Category Archives: Cardiology

Go Natural to Lower Cholesterol & High Blood Pressure!

1Natural treatments for heart disease often aim to control cholesterol levels, lower blood pressure, and improve heart health. Generally, research on such treatments is limited, compared to conventional medical treatments.

Few natural sources have clinically proven to reduce cholesterol. There’s no evidence that alternative therapies lower the risk of heart failure. However, many people have experienced success with alternative treatments.

Types of Cholesterol:

There are two kinds of cholesterol:

  • Low-density lipoprotein (LDL), also called “bad” cholesterol
  • High-density lipoprotein (HDL), also called “good” cholesterol

 Cholesterol Levels:

Usually, normal human should have low levels of LDL and higher levels of HDL. The recommended cholesterol levels are:

  • Total cholesterol: less than 200 mg/dL
  • LDL cholesterol: less than 100 mg/dL
  • HDL cholesterol: 50 mg/dL or higher

Natural Remedies:

The ingredients in some alternative therapies can interfere with certain medications or have harmful side effects.

Few regularly used organic products which may prone to reduce cholesterol are;

  • Astragalus
  • Hawthorn
  • Flaxseed
  • Fish with omega-3 fatty acids
  • Garlic
  • Red yeast rice
  • Plant sterol and stanol supplements

 Benefits of natural remedies

  • No prescription required
  • Can be implemented along with standard treatment plan 

Drawbacks of natural remedies

  • No clinical evidence
  • Side effects may occur

 Medications for high cholesterol

A variety of medications are also available to lower high cholesterol. Usually prescribed medications are,

  • Statins such as lovaststin or atorvastatin
  • Cholestyramine
  • Injectable medications like volocumab

 Blood Pressure

Blood pressure is association of systolic and diastolic pressure. Systolic pressure represents BP, while the heart is pumping and diastolic pressure stands for BP when the heart is at rest.

High blood pressure (hypertension) occurs when the pressure on the arteries and blood vessels becomes too high and the arterial wall becomes distorted causing extra stress on the heart.

Long term hypertension increases the risk of stroke, heart attack and diabetes.

Blood pressure ranges:

  • Normal: Less than 120/80 mm Hg
  • Prehypertension: Systolic pressure between 120–129 and diastolic pressure less than 80
  • Stage 1 Hypertension: Systolic pressure between 130–139 or diastolic pressure between 80–89
  • Stage 2 Hypertension: Systolic pressure at least 140 or diastolic pressure at least 90 mm Hg

Outcomes of high blood pressure:

  • Arterial damage
  • Aneurysm
  • Metabolic syndrome
  • Reduced kidney function
  • Heart failure
  • Blocked or ruptured blood vessels
  • Vision loss
  • Loss of cognitive function

Causes of high blood pressure:

  • A high-salt diet
  • Obesity
  • Emotional stress
  • Birth control pills
  • Alcohol
  • Caffeine
  • Smoking
  • Heavy-metal poisoning

Natural Ways to Lower Blood Pressure

  • Flax seeds
  • Fish oil supplement
  • Magnesium supplements
  • Potassium supplements
  • Omega-3 foods
  • Foods That Reduce Blood Pressure:
  • Dark chocolate
  • Garlic
  • Spinach
  • Sunflower Seeds
  • Bananas
  • Tomatoes
  • Broccoli
  • Melon

Future of Cardiac Ultrasound: A Glimpse

Cardiac ultrasoundCardiac Ultrasound

Cardiac ultrasound is also known as Echocardiography. It deals with the ultrasound imaging of a rapidly moving complex organ oriented deep within the body i.e., heart.

An electrocardiogram uses ultrasound waves to look at the shape, size and movement of the heart.

Test usually shows.

Heart Chambers

Walls and valves of the Heart

Blood vessels associated with Heart

Pericardium layer of Heart

History:

A group of engineers and doctors have a more than 30 year history for collaborative efforts on improving the techniques for imaging and investigation of the function of heart in Trondheim.

Types of Cardiac Ultrasound techniques:

Tissue Doppler imaging (TDI)

Speckle tracking

3D strain

Types of Echocardiograms:

– Contrast echocardiogram

– Transthoracic echocardiogram

– Transesophageal echocardiogram (TEE)

– Stress echocardiogram

– Dobutamine stress echocardiogram

– Intravascular ultrasound

Uses of Echocardiogram:

Determine a heart murmur

Diagnose valve conditions

Disturbances in structure of Heart

Damage to heart walls and muscles after Heart attack

To determine the functional changes of Heart in chronic heart disease

Determine Fluid retention in n around the heart

Identify extra growths in the heart

To identify and monitor birth defects

Test blood flow through the heart

Investigate heart or major blood vessel damage caused by trauma

Test heart function and diagnose heart and lung problems in severely ill patients

Identify the blood clots within heart chambers

Advancements in Cardiac Ultrasound techniques:

Real 3-D Image Navigation

Vector Blood Flow and Shear Stress Imaging

Artificial Intelligence to Aid Reproducibility

Strain Imaging

Pediatric cardiology

There is a number of heart conditions that can affect children. Few children have structural differences by birth others involve the electrical system that controls the heartbeat. Pediatric cardiologists mainly treat, diagnose and manage the problems in the child.  Pediatric heart problems in children include congenital heart disease and Arrhythmias. Congenital heart disease refers to heart structural variation by birth in the child which include holes between chambers of the heart, abnormal blood vessels and valve problems. Arrhythmiasis know as abnormal heart rhythms caused by the system that controls the heartbeat electrically. Pediatric cardiologists will treat pulmonary hypertension and systemic hypertension. Systemic hypertension means high blood pressure in the body. But in few regions, pulmonary hypertension is treated by pediatric pulmonologists and systemic hypertension is treated by pediatric nephrologists.

edhgjnIn Food industries generally, Pediatric cardiologists work closely with primary care pediatricians to provide coordinated and comprehensive care. Heart Problems can arise due to various other symptoms in the body so pediatric cardiologist will team up with health care providers. For child care, there are pediatric heart surgeons, cardiac anesthesiologists, neonatologists, cardiac pediatric intensivists, pediatric radiologists, as well as pediatric nurses, nutritionists, and speech, occupational, and physical therapists. There are various Tools to diagnose cardiac conditions in children. Based on Physical and cardiac examination. For Physical examination: Vital signs and Cardiac examination will be carried out. For Laboratory examination: Electrocardiography, Chest X-ray, Pulse oximetry, Blood counts, Echocardiography, Magnetic resonance imaging (MRI and MRA), Computed tomography, Exercise testing, Cardiac catheterization are done. Environmental and genetic conditions associated with heart disease in children also play a major role. There are various Unusual forms of congenital heart disease in children, Unique cardiac conditions in newborn infants, cardiac conditions acquired during childhood, Abnormalities of heart rate and conduction in children and Congestive heart failure in infants and children. For preventing follow the treatment and precautions given by pediatric cardiologist and have a healthy lifestyle

Trending Cardiovascular Nutrition Controversies

The cardiovascular benefits in several trending foods and dietary patterns are still incompletely understood. The nutritional science continues to evolve as the number of controversial dietary patterns, foods, and nutrients have received significant media exposure. Popular foods and dietary patterns that are promoted for cardiovascular health to provide clinicians. The case-control studies can be done (inexpensive), thus we can get the exposure and the outcome easily. The major issue will be how to select the study population or how retrospective data are collected. In nutrition studies that process done is recall and record (i.e., that involve keeping a food diary or collecting food frequency information) accurate memory and recording of food and nutrient intake over prolonged periods will be problematic and subject to error, mainly in the diagnosis of disease. The advent of mobile technology and food diaries may provide opportunities to improve accuracy for case studies.

ertyBlood cholesterol is increased due to the intake of Dietary cholesterol. Vegetable oils vary greatly in the content of SFAs, except coconut oil, palm oil is high in SFAs, mostly palmitic acid. The berry boom, berries were the third most consumed fruits, then bananas and apples. Nuts for cardiovascular health: Nuts include Brazil nuts, pistachios, pine nuts, almonds, walnuts, hazelnuts, and pecans (tree nuts), and also peanuts, which are legumes. Green leafy vegetables for cardiovascular health: The dark green vegetables attribute to vascular benefits like including reduced arterial stiffness and blood pressure, resulting in part to the enrichment of inorganic nitrate, which undergoes salivary bacterial conversion to nitrite, followed by gastrointestinal acidification to NO. Juicing: leads to heart health Juicing of fruits and vegetables, often in combination with other foods and nutritional supplements, has become very popular, with no end of technologies to prepare the elixirs of health which mainly leads to stroke.

3-Treatments for Heart-Disease that are changing lives

A Drug for Heart Failure: The failure of the heart muscle to forcefully pump blood to the body’s tissues is a common disorder called Congestive heart failure. Heart attacks (stroke), high blood pressure, or diseases that weaken the heart muscle are common causes. The severe shortness of breath or fatigue that limits the ability to enjoy a life of the patients. Paradigm-HF is used in the large clinical trial, the new drug LCZ696 was used to treat heart failure, and it was highly effective. It achieved a substantial 20 % reduction in death or repeat hospitalization compared with the best currently available therapies. Currently, 20 % or more of patients hospitalized for heart failure are readmitted within 30 days which represents a significant burden for patients and the healthcare system.LCZ696 will probably be approved, providing a new, promising option for the 5.7 million Americans with heart failure.

heart dec 28

Treatment for High Cholesterol: The PSCK9 inhibitor is second innovative drug therapy. These specify class of drugs has moved from discovery to the clinic more rapidly than any cardiovascular advancement. The single most important risk factor for developing coronary heart disease is an elevated level of cholesterol, LDL-C. The best drugs for reducing cholesterol, statins, have been shown to lower the risk of heart attack or stroke up to 35%. Statins have been available for 25 + years and have been enormously successful at reducing the burden of heart disease. Patients cannot tolerate statins or can’t take large enough dosages to adequately reduce cholesterol levels. LDL-C will be very high due to a genetic cause, and even the most powerful statins cannot reduce it to safe levels. PSCK9 inhibitors reduce bad LDL-C by as much as 50 % to 70 %. These drugs are given by every 2 weeks or once a month given by very small needles. These can be self-injected by the automated injector. This new class of drugs appears to be well tolerated even in patients who cannot take statins due to adverse effects.

Less Invasive Surgery: In 2011, the FDA approved a new procedure to treat heart valve disease without a major surgical operation, known as Trans-catheter aortic valve replacement (TAVR). This device is approved for who need an aortic valve replacement, but who are too high risk for standard open-heart surgery.

Is there any connection between heart and brain?

Your heart and your brain are more intricately connected than you may realize. Brain signals the heart to pump its oxygen-rich blood through the autonomic nervous system, and heart responds by delivering blood to the entire body, including to brain. If the brain does not receive enough oxygen from the heart, you may experience symptoms ranging from fuzzy thinking to a life-threatening stroke. When blood flow to the brain is interrupted or blocked by a blood clot or plaque that has broken away from an artery or valve and is floating in the bloodstream leads to stroke. The lack of oxygen can cause brain cells to die, leading to symptoms of dementia, disabilities, or even death. The major step to the heart is also ways to protect the brain. The steps to prevent from the stroke: Managing your blood pressure is especially important because high blood pressure is the leading cause of stroke. It also may cause tiny lesions in the brain that can slow your thinking and progress to a loss of brain function in the future.

heart 2019

Steps to Take during Heart Surgery: When your Heart Surgery includes the valve replacement, it is all the more important to consider ways to protect your brain. Valve replacement procedures, such as transcatheter aortic valve implantation (TAVI), can be life-saving interventions. It will correct restricted blood flow caused by a narrowing or obstruction of the heart valve. However, during valve replacement, small particles of debris can break loose and find their way into the blood vessels of the brain.

What is good for the heart is good for the brain. Understanding the unique relationship between the heart and brain, and taking steps to protect both of these vital organs throughout life, is important for lifelong health.

 

Cardiac Rhythm Devices

Cardiac Devices are meant for controlling irregular heartbeats in patients with heart rhythm disorders. These irregularities are caused by noise in the heart’s electrical system, which signals the heart to contract and pump blood throughout the body.

Types of Cardiac Devices:

  • Pacemaker
  • Biventricular Pacemaker
  • Implantable Cardioverter Defibrillator
  • Implantable Cardiac Loop Recorder
  • Left Ventricular Assist Device

Advantages:

  • Eliminate the symptoms of bradycardia

Disadvantages:

  • Infection at the surgical site
  • Sensitivity to the device material
  • Failure to deliver therapy when it is needed
  • Limitations with respect to magnetic and electromagnetic fields
  • Limitations with electric or gas-powered appliances

Cardiac Rhythm Products:

  • Ablation Products for Arrhythmias
  • Ablation Products for Atrial Fibrillation
  • Ablation Surgical Products
  • Cardiac Mapping Products
  • Cardiac Monitors
  • Cardiac Resynchronization Therapy Systems
  • Electrosurgical Products
  • Implantable Cardioverter Defibrillator Systems
  • Infection Control Products
  • Pacing Systems
  • Managing Your Patients
  • Ventricular Assist Devices

Complications:

  • Incidence of pneumothorax was remarkably low
  • Cardiac tamponade is seen
  • Lead dislodgement
  • Device infection
  • Non-septic pocket decubitus
  • Anticoagulation with warfarin
  • Antiplatelet therapy

Indications:

  • Chronic Atrioventricular Heart Block in Adults
  • Chronic Bifascicular and Trifascicular Block
  • Atrioventricular Heart Block after Acute Myocardial Infarction
  • Sinus Node Dysfunction
  • Hypersensitive Carotid Sinus and Neurally Mediated Syndromes
  • Pacing in Children and Adolescents
  • Hypertrophic Obstructive Cardiomyopathy
  • Dilated Cardiomyopathy
  • Cardiac Transplantation
  • Termination and Prevention of Tachydysrhythmias by Pacing

Device Selection:

  • Temporary Pacing
  • Selection of a Permanent Pacemaker
  • Adaptive-rate Pacemakers
  • Single-pass Lead Systems
  • Programmable Lead Configuration and Automatic Mode-switching
  • Pacemaker Leads
  • Selection of an ICD

Women and Heart Disease

Heart Diseases are faced in both men and women. But for Women symptoms and risk factor varies. If unique symptoms of women are understood, the risk of heart disease can be reduced. Most commonly observed heart attack symptoms for women. The usual one is of pain, pressure or discomfort in the chest rarely women may have the heart attack without any symptom. The other symptoms unrelated to chest pain Neck, jaw, shoulder, upper back or abdominal discomfort, Shortness of breath, Pain in one or both arms, Nausea or vomiting, Sweating, Lightheadedness or dizziness and Unusual fatigue. The chest pain as pressure or a tightness because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or coronary microvascular disease

heart

Heart disease risk factors for women: The traditional risk factors are high cholesterol, high blood pressure, and obesity: Diabetes, Mental stress and depression, Smoking, Inactivity, Menopause, Broken heart syndrome, certain chemotherapy drugs and radiation therapy for cancer, Pregnancy complications. To reduce their risk of heart disease, Quit or don’t start smoking, Exercise regularly, Maintain a healthy weight, Eat a healthy diet that includes whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats, and Avoid saturated or trans fat, added sugars, and high amounts of salt. The above-mentioned factors reduce the condition for Heart Disease and Heart Surgery.

The Regular exercise, maintaining the body mass index (BMI) reduced the risk factors. For few women, routine use of daily aspirin therapy to prevent heart disease in low-risk women younger than 65 years old isn’t recommended by American Heart Association (AHA). The intake of aspirin without doctor recommendation is not welcomed.

Role of Drug in Heart Disease and Stroke

 Role of Drug in Heart Disease and Stroke

Pharmaceutical research companies are developing large amount of medicines for two of the leading causes of death in Americans—heart disease and stroke. Later, therapies promise to build on the progress made by existing treatments, which have helped cut deaths from heart disease.

Medicines designed by type and phase of development (For cardiovascular Diseases)

The death rates due to cardiovascular Disease were on the rise and doctors had few tools to treat their patients. Now, latest treatments are done for cardiovascular disease. New tools helped to decrease the number of death rates. Advancement in medicine leads to 30% decrease in death rate.

Progress against cardiovascular disease has had a profound impact on helping to control health care costs. Based on the survey in health affairs, 70% of the money is spent for congestive heart failure.

Two cases :

  • The people who were treated with atrial fibrillation (AFib)—the most common form of arrhythmia will be at risk for a stroke than people without AFib. Intake of AFib requires continuous monitoring of blood, dosage adjustments and food restrictions

While the new drugs use different mechanisms of action—both have an easy treatment regimen—with one or two dosages daily

  • Lipid Disorders—High Cholesterol -side effects by decreasing the average cholesterol level.

CARDIOVASCULAR DISEASE RISK FACTORS

Studies published last year, found lifestyle factors have a huge impact on lowering the risk of heart disease and stroke, and in helping people extend their lives. People with “ideal cardiovascular health,” measured by health behaviours (not smoking, regular exercise and healthy diet) and health factors (ideal body mass index, cholesterol, blood pressure and blood glucose) had the lowest risk. Even with adequate cardiac care, prevention is still the most important factor in reducing cardiovascular disease.

Major risk factors include: • Family history and genetics • Smoking • High Blood Cholesterol and Other Lipids • Physical Inactivity • Overweight/Obesity

To know more reach us @Heart 2019

Stable Ischemic Heart Disease: Overview of Cardiac care

Definition:

Stable ischemic heart disease (SIHD) is most commonly caused by abnormal accumulation of material in the inner layer of the wall of coronary arteries that obstruct blood flow.

The three principal presentations of unstable angina

Rest Angina: Angina occurring at rest and usually for more than 20 minutes, and occurring within 1 week of presentation

New-onset angina: angina of at least Class III severity with onset within 2 months of initial presentation

Increasing angina: 1 or none of the above characteristics; previously diagnosed angina that is distinctly more frequent, longer in duration, or lower in threshold (i.e., increased by at least 1 CCS class within 2 months of initial presentation to at least CCS Class III severity).

Symptoms:

  • Chest discomfort
  • Emotional stress
  • Pain in the epigastrium, jaw, neck, or arms
  • Dyspnea,
  • Nausea,
  • Vomiting
  • Perspiration
  • Lightheadedness
  • Fatigue

Diagnosis:

  • Clinical history
  • Physical examination
  • Laboratory testing
  • Resting ECG
  • Resting echocardiography
  • Estimating pretest probability

Diagnostic Factors:

  • Typical angina symptoms
  • Atypical angina symptoms
  • Symptoms of low-risk unstable angina
  • Known medical history of exacerbating factor
  • Non-anginal chest pain
  • Epigastric discomfort
  • Jaw pain
  • Arm pain
  • Dyspnea on exertion
  • Nausea/vomiting
  • Perspiration (diaphoresis)
  • Fatigue
  • Hypoxia
  • Tachycardia
  • Mitral regurgitation murmur
  • Bibasilar rales
  • Aortic outflow murmur
  • Carotid bruit
  • Diminished peripheral pulses
  • Signs of abdominal aortic aneurysm
  • Retinopathy seen on fundoscopic examination
  • Xanthomas or xanthelasma

Types of diagnostic test:

  • Functional tests
  • Anatomic tests

Risk Factors:

  • Advancing age
  • Smoking
  • Hypertension
  • Elevated LDL cholesterol
  • Isolated low HDL cholesterol
  • Diabetes
  • Inactivity
  • Obesity
  • Family history of premature ischemic heart disease
  • Illicit drug uses
  • Male sex
  • Hypertriglyceridemia
  • Mental stress/depression
  • Plasma biomarkers
  • Polluted air

Prevention Parameters:

Primary Prevention:

  • Diet and exercise to maintain ideal body weight
  • Smoking cessation
  • Statin therapy
  • Aspirin therapy

Secondary Prevention

  • Decreasing anginal symptoms
  • Blood pressure
  • Patient education is a continuous process to help patients achieve risk-factor reduction through weight management
  • Increased physical activity
  • Dietary modifications
  • Lipid management
  • Annual influenza immunizations are recommended for all patients.
  • Antiplatelet therapy