Category Archives: Cardiology

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.

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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.

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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

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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

Stressful jobs are associated with a higher risk of Heart Rhythm Disorders

Having a stressful job is linked with a higher probability of suffering from a heart rhythm disorder called atrial fibrillation, the most nerve-racking jobs are psychologically insistent but give employees little control over the work condition – for example, assembly line workers, bus drivers, secretaries, and nurses. The research found that being stressed at employment was related with a 48% higher risk of atrial fibrillation, subsequent to adjustment for education, age, and sex.

Heart 2019 MEblog

We require people to do the jobs but managers can help by making sure staffs have the resources necessary to complete the allotted tasks. Bosses should programme breaks and listen to employees’ thoughts on how the work itself and the job environment can be improved.” Atrial fibrillation is the most common heart rhythm disorder (arrhythmia). Indications include palpitations, weakness, fatigue, feeling light-headed, dizziness, and shortness of breath.

Atrial fibrillation causes 20-30% of strokes overall and increases the jeopardy of dying prematurely. One in four middle-aged people in Europe and the US will be prone to atrial fibrillation. It is evaluated that by 2030 there will be 14-17 million patients suffering from atrial fibrillation in the European Union, with 120,000-215,000 new diagnosed each year.

Atrial fibrillation is a common condition with serious results and consequently it is of main public health significance to find ways of avoiding it. Little is recognized about risk factors for the disease and especially the role of the work environment.

Heart2019 ME blog

This research assessed the association between work stress and atrial fibrillation. The investigation included 13,200 members enrolled in the Swedish Longitudinal Word related Survey of Health (Slosh) in 2006, 2008, or 2010. Members were in employment and had no account of atrial fibrillation, heart attack, or heart failure. At revise inclusion, members completed postal studies on sociodemographics, lifestyle, health, and work-related factors.

Work pressure was defined as job strain, which refers to jobs with high psychosomatic demands combined with near to the ground control over the job situation. The investigation included five questions on job burden and six on controls – for example: Do you have to work very hard or very fast? Are there conflicting demands in your work? Do you have an adequate amount time to complete your work tasks? Does your work include a lot of recurrences? Can you make a decision on how and what to do at work?

 All through a median follow-up of 5.7 years, 145 cases of atrial fibrillation were acknowledged from national registers. In the universal working populace in Sweden, employees with stressful jobs were approximately 50% more likely to happen atrial fibrillation. The evaluated risk remained even later it was taken into account other factors such as smoking, leisure time physical activity, body mass index, and hypertension.” then pooled their results with two other studies on the same topic, and found that job strain was associated with a 37% increased the risk of atrial fibrillation. “Crossways studies there was a coherent pattern of work stress being a risk factor for atrial fibrillation,

Work stress has before has been linked with coronary heart disease. Work stress should be measured as an amendable risk factor for avoiding atrial fibrillation and coronary heart disease. Individuals who feel stressed at work and have palpitations or other symptoms of atrial fibrillation should see their consultant and speak to their manager about improving the condition at work.”

European guiding principle on the prevention of cardiovascular disease state that stresses at work contributes to the risk of causing cardiovascular disease and having a worse prognosis. Assessment of psychosocial risk factors is suggested in people who have or are at risk of developing cardiovascular disease.

Battling myocardial infarction by means of nanoparticle tandems

How can injured cardiac tissue resultant of heart attack be treated through replacement muscle cells? An investigation team has presented an innovative method on mice: Muscle replacement cells, which are to endure the function of the damaged tissue, are loaded by means of magnetic nanoparticles. These nanoparticle-loaded cells are then infused into the injured heart muscle and held in place by a magnet, causing the cells to engraft well onto the existing tissue. By means of the animal model, the researchers show that this leads to a considerable improvement in heart function.

In a heart attack, clots more often than not lead to diligent circulatory issues in parts of the heart muscle, which results in heart muscle cells to die. Attempts have been made for some time to revitalize the injured heart tissue with replacement cells. In spite of this, most of the cells are pushed out of the deflate channel during the infusion due to the pumping action of the beating heart. Therefore, only a few spare cells remain in the heart muscle, which implies that restoration is limited.Heart20192 28-09-2018

An interdisciplinary team tested a pioneering approach on how to ensure that the infused replacement cells continue in the desired spot and engraft onto the heart tissue. The tests were performed on mice that had earlier suffered a heart attack. In order to be able to better follow the cardiac muscle replacement EGFP expressing cells from fetal mouse hearts or mouse stem cells were utilized. These fluorescent muscle cells were loaded with small magnetic nanoparticles and infused through a fine cannula into the injured heart tissue of the mice.

In the magnetic field, the nanoparticle-loaded replacement cells remain in place

In few of the rodents treated this manner, a magnet positioned at a distance of a little millimetre from the surface of the heart guaranteed that a large part of the nanoparticle-loaded replacement cells remained at the desired spot. Devoid of a magnet, about a quarter of the added cells remained in the heart tissue, but with a magnet, about 60 percent of them remained in location, throughout the project. Ten minutes in the influence of the magnetic field was previously sufficient to keep a significant proportion of nanoparticle-loaded muscle cells at the target spot. Even days after the procedure, the injected cells remained in position and slowly attached themselves to the existing tissue.

This is remarkable; exceptionally as the infarct tissue is generally undersupplied due to reduced perfusion. In the influence of the magnet, the substitute muscle cells did not die as frequently, engrafted well again and duplicated more. The analysts investigated the reasons intended for the progressed growth: It was established that these implanted heart muscle cells were filled more densely and could stay alive better credit to the more intensive cell-cell interaction. In addition, the genetic material activity of many endurance functions, such as for cellular respiration, was higher than without a magnet in these replacement cells.

The researchers also illustrated that cardiac function significantly improved in mice that were treated with nanoparticle muscle cells in combination with a magnet. Following two weeks, seven times numerous replacement muscle cells survived, and later than two months, four times as many compared to conventional implantation technology. Known the lifespan of mice of utmost of two years, this is an amazingly lasting effect.

#cardiacarrest #nanoparticle #Stemcell #Heartregeneration