Complete Information on Esophageal Atresia

by Alicia Stock

Esophageal atresia is a condition in which a part of the oesophagus misses. Esophageal atresia is often associated another congenital anomalies, anomalies most generally cardiac. The disorder is a congenital defect, that the means it occurs before birth. There are several types of atresy oesophagienne. Esophageal atresia with the dent tracheoesophageal occurs in one from 3.000 to 5.000 births. This condition is frequently complicated by the saliva of breathing and secretions of infant in the lungs, causing pneumonia, obstruction, and probably dead. The disorder is usually detected little time after the birth when the food is tested.
Symptoms of esophageal atresia include bluish colouring with the skin with food tested, coughing, bâillonant, and obstructing with the food tested of food, radoter and poor. More one 30% people affected by this condition will also have another anomalies, such as disorders of heart or other digestive disorders of area. Roughly 50 % of children supported with the atresy oesophagienne have other associated problems which can be present. The atresy oesophagienne is considered a surgical urgency. Surgery to repair the oesophagus should be made quickly after the baby is stabilized so that the lungs are not damaged and the baby can be Fédéral.
Before the surgery, the baby is not fed by mouth. The care is taken to prevent the baby of secretions of breathing in the lungs. Mucus and saliva also without interruption will be removed by the intermediary of a catheter until the re-establishment occurred. When the surgery is carried out, the oesophagus is replugged and, if neccessary, is separated from the trachea. The therapy of oxygen is employed like necessary to maintain the saturation normal of oxygen. If one suspect the oral ea or TEF, all food are stopped and of the intravenous fluids are started.

Early Attention Is Required With Children With Down Syndrome

by Mike Selvon

Parents of children with Down syndrome are flooded with a barrage of emotions. They may experience disappointment, anger, grief, frustration, fear and anxiety. Mothers over the age 35, who have a higher chance of having a baby with Down syndrome, may experience guilt or self-blame.
These feelings naturally come up, which is why establishing a support network is important for new parents. Talking with others who've been through the same challenges will offer inspiration and ensure the best possible upbringing for the developmentally disabled child.
Children with this chromosomal disorder will have tribulations early on. Parents should be aware of the special-care needs for babies with Down syndrome as early as possible, to prepare themselves for the challenges that lie ahead. Some babies require medication to address a heart defect, while others require physical therapy sessions to help develop better muscle tone and coordination.
Some syndrome babies have a difficult time learning to breastfeed at first, which is sometimes related to stomach or intestinal blockages. Eye, ear, nose, throat and thyroid problems are not uncommon, as is late teething. The main thing to keep in mind is that the baby will eventually get there, but patience and offering loving support are critical to the child's development.
The educational needs for children with Down syndrome vary, depending on the degree of mental retardation. Early intervention and skill assessment is the key to relating to the child on terms he or she can relate with. For example, often concrete concepts are more easily understood than abstract ideas.
Step-by-step teaching and providing consistent feedback are two techniques that can help the developmentally disabled. In the past, Down syndrome children went to separate schools or were home-schooled.
Now, the mainstreaming of these children is proving effective at decreasing the emotional gap between children with this chromosomal disorder and those without. In countries like Denmark or Germany, a two-teacher approach allows these kids to observe and be exposed to others, while focusing on their special needs.
There are certain health risks for children with Down syndrome. About half of all Down syndrome babies are born with congenital heart defects and 60% suffer an eye disease, including cataracts (15%) and the need for corrective glasses or contact lenses (50%). Nearly 75% suffer hearing loss, sleep apnea and persistent ear infections.
Other problems include thyroid disease (15%), gastrointestinal atresias (12%) and acquired hip dislocation (6%). Less than 1% of all cases report leukemia or Hirschsprung disease. Over time, adults with Down syndrome may suffer respiratory infections, heart disease, surgery for bowel obstruction or cataracts, hearing loss, epilepsy and osteoarthritis.

Heart Disease At Young Age

by Cindy Heller

If a woman should go into labor before thirty-seven weeks of gestation, the baby born at that time is considered to be premature. In many cases premature infants tend to have some form of heart impairment arising from heart disease or defect. The incidence of heart malfunction in premature babies is rather alarming.
Premature infants do not have fully formed organs, and because of this the baby has to be cared for in a neonatal nursery or neonatal intensive care unit until such time as they have developed and strengthened enough to continue living without medical support. However premature infants suffer from many other symptoms, not only heart disease. Some common symptoms are hyaline membrane disease, poor ability to feed, inactivity, enlarged clitoris in females, small scrotum in males, weak cry, body hair, breathing apnea as well as many others.
Treatment
Heart disease in premature infants is not completely avoidable although there are treatment protocols that may be followed to treat this. These premature infants are unable before 34 weeks gestation, to suck and swallow at the same time, so many are fed by a tube inserted into the stomach or in very small infants into a vein.
Complications
Complications in premature infants may not necessarily be related to the premature birth but there are many serious complications that can occur as well as heart disease. Some of these are hyaline membrane disease, retinopathy, low blood glucose, bleeding in the brain, jaundice, anemia, growth retardation as well as mental-motor and developmental retardation.
Prevention
There is absolutely no way for a woman to prevent premature labor and the delivery of a premature infant. But there are ways to ensure you are taking the correct steps to minimize the chances of this happening. One of the most important is to receive good prenatal care early and continue throughout the pregnancy. Statistics do indicate that early, proper and continued prenatal care make a huge impact on reducing the odds of giving premature birth and its related risks and deaths.
During pregnancy it is also extremely important to take care of your own health as well. It is vital to eat nutrient rich foods, including fruits and vegetables, daily exercise and drink adequate amounts of water. Although the combination of premature infants and heart disease is a serious situation, with modern medical technology and better methods to lessen the chances of occurrence, the chances of pulling out of this medical quandary are getting better with each day.
Heart Disease In Children
It is amazing that few people are aware that a child can suffer from heart disease. Many people think that heart disease only affects the aged. Heart disease is a very serious problem and child heart disease is in fact a relatively common ailment worldwide. Child heart disease or congenital heart defects are recognized as one of the most widely known birth defects of all. There are statistics to prove that worldwide nearly one percent of all babies born are affected by some form of heart malfunction. These infants are usually diagnosed as having child heart disease upon examination by their pediatrician at birth. Sometimes this is usually referred to as a heart murmur.
Information About Child Heart Malfunction
A child's heart might have a slight abnormality that may not even be noticeable at birth and therefore it might be difficult to detect any heart malfunction. But normally if a child has a heart defect there is a small hole in the wall of the heart that allows oxygenated and deoxygenated blood to move from one side of the heart to the other. This causes the infant to have either blue fingers or lips.
A problem that might also be experienced is an abnormal heart valve. The consequences are that the blood flows through the heart in the wrong direction. This type of child heart malfunction usually calls for surgery but this is normally performed when the child is older.
What A Heart Murmur Is
A heart murmur is the sound made by the blood flowing through the heart. This sound has been described as akin to the sound of water flowing through a hose. Heart murmurs occur frequently in infants, many are harmless, but others may create serious health risks for the child.
A heart murmur is a common sign of the evidence of child heart malfunction. In many instances the heart murmur is referred to as being 'innocent' or 'functional'. Naturally parents do become extremely worried when the term is used to describe their child's ailment. But a heart murmur does not necessarily mean that there is anything seriously amiss with the infant.
With the significant advances in medical technology in the last decade, parents can be assured that there will be a suitable course of treatment to alleviate their child's heart disease.

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.

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 ;)

Complete Information on Eisenmenger syndrome with Treatment and Prevention

by Alicia Stock

Eisenmenger syndrome occurs in patients with big inborn cardiac or surgically created extracardiac left-to-right shunts. These shunts initially induce increased pulmonary blood flowing. People who have Eisenmenger's syndrome are normally born with a big hole in the eye. The most common situation is a hole between the two pumping chambers, called a ventricular septal defect. Usually, Eisenmenger syndrome develops while individuals with heart defects are still children, but it may occur in adolescence or young adulthood. A number of congenital heart defects can cause Eisenmenger's syndrome, including atrial septal defects, ventricular septal defects, patent ductus arteriosus, and more complex types of acyanotic heart disease. Eisenmenger syndrome usually develops before puberty but may develop in adolescence and early adulthood.

Eisenmenger's syndrome primarily affects adolescents and adults with sure inborn eye defects that are repaired later or that are never repaired. Because the pressures within the left position of the eye are usually greater than those within the correct position of the eye, a beginning between the left and correct position of the eye will induce blood to flood from the left position of the eye into the correct position. The symptoms of Eisenmenger's syndrome may resemble other medical conditions or heart problems. A cardiac catheterization is an invasive procedure that gives very detailed information about the structures inside the heart. Eisenmenger syndrome specifically refers to the combination of pulmonary hypertension and right-to-left shunting of the blood within the heart. Eisenmenger's syndrome in rare instances may also develop with an atrial septal defect.

Symptoms related specifically to pulmonary hypertension result from the inability to increase pulmonary blood flow in response to physiological stress. A person with Eisenmenger's syndrome is paradoxically subject to the possibility of both uncontrolled bleeding due to damaged capillaries and high pressure, and random clots due to hyperviscosity and stasis of blood. The syndrome affects both males and females. Eventually, due to increased resistance, pulmonary pressures may increase sufficiently to cause a reversal of blood flow, so blood begins to travel from the right side of the heart to the left side, and the body is supplied with deoxygenated blood, leading to cyanosis and resultant organ damage. Eisenmenger syndrome is first suspected when an individual begins to show symptoms of pulmonary hypertension.

In early childhood, surgical intervention can repair the heart defect, preventing most of the pathogenesis of Eisenmenger's syndrome. Avoid very hot or humid conditions, which may exacerbate vasodilation, causing syncope and increased right-to-left shunting. If treatment has not taken place, heart-lung transplant is required to fully treat the syndrome. If this option is not available, treatment is mostly palliative, using anticoagulants, pulmonary vasodilators such as bosentan, antibiotic prophylaxis to prevent endocarditis, phlebotomy to treat polycythemia, and maintaining proper fluid balance. It is important to eat a nutritious diet and avoid alcohol and salt. Overexertion and smoking also should be avoided. Some patients might benefit from nocturnal supplementation, although it is most useful as a bridge to heart-lung transplant.

Heart Defects in Children

Author: Li Ming Wong

A Congenital heart is when a heart develops a problem from before birth. Often this is such things as a hole in the heart. These problems usually develop before anyone is aware that they exist. Heart defects can have a wide degree of severity. There are simple problems such as holes between the chambers of the heart to extreme malformations such as the complete absence of one or more chambers or valves within the heart.

Anyone can have a child with a congenital heart defect. Statistics have shown that out of one thousand births, eight babies will have some form of congenital heart disorder, most of which are mild. If some family members have already had a baby with a heart defect, the risk of having a baby born with a heart disease may well be higher.

This is something that most of the time cannot be predicted. The main reason defects occur is presumed to be genetic, only a few genes have been discovered that have been linked to the presence of heart defects. Rarely the ingestion of some drugs and the occurrence of some infections during pregnancy can cause defects.

Most heart defects in children are congenital. They are usually but not always diagnosed early in life. There are rare case where hear disease in children is not congenital. This type of heart disease is called acquired; examples include Kawasaki disease and rheumatic fever. Children also can be born with or develop heart rate problems such as slow, fast, or irregular heart beats, known as "arrhythmias".

Severe heart disease generally becomes evident during the first few months after birth. Some babies are blue or have very low blood pressure shortly after birth. Other defects may cause breathing difficulties, feeding problems, or poor weight gain.

About the author:

Stop fearing premature death, get your Health Education Now ! at http://thehealtheducation.blogspot.com

Prevention Of Congenital Heart Disease (CHD)

Author: Safron Jeen

It is indeed difficult to deal with this topic. Not much is known about the various causes, for operating on a pregnant woman, in the first three months of pregnancy, during which period, development of the heart in the foetus is expected to be complete.

Under the above circumstances, the best thing would be that all pregnant mothers must undergo a routine ultrasonography, and if some abnormality is suspected, foetal echocardiography must be undertaken for the precise detection of congenital defect in the heart. However, the question of termination of pregnancy must be taken especially in consultation with a heart specialist, or one who is dealing with pediatric cardiac surgery. Many of the congenital lesions of the heart can be satisfactorily treated, though surgically. All aspects of the case must be studied like the number of children, and if the previous offspring have any congenital defect or not, or, if this pregnancy has occurred after a long period of time.

Heredity may play some role in the causation of the disease. If the mother has any congenital defect in her heart, the chances, though minimal, of a defect in the heart of the expected baby may increase. Genetic counselling may help in such cases before the pregnancy is planned.

There are some conditions worth mentioning which must be avoided by a pregnant mother, as there are some likely factors which may disturb the development of the heart in the foetus.

If the mother is diabetic, it must be properly controlled. Diabetes, and even prediabetes, is known to cause congenital defects in the heart. Similarly, if the mother is suffering from epilepsy, the teratogenic effect of antiepileptic drugs must be kept in mind. Therefore, in such cases foetal echocardiography is a must to assess the condition of the heart. Exposure to X rays/radiation should also be avoided.

All pregnant mothers, especially in the first three months of pregnancy, must be prevented from contracting any viral infection, particularly infection caused by the virus of German measles. A good diet is also essential during pregnancy, and in case the individual is taking alcohol, it must be stopped altogether. It may not only cause a congenital defect in the heart, it may also affect the general development of the foetus, especially the brain.

A drug like thalidomide, which is a known teratogenic, and one used in psychiatry, i.e. lithium, should also be stopped.

However, in spite of taking best possible precautions, the child may still be born with some congenital lesion in the heart. Therefore, as stated earlier; a routine ultrasonography and if need be, foetal echocardiography, is a must for all pregnant mothers in their first trimester. This will help them know the exact position of the heart of the foetus they are carrying and whether the pregnancy should be terminated, or continued, though there may be a little congenital lesion in the heart which can be treated/taken care of after the child is born.

It may be concluded that although prescribed precautions must be taken bya pregnant mother, yet detection of a lesion in the heart of the foetus during the period of pregnancy, or after the child is born, or during childhood (if the case has remained undetected earlier), as well as timely treatment/ surgery, will help a lot in improving the overall healthy span of life in such cases. And for all this, a mass consciousness is essentially required for successful completion of this aim.

Types and Symptoms Of Heart Valve Disease

Author: Judy Wellsworth

There are two types of heart valve disease--heart disease resulting from narrowed heart valves, and heart disease resulting from leaky heart valves. Each of them stems from several different causes, ranging from birth defects, to bacterial infection, to aging.

Congential Heart Valve Disease

Congenital heart valve is the most common, and can result in inflexible or narrowed, or floppy, valves, or irregular valve flaps. Congenital heart valve disease is often diagnosed within a few days of a baby's birth, but if the defect is minor, may not be discovered until much later. Heart valve disease can be very hard to diagnose because some forms of it do not produce symptoms.

Some people, however, acquire heart valve disease because of complications from another disease such as heart muscle disease, coronary artery disease and heart attack. A child who has suffered from a rheumatic heart disease because of a simple strep throat will likely to have a valvular disease when he or she reaches adulthood.

Heart valve disease, however, can also develop as a complication from some other illness; children who have had rheumatic fever following an untreated case of strep throat have a greater than fifty percent chance of developing scarring on their heart valves. A heart with scarred valves has to work harder than one with smooth ones, and as the years mount, the extra strain on the heart can lead to rheumatic heart disease.

Endiocarditis

Another form of heart valve disease which can result from infection is endiocarditis. Endiocarditis develops when bacteria enters the bloodstream during surgery or dental procedures, causing inflammation of the heart and scarring both its valves and leaflets. In the case of endiocarditis, the scarred leaflets will allow blood entering the heart to back up, or "regurgitate," diminishing the blood volume within the heart and the amount of blood and oxygen which reaches the body's other organs.

The elderly are susceptible to heart valve disease resulting from calcification, or calcium deposit buildup, along the valves.

Testing For Heart Valve Disease

Echocardiograms

and MRIs are the tests best suited to diagnose heart valve disease. Either one will give the cardiologist a good look at abnormalities both in the main chambers of the heart and all its smaller structures including the valves.

http://www.treatheartdiseasehelp.com/Pulmonary_Heart_Disease/

Symptoms of heart valve disease can include vertigo resulting from a quick shift of positions, such as standing up or sitting, heart palpitations or racing, shortness of breath after minimal activity, and sever afternoon fatigue.

Those experiencing any of these symptoms on a regular basis should arrange to see a cardiologist and be tested for a heart murmurs, a strong indication of heart valve disease.

About the author:

You can also find more info on http://www.treatheartdiseasehelp.com/Reversing_Heart_Disease/

Reversing Heart Disease and http://www.treatheartdiseasehelp.com/

Heart Disease.

Treatheartdiseasehelp.com is a comprehensive resource to know about Heart Diseases.

tags:Congenital Heart Defects,Heart Diseases,Heart valve Diseases

Heart Disease Treatment: What Options Are Available

Author: Saul Peterson

There are many forms of heart disease including ischemic heart disease (plaque-blocked arteries), congenital conditions, arrhythmia, and diseases of the actual heart muscle. Whether heart disease is detected early or not revealed until after heart failure, there are now available to doctors and medical professionals many differing remedies and treatments to reduce the risks of further heart disease. Very basically there are three categories of heart disease treatment.

Just keep taking the tablets!!

When a heart beats too quickly, or if the arteries around it contract tightly, the heart will be overtaxed, like revving an engine that's in park, which, long term can result in damage to the heart muscle. Doctors prescribe three classes of pills called nitrates, beta blockers, and calcium channel blockers to enable the heart to run more efficiently. Each of these types of heart disease treatments help the heart to beat regularly and slowly, or expand the arteries in the area of the heart so that blood flow to the heart muscle is more efficient.

Surely everyone these days knows that Aspirin thins the blood and reduces the risk of blood clots forming, causing blocked arteries. Aspirin does diminish the blood's ability to form clots, as do Heparin and Warfarin, other drugs fight cholesterol, which can form plaque in the arteries (ischemic heart disease) and lead to heart failure. These drugs are usually called cholesterol reducing drugs or are part of a subcategory called 'statins'.

As always, if your doctor prescribes medicine, don't forget to ask plenty of questions about what the drug is and what it does, including any possible side effects.

Scalpel, Please!!

When clogged caronary arteries are life threatening, heart disease treatment can mean going into surgery. Some surgeries will clear the plaque in the arteries by cleaning or grinding it away or inflating a balloon (angioplasty) in the arteries to break up the plaque. During bypass surgery a large blood vessel will be taken from elsewhere in the body and grafted to the blocked artery so blood can pass around the blockage to the heart.

Surgeries for other conditions include implanting a pacemaker into the heart to treat arrhythmia, and doctors can transplant aortic valves into a patient whose valve has stopped functioning properly. In case no heart disease treatment is possible, such as in infants born with heart defects, artificial hearts do exist, though they are only a temporary solution until a heart transplant can be performed.

Treat The Whole System!!

Of course, before your heart gets desperate enough to need drugs or surgery, look to the risk factors you can control. Don't smoke; control your cholesterol as best as possible so that plaque never gets a chance to clog your arteries, although the body produces cholesterol itself so in some cases tight control of your cholesterol level is extremely difficult; and exercise regularly, most days in a week, to keep your heart muscles healthy. Hopefully if you undertake these simple steps, heart disease treatment will be for other people, not you.

For a free e-book, more articles and information about heart disease please visit http://www.a1toparticles.com/heart.html/

About the author:
Saul Peterson has suffered heart

Save Now

failure and disease for over 10 years - having numerous operations during this time - he knows heart disease first-hand

tags:Congenital Heart Defects,Heart Diseases

Paxil and Ventricular Septal Defects

Author: Robert H Hilley IV

Just like the atrial chambers (the left atrium and right atrium), the ventricular chambers also have a wall dividing them. The left ventricle and the right ventricle are divided by the ventricular septum and it is this septum that prevents arterial blood from mixing with venous blood.

When arterial blood mixes with venous blood, there are a multitude of potential side effects that could occur to a person as a result of this mixing. First and foremost, the main effect of the mixing the blood together is that the oxygenated and non-oxygenated blood groups will intermingle with each other, creating an imbalance between the blood coming in and leaving the heart. Some of the blood coming into the heart will already be oxygenated and some blood will leave the heart with poor oxygenation. This poorly oxygenated blood will circulate around the body and organs that are very sensitive to changes in blood oxygen levels (such as the Brain) may become damaged if a prolonged period of poor blood oxygenation takes place.

Additionally, there are also blood pressure concerns that can arise from the mixing of arterial and venous blood, not to mention the possibility of chronic pulmonary hypertension problems. These are the kinds of problems that can result from a hole in heart condition, especially if that condition is a ventricular septal defect (a hole in the ventricular septum). In general it is a very undesirable problem to have because of the large number of complications that can result from it.

The Connection to Paxil

In 2005 (especially late 2005 in the September to December month range), a lot of information was revealed about the side effects of Paxil. From the FDA warnings against pregnant women taking Paxil to multiple studies that showed the drug's propensity to cause multiple birth defects, Paxil and all selective serotonin reuptake inhibitors (SSRIs) were deemed dangerous to fetal matter and as such all pregnant women were urged to avoid taking those kinds of drugs.

Amongst the rather large list of birth defects that had been traced to the use of Paxil was ventricular septal defect. In many ways, this defect is worse for infants than it is for adults, because adults by and large, with medical assistance in some cases, have learned to deal with the problems of having a ventricular septal defect. In newborn children, obviously that acclimation is not there and conditions like pulmonary hypertension that result from a ventricular septal defect can be very painful for the child to experience and very stressful for the parent to see.

As with most things relating to the world of drug taking, knowledge and information are a person's best allies. If you are pregnant and suffering from depression, try to seek alternatives to taking SSRI drugs such as Paxil. If you must take these types of drugs, do so only under the supervision of a medical professional and do not under any circumstances take the drug without the permission of one. The list of mothers today that

regret taking Paxil during their pregnancy is vast and many of them feel nothing but sorrow for the painful lives their children now lead.

Robert H Hilley IV http://www.roberthilley.com

Tags:Congenital Heart Defects,Heart Diseases,Ventricular Septal Defects,Paxil

Double Outlet Right Ventricle

Morphology

Double outlet right ventricle (DORV) is a partial abnormality of ventriculoarterial connection and intracardiac ventricular septation. It is a congenital anomaly in which both great arteries arise wholly or in large part from the right ventricle. Both the arrangement of the atrioventricular valves and the ventriculoarterial connections are quite variable, and lie somewhere in between those noted in the tetralogy of Fallot and those in D-transposition. The aorta and main pulmonary artery are dextrorotated from the normal arrangement, and are classically side-by-side or nearly so. There is often both a subaortic and a subpulmonary infundibulum, in contrast to classic tetralogy of Fallot in which there is only a subpulmonary conus, or to D-transposition in which there is only a subaortic conus. The great vessel relationships also lie somewhere in between that of the tetralogy of Fallot and of D-transposition, resulting in both aorto-mitral and aorto-tricuspid discontinuity.

The actual diagnosis of DORV takes into account the morphology of only a very small part of the heart, namely that of the ventriculoarterial junction. There are numerous additional abnormalities of atrial arrangement and atrioventricular connections, any of which can be associated with the abnormal ventriculoarterial connection. When present, these anomalies, such as atrial isomerism or discordant or double-inlet atrioventricular connections, dominate the clinical picture and are referred to in other sections. Only the largest subset of double outlet ventricle are considered in this section, those with the usual atrial arrangement and concordant atrioventricular connections. Within this subsets, there are many anatomical variants, the most important variable feature being the location of the ventricular septal defect. The location of the ventricular septal defect forms the basis for both a morphological and operative classification, although within this spectrum of variability, any position of the aorta can combine with any position of the main pulmonary artery and any location of the ventricular septal defect thereby creating an infinite number of morphological possibilities. Only rarely is DORV found in the presence of an intact ventricular septum, and in almost all such circumstances the features would suggest that intrauterine or postnatal closure of a preexisting ventricular septal defect took place.


The ventricular septal defect was classified by Lev as being subaortic, subpulmonary, doubly-committed, and noncommitted.

a) Subaortic ventricular septal defect. Double outlet right ventricle with subaortic ventricular septal defect is the most common sub-type, and is morphologically a close cousin to tetralogy of Fallot. The ventricular septal defect, which is the primary outlet from the left ventricle, is located beneath the outflow tract supporting the aortic valve, and as in the tetralogy of Fallot, is positioned between the limbs of the septomarginal trabeculation. In this setting, the leaflets of the aortic valve often override the crest of the ventricular septum, and there can be doubt about which ventricle the aorta is most connected to, particularly when the morphology of tetralogy of Fallot is also present. Then, although there is discontinuity between the aortic valve and both atrioventricular valves, there still remains fibrous continuity between the mitral and tricuspid valves - that is, for the ventricular septal defect to be perimembranous. This feature is of surgical importance, since it indicates that the conduction tissue is closely related to the margin of the interventricular communication at its postero-inferior rim. Only rarely with a subaortic interventricular communication is there discontinuity between the mitral and tricuspid valves. Irrespective of the infundibular morphology, the interventricular communication is the only direct outlet of the left ventricle. Therefore, stenosis of the interventricular communication effectively produces subaortic obstruction although there is, of course, free access to the aortic outflow tract from the right ventricle. In the majority of cases however, the subaortic outflow tract is widely patent from both ventricles, and the outlet septum, which in this setting is an exclusively right ventricular structure, is deviated in antero-cephalad direction to produce subpulmonary obstruction. Almost always the arterial trunks are normally related when the interventricular communication is subaortic, or side-by-side with the aorta to the right. In one rare variant, however, the aorta can be anterior and to the left of the pulmonary trunk (with usual atrial arrangement and concordant atrioventricular connections). Although the ventricular septal defect is almost always in subaortic position with this rare pattern, making it possible in most cases for the surgeon to connect the aorta directly to the left ventricle, the septal defect can rarely occupy the locations to be described below when the aorta is left-sided.

b) Subpulmonary ventricular septal defect. With this arrangement, the ventricular septal defect is between the limbs of the septomarginal trabeculation, but in a subpulmonary (rather than a subaortic) location. This pattern, the second most frequent, is associated with parallel alignment of the arterial trunks, the aorta being to the right and slightly or markedly anterior to the pulmonary trunk. It is the orientation of the outlet septum, an exclusively right ventricular structure, that is the central feature, and the resulting lesion is usually described as the Taussig-Bing heart. Such hearts exhibit a spectrum of malformation determined by the precise connection of the overriding pulmonary valve. In most cases, there is mitral to tricuspid discontinuity, so that the defect has a muscular postero-inferior rim. Rightward deviation of the outlet septum producing subaortic obstruction is also frequent, as is aortic coarctation. Straddling and overriding of the mitral valve is the other malformation frequently associated with this pattern of DORV.


c) Doubly-committed, juxta-arterial ventricular septal defect. This subgroup of double outlet right ventricle is also closely related to tetralogy of Fallot. The central feature of this subgroup is complete absence of the muscular outlet septum, so that there is fibrous continuity between the facing leaflets of the aortic and pulmonary valves. The large interventricular communication is located immediately beneath both the aortic and valves, which have a marked tendency to override. The defect can be associated with mitral - tricuspid continuity and therefore be perimembranous, or with mitral - tricuspid discontinuity, and have a muscular postero-inferior rim. Reminiscent of the tetralogy of Fallot, the raphe between the arterial valves is deviated in an antero-cephalad direction to produce pulmonary stenosis with overriding of the aortic valve. Hence, this variant can be diagnosed as tetralogy of Fallot, although it is best considered as DORV with a doubly-committed and juxta-arterial ventricular septal defect, and describe the mode of ventriculoarterial connection.

d) Noncommitted ventricular septal defect. This is the most complex variant of double outlet right ventricle. Most commonly, the defect is noncommitted because it is perimembranous and opens into the right ventricle beneath the septal leaflet of the tricuspid valve, or because the tension apparatus of the atrioventricular valves is interposed between the margins of the defect and the subarterial outflow tracts. The surgical correction of these variants is quite difficult, and complete repair may not be possible. Rarely is the defect noncommitted because it is within the inlet or apical trabecular components of the muscular septum. To this extent, there is a conflict between the anatomical and functional definitions of a noncommitted defect. What is anatomically a committed defect may be rendered noncommitted functionally because of the interposition of vital structures, usually a valvar tension apparatus, between the defect and the arterial valves. These features are of profound surgical important, and must be taken into account in order to decide when a defect is noncommitted or subarterial.

Hemodynamics

The hemodynamics are dependent on the position of the ventricular septal defect, the relationships of the great arteries, and the presence of associated cardiac malformations, such as outflow obstruction and atrioventricular valve abnormalities. Variable degrees of cyanosis are present in all patients, depending on the location of the ventricular septal defect and the volume of pulmonary blood flow. Patients with DORV and unrestricted pulmonary blood flow have hemodynamics indistinguishable from those with an nonrestrictive ventricular septal defect; those with pulmonary stenosis have hemodynamics analogous to tetralogy of Fallot; and those with subaortic stenosis (Taussig-Bing heart) have hemodynamics similar to transposition of the great arteries with a large ventricular septal defect.

Clinical Findings

The clinical findings are also quite variable, although most patients present in early infancy. Patients with double outlet right ventricle and pulmonary stenosis present analogously to those with tetralogy of Fallot, cyanosis may be initially mild but may progress, and young infants may exhibit cyanotic spells. Patients with a large nonrestrictive ventricular septal defect and no outflow tract obstruction usually present at around 3 months of age with congestive heart failure and minimal signs of cyanosis, and finally those with double outlet right ventricle, unrestricted pulmonary blood flow and left ventricular outflow tract obstruction may present with severe congestive signs and poor peripheral perfusion.
Echocardiography localizes the position of the ventricular septal defect, demonstrates the relationships of the outflow tracts and the presence of obstruction(s) if present, and defines any atrioventricular valve abnormalities. Importantly, echocardiography is able to assess the tricuspid-pulmonic valve distance, and define the presence of straddling atrioventricular valves. Cardiac catheterization is performed to further define the anatomy, to obtain data on pulmonary vascular resistance and to identify coexistent conditions.

Medical & Surgical Management

Palliative operative procedures include pulmonary artery banding in cases of excessive pulmonary blood flow, and placement of systemic-pulmonary shunts in cases of pulmonary outflow tract stenosis. Palliative procedures are currently utilized only in cases in which definitive correction is anatomically not feasible. The goal of corrective operative management is to achieve a biventricular repair, in which the left ventricle is connected to the aorta, and the right ventricle to the main pulmonary artery. There are three main variables to be considered when deciding upon the most suitable operation, these being the location of the ventricular septal defect, the degree of tricuspid - pulmonary discontinuity, and the presence of right or left ventricular outflow tract obstruction. Often time, the decision on which operation to perform depends on the intraoperative findings.

Repair with subaortic or doubly-committed ventricular septal defect.

In the spectrum of double outlet right ventricle that is tetralogy of Fallot-like, namely in the presence of a subaortic or doubly-committed, juxta-arterial ventricular septal defect, and adequate tricuspid - pulmonary discontinuity to allow for an unobstructed intraventricular baffle, (usually at least equal to the diameter of the aortic annulus), a Kawashima intraventricular repair can generally be performed, in which the ventricular septal defect is baffled directly to the aorta by use of a tunnel.[306, 310] When the morphology is not favorable for an intraventricular repair, due either to insufficient tricuspid - pulmonary discontinuity or to pulmonary stenosis, then the pulmonary valve may be sacrificed in order to gain sufficient space to place an intraventricular baffle. Right ventricular to pulmonary artery continuity is then established by a conduit, the so-called Rastelli operation. Three other operations, not in common use include réparation à l’étage ventriculaire (REV operation)[61], Nikaidoh’s aortic translocation operation[54], and the pulmonary translocation operation. These operations are described in greater detail below. Resection of the outlet septum or enlargement of the ventricular septal defect may also be necessary to avoid outflow obstruction.

Repair with subpulmonary ventricular septal defect.

In the spectrum of double outlet right ventricle that is D-transposition-like, namely that there is a subpulmonary ventricular septal defect and insufficient tricuspid - pulmonary discontinuity, two options are available for complete repair without the use of a conduit. These include the arterial switch operation, in which an intraventricular patch diverts blood from the ventricular septal defect to the pulmonary valve and a standard arterial switch operation is performed[53], and the pulmonary translocation operation, (see below). A third option is the Damus-Kaye-Stansel operation, in which an intraventricular patch diverts blood from the ventricular septal defect to the pulmonary valve, the main pulmonary artery is divided at its bifurcation, the proximal end is anastomosed to the ascending aorta, and the right ventricular outflow tract reconstructed with a valved conduit from the right ventricle to the distal divided end of the main pulmonary artery. Resection of the outlet septum or enlargement of the ventricular septal defect may also be necessary to avoid outflow obstruction.

Repair with noncommitted ventricular septal defect.

The most common form of noncommitted ventricular septal defect is the atrioventricular septal defect, which extends under the septal leaflet of the tricuspid valve. Several authors have suggested that when this defect occurs with pulmonary stenosis, (which thereby precludes an arterial switch operation), the procedure of choice is patch closure of the ventricular septal defect with creation of a generous anterior and superior extension. The ventricular septal defect extension is then baffled to the aorta as for the standard intraventricular repair described previously. However, in view of the known tendency for surgically created ventricular septal defects to close spontaneously, as well as the inherent risk of creating subaortic stenosis with the tunnel repair, this approach is generally best avoided.
Certain anatomic forms of double outlet right ventricle require surgical approaches that are more closely related to those used for management of a functional single ventricle[538]. In these forms of double outlet right ventricle, the right ventricle is quite hypoplastic, and the defect results in essentially a single functional ventricle. In this subgroup, there is frequently a straddling tricuspid valve and sometimes a superior-inferior ventricular relationship. In other forms of double outlet right ventricle the left ventricle is hypoplastic, and frequently there is hypoplasia or atresia of the mitral valve. However, in still other patients there are two relatively well-formed ventricles, but the ventricular septal defect is of the atrioventricular septal defect type, and construction of a baffle to divert the left ventricular output to the aorta may be extremely difficult without disruption of the tricuspid chordal attachments and anterior enlargement of the ventricular septal defect. Under all of these circumstances, a univentricular palliation may be elected. When a univentricular palliation is considered, the critical surgical features are the function of the atrioventricular valves and obstruction to outflow from both ventricles into the aorta. There is a high incidence of obstruction to either the aorta or the pulmonary artery in patients with double outlet right ventricle, in addition, straddling tricuspid valves and common atrioventricular valves are not infrequently regurgitant in patients with double outlet right ventricle.

Tags :Congenital Heart Defects,Heart Diseases,DORV,Double Outlet Right Ventricle

Murmurs, Arrythmias, Heart Disease, & Failure

Author: Linda Mar Veterinary Hospital

Basic heart function

The heart is divided into four chambers. The right atriumreceives unoxygenated blood which then goes past the tricuspid valve into the right ventricle. From here, blood is pumped into the lungs through the pulmonic arteries as it passes by the pulmonic valve. Blood flows to the lungs where it is oxygenated. The blood returns via pulmonary veins into the left atrium. From here, blood flows past the mitral valve into the left ventricle. From here, blood is pumped out to the rest of the body via the aorta as it passes by the aortic valve. This sequence of events is coordinated by an electric impulse triggered by the SA node to result in a regular rhythmic lup-dup of the heart as it consistently relaxes and contracts.

Heart disease results from any abnormality of the heart. While heart disease can result in heart failure, it can be present and never lead to heart failure. Murmurs can be associated with heart disease that may be minor or serious in nature. Arrythmias are usually associated with serious heart disease. The heart disease may or may not necessitate treatment.

Heart failure is the end-result of heart disease and occurs when the heart is decompensating from its heart disease and is working inefficiently to cope with the body's needs. It is associated with signs of congestion/edema, poor perfusion and low blood pressure. This condition always necessitates treatment.

Signs

Some pets may have significant heart disease without signs. However, their condition can change quickly with stress or exertion as the heart starts to fail.

Most dogs with significant heart failure will show some or all of the following signs- coughing, especially at night, fatigue, tiring with exercise, a change in gum color from pink to a bluish color, difficulty breathing or rapid, shallow breathing at rest. These signs occur due to accumulation of fluid in or around the lungs and in the abdomen.

Most cats, however, show no signs before complete failure occurs. They can go from being apparently normal cats to open mouth breathing or fast, shallow breathing or having inabilityto use their legs when they have a clot (emboli) originating from the heart that lodges in their aorta. Cats can also suddenly die at home and pass away before anything can be done to help them.

Problems with the heart

Arrythmias

These may be primary, that is, associated with the heart directly and resulting from a heart condition. Arrythmias can also be secondary to problems with other organs in the body or occur in reaction to toxins or anesthesia.

Arrythmias may be heard during a routine physical exam where the animals shows no outward signs of a problem; they may be heard when an animal presents for fatigue, collapse or "seizure" like signs.

Arrythmias are categorized according to the chamber with which they are associated. Arrythmias of the atrium are called supraventricular, while arrythmias of the ventricles are called ventricular. Bradyarrythmia is a decreased heart rate, while tachyarrythmia is an elevated heart rate.

Murmurs

Murmurs result when there are changes within the heart. These can be from thickening of the valves (endocardiosis), narrowing near the valves (stenosis), thickening or thinning of the chambers (cardiomyopathy) or infection of the heart (endocarditis).

Murmurs may be heard during a routine physical exam where the animal has no symptoms of a problem (asymptomatic). Murmurs may be heard when the animal is showing signs of heart failure (fatigue, difficulty breathing, fainting or coughing).

Sometimes, with soft murmurs in puppies and kittens, they can be "innocent", that is, they will eventually disappear and cause no problems for the animal. A murmur that develops later in life, after six months of age, is more likely to be from disease. Murmurs are graded in loudness on a scale from 1 to 6, one being a soft, barely heard murmur to six being able to be heard without a stethoscope. While murmur loudness is useful in its description, it often doesn't correlate directly with the severity of the heart problem.

Murmurs can indicate a primary heart problem or can be secondary to other conditions such as anemia in dogs and cats (when the blood is thin and more prone to turbulence) or hyperthyroidism in cats (when having elevated levels of thyroid hormone put an excessive strain on the heart).

Congenital Heart Conditions

Animals can be born with a heart condition resulting from a congenital malformation. These are seen in young animals and can be hereditary. For this reason, these animals should not be bred. Certain breeds of dogs and cats are more likely to have certain congenital heart conditions, but even mixed breeds can be affected. Some common congenital heart defects are:

Patent Ductus Arteriosis (PDA)

A shunt is present in the fetal state that fails to close in the young animal, resulting in a direct connection between the pulmonary artery and aorta. The flow of blood is usually left-to-right; occasionally, though, if pressure builds up in the lungs, the flow can be right-to-left. These conditions are treated differently.

Pulmonic Stenosis and Aortic Stenosis There are areas of constriction or narrowing near or at the pulmonic or aortic valves.

Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD)

There are openings due to an incomplete wall between the two atria or two ventricles.

Mitral or Tricuspid Valve Dysplasia

There are malformed mitral or tricuspid valves that result in abnormal blood flow.

In general, subaortic and pulmonic stenosis and patent ductus arteriosus are the most common congenital abnormalities in dogs, and ventricular septal defect and tricuspid valve dyplasia are the most common congenital abnormalities in cats.

Hernias

Peritoneopericardial diaphragmatic hernias refer to the condition in which an animal is born with an opening of the diaphragm and the pericardial sac, allowing herniation of abdominal contents into the chest cavity and into the sac that surrounds the heart.

Acquired Heart Conditions

Most heart disease in animals is acquired, that is, associated with a condition that develops over time. Certain breeds of dogs and cats are more likely to have certain acquired heart disease.

The most common conditions are:

Mitral valve disease (MVD)

This occurs when there is thickening of the mitral valve on the left side of the heart; this results in abnormal blood flow. It is also known as mitral regurgitation.

Cardiomyopathy

These are disease of the heart muscle. This condition is common in older small breed dogs.

• Dilative, the most common form in dogs, is when the chamber walls are thin and the chamber size is enlarged. There is a higher incidence in Boxers, Doberman pinschers, Cocker spaniels and Great Danes.
• Hypertrophic, the most common form in cats, is when the chamber walls are thickened, and there is less room for blood inside the chamber.
• Restrictive and mixed forms of cardiomyopathy are two other forms that can occur in cats.

Pericardial disease

This refers to accumulation of fluid in the sac that surrounds the heart (pericardial sac); this can occur from cancer, trauma, infection or for no known reason (idiopathic).

Heartworm disease

This can occur in dogs and is acquired via mosquitoes; cats living in areas frequented with mosquitoes carrying the heartworm larvae can occasionally acquire this disease. Heartworms, left untreated, will lead to heart failure.

Cardiac tests

Tests are required to differentiate between the different forms of heart disease and indicate what type of treatment is needed.

Radiographs

These show the overall heart size and arteries and veins of the lungs. It can show if one side of the heart is larger than the other and suggest what chambers may be enlarged. It can also check for the presence of fluid associated with the lungs (pulmonary edema or effusion) and for the presence of abdominal fluid (ascites) and other organ enlargement, especially, the liver.

Echocardiogram

This is an ultrasound of the heart, the most useful test there is to determine the presence and type of heart disease. Itallows for the measurement of the chambers (the wall thickness) and for the evaluation of heart valves' efficiency. It indicates overall heart performance and helps to dictate what type of treatment is needed. Follow-up echocardiograms show if the treatment is working or not.

Electrocardiogram (ECG or EKG)

This shows the heart's rate and rhythm and helps to determine what type of arrythmias are present. It can also suggest if there is chamber enlargement.

Blood and urine tests

A blood panel and urine test showing organ function is valuable in evaluating the body as a whole. Sometimes, the heart can affect other organs; sometimes, the animal has concurrent disease. It is important to have a "baseline" of the body'sfunction, before heart medication is started. Some values, especially kidney function and electrolytes, may need to be rechecked over time once treatment is started.

Blood pressure

Hypertension can occur with both heart and kidney disease and can make the animal's condition worse. High blood pressure is treatable and it's control may help the pet's heart condition.

Monitoring

Home monitoring

Since a pet is more relaxed at home, heart and respiratory rates taken at home are more accurate than those in the hospital. It is important to learn to monitor a pet's breathing pattern since this can be a clue of fluid accumulation in the chest and even a pet's heart rate can indicate if the heart disease is under control or not.

A heart rate can be measured by placing a hand on the pet's chest and inside the thigh to feel the femoral artery. An inexpensive stethoscope can serve this purpose also. Count the

heart rate for 15 seconds and multiply the number by four to get the number of beats per minute. Similarly, the respiration rate can be counted. A normal resting heart and respiratory rate for a dog, respectively, is 100-120 beats per minute and 12-20 respirations per minute. A normal resting heart and respiratory rate for a cat, respectively, is 120-160 beats per minute and 24-32 respirations per minute.

Hospital monitoring

Rechecks for radiographs to evaluate lung changes, ultrasound to evaluate heart function, rechecks of blood pressure levels, and blood and urine tests to evaluate organ function while on medications are all important to assuring the pet a good quality of life while coping with heart disease or heart failure. The goal is to make the heart last longer and prevent complications of heart disease and failure by giving daily medications.

Treatment

Treatment is usually medical and is directed at helping the heart cope with the results of its inefficient state. There are many human drugs that are used to manage pets with heart disease and in heart failure. However, is surgery is rarely of help; only in patients with left to right patent ductus arteriosis (PDA) may benefit from surgery.

Diet

Since sodium/ salt can retain water and further increase work on the heart, feeding a prescription low sodium diet is recommended for pets in heart failure. However, it does not appear to be beneficial in preventing heart failure. Diet changes for a pet with heart problems include not feeding salty snacks and commercial dog and cat foods since they tend to have a lot of sodium. However, low sodium diets are less palatable, and some pets refuse to eat them. Examples of low-sodium prescription diets are: Hill's H/D for dogs and Purina's CV for cats. For dogs, there is also a home-made diet formulation.

Diuretics

This is a class of drugs that result in increased urine output as they "draw" fluid out of the lungs. Examples of commonly used drugs are lasix (Furosemide or Disal), spironolactone

(Aldactone) and hydrochlorothiazide (Chlorothiazide). These drugs are overall safe, but animals must be monitored for dehydration, electrolyte imbalances and for the worsening of kidney failure, if present.

Angiotension converting enzyme (ACE) inhibitors

This is a class of drugs that reduce the work load on the heart and lower blood pressure. Examples of commonly used drugs are enalapril (also known as Vasotec or Enacard) or benazapril (Lotensin). These drugs are overall safe, but animals must be monitored for negative effects on the kidneys and excessive lowering of blood pressure.

Digitalis

This is a class of drugs that increase the strength of contractions of the heart. They also have anti-arrythmic effects and are used to control supraventricular arrhythmias. Examples of commonly used drugs are digoxin (Lanoxin) and digitoxin (Crystodigin). These drugs can be toxic and must be used carefully. Blood levels can be monitored as a guide to dosing the drug. Excessively high levels can cause a decreased appetite, kidney dysfunction or ventricular arrhythmias.

Calcium channel blockers

This is a class of drugs that relax the heart tissue and decrease the rate of an excessively fast heart rate, such as in cases of hypertrophy, so the heart can fill more efficiently. They can also be used to treat hypertension. Examples include dilitazem (Cardizem) and amlodipine (Norvasc). These drugs are overall safe but blood pressure must be monitored.

Beta adrenergic blockers

This is a class of drugs that decrease the heart rate and relax the heart muscle in cases of hypertrophy. Examples include atenolol (Tenormin) and sotalol (Betapace).

Oxygen therapy

While it is helpful in an emergency situation for a pet in fulminant heart failure in a hospital, it is not practical for home application.

Nutritional supplements

Taurine- in the past, taurine deficiency was a common cause of dilated cardiomyopathy in cats. Due to supplementation in cat foods, it is a rare condition now. Some forms of dilated cardiomyopathy in dogs, especially that occurring in Cocker spaniels, can be responsive to taurine supplementation.

Carnitine- Some dogs, especially Boxers with dilated cardiomyopathy, may benefit with supplementation of carnitine.

If you have questions regarding this disease, please don't hesitate to call your veterinarian.

The above is general veterinary information. Do not begin any course of treatment without consulting your regular veterinarian. All animals should be examined at least once every 12 months.

Tags:Congenital Heart Defects,Arrythmias,Heart Diseases

Genetic or Congenital Anomalies

Author: Hope Ocampo

Though some congenital anomalies can be put down to genetic problems or environmental problems there is still a strong link between many congenital anomalies and umbilical cords while the baby is still in the womb. The umbilical cord is vital to the survival and good health of your baby and is relatively delicate, meaning that in some cases a small amount of damage can lead to your baby being born with one of several congenital anomalies. However, these cases are quite rare so there is little reason to worry about them unduly.

The length of your umbilical cord can vary widely from less than 35% to more than 80%. And the length of the cord can have an effect on your baby this is usually through knots or similar problems and not simply because the cord is either too long or too short.

Achordia means that you have no umbilical cord and this can be a serious problem, and will at the very least need serious and regular monitoring by your physician. On average, the umbilical cord is 55cm long but determining the actual length of the cord before baby is born is virtually impossible. Exceptionally long cords can lead to knotting and possibly even eventual prolapsing through the cervix, whereas exceptionally short cords can lead to the cord rupturing. Umbilical cord entanglement and excessive fetal movement can lead to prenatal death in rare cases.

Umbilical cords should usually contain two arteries and one vein. A single artery cord will usually lead to congenital defects such as a cleft lip and there is a 20% mortality rate

associated with single artery cord babies. However, this can usually be detected with an ultrasound. A 2 vessel umbilical cord on your ultrasound more than likely indicates a single artery cord. Because further complications are common, such as heart defects and cystic hygroma single artery umbilical cord pregnancies should be tested for further possible congenital complications.

What are complications from cysts on umbilical cord?

There are basically two different types of umbilical cord cysts; these are true cysts and false cysts. Many cysts will clear over time but the longer that one is evident the more likely congenital defects become.

20% of both types of cysts are likely to culminate in a congenital defect of one sort or another, but most commonly these will be structural or chromosomal anomalies. Cysts occur in 3% of all pregnancies but may be diagnosed early in the pregnancy.

A prolapsed cord can lead to serious problems for potentially both mother and baby, and can be caused by an elongated cord, abnormal presentation, prematurity and other problems. The hospital or your preferred care giver will determine whether you are considered to be at risk and if you are then you will need to undergo vaginal and other examinations to ensure that everything goes as smoothly as possible. If the membranes are in tact then the cord should repair itself naturally but if this isn't the case then you will need to undergo an immediate vaginal birth or a caesarian birth but the doctor will know how to access the fetus when the umbilical cord is broken.

The advance of ultrasound and medical science in general means that it is becoming more and more possible to detect these problems before the baby is born and in many cases something can be done to rectify the situation. At the very least further problems associated with these congenital defects and umbilical cords problems can, such as an avulsed umbilical cord, can be avoided. That said, not all problems can be determined prenatally and some problems may not present themselves until after the birth.

congenital heart defects,heart diseases,Congenital Anomalies

Conditions That Contribute To The Development Of Congenital Heart Disease

Author: Joann Cheong

The term "congenital" means inborn or present at birth. So it's understandable that congenital heart disease is a health problem that is present since birth. You may often hear the terms congenital heart defect or congenital cardiovascular disease, but all means the same : a serious health problem that affects thousands of newborns worldwide.

Such disease is said to be present in about one percent of the total live births. It is manifested by a structural defect in the heart and happens when the heart does not develop normally prior to birth. The defects may occur in the heart walls, valves, veins and arteries near the organ. It becomes severe when it starts to disrupt or block the normal flow of the blood and oxygen to the heart, causing the heart to weaken and the heart muscles to die with lack of oxygen.

Doctors found no concrete evidence to show the real cause of congenital heart disease. However, there are certain conditions that may contribute to the development. These include:

• Diabetic mother
• History of the disease in the family
• German measles
• Toxoplasmosis, which is an infection that is transmitted through contact with cat feces
• HIV infection in the mother
• Use of alcohol during pregnancy
• Intake of cocaine and other drugs during pregnancy
• Use of certain prescription and over-the-counter drugs during pregnancy

It is worth noting that although one or more of these condition sare present prior to birth, it doesn't mean that the baby will be born with a congenital heart disease. In the same way, several studies have noted that babies can be born with certain heart defects even if none of the mentioned conditions are present. If this is really the case, then it could be rare for families to exactly identify if their babies will be born with or without such disease. This also means that families can't do anything to prevent their babies from developing such condition. But still, there's nothing wrong from avoiding such contributing factors of congenital heart defects. Mothers should still avoid drugs, alcohol and exposure to the German measles and some environmental toxins, not just for the unborn she is carrying, but also for herself.

Today, the disease is identified in a number of types, and much to your surprise, more than one heart defect may be present at the same time. Among the most common and most treated types of defects are atrial septal defect (ASD), pulmonary stenosis, Ebstein's anomaly, aortic stenosis, ventricular septal defect (VSD), tetralogy of fallot, transposition of the great arteries, and a lot more. Note that each of these types are treated individually, depending on the type and severity of the case.

congenital heart defects,heart diseases

Abnormal Beating of the Heart: Cardiac Arrhythmias

Author: Lindsay Fox

Heart has a rhythmic capability to beat and pump blood to our body and remarkably, does so without fail, throughout our life. The rhythm has been destined to beat in certain prefixed numerical limits and with certain regularity. Arrhythmias are disorders characterized by abnormal beating of the heart. Arrhythmias can occur in a healthy heart and be of minimal consequence. At the same time they may co-exist with diseased heart and may be life-threatening or may cause, stroke, heart failure or sudden death.

An arrhythmia occurs when the normal electrical cycle of the heart is disturbed. Normally, tiny currents activate the upper part of the heart, just before the bottom part of the heart, which are the muscular chambers that pump blood around the body. Fast arrhythmias are referred to as 'tachyarrhythmias'. When the heart goes too slowly due to a failure of electrical activation, it is referred to as a brady arrhythmia. Most arrhythmias arising from the top of the heart are troublesome but not life-threatening. Many arrhythmias arising from the lower of the heart, are life-threatening.

Causes of Cardiac Arrhythmias

Some cardiac arrhythmias result from congenital heart defects that run in families. Others arise from a variety of diseases that develop in individuals over a period of years. Others still result from sudden events such as heart attack. They may also be the result of excessive alcohol, smoking or certain drugs. Rarely despite extensive investigations no cause is found of their occurrence. Cardiac arrhythmias may be symptomatic or may cause a variety of warning symptoms such as palpitations or rapid thumping in the chest, feeling tired or light-headed, getting unconscious, having shortness of breath or chest pain.

Types of Arrhythmias

1. Following are the different types of cardiac arrhythmias:

2. Atrial fibrillation: The heart beats too fast and irregularly. This type of arrhythmia requires treatment and canincrease risk of stroke.

3. Paroxysmal atrial tachycardia: The heart has episodes when it beats fast, but regularly. This type of arrhythmia may be unpleasant but is usually not dangerous.

4. Ectopic beats: The heart has an extra beat. Treatment usually is not needed unless you have several extra beats in row and/or other problems with your heart - such as heart disease or congenital heart failure.

5. Ventricular tachycardia: The heart beats too fast and may not pump enough blood. These types of arrhythmias are very dangerous and need immediate treatment.

The Remedy

Treatment depends on the type of cardiac arrhythmia you have. Some mild arrhythmias require no treatment. Other arrhythmias can be treated with medicines. In more serious cases, other treatments are available:

1. Drugs.

2. A pacemaker: An electronic device placed under the skin on the chest. It helps the heart maintain a regular beat, especially when the heart beats too slowly.

3. Implantable cardiac defibrillation: Can be used to stop an abnormal rhythm and restore a normal one.

4. Surgery: Can correct certain types of arrhythmias. For example, arrhythmias caused by coronary artery disease may be controlled by bypass surgery. When an cardiac arrhythmia is causes by a certain area of the heart, sometimes that part of the heart can be destroyed or removed.

Tags:congenital heart defects,heart diseases,Cardiac Arrhythmias

Down syndrome- Tracing it to the extra DNA

Author: Nilutpal Gogoi

The Down syndrome is also known as trisomy 21 or Down's syndrome. A patient ffected by Down syndrome suffers from acute abnormalities in body functioning which arises from the person's abnormal body structure. The root cause of Down syndrome is the 21st chromosome (DNA). This dysfunction can occur due to the presence of just a portion of the chromosome or the entire genetic material. The Down syndrome symptoms were first documented in detail by the English physician, John Langdon Down, way back in 1866. Hence, it is in his name that the ailment is named. The chromosomal abnormalities insofar as its shape or number is concerned were clearly identified in the 1950s following the discovery of the special karyotype methods.

It was in 1959 that the cause of Down syndrome was traced to the presence of the extra DNA. But it was only in the 21st century that the chromosome was labeled and the ondition termed as trisomy 21. Thus we see that the medical detectives and researchers were unable to pin down the exact cause of Down syndrome till the 20th century. The Down syndrome was found to affect people in all the races. What is more, the Down syndrome was found to attack the women in their advanced years. Another significant aspect of Down syndrome that attracted the attention of the researchers was the rarity of its recurrence. Till the middle part of the last century, the common medical perception on Down syndrome was that it takes place due to several aspects that were basically in herited. Even then the intensive searches for these factors were eluding results. The fact that the Down syndrome was particularly noticed among the mothers after they reach an advanced stage led a school of medical thought to trace the cause of the dysfunction to some shock(s) undergone by the expecting mother. The commonly reported symptoms of Down syndrome are a facial layout that remains as it was during that person's birth, and total impairment in the development of that person's physical appearance. Besides, the Down syndrome affected child fails to have the learning capability, and have retardation besides below par cognitive aptitude. His/her social and emotional abilities are largely dependent on the mental retardation of the child affected by Down syndrome. The child's

mild IQ ranges from 50 to 70 while the moderate IQ ranges from 35 to 50. Those affected by Mosaic Down syndrome have IQ range that may go up by 10-30 points higher. The Down syndrome kids can also develop serious health problems like thyroid

dysfunctions, sleep apnea (obstructive), recurring ear infections, gastroesophageal (reflux) disease, and heart defects that are congenital in nature. Mentionably, there are instances of people possessing the usual sets of DNA also suffering from

the Down syndrome symptoms. The signs are enlarged tongue, speech impairment, shorter limbs, almond (shaped) eyes, and a single crease across one or both palms (simian crease). Depending on the child's disability in the cognitive sphere,. It is of necessity that kids affected with Down syndrome are provided immediate medical attention. Despite the fact that many Down syndrome dysfunctions stays on for life, yet the patient can be taught to adjust with the prevailing physical conditions. For this, the parents or guardians of any child must always be attentive about any such abnormalities in their children. If any such signs are noticed, the physician must be immediately consulted, and the required medical screenings carried out. The initial tests pertain to the thyroid among others. The growing child can be provided vocational training The foremost thing to

remember that Down syndrome patients require a homely environment to recuperate whatever he/she can.

Tags: congenital heart defects,heart diseases,Down syndrome