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Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a rare form of pulmonary hypertension that occurs when blood clots, or thrombi, form in the arteries of the lungs and do not fully dissolve.
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Obesity is a significant public health issue that has reached epidemic proportions globally. It is a condition characterized by a body mass index (BMI) of 30 or higher. BMI is calculated by dividing a person's weight in kilograms by their height in meters squared.


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Diabetes mellitus is a chronic condition that affects more than 37 million Americans. By 2030, the disease will likely be prevalent in 1 in 10 people worldwide. Often known as a silent killer, diabetes can lead to life-threatening health complications if left untreated.

Prolonged diabetes can damage various organs of the body, including the eyes, kidneys, and skin. Also, it can lead to nerve damage (a condition known as diabetic neuropathy). However, one of the most catastrophic complications of diabetes is an increased risk of heart disease.

In this article, we’ll take a closer look at the link between diabetes mellitus and heart disease. Also, we’ll discuss how people with diabetes can lower their risk of developing cardiovascular diseases. Let’s get started.

Diabetes Mellitus and Heart Disease: Understanding the Connection


When an individual has diabetes, their body doesn’t metabolize glucose properly, which leads to elevated blood glucose levels. The excess sugar in the blood can stick to the walls of blood vessels, thus damaging and narrowing them. Also, diabetes causes damage to the nerves that control the cardiovascular system.

That, in turn, requires the heart to work harder to pump blood throughout the body. Ultimately, it can result in chronic conditions, such as coronary artery disease and heart failure. Diabetes can also increase the likelihood of blood clots, thus leading to heart attacks and strokes.

It’s also worth noting that most people with diabetes also have other underlying conditions, such as hypertension and high cholesterol levels. That, in turn, increases the risk of cardiovascular diseases.

On the other hand, a history of heart disease also increases your predisposition to diabetes mellitus. That’s because most people with cardiovascular ailments have pre-existing conditions, such as high blood pressure and obesity, which are linked to increased diabetes risk.

Minimizing the Risk of Heart Disease

Once you realize the close link between diabetes and cardiology, it’s easy to feel overwhelmed. The good news is that many of the techniques to manage and treat diabetes also help keep heart disease at bay.

Here are a few tips to help you get started:

Control Blood Sugar Levels

It’s crucial to undergo regular HbA1c and fasting blood glucose tests to monitor your blood sugar levels. You can even use a glucometer to test your blood glucose levels at home. Also, consult a diabetes mellitus specialist to understand whether you need to take any medications or insulin injections to keep your blood sugar levels in check.

Maintain a Healthy Body Weight

Being overweight or obese is a risk factor for both diabetes mellitus and heart disease. That makes it crucial to control your body weight. If you have a higher body mass index (BMI), consult a fitness expert or nutritionist to create a holistic weight loss plan.

Embrace a Balanced Diet

A balanced, nutrient-rich diet will help maintain your blood sugar levels and facilitate weight loss. Also, it can help keep your blood pressure and cholesterol levels in check. Avoid sugar-rich packaged and processed foods. Instead, include more fruits, vegetables, and whole grains in your diet. It’s a good idea to consult a nutritionist for a DASH or Mediterranean diet plan.

Get Regular Exercise

Exercise offers several health benefits, including weight control and emotional well-being. You can work out at the gym, go for occasional hikes, or try doing yoga. The key is to incorporate some kind of physical activity into your daily routine.

Besides these measures, you should also get your blood pressure and cholesterol regularly checked. Talk to your doctor to understand whether you need to take any medications, such as beta-blocker or statins, to lower your risk of diabetes complications further.

Safe diabetic medicines for heart disease individuals 

Conclusion

There is a clear link between diabetes mellitus and heart disease. People with diabetes are at an increased risk of developing heart disease due to the effects of high blood sugar on the blood vessels and heart. Proper management of diabetes and heart disease risk factors is essential to prevent the development of heart disease in people with diabetes.

Dr. C Raghu is an eminent cardiologist based in Hyderabad. If you or anyone you know has been diagnosed with diabetes and is at risk of developing heart disease, feel free to book a consultation with Dr. Raghu today.

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    Diabetes Mellitus and Heart Disease Blog

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      Diabetes-mellitus.jpg

      Diabetes mellitus, commonly known as diabetes, is a chronic condition that interferes with the way the body processes glucose (sugar). Glucose is the primary source of energy for the body's cells. 


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      Renal artery stenosis is a serious condition that can cause life-threatening complications if left untreated. It’s characterized by the narrowing of the renal arteries that carry oxygenated blood to the kidney.


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      Renal artery stenosis is a serious condition that can cause life-threatening complications if left untreated. It’s characterized by the narrowing of the renal arteries that carry oxygenated blood to the kidney.


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      TAVR is a new procedure that has been gaining popularity in recent years. It’s used for the treatment of aortic stenosis. It involves the use of a catheter to replace a damaged aortic valve with a biological tissue valve.


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      Why Should One Undergo Early Treatment for Aortic Stenosis?

      Aortic valve stenosis is a serious condition that doesn’t just affect the aortic valve. It reduces or blocks the blood supply to the aorta. That, in turn, restricts blood flow to vital organs, including the brain, kidneys, and liver.

      If left untreated, aortic stenosis can lead to severe complications, including:

      • Heart failure
      • Blood clots and stroke
      • Arrhythmias (irregular heartbeat)
      • Bleeding
      • Infections of the heart (including endocarditis)

      All these conditions can threaten a patient’s well-being and, ultimately, result in death.

      Also, it’s worth noting that aortic stenosis can worsen over time, progressing from stage A (at risk) to stage D (symptomatic severe). As the disease progresses, the prognosis becomes worse, too.

      As the above graph shows, the likelihood of a patient’s survival rapidly decreases after the onset of aortic stenosis symptoms. Despite advancements in medical science, the outlook for patients with severe aortic stenosis remains poor.

      That makes it crucial for aortic stenosis patients to seek treatment at the earliest. Timely diagnosis and treatment can help prevent unfavorable outcomes like arrhythmias and strokes. Also, early intervention increases the likelihood of success of treatments like aortic valve replacement and aortic valve repair.

      If you’re at risk of aortic stenosis due to congenital heart defects or a genetic predisposition, watch out for symptoms like heart murmur, chest pain, and shortness of breath. Also, make sure you regularly visit a cardiologist to get your heart’s chambers and valves evaluated.

      What Is the Treatment for Severe Aortic Stenosis?

      Severe aortic stenosis is characterized by significant damage to the aortic valve. Whether asymptomatic or symptomatic, the condition poses the risk of heart failure, blood clots, and even death. That makes it crucial for patients to receive treatment for aortic valve stenosis.

      Patients with severe aortic stenosis need surgery to repair or replace the aortic valve. Typically, your cardiologist will recommend one of the following procedures:

      Balloon Valvuloplasty

      It’s a minimally invasive procedure that involves inserting a catheter with a balloon tip into an artery in the arm or groin. Once the catheter reaches the aortic valve, the balloon is inflated to expand the narrowed valve opening. Thereafter, the balloon is deflated and removed, along with the catheter.

      Balloon valvuloplasty is a suitable aortic stenosis treatment option for infants and children. In adults, the aortic valve can narrow again after the procedure. However, it can be used as temporary aortic valve stenosis treatment for adults waiting for valve replacement.

      Aortic Valve Replacement

      It’s a type of open heart surgery where a cardiac surgeon removes the damaged aortic valve and replaces it with a mechanical valve or biological tissue valve. Biological tissue valves are made from cow, pig, or human heart tissue. They usually disintegrate over time and may need to be surgically replaced.

      While mechanical valves are more durable, they increase the risk of bleeding and thromboembolic complications. Patients with mechanical valves will need to take blood thinners to minimize the risk of blood clots.

      In some cases, the patient’s pulmonary valve is used to replace the aortic valve, and a mechanical valve is secured in place of the pulmonary valve. Also known as Ross Procedure, the surgery is more complex and time-consuming.

      Transcatheter Aortic Valve Replacement (TAVR)

       

      TAVR is a minimally invasive procedure suitable for patients who can’t undergo open-heart aortic valve replacement due to comorbidities or old age. In TAVR, the surgeon inserts a catheter through a tiny incision in the patient’s arm or groin. The catheter is used to transport and install a replacement valve made from cow or pig tissue to the aortic valve region. We’ll cover TAVR in more detail later in this article.

      What Is Medical Treatment for Moderate Aortic Stenosis?

      Mild or moderate aortic valve stenosis may not need to be treated with surgery right away. However, it’s worth noting that aortic stenosis will worsen over time, and the outlook is poor for patients in the severe stage.

      That makes it crucial for patients with moderate aortic stenosis to visit their doctor for routine evaluation and follow-ups. Your doctor might prescribe tests like echocardiogram and chest X-rays to assess the extent of valve damage.

      Additionally, your doctor will recommend healthy lifestyle changes to slow down the progression of aortic stenosis. These include:

      • Avoiding tobacco smoking and alcohol consumption
      • Getting enough sleep
      • Following a daily exercise routine
      • Eating a balanced, low-fat diet

      At this stage, your doctor will also focus on the management of underlying conditions, such as hypertension and chronic kidney disease, that increase the risk of aortic stenosis. They’ll prescribe suitable medications to treat these conditions.

       

      Depending on your overall health and medical history, you can talk to your doctor and explore the possibility of undergoing aortic valve replacement (open-heart or transcatheter). Make sure you visit the doctor for regular check-ups to monitor the progression of aortic stenosis.

      Surgery for Aortic Stenosis 

      Medical treatment and lifestyle changes can help manage the symptoms and slow down the progression of aortic valve stenosis. However, surgery is the only way to improve a patient’s longevity and quality of life.

      If you’re looking for aortic stenosis treatment, you can choose from the following surgeries:

      • Balloon valvuloplasty
      • Aortic valve replacement (AVR)
      • Transcatheter aortic valve replacement (TAVR)

      Balloon valvuloplasty involves inserting a catheter with a balloon tip into an artery and inflating the balloon tip to widen the aortic valve opening. The procedure is minimally invasive and better suited for children and infants. It can also be used as a temporary fix for patients with severe aortic stenosis awaiting valve replacement.

      Aortic valve replacement involves replacing the damaged aortic valve with a mechanical or biological tissue valve during open-heart surgery. If a patient has several comorbidities, they may not be an ideal candidate for AVR. In such cases, they can opt for a less invasive procedure called transcatheter aortic valve replacement.

      Just like balloon valvuloplasty, TAVR also involves inserting a catheter with a balloon tip into a blood vessel. The catheter is guided to the aortic valve region and used to transport the replacement valve. 

      The type of surgery you’ll need depends on your current health, medical history, and the severity of aortic stenosis. It’s wiser to talk to your doctor to explore your options and choose the right surgery.

      TAVR for Aortic Stenosis

      Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure used for the treatment of aortic stenosis. It’s an alternative to traditional aortic valve replacement, which requires open-heart surgery.

      The minimally invasive nature of TAVR makes it suitable for aortic stenosis patients who can’t undergo open-heart surgery due to comorbidities, such as lung and kidney diseases. Also known as transcatheter aortic valve implantation (TAVI), the procedure can relieve symptoms like chest pain and shortness of breath and improve a patient’s quality of life.

      Unlike open-heart surgery, TAVR doesn’t require the surgeon to make a long incision on the patient’s chest. Instead, they insert a thin tube (catheter) into the patient’s artery through a tiny incision in the arm or groin area. The catheter is fitted with a balloon tip and guided to the aortic valve region.

      Once the catheter reaches the aortic valve, a replacement valve (made from cow or pig tissue) is passed through it. The balloon tip inflates to securely place the replacement valve in the correct position (in place of the aortic valve). After the successful implantation of the replacement valve, the catheter and balloon tip are withdrawn.

      You might receive sedatives before the procedure to help you relax. Also, you’ll likely have to spend the night in the ICU after undergoing TAVR. It helps your treatment team monitor your vitals and manage any complications that might arise after the procedure.

      While TAVR is a fairly safe procedure, it comes with the following risks:

      • Heart attack
      • Stroke
      • Bleeding
      • Infection
      • Arrhythmias

      Most patients have to take anticoagulant medications to prevent the formation of blood clots. Also, your doctor might prescribe antibiotics to protect the replacement valve from infection. It’s wiser to talk to your doctor and assess the benefits and risks of TAVR before undergoing the procedure.

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        Treatment of Aortic Stenosis – Blog

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          Grading Severity of Aortic Stenosis

          Aortic valve stenosis is a serious disease that can lead to heart failure, strokes, and even death if left untreated. That makes timely diagnosis and treatment of the condition crucial. However, treatment of aortic stenosis depends on its severity.

          Typically, the following parameters are used to determine the severity of aortic stenosis:

          • Pressure gradient – High gradient (HG; >/=40 mm Hg) or low gradient (LG; <40 mm Hg)
          • Blood flow – Normal flow (NF; SVi>35 ml/m2) or low flow (LF; SVi<35ml/m2)
          • Left ventricular ejection fraction (LVEF) – Preserved (>/=50%) or reduced (<50%)

          Depending on the pressure gradient and blood flow parameters, aortic stenosis is graded as follows:

          • Normal flow-low gradient (NF-LG)
          • Normal flow-high gradient (NF-HG)
          • Low flow-high gradient (LF-HG)
          • Low flow-low gradient (LF-LG)

          NF-HG is the most prevalent type of aortic stenosis and has well-established management protocols. Patients with NF-HG are also ideal candidates for aortic valve replacement. While LF-LG is fairly rare, it’s often associated with a poor prognosis.

          Aortic-valve-stenosis 

          Additionally, depending on progression, heart valve disease can be categorized into the following four stages:

          • Stage A (At risk) – Characterised by the presence of risk factors
          • Stage B (Progressive) – Mild or moderate valve disease with no noticeable symptoms
          • Stage C (Asymptomatic severe) – Severe valve damage with no noticeable symptoms
          • Stage D (Symptomatic severe) – Severe valve disease with noticeable symptoms

          Doctors use a variety of diagnostic tests to evaluate the aforementioned parameters and determine the severity of aortic stenosis. If you experience symptoms like chest pain, heart murmur, or palpitation, it’s crucial to reach out to an experienced cardiologist and get the right treatment for aortic valve stenosis.

          How Does One Diagnose Aortic Stenosis – ECG, ECHO, TEE, or CT aortogram?

          Early diagnosis of aortic valve stenosis is crucial to prevent severe complications, such as arrhythmias, heart failure, stroke, and death. Also, it can help administer timely treatment, thus improving the patient’s prognosis and quality of life.

          That’s why cardiologists use a series of tests to diagnose aortic valve stenosis and its underlying cause. When you visit the doctor, they’ll start by asking you about your symptoms and medical history. Also, they ask whether your family has a history of cardiovascular ailments. Next, they’ll use a stethoscope to detect the presence of the characteristic aortic stenosis murmur.

          Additionally, your doctor will use one or more of the following tests for the complete diagnosis:

          • ECG (Electrocardiogram) – It’s one of the most preliminary tests that evaluate the heart’s electrical activity and helps doctors identify an irregular heartbeat and other abnormalities.
          • Echo (Echocardiogram) – It uses sound waves to generate images of the beating heart. It helps doctors examine how blood flows through each valve and determine the severity of aortic stenosis.
          • TEE (Transesophageal echocardiogram) – It’s a special type of echocardiogram in which an ultrasound probe is inserted into the esophagus and directed closer to the heart. It helps doctors take a closer look at the aortic valve and identify the underlying cause of aortic stenosis.
          • CT aortogram – It’s used to evaluate the blood supply to the upper body and identify conditions such as atherosclerosis.

          Echocardiography (ultrasound) machine. doppler of aortic stenosis

          Additionally, your doctor might recommend tests like cardiac catheterization and chest X-ray to get a complete picture of your cardiac health and plan the right course of treatment.

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            Diagnosing Aortic Stenosis – Blog

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              040-4959-4959

              Call us now if you are in a medical emergency need, we will reply swiftly and provide you with a medical aid.




              040-4959-4959


              Call us now if you are in a medical emergency need, we will reply swiftly and provide you with a medical aid.


              Dr. Raghu | Best Cardiologist in Hyderabad
              Aster Prime Hospital, Plot No: 2, Mytri Vihar, Satyam Theatre Lane Nearest Metro Station: Ameerpet Metro (100 Mtrs), Telangana 500016



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