart failure (CHF), which is also referred to as congestive cardiac failure (CCF) or simply heart failure, is a medical problem, wherein, the heart loses its ability to fill with or pump adequate amount of blood to the various parts of the body as well as the organs, which causes fluid retention in the body. This condition occurs due to various factors, such as:

The narrowing of the arteries supplying the heart muscle with blood, known as coronary artery disease Myocardial infarction, in which, there is a scar tissue that hinders the normal working of the heart Impairment of the heart valve because of rheumatic fever in the past, or other reasons

Congenital defects of the heart

High blood pressure

Cardiomyopathy, which is a disorder of the heart muscle or myocardium, generally of unknown causes Endocarditis, which is an inflammation of the heart valves and the endocardium Myocarditis, which is the inflammation of the muscular tissue of the heart, or myocardium

The impaired heart continues to work, but not as efficiently as it does normally. Those who are affected with this condition, lose their ability to exert themselves as they tire faster and experience shortness of breath.

Effects

As there is a slow down in the blood flow from the heart, the blood that returns to the heart via the veins, begins backing up, resulting in the tissues becoming congested. Often, this results in edema, or swelling, usually in the ankles and legs, although it can also affect other areas of the body as well as organs. For instance, the impaired heart muscles may be incapable of supplying the kidneys with enough blood, causing them to lose the ability to excrete water and sodium, which in turn, causes increased fluid retention in the body. There is also a buildup of fluid in the lungs, known as pulmonary edema, which results in shortness of breath, hence, diminishing the individual's exercise capacity. Likewise, fluids may get accumulated in the liver, because of which, it loses its ability to get rid of toxins from the body as well as make essential proteins. Fluid retention also affects the intestines, which makes them lose their ability to absorb nutrients as well as medications efficiently. If left untreated, eventually, congestive heart failure can affect almost every organ in the body.

As a matter of fact, it is one of the leading causes of people above the age of 65 getting hospitalized. There is a 10 percent mortality rate annually, even with the best of treatment methods. In addition, the condition often goes undiagnosed because of difficulties in the diagnosis, especially at its initial stages or when it occurs in its mild form.

Signs and Symptoms

One of the earliest indications is fatigue, accompanied by the affected person's diminished capacity to exercise. In fact, most people don't even realize this reduction, with them usually compensating subconsciously by reducing their activities in order to adapt to this limitation. 

Sometimes, the affected person may wake up at night gasping for breath. Some even have to sleep sitting in an upright position. The excessive fluid in the body also results in an increase in urination, especially at night. When the fluids accumulate in the intestines and liver, it may result in a decrease in the appetite, pain in the abdomen, and nausea.

Treatment Options

The treatment usually includes, adequate rest, a balanced diet, modification in daily activities, and drugs like, angiotensin-converting enzyme, or ACE inhibitors, beta blockers, vasodilators, digitalis, and diuretics.

Vasodilators and ACE inhibitors help to expand the blood vessels as well as decrease the resistance of the blood flow in them. This enables the easier flow of blood, easing the working of the heart, thus making it more efficient. Digitalis is a powerful heart stimulant. Beta blockers improve the pumping of the left ventricle. And, diuretics help in eliminating the excess fluid and salt from the body.

Sometimes, when a specific cause is identified, treating that or correcting it can alleviate this disorder. For instance, sometimes treating high blood pressure can ease CHF, or if an abnormal heart valve is found to be the cause, surgically replacing it can ease the condition.

A more drastic step, like a heart transplant, has to be taken in case of the heart becoming so damaged that repairing it becomes impossible.

What Is an ECG / EKG?

by Michael A. Morales

An electrocardiogram (ECG or EKG) is a painless, noninvasive measurement of the heart's electrical activity, and it is a diagnostic tool that is used to determine the condition of the heart (i.e., whether the heart is damaged or poorly functioning). This is helpful either when trying to diagnose an existing complaint or when proactively looking for warning signs. With several electrodes hooked up to standard locations on a patient's body, the electrocardiogram's results are examined for patterns that may be indicators of possible problems.

The heart uses an electrical pulse to initiate and regulate the flow of blood through the heart, and a heartbeat is one full cycle in the process of relaxing and contracting the heart chambers so that blood can enter and then be forced out to the rest of the body. The pulse begins in the right atrium, which contracts and forces blood to the ventricles. The pulse then moves to the ventricle walls, forcing the ventricles to contract, thus pushing the blood out of the heart and to the rest of the body. The pulses also control the direction of the blood flow through a series of valves. The ECG / EKG measures the strength of the pulses in the chambers of the heart, along with the rate at which the pulses are occurring.

When the heart is functioning correctly, oxygenated blood and nutrients are pumped from the heart to the other organs of the body. The blood carries waste (such as carbon dioxide) from the organs to the lungs, where the waste is emitted. If the heart is failing or is injured, the oxygen may not make it to all the organs and the waste may not make it completely out of the body. Those organs and their associated bodily functions are then at risk of failing.

The ECG / EKG can uncover heart attacks; arrhythmia (irregular rhythm of the heart); heart valve problems, congenital heart defects (problem with the heart from birth); heart failure (i.e., the heart is incapable of pumping hard enough to get blood to some organs); and pericarditis, inflammation of the sac surrounding the heart.

Electrocardiograms are performed by nurses, doctors, and lab technicians, but typically the results are examined by doctors and cardiologists. If a general physician identifies abnormalities in the ECG / EKG results, he most likely will contact a cardiologist to seek his expertise.

Antidepressants May Lead to Ventricular Septal Defects

by Josephine Osborn

The US Food and Drug Administration (FDA) has warned both health care service providers and their patients about the side effects of paroxetine antidepressant Paxil. Studies suggested that Paxil increases the risk of birth defects on infants of mothers who used it during the first three months of gestation. These birth defects may come in the form of physical deformities such as irregular head sizes, cardiovascular complications or mental disorders such as autism.

The FDA likewise issued a "black box" warning for contraindications of Paxil which included suicidal behavior among adolescent users and cardiovascular complications. Birth defects, however, are the most complained about side effect of Paxil intake which has been the subject of various lawsuits against is manufacturer GlaxoSmithKline. Most of the heart defects reported among infants in these studies were atrial and ventricular septal defects, which prompted the FDA to change Paxil's pregnancy warning category from C to D.

According to the University of Maryland Medical Center (UMMC), ventricular septal defect describes one or more holes in the wall that separates the right and left ventricles of the heart. Ventricular septal defect is one of the most common congenital heart defects, which is often present upon birth. The infant may show no symptoms, and the hole may eventually close as the wall continues to grow after birth. However, if the hole is large, too much blood will be pumped to the lungs, leading to heart failure, says the UMMC.

The American Heart Association also says that if the opening is large, the child may breathe faster and harder than normal. Infants may have trouble feeding and growing at a normal rate. Over time, this may cause permanent damage to the lung blood vessels of the infant because more blood than normal is being pumped there. According to the Cedars-Sinai Heart Institute, heart failure may be regulated through heart stimulating drugs which will eventually help the child grow naturally. However, Cedars-Sinai adds that if the baby does not respond to treatment, surgery may be necessary to repair the defect.

The FDA has already verified some complaints that associated Paxil to ventricular septal defect. Other cardiovascular complications that constitute Paxil birth defects are persistent pulmonary hypertension on newborns, congenital central hypoventilation syndrome and hypoplasia. Although, more studies are required to substantiate these claims, the link between Paxil and the aforementioned birth defects are increasingly becoming clear, warranting more interest and concern.

Heart Rhythm is Slowing Down?

 by Bruce S Parsons

Feeling fatigued? Dizzy sometimes for no apparent reason? Finding it difficult to stay awake or focus without getting lightheaded?

Check your pulse! If it is less than sixty beats per minute, you may be suffering from a slow heart rate, or bradycardia. This can be due to many different factors, some related to heart function, others due to dietary or lifestyle habits. It is important, however, that if you feel faint, or are experiencing lasting chest pains or difficulty in drawing breathe, that you get emergency care at the earliest opportunity.

For some people, a resting heart rate less than sixty beats per minute can be considered normal. Trained athletes and others in peak physical condition frequently have slower resting heart rates than average individuals. It is important to note, though, that they do not exhibit any of the negative side effects normally associated with bradycardia, as their bodies are functioning properly, and sufficient oxygen-rich blood is flowing to necessary organs. Through extensive training, they have shaped their bodies to be stronger, and function properly when resting, even though clinically speaking they have bradycardia.

A heart rate of less than one hundred beats per minute is considered bradycardia in infants. Normally, infants should have a heart rate of between 120 to 160 beats per minute. Researchers are still working to determine the causes; though it is theorized that bradycardia in infants could potentially be caused by yet-underdeveloped centers in the brain that regulate breathing. Also, premature babies are more likely to exhibit bradycardia than those born full-term. In minor cases, rocking the incubator or touching the child lightly is known to remedy the matter. In severe or potentially life-threatening cases, medications containing caffeine or theophylline are used. Premature babies are monitored extensively, and their hearts are no exception.

As we all know, the heart is regulated by electrical impulses. Many factors can modify this, the most common being aging. High blood pressure can also be a reason, or an underactive thyroid gland. Certain congenital defects could be the reason, or an infection of the heart tissue later in life. People who have heart disease or suffered a heart attack could later exhibit bradycardia also. Certain drugs can influence heart rate to a great degree, and if they are abused, severe bradycardia can manifest, resulting in hospitalization in fortunate cases, or death if left untreated.

Summarily, if you have a pain in your chest lasting over a minute, or if you faint or can't seem to catch your breath, call an ambulance immediately. Exercise regularly, eat well, and live life to its fullest!

Ventricular Fibrillation (VF)

by jeanne abayie

Ventricular fibrillation is called V-fib for short. This life threatening condition is the most serious cardiac rhythm disturbance. It is a severe form of arrhythmia. The lower chambers of the heart ( ventricles ) quiver with no useful contractions. Therefore the heart can't pump any blood and this causes cardiac arrest. Ventricular fibrillation needs immediate medical attention.

CAUSES

The heart pumps blood to the lungs, brain and other parts of the body. Interruption of heart beat for a few seconds can lead to fainting or cardiac arrest. Fibrillation is uncontrolled quivering of the heart muscles ( fibrils). When this occurs in the lower chamber of the heart, it is called ventricular fibrillation.

During ventricular fibrillation, the heart's lower chambers contract in a rapid, unsynchronized way. The ventricles flatter and the heart pumps little to no blood. Sudden cardiac death follows.

The cause of this condition is not always known. However the most common cause is a heart attack. VF may occur when the heart muscles don't get enough oxygen. Other conditions that can lead to VF include the following:

• heart injury
• congenital heart defect
• heart surgery
• narrowed coronary arteries
• heart muscle disease
• electrocution accidents

Most people who get ventricular fibrillation have no heart disease history but often have risk factors such as high blood pressure, smoking and diabetes. If you've had VF before, you are more likely to get it again.

SYMPTOMS

Lost of consciousness or collapse are usually the most common signs of ventricular fibrillation. Other symptoms that may be experienced earlier include

• chest pain
• rapid heart beat
• nausea
• shortness of breath
• dizziness

TEST AND DIAGNOSIS

Ventricular fibrillation is usually diagnosed after it happens. It is not likely to be diagnosed during a routine medical exam.

The doctor will monitor your heart beat and check your pulse. The doctor will do additional tests to find out the cause of your V - fib. These include

• Blood test
• Electrocardiogram
• Imaging tests such as chest x-ray, cardiac MRI, CT scan and echocardiogram
• Coronary catheterization (angiogram)
• TREATMENT

Ventricular fibrillation is a medical emergency and immediate treatment is needed to save the person's life. If a person has v fib episode at home, call an emergency number such as 911. While waiting for help, you needs to do cardiopulmonary resuscitation (CPR) to help restore blood flow to the rest of the body. Continue to do CPR until help arrives or person becomes alert.

Defibrillation may also be done to restore the heartbeat to a normal rhythm. This should be done immediately. It delivers quick electric shock to the chest using a defibrillator. This can be done by an emergency personnel or by stander using a public defibrillator. Most public places now have this machine.

Treatment may also be given to prevent future episodes. These include

• medications to control heart beat and function
• Implantable cardioverter-defibrillator (ICD) may be implanted in the chest for people at risk for VF. It quickly sends an electrical shock when ventricular fibrillation occurs and prevents sudden cardiac death
• coronary angioplasty and stent placement to open blocked coronary arteries and improve blood flow
• ventricular tachycardia ablation to destroy tissue that blocks the electrical signal that travels through your heart to make it beat
• coronary bypass surgery to improve blood supply to the heart

PREVENTION

Adapting healthy lifestyle change can reduce your risk for v fib.

Quit smoking

Stay active

Eat heart healthy diet

Control high blood pressure

Maintain a healthy weight

Manage cholesterol

What You Should Know About The Symptoms of Heart Problems

by Larry Johnson

The symptoms of heart diseases can be very varied. However, it is important to be aware of what those symptoms are so that you can get medical help right away. Heart problems, when left untreated, can lead to death. In fact, cardiovascular diseases are some of the leading killers in the world today.

Symptoms of Cardiovascular Diseases

Cardiovascular diseases are very common today. These start out not as problems in the heart itself but on the blood vessels. When some materials block the blood vessels and makes it hard for the blood to pass through then that can cause the more serious problems. The most usual symptoms of these are chest pain, shortness of breath and numbness of weakness in the parts of the body where the affected blood vessels are located. If you feel any of these symptoms then you should seek medical attention right away. People might not get diagnosed that they have cardiovascular problems until it is too late.

Symptoms of Abnormal Heartbeats

Another common heart ailment is having an abnormal heartbeat. This can be signify a congenital disease, which means that a person has had it since birth. Sometimes this kind of condition is not detected right away and a person can reach adulthood without knowing that he has this kind of disease. Symptoms of this condition would include a fluttering feeling in the chest, very fast heartbeat, pain in the chest, shortness of breath, dizziness and fainting spells. A person who feels these symptoms should see a doctor right away because this condition can be very serious.

Heart Defects

Another type of condition that a person can be born with is having a defective heart. Normally, this condition becomes evident right after the birth of a child because of its physical symptoms. Symptoms include a grayish or bluish color of the skin, swelling on some parts of the body, shortness of breath especially during feeding time. Sometimes, if the heart defect is not too serious, it might not get diagnosed right away until later in life.

Cardiomyopathy

This is the condition where the muscle tissues of the heart thicken. Initially this condition would have no serious symptoms, but as the condition progresses, the person will start to feel the signs. Symptoms would include getting tired easily, shortness of breath, bloating of the abdomen because of fluid, irregular breathing and dizziness.

Heart Infections

Like other parts of the body, the heart is also prone to infections. When it becomes infected, the person will start to feel a whole range of symptoms. Those symptoms could include, fever, shortness of breath, getting tired easily and dry cough that is very persistent.

Like most other diseases, heart problems are a lot easier to treat during the early stages. This is the reason why early detection is very important. The moment you start feeling any of the symptoms, seek medical help right away.

The Basic Facts About Heart Disease - What Is It and What are the Risk Factors?

by Dee Braun

Heart diseases are also called cardiac diseases. Individuals of all ages can develop heart diseases. The most common form of heart disease in adults is coronary artery disease, which is the major cause of heart attacks and the most common form of heart disease in children, is congenital heart disease.
Heart disease can affect the heart muscle, the heart vessels, heart tissue or the heart valves. Heart disease can be caused by smoking, high blood pressure, high cholesterol, infection, and toxins or from a birth defect. Some people are born with heart disease and most develop heart disease over time.
There are certain factors that put certain people at risk for heart disease such as individuals who have a family history of heart disease, those who smoke, and those who have high blood pressure or high blood cholesterol. Individual who are obese or lead inactive lives are also at an increased risk for heart disease. Age increases your risk for heart disease. Some of the risk factors such as family history and age cannot be controlled.
Heart disease present at birth can usually not be controlled if it is heredity in nature. Factors such as smoking, blood pressure and blood cholesterol and controlling diseases such as diabetes that when uncontrolled can lead to heart disease. You can reduce your risk for heart disease by controlling your blood pressure and blood cholesterol, by not smoking, and by getting enough exercise and eating healthy foods.
If an individual suspects heart disease due to having symptoms such as chest pain or discomfort, nausea, vomiting, shortness of breath, dizziness or a feeling that something bad is going to happen they should contact their doctor for an exam and diagnosis. Doctors are trained and have the skills to make the diagnosis of heart disease. You will first be asked to fill out a medical history form that will list your general health, and your symptoms as well as any family history. During the examination your vital signs will be taken including your blood pressure, weight, height, pulse, respiratory rate and temperature.
The doctor will give you a complete examination to rule out any other diseases. You may be sent to a laboratory for blood tests and to the x-ray department for a chest x-ray. Your doctor will be evaluating your risk for heart disease and any sign of present heart disease. You may also be sent for an electrocardiogram (ECG or EKG), which will reveal any arrhythmias or irregular heart rhythms.
You may then be sent for special tests such as an exercise electrocardiogram, a fluoroscopy, phonocardiography, echocardiography, or an angiocardiography (cardiac catheterization). Your doctor will then put all the test results together and determine if you have heart disease or are at risk for heart disease.
Risk factors for heart disease are high blood pressure, high blood cholesterol, the presence of diabetes, and smoking. These are the highest risk factors. Other factors are age, family history, and being obese and having an inactive lifestyle as well as stress. These last factors are considered minor risk factors.
After your doctor review your test results and determines your heart health and your risk factors for heart disease the doctor will give you a diagnosis or tell you what you can do to decrease your risk for heart disease.

Natural Home Remedies for Heart Diseases

by Dr John Anne

The heart is one of the five major organs of the body, the other being the brain, the liver, the lungs and the digestive system-any defect in or malfunctioning of which leads to serious complications. The major function of the heart is to pump the blood into the arteries and send the blood returning from the various organs with carbon dioxide to the lungs for purification.

Considering the amount of work that the heart does-it never stops till death-it is subject to few disorders. The main causes of heart disease are the diseases of the coronary arteries (which nourish the heart muscle), high blood pressure and syphilis. Acute rheumatism-a predominantly infantile disorder-is responsible for most cases of heart disease occurring between the ages of 5 to 45 years. Other causes of heart diseases are disorders like diphtheria, diseases of the thyroid gland and certain forms of chronic lung ailments. A small, but important group of heart diseases is due to the congenital abnormalities of the heart. In those disorders for example, the malformation of the valves or cavities in the valve developed in the mother's womb, the only recourse is to heart surgery. Certain deficiency diseases like gross lack of vitamin B cause the condition known as beri-beri.

The tendency of the heart to adjust to changes in the mode of living of its owner, known as compensation, is one of the vital factors, which prolong life in spite of maladies to which this king of organs is susceptible. This adjustment sometimes enables a person to go through life without suspecting the disease, which invade the heart. It is a common fallacy to suppose that heart disease ends in sudden death. A man with a defective heat may live long, if he is careful. It is only when the heart muscle has become weakened due to some other illness, for example, diabetes, that the end may come suddenly. Another cause of sudden death by heart failure can be ascribed to the formation of a clot in the blood (thrombosis). Hardening of the arteries may lead to failure of the heart, but in most cases that is a gradual development.

Chief Ailments

The broad categories of heart ailments are:

(i) Those caused by inflammation of the muscle, the outer covering or the inner covering of the heart;

(ii) Hardening of the arteries and formation of a clot which may result in sudden interruption of the functioning of the heart;

(iii) Weakening of the muscle or degeneration of the organ because of advancing years;

(iv) Involvement of the heart as a corollary to rheumatism or syphilis; and

(v) Functional disorders like techycardia, bradicardia or hypertension and arrhythmia (lack of rhythm in the heart beat) and angina pectoris (pain in the chest, behind the sternum) and a sense of impending death.

As stated earlier, naturopathy is the only recourse in case of all bodily ailments. Heart diseases can be cured safely and in a better manner under this system of medicine. The only exception, it may be stated here, is congenital defects of the heart for which surgical interference is necessary after the "compensation" fails to relieve the condition.

Here we give the treatment that is to be under taken in angina pectoris. The same course of treatment would help other heart ailments too regardless of the technical name given by the doctors.

Angina pectoris is characterized by a sharp pain in the chest (behind the sternum), which leaves the victim breathless. There is a sense of impending doom. It is generally caused by the constriction of the main artery that leads into the heart, because of its hardening or deposition of fat in the insides. The pain radiates to the back, the shoulders and the arms, particularly the left arm. The attack may come on after a hearty meal, a sudden over exertion or intense grief or excitement.

Lest the reader confuse a gastric pain with angina, let us make it clear that the true pain of angina has a tendency to spread to the shoulders and the arms. There is a constriction in the chest and profuse sweating. True angina must be differentiated from false or pseudo-angina which is of a nervous origin.

Drugs taken to relieve angina only help to make the condition more chronic. Patients taking recourse to traditional methods of treatment would be seen carrying tablets of nitro-glycerine to relieve the pain. The drug may be taken in an emergency but the correct treatment for angina begins when it is aimed at building the general health level of the patient.

When an attack is on, the best thing is to apply hot towels over the heart region. That will relieve the constriction around the chest by dilating (through heat) the clogged artery, which finds it difficult to pass the required amount of blood through it to the heart.

Treatment

The best way to deal with heart disease is to start a cleansing diet because the cleaner the blood, the less will be chance of any toxicity building up around the region of the heart. The patient should subsist on a diet of fruit and fresh vegetables. His breakfast should consist of two oranges, an apple and grapes. For lunch he should take salad of lettuce, grated carrots and best root together with some boiled vegetables and bread made out of whole meal flour. Fats, particularly saturated ones like ghee, should be banned and only a pat of butter -preferably fresh and not the tinned variety--should be taken.

Salt should be avoided totally or taken in small quantities if the patient prefers a non-vegetarian diet they should eat steamed fish or boiled white meat. Fatty portions of meat, particularly pork, should be avoided. He should never overload his stomach because distention of the organ by flatulence or overloading may depress the diaphragm and the pain of angina may start.

Sufferers from heart disease should fast for a short period according to their bodily strength so that the system is not overtaxed. Ailments like indigestion should not be allowed to arise, as they are likely to tax the heart. A heart patient should eat so sparingly that he should feel hungry all the time. The last meal of the day should be taken at least three hours before retiring.

Gravity douche or enema should be taken recourse to in case of constipation. A short walk in the morning and evening is beneficial. Even traditional doctors have come to realize now that walking is the best exercise for a heart patient. Some of them even recommend jogging. A medical fact which should be stated here is that when you are walking the pressure on the heart is reduced to some extent because the blood going back for purification through the heart to the lungs flow back more easily when you are walking than when you are sitting or lying down. Epsom salt bath should be taken once or twice weekly.

A heart patient must have a strict regimen of living in addition to eating. He must avoid stress, worry and excessive physical strain. If he has been on drugs before turning to naturopathy, they should be gradually withdrawn. A sudden stoppage of drugs is not advised.

Facts About Heart Disease You Need To Know

by Cindy Heller

Basically, heart disease is a disorder affecting the ability of the heart to function normally. There are many forms of heart disease of varied etiology.
The most widespread form of heart disease is high cholesterol. In the initial stages of the disease, lesions and cracks will form in the walls of blood vessel walls, usually close to the heart itself. The body will repair the damage by depositing fatty substances such as cholesterol and lipoproteins to fill the cracks.
If the body does not get adequate vitamin C that are vital for keeping the blood vessel walls from cracking, the repeated deposition of fatty substances can clog the blood vessels and thus cause a stroke or heart attack.

Types of Heart Diseases 

The common forms of heart disease are: coronary heart disease, ischaemic heart disease, pulmonary heart disease, hereditary heart disease, hypertensive heart disease, inflammatory heart disease, and valvular heart disease.

Heart diseases may also occur due to congenital reasons, heart valve malfunction, electrical rhythm of the heart going out of sync, alcoholic cardiomyopathy, aortic regurgitation, heart attacks and heart failure.

Causes of Heart Disease

The major causes of heart disease include obesity, smoking, hypertension, diabetic and a sedentary lifestyle. Others include menopause in women, getting on in age, especially after reaching sixty-five years of age and finally, the arterial walls being struck down with infections.

Damage to the heart muscle or valves due to a congenital defect, as well as inflammation and damage associated with various viral, bacterial, fungal or parasitic diseases can also cause heart disease.
Disease can also cause heart disease, for example atherosclerosis, dermatomyositis, Friedrich's ataxia, hemochromatosis, Kawasaki disease and Paget's disease of bone. Rheumatic fever and syphilis can also cause heart disease, as can genetic or autoimmune disorders in which cellular proteins in the heart muscle are deranged or which disrupt enzymes affecting cardiac function.

Common Symptoms of Heart Disease

The most common symptoms of heart disease include heaviness or pressure on the chest; dizziness; nausea; shortness of breath; back or shoulder pain; irregular or fast heartbeats and excessive heart palpitations. If one encounter any of these problems, it would be prudent to consult a doctor as soon as possible.

Diagnosing Heart Disease

Everyone should be concerned with heart disease and should discuss testing for heart disease with a doctor especially if one have a family history or aggravating lifestyle choices. High blood pressure, frequent loss of breath, heavy smoking or drinking, obesity, high cholesterol, inactivity and diabetes are sound reasons for heart disease testing.

Cure for Heart Disease

On diagnosis of heart disease, the doctor will probably recommend that a patient adopt a healthy lifestyle such as having frequent exercise, a healthy diet, avoiding alcohol and cigarettes. The next treatment will more than likely involve medications and finally surgery. Although there are many different forms of treatment for heart disease, there is no cure for heart disease. There are promising theories, however none yet have been perfected yet.

Cellular therapy is promising as a possible cure for heart disease. Cellular products have been shown to hold great potential for the treating of damaged and diseased tissues in the body. The sources for cellular product also come in a variety of sources, such as bone marrow stem cell and peripheral blood, as well as from myoblasts from skeletal muscle cells.
Cellular therapy is a growing field for clinical research. It is of growing interest to medical researchers as potential treatments for congestive heart failure and ischemic heart disease, for instance.
The research to date has shown positive results. There are also various other forms of promising treatment. So a cure for heart disease may be a reality in the future.
All treatment for heart disease should be discussed with a doctor but most of the medications will be available on prescription. If the medication is not effective, then the last option may be surgery. There are wide ranges of surgeries and many of them are less invasive so recovery time is shorter.
One should also understand that heart disease is preventable by living a healthy lifestyle such as regular exercise, having low salt and low fat diets as well as abstaining from alcohol and smoking. After all, prevention is much better than cure.

Major Types Of Degenerative Heart Disease

by Joann Cheong

As you may know, heart disease comes in a number of types. All types are serious, degenerative conditions that can cause sudden death. Given this fact, degenerative heart disease is no doubt a health problem that needs to be considered and solved.

However, before one can solve degenerative heart disease, it is important first to know that major types of such disease. Understanding of these types can help you find the right solution and treatment.

So what are the major types of degenerative heart disease? Consider the following:

Coronary Heart Disease

This is by far the most common type. This is often associated to heart attack and chest pain, and many studies have shown that about 7 million people in the United States alone suffer from this condition.

The coronary heart disease actually occurs when the coronary arteries that carry the blood and oxygen to the heart become narrowed with fatty substances, known as plaque. The plaque builds up on the inner wall of the arteries, and when the arteries are narrowed, the blood and oxygen flow to the heart is slowed down. This may even lead to full blocking of the arteries, leading to heart attack.

Congenital Heart Disease

This type is often identified by a number of heart defects that are present at birth, hence the name. The defects may include patent ductus arteriosus, coarctation of the aorta, atrial septal defect, ventricular septal defect, atrioventrivular septal defect, aortic stenosis, pulmonary stenosis, transposition of the great vessels, tetralogy of fallot, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous return, and hypoplastic left heart syndrome. All of these defects occur before or shortly after birth, making it one of the leading causes of deaths in newborn.

Rheumatic Heart Disease

This is also considered by many as one of the major types knowing that millions of people in the whole world are affected by it. Basically, this affects children and adolescents. It involves damage to the entire heart and its membranes. Also, it is important to note that this type is a complication of rheumatic fever that is said to have resulted from an untreated strep throat. This condition occurs with the heart valve is damaged due to the fever, leaving it incapable of opening and closing properly.

Angina Pectoris

Commonly known as chest pain, angina pectoris is a major type that affects people of different age. It is actually a specific type of pain in the chest that resulted from an inadequate flow of blood through the blood vessels. This condition is considered as one of the symptoms of almost all types of heart disease, so it is not only deemed as a disease itself, but a symptom as well.

There are other types such as atherosclerosis, arrhythmia, myocarditis, and a lot more. The best way to treat these types, however, is to ask for recommendations first from your doctor before opting for one of the available treatments. This is highly important as degenerative heart disease comes in a number of types with varying symptoms and levels of severity

Fish Oil and Heart Disease

by David McEvoy

According to National Statistics online, nearly 15% of the population of the UK are suffering or have suffered from a cardiac health event in their lifetimes. That means that for every 100 people in the room, about 15 of them will have a heart attack or suffer from a coronary disease. Interestingly enough, this statistic includes both men and women, with men only having a slight advantage over the women in terms of number of cases. Even with all we know about heart disease and how to prevent it, it seems that there is so much more to learn.
What is Heart Disease?
The heart is the muscle in the body that allows for transportation of materials throughout the body. When a person takes in food, these meals are broken down by the digestive system in order to be accessible for functions in the body. As the food is broken down into nutrients, these nutrients are then transported into the blood stream in order to get to the right areas of the body. When the heart pumps, it moves these blood cells around to the extremities and then when it contracts, it pulls the blood into itself by means of the veins in order to push that blood into the body into the arteries. When the heart is unable to function properly, this process can not take place.
There are a number of reasons and names for the idea of heart disease. At its simplest definition, heart disease is when the heart is damaged or just unable to work as it should. This can be a hereditary and congenital condition, like in the instance of a valve problem. A patient can have this from birth and never need to have anything done to repair it, while other patients need to have this fixed in order to make sure that heart works properly.
Heart disease can be grouped into being caused by heredity, lifestyle or by a defect or injury. Hereditary factors like a predisposition to high cholesterol can cause troubles like heart attacks and myocardial infarction. Then again, if a patient takes in too much cholesterol and fat into their diet, they can also increase their risk for heart disease.
The heart disease cases that cause troubles for patients will have conditions like hardening of the arteries, blockages of the vessels, and a narrowing/widening of these passageways for the blood. When the vessels become too blocked, blood can not get to the heart, resulting in heart damage and death.
What are the Symptoms of Heart Disease?
The real concern when it comes to heart disease is that there may be few, if any, symptoms at first. A patient may have completely normal lab results as well as no noticeable physical symptoms. In more advanced cases, the cholesterol levels will be high, the LDL levels will be high, and HDL levels will be low. Blood pressure readings may increase and the patient may report mild chest pain and tightness. Some patients even report troubles with breathing during activity. The heart rate may be higher as has become more difficult for the heart to do the same job on a lower number of beats per minute.
In an emergent condition, the symptoms would be an increased heart rate, crushing chest pain, and possibly nausea. Others report that they had a raised temperature and sweating, as well as left arm weakness.
How Can Fish Oil Help?
According to recent studies done at Harvard Medical University, fish oil seems to be able to prevent heart disease. With its anti-inflammatory properties, fish oil seems to allow the body to repair smaller damage spots before they become too problematic. There have also been previous studies linking the idea of using fish oil and lowering bad cholesterol as well as increasing good cholesterol. The essential fatty acids in fish oil help the body process the cholesterol and other toxins in the body before they build up in the liver and cause damage.
Where Can You Find Fish Oil Sources?
Understandably so, fish oil can be found in its purest form in oily fishes. Fish choices like salmon, herring, kipper, and mackerel all contain high levels of Omega 3 fatty acids that can help to protect the heart from heart disease. In addition, there are studies being done now that indicate that fish oil might be able to help in the repair of damage from previous concerns with heart disease and heart attacks. In countries with a high fish consumption, the prevalence of heart disease is much lower, even with the high smoking rates (as in Japan, for example).
Conclusion
While there are many studies that are questioning the use of fish oil in the treatment and prevention of heart disease, it's clear that there is some connection. Since the body can not make this essential fatty acid on its own, adding a supplement to the diet can not be a hard decision to make

All About Our Heart

by Naveen Kumar Sanagala

Our Heart :
The heart is a hollow, muscular organ that pumps blood, rich with oxygen and nutrients to all parts of the body. It is the organ which functions incessantly round the clock. Heart lies in the center of the chest, slightly to the left and protected by the breast bone (sternum). The heart is made up of a powerful muscle called Myocardium. The heart has two separate pumps that continuously send blood through out the body carrying nutrients, oxygen and helping remove harmful wastes. A wall (septum) divides the heart into a right side and left side. The right side heart receives impure blood low in oxygen. The left side heart receives pure blood that has oxygenated by the lungs. This cycle is repeated about 70 times per minute and is counted as a pulse. The heart is divided into four chambers. Two upper chambers (atria) receive blood from the veins. Two lower chambers (ventricles) pump blood out of the heart through arteries. The heart has four valves that keep the blood flowing in the correct direction i.e., work as regulators. The heart muscle is nourished by a system of arteries, which originate from the 'aorta': the right and left coronary arteries.
Heart Functions: The heart functions as interrelated double pumps. One pump (right heart) receives blood, which has just come from the body after delivering nutrients and oxygen to the body tissues. It pumps this dark, bluish red blood to the lungs where the blood gets rid of a waste gas (carbon dioxide) and picks up a fresh supply of oxygen which turns it a bright red again. The second pump (left heart) receives this "reconditioned" blood from the lungs and pumps it out through the great trunk -artery (aorta) to be distributed by smaller arteries to all parts of the body. Types of Heart disorders : There are three main diseases of the heart.

1. Coronary artery disease (King's Disease): Coronary arteries become narrow or blocked due to the deposition of Cholesterol and other body fats leading to 'artherosclerosis', commonly called 'hardening of the arteries'. Artherosclerosis causes insufficient blood flow to the heart muscles. Angioplasty, intensive medication, life style changes, and in severe cases, a by-pass surgery is recommended to correct the defect.
2. Valvular heart disease: It is a defect in the valves by birth, infection causing scarring or thickening leading to insufficient opening or closure of valves for blood flow. This disorder can be cured either by medication or by artificial valvular surgery.
3. Congenital heart disease: Congenital heart defects are problems with the heart's structure that are present at birth. These defects can involve the interior walls of the heart, valves inside the heart, or the arteries and veins that carry blood to the heart or out to the body. Congenital heart defects change the normal flow of blood through the heart. There are many different types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms. Congenital heart defects are the most common type of birth defect, affecting 8 of every 1,000 newborns. Most of these defects are simple conditions that are easily fixed or need no treatment. A small number of babies are born with complex congenital heart defects that need special medical attention soon after birth. Over the past few decades, the diagnosis and treatment of these complex defects has greatly improved. As a result, almost all children with complex heart defects grow to adulthood and can live active, productive lives because their heart defects have been effectively treated. Most people with complex heart defects continue to need special heart care throughout their lives. They may need to pay special attention to certain issues that their condition could affect, such as health insurance, employment, pregnancy and contraception, and preventing infection during routine health procedures.

How To Test For Heart Failure

by Mike Selvon

Each year, 5 million Americans will suffer from heart failure, a condition in which the heart can't pump blood to other organs in the body. The root cause is not simply a matter of "blocked pipes" or genetics.

Culprits behind this include narrowed arteries, scar tissue, high blood pressure, heart valve disease, cardiomyopathy (disease of the heart muscle itself), congenital heart defects, infection of the valves (endocarditis), infection of the heart (myocarditis), or a combination of factors.

Coronary Artery Disease is the leading cause of heart failure today. CAD is a manifestation of atherosclerosis, which results from smoking, high cholesterol, hypertension (high blood pressure) and diabetes.

Sometimes a viral infection, exposure to toxins like lead or alcohol, or genetics can cause a disease in the actual heart muscle, also known as cardiomyopathy. Diabetes, high salt intake, sustained rapid heart rhythms, alcoholism and marked obesity can all be contributors to chronic failure of the heart.

To check if you may have heart health problems, your general practitioner can run several tests to be sure. Many people avoid getting tested in advance because they fear invasive pokes and prods, but most of these screening tests are very non-invasive. For instance, one test, which is a "stress test," has you walking on a treadmill for a specific interval of time through several intensity levels, while an IV-injected tracer moves through the blood, indicating possible obstructions or strain.

Another test, the EKG, simply monitors your heart rhythms through electrical wires with adhesive ends stuck to your chest, arms and legs. An "Echocardiogram" is simply an ultrasound image taken of your chest, which is as painless as a photograph.

Most people are familiar with the usual hypertension/blood pressure test done with a cuff around your bicep. The most invasive test, which is recommended for people with a genetic predisposition, is the "Catheriterization," which is a small tube inserted into the artery, which may open an obstruction or insert dye to see where the problem spots are.

If you've been diagnosed with heart failure, then you'll need to adjust your diet considerably. An overwhelming amount of evidence suggests the importance of Omega-3 fatty acids, which are found in fish oil supplements. Dr. James O'Keefe of the Mid America Heart Institute in Kansas recommends at least 1 gram of fish oil per day and as much as 4 grams for people with high triglyceride levels.

"Research shows that this dosage lowers triglyceride levels by 20 to 50 percent," he explains. In addition, you'll be trading in eggs for oatmeal, red meat for fish and hummus instead of chip dip.

Angiotensin II antagonism in Congestive Heart Failure

by Andre Garcia

Congestive Heart Failure (CHF) is a clinical syndrome corresponding to the inability of the heart to meet the metabolic requirements of the body at normal filling pressures. Although many times heart failure is mainly precipitated by left ventricular systolic dysfunction, it sometimes also can be secondary to diastolic dysfunction; or a combination of both. CHF is highly prevalent in the USA, Canada, Europe, Australia (corresponding to the "developed countries" as sometimes is told). Mortality, morbidity, direct and indirect costs; all remain being very high yet. The hemodynamic model of CHF has been largely abandoned and replaced by the concept of left ventricular remodeling; which indicates stretching and dilation with subsequent reduction in left ventricular function. Causes include: Coronary Artery Disease (CAD), Myocardial Infarction (MI), hypertension, valvular heart disease, diabetes, congenital heart defects, anemia, and alcoholism. Independently of the precipitating injury, neuro-hormonal mechanisms are activated and promote the remodeling process. These include the Renin-Angiotensin-Aldosterone System (RAAS) and the sympathetic nervous system. A rise in endothelin-1 production, resulting from dysfunctional endothelium, also occurs and contributes to vasoconstriction. Inflammatory markers and cytokines are increased, hence further exacerbating endothelial dysfunction (a "vicious cycle" thereby occurs). A rise in angiotensin II promotes apoptosis (programmed cell death), hypertrophy, and fibrosis. Angiotensin II also causes an increase in aldosterone secretion, which in return augments the harmful effects of angiotensin II on myocardium and promotes adverse remodeling.

Angiotensin-converting enzyme inhibitors (ACEi) were the first class of drugs proved to reduce mortality on patients with CHF. In 1987, NEJM (New England Journal of Medicine) published the results of CONSENSUS (Cooperative North Scandinavian Enalapril Survival Study), showing that enalapril, used at 2.5 to 40mg per day dosage, on patients with severe (class 4) CHF, resulted in a 40% reduction in risk of death (versus placebo). Later, in 1991, NEJM, again, published a new study about enalapril on patients with severe CHF - it was the SOLVD (Studies of Left Ventricular Dysfunction). (Source: N Engl J Med 1991 Aug 1;325(5):293-302 PMID: 2057034, UI: 91278933) SOLVD was focused on the effect of enalapril on mortality and hospitalization in CHF patients with ejection fractions less than 35%. The reduction in risk of death was 22% (versus placebo). This 2 studies were the first giving some good hope in front of a very catastrophic and disastrous clinical picture (CHF) until then. Enalapril was the hero; the angel that saved lives! Next, many, many studies showed (thus confirming) the same idea - ACEi significantly reduced mortality on patients with severe CHF. This became, then, an (almost) unquestionable and irrefutable golden rule/pearl in the treatment of CHF.

Nowadays, about ACEi, we know as being Level of Evidence A: *) ACEi are recommended in all patients with CHF and left ventricular dysfunction unless a contraindication exists (ACC/AHA Guidelines). *) ACEi should be used in all patients with a history of MI and asymptomatic reduced left ventricular function irrespective of ejection fraction (ACC/AHA Guidelines).

ACEi, as name suggests, inhibit the angiotensin-converting enzyme, thereby blocking the conversion of angiotensin I to angiotensin II and bradykinin breakdown. However, since there are other angiotensin II generation pathways, even a total (100%) ACE blockade would not put angiotensin II levels on absolute zero. Here, angiotensin-receptor blockers (ARBs) can fit in.

ARBs bind to the type 1 angiotensin II (AT1) receptor and block it, what leads to plasma renin, angiotensin I, and angiotensin II increased levels. Blockade of the AT1 receptor will also result in the stimulation of the AT2 receptor (physiologically paradoxical), what will increase nitric oxide (NO) production and will trigger other molecular actions which mediate vasodilation; inhibition of fibrosis and of apoptosis (hence, less ventricular remodeling will happen; more time patient will be alive). Overall, ACEi are cheaper, older and better known than ARBs. However, ARBs tend to be better tolerated (less side effects; specially - less persistent cough and recurrent angioedema - very probably because bradykinin levels will not be raised). Many studies were then done, aiming to directly compare the efficacy and safety of the yet "newborns" (ARBs) versus their "bigger and older cousins" (ACEi). This would not be an easy task for ARB laboratory producers - ACEi had the "golden crown of king" - the only drug class (before Losartan, the first ARB on the market, on 1997) which until then had proved to reduce mortality on patients with CHF, do you remember? Well, ARBs proved to have an efficacy similar to ACEi in treatment of CHF and also for patients with non-complicated or complicated hypertension; MI; and diabetic nephropathy. Great, isn't it? The list of studies is enormous.

Sometimes you can find results different from what I have just said about ARBs efficacy and safety, but such studies were methodologically incorrect (or "less correct"), so it became consensual to use an ACEi as first option to antagonize angiotensin II (same efficacy, less price), and only switch to an ARB if patient cannot tolerate an ACEi due to its side effects (persistent cough is, by far, the side effect more frequently forcing patients to give up using an ACEi; but angioedema, although rarely, can kill, if it makes airway obstruction). This seems a prudent and intelligent strategy; I agree. But from present, I would like all doctors to think on a question - maybe now is the moment to begin researching a new plan - why not associate a lower-dose of an ACEi with a lower-dose of an ARB? It makes sense to suppose a better efficacy (by synergy) and less side effects (lower-dose of each one). Why not give a try on this hypothesis rather than continue repeating the same type of studies (ACEi versus ARB - who wins? - neither! - it's a draw! - surprised? - no! -I have already read it so many times!!)? Feel free to discuss your point of view about this! ;) Statistical and methodological analysis of Clinical Trials always is a supreme challenge for all MDs ;)

Information on Infectious Endocarditis

by Alicia Stock

Infectious Endocarditis is an illness of the lining of the heart chambers and heart valves, result by bacteria, fungi, or other infectious agents. In several congenital cardiac diseases, infection can also happen in the lining of the arteries that come out of the heart. Infectious endocarditis may arise in a person of any age. The prevalence of infective endocarditis is between 1.7 and 4 per 100,000 persons, most commonly affecting men in their fifties. There are two forms of infective endocarditis. One form, called acute infective endocarditis, develops suddenly and may become life threatening within days.
The other type, called subacute infective endocarditis or subacute bacterial endocarditis, develops slowly and faintly over a period of weeks to several months. Bacteria may be introduced into the bloodstream. These organisms can then lodge on heart valves and infect the endocardium. Abnormal, damaged, or artificial valves are more susceptible to infection than normal valves. The bacteria that cause subacute bacterial endocarditis nearly always infect abnormal, damaged, or artificial valves. However, normal valves can be infected by some aggressive bacteria, especially if many bacteria are present.
The signs and symptoms of infective endocarditis depend on the causative organism. Symptoms of endocarditis may grow gradually or suddenly. Symptoms may involve fever, tiredness, weight loss, new rashes, headaches, backaches, joint pains, and confusion. A new heart murmur as well as new skin, fingernail, and retinal lesions are typical physical findings in endocarditis. Risk factors for children and young adults include birth defects, particularly a defect that allows blood to leak from one part of the heart to another. One risk factor for older people is degeneration of the valves or calcium deposits in the mitral valve or in the aortic valve.
Infective Endocarditis affects twice as many men as women of all ages but 8 times as lots of older men as older women. Damage to the heart by rheumatic fever as a child (rheumatic heart sickness) is also a risk issue. Infective endocarditis is treated with antibiotics and with surgery in some situations. The chosen antibiotic must be specific for the organism causing the condition. Treatment is generally given for 4-6 weeks, depending on the definite type of bacteria. Surgery may be required to replace damage heart valves. Good oral and dental hygiene is also thought to be important.

Heart Diseases - How can we prevent them?

Author: Peter Sams

Introduction

The heart has long been associated with the very nature of humanity. As long ago as the fourth century BC, Aristotle considered it to be the seat of the soul, the centre of nutrition and the vital source of heat. The very word ‘heart’ is still deeply embedded in our language in phrases such as ‘heart-felt sympathy’, ‘heart-to-heart talk’, or ‘the heart and soul of the party’, no doubt reflecting its central location in the body and its regular beat. It is also associated with many emotional sensations, so heart disorders hit at the very core of a person’s fabric and psyche.

Types of Heart disease

• Heart Attack High blood pressure
• Ischemic heart disease
• Heart rhythm disorders
• Tachycardia Heart murmurs
• Rheumatic heart disease
• Pulmonary heart disease

Causes Of Heart Disease : For almost forty years, the lipid hypothesis or diet-heart idea has dominated medical thinking about heart disease. In broad outlines, this theory proposes that when we eat foods rich in saturated fat and cholesterol, cholesterol is then deposited in our arteries in the form of plaque or thermos that cause blockages. If the blockages become severe, or if a clot forms that cannot get past the plaque, the heart is starved of blood and a heart attack occurs.

Many distinguished scientists have pointed to serious flaws in this theory, beginning with the fact that heart disease in America has increased during the period when consumption of saturated fat has decreased. "The diet-heart idea," said the distinguished George Mann, "is the greatest scam in the history of medicine.” And the chorus of dissidents continues to grow, even as this increasingly untenable theory has been applied to the whole population, starting with low fat diets for growing children and mass medication with cholesterol-lowering drugs for adults.

But if it isn’t cholesterol, what causes heart disease? We don't know enough to say for sure but we do have many clues; and although these clues present a complicated picture, it is not beyond the abilities of dedicated scientists to unravel them. Nor is the picture so complex that the consumer cannot make reasonable life-style adjustments to improve his chances.

Heart disease includes the 13 Symptoms listed below: •Angina- and its symptoms •Chest discomfort •Chest pain •Brief pain episodes- often 2-5 minutes •Pain worsens on exercise •Pain relief from rest •Shortness of breath •Indigestion •Palpitations •Arrhythmias •Light-headedness •Fainting


Treatments for Heart Disease

There is a wide range of effective drug treatments for people with heart disease. These drugs can help lower blood pressure or cholesterol, prevent or dissolve blood clots, relieve and prevent angina symptoms or improve the strength or rhythm of the heart's contractions.

Medical procedures to diagnose and treat heart disease include coronary angiography, coronary artery bypass grafts, coronary angioplasty, coronary stinting, heart transplants, operations for congenital defects, surgery for heart valve defects, electrophysiological treatments and implanting of cardiac defibrillator.

How can I avoid having a heart attack?

Talk to your family doctor about your specific risk factors (see box above) for a heart attack and how to reduce your risk. Your doctor may tell you to do the following:

•Quit smoking. Your doctor can help you. (If you don't smoke, don't start!) •Eat a healthy diet. Cut back on foods high in saturated fat and sodium (salt) to lower cholesterol and blood pressure. Ask your doctor about how to start eating a healthy diet.

Lose weight if you're overweight Control your blood pressure if you have hypertension.


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