Heart & Vascular Institute

Aortic stenosis occurs due to the narrowing of the heart’s aortic valve. When the valve does not open properly, there is a blockage or reduction in the blood flow through the heart into the main artery supplying blood to the rest of the body. Aortic stenosis can also be called aortic valve stenosis. Aortic Stenosis Causes Our heart has four valves to keep the blood flow constant and correct – the aortic, mitral, pulmonary, and tricuspid valves. Each valve has flaps that help them open and close themselves once during every heartbeat. If these valves are not open or closed properly, the blood flow is reduced or blocked. In aortic stenosis, the aortic valve, situated between the lower left heart chamber and the aorta, does not open correctly or completely. The part through which blood flows out of the heart to the aorta is shrunk or narrowed. When the opening of the valve narrows, our heart needs to work harder to pump enough blood into the other parts of the body. This extra pressure on the heart can lead to the left ventricle enlarging and thickening. Gradually, heart muscles can weaken, and this can cause heart failure and various other serious heart problems. Some other causes include: Congenital heart defect: Instead of three cups, some children are born with an aortic valve with only two cups. An aortic valve rarely has one or four cups. These valve defects may not cause any problems until adulthood. But, if the valve begins to leak or starts narrowing, congenital heart defects need to be replaced or repaired. Calcium storage on the valve: Usually, storage of calcium on the valve may not lead to any problems. Aortic valve stenosis is related to increasing age, and problems or symptoms are not noticed until the age of 70 or 80. But for some people, usually those who have congenital aortic valve defects, calcium storage may result in damage of aortic valve cups at an early age. Rheumatic fever: This can occur through throat infection, which can further scar the tissues over the aortic valve. Scarred tissues can shrink or narrow the opening of the aortic valve or create a rough surface on which calcium storage can take place.More than one heart valve can be damaged in more than one way due to rheumatic fever. Aortic Stenosis Symptoms Aortic valve stenosis varies from mild to severe. Signs and symptoms of aortic stenosis generally occur when the shrinking or narrowing of the valve is severe. Some people may not have symptoms for many years. Signs and symptoms of aortic stenosis may include: Fluttering or rapid heartbeat (palpitation) An abnormal sound of the heart (heart murmur) which can be heard through a stethoscope Pain over the chest (angina) or tightness while doing an activity Feeling faint or dizzy or fainting while doing an activity Shortness of breath while being active Fatigue while performing increased activity Not eating properly (especially in children with aortic stenosis) Not gaining enough weight (especially in children with aortic stenosis) Aortic stenosis may also lead to heart failure. Heart failure signs and symptoms include shortness of breath, fatigue, and swollen feet and ankles. Aortic Stenosis Diagnosis Aortic stenosis can often be found during an examination when your doctor listens to the heart rate. But murmuring sounds generally cannot reflect the severity of the aortic stenosis. Your doctor will prescribe some tests to confirm and determine the issue or damage to your heart valve. These tests may include: Electrocardiogram (ECG) Chest X-ray Echocardiogram (heart ultrasound) Cardiac Computed Tomography (CAT scan) Cardiac Catheterization (heart catheterisation and or coronary angiogram). Stages of Aortic Stenosis The stages in patients with severe aortic stenosis are determined according to the presence or absence of cardiac damage detected by echocardiography before AVR. Stage 0: If no extra valvular cardiac is damaged. Stage 1: If the left ventricle is damaged. Stage 2: If the left atrial or mitral valve is damaged. Stage 3: If the pulmonary vasculature or tricuspid valve is damaged. Stage 4: If the right ventricular is damaged. Aortic Stenosis Treatment The treatment plan usually depends upon how severe the patient's condition is. Mild cases require regular checkups as well as echocardiograms by the doctors. Medications for Aortic Stenosis Medications are administered to control the symptoms and avoid complications. Along with medications for aortic stenosis, doctors also prescribe: Medicine to control heart rate problems ACE inhibitors to help in the proper opening of blood vessels Beta-blockers to lower the heart rate. Diuretics (“water pills”) to reduce the amount of liquid in the body and ease the stress on the heart Surgery for Aortic Stenosis In severe cases, surgeries are done to repair the faulty valve or replace it. It includes: Balloon Valvuloplasty This procedure is suitable for children and for patients who are too weak for open heart surgery. It opens the faulty heart valve. A flexible, thin catheter is inserted with an attached deflated balloon via the through into the aortic valve. Once the correct location is reached, the balloon inflates and stretches the narrowed valve. The balloon then deflates and comes out from the same pathway. The effect of this procedure is temporary. Replacement Surgeries Artificial or biological valve replacement: It involves aortic valve with replacement (artificial valves) or The artificial valve are of two types I.e mechanical to tissue valve. Mechanical last longer; however, patients must switch to blood thinners for the rest of their lives. Meanwhile, tissues from other animals or humans last for 10–15 years before needing to be replaced again. Transcatheter Aortic Valve Replacement (TAVR): Transcatheter Aortic Valve Replacement (TAVR) is similar to balloon valvuloplasty and involves using a catheter threaded to the heart's artery. The catheter passes through the groin (transfemoral), neck (carotid), and chest (transapical). The tube carries an attached deflated balloon and the replacement valve. After positioning the replacement valve, the balloon is inflated. This positions the replacement valve at the correct place inside the damaged valve. The balloon is then deflated and removed along with a catheter. Risk Factors of Aortic Stenosis Risk factors of aortic valve stenosis include: Old age Some heart conditions present at birth (congenital heart disease), like a bicuspid aortic valve. Prior history of infections that can affect the heart valves. Having cardiovascular risk factors, such as high blood pressure, diabetes, and high cholesterol. Chronic kidney disease Prior history of radiation therapy over the chest. Complications of Aortic Stenosis Aortic valve stenosis can cause some severe complications, which include: Heart failure Stroke Heart rate problems (arrhythmia) Endocarditis infections that affect the heart Death. Aortic Stenosis Prevention There are some possible ways to prevent aortic stenosis: Take necessary steps to prevent rheumatic fever. Maintain your blood pressure. Take care of your teeth and gums. Maintain your cholesterol. Quit smoking and alcohol. Maintain your blood sugar. Epidemiology of Aortic Stenosis Population over the age of 65 Population with cardiovascular diseases Certain heart conditions by birth, like bicuspid aortic valve Prior history of infection. Expected Prognosis of Aortic Stenosis Without any surgical treatment, the survival rate of symtomatic aortic stenosis is 2–3 years.

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Atrial fibrillation (AFib) is a type of arrhythmia, causing an irregular and often rapid heartbeat. This condition can lead to blood clots in the heart and raises the risk of stroke, heart failure, and other serious heart-related issues. Atrial Fibrillation Causes Atrial fibrillation has no known exact cause, but it has been linked to several diseases, including: Heart valve abnormalities, particularly the mitral valve Cardiomyopathy - A disease of the heart muscle. Ischemia - A condition in which blood flow to the heart is reduced. Hypertension Hypertrophy - An enlarged heart chamber Surgery on the heart (open-heart surgery) Pulmonary embolism - A blood clot in a pulmonary blood artery. COPD (chronic obstructive pulmonary disease) is a disorder in which the amount of oxygen in the blood decreases. Hyperthyroidism - An overactive thyroid gland. Pericarditis - A condition in which the pericardium-the sac-like covering around the heart becomes inflamed. Infections caused by viruses, such as the Human Immunodeficiency Virus (HIV/AIDS), Covid-19, and others. Lifestyle causes - This can include drinking too much alcohol, smoking, drinking too much caffeine, taking specific prescriptions like diet pills or cold meds, etc. Atrial Fibrillation Symptoms Heart palpitations (a racing or pounding feeling in your chest). Reduced ability to exercise due to weakness, lack of energy, or feeling overtired Lightheadedness or faintness. Shortness of breath - having trouble breathing throughout everyday activities and even at rest. Discomfort in the chest—a sensation of pain, pressure, or discomfort in the chest. Stages of Atrial Fibrillation Different stages/types of atrial fibrillation are- Occasional atrial fibrillation - In it, atrial fibrillation occurs from time to time. Paroxysmal atrial fibrillation is another name for it, and it can last anywhere from a few minutes to several hours. The signs and symptoms may fade away on their own. Persistent atrial fibrillation - Atrial fibrillation that persists. The heart rhythm does not return to normal on its own. To restore and maintain a normal cardiac rhythm, the person may require cardioversion or pharmaceutical treatment. Long-standing persistent - It persists for a long time. It is ongoing and lasts for more than a year. Permanent - The abnormal heartbeat cannot be corrected in this type of atrial fibrillation. Medications are required to keep the heart rate under control and prevent blood clots. Atrial Fibrillation Diagnosis The most commonly used tests to diagnose atrial fibrillation are: Electrocardiogram (ECG or EKG) Echocardiogram Electrophysiology (EP) studies Holter monitors Stress test Chest X-ray Atrial Fibrillation Treatment Your doctor will choose the best treatment for you based on the kind and severity of your arrhythmia. The following are examples of treatments: Medications Specific medications to help you calm down your heart rate. Heart rhythm drugs (also known as chemical cardioversion) reduce electrical signals to return your heartbeat into a normal sinus rhythm and help prevent stroke. Electrical cardioversion An electric current shocks the heart into a regular sinus rhythm. Catheter ablation In Catheter ablation, a thin metal-tipped wire catheter is threaded through a vein in the leg and the heart. The electricity is sent through these small wires to kill the little patches of heart tissue that cause atrial fibrillation. Pacemaker A pacemaker is a tiny device inserted beneath the skin beneath the collarbone. It is used to treat irregular heartbeats. Biventricular pacemaker Biventricular pacemaker is a novel pacemaker that coordinates the contractions of both ventricles of the heart and improves pumping ability. Risk Factors of Atrial Fibrillation Atrial fibrillation is more likely to develop if you have any of the following risk factors: Hypertension - Long-term, uncontrolled high blood pressure can raise the chance of atrial fibrillation or fibrillation. Heart diseases - such as coronary artery disease, heart valve disease, heart muscle disease, and heart infection are underlying heart disorders. Prior heart attack, past heart surgery, Wolf-white Parkinson's syndrome, etc. Family history of atrial fibrillation - If you have a relative with this problem, you are more likely to get it. Sleep apnea, or sleep disorder, is a condition in which breathing stops and starts repeatedly. Other chronic illnesses - People with diabetes, asthma, thyroid disease, and other chronic conditions also risk developing atrial fibrillation. Possible Complications of Atrial Fibrillation The most serious side effect of AF is an increased risk of stroke. AF causes turbulent blood flow in the heart chambers. A tiny blood clot can form in the heart chamber due to this. Other consequences include heart failure, heart muscle weakness (dilated cardiomyopathy), angina or chest pain intensifying, etc. Atrial Fibrillation Preventions Primary Prevention of Atrial Fibrillation Basic preventive strategies that can help prevent atrial fibrillation (or A-fib) are - Give up smoking Eat a diet rich in plant-based foods, fruits, and vegetables, and low in saturated fats. Physically active & maintaining a healthy weight. If you are obese or overweight, try to keep a normal weight. Limit your intake of alcohol and caffeine Blood sugar, blood pressure, and cholesterol levels should all be kept at a safe level. Increase your physical activity by exercising every day. Secondary Prevention of Atrial Fibrillation A preventative therapy used to prevent the re-occurrence of the Atrial fibrillation includes - Take your prescriptions regularly, and make sure you follow the surgeon's medication and dietary recommendations. Keep a symptom diary. Write down any quivering episodes you have and the time and other symptoms you are experiencing. Recognize Triggering Variables. Make a list of potential triggering factors for an irregular heartbeat, such as stress, caffeine, and alcohol. It is possible to avoid these triggers if you are aware of them. Epidemiology of Atrial Fibrillation The prevalence of AF in the general population rises with age, from 0.12–0.16 per cent in those under 49 years old to 1.7–4.0 per cent in those 60–70 years old and as high as 13.5–17.8 per cent in those over 80 years old. AF incidence and prevalence are larger among men and women who are older at the time of AF diagnosis. They have a larger risk for AF-associated adverse outcomes such as morality and stroke. Based on findings from epidemiological research, males with a higher BMI appear to have a higher risk of AF. Natural Progression of Atrial Fibrillation Although atrial fibrillation is rarely fatal initially, it does reduce the efficiency with which your heart pumps blood. This can result in a blood clot forming in your heart. A stroke could occur if the clot breaks loose. Atrial fibrillation can cause a fast heartbeat if left untreated. The duration and frequency of AF paroxysms generally increase over time, and many patients eventually develop permanent AF. Pathophysiology of Atrial Fibrillation Atrial fibrillation is classified as “typical” or “atypical” depending on the location of the short circuit (the pathway that allows the electrical signal to move too fast around the heart) The right atrium is where typical atrial fibrillation occurs. Atrial fibrillation that originates in the left atrium is known as a typical atrial fibrillation. Related Blogs Protect Your Brain Health: How Lifestyle Changes and Medical Intervention Can Help Prevent Stroke Brain Stroke: Warning Signs, Symptoms, and Prevention

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Atrial flutter (AFL) is a type of arrhythmia characterised by a rapid but regular heartbeat originating in the atria, the heart's upper chambers. This condition frequently results in poor blood circulation and heightens the likelihood of blood clots and strokes. While it shares similarities with atrial fibrillation (AFib), atrial flutter's rhythm is more organised and regular. Timely diagnosis and intervention are essential for managing symptoms, avoiding complications, and enhancing overall quality of life. Alternate Name of Atrial Flutter Supraventricular arrhythmias Types of Atrial Flutter There are several types of atrial flutter, including: Typical atrial flutter The most common form, where the electrical impulse follows a circular path within the right atrium. Reverse typical atrial flutter Similar to typical flutter but with the electrical circuit moving in the opposite direction. Atypical atrial flutter Less common and can occur in either atrium, often after heart surgery or catheter ablation. Recognising the type of atrial flutter aids in determining the most appropriate treatment approach. Atrial Flutter Symptoms Atrial flutter often presents with distinct symptoms, though they may vary in severity: Palpitations: Noticeable rapid or irregular heartbeats that can be unsettling. Fatigue: Persistent tiredness due to the heart's reduced efficiency in pumping blood. Shortness of breath: Breathing difficulties, especially during physical activities, caused by insufficient oxygen supply. Dizziness or lightheadedness: Sensations of fainting or unsteadiness caused by reduced blood circulation to the brain. Chest pain: Chest discomfort or tightness, often mistaken for a heart attack. Fainting: Temporary loss of consciousness, particularly during episodes of rapid heartbeats. Weakness: A general feeling of weakness, especially during exertion. These symptoms differ from other arrhythmias and warrant medical attention, especially if they are persistent or severe. Atrial Flutter Causes Atrial flutter can be triggered by various underlying factors, including: Heart disease: Conditions such as coronary artery disease or hypertension that strain the heart. Previous heart surgery: Procedures, especially involving the atria, can disrupt normal heart rhythms. Lung diseases: Chronic obstructive pulmonary disease (COPD) and other lung conditions can affect heart function. Electrolyte imbalances: Abnormal levels of electrolytes such as potassium or magnesium can lead to arrhythmias. Alcohol consumption: Excessive alcohol intake is a known trigger for atrial flutter episodes. Identifying these causes helps in crafting a personalised treatment plan. Stages of Atrial Flutter Different stages/types of atrial flutter are- Occasional atrial fibrillation In it, atrial fibrillation occurs from time to time. Paroxysmal atrial fibrillation is another name for it, and it can last anywhere from a few minutes to several hours. The signs and symptoms may fade away on their own. Persistent atrial fibrillation Atrial fibrillation that persists. The heart rhythm does not return to normal on its own. To restore and maintain a normal cardiac rhythm, the person may require cardioversion or pharmaceutical treatment. Long-standing persistent It persists for a long time. It is ongoing and lasts for more than a year. Permanent The abnormal heartbeat cannot be corrected in this type of atrial fibrillation. Medications are required to keep the heart rate under control and prevent blood clots. Atrial Flutter Diagnosis Diagnosing atrial flutter involves several tests: Electrocardiogram (ECG) A primary tool to detect abnormal heart rhythms. Holter monitor A portable device that continuously monitors heart activity for 24 to 48 hours. Event monitor Similar to a Holter monitor but worn longer to capture intermittent symptoms. Echocardiogram A heart ultrasound to evaluate its structure and functionality. Electrophysiology study (EPS) An invasive test to map the heart's electrical activity and pinpoint the source of arrhythmias. Accurate diagnosis is critical for selecting the right treatment and preventing complications. Atrial Flutter Treatment Treatment aims to restore normal heart rhythm and prevent future episodes. Medications Antiarrhythmic drugs: Medications that help restore normal rhythm and prevent future episodes. Blood thinners: These reduce the risk of stroke by preventing blood clots. Beta-blockers and calcium channel blockers: Help control heart rate and reduce symptoms. Cardioversion Electrical cardioversion: A method in which an electrical shock is administered to the heart to restore its normal rhythm. Chemical cardioversion: Involves administering medications to restore normal rhythm without a shock. Cardioversion is generally effective, though it may need to be repeated in some cases. Catheter Ablation How it works: A minimally invasive procedure where a catheter destroys the area causing the arrhythmia. Candidate selection: Ideal for those with recurrent atrial flutter or who do not respond to medications. Risks and benefits: While highly effective, it carries risks such as bleeding or infection. Lifestyle Changes Healthy diet: A diet low in sodium and unhealthy fats helps manage heart conditions. Regular exercise: Promotes overall heart health and reduces arrhythmia risks. Stress management: Techniques such as meditation or yoga can help prevent arrhythmia triggers. Monitoring and follow-up care: Regular check-ups are vital to adjust treatment plans as needed. Lifestyle changes complement medical treatments and can reduce the frequency of atrial flutter episodes. Risk Factors of Atrial Flutter Certain factors increase the likelihood of developing atrial flutter: Age: The risk increases with age, especially after 60. Gender: Males are more likely to develop atrial flutter than females. Heart conditions: Pre-existing conditions like heart failure or valvular heart disease raise the risk. Lifestyle factors: Smoking and excessive alcohol use are significant contributors. Genetics: A family history of arrhythmias can predispose individuals to atrial flutter. Understanding these risk factors is important for both prevention and early intervention. Complications of Atrial Flutter Atrial flutter can lead to several serious complications: Increased risk of stroke: Blood clots formed due to inefficient heart pumping can lead to strokes. Heart failure: The heart may weaken over time, leading to heart failure. Thromboembolism: Blood clots can travel to other body parts, causing blockages. Recurrence: Even after treatment, atrial flutter can return, necessitating ongoing management. Addressing these complications early is key to improving long-term outcomes. Prevention of Atrial Flutter Preventive strategies include: Healthy heart tips: Maintaining a balanced diet, regular exercise, and avoiding smoking are foundational for heart health. Avoiding triggers: Limiting alcohol and managing stress help reduce the likelihood of arrhythmias. Regular medical check-ups: Timely detection and intervention can prevent atrial flutter from progressing. These steps are vital for those at risk and those already diagnosed with atrial flutter. Primary Prevention of Atrial Flutter Basic preventive strategies that can help prevent atrial flutter (or A-fib) are - Give up smoking Eat a Mediterranean-style diet to keep your heart healthy (high in plant-based foods, fruits, and vegetables, and low in saturated fats) Physically active & maintaining a healthy weight. If you are obese or overweight, try to keep a normal weight. Limit your intake of alcohol and caffeine Blood sugar, blood pressure, and cholesterol levels should all be kept at a safe level. Increase your physical activity by exercising every day. Secondary Prevention of Atrial Flutter A preventative therapy used to prevent the recurrence of the Atrial flutter includes - Take your prescriptions regularly, and make sure you follow the surgeon's medication and dietary recommendations. Keep a symptom diary. Write down any quivering episodes you have and the time and other symptoms you are experiencing. Recognize Triggering Variables. Make a list of potential triggering factors for an irregular heartbeat, such as stress, caffeine, and alcohol. It is possible to avoid these triggers if you are aware of them. Managing Atrial Flutter Long-Term Long-term management focuses on: Regular check-ups: Monitor heart health and adjust treatments as needed. Treatment adjustments: Medications or procedures may need to be revised based on how the condition evolves. Complication management: Ongoing vigilance is required to manage potential complications like stroke or heart failure. Effective long-term management can significantly improve quality of life and reduce the risk of severe outcomes. When to Seek Emergency Care Emergency care is necessary if: Signs of stroke: Sudden weakness, difficulty speaking, or vision problems require immediate medical attention. Heart failure symptoms: Severe shortness of breath, leg swelling, or fatigue may indicate heart failure. Persistent atrial flutter symptoms: If symptoms are severe or do not resolve, seeking immediate care is critical. Epidemiology of Atrial Flutter The prevalence of AF in the general population rises with age, from 0.12–0.16 per cent in those under 49 years old to 1.7–4.0 per cent in those 60–70 years old and as high as 13.5–17.8 per cent in those over 80 years old. AF incidence and prevalence are larger among men and women who are older at the time of AF diagnosis. They have a larger risk for AF-associated adverse outcomes such as morality and stroke. Based on findings from epidemiological research, males with a higher BMI appear to have a higher risk of AF. Expected Prognosis of Atrial Flutter Overall mortality increases as a result of atrial flutter. It usually transitions to normal sinus rhythm or atrial fibrillation within a week, but it might last weeks or months on rare occasions. Natural Progression of Atrial Flutter Although atrial flutter is rarely fatal initially, it does reduce the efficiency with which your heart pumps blood. This can result in a blood clot forming in your heart. A stroke could occur if the clot breaks loose. Atrial flutter can cause a fast heartbeat if left untreated. The duration and frequency of AF paroxysms generally increase over time, and many patients eventually develop permanent AF. Pathophysiology of Atrial Flutter Atrial flutter is classified as “typical” or “atypical” depending on the location of the short circuit (the pathway that allows the electrical signal to move too fast around the heart) The right atrium is where typical atrial flutter occurs. Atrial flutter that originates in the left atrium is known as atypical atrial flutter. Frequently Asked Questions 1. What is the difference between atrial flutter and atrial fibrillation? Atrial flutter involves an abnormally rapid heartbeat, while atrial fibrillation is an irregular, chaotic rhythm. Both can cause similar symptoms but differ in their heart rhythm patterns. 2. Can you live a long life with atrial flutter? Yes, with proper management and treatment, many people live a long, healthy life despite having atrial flutter. 3. How does atrial flutter affect my body? Atrial flutter can reduce the heart's efficiency, leading to symptoms like palpitations, fatigue, and dizziness, potentially increasing stroke risk. 4. How long does the atrial flutter last? Atrial flutter episodes can last from minutes to hours. Some may experience it intermittently, while others have persistent symptoms. 5. Can atrial flutter be cured? Yes, atrial flutter can often be cured through catheter ablation, which targets and eliminates the abnormal electrical circuits causing the arrhythmia. 6. Can a flutter cause heart failure? If left untreated, atrial flutter can weaken the heart, leading to heart failure, especially in those with existing heart conditions.

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Cardiomyopathy is a complex heart condition characterised by the weakening of the heart muscle, leading to impaired blood flow. It can affect people of all ages and, if left untreated, may lead to severe complications, such as heart failure or arrhythmias. Associated Anatomy of Cardiomyopathy Heart, myocardium Alternate Name of Cardiomyopathy Hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy. Types of Cardiomyopathy Hypertrophic cardiomyopathy Hypertrophic cardiomyopathy is usually genetic and occurs when the heart muscles become thick and prevent the blood flow through your heart. Dilated cardiomyopathy It is the most common type of cardiomyopathy and occurs as a result of an enlarged heart muscle. This makes the heart too weak to pump blood efficiently. It can be inherited or be the result of coronary artery disease, valve disease, congenital heart disease etc. Restrictive cardiomyopathy It occurs due to stiffening of the ventricles, resulting in inadequate filling of the blood. Ischemic cardiomyopathy Ischemic cardiomyopathy occurs when coronary arteries become narrowed or obstructed, decreasing blood flow to the heart muscle. This condition often results from a previous heart attack, which weakens the heart's ability to pump blood effectively. Patients may experience symptoms such as chest pain, fatigue, and shortness of breath. Arrhythmogenic right ventricular dysplasia (ARVD) ARVD is a rare inherited condition characterised by the replacement of healthy heart muscle in the right ventricle with fatty or fibrous tissue. This can lead to life-threatening arrhythmias. Symptoms include palpitations, dizziness, and fainting, primarily affecting young adults and athletes. Transthyretin amyloidosis cardiomyopathy (ATTR-CM) ATTR-CM occurs when abnormal deposits of the protein transthyretin accumulate in the heart, leading to thickening and stiffening of the heart muscle. This condition is more common in older adults and can be hereditary or acquired. Symptoms may include fatigue, shortness of breath, and leg swelling. Broken heart syndrome (Takotsubo cardiomyopathy) Often triggered by severe emotional or physical stress, broken heart syndrome mimics the symptoms of a heart attack. The heart's left ventricle temporarily weakens and balloons out, leading to chest pain and shortness of breath. Fortunately, this condition is usually temporary and reversible with proper treatment. Chemotherapy-induced cardiomyopathy Certain chemotherapy drugs can damage heart cells, leading to chemotherapy-induced cardiomyopathy. This type of cardiomyopathy may develop during or after cancer treatment and requires careful monitoring and management. Symptoms may consist of fatigue, shortness of breath, and swelling. Alcohol-induced cardiomyopathy Excessive alcohol consumption over an extended period can weaken the heart muscle, leading to alcohol-induced cardiomyopathy. This condition is preventable and may be reversible with lifestyle changes, including reducing or eliminating alcohol intake. Left ventricular non-compaction (LVNC) Left ventricular non-compaction (LVNC) is a rare congenital condition in which the heart muscle in the left ventricle doesn't develop properly, leading to a spongy appearance. This can result in heart failure, arrhythmias, and blood clots. Symptoms vary widely but may include fatigue, shortness of breath, and palpitations. Peripartum cardiomyopathy Peripartum cardiomyopathy is a rare but serious condition that occurs in the last month of pregnancy or within five months after delivery. The heart becomes weakened, leading to symptoms of heart failure such as swelling, fatigue, and shortness of breath. Early diagnosis and treatment are crucial for a favourable outcome. Cardiomyopathy Causes Mostly, cardiomyopathy occurs without any warning, and the cause remains unknown. In other cases, the cause can either be inherited or acquired. Having inherited causes means you were born with cardiomyopathy due to your parents' genes, whereas having acquired causes means you got them as a consequence of another disease or factor. Some common causes of cardiomyopathy are listed below: Coronary artery disease Valvular heart disease Infection in the heart muscle A family history of heart attacks, sudden cardiac arrest, or cardiomyopathy Hypertension Autoimmune disease Diabetes Alcohol abuse Viral infections Conditions that damage the heart, like high cholesterol Drugs like cocaine, amphetamines, and anticancer medications Cardiomyopathy Symptoms The signs and symptoms associated with cardiomyopathy are listed below: Fatigue Shortness of breath Rapid heartbeats or heart palpitations Chest pain Swelling of the lower limbs Dizziness Restlessness, agitation due to low oxygen in the brain Unconsciousness or syncope Ascites, or bloating of the stomach Swelling in the lower limbs Coughing when lying in a horizontal position Cardiomyopathy Diagnosis Chest X-ray A diagnostic chest X-ray is performed to determine whether the heart is enlarged. Cardiac CT Cardiac CT is a procedure that uses X-rays to create a video of the heart and blood arteries. Cardiac Catheterization A catheter (a tiny tube put into a blood vessel) is used to measure the heart's blood flow and pressure during cardiac catheterization. Echocardiography During an echocardiogram, sound waves are used to create an image of your blood flow and heartbeat. Angiography Angiography is used to rule out ischemic heart disease. A dye is injected into the vein to highlight any blockage in the artery. Cardiac MRI Cardiac MRI creates images of the heart using radio waves and magnets. Electrocardiogram (ECG) An ECG is a non-invasive test that records the heart's electrical activity. It can detect abnormalities in heart rhythm, structure, and function, providing valuable information for diagnosing cardiomyopathy. Stress Test The purpose of an exercise stress test is to boost your heart rate in a controlled manner to see how your heart reacts to stress. Myocardial biopsy A small sample of heart muscle tissue is examined for cell alterations during a myocardial biopsy. Ambulatory monitoring Ambulatory monitoring involves wearing a portable device, such as a Holter monitor, that records the electrical activity of the heart for around 24 to 48 hours or longer. This test helps detect irregular heart rhythms (arrhythmias) and assess the severity of the condition. Blood tests Blood tests can identify markers of heart damage, such as elevated levels of certain enzymes and proteins, as well as underlying conditions like thyroid disorders or infections that may contribute to cardiomyopathy. Cardiomyopathy Treatment The treatment of cardiomyopathy varies depending on its type, cause, and severity of symptoms. Medication It includes diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, and digoxin. Devices to Correct Cardiomyopathy Pacemakers: These devices help regulate abnormal heart rhythms by sending electrical impulses to the heart. Implantable Cardioverter Defibrillators (ICDs): ICDs monitor heart rhythms and deliver shocks if life-threatening arrhythmias are detected, preventing sudden cardiac death. Devices to Improve Blood Flow Cardiac Resynchronisation Therapy (CRT): CRT uses a special pacemaker to improve the timing of the heart's contractions, enhancing its efficiency. Left Ventricular Assist Device (LVAD): LVADs are mechanical pumps that help the heart pump blood from the left ventricle to the rest of the body. They are often used in cases of severe heart failure. Surgery If symptoms are severe and medications aren't working, valve surgery, bypass surgery, or a heart transplant may be an option. Septal myectomy: It includes removing some cardiac tissue to increase blood flow through the heart. Via open heart surgery. Heart transplant: In cases of advanced heart failure where alternative therapies have proven ineffective, a heart transplant may represent the sole viable solution. Alcohol septal ablation: This procedure treats hypertrophic cardiomyopathy by injecting alcohol into the small artery supplying the thickened heart muscle, reducing its size. Catheter Ablation: This procedure targets and destroys the small areas of heart tissue causing arrhythmias, helping to restore normal rhythm. Risk Factors of Cardiomyopathy Cardiomyopathy can affect anyone at any age. The following conditions or lifestyle choices can act as risk factors for cardiomyopathy: A family history of cardiomyopathy, cardiac arrest, or heart failure is a major risk factor. Long-term high blood pressure Coronary artery disease (CAD) or cardiovascular illness Previous heart attacks Infections that induce heart inflammation and heart valve problems Diabetes Obesity Thyroid problems Abnormalities of the connective tissue Cocaine or amphetamine abuse Certain cancer treatment options Toxins, such as lead and mercury Cocaine and alcohol abuse Sarcoidosis Hemochromatosis Amyloidosis Complication of Cardiomyopathy Cardiomyopathy can be life-threatening. Since the heart can't pump blood effectively, blood clots might form in the heart. If clots enter the bloodstream, they can block blood flow to other organs, including the heart, lungs, and brain. The heart valves might not close properly, causing blood to flow backwards in the valve. Cardiomyopathy can trigger an irregular heartbeat that causes fainting. In some cases, it can also lead to heart failure or sudden cardiac arrest. Cardiomyopathy Preventions Primary Prevention of Cardiomyopathy Cardiomyopathy is genetically inherited and cannot be prevented. However, its symptoms can be reduced by following a healthier lifestyle. Early detection and treatment of etiological factors can help lead a better quality life. Secondary Prevention of Cardiomyopathy Diet: Limit your intake of sugary, fried, fatty, and processed meals to maintain a heart-healthy diet. Eat more fruits, vegetables, whole grains, lean proteins, nuts, seeds, and low-fat dairy. Limit your salt (sodium) intake. Maintain a healthy weight. Stop smoking: Smoking can harm your heart, blood, blood vessels, and overall cardiovascular system. Exercise regularly: Limit your sitting time and aim to exercise for at least 30 minutes on most days of the week. Epidemiology of Cardiomyopathy Cardiomyopathy can affect as many as one in every 500 adults. Cardiomyopathy can affect men and women of different ages and races. Blacks have a higher rate of dilated cardiomyopathy than whites, and males have a higher rate than females. The most prevalent inherited or genetic cardiac condition is hypertrophic cardiomyopathy. Expected Prognosis of Cardiomyopathy Cardiomyopathy can be fatal and reduce life expectancy. As the disease progresses, it worsens over time if left untreated. Treatments can help you live longer by reducing the deterioration of your heart's condition. If you have cardiomyopathy, you must adjust your lifestyle to improve your heart's health. Visit your doctor for regular treatment and follow-ups. Natural Progression of Cardiomyopathy The progression of the disease varies greatly from person to person. In some people, symptoms may appear suddenly and worsen quickly. Others may see a gradual development over a period of time. Patients experience abnormal heart rhythms and cardiac failure as the disease progresses. Sudden death due to ventricular arrhythmias can also occur. Pathophysiology of Cardiomyopathy Due to the underlying cause, there is inflammation and rapid degeneration of myocardial fibres, resulting in ventricular dilation. Blood flow is stagnant or slow in the chambers of the dilated heart. It results in weaker contractions of the ventricles to pump blood. Less cardiac output reduces oxygen supply to the body and leads to the failure of the heart. Outlook The outlook for cardiomyopathy varies depending on the type, severity, and timeliness of treatment. With early diagnosis and appropriate management, many patients can lead active lives and manage symptoms effectively. However, some forms of cardiomyopathy, particularly those that are genetic or progressive, may require long-term care and monitoring. Frequently Asked Questions 1. What can I expect if I have cardiomyopathy? Patients with cardiomyopathy should expect regular monitoring and treatment to manage symptoms and prevent complications. Lifestyle changes and medication adherence are crucial for maintaining heart health. 2. How long does cardiomyopathy last? The duration of cardiomyopathy varies depending on the type and response to treatment. Some forms may be temporary, while others can be chronic and require lifelong management. 3. How do I take care of myself? Patients should follow their healthcare provider's advice, including taking prescribed medications, maintaining a healthy diet, exercising regularly, avoiding alcohol, and attending regular check-ups. 4. How common is cardiomyopathy? Cardiomyopathy affects millions of people worldwide, with varying prevalence depending on the type. It can occur in people of all ages, though some forms are more common in specific populations. 5. Is cardiomyopathy curable? While some forms of cardiomyopathy are manageable with treatment, others may not be curable. However, many patients can achieve a good quality of life with proper care. 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Carotid Artery Disease is a medical condition characterised by the narrowing or stenosis of the carotid artery (that supplies blood to the head and brain) due to the deposition of the plaques along the walls of the arteries. The fatty substance or cholesterol deposits in the artery leading to increased stroke risk. Alternate Name of Carotid Artery Disease Carotid artery stenosis Carotid Artery Disease Causes The most prominent cause of carotid artery disease is plaque formation due to the deposition of various substances along the carotid artery wall, such as cholesterol, calcium. The plaque formation leads to atherosclerosis of the carotid artery. Clogging leads to stiffness and narrowing of the artery. This increases the risk of cerebrovascular stroke. Carotid Artery Disease Symptoms There could be no visible signs and symptoms of carotid artery disease during the initial stages. As the clogging increases, the blood supply to the brain is affected and could lead to stroke or transient ischemic attack (TIA) with the presentation of the following symptoms: Sudden onset of numbness or weakness in the limbs or face, usually on one side Sudden onset of severe headache Sudden loss of balance Sudden trouble in the vision of one or both eyes Sudden trouble speaking Sudden dizziness Confusion. Carotid Artery Disease Diagnosis Presentation of carotid artery disease might mimic other disorders or cardiac conditions such as aortic valve stenosis, seizures, fibromuscular dysplasia, carotid artery dissection, cerebellar infarction, complex migraine headache, stroke, atrial fibrillation associated with a cardioembolic event, etc.; hence a differential diagnosis is required to rule out other possibilities. Carotid Artery Disease Test Typical diagnosis includes a physical examination and monitoring of vitals such as blood pressure and pulse. Your doctor monitors blood flow in your carotid artery by hearing the sound of the blood using a stethoscope placed on your neck. The doctor will also run certain blood tests to examine parameters such as calcium levels, cholesterol levels, etc. In addition, you might also be required to undergo an ultrasound, cerebral angiography, CT angiography, or magnetic resonance imaging (MRI) angiography to confirm the diagnosis. Stages of Carotid Artery Disease Carotid artery disease can be classified into three stages depending upon the blockage: Mild: Blockage of the artery is less than 50%. Moderate: Blockage of the artery is 50-79%. Severe: Blockage of the artery is 80-99%. Carotid Artery Disease Treatment It depends on the severity of the disease and the patient's age. The following treatment options can be considered: Lifestyle Changes A timely diagnosis before the onset of stroke can be treated by lifestyle modifications such as regular exercise, managing stress, eating a balanced diet, quitting smoking, limiting alcohol use, etc. Medications Various medications, such as cholesterol-lowering drugs, blood pressure-lowering drugs, etc., could be prescribed to reduce the risk of developing stroke. Medications are also prescribed after the surgery to prevent recurrences. Surgery In the case of stroke, surgery is a preferred treatment option. Carotid endarterectomy could be used in severe cases to cut the carotid artery and remove the blockage. Risk Factors of Carotid Artery Disease Risk factors for carotid artery disease include the following: Age: Arteries become less flexible with age, and the risk of carotid artery disease increases. Obesity: Obesity and excess weight leads to an excess of fats in the body that increase the risk of carotid artery disease. Diabetes: Diabetes affects your fat metabolism and increases the risk of developing carotid artery disease. High blood pressure: High blood pressure weakens the walls of the arteries and makes them more prone to injury, increasing the risk of plaque formation. Tobacco use: Smoking or tobacco use puts you at a greater risk of developing carotid artery disease. Family history: Having a family history of carotid artery disease or atherosclerosis increases your chances of developing carotid artery disease. Sedentary lifestyle: Lack of physical activity or exercise leads to an increased risk of carotid artery disease. Complications of Carotid Artery Disease Untreated carotid artery disease can lead to the following complications: Carotid artery occlusion: An increase in blockage of the artery can lead to complete occlusion. Stroke or TIA: Stroke or TIA is a common complication of carotid artery disease due to the reduced blood supply and lack of nutrients to the brain. Death: Severe cases of stroke can lead to sudden death. Carotid Artery Disease Prevention Primary Prevention of Carotid Artery Disease The risk of carotid artery disease and associated stoke can be reduced or prevented by the following preventive measures: Eating a balanced diet: Eating a balanced diet with a good mix of protein, carbohydrates, and fats is crucial for good metabolism and overall health. Adding fruits, nuts, and leafy vegetables has great effects on vascular health. Exercise: You should aim to exercise for at least 30 minutes a day or 150 minutes a week to maintain a healthy heart. Also, get physically active to stay ahead of the disease. Regular health check-ups: Regular monitoring of blood pressure and cholesterol levels and getting regular check-ups are crucial to keeping your vascular health and reducing the risk of carotid artery disease. Managing stress: Practice yoga, mindfulness, etc. to reduce stress in your life Quit smoking: Tobacco use is a major risk factor for carotid artery disease via injury to blood vessels at the microscopic level. Secondary Prevention of Carotid Artery Disease Secondary prevention aims to reduce the risk of recurrences or avoid complications post-treatment. Symptom watch-out: Always lookout for any signs or symptoms of carotid artery disease and seek immediate medical care if required. Lifestyle modifications: Eating a balanced diet, exercising regularly, and getting physically active is crucial for heart health and reducing recurrences. Regular health check-up: Regular monitoring of your vitals and visiting the doctor on scheduled follow-ups is crucial for an event-free recovery. Epidemiology of Carotid Artery Disease Carotid artery disease is a leading cause of stroke and associated deaths globally. The prevalence of carotid artery disease increases with age and is more common in people aged above 50 years. It is more prevalent in men compared to women. Carotid artery disease is more prevalent in whites and Native Americans. Expected Prognosis of Carotid Artery Disease Carotid artery disease with moderate or severe blockage requires aggressive treatment such as surgery. The chances of survival in long-term follow-up are around ten years post carotid endarterectomy. Natural Progression of Carotid Artery Disease Undiagnosed and untreated plaque formation will increase blockage with time and will eventually lead to occlusion of the carotid artery and associated stroke or TIA. Pathophysiology of Carotid Artery Disease At the microscopic cellular level, injuries caused by free radicals or weakened artery walls lead to the creation of sites for plaque formation. As the plaque formation starts and deposits increase in volume along the walls of the arteries, atherosclerosis occurs. Atherosclerosis causes arteries to clog and become narrow.

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Electrical signals control the beating of the heart. When this electrical signal is partially or fully blocked, it is known as heart block or AV block. As a result, the heart might beat slowly or skip beats and cannot pump blood adequately. Complete heart block usually refers to a third-degree block wherein the heart's pumping ability is severely compromised. If left untreated, this condition could lead to an abrupt cardiac arrest. Alternate Names of Complete Heart Block Atrioventricular block or AV block; AV nodal block or AVB; Conduction disorder. Complete Heart Block Causes A malfunction with the heart's electrical signals, which controls the heart rate and rhythm, causes heart block. Other causes include heart muscle disease (cardiomyopathy), heart valve dysfunction, and structural abnormalities in the heart. Damage during open-heart surgery, as an adverse event of some drugs or exposure to toxins, can also induce heart block. Complete Heart Block Symptoms Extreme exhaustion Breathing problems Pain in the chest Dizziness Nausea Fainting Irregular heartbeat Stages of Complete Heart Block Depending on the extent of the impairment of the electrical signal, heart block might be of first, second, or third-degree as discussed: First-degree heart block – although the electrical impulse reaches the ventricles, it travels via the AV node more slowly than usual. There is a delay in the impulses. Second-degree heart block – intermittent disruption of the impulses, which gradually becomes more frequent Mobitz type 1 block- a less severe second-degree heart block wherein symptoms include mild dizziness. Mobitz type 2 block – a more severe second-degree heart block wherein symptoms are more prominent and need pacemaker intervention. Third-degree heart block – the electrical transmission between the atria and ventricles is completely disrupted. Congenital – where the blockage exists from the time of birth Acquired – where the blockage develops with advancing age and increased damage to the heart Complete Heart Blockage Diagnosis and Tests A cardiologist will first check the following: Medications (both prescribed and over-the-counter ones) being currently used Certain lifestyle choices relating to smoking and substance use The heart rate and the blood pressure Accumulation of fluid in the legs and feet Recommended Tests Include An electrocardiogram (ECG) measures the electrical impulses in the heart. Holter or an event monitor to track the heart's rhythm over a length of time A Loop recorder, a little gadget that can be implanted, is injected beneath the skin of your chest and can track. An electrophysiology checkup involves inserting a long, thin catheter into a blood vessel and guiding it to the heart to assess and record electrical activity. Complete Heart Blockage Treatment The heart blockage treatment is generally dependent on the extent of the blockage in the heart. The therapeutic options available are: The prescriptions might need to be adjusted, or related underlying illnesses may need to be treated. Generally, no therapy is advised in case of a first-degree heart block. Tweaking lifestyle choices and taking preventive medications usually helps. In the case of second-degree heart block, medications are given but under observation. If severe symptoms appear, pacemaker therapy could be advised. In the case of a third-degree heart block, most certainly, a pacemaker should be installed. Complete Heart Blockage Prevention A healthy lifestyle is beneficial to overall health, as well as heart health. Avoid smoking, exercise regularly and eat a well-balanced diet. Medicine-induced heart block can be reduced by understanding the hazards of your medications and discussing them with your healthcare provider. Before using any herbal supplements or new medicines, consult your doctor, especially if you have heart block risk factors. Risk Factors of Complete Heart Block Advancing age Deranged sodium and potassium levels Coronary artery disease (CAD) or a heart attack Hypertension Cardiomyopathy – a condition involving improper functioning of the heart muscles Neuromuscular illnesses that are hereditary Sarcoidosis – an inflammatory condition that also affects the heart Medicines that reduce the pace of the heart Lyme disease – It is a type of tick-borne illness that affects the heart A renal disease that has progressed to an advanced stage Hypothyroidism – a condition in which the thyroid gland does not function properly As an after-effect of a heart surgery Possible Complications of Complete Heart Block Arrhythmia Low blood pressure Heart failure Cardiac arrest Collateral damage to other internal organs Life after a Complete Heart Block Most people with extensive heart block can live a normal life with the help of pacemaker therapy. However, the need to abide by a few rules: Avoid circumstances where the pacemaker could be disturbed Avoiding electrical equipment that produces powerful magnetic fields Carry a card that identifies the type of pacemaker installed Check the pacemaker regularly to ensure it is in good operating order Maintain a healthy level of activity while avoiding contact sports Complete Heart Blockage Epidemiology 0.5-2 % of otherwise healthy persons suffer from a first-degree or a Mobitz type 1 second-degree heart block. One in every 30 persons with heart failure, for example, is thought to develop Mobitz type 2 heart block. Congenital third-degree heart blockages are extremely uncommon, occurring in about one out of every 20,000 newborns. Acquired third-degree heart block, on the other hand, is a common consequence of cardiac disease, especially in elderly people. 5-10% of adults over the age of 70 with a history of cardiac abnormalities usually have a third-degree heart block. Complete Heart Blockage Pathophysiology The electrical signals that generally pass from the atria to the ventricles are disrupted. Conduction is slowed without missing beats for a first-degree block. QRS complexes follow all regular P waves; however, the PR interval is greater than usual (> 0.2 sec) Second-degree AV block occurs when the ECG shows more P waves than QRS complexes, but there is still a link between the P waves and QRS complexes. The P wave rate is bigger than the QRS rate, and there is no correlation between P waves and QRS complexes in a third-degree block. Frequently Asked Questions 1. What Is The Role Of A Pacemaker In Treating Complete Heart Block? A pacemaker is a small device that helps regulate the heart's electrical signals in individuals with complete heart block. It ensures a normal heart rhythm by delivering electrical impulses to coordinate the heart's pumping action. 2. How Is a Pacemaker Implanted for a Complete Heart Block? Pacemaker implantation involves a minor surgical procedure where a small device is placed under the skin near the collarbone. Leads are threaded into the heart to deliver electrical signals and monitor the heart's activity. 3. Can a Complete Heart Block Lead to other Heart Complications? Yes, complete heart block can increase the risk of other heart-related complications such as heart failure, fainting, and arrhythmias if not properly managed and treated. Regular monitoring and appropriate treatment are important to prevent these complications. 4. Can Exercise Worsen Symptoms in Individuals with Complete Heart Block? In complete heart block, while exercise is generally beneficial for cardiovascular health, individuals with complete heart block should consult their doctor for specific guidelines. Exercise intensity and limitations may need to be tailored to their condition to avoid exacerbating symptoms or putting excessive stress on the heart. 5. How Much Does Heart Block Surgery Cost in Delhi? The cost of heart block surgery in Delhi can vary depending on several factors, including: The type of procedure Any additional tests or treatments required The device your doctor will help you choose according to the functions needed.   It is best to consult with the healthcare provider or hospital directly to get an accurate cost estimate for heart block surgery in Delhi. Related Blogs Build The Body, But Don`t Break The Heart The Best Diet For Your Speed Recovery After Heart Bypass Surgery

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Coronary Artery Disease (CAD) is a disease that occurs when the arteries that supply blood to the heart become narrow due to plaque buildup. Plaque is made up of cholesterol and other fatty substances. CAD is not sudden, as the buildup takes years to reach a level that impacts the heart's working. Another word for CAD is coronary heart disease (ischemic heart disease). Associated Anatomy of Coronary Artery Disease (CAD) Coronary Artery disease affects the blood vessels, i.e., arteries that supply oxygen-rich blood to the heart. There are three main arteries: Right Coronary artery Left Anterior Descending Artery Left Circumflex artery Coronary Artery Disease Causes Coronary Artery Disease starts when the vessels start getting significantly narrowed due to plaque formation. Injury to the arteries can be caused by: High blood pressure Smoking Prolonged diabetes High levels of cholesterol in the blood A sedentary lifestyle Plaques consisting of fatty substances and cholesterol start building up in the place of injury. This plaque is called atherosclerosis. The plaque slowly builds up over a long period and narrows the arteries restricting blood flow to the heart. Clogged arteries significantly reduce the amount of oxygen-rich blood required for the heart to function. Reduced blood supply could lead to chest pain which can further aggravate heart attack and eventually heart failure. Coronary Artery Disease Symptoms Since plaque buildup in the arteries happens gradually over the years, Coronary Artery Disease (CAD) is difficult to detect in its early stages. Over the years, the first signs of CAD are shortness of breath or tiredness. The other main signs of Coronary Artery Disease are: Chest pain or tightness in the chest (Angina). Shortness of breath Pain in the shoulder Sweating Tiredness Nausea Coronary Artery Disease Symptoms in women are usually different. These include: Discomfort in the back or neck Cold sweats Unexplained anxiety Coronary Artery Disease Diagnosed If you are seeing mild symptoms of coronary heart disease or you have a family history of coronary heart disease, a doctor might suggest a few tests to identify the problem. Electrocardiogram (ECG) The test measures the heart's electrical activity and the frequency of heartbeats. X-Rays Chest X-rays can help doctors get a clear picture of the heart. Echocardiogram Using sonic waves in ultrasound to get a clear picture of the heart to look for regional wall motion abnormalities and valvular structure and function which are affected by coronary artery disease. Stress Test Measuring heart rate while walking on a treadmill. The test helps to determine how healthy your heart is while under stress. Coronary Angiogram In this test, a dye is injected into the arteries. Then, using an x-ray, it is tracked to understand blockages in the arteries. Calcium Scan of the Arteries This scan allows doctors to track calcium buildup and plaque in the arteries. Coronary Artery Disease Treatment Your doctor would likely diagnose you with coronary artery disease based on your symptoms. Then, depending on your health, medical history, and various other factors, a treatment plan will be mapped by your doctor. Lifestyle Changes The first step in treating or reducing the impact of CAD is a change to a healthier lifestyle. These include, No smoking Eating foods that are low in trans fat, excessive sugar, and salt Following an active lifestyle with sufficient workouts Managing stress Medications Along with lifestyle changes, doctors would prescribe medications to manage the heart condition. Medications would include drugs to reduce cholesterol, blood thinners, beta-blockers, and other drugs to reduce cholesterol and help prevent further deterioration of the arteries. Angioplasty Angioplasty refers to the procedure that can help open blocked arteries through peripheral arterial access using wires A long, thin, and flexible wire is inserted into the arteries. The wire is equipped with a deflated balloon. The balloon is inflated at the blocked artery walls to increase blood flow. A stent is a small tube that may also be used to keep the widened artery walls open. Coronary Artery Bypass Graft Bypass surgery involves using healthy blood vessels from other body parts to bypass the diseased arteries of the heart so that perfusion is re-established to the muscle of the heart. In today’s era bypass surgery is a very safe procedure and has superior long term symptom free survival. Coronary Artery Disease Risk Factor Coronary Heart Disease is more likely in case of these risk factors. Genetics Age High cholesterol Diabetes Hypertension Smoking Drinking too much alcohol Unhealthy diet Obesity No exercise Stress While Coronary Artery Disease would be difficult to control if you are genetically predisposed to it, the other risk factors would be easier to control. Possible Complications of Coronary Artery Disease Although preventive measures are taken to reduce the occurrence of Coronary Artery Disease, it could lead to complications like, Heart Attack: If a blood clot forms in the arteries, this could result in the complete blocking of blood to the heart. This could trigger a heart attack and damage the heart muscles irreparably. Heart Failure: Reduced blood flow to the heart could weaken heart muscles and make them too weak to function optimally. Arrhythmia: Insufficient blood supply can cause irregular heartbeats in the heart. Arrhythmia can lead to heart attack or heart failure if not monitored and checked. Coronary Artery Disease Primary Prevention Primary Prevention of Coronary Artery Disease Primary prevention of CAD means minimizing the chances of the disease occurring. While it may be challenging to prevent CAD if you are genetically predisposed to it, you can take specific measures to prolong the disease as much as possible. Managing cholesterol is one of the best ways to reduce the risk of coronary artery disease. To control cholesterol, a patient needs to be physically active. Limiting alcohol and smoking habits could also help towards reducing CAD. A healthy diet consisting of less sodium, sugars, and trans or saturated fats can help prevent CAD. Secondary Prevention of Coronary Artery Disease Other than the primary prevention factors of following a healthy lifestyle and managing weight, secondary prevention involves surgical coronary bypass surgery and other medical therapies to reduce the occurrence of CAD. Epidemiology of Coronary Artery Disease The epidemiology of Coronary Artery Disease is the study of the occurrence of CAD globally depending on various demographics. CAD is one of the diseases that is one of the leading causes of death globally. Approximately 7% of adults in the United States have CAD. Expected Prognosis of Coronary Artery Disease CAD can be identified by studying the signs and symptoms in individuals and the risk factors of each individual. While CAD can be treated with preventive measures like lifestyle changes and medications, it cannot be cured completely. A person who has been diagnosed with CAD will need to use preventive measures and stick to a healthy lifestyle to prevent severe degradation of the heart. Natural Progression of Coronary Artery Disease Coronary Artery Disease starts with a buildup of plaque and fatty substances in the arteries supplying blood to the heart. Over the years, the buildup starts restricting blood flow and compromises the functioning of the heart. If the condition is neglected and not prevented in time, CAD could lead to heart failure and death. Pathophysiology of Coronary Artery Disease Coronary Artery Disease deals with the functioning of the heart. The arteries become blocked due to fatty buildup, which affects how the heart functions. The heart needs oxygen-rich blood to keep the body healthy. 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When the blood supply to the heart is blocked by the accumulation of fatty substances in the arteries supplying blood to the heart muscle, it results in what is known as Coronary heart disease. This can lead to the artery walls becoming clogged with fatty deposits. For some people, the first sign of coronary heart disease may be a heart attack which may be fatal. Alternate Name of Coronary Heart Disease Coronary heart disease is sometimes known as ischemic heart disease. Associated Anatomy of Coronary Heart Disease It affects the coronary arteries and therefore heart muscle. Coronary Heart Disease Causes When the blood supply to the heart is affected by the accumulation of fatty substances in the coronary arteries, it can lead to coronary heart disease. The coronary artery gets obstructed with fatty deposits and calcium (atherosclerosis). Lifestyle factors such as lack of exercise, smoking, excessive alcohol consumption, as well as high cholesterol, hypertension, diabetes, and insulin resistance can put you at risk for atherosclerosis. Family history of heart disease also is a very important risk factor. Coronary Heart Disease Symptoms Coronary Heart Disease Symptoms are: Chest pain or angina: Exhibits pressure or tightness in your chest, usually in the middle or left side of the chest, especially on exertion. Heart attack: This is caused by a completely blocked coronary artery. Symptoms include crushing pressure in the chest and pain in the shoulder or arm. May be associated with profuse cold sweat. Shortness of breath: The reason for this is your heart can no longer pump enough blood to meet your body's needs. Pain throughout the body Feeling of light-headedness Nausea/vomiting. Coronary Heart Disease Stages The various stages of coronary heart disease are as follows: Stage A: Hypertension, coronary artery disease, diabetes, and metabolic syndrome may contribute to the development of this stage. Chances are also higher for those with a history of alcohol abuse, inflammations such as rheumatic fever, certain forms of cardiotoxic drug intervention, or cardiomyopathy (a hereditary heart disease). Stage B: This is when there is a dysfunction in the left chamber or ventricle of the heart. Those who have had valve disease, a heart attack, or been diagnosed with cardiomyopathy may enter this stage. Stage C: Systolic heart failure is exhibited at this stage, accompanied by tiredness and difficulty breathing. Stage D: Here, the left ventricle may not be able to contract properly, resulting in heart failure. Coronary Heart Disease Diagnosis First, the doctor will do a risk assessment, where you will be asked about your medical and family history. Blood pressure and cholesterol are checked through blood tests. You will also be asked about lifestyle, exercise, and whether you smoke. Other tests include Electrocardiogram to reveal evidence of a previous heart attack or one that is in progress Echocardiogram to determine whether all parts of the heart wall are contributing normally to your heart's pumping activity X-rays to detect the presence of calcium in the heart or blood vessel Exercise stress tests, where you will be asked to walk on a treadmill Nuclear stress test to measure blood flow to the heart Cardiac catheterization and angiogram to determine blockages Cardiac CT scan is to examine if there are calcium deposits in the arteries CT coronary angiogram to produce detailed images of the heart arteries Coronary Heart Disease Treatment Coronary Heart Disease Treatment  involves: Lifestyle Changes This includes quitting smoking, eating healthy, exercising regularly, avoiding drugs and excessive amounts of alcohol, and reducing stress. Drugs The condition is treated with drugs such as cholesterol-modifying medications, aspirin (to reduce the tendency of the blood to clot), beta-blockers (to slow heart rate), calcium channel blockers (if beta-blockers alone aren't effective), and ACE inhibitors (to decrease blood pressure). Surgery Coronary artery stent, angioplasty, and coronary bypass surgery help to restore and improve blood flow to the heart muscle. Coronary Heart Disease Risk Factors Risk factors for coronary heart disease include - Age: Advancing age increases the risk of damaged and narrowed arteries. Sex: Men are generally at greater risk of coronary heart disease. In the case of women, the risk increases after menopause. Family history: This is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. The risk is highest if a person’s father or brother was diagnosed before age 55 or if their mother or sister developed Coronary heart disease younger than 65. Smoking: This significantly increases the risk of heart disease. Breathing in second-hand smoke also increases risk. Hypertension: Uncontrolled high blood pressure can result in the hardening, narrowing, and thickening of arteries. High blood cholesterol: This can increase the risk of plaque formation and atherosclerosis. Diabetes: Type 2 diabetes increases the risk of coronary heart disease and share similar risk factors, such as obesity and hypertension. Obesity: Excess weight typically worsens other risk factors and itself increases risk. Sedentary lifestyle: Lack of exercise is associated with coronary heart disease. High stress: Unrelieved stress may damage arteries. Unhealthy diet: High amounts of saturated fat, trans fat, salt, and sugar can increase the risk of coronary heart disease. Sleep apnea: Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure, possibly leading to coronary heart disease. Alcohol use: Heavy consumption can lead to heart muscle damage. Autoimmune diseases: Inflammatory conditions such as rheumatoid arthritis and lupus may increase the risk of atherosclerosis. High-sensitivity C-reactive protein: This protein appears in higher-than-normal amounts when there's inflammation in the body. Triglycerides: High levels of this lipid may raise the risk of coronary heart disease, especially for women. Homocysteine: High levels of this amino acid may increase the risk of coronary heart disease. Preeclampsia: This condition, which sometimes develops in women during pregnancy, causes high blood pressure leading to a higher risk of heart disease later in life. Coronary Heart Disease Prevention The same lifestyle habits used to help treat coronary artery disease can also help prevent it. They include - Quitting smoking Maintaining a healthy weight Exercising regularly Controlling conditions such as hypertension, high cholesterol, and diabetes Staying physically active Eating a balanced, low-fat, low-salt diet rich in fruits, vegetables, and whole grains Reducing stress levels Secondary Prevention of Coronary Heart Disease Maintaining a healthy lifestyle that includes a low-fat, low-salt diet rich in vegetables, fruits, and whole grains, exercising regularly, managing stress, and quitting smoking are some ways to prevent coronary heart disease. Secondary prevention includes medical therapy, cardiac rehabilitation, surgical intervention in the form of coronary artery bypass grafting, and drug treatment. Coronary Heart Disease Epidemiology It is estimated that coronary heart disease affects around 126 million individuals or 1.72% of the world’s population. Men are usually more commonly impacted than women. Expected Prognosis of Coronary Heart Disease Coronary heart disease is treatable, but there is no cure. Timely diagnosis and treatment provided excellent quality of life, Survival advantage and event-free survival and very good progress. Natural Progression of Coronary Heart Disease Although atherosclerosis is believed to progress over many years, in some patients it can progress over a few months to two years. But healthy lifestyle habits can help to halt the progress of heart disease. Pathophysiology of Coronary Heart Disease Atherosclerosis is the pathologic process of lipid accumulation, scarring, and inflammation in the vascular wall, leading to thickening, calcification, and in some cases, thrombosis. Possible Complications of Coronary Heart Disease Coronary heart disease can lead to: Chest pain or angina occurs when coronary arteries narrow. Heart attack: Complete blockage of the heart artery may trigger a heart attack. Arrhythmia: Abnormal heart rhythm occurs when there is an inadequate blood supply to the heart. Frequently Asked Questions 1. What Is The Success Rate Of Angioplasty/Stenting For Coronary Heart Disease in Delhi? The success rate of angioplasty/stenting for coronary heart disease in Delhi is generally high, with a significant improvement in blood flow and symptom relief. However, success rates may vary depending on individual factors, the extent of the disease, and the expertise of the medical team. 2. Can Lifestyle Changes Alone Treat Coronary Heart Disease? Lifestyle changes alone may not completely treat coronary heart disease, but they play a crucial role in managing the condition. Adopting a heart-healthy diet, engaging in regular physical activity, quitting smoking, managing stress, and controlling other risk factors can significantly improve heart health and potentially slow down the progression of the disease. 3. Can Medication Effectively Manage Coronary Heart Disease? Medications play a crucial role in managing coronary heart disease. They help control blood pressure, cholesterol levels and reduce the risk of blood clot formation, thus improving overall heart health & some cases are managed with medication & lifestyle changes along with regular follow up. 4. Can Stress Management Techniques Help in The Treatment Of Coronary Heart Disease? Yes, stress management techniques like relaxation exercises, meditation, and counseling can be beneficial for individuals with coronary heart disease. Reducing stress levels can help improve overall well-being and potentially reduce the risk of cardiovascular events. 5. What are The Long-Term Outcomes of Coronary Heart Disease Treatment? The long-term outcomes of coronary heart disease treatment vary depending on the individual's condition, the chosen treatment approach, and adherence to lifestyle modifications. With proper management, many individuals  lead a fulfilling and active life. 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When blood clots are formed in the veins located deep inside the body, especially the legs and thighs, this condition is known as Deep Vein Thrombosis. Alternate Name of Deep Vein Thrombosis Venous Thromboembolism Associated Anatomy of Deep Vein Thrombosis Blood and blood vessels (veins) Deep Vein Thrombosis Causes Blood clots block the veins and prevent proper blood circulation in the body, resulting in deep vein thrombosis. The causes of blood clots can be: Injury Any damage or destruction to blood vessels can cause restriction in blood flow and result in blood clots. Inactivity Less physical activity, prolonged sitting or restricted movement can reduce blood flow in lower body parts such as the legs and lower limbs. Health Conditions Surgery, medication, trauma, inflammation or underlying conditions can cause blood clots. Other Varicose veins, inherited conditions of blood clots, cancer, obesity, and side effects from medicines can also cause deep vein thrombosis. Deep Vein Thrombosis Symptoms It is not always necessary that deep vein thrombosis occurs with some signs or symptoms. However, common symptoms associated with deep vein thrombosis are: Swelling and inflammation in legs Difficulty in moving legs or arms Fever or feeling of warmness in the affected leg Redness and discolouration of skin in the affected area Unreasonable pain, cramps and soreness in calf muscles Pain in the neck, arm or shoulder can occur if blood clots occur in the upper limbs Weakness in the arms or legs Deep Vein Thrombosis Diagnosis Doctors can diagnose deep vein thrombosis from certain blood tests, coagulation profiles and ultrasonography. For example, elevated values from the D-dimer test indicate a condition of blood vessels. Ultrasound images can help confirm the changes in the proximal veins of the leg. A venogram helps get a clearer image of an injured vein and the clots in the vein. Deep Vein Thrombosis Treatment The most common course of treatment for deep vein thrombosis is to de-coagulate the blood clots using blood thinners and anticoagulants like heparin and warfarin. Treatment is done to prevent blood clots from getting bigger and affecting other blood vessels and travelling to distant body parts like lungs, leading to deadly conditions like pulmonary embolism. Intravenous drugs like thrombolytic drugs are given to patients with conditions of deep vein thrombosis. These drugs break blood clots and decrease their size. For patients with a risk of developing clots in their legs, doctors may suggest they wear compression stockings, which prevent blood clots from forming and control swelling. Filters can be used for shorter durations in patients that cannot take blood thinners. Filters placed inside the vena cava (large abdominal vein) prevent blood clots from travelling to the lungs and causing pulmonary embolism. Surgery is the ultimate option to remove large blood clots if they are causing tissue damage, infection or other complications in the body. Risk Factor of Deep Vein Thrombosis Some lifestyle and health conditions can increase the risk of developing deep vein blood clots. Some risk factors are mentioned below: People aged 40 years or older are at a higher risk of developing blood clots. People suffering from bone or tissue injuries have high chances of developing thrombosis. People with a medical history of blood clots or thrombosis genetics are more likely to develop blood clots. Diseases like cancer, heart failure, and a catheter placed in veins restrict the blood flow and result in blood clots. Heavy smoking and a sedentary lifestyle can contribute to the disease. Birth control pills and hormonal therapy can increase the chances of blood clots. Deep Vein Thrombosis Complication Pulmonary embolism is one of the major complications arising from deep vein thrombosis. If blood clots reach the lungs, they can cause serious health complications and block a blood vessel, leading to death. Rapid heart rate, dizziness, sweating, blood in cough and severe chest pain are the common signs of this complication. Moreover, some side effects can also arise from the blood thinners used in the treatment. So, it is necessary to have regular health check-ups. Deep Vein Thrombosis Prevention Primary Prevention Lifestyle Changes: Avoid sitting for long durations. Keep moving and be active to keep the muscles working and maintain blood flow. Smoking: Avoid smoking as it alters blood flow in the body. Exercise: Exercising regularly and keeping the weight in check reduces the chances of blood clots and thrombosis. Reducing Blood Pressure: Keeping blood pressure normal reduces the chances of blood clots. Secondary Prevention Take blood thinners and other medications as prescribed by a doctor on time. Move around frequently and do not sit for more than 4 hours at a stretch. Walking and stretching help the blood flow normally in the body. Keeping your limbs, especially legs, at an elevated position on a stool or chair can maintain the blood flow in the legs. Epidemiology The chances of developing deep vein thrombosis increase with age, especially after 50 years. Men are more prone to this condition in old age than women. Cases of pulmonary embolism increase as patients approach the age of 80 years. The condition is often underestimated and undiagnosed, which leads to deaths. Expected Prognosis If the treatment for deep vein thrombosis is provided timely, the disease rarely proves to be fatal. Patients suffering from thrombosis in lower extremities for quite some time can have a chance of around 3% of developing pulmonary embolism if the clot diffuses and reaches the lungs. The survival rate for patients in the short term is 95-97%, and even in the long term, it is likely to be 75% for pulmonary embolism patients. Natural Progression Regular blood tests and ultrasounds are necessary to ensure the right treatment and dosage of medication. Blood clots can increase in size and number with time. If the condition is left untreated, it can be life-threatening. Pathophysiology If there is any damage to the walls of blood vessels, injury or changes in blood circulation, there are chances of coagulation of blood. Most of these clots resolve on their own, and only one out of six results in deep vein thrombosis. Related Blogs Understand Leg Pain and Know Its Major Reasons Blood Clot in Brain: Symptoms, Diagnosis, Treatment What Are The Different Types, Procedures And Risks Of Bariatric Surgery?

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Gangrene develops due to a wound, tissue infection, or other diseases that impair blood circulation. The dead or diseased tissue must be removed while the infection must be treated to prevent gangrene from spreading. The root cause of gangrene must be addressed. Alternate Name of Gangrene Gangrenous necrosis Associated Anatomy of Gangrene It can affect any region of the body. Although, it most commonly begins in the toes, feet, fingers, or hands. Types of Gangrene Dry Gangrene When blood flow to a region is interrupted or disrupted, the tissue dies. Poor circulation is a frequent cause of dry gangrene. Wet Gangrene It is caused by a bacterial infection combined with an injury that cuts off the blood supply. In wet gangrene, tissue expands, and blisters and pus form. Medications must be administered immediately when wet gangrene spreads. Gas Gangrene This refers to the infection with the bacteria Clostridium that causes tissue death. Within the body, bacteria multiply rapidly, releasing poisons and gas. Without treatment, gas gangrene can swiftly lead to death. Fournier's Gangrene This is an infection of the penis, scrotum, or under the surface of the skin. Internal Gangrene These severe cases of gangrene occur when a blockage in blood flow occurs within internal organs like the intestines or the appendix. Gangrene Causes Among the causes of gangrene are: Blood supply shortage: A blood supply shortage exists in the body. Your blood transports oxygen and nutrients throughout your body. It also offers antibodies to your immune system to help it fight infections. Your cells cannot live without an adequate blood supply. Thus, tissue decays. Infection: Gangrene can result from an untreated bacterial infection. Injuries caused by trauma: Gunshot wounds or crushing injuries from vehicle accidents can result in open wounds that allow germs to enter the body. Gangrene can occur if germs invade tissues and go untreated. Gangrene Symptoms The symptoms of gangrene differ depending on the cause of the disease. Among the general signs are: Pale, cold skin A loss of sensation in the afflicted region The afflicted region may or may not be painful. Skin in the afflicted region is red and inflamed. Other indications and symptoms of gangrene caused by a bacterial infection may include: Fever Chills Appetite loss Both breathing and heartbeats are quick. Dizziness Blisters and sores that bleed and expel foul-smelling pus When pushing on the skin, there is a crackling sound (indicates a buildup of gas in tissue). Skin colour changes as it dies, from red to brown to purple to black. Gangrene Diagnosis and Tests Blood tests Blood tests may be ordered by your physician to confirm the presence of a specific type of bacteria or germs. Tissue culture Microorganisms that cause gangrene may be examined in the fluid from a skin blister. A sample of tissue may be examined under a microscope by your physician for evidence of apoptosis. X-rays, Computed Tomography (CT) Scans, and Magnetic Resonance Imaging (MRI) Scans These tests can provide more information through pictures about your organs, arteries, and bones. The findings of these tests can be used by your doctor to evaluate how far the necrosis has progressed in your body. Surgery Surgery may be conducted to understand the interior of the body better and assess the amount of cell damage. Gangrene Treatment and Care Tissue destroyed by gangrene cannot be saved. However, certain actions can be taken to keep the gangrene from worsening. The sooner you receive therapy, the greater your chances of recovery. Gangrene treatment in extreme stages may include medication, operation, hyperbaric therapy, or a combination of these options. Medications Antibiotics are either intravenously or orally administered. To alleviate your suffering, pain medicines may be used. Other treatments include surgery. Depending on the level of gangrene and its severity, you may require more than one procedure. Gangrene surgery involves the following procedures: Debridement The debridement procedure is intended to eliminate the contaminated tissue and prevent the disease from spreading. To improve the flow of blood to the afflicted area, surgery on damaged or diseased blood vessels may be performed. Whether a prescription is required in a specific case depends on the severity of the infection. Amputation In extreme gangrene situations, the affected body part, such as a toe, hand, or any other part, may need to be amputated. In such cases, patients can consider getting a prosthesis later. Skin transplantation Transplantation of skin is another treatment method. Hyperbaric oxygen therapy/treatment Treatment is performed in a chamber pressured with only oxygen. There is typically a cushioned surface inside a tube that slides into a transparent plastic tube. As the chamber gradually fills with more air, the pressure increases to around 2.5 times the typical air pressure. When a patient’s body is exposed to greater pressure and oxygen, the body can transport more oxygen through the blood. Infected wounds are more likely to heal if oxygen-rich blood is present. Certain germs can thrive in tissues that lack oxygen. It usually takes 90 minutes for gangrene therapy to take effect. Two out of three treatments may be necessary until the infection can be fully treated. Take charge of your health. Keep your sugar levels under control if you have diabetes. Examine your hands, feet, and legs daily for symptoms of the damage, slow wound healing, or other skin issues. Risk Factors of Gangrene Individuals with the following conditions are more prone to develop gangrene: Atherosclerosis Diabetes wreaks havoc on the nerves and blood vessels. Diabetes causes wounds to heal slowly. Infection is more likely in slow-healing wounds. Diabetes complications put the feet in particular danger of infection. Raynaud's phenomenon Serious skin and tissue injuries, such as burns, frostbite, and trauma. Compromised immune system Complications of Gangrene If left untreated, gangrene can lead to sepsis, a deadly blood infection. Sepsis can lead to organ failure, dangerously low blood pressure, changes in cognitive state, shock, and death. Related Blogs What is Diabetic foot and how to prevent it? Harmful Effects Of Tobacco

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A heart attack is a serious, fatal medical condition where sections of the heart muscle begin to die as they do not receive the appropriate amounts of blood. It is also called a myocardial infarction. It is typically observed when the arteries supply blood to the heart. An occlusion due to plaque rupture and clot formation blockage, such as a blood clot. The longer the muscle remains without blood, the more damage is caused. Untreated heart attacks can lead to permanent heart damage and even result in death. Associated Anatomy Heart and Cardiac Muscles Alternate Name of Heart Attack Myocardial Infarction Heart Attack Causes A heart attack usually results from a condition that causes the blockage of blood flow through the coronary arteries. Some of these conditions are: Atherosclerosis: This is a buildup of fatty deposits in the arteries, including cholesterol, resulting in the formation of "plaques." It causes narrowing of the arteries. Lschemia: Such buildups can rupture causing the formation of a blood clot. which results in sudden occlusion of the artery. If the blood clot is big enough to block the artery, it prevents oxygen movement to the heart, causing severe damage. Spasms of the Blood Vessels: Blood vessels are lined by a muscular layer that can expand or contract to receive blood. Like cramps in the body, certain conditions may cause these vessels to cramp, preventing blood flow to the heart. Heart Attack Symptoms Continuous discomfort and pain in your shoulder, chest, and arm area. Tingling in the shoulder and arm area Persistent heartburn or indigestion Severe anxiety, fatigue, weakness Shortness of breath or difficulty in breathing Nausea and dizziness Excessive sweating Uneven or paced heartbeat Additional Types of Heart Attack Angina Pectoris is characterized by persistent pain in the chest area, arms, and shoulders. Constant Angina cuts off the blood supply to the heart, resulting in a heart attack. Angina is typically a result of narrow arteries. It can be a preliminary symptom of a heart attack. Heart Attack Diagnosis Typical Test for Heart Attack The most common test conducted is the Electrocardiogram or ECG for diagnosing cardiac issues. The doctor uses this test to see how the blood is being pumped through the heart's chambers. In addition, it can be used to assess if there is any damage caused due to a previous heart attack or if there is a heart attack in progress. Different Diagnosis of Heart Attack A differential diagnosis is given for a heart attack by observing radiating pain in both arms and hearing a third heart sound on a stethoscope examination. A decrease in blood pressure may also be observed. Heart Attack Treatment A heart attack is a grade 1 medical emergency. Do not try treating it at home. If you suspect someone has a heart attack, contact a doctor immediately or rush to a medical centre where appropriate help will be provided. As per the symptoms, Cardiologists opt for: Drugs Medications such as blood thinners, thrombolytics, antiplatelet agents, beta-blockers, etc., allow clot lysis to restore blood supply in cases where & and angioplasty is not feasible. Surgery Bypass or in cases where there are multiple critical blockages. Risks Factors of Heart Attack A variety of risk factors can increase the chances of a heart attack. Age: Men aged 45 and older and women aged 55 and older are more likely to have a heart attack Sedentary lifestyle. Tobacco: Tobacco consumers and smokers, including passive smokers Obesity: Obesity is linked with higher cholesterol levels, which can increase the plaque buildup Metabolic Syndrome: A collection of disorders like diabetes, high blood pressure can increase the likelihood of having a heart attack Stress: This may induce unhealthy reactions from the body, including a heart attack Family History: Heart disease is familial Many other conditions like lack of physical activity, high cholesterol, autoimmune disorders, illicit drug use, etc., are also risk factors for heart disease. Possible Complications of Heart Attack A heart attack may escalate into advanced Heart Failure, cardiac arrest, or Arrhythmias. This disrupts the heart’s normal functions and may require external fixes through lifelong medications or surgical fixes. Heart attacks can lead to brain death or multi-system organ failure if not treated on time. Heart Attack Prevention Primary Prevention of Heart Attack Since this is a lifestyle disease, primary prevention involves lifestyle modifications. Maintaining fitness through physical activity or weight management Ceasing smoking to promote healthy lungs and heart Managing stress or decreasing stress Health management through regular healthcare screenings and consultations Secondary Prevention of Heart Attack Medications: Aspirin and cholesterol-lowering drugs are usually recommended to prevent re-occurrences of heart attacks Surgical Revascularization: Coronary Artery Bypass Grafting or Stent surgeries to restore blood flow to the heart Quitting Smoking: Heavy smokers are advised to quit smoking as soon as possible Lifestyle Changes: Switching to healthier diets and including fitness regimes. Epidemiology of Heart Attack In India, the previous 60 years have seen an upsurge in heart attacks from >1% to 9-10% in urban populations vs. 2-6% in rural areas. 31% of these occurred at less than 60 years of age, while 58% occurred at less than 70 years. Expected Prognosis of Heart Attack The expected prognosis of a first attack is usually that most people live healthy lives. This holds with the assistance of medicines and physician advice & other twenty interventions are needed. Natural Progression of Heart Attack If no lifestyle modifications are carried out, 20% of the affected population reports having a second heart attack within five years. Pathophysiology of Heart Attack A heart attack is usually the result of the sudden cut off of blood supply to part of the heart being cut off from blood supply. This is associated with narrowed arteries or plaque buildup. Due to the decrease in blood supply, the heart muscles do not receive their required oxygen and nutrients, thus failing to keep up with their functions. In turn, it may fail to pump blood to the rest of the body effectively. Related Blogs Heart Attack Symptoms: Guide to Recognize Vital Signs Build The Body, But Don`t Break The Heart Feelings After a Heart Attack: The Good, The Sad and The Anxious Help your hurting heart Changes to Make in Lifestyle to Prevent Heart Attack 7 Key Facts to Understand About Cardiac Stress Test

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Hypertensive heart disease (HHD), as per name suggests, is a group of heart disorders that develops due to consistently high blood pressure over the years. High blood pressure increases pressure on the heart tissue, which gets enlarged and dilated, degrading its function further. Hypertensive heart disease includes: left ventricular hypertrophy, which is the main cause of heart failure in adults. Systolic and diastolic dysfunction. Heart arrhythmias. Other cardiovascular conditions like coronary artery diseases. Alternate Name of Hypertensive Heart Disease Left ventricular hypertrophy. Associated Anatomy of Hypertensive Heart Disease Cardiovascular system (heart, arteries, veins) Hypertensive Heart Disease Causes HHD is an interplay of various factors which are: Chronic high blood pressure: Hypertension over the years is the main cause behind this condition. Advanced age: Chances of hypertension and heart disease increase after 65 years of age. Obesity: High cholesterol levels are a significant risk factor for HHD. Lack of physical activity. Diet rich in trans fats and sodium. Alcohol intake and smoking. Hypertensive Heart Disease Symptoms Hypertensive heart disease presents with several signs and symptoms which are Very high blood pressure >140/90. Irregular palpitations Shortness of breath Dizziness and headaches Chronic fatigue Chest pain during exertion Cardiomegaly (enlarged heart muscle) An episode of myocardial infarction (MI) or heart attack. Hypertensive Heart Disease Diagnosis Hypertensive heart disease is a complicated condition that resembles other conditions related to the heart such as: Cardiomyopathy Disorders of heart valves (aortic stenosis) Coronary artery disease Sleep apnea. Hypertensive Heart Disease Tests The doctors diagnose this condition through clinical examinations, medical history and through various diagnostic tests which are: Transthoracic Echocardiogram: It is a very sensitive test for diagnosing left ventricular hypertrophy. Electrocardiogram (ECG or EKG): It is the typical test that measures the electrical activity and abnormal enlargement of heart tissue due to this condition Lipid Profile: This is the basic test conducted if doctors suspect any condition related to hypertension and heart to check the levels of HDL, LDL, and triglycerides. Urine Test: It is done to assess the presence of proteins in urine Other tests like thyroid profile, complete blood count, and kidney function tests. Stages of Hypertensive Heart Disease Based on the degree or extent of tissue damage, it is divided into Degree I: Diastolic dysfunctions begin to appear with no muscle enlargement. Degree Il: Diastolic dysfunction still persists, along with the beginning of heart muscle enlargement. Degree Ill: It is the stage of heart failure with no compromise in blood pumping capacity of the heart (LV ejection.) Degree IV: The heart muscle is quite enlarged in this stage, along with the reduced capacity to pump blood to the body. Hypertensive Heart Disease Treatment The treatment of hypertensive heart disease is targeted to lower blood pressure to optimum level and prevent heart failure. After assessment of the reports, different groups of antihypertensive medications are given to these patients as monotherapy (only one drug at a time) or in combination with other medications such as Thiazides or Diuretics: Hydrochlorothiazide, indapamide, etc. Beta-blockers: Metoprolol, bisoprolol. Angiotensin-converting enzyme inhibitors (ACE inhibitors): Enalapril, Ramipril, etc. Calcium channel blockers: Amlodipine, clinidipine. Lifestyle modifications Losing weight. Reducing salt intake. Regular physical exercise. Eliminating junk food and smoking. Limiting alcohol intake. Having a diet rich in fruits, vegetables, and fiber. Surgical treatment involves Coronary artery bypass graft surgery (CABG) for treating blocked arteries in severe cases of heart failure. Risk factors for Hypertensive Heart Disease Various risk factors are associated with hypertensive heart disease Age: Chances of the hypertensive heart disease increase with an increase in age Gender: Females are more prone to this condition than men. Ethnicity: It is more common in the African-American race than among Caucasians. Chronic High blood pressure over the years Diabetes: Diabetes also adds to the risk of developing HHD. Hypertensive Heart Disease Preventions Primary Prevention of Hypertensive Heart Disease The foremost thing to prevent hypertension and heart disease is to control the blood pressure. This condition develops over the years, hence early diagnosis with timely treatment which includes making lifestyle modifications, losing weight, doing physical activity regularly, and monitoring the diet and salt intake is the key to preventing this fatal condition. Secondary Prevention of Hypertensive Heart Disease After the diagnosis, it is imperative to stick to a strict diet regime with regular exercise to control blood pressure and maintain weight. With medicines and lifestyle changes, one can prevent the chances of heart failure and other heart-related issues in due course of time. Complications of Hypertensive Heart Disease Hypertensive heart disease is a debilitating condition that increases the chances of other heart and endorgan dysfunction conditions, which include: Stroke Heart failure Cardiac arrest or heart attack Retinal damage Chronic kidney disease Atherosclerosis Epidemiology of Hypertensive Heart Disease Hypertensive heart disease in adults has increased considerably in the last few decades. Globally, 19.60 million were documented in 2019. India has the third-highest prevalence of HHD cases in the world. Prognosis of Hypertensive Heart Disease The outcome of this condition varies among different individuals. Hypertensive heart disease causes a lot of morbidity among its patients. However, by reducing different modifiable risk factors (quitting smoking and alcohol, exercising) and appropriate medications can reduce its progression. Natural Progression of Hypertensive Heart Disease In absence of any treatment, this condition damages the heart muscle to an extent that it fails to pump blood effectively. This leads to various conditions like heart palpitations, and coronary artery diseases and eventually causes death. It also causes CKD and other end organ damage, for example brain (CVA), Eye (retinal detachment). Pathophysiology of Hypertensive Heart Disease In this condition, the heart muscle thickens due to constant elevation of blood pressure over time. This eventually causes dilation of the left ventricle muscle, which is the main muscle of the heart for pumping blood into the body. Over time, this weakens the heart muscle to pump blood effectively, leading to the death of heart muscles culminating in heart failure. Related Blogs 7 Myths About Hypertension and Facts What Are the 4 Stages and Treatment of Congestive Heart Failure? 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Hypertrophic cardiomyopathy is a genetic type of cardiomyopathy that causes thickening of the heart muscles. As a result, blood circulation becomes less efficient inside the heart. Associated Anatomy of Hypertrophic Cardiomyopathy The Heart muscle: the muscle region near the bottom chambers of the heart. Hypertrophic Cardiomyopathy Causes Gene mutations are primary factors for developing hypertrophic cardiomyopathy. Multiple genes are implicated in the thickening of heart muscles. These mutations affect the muscular wall of the bottom chambers of the heart, also known as ventricles, and they become thicker than normal. As a result, blood flow out of the heart becomes difficult. The disease is passed down through the family. If a parent has hypertrophic cardiomyopathy, their children have a 50 percent chance of inheriting this genetic condition. Hypertrophic Cardiomyopathy Symptoms Pain in the chest region Fainting after an intense exercise session Murmuring of the heart Uneven heartbeats Breathing problems Sudden cardiac death Hypertrophic Cardiomyopathy Diagnosis The symptoms of hypertrophic cardiomyopathy are shared with other conditions, such as hypertensive heart disease, athlete’s heart, and aortic stenosis. All of which affect either the heart or the muscles of the heart. A significant number of patients suffering from hypertrophic cardiomyopathy are diagnosed with a cardiac MRI. It can detect the thickening of the heart muscles above 15 mm. Hypertrophic Cardiomyopathy Diagnosis Tests Diagnosis of hypertrophic cardiomyopathy depends on the progression of the disease into its distinct features. The techniques used in the diagnosis are cardiac MRI, catheterization of the heart, echocardiography along with electrocardiography (ECG), and DNA testing of the genes implicated in disease development for ultimate confirmation. Types of Hypertrophic Cardiomyopathy The disease can be categorized into two variants, depending on whether there is an obstruction to the flow of blood. The classifications are: Obstructive hypertrophic cardiomyopathy: blood flow is obstructed. Nonobstructive hypertrophic cardiomyopathy: blood flow is unobstructed but the heart muscle is still stiff. Hypertrophic Cardiomyopathy Treatment Asymptomatic Condition Treatment A majority of people with hypertrophic cardiomyopathy don’t experience symptoms associated with the disease. Hence, a person can leave a normal life with a normal life expectancy. Yet, asymptomatic people should be checked because of the risk of sudden cardiac death. It is also advised to avoid any intensive exercises or actions that increase pressure on the heart. Beta-blockers Medications are used to relieve the symptoms of this condition. Beta-blockers can slow down the rate of heartbeats and decrease the likelihood of uneven heartbeats. Other medications, such as calcium channel blockers, are also used to treat symptoms, as there is no known cure for this condition. Risk Factor of Hypertrophic Cardiomyopathy Hereditary factors: Hypertrophic cardiomyopathy belongs to a set of genetic diseases that are inherited. If parents or siblings of a person are affected by hypertrophic cardiomyopathy, the person carries affected genes. Then it is in the person’s best interest to be screened for this disease regularly, as there is a high chance of developing the disease. Possible Complications of Hypertrophic Cardiomyopathy The changes in the heart's muscle thickness can cause changes in the electrical system powering the heart, causing irregular heartbeats in a condition known as atrial fibrillation. Again, this condition also causes heart muscles to block the flow of blood to the rest of the body. Once the heart muscle is thick enough, which will cause blood to leap back into the atrium (upper chambers) of the heart. The thickened heart muscle becomes so stiff that the heart cannot accommodate the needs of the body. In extreme cases of hypertrophic cardiomyopathy, death can occur in patients in any age group. As the disease can be asymptomatic, people who have inherited the condition are not aware that they have the problem. Sudden cardiac death is often the first sign of the condition. Hypertrophic cardiomyopathy can affect a wide age group - it can be seen in the pediatric population to active, healthy adults. Hypertrophic Cardiomyopathy Prevention Preventive medications: Hypertrophic cardiomyopathy has no known prevention methods. Patients need to identify the condition as early as possible and then treat the condition with medications at the earliest to prevent any complications in the future. Gene testing: Thanks to the predictable nature of the disease, doctors immediately recommend gene testing if the person’s first-degree relatives are affected by the disease. If the DNA testing method is inconclusive, an echocardiogram can be used for confirmation of the disease. Healthy adults should be screened for the conditions at least once a year. People other than athletes should check up once every five years. Epidemiology of Hypertrophic Cardiomyopathy Genetic: the estimated figures from the general population for hypertrophic cardiomyopathy is one affected individual per 625 members of the population. And it is one of the most common causes of sudden cardiac death for people under 35 years of age. Expected Prognosis of Hypertrophic Cardiomyopathy Hypertrophic cardiomyopathy has a mortality rate of 1 percent but is also associated with premature death. Patients affected usually display mild symptoms and have a normal life expectancy. However, they are advised to refrain from intensive training and exercises. Natural Progression of Hypertrophic Cardiomyopathy Patients usually lead a normal life. Unless they are involved in athletics, in which case the symptoms might be noticeable. Yet, a tiny percentage of cases develop some serious life-threatening complications, such as sudden heart failure and cardiac death. Pathophysiology of Hypertrophic Cardiomyopathy In hypertrophic cardiomyopathy, the muscular region known as the septum between the bottom chambers of the heart becomes thicker than usual. And as a result, the muscles become too stiff and block blood flow out of the heart. Worse, the blood leaks back into the heart, affecting circulation. Related Blogs What Are the 4 Stages and Treatment of Congestive Heart Failure? Broken Heart Syndrome: Its Very Much Real Chest Pain: Its Major Reasons & Preventive Lifestyle Changes Surgical Options For Heart Failure: When Is It Necessary?

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Myocardial infarction refers to the necrosis in heart muscle resulting from an insufficient supply of oxygenated blood to an area of the heart. The inadequate blood supply is due to SUDDEN occlusion of a coronary artery supplying heart muscles. Causes of Myocardial Infarction The following condition can cause myocardial infarction: Atherosclerosis: It refers to the development of fatty deposits on the walls of the arteries in the heart. The deposition of fat makes the arteries narrower and reduces the blood flow to the heart muscles. If place rupture suddenly, a clot forms over it and cause sudden blockage of that coronary artery resulting in heart attack. Myocardial infarction can also occur due to reasons other than blockage of arteries. The following are such causes, and it constitutes only 5% of all myocardial infarctions. Spasm of the artery: The muscle lining the blood vessels undergo spasm and restrict the blood flow to the heart muscles. Trauma: The injuries to coronary arteries can end up in myocardial infarction Embolism: It is the lodging of a blockage-causing piece of material inside a blood vessel resulting in infarction. Electrolyte imbalance: The high or low levels of important minerals like potassium can cause an infarction. Rare medical conditions: Rare diseases cause narrowing of blood vessels. Signs and Symptoms of Myocardial Infarction Signs and symptoms of myocardial infarction include: Chest Pain (Angina) chest pain or discomfort, which is very severe, like crushing, constricting, or weight over the chest. Pain is retrosternal, diffuse, and radiating to the left body side (upper limb and shoulder), right upper limb, jaw, back, and epigastrium. Shortness of breath or trouble breathing Heart Palpitations Stomach discomfort that feels like indigestion Profuse Sweating Drowsiness Fatigue Anxiety or a feeling of “impending doom” Nausea and vomiting Insomnia Risk Factors of Myocardial Infarction Age: About 80% of heart disease deaths occur in people aged 65 or older. Although now more patients in younger age also having with heart attack. Sex: Males are more likely to develop heart attacks earlier in life than women. The rate of heart attack increases after menopause in women. Family history: It is an independent risk factor for acute myocardial infarction. A family history of acute myocardial infarction in a first-degree relative doubles the risk of myocardial infarction. Lifestyle: Lack of physical activity, a diet high in sodium, sugar and fat, and addictions (smoking, alcohol consumption and drug abuse) increase the risk of heart attack. Comorbidities: Diseases like diabetes, hypertension, hyperlipidemia, and obesity, sedentary increase the risk of myocardial infarction. Stages of Myocardial Infarction The myocardial infarction has two phases: An Early Evolving Phase: It comprises the first 6 hours associated with an occluded coronary artery. This phase is usually responsive to treatment. Later Convalescent Phase: After the first 6 hours, the heart attack is not usually responsive to treatment in a way that dead heart muscle may not salvageable by restoring blood supply. Diagnosis and Tests The doctors diagnose myocardial infarction by enquiring about the patient’s medical history, signs, symptoms, and physical examination. They may ask the patient to undergo some imaging tests and blood tests. Various diagnostic tests include: Electrocardiogram (ECG): An ECG is the most basic test for this condition, and it records the electrical signals travelling through the heart. Blood tests: Certain heart enzymes (Troponin–T, Troponin-I, CK-MB, AST, LDH) slowly leak into the blood after heart damage. Blood tests help analyse these enzymes. In addition, various confirmatory tests could be recommended, such as: Chest X-Ray: It will show the size of the heart, and checks the fluid in the lungs. Echocardiogram: This test is handy to understand heart chambers’ functioning and identify regional wall motion abnormalities. Angiogram (Coronary Catheterization): It is a special type of X-Ray used to visualise the heart’s blood vessels after injecting a liquid dye into it. It shows blocked coronary artery. Cardiac CT scan (Computerised Tomography) or MRI (Magnetic Resonance Imaging): These are the imaging techniques used to create an image of the heart and to assess the extent of heart damage. Biochemical Parameters: Healthcare professionals must assess the patient’s lipid profile, blood sugar, renal parameters, and liver functions. Alternate Name Myocardial infarction is commonly known as heart attack. Epidemiology Acute myocardial infarction is the leading cause of morbidity and mortality worldwide. MI accounts for 10-25% of all deaths in industrialised countries. Myocardial ischemia with nonobstructive coronary arteries is common in young patients, constituting 9%-15% of all acute myocardial infarction cases. Expected Prognosis with timely treatment, the damage to heart is aborted with good results. Poor prognostic factors include: Advanced age Gender (females are more prone) Diabetes Previous heart attack. Late presentation Long term prognosis depends on ventricular function and degree of obstruction. Natural Progression The gross and microscopic changes in the heart show the initial ischemia followed by necrosis or cell death. It eventually leads to tissue fibrosis. Pathophysiology The pathogenesis includes: Occlusive intracoronary thrombus: A thrombus over a plaque results in myocardial infarctions. Vasospasm: The spasm of blood vessels can be with or without atherosclerosis. One can associate it with platelet aggregation. Emboli: It creates blockage inside a blood vessel resulting in infarction. Possible Complication 80-90% of people develop major complications. 50% of Sudden cardiac deaths occur within an hour. The few common possible complications are: Arrhythmias Cardiogenic shock Progressive heart failure Thrombus or thromboembolism Myocardial rupture Primary Prevention Lifestyle Modification Maintain a healthy weight. Experts consider a BMI of 25 or higher as overweight. Eat a healthy diet, including vegetables, fruits, whole grains, and pulses. Reduce food having excess salt, sugar, and saturated fat. Complete stoppage of smoking and tobacco in any form. Indulge in 30 - 60 min of regular physical activity. Follow relaxation techniques and meditation to manage stress. Undergo regular health Screening, including monitoring blood pressure, blood sugar, and cholesterol levels. Ensure quality sleep. Secondary Prevention It focuses on the early detection of the disease and reduces the impact of disease on the life of patients. Medical Interventions The most common cause is an abnormal amount of lipid in the blood. Medical professionals commonly use statin therapy to treat it. Hypertension is another common cause; doctors treat it with beta-blockers and others medicines as appropriate along with advice for lifestyle change. Lifestyle interventions: Weight reduction Dietary sodium restriction Avoid smoking and tobacco Daily physical activity Stress control Treatment and Care Medications Anti-clotting medications such as Aspirin and other blood-thinning medicines as indicated Nitroglycerine dilates the blood vessels and relieves chest pain. Thrombolytic (Clot-busting) medications are used in the first 12 hours of a heart attack to break the clot and dissolve it. A heart attack can result in the improper beating of the heart. Antiarrhythmic medications can stop or prevent these malfunctioning. Interventional Surgery Primary Percutaneous coronary intervention (PCI) restores the blood supply to the affected heart muscle. Coronary artery bypass grafting (CABG) takes a blood vessel elsewhere in the body to create a bypass around the blocked artery section. This procedure is often called open-heart surgery or bypass surgery.

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Peripheral artery disease (PAD) is a condition characterised by narrowing arteries or blood vessels that reduce blood flow to your limbs (arms and legs). It is a disease of blood vessels (arteries) located away from the heart and brain. In most cases, a buildup of plaque (fatty deposits or cholesterol) in the arteries of your arms or legs causes this disease. Narrowed arteries decrease the blood supply to your limbs, causing the allied symptoms. You can treat this condition with the help of medications and some lifestyle changes. Associated Anatomy of Peripheral Artery Disease Arteries or blood vessels that carry blood away from the heart and brain (arteries of arms and legs). Alternate Names of Peripheral Artery Disease arteriosclerosis obliterans Types of Peripheral Artery Disease We have two common types of peripheral vascular disease (PVD): functional and organic PVD Functional PVD Your blood vessels narrow in response to factors such as brain signals or temperature changes. Organic PVD Changes in the structure of blood vessels due to inflammation, tissue damage or plaque deposition. Peripheral Artery Disease Causes The primary cause of peripheral artery disease is atherosclerosis, narrowing arteries due to the buildup of cholesterol or other substances inside the artery walls. Some other reasons include: Blood clots in arteries High cholesterol levels Blood vessel inflammation Injury to your limbs Unusual anatomy of muscles or ligaments Radiation exposure Peripheral Artery Disease Symptoms Almost half the people with PAD do not experience any symptoms. Pain in the legs is the most common symptom; this pain characteristically subsides with rest and increases with activity (claudication). However, some possible symptoms include: Pain in thigh or calf muscles while walking or climbing stairs Painful hips Weakness in legs The lower leg or feet may feel cold Hair loss on feet and legs Numbness in legs Delayed healing of sores, infections or ulcers on legs and feet Pale, reddish or bluish skin Brittle toenails Difficulty in finding the pulse in the leg or feet Erectile dysfunction in men Peripheral Artery Disease Diagnosis The differential diagnosis of PAD comprises: Chronic Exertional Compartment Syndrome Chronic Venous Insufficiency Degenerative Disk Disease Osteoarthritis (hip, knee, ankle) Spinal Stenosis (i.e. pseudo claudication) Thromboangiitis Obliterans Varicose Vein Surgery Medial Tibial Stress Syndrome Nerve Entrapment Nerve Root Compression Peripheral Neuropathy (diabetes mellitus, alcohol abuse) Deep Venous Thrombosis Popliteal Artery Entrapment Vasculitis Venous Insufficiency Typical tests for diagnosing PAD You can diagnose PAD in several ways. If the doctor suspects the disease, the doctor will initially check the patient’s legs. Ankle-brachial index (ABI)- It is the most common test conducted for PAD, which compares the blood pressure variation between your ankle and arms.& Angiography- Detects the blockage in the artery with the help of X-rays by injecting a contrast agent into the artery. Blood tests- To check cholesterol, homocysteine and C-reactive protein levels. Doppler and ultrasound (Duplex) imaging. Ultrasound scan. Computed tomographic angiography (CT). Magnetic resonance angiography (MRA). Stages of Peripheral Artery Disease Depending on the severity of PAD, there are two classification systems: Fontaine classification Stage I- No symptoms Stage II a- Mild claudication (pain on walking or using arms) >200 m of walking distance Stage II b- Intermittent (moderate to severe) claudication <200 m of walking distance Stage III- Rest pain Stage IV- Avascular Necrosis/gangrene Rutherford classification Stage 0- Asymptomatic Stage 1- Mild claudication Stage 2- Moderate claudication Stage 3- Severe claudication Stage 4- Rest pain Stage 5- Ischemic ulceration, which does not exceed the digits of the foot Stage 6- Severe ischemic ulcers or gangrene Peripheral Artery Disease Treatment PAD treatment aims at reducing the risk of stroke or heart attack and improving quality of life by alleviating your pain on walking. Possible treatment options include: Doctors may prescribe aspirin or similar antiplatelet medicines to prevent PAD and allied atherosclerosis complications Medications to reduce your cholesterol and blood pressure Surgical treatments such as balloon angioplasty, stents or atherectomy Surgery to bypass blocked arteries Changes in lifestyle that can stop the worsening of PAD Daily exercise Following a balanced diet Decreasing stress levels Quitting smoking tobacco Risk Factors of Peripheral Artery Disease Some risk factors that can lead to peripheral artery disease are: High blood pressure and cholesterol Family history of heart disease Excess levels of homocysteine or C-reactive protein Atherosclerosis Diabetes Smoking Obesity Increase in age Peripheral Artery Disease Prevention The following measures can help you prevent PAD: Managing your diabetes, blood pressure, and cholesterol levels Getting plenty of physical activity or exercise Following a nutritious diet Avoiding consuming tobacco Maintaining your weight Possible Complications of Peripheral Artery Disease The restricted blood flow caused by the narrowing of arteries may result in complications such as critical limb ischemia, which occurs when sores, injury or infection of your feet or legs fail to heal, progress and cause tissue death, occasionally requiring amputation; stroke and heart attack, when atherosclerosis or plaque form in arteries that may even affect arteries supplying blood to your heart and brain, which may result in a heart attack; severe pain that limits mobility; non-healing wounds; life-threatening infections; impotence and death. Epidemiology of Peripheral Artery Disease More than 200 million people suffer from PAD globally. Incidence of PAD is relatively uncommon in younger people, and its prevalence is high in the age group of 60 to 80, with >20% cases in >80-year-old individuals. It is more likely to affect men than women (ratio of 2:1). Smokers have a 2.5 times risk of getting PAD. Incidence of PAD is 50% greater in African Americans as compared to Americans. Expected Prognosis of Peripheral Artery Disease The prognosis of PAD largely depends on its severity, as measured by an ABI, your overall health and the amount of plaque formed in your body. PAD with large vessels is associated with an increased risk of ischemia, coronary disease or morbidity. Its outcome is much better when PAD is diagnosed in the early stages. With lifestyle changes, you can have an active and healthy life. Although the plaque buildup may aggravate PAD and can sometimes be painful, there are ways to slow it down. Pathophysiology of Peripheral Artery Disease PAD is usually caused by the plaque buildup in the arteries of your legs and arms, which are meant to carry oxygen and nutrient-rich blood from the heart to your limbs. The smooth lining of arteries usually prevents blood from clotting and supports steady blood flow. However, in PAD, plaque formed by (fat, cholesterol or other substances) eventually narrows your arteries, restricting the blood flow to organs and tissues, causing further complications. Natural Progression of Peripheral Artery Disease PAD is usually associated with plaque deposits in your arteries. Often these deposits are hard on the outside and soft on the inside. The hard surface can crack or tear, causing platelets to gather and form a clot, which further narrows the arteries. The lack of blood supply to tissues and organs can deprive them of oxygen and nourishment, resulting in organ damage or death (gangrene). However, the progression depends on several factors and varies with every person. Related Blogs Harmful Effects Of Tobacco Build The Body, But Don`t Break The Heart

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Peripheral vascular disease (PVD) is a disorder in the blood circulation caused by the narrowing or blocking of blood vessels. The blood vessels affected by PVD lie outside the heart and may afflict arteries, veins, or lymphatic vessels. Associated Anatomy of Peripheral Vascular Disease Narrowing blood vessels results in decreased blood flow, especially to the brain and legs, thereby affecting these organs the most. Peripheral Vascular Disease Causes Peripheral vascular disease is caused by: Plaque buildup inside the artery wall: Plaque formation decreases the blood flow to the limbs and reduces nutrients and oxygen available in the tissue. Blood clots form a layer in the arterial walls, narrowing the blood vessels and decreasing blood flow. Blood vessel inflammation: PVD can occur when the blood vessels are inflamed due to infection or auto-immune diseases such as rheumatoid arthritis. Cold temperature: Blood vessels tend to constrict and reduce blood flow to the skin in cold temperatures. This leads to increased blood pressure and can also cause peripheral vascular disease. Injury to the arms or legs: Injuries on the arms or legs can cause a narrowing of arteries, thereby preventing blood from reaching the desired locations. Peripheral Vascular Disease Symptoms Reduced hair growth on legs Impotence Numbness or weakness in muscles Severe burning on toes with blue colour Decreased mobility Opaque toenails Pain in toes at night while lying flat Weak pulses Leg cramping Peripheral Vascular Disease Diagnosis The most commonly used test for PVD is the Ankle/Brachial Index Test. In this test, the physician compares the systolic blood pressure in your ankle to the systolic blood pressure in your arm. The blood pressure ratio in your ankle and arm indicates the PVD risk. Stages of Peripheral Vascular Disease There are different stages of PVD. About 20% of individuals above the age of 60 years have PVD, encompassing both asymptomatic and symptomatic diseases. Below are the different stages of PVD: Stage 0: Asymptomatic Stage 1: Mild lameness Stage 2: Moderate lameness Stage 3: Critical lameness Stage 4: Pain Stage 5: Ischemic ulceration Stage 6: Severe Ischemic ulceration Peripheral Vascular Disease Treatment Change in Lifestyle It is imperative to change your lifestyle to control PVD symptoms. Regular exercises and consuming proper nutrition are a must. Quit Smoking Smoking is hazardous to health and causes reduced blood flow in vessels. Therefore, it is advisable to quit smoking, as smoking is also associated with other diseases. Take Anticoagulants and Beta-blockers Anticoagulant drugs can prevent blood clots, and beta-blockers slow the heart rate & lower the pressure. Take Cilostazol Cilostazol helps to relax arteries, allows them to enlarge, and increases the blood flow. Angioplasty A catheter may be inserted to create a large opening in an artery to increase the blood flow. Vascular Surgery In Vascular surgery, a bypass graft using a blood vessel is placed in the area of the narrowed artery for rerouting the blood flow. Risk Factors of Peripheral Vascular Disease Age: If you are above 50, you have more chances of developing PVD. Obesity: By accumulating more fats, the cholesterol plaque slowly buildups up. Over time, this plaque hardens and blocks the blood flow. History of heart disease: Those who have a history of heart disease have a greater risk of complications arising from peripheral vascular disease. Diabetes: Individuals who have diabetes are also prone to PVD. Familial high blood pressure and cholesterol: High blood pressure also causes plaque formation in the artery walls. Due to a large amount of plaque, your arteries become narrowed. Family history of high blood pressure and heart diseases are indicators for taking due precautions. Complications of Peripheral Vascular Disease (PVD) Several complications associated with PVD include severe pain, poor wound healing, bone infection, restricted mobility, tissue death, and stroke. Peripheral Vascular Disease Prevention Primary Prevention of Peripheral Vascular Disease Smoking Cessation: The primary prevention of PVD in the initial stage is to stop smoking. It is recommended to avoid smoking because it also prevents other critical illnesses like lung cancer, coronary artery disease, and stroke. Reduce fat and cholesterol in your diet: Fat and cholesterol-rich food items encourage plaque formation in the artery walls. Therefore, reducing these items in your diet can prove beneficial. Weight loss: It is also essential to maintain a proper weight to prevent symptoms of PVD. Secondary Prevention of Peripheral Vascular Disease Correction of hypertension: It is essential to control your blood pressure to avoid the recurrence of PVD symptoms. Take proper medicine: If your healthcare provider recommends medications to reduce your risks of blood clots, take them on time. Control diabetes: An increase in blood sugar level affects the lining around the cells in the blood vessels and leads to stiffness in the blood vessels. This causes hindrance in the blood flow. Thus, controlling diabetes helps maintain the flexibility of blood vessels. Epidemiology of Peripheral Vascular Disease (PVD) Peripheral vascular disease is uncommon until middle age, but the progress is rapid after that. The occurrence has been determined to be higher in men than women. Expected Prognosis of Peripheral Vascular Disease (PVD) PVD can give rise to severe health issues such as permanent damage to heart muscles, heart attack, and stroke if left untreated. In extreme cases, the patient may need to undergo amputation. Natural Progression of Peripheral Vascular Disease Once you are diagnosed with PVD, there is no cure. However, you can control and decrease the symptoms with the help of medicines and lifestyle changes. Pathophysiology of Peripheral Vascular Disease (PVD) PVD arises due to the formation of plaque inside the artery wall. Changes in your lifestyle and embracing a healthier balance go a long way to help you lead a better life. These include controlling your weight & blood sugar levels, quitting smoking, regular exercise, and reducing fat intake. Related Blogs Harmful Effects Of Tobacco How Diabetes Affects Your Kidneys

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A prosthetic valve failure is when an implanted valve in the heart is diseased or damaged. There are several reasons why a prosthetic valve failure can happen. Any heart valve can be diseased, and the damaged prosthetic valve may not open and close. Etiology of Prosthetic Valve Failure Thrombosis - Thrombosis occurs due to inadequate anticoagulation, low cardiac function, and atrial fibrillation. Pannus formation - It is the result of an overgrowth of fibrous tissue that invades the valve orifice and may lead to a non-immune inflammatory reaction. Pannus formation can also be one of the reasons for the re-operation of the valve. Infection - Some lifestyle habits and diseases such as diabetes, metabolic syndrome, smoking, and others may lead to prosthetic valve failure. Calcification - Calcium builds up on the implanted tissue leading it to be hardened, causing prosthetic heart failure. Two of the most common causes of prosthetic valve failure are pannus formation and thrombosis. These causes have been identified in more than 80% of patients with prosthetic valve failure. Prosthetic Valve Failure Symptoms Some of the common symptoms observed in prosthetic valve failure are as follows: Muffled mechanical heart sounds. Dyspnea. New murmur. Cardiogenic shock or heart failure. If the thrombosis is on the right side of the heart, it can cause right-sided heart failure. Swelling of legs. Pulmonary congestion. Swelling in the abdomen. The symptoms can be acute or progressive depending on the rate or degree of the stenosis. Additionally, a prosthetic heart failure can also lead to transient ischemic stroke or pulmonary embolism if not treated on time. Thus, it is advisable to immediately seek professional medical help if you observe or suspect any of the above-mentioned signs and symptoms of prosthetic valve failure. Prosthetic Valve Failure Diagnosis and Tests The doctor will conduct a physical examination and listen to the heart murmur. In addition, the doctor may prescribe several tests before diagnosing the condition. Some of the tests prescribed by the doctors are as follows: Echocardiography This test helps assess the structure of the heart, the heart valves and the blood flow through the heart. Cardiac MRI An MRI uses radio waves and magnetic fields to create detailed images of the heart. Cardiac Catheterization This test gives the doctor a detailed picture of the heart arteries and how it functions. Chest X-ray A chest X-ray can help the doctor determine whether the heart has enlarged. Electrocardiogram (ECG) An ECG detects the enlarged chambers of the heart, heart disease and abnormal heart rhythms. Stress Tests It helps measure activity tolerance and monitor the heart’s response to any physical exertion. Prosthetic Valve Failure Treatment The treatment of prosthetic valve failure would depend on the symptoms, severity, and condition of the patient. The treatment options for prosthetic valve failure are as follows: A mechanical valve failure or obstruction caused due to pannus formation requires heart surgery. This surgery would help remove the pannus and replace the damaged valve. Thrombolytic therapy followed by Intravenous heparin is recommended for the treatment of mechanical valve thrombosis. Surgery is considered if heparin and thrombolytic therapy fails. Surgery may involve either removal of thrombus or if not possible re-replacement of the mechanical valve. But 99% times thrombus can be managed conservatively by thrombolytic agents without the need of surgery. In addition to the above surgery options, the doctor could also recommend a few lifestyle changes such as: Maintaining the required dose of anti-coagulation Eating healthy and maintaining a balanced diet. Maintain healthy body weight. Manage your stress levels. Regular physical activity. Avoid consumption of tobacco. Prosthetic valve repair is increasing among the geriatric population. Prosthetic valve thrombosis is a serious complication of valve replacement. The rising morbidity and mortality associated with this condition lead to rapid diagnostic evaluation. The doctors may recommend various tests for the diagnosis of prosthetic valve failure along with physical examination. Also, healthy lifestyle changes, taking regular prescribed medication, and using blood thinners to reduce the risk of blood clots are the other treatment options recommended by doctors for patients diagnosed with prosthetic heart valve failure.

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Rheumatic heart disease is an acquired heart disease in which the heart valves become damaged due to rheumatic fever. Rheumatic fever is an autoimmune disorder caused due to streptococcal bacteria. The damage to heart valves develops if the rheumatic fever is inadequately treated. If a rheumatic heart disease is left untreated, it can lead to critical health conditions like heart failure. Associated Anatomy of Rheumatic Heart Disease Heart Rheumatic Heart Disease Causes Rheumatic fever: Rheumatic heart disease is caused due to rheumatic fever. Inadequate treatment of rheumatic fever exacerbates the valve involvement. Rheumatic fever occurs following a throat infection from group A streptococcus infections. Rheumatic fever causes inflammation of heart valves and muscles, resulting in rheumatic heart disease. Rheumatic Heart Disease Symptoms Common symptoms of rheumatic fever include- Fever Fatigue Fleeting pain and swelling in joints, especially knees and ankles Weakness Lumps under the skin (nodules) Jerky or uncontrolled movements of facial muscles, arms, and legs (chorea) Heart murmur Symptoms of rheumatic heart disease may not be apparent for many years. When they eventually occur, the symptoms depend on the extent of damage to the heart valves. Some symptoms of rheumatic heart disease include: Chest discomfort or Pain Fatigue Shortness of breath Swelling of feet or hands, Irregular or rapid heartbeats Heart murmur. Rheumatic Heart Disease Diagnosis In addition to a thorough medical history analysis and physical exam, the following tests help diagnose rheumatic heart disease- Blood test To detect bacteria and inflammation. Electrocardiogram (ECG) This test evaluates the electrical conductivity of the heart. It detects abnormal heart rhythms. Chest X-ray To check if the heart is enlarged. Echocardiogram (echo) This test can diagnose heart valve problems Cardiac MRI This test gives detailed heart images to get precise information regarding heart muscles and valves. Rheumatic Heart Disease Treatment The damage to the heart valves is permanent. However, treatments can aid in controlling the symptoms and halt the disease progression. Treatments for rheumatic heart disease include- Drugs Depending on the severity of rheumatic heart disease, the doctor may use drugs to manage arrhythmia or heart failure (irregular heart rhythm). Anticoagulants may reduce the risks of blood clots or stroke. Surgery Heart valve surgery helps in severe cases of rheumatic heart disease which has resulted in permanent damage to the heart valves. Risk Factors of Rheumatic Heart Disease People who live in unhealthy conditions and overcrowded places are also at increased risk. Improper treatment of streptococcal infections increases the risk of rheumatic heart disease. Children or adolescents who get repeated streptococcal infections are the most susceptible to rheumatic heart disease. People are at increased risk for rheumatic heart disease if they do not have easy access to medications or health care. Rheumatic Heart Disease Prevention Primary Prevention of Rheumatic Heart Disease Medications for rheumatic fever: An effective strategy would be to prevent the occurrence of rheumatic fever by using appropriate antibiotics like benzathine penicillin G. It is essential to ensure an entire antibiotic course is completed as prescribed and instructed by the health care provider. Improving the quality of life, increasing access to health care, ensuring a constant supply of medications, etc., are some ways of preventing rheumatic heart disease in endemic countries. Secondary Preventions of Rheumatic Heart Disease Long-term antibiotic therapy is critical to halt disease progression to a severe form and prevent additional bacterial infections. Epidemiology of Rheumatic Heart Disease; More than 2,50,000 people succumb to rheumatic heart disease every year, with a majority of the fatalities occurring in middle or low-income countries. Rheumatic heart disease is the most common acquired heart disease in people under 25. Expected Prognosis of Rheumatic Heart Disease Individuals with well-controlled rheumatic heart disease can have an excellent quality of life, though the condition is life-long and requires long-term therapy. Proper care can delay or halt the development of permanent damage to the heart valves and heart failure. Natural Progression of Rheumatic Heart Disease If a rheumatic heart disease is left untreated, it can lead to life-threatening conditions like heart failure. Pathophysiology of Rheumatic Heart Disease Rheumatic heart disease is an autoimmune disorder characterised by damaged heart valves. This occurs following repeated episodes of rheumatic fever caused by streptococcal bacteria. The human body elicits an immune response generally to fight infections caused due to bacteria, viruses, or other foreign organisms. However, in rheumatic fever, the developed immune response starts attacking normal healthy tissues in the heart, skin, central nervous system, etc. After repeated episodes of rheumatic fever, the heart valves get damaged, resulting in rheumatic heart disease. If it is left untreated, heart failure or death ensues. Complications of Rheumatic Heart Disease Rheumatic heart disease may lead to: Endocarditis: In this condition, the infection involves the damaged heart valves and becomes difficult to eradicate. Pregnancy and delivery complications: Individuals should consult their health care provider if they intend to get pregnant. Heart failure: A disease characterised by inadequate pumping of blood by the heart. Leaking or severely narrowed heart valves are important risk factors . Atrial fibrillation (irregular, rapid heartbeat), arrhythmia (improper heartbeat, either too slow or fast), and pulmonary hypertension are other possible complications of rheumatic heart disease. Related Blogs What Are the 4 Stages and Treatment of Congestive Heart Failure? Broken Heart Syndrome: Its Very Much Real How To Cure Rheumatoid Arthritis Permanently?

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Supraventricular Tachycardia (SVT) refers to a medical condition characterised by an irregularly fast and erratic heartbeat (arrhythmia) that arises from the heart's upper chambers. In other words, in SVT, the heart suddenly beats much faster than the normal rate. A person's heart typically beats about 60 to 100 times per minute. A heart rate of more than 100 beats per minute is called tachycardia. During an attack of SVT, the patient's heart rate can range between 150 and 220 beats per minute. SVT arises from the atria or the atrioventricular node in the heart. In this condition, electrical signals in the atria fire on early and hence the atria contracts too soon. This interrupts the main electrical signal coming from the SA node, and as a result, the heart beats quickly, causing the abnormality. Types of Supraventricular Tachycardia (SVT) There are four main types of SVT: Atrial Fibrillation Atrial Flutter Paroxysmal Supraventricular Tachycardia (PSVT) Wolff-Parkinson-White syndrome. Supraventricular Tachycardia (SVT) Causes In some cases, Supraventricular Tachycardia patients are born with abnormal pathways or electrical circuits in the heart. However, in some cases, SVT can also be caused due to the following reasons: Consumption of caffeine or alcohol Smoking, tobacco in any form Physical or emotional stress Any kind of heart disease Diabetes Chronic lung disease Thyroid disease Side effects of certain medications such as asthma drugs, decongestants, and some herbal diet remedies Consumption of chemical drugs such as cocaine or meth, etc. Pregnancy Excessive exercise. Supraventricular Tachycardia (SVT) Symptoms The main symptom of supraventricular tachycardia is a very fast heartbeat that may last for a few minutes to a few days. Some people with SVT have no signs or symptoms. In some cases, SVT symptoms may arise and get resolved suddenly without any kind of treatment. Symptoms of SVT include: Rapid heartbeat (more than 100 beats per minute) Pounding in the chest, i.e. palpitations Pounding sensation in the neck Fatigue or tiredness Chest pain Shortness of breath Dizziness or Lightheadedness Sweating Fainting In infants and very young children, signs and symptoms of SVT may also include pale skin, sweating, poor feeding and a rapid pulse. Supraventricular Tachycardia (SVT) Diagnosis and Test Diagnosis starts with a physical exam and medical history. After the physical examination, a few tests can be prescribed by the healthcare provider. These tests may include: Electrocardiogram (ECG)and holter ECG analyses the abnormal heart rhythm. ECG helps to watch heart rhythm over a long period continuously (holter). Blood test Blood work is done to test for various underlying medical conditions such as hyperthyroidism or electrolyte abnormalities. Chest X-ray X-ray is done to check for lung problems and examine the size of the heart. Treadmill test (TMT)/ Stress test TMT is done to check how the heart works during physical exercise. Echocardiography Echocardiography is done to check the heart structure and function. Electrophysiologic study (EPS) EPS is done to evaluate the electrical activity and detect abnormal pathways in the heart and these are ablated if found. Supraventricular Tachycardia (SVT) Treatment Supraventricular tachycardia is rarely a life-threatening condition. But some patients require treatment. Treatment of SVT includes procedures like: Radiofrequency ablation Thin tubes are placed through a vein or artery into the heart to deliver radiofrequency waves to locate and destroy the abnormal electrical pathways. This is an invasive but low-risk procedure that permanently cures most patients' problems. Cryoablation This treatment involves the AV node. It uses extreme cold to destroy those tissues in the brain that triggers SVT. Cardioversion A small electric shock is given to the heart to help it get back to a normal rhythm. Medicines Medication is given in the form of tablets or intravenously. An acute attack of Supraventricular Tachycardia is treated with Esmolol. A severe attack of SVT is treated with a variety of drugs, including simple AV nodal blocking agents such as beta-blockers, verapamil and sometimes, antiarrhythmic drugs. Risk Factors of Supraventricular Tachycardia (SVT) Supraventricular tachycardia is very common in infants and children. It also occurs in pregnant women. Other risk factors for SVT are: Age: SVT is more common in middle-aged or older people. Acquired heart disease: Patients who have a medical history of narrowed heart arteries, heart failure, damage to the heart or heart valves, cardiomyopathy, or any previous heart surgery have increased risks of SVT. Nicotine and illegal drug use: Excessive use of nicotine and drugs, such as amphetamines and cocaine, can trigger SVT. Thyroid disease: Chances of SVT are higher in patients who have an overactive or underactive thyroid gland. Diabetes: Diabetes increases the risk of developing heart disease and high blood pressure and arrhythmia. Obstructive sleep apnea: In obstructive sleep apnea, breathing is interrupted during sleep. This increases the risk of SVT in patients. Congenital heart disease: SVT is common in people born with a congenital heart defect. Supraventricular Tachycardia (SVT) Prevention Maintaining a healthy lifestyle is an important step in preventing SVT. These include steps like eating a heart-healthy diet, not smoking, getting regular exercise and managing stress. Large amounts of caffeine intake should be avoided. To prevent an episode of Supraventricular tachycardia, it is crucial to identify the triggers and try to avoid them. Medications, which the patient regularly uses for treating any kind of medical condition, should be consumed with utmost care and caution. Some medicines may contain stimulants that trigger SVT. Most important thing to remember is that the medications may not be discontinued abruptly.

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A thrombus (clot) formed in the blood vessel or heart breaks loose and is carried by the bloodstream to plug in another blood vessel and blocks it, called a thromboembolism. It is dangerous as it can affect multiple organs like lungs, brain, kidneys, gastrointestinal tract, or legs. It can cause disease (morbidity) or death (mortality). Associated Anatomy of Thromboembolic Disease Blood Vessels Thromboembolic Disease Causes Having inherited this disorder or having a family history of thromboembolism Overweight or obesity Advanced age Chronic diseases like cancer, heart disease, or lung disease, and IBS (inflammatory bowel disease). An injury to a vein either due to disease, trauma, or major surgery Use of a central venous catheter Wearing a cast Being confined to the bed for a prolonged, i.e., immobility for any reason Maintaining a sitting posture for a long duration (crossed legs) Treatment for birth control that is estrogen-based Restriction of movements due to fracture Autoimmune disorders Hardening of arteries Hypercoagulable state Thromboembolic Disease Symptoms Cramps or soreness, often starting in the calf area. Swelling and pain in the affected leg or arm. Sometimes it may be in both legs or arms. Feeling warmth in the affected leg can be severe. The skin of the affected leg may look red, shiny or discolored. Discomfort or pain in the chest may worsen while coughing or taking a deep breath. Feeling dizzy or lightheaded. One side of the body feels weak or numb. Sudden change is felt in the mental state. The rapid increase in pulse and breathing. Blood in sputum. Types of Thromboembolic Disease There are two types of thromboembolism. Venous Thromboembolism Venous thromboembolism occurs when a clot in the veins blocks it. It includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Arterial Thromboembolism Arterial thromboembolism occurs when a clot in the artery blocks it. It restricts the blood flow due to clots (ischemia). Thromboembolic Disease Diagnosis The symptoms of DVT can be similar to that of hematoma, lymphedema, cellulitis, and arterial insufficiency. Patients with PE can have a differential diagnosis Congestive heart failure Acute respiratory distress syndrome Pneumonia Myocardial infarction So to evaluate PE, an assessment must be done to rule out the above conditions. Typical Test of Thromboembolic Disease Duplex ultrasonography uses sound waves to check blood flow in the veins. It detects blockages or clots in the deep veins. D-dimer blood test measures the substance released when a blood clot breaks in the blood. A contrast dye is injected into a large vein, and an X-ray is taken. This is called Contrast Venography. Magnetic resonance imaging (MRI) and computed tomography (CT) scan are imaging tests. Ventilation-perfusion scan uses a radioactive substance to show the ventilation and perfusion scan. Pulmonary angiography is an invasive test and is used in certain patients to diagnose pulmonary embolism. Thromboembolic Disease Treatment Anticoagulants or blood thinners reduce the clotting ability of the blood. Anticoagulants can cause bleeding, so they must be monitored to prevent bleeding. Some injectable anticoagulants are: Unfractionated heparin is injected into a vein Low molecular weight heparin (LMWH) and fondaparinux are injected under the skin subcutaneous Some oral anticoagulants are: Warfarin No AC3: Dabigatran Rivaroxaban Apixaban Edoxaban. Thrombolytics are also called clot busters. They work by dissolving the clot. They are for severe cases. The filter can be inserted inside the Inferior vena cava to trap or capture the moving clot. Surgical procedures like thrombectomy/embolectomy are done to remove the lodged clot. Risk factors of Thromboembolic disease People aged 60 and above are at risk. An extended stay in the hospital and prolonged bed rest or paralysis restricts movements of the legs still and stops. Surgery or injury of the veins increases the risk. The veins in the pelvis and legs feel more pressure during pregnancy. Hormone replacement pills or oral contraceptives. Being obese or overweight increases the pressure in the veins of the pelvis and legs. Smoking affects blood circulation and can increase the risk of blood clots. Cancer, heart failure, and Inflammatory bowel disease increase the risk. Complications of Thromboembolic Disease The blood flow can be hindered in both veins and arteries by thrombosis. Stroke, heart attack, and breathing issues are the most severe problems. As PE is life-threatening, immediate help is needed as the lung is blocked by a blood clot that travels from another part of the body to the pulmonary artery. Postphlebitic syndrome occurs when a clot damages a vein and reduces blood flow, causing swelling, skin sores, and discoloration. Blood thinners can cause bleeding, increasing the treatment complications. Thromboembolic Disease Prevention Primary Preventions of Thromboembolic Disease If you are in bed for a long duration, try to move as soon as possible. One should avoid sitting still so that blood starts to flow. Quit smoking Regular exercise will help in blood circulation and will help to control weight. While travelling for more than four hours, one needs to change posture around every 1 to 2 hours. Exercising legs by raising and lowering heels and keeping toes on the floor will benefit. Avoid wearing tight clothes. Change the lifestyle and follow the doctor’s recommendation. Secondary Prevention of Thromboembolic Disease Using oral anticoagulants instead of vitamin K is growing, effective, and safe even if lower doses are given. Epidemiology of Thromboembolic Disease There is an exponential increase in the risk with age (after 60). There is not much difference between men and women suffering from thromboembolism. Asian-Pacific Islanders and Hispanics are at a lower risk of developing thromboembolism. In the US, 100000 to 300000 deaths from VTE are reported yearly. In Europe, the number rises to more than 500000 deaths annually. Thromboembolism is seen to develop more commonly in winter than in summer. Expected Prognosis of Thromboembolic Disease The expected outcome of thromboembolic disease often depends on the present type. For many conditions, such as deep vein thrombosis and pulmonary embolism, it is essential to treat the condition immediately to avoid severe complications and even death. Natural Progression of Thromboembolic Disease Depending on the comorbidities, the mortality rate varies. In the first 30 days, patients with acute VTE and have multiple comorbidities, including heart failure and atrial fibrillation, have a high mortality rate (4.5%) when hospitalized. Patients with unstable PE have reported a mortality rate of 14%. Pathophysiology of Thromboembolic Disease When a platelet and fibrin clot is formed within the vascular lumen, venous thrombosis, the clinical formation of thrombi, is seen in vessels with large lumens having deep veins like that of the arms, legs, and pelvis. There is propagation with the proximal extension of the clot. Clinical symptoms are visible when the clot propagates such that it obstructs vascular flow. When the clot dislodges, it can embolize to a distant site. The pulmonary vasculature is the most common site. Pulmonary vascular flow, if obstructed, can cause impaired gas exchange, alveolar edema, or even pulmonary alveolar necrosis. Increased pulmonary vascular resistance and pulmonary hypertension are seen in chronic repetitive pulmonary embolization. In the cardiac abnormalities, paradoxical embolism of the clot occurs in systemic arterial vascular tree may cause CVA. Related Blogs Debunking 10 Myths Related To Contraception

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Unstable angina is a form of angina characterized by a sudden, intense chest pain that occurs even while you're resting. Unstable angina is a clinical condition associated with decreased blood flow and oxygen supply to the heart. Associated Anatomy of Unstable Angina Heart, Shoulders, Arms, Jaw Alternate Name of Unstable Angina The other alternative name for unstable angina is crescendo angina. Unstable Angina Causes The most common cause of unstable angina is the narrowing of the coronary arteries. This narrowing of the artery is mainly caused by plaque or fat deposits inside the wall of the arteries. They decrease the area for the blood to flow and reach the heart. This reduced flow of blood to the heart decreases the oxygen supply to the heart and leads to unstable angina. This condition is known as atherosclerosis, which leads to coronary artery disease, the major cause of unstable angina. Various risk factors increase the chances of coronary artery disease. Unstable Angina Symptoms One of the most important signs of unstable angina is pain and discomfort in the chest. These chest pain could be sharp squeezing pain which may sometimes radiate to the extremities, including shoulders, arms, jaws, and neck. Chest pain that occurs even at rest is an indication of unstable angina. The other signs and symptoms of unstable angina are: Nausea Anxiety Sweating Shortness of breath Dizziness Unexplained fatigue Long duration of chest pain and Chest pain that doesn’t improve even after taking nitroglycerine may indicate progression to heart attack. Unstable Angina Diagnosis The differential diagnosis for unstable angina are as follows: Acute myocarditis Microvascular disease Pneumonia Pulmonary hypertension Tracheobronchitis Typical Tests of Unstable Angina The initial diagnosis of unstable angina is determined by the medical history, signs, symptoms, and the patient's physical examination, including the blood pressure. Once the initial diagnosis is established, your doctor may advise additional tests to confirm the diagnosis. These include: Blood tests: This is used to detect any damage to the heart muscle Electrocardiogram: This is a specific test to check the pattern of your heartbeat that indicates any reduction in blood flow. Echocardiography: This test uses an imaging technique to produce images of your heart which is used to detect any problems in the blood flow. Stress tests Computed tomography angiography: This helps in visualizing the narrowing of the artery. Coronary angiography: This is one of the most common tests and important used to diagnose unstable Angina due to coronary artery stenosis. Unstable Angina Treatment The management of unstable angina based on the severity of the disease and overall health can be divided into three types Drug therapy One of the main therapies advised by the physician includes prescribing blood thinners. These groups of drugs are used to make the blood thin and increase the blood flow through the narrowed artery. The major drugs in this group are aspirin, clopidogrel, and heparin. The other medications that can also be advised to help in relieving the symptoms of unstable angina are: Drugs that reduce blood pressure Drugs to control cholesterol levels Anti-anxiety drugs Surgery and Procedures Your doctor may advise more extensive treatment if you have a blockage or significant obstruction in an artery. Angioplasty with stenting: Angioplasty is one of these procedures in which a previously blocked artery is opened. This involves the insertion of an artificial tube-like device called a stent to maintain the blood flow in your artery. Coronary artery bypass grafting (CABG): In extreme cases, bypass surgery may be required. Coronary artery bypass grafting (CABG) technique helps increase blood flow to your heart by bypassing blockage. Lifestyle changes The long-term management of unstable angina may need to make lifestyle changes. These lifestyle changes are one of the important aspects in the management of unstable angina. These lifestyle changes include: Moving to a healthy diet Stress reduction exercises and therapies Physical activity Weight loss Quitting smoking All these lifestyle changes help reduce and manage the symptoms of unstable angina. However, it is always advisable to consult your physician to decide on the exact treatment plan, including the lifestyle changes appropriate for your individual need. Risk Factors of Unstable Angina Risk factors for coronary heart disease that eventually increase the chances of unstable angina are: Diabetes Obesity Family history of heart disease High blood pressure high low-density lipoprotein (LDL) cholesterol low high-density lipoprotein (HDL) cholesterol being male using any form of tobacco leading a sedentary lifestyle. Complication of Unstable Angina When you have unstable angina, you might have a heart attack, heart failure, or difficulties with your heart rhythm. Your future is determined by how well your heart is functioning, the severity of your arterial blockages, and whether or not you have had a heart attack. Prevention of Unstable Angina The main aspect of primary prevention is to avoid any risk factors that increase your chances of getting unstable angina. These Self-care choices that aren't medical include losing weight, quitting smoking, and exercising more frequently. A healthy lifestyle will protect your heart and decrease your risk of unstable angina attacks in the future. Epidemiology of Unstable Angina Coronary artery disease affects a substantial percentage of the population. Over a third of all deaths from coronary heart disease occur among people over 35 years of age. It is the most common cause of death in this age group. Males are affected more frequently than females, but as they become older, the prevalence of males and females becomes closer. Related Blogs Chest Pain: Its Major Reasons & Preventive Lifestyle Changes

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The human heart has different valves (tricuspid, pulmonary, mitral and aortic valve) to ensure that blood flows in the right direction. They prevent the backflow of blood by opening and closing their flaps at correct intervals. Valvular heart disease (VHD) is the condition when one or more valves stop functioning properly, causing disruption in blood flow. Alternate Name of Valvular Heart Disease Heart Valve Disorder Causes of Valvular Heart Disease Congenital Malformation of heart valves: The heart valves are irregular in shape, and the flaps are improperly attached. Bicuspid aortic valve disease: The bicuspid valve has only two flaps instead of three, which do not allow it to open or close properly. This causes a backflow of blood. Marfan syndrome: This affects the connective tissue and may lead to bicuspid valve prolapse and aortic valve regurgitation (backflow). Acquired Rheumatic fever: Untreated streptococcal bacterial infection in the throat causes strong immune system reactions. This may lead to scarring or inflammation of the heart valves. Infections: Infective endocarditis causes germs to attack the heart’s surface, enter the valves and cause damage. Syphilis infections weaken the aortic valves. Age-related Calcification: Calcium deposition on the valves leads to stenosis (narrowing). Degenerative valve disease: Valves tend to deteriorate with age. It may cause valve prolapse. Heart-related issues Like cardiomyopathy, heart attack, atherosclerosis, and coronary artery disease are major causes. Radiation therapy Exposure to radiation therapy may make an individual more susceptible to valve fibrosis and calcification. Valvular Heart Disease Symptoms Feeling of tightness in the chest Irregular heartbeat and palpitations Shortness of breath Constant fatigue Episodes of dizziness Fever Unexplained weight gain Heart murmur Swelling in body parts like feet, ankles or abdomen Pulmonary edema Valvular Heart Disease Diagnosis Valvular Regurgitation Also known as leaking of heart valves, this condition is caused due to the inability of the valves to close properly. Valvular Stenosis The valves stiffen and narrow. It restricts the blood flow and induces the heart to pump harder. This causes weakening of heart muscles. Valvular Prolapse There is a deformity in the tissue of the valves, which makes it slip backward loosely. Valvular Heart Disease Tests The diagnosis for this condition involves a thorough physical examination that includes checking for heart murmur and fluid build-up. This is followed by a chest x-ray. An echocardiogram or electrocardiogram may be advised. Angiograms, cardiac MRIs, or CT scans may be needed before surgery. Routine blood tests are also done. Stages of Valvular Heart Disease At risk: The individual has one or more risk factors pertaining to the disease. Progressive: The individual is asymptomatic, and the situation is not that grave. Asymptomatic severe: Although heart valvular disease symptoms are not noticeable, the severity of the condition has increased. Symptomatic severe: The individual develops symptoms due to the severity of the disorder. Heart Valvular Disease Treatment Depending upon the individual’s age, health and severity of the condition, one of the following remedies are suggested: Medication Blood thinners, diuretics, and antiarrhythmics are prescribed to alleviate the symptoms. They prevent complications like hypertension and blood clots. Beta-blockers are administered to slow down the palpitations. Surgery If valve repair or replacement is necessary, surgery has to be performed: Valve repair surgery: This is achieved through the removal of calcium deposits (commissurotomy and decalcification), reshaping and patching up the flaps, or tightening the ring supporting the valve (annuloplasty). Valve replacement surgery: If beyond repair, the surgeon replaces the valve with a mechanical (carbon, metal, or ceramic) one or a biological one (own or donated or animal tissue). Risk Factors of Valvular Heart Disease Age: Individuals above 60 years are more susceptible to the disease. Related health conditions: Individuals with diabetes, high blood pressure and cholesterol are more likely to develop this condition. Other heart diseases: People with a history of heart diseases like heart attack or cardiomyopathy should get themselves assessed periodically. Smoking: The chemicals may change the valve structure and cause disruption in its functioning. Family history: There is a possibility of a congenital risk factor. Autoimmune diseases: Lupus may cause inflammation in the heart valves. Diet medications: These may alter the structure of heart valves. Complications of Valvular Heart Disease As with any other procedure, the heart valve repair or replacement surgery, has some known possible complications. However, the success rates are much higher for these to be a cause for concern. Valvular Heart Disease Preventions Primary Prevention of Valvular Heart Disease Treating streptococcal throat infections with antibiotics. Reducing smoking and alcohol consumption. Exercising regularly. Eating healthy and reducing sodium intake. Maintaining dental hygiene to prevent infections. Secondary Prevention of Valvular Heart Disease Maintaining an active lifestyle. Reducing consumption of bad cholesterol food. Taking medications on time. Being regular with the follow-up visits. Watching out for secondary infections and getting them treated. Joining a support group for tips on exercise, physiotherapy and rehabilitation. Epidemiology of Valvular Heart Disease Prevalence: About 2.5% of the population has VHD Age: Predominantly over 40 years but can also occur at early ages depending on the etiology. Gender: More prevalent in men above 60 years and women above 70 years of age Ethnicity: It is a global health issue. Expected Prognosis of Valvular Heart Disease Early diagnosis helps in deciding the mode of treatment - medicines or surgery. Timely surgery and frequent follow-ups prevent further damage and complications. Most types of VHD can be treated safely. The life expectancy after treatment can be brought to near-normal ranges. Natural Progression of Valvular Heart Disease If left untreated, the condition degrades the quality of life. In the worst-case scenario, it may lead to blood clots, stroke, heart failure, or cardiac arrest. Pathophysiology of Valvular Heart Disease The changes in valve structure cause failure of the flaps to open and close properly. This results in the backflow of blood. The atria and ventricles (upper and lower chambers of the heart) enlarge. The rise in pressure leads to inflammation and even pulmonary edema. Related Blogs What Are the 4 Stages and Treatment of Congestive Heart Failure? Surgical Options For Heart Failure: When Is It Necessary? What Are The Different Types, Procedures And Risks Of Bariatric Surgery? Blood Clot in Brain: Symptoms, Diagnosis, Treatment How are Laparoscopic Procedures Helpful in Gastric Bypass Surgery? The Best Diet For Your Speed Recovery After Heart Bypass Surgery

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Varicose veins or varicosities is a condition that generally affects the lower legs, ankle, and feet. Varicose veins are characterised by swollen and twisted veins that appear as purple or blue bulges. Varicose veins can occur anywhere in the body, though they predominantly occur in the lower legs since veins experience higher pressure when standing or walking. Varicose veins are generally mild. However, certain individuals can experience severe discomfort. Varicose veins can be treated at home or managed through surgical or therapeutic interventions. Associated Anatomy of Varicose Veins Veins Alternate Names of Varicose Veins Varicosities, Varicosities Varicose Veins Causes The varicose vein is caused due to weakened or damaged valves in the veins due to high blood pressure. As these veins get weakened or damaged, blood starts pooling in the veins, causing them to enlarge. Veins can become weak due to several reasons, including the following - Hormones Ageing process Overweight Obesity Tight and restrictive clothes. Standing or walking for extended periods. Varicose Veins Symptoms The most apparent sign of a varicose vein is a twisted, blue, or purple colour vein under the skin. Some varicose veins symptoms of varicose vein include - Bulging Veins Swollen, twisted veins that generally appear blue or purple under the skin in the legs, ankle, or feet. They can appear in bunches. Small red or blue lines called spider veins may also be visible. Itching You may experience itching in the surrounding regions of the varicose vein. Heavy and Painful Legs Muscles in the legs would be tired and sluggish. Sometimes you may experience muscle cramps. Swelling Swelling or throbbing of legs, ankles, and feet. Skin Discolouration and Ulcers Varicose veins left untreated may cause brown discolourations on the skin. Severe varicose veins can also cause ulceration on the skin. Varicose Veins Diagnosis In addition to medical history examination and physical assessment, healthcare providers also use diagnostic tests like ultrasound or venogram to assess the condition's severity. These tests assess the blood flow through the veins and examine the presence of blood clots. Varicose Veins Treatment Treatment measures for varicose veins include self-care strategy, compression stockings, and surgical procedures. Your health care provider would decide the best course of treatment based on your age, medical history, signs, symptoms, severity of conditions, etc. Self-Care Regular Exercise, raising the legs while lying down and during sleep can alleviate pain and can prevent worsening of the condition. Compression Stockings Compression stockings can squeeze the legs, aiding the muscles and veins to move blood more easily. Surgery or other Procedures If the varicose veins are severe and unable to be managed through compression stockings or self-care measures, your healthcare provider may suggest surgery or other procedures. These include sclerotherapy, laser treatment, ambulatory phlebectomy, vein stripping, etc. Risk Factors of Varicose Veins Following are some factors that can increase the risk of developing varicose veins- Gender: Females are at a higher risk of developing varicose veins when compared to males. Pregnant people, people on birth control pills, or individuals approaching menopause are more prone than others because of the hormones released during these conditions. Age: With age, valves become less efficient. Veins generally become stiffened and lose elasticity. Family history: Varicose veins are inheritable. Lifestyle: Standing and sitting continuously for a long time restricts blood flow. Wearing restrictive clothes like girdles lowers blood circulation. Existing health conditions: Certain health ailments like severe constipation or tumours increase pressure in the veins. Overweight or Obesity: Weight influences blood pressure and can increase pressure in the blood vessels. Tobacco: Individuals who consume tobacco are more prone to develop varicose veins. Complications of Varicose Veins Complications of varicose veins include ulcers, bleeding, and blood. Varicose Veins Preventions Primary Prevention of Varicose Veins Some measures that can be undertaken to reduce the chance of developing varicose veins include - Avoid standing for long periods: Stretch or walk around regularly to improve blood circulation. Elevate legs: Elevating feet above the waist helps blood flow back to the heart. Quit tobacco: Tobacco usage leads to many health complications, including damage to blood vessels. Maintaining a healthy weight can reduce blood pressure. Exercise regularly and avoid long periods of inactivity. Wear clothes that are not too tight to ensure proper blood circulation. Secondary Prevention of Varicose Veins Varicose veins can reoccur after treatment. Maintaining a healthy weight, exercising regularly, and avoiding a sedentary life are a few ways to reduce the risk of a second occurrence. Epidemiology of Varicose Veins The development of varicose veins is influenced by lifestyle and activity. It is observed worldwide, and the women population is more prone to developing the condition than men. Expected Prognosis of Varicose Veins Varicose veins are pretty common, and they are not dangerous. Varicose veins generally do not lead to long-term health complications and can be managed through self-care measures and other interventions. Natural Prognosis of Varicose Veins If untreated, varicose veins can lead to skin discolouration, ulcers, blood clots, and inflammation. Pathophysiology of Varicose Veins Varicose veins is a disorder caused due to weakened or damaged valves in the veins. Arteries and veins are blood vessels that aid in transporting blood. While the arteries carry blood from the heart to the rest of the body, veins transport blood vice-versa. The veins in the leg work against gravity to return blood to the heart. Muscle contractions and valves in the veins aid in this process. Valves open when blood flows to the heart and then close to prevent backflow. If the valves are damaged, there is backward flow, and blood pools in the vein, leading to enlarged and twisted veins. Many factors like age, gender, and blood pressure, among others, increase the risk of varicose veins. Related Blogs Hemorrhoid Symptoms: What You Need to Know

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Vascular malformation is a blanket term for abnormal non-cancerous connections of different blood vessels such as arteries, veins, lymphatic system, and capillaries. They are formed during the stage of development inside the womb or may develop soon after birth. It usually affects children and young people and grows in size with age. These can occur anywhere on the skin (superficial) or can be deep inside the body like in the brain or heart. Depending on their extension in the body, these are divided into: Low flow: involving a single type of vessels such as venous, lymphatic, or capillary malformations. High flow: involving arterial malformations and arteriovenous malformations. Associated Anatomy of Vascular Malformations (VMs) Blood vessels, arteries, veins, lymphatic system Alternate Name of Vascular Malformations (VMs) Vascular anomalies Vascular Malformation Causes The exact cause behind the development of vascular malformations is unknown. However, certain conditions are known to cause these aberrant connections: Genetic mutations: These may occur during errors in the development phase of the embryo. Trauma due to any injury to the blood vessels. Puberty or pregnancy: Hormonal surge during certain conditions can induce increased blood flow to these poorly developed blood vessels which can make them visible, if not visible earlier. Any major surgery can trigger the already existing malformation. Infections: Although very rare, some infections can lead to these malformations. Vascular Malformations Symptoms Unless triggered due to any injury or action of hormones, they don't produce any symptoms except for cosmetic concerns. Also, the signs and symptoms mostly depend on the location and extent of the lesions. Some common symptoms of vascular malformations include: Pink-coloured birthmark-like lesions. Example: port wine stains A painful bluish lesion that may or may not be swollen. Frequent bruising and bleeding. Fluid-filled swellings (microcystic) in case of lymphatic malformations. Seizures, headaches, brain damage, paralysis, etc, in case of arteriovenous malformations present in the brain. Shortness of breath, blood-tinged vomit if present in lungs. Vascular Malformations Diagnosis Vascular malformations closely resemble other vascular anomalies like hemangiomas, cerebral aneurysms (in case of AVM), blue rubber bleb nevus, and hereditary hemorrhagic telangiectasia. However, there are significant differences among all these conditions which can be understood by histological profiling. Vascular Malformations Tests Doctors diagnose this condition both clinically and through various tests. Magnetic resonance angiography (MRA) scans: These produce better images of abnormal vessels and provide details about structural defects and the speed of blood flow in these connections. Direct percutaneous puncture (DPP) or phlebography: This is a standard test to diagnose venous malformations. Angiography: It uses a dye that produces a better image of lesions on X-rays. Computed tomography angiography (CTA) scans Doppler ultrasound: It uses sound waves to detect blood flow in the blood vessels. Stages of Vascular Malformations Being a non-cancerous condition, vascular malformations don’t have any stages. However, this condition grows in size with time. Vascular Malformation Treatment The treatment of vascular malformation depends on its location and its extension. Some treatment modalities for vascular malformations are: Laser Therapy It is preferred for superficial lesions, especially for venous and lymphatic vascular malformations. Laser therapy reduces the discolouration and swelling caused by this condition. Embolisation This is a minimally invasive process involving the closure of the abnormal blood vessels with a glue (any liquid sclerosing agent or metallic coil) that blocks the blood flow to these vessels. Sclerotherapy This uses ethanol or other sclerosants that clog the malformed vessels by damaging their walls. The collapsed tissue stops the blood flow to these connections and redirects the blood to normal blood vessels. It is done over multiple sittings. Stereotactic Radiosurgery Stereotactic Radiosurgery is sometimes considered if other treatment options fail to bring any relief. Surgery can also be used in addition to other treatment options like sclerotherapy and embolisation. Risk Factors of Vascular Malformations Genetic: an inherited abnormality or a syndrome like Klippel Trenaunay syndrome, or Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia). Trauma: any injury during the embryonic stage or after birth that damages the blood vessels. Hormones: these can exacerbate the existing vascular lesions later in life. Complications of Vascular Malformations Low flow malformations don't pose any threat. But complications from AVMs are usually concerning as they occur deep in the organs like the brain and the lungs. These malformations can have life-threatening complications, like stroke, internal bleeding, seizures, aneurysms, and even paralysis if they are located in the brain and spinal cord. Vascular Malformations Prevention There is no possible way to prevent this condition since it develops before birth and sometimes during early childhood. However, early diagnosis and treatment can effectively hamper its progression in later life. Epidemiology of Vascular Malformations It is a rare condition affecting less than1% population all over the world. Among all the types, venous malformations are the most common, followed by lymphatic malformations. Venous malformations are commonly found in the head and neck region, and occur in 1 or two people in a population of 10,000. The incidence of AVM is quite uncommon. Expected Prognosis of Vascular Malformations The prognosis of this condition depends on the extent of malformations and organs that it affects. Recent advancements in the field of vascular surgery have made the cure possible with lower patient morbidity, especially for venous and lymphatic malformations, if diagnosed early. Natural Progression of Vascular Malformations Although these are non-cancerous, these malformations continue to grow as the person ages. Apart from aesthetics, they don't cause any issue to the person if they are superficial. However, if they are found deeply near organs like the lungs or the brain, they can affect the working of these organs. Pathophysiology of Vascular Malformations Vascular malformations occur during the process of vascular system development in the embryonic stages of life; a phase technically known as angiogenesis. This process is facilitated by angiogenic factors like VEGFs (vascular endothelial growth factors), FGFs (fibroblast growth factors), etc, in cell division and formation. If any abnormality occurs during this phase, it leads to the formation of abnormal growth of these vascular channels causing vascular malformations.

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Ventricular fibrillation (VF or v-fib) is an arrhythmia or severely abnormal rhythm of the heart, because of which the heart fails to pump blood to the rest of the body. Alternative Names of Ventricular Fibrillation (VF) Ventricular fibrillation, also called v-fib or the most severe form of arrhythmia. Ventricular Fibrillation Causes Lack of oxygen or enough blood flow to the heart muscle can make it electrically unstable, causing severe and abnormal heart rhythms. The cause of VF is not always known, but it mainly occurs during a heart attack or just after a heart attack. Besides, a previous history of heart problems and certain underlying medical conditions can cause VF. Here are some causes of VF. Heart attack or angina Congenital heart disease (present at birth) Heart muscle disease (muscle becomes weak, stretched, or thickened) Heart surgery Heart injury Electrolyte abnormalities related to potassium or sodium Adverse effects of certain medications Genetic disorders associated with hearts ion channels Electrocution accidents. Ventricular Fibrillation Symptoms The most common symptom of VF is loss of consciousness. Besides, a person may experience Transient dizziness or near fainting Fainting Chest pain Acute shortness of breath Very fast heartbeat (tachycardia) Nausea Types of Ventricular Fibrillation On ECG, ventricular fibrillation appears as a wave of peaks and valleys. Depending on their appearance, you can classify VF as coarse and fine. Coarse Ventricular Fibrillation In strong VF, the peaks are tall, and valleys are more profound. This type is associated with survival and better outcomes. Fine Ventricular Fibrillation The peaks are short, and valleys are shallow in fine ventricular fibrillation. Refractory Ventricular Fibrillation It occurs when ventricular fibrillation continues even after three consecutive shocks from a defibrillator. Ventricular Fibrillation Diagnosis The differential diagnosis of VF includes: Ventricular arrhythmia Ventricular tachycardia (V-tach) Premature ventricular contractions (PVCs) Asystole Wide complex tachycardia (WCT) Torsade de Pointes Atrial fibrillation (A-fib) Atrial flutter Polymorphic ventricular tachycardia Pulseless electrical activity Ventricular Fibrillation (vfib) Tests While interpreting VF, a doctor will consider: Your overall health and ventricular fibrillation symptoms Your vitals; blood pressure, heart rate, and pulse Heart function tests like ECG (electrocardiogram) Blood tests to check heart damage X-rays, CT scans, MRI exams, and ECGs Ventricular Fibrillation Treatment The VF treatment involves stopping your Ventricular fibrillation immediately and restoring your pulse and blood pressure. Treatment includes: Cardiopulmonary Resuscitation (CPR) Cardiopulmonary resuscitation (CPR) will help keep your blood moving. Defibrillation It is required during or immediately after the VF. Electric shock by defibrillation can help correct signals, fixing your heart rhythm. Medication Doctors prescribe medications immediately after VF to control and prevent its recurrence, like those used to control arrhythmia, thereby decreasing your risk over time. Catheter Ablation Surgery Targets specific areas of the heart to eliminate electrical triggers causing VF. Implantable and Wearable Defibrillators To prevent its recurrence in the long term. Left Cardiac Sympathetic Denervation For specific cases. Risk Factors of Ventricular Fibrillation Factors that increase your risk of VF include: Previous heart attack History of VF Weakened heart muscle Medications affecting heart function Abnormal levels of potassium, magnesium, or sodium Genetic diseases like hypertrophic cardiomyopathy, long or short QT syndrome, or Brugada disease Drug toxicity Smoking High blood pressure, diabetes. Complications of Ventricular Fibrillation The complications usually depend on how soon you receive the treatment. Yet possible serious complications include: Repeated episodes of fainting Poor blood circulation and damage to vital organs Heart muscle Injury Injuries resulting from CPR Skin burns because of defibrillation Brain injury from a lack of oxygen Cardiac arrest Death Ventricular Fibrillation Prevention You can’t entirely prevent an episode of ventricular fibrillation. But you can decrease its possibility by: Diagnosing and treating underlying medical conditions that can cause VF Medications that help manage unusual heart rhythms (like arrhythmia medications) Devices like implantable cardiac defibrillators Following a healthy lifestyle with adequate exercise and a nutritious diet. Epidemiology of Ventricular Fibrillation (vfib) VF is responsible for approximately 50% of deaths from CAD. Out of three lakh cases of sudden cardiac death caused by ventricular fibrillation in the US, one-third are attributed to ventricular fibrillation. VF is observed in around 0.08% to 0.16% of the adult population and 0.001% to 0.008% of the pediatric and adolescent age group, accounting for 5% of deaths every year. Most data states that VF is more likely to affect the black population than white individuals. VF is more likely to affect men than women (3:1). Expected Prognosis of Ventricular Fibrillation The chances of surviving an episode of ventricular fibrillation depend on bystander cardiopulmonary resuscitation (CPR), instant availability of arrival of personnel, required apparatus for defibrillation, life support, and transport to a hospital. The survival rate ranges from 17% (out of hospital) and 46% (for patients in the hospital). Although in cases of nontraumatic cardiac arrest, patients are more likely to be successfully resuscitated from VF than in other cases of arrhythmia, success is highly time-dependent. The success rate declines by 2% to 10% with every minute. Pathophysiology of Ventricular Fibrillation Your heart comprises four chambers; two bottom chambers are ventricles. A healthy heart pumps the blood evenly in and out of these chambers and keeps the blood flowing throughout the body. Arrhythmia (irregular heartbeat), which starts in the ventricles, is known as VF. Ventricular fibrillation occurs when a lack of oxygen or blood supply to your heart muscle causes your ventricles to fibrillate (uncontrolled twitching or quivering) instead of pumping the blood. As a result, the heart cannot pump blood into your body. Natural Progression of Ventricular Fibrillation The heart pumps the blood to the lungs, brain, and other vital organs. Ventricular fibrillation causes rapid, erratic heartbeats, and the heart fails to pump the blood to your body. This causes a sudden and notable drop in blood pressure. The lack of blood supply increases the risk of damage to the brain and other organs. This results in fainting, cardiac arrest, or sudden cardiac death within a few minutes. Related Blogs Feelings After a Heart Attack: The Good, The Sad and The Anxious Help your hurting heart

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Ventricular tachycardia is a medical condition characterised by faster heart rhythm (arrhythmia) due to irregular electrical conduction in the ventricles of the heart (lower chambers). Typically, the heart beats 60 to 100 times per minute. However, the heart beats 100 or more times per minute in ventricular tachycardia. Alternate Name of Ventricular Tachycardia V-tach or VT Ventricular Tachycardia Causes Ventricular tachycardia is due to faulty conduction of the electrical signals. The following conditions can affect the electrical signal conduction: Structural heart disease: Scarring of the cardiac tissue caused by a previous heart attack or other cardiac conditions. Poor blood flow: Reduced supply of the blood to the cardiac tissue, as in case of coronary artery disease. Electrolyte imbalance: Dehydration or other conditions leading to an imbalance of electrolytes, such as potassium, magnesium, calcium, sodium, etc. Congenital: Presence of heart diseases at birth, such as QT prolongation Medication side effects: Medication can cause ventricular tachycardia as an adverse reaction. It can also be caused due to an overuse of cocaine or other habit-forming substances. Ventricular Tachycardia Symptoms Signs and symptoms of ventricular tachycardia include the following: Chest pain radiating to arm (angina) Dyspnea (difficulty in breathing) Palpitations (pounding heart) Rapid pulse Dizziness Lightheadedness Ventricular tachycardia symptoms should go away within 30 seconds. If not, it could lead to severe symptoms such as: Loss of consciousness Fainting Cardiac arrest Sudden death Ventricular Tachycardia Diagnosis Presentation of ventricular tachycardia might mimic other heart disorders or cardiac conditions, such as ventricular fibrillation, atrial tachycardia, supraventricular tachycardia, premature ventricular contraction, accelerated idioventricular rhythm, pacemaker failure, ECG lead motion artifact, Wolff-Parkinson-White syndrome, multifocal atrial tachycardia, pacemaker syndrome, etc. Hence, a differential diagnosis is required to rule out other possibilities. Typical Test of Ventricular Tachycardia Typical diagnosis includes a physical examination and monitoring of vitals, such as blood pressure, heart rhythm, respiration rate, and pulse. Your doctor will also run a certain blood test to examine various parameters, such as troponin levels, electrolytes, etc. In addition, you will undergo an electrocardiogram (ECG) that measures the electrical conduction in your heart. You might also be required to undergo a CT scan or cardiac magnetic resonance imaging (MRI), or transesophageal echocardiography (esophageal ultrasound) to confirm the diagnosis. Stages of Ventricular Tachycardia There is typically no staging system for ventricular tachycardia. However, based on the lasting duration of the arrhythmia, it can be categorised as follows: Non-sustained VT (NSVT) Having a heartbeat of more than 100 that lasts for less than 30 seconds for consecutive three or more times. Sustained VT (SVT) Having a heartbeat of more than 100 that lasts for more than 30 seconds consecutively three or more times. Ventricular Tachycardia Treatment Treatment approaches for ventricular tachycardia include the following: Medications Certain anti-arrhythmia medications, such as amiodarone, lidocaine, sotalol, etc., can be used to slow the heart rhythm. Cardioversion Electrical shock is given to bring the heart rhythm to normal. Cardiac resynchronisation therapy This technique involves placing a pacemaker to regulate the synchronisation of both ventricles to send regulated signals. Cardiac ablation Heat waves are used to destroy the damaged heart tissues to cure ventricular tachycardia. Implantable cardioverter-defibrillator (ICD) A device is placed under your skin below the collarbone to adjust the heartbeat by giving shocks whenever the heartbeat becomes abnormal. Risk Factors of Ventricular Tachycardia Risk factors that increase the chances of developing ventricular tachycardia include the following: Heart conditions: Any pre-existing heart diseases, such as a history of heart attack, structural heart changes, etc., increase the risk of developing ventricular tachycardia. Substance overuse: Misuse of stimulating substances such as cocaine or methamphetamine increases the risk of developing ventricular tachycardia. Electrolyte disturbances: Severe electrolyte disturbances, such as acute serious dehydration, make you more prone to develop ventricular tachycardia. Side effects of medications: Various medications, such as antibiotics, antifungals, antipsychotic drugs, etc., can cause ventricular tachycardia. Possible Complications of Ventricular Tachycardia Ventricular tachycardia requires emergency treatment. If left untreated, it causes the following complications: Ventricular tachycardia storm: One of the common complications is experiencing three or more episodes of ventricular tachycardia and associated fainting. Heart failure: Untreated ventricular tachycardia can lead to failure of the heart to pump the blood and stop functioning. Sudden death: Sudden unexplained death is associated with uncontrolled ventricular tachycardia. Ventricular Tachycardia Preventions Primary Prevention of Ventricular Tachycardia The risk of developing ventricular tachycardia can be reduced or prevented by the following: Eating a healthy diet: Eating a diet with a good balance of protein, carbs, and fats is essential for heart and overall health. Adding fruits, nuts, and leafy vegetables has great effects on heart health. Exercise: You should exercise for at least 30 minutes a day or 150 minutes a week to maintain a healthy heart. Regular health check-ups: Regular monitoring of blood pressure, cholesterol levels, and getting regular health check-ups are crucial to keep your heart healthy and reduce the risk of ventricular tachycardia. Avoid the use of certain drugs: You should avoid the use of drugs and stimulating substances that are known to cause ventricular tachycardia. Managing stress: Reduce stress levels in your life and practice yoga, mindfulness, etc. Secondary Prevention of Ventricular Tachycardia Secondary prevention aims to reduce the risk of recurrences or avoid complications post-treatment. Symptom watch-out: Always look out for any signs or symptoms of ventricular tachycardia and seek immediate medical care if required. Lifestyle modifications: Eating a balanced diet, exercising regularly, and getting physically active are crucial for heart health and reducing recurrences. Regular health check-up: Regular monitoring of your vitals and visiting the doctor on scheduled follow-ups is crucial for an event-free recovery. Epidemiology of Ventricular Tachycardia Ventricular tachycardia is more prevalent in men compared to women, as men are more prone to ischemic heart disease. The prevalence of ventricular tachycardia increases with age and the maximum prevalence is observed in the middle years. Ventricular tachycardia is more common in developed countries compared to developing countries. Expected Prognosis of Ventricular Tachycardia Prognosis in patients with ventricular tachycardia usually depends on age, gender, cardiac condition, and the overall health condition. People with ventricular tachycardia develop hemodynamic instability, leading to heart failures and associated co-morbidities. Natural Progression of Ventricular Tachycardia The progression of ventricular tachycardia depends on how fast the heart is beating. If the heart is beating very fast, it will progress to episodes of fainting and consciousness loss. Eventually, it will cause a heart attack and can cause sudden death. Pathophysiology of Ventricular Tachycardia Ventricular tachycardia is the result of the electrical signal abnormalities in the ventricles, at the cellular level. Damaged heart tissue or scarring of heart tissue, as in previous myocardial episodes, leads to electrical reentry and enhanced automaticity, causing the triggered activity in the electrical conduction. This leads to fast heart rhythm and reduced cardiac output. Related Blogs Feelings After a Heart Attack: The Good, The Sad and The Anxious Help your hurting heart

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Wolff-Parkinson-White (WPW) Syndrome is a condition wherein there is an extra electrical pathway between the atria and the ventricles of the heart. This can lead to a rapid heart rate called tachycardia. Associated Anatomy of Wolff Parkinson White (WPW) Syndrome Human Heart Alternative Name of Wolff Parkinson White Syndrome Ventricular preexcitation with arrhythmia Wolff Parkinson White (WPW) Syndrome Causes It may be important to know how the heart normally beats to better comprehend the reasons for WPW syndrome. It can be caused by: Congenital diseases WPW syndrome is a form of congenital heart abnormality (present from birth). Other congenital cardiac diseases, such as the Ebstein anomaly, can lead to WPW syndrome. Hereditary WPW syndrome is inherited in a small percentage of cases. A thicker heart muscle is linked to the hereditary or familial type. Hereditary WPW syndrome is a form of hypertrophic cardiomyopathy. Wolff Parkinson White Syndrome Symptoms Signs and symptoms of WPW syndrome can be different for infants and adults. WPW Syndrome in Adults Tachycardia (rapid heart rate; >100 beats per minute) Arrhythmia (Heart rhythm problem) Atrial fibrillation (chaotic and fast heart rhythm) Heart palpitations Pain in chest Breathing problems Nausea and dizziness Fatigue Anxiety WPW Syndrome in Infants Pallor: Faded and pale skin colouration Cyanosis: Lips and nails turning bluish grey Pale or faded skin colour (pallor) Irritability and restlessness Rapid breathing Loss of appetite. Wolff Parkinson White Syndrome Diagnosis Electrocardiogram (ECG or EKG): ECG is a rapid and painless test that measures the heart's electrical impulses. WPW syndrome is marked by the presence of extra electrical pathways while looking for patterns of heart signals. Other tests include a Holter monitor, which records heart rate for a couple of days during routine life activities, event recorder to check for arrhythmias and electrophysiological study to differentiate between WPW pattern and syndrome. Wolff Parkinson White Syndrome Treatment Treatment of WPW syndrome depends upon the associated arrhythmia’s type and the presence of other structural heart disease. Following treatment options are there to monitor and eliminate the extra pathway. Medications Medications are given to treat arrhythmias. Different types of arrhythmias require different drugs. Therefore, patients may have to go through a few trials of arrhythmia medications. Catheter ablation Ablation therapy is a non-surgical invasive procedure. A flexible, thin tube called a catheter is inserted through blood vessels. The insertion is done via the groyne; the catheter reaches the heart and creates minute scars in the heart by producing radiofrequency energy. The scarring permanently blocks the abnormal electrical signals and restores normal heartbeat. Risk Factors of Wolff Parkinson White Syndrome Risk factors include: Tachycardia: Sudden cardiac arrest in young adults and children Accessory pathways in the heart Presence of multiple accessory pathways R-R interval of <250 milliseconds: happens during forward conduction of nerves through accessory pathways during atrial fibrillation (rapid heart rate due to poor blood flow) Structural heart diseases such as hypertrophic cardiomyopathy, Ebstein anomaly. Possible Complication of Wolff Parkinson White Syndrome Complications arise if the disease is not treated on time. The following can occur: Heart failure Serious arrhythmias Atrial fibrillation Cardiac arrest Tachyarrhythmia Palpitations Dizziness or syncope Sudden cardiac death Complications of drug therapy (eg proarrhythmia, organ toxicity) Complications associated with invasive procedures and surgery Recurrence Wolff Parkinson White Syndrome Preventions Primary Prevention of Wolff Parkinson White Syndrome WPW is a congenital disease, therefore, it cannot be prevented. But, complications can be prevented by being aware of the disease. Some lifestyle changes also help prevent complications: Avoid smoking. Keep cholesterol and blood pressure in check. Consume healthy food. Maintain a healthy weight. Manage stress and do regular workout. Secondary Prevention of Wolff Parkinson White Syndrome Following are the secondary preventions for WPW syndrome recurrence: Avoid using over-the-counter decongestants and diet pills as they contain stimulants. Avoid taking drugs like cocaine, etc. All these drugs make your heart beat faster. Always be in touch with your cardiologist. Learn to perform Valsalva manoeuvre. Epidemiology of Wolff Parkinson White Syndrome Prevalence: 100-300 per 100000 individuals are affected globally. Age: Generally affects people at the age of 30 to 40 years of age. The men to women ratio is 2:1. Gender: prevalent more in men than in women. Not particular to any racial community Only 7% of affected individuals are above 60 years of age worldwide. Expected Prognosis of Wolff Parkinson White Syndrome Timely identification and appropriate treatment can lead to positive prognosis in case of WPW syndrome. It can be permanently cured through radiofrequency (RF) catheter ablation. Patients with no symptoms and only showing preexcitation on ECG tend to have a very good prognosis. Natural Progression of Wolff Parkinson White Syndrome WPW is not a fatal disease for most affected people. Timely and appropriate treatment can cure the condition. However, the biggest challenge is sudden cardiac arrest because of tachycardia. Pathophysiology of Wolff Parkinson White Syndrome In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's atria and ventricles causes a rapid heartbeat, called tachycardia.

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