For Patients - DrCRaghu


Introduction

Atrial Fibrillation means the upper chambers of the heart. These upper chambers of the heart start  beating chaotically quiet irregularly that is what is called as Atrial Fibrillation. Normally a heart beats  around 60-100 times per minute so the number of beats a heart should beat is determined by the  sinus node and its function but at times when there is an enlargement of atria or sometimes there is  an infection or inflammation of the atria what happens is these atria start beating chaotically so this  chaotic beating of the atria is called Atrial Fibrillation. In this video Dr. C Raghu TAVR expert in India explains  to  you all about Atrial Fibrillation, What are  the  types in Atrial Fibrillation? What are  the  complications of Atrial Fibrillation? How to detect Atrial Fibrillation?

Atrial Fibrillation means the upper chambers of the heart. These upper chambers of the heart start  beating chaotically quiet irregularly that is what is called as Atrial Fibrillation. Normally a heart beats  around 60-100 times per minute so the number of beats a heart should beat is determined by the  sinus node and its function but at times when there is an enlargement of atria or sometimes there is  an infection or inflammation of the atria what happens is these atria start beating chaotically so this  chaotic beating of the atria is called Atrial Fibrillation. In this Atrial Fibrillation in contrast to the 60- 100 beats per minute of the atrial contraction here the atrial rate is between 400-600 per minute so  the atria start beating very fast and quiet irregularly.

 

So if the atria beat very fast and irregularly what does it mean? 

It means that if a structure is beating at 400-600 per minute the beating is quiet ineffective so that is  what we call as atrial paralysis or the atria is not effectively functioning so atrial fibrillation leads to  dysfunction of the atrium

This atrium contributes to about 20% of heart output so when the atrium is dysfunctional the heart  pumping is reduced by around 20%.

 

Onset of Atrial Fibrillation

Atrial Fibrillation can be either

  • sudden onset
  • chronic
  • paroxysmal.

Acute Atrial Fibrillation: Atrial Fibrillation sometimes it happens suddenly like in the scenario of an  acute heart attack or in a scenario of an inflammation of pericardium or sometimes when there is a  sudden pulmonary embolism that means there is a blood clot within the blood vessels supplying the  lungs. In  those circumstances  there can be a  sudden onset of Atrial Fibrillation  so  this is called an  acute Atrial Fibrillation so once after the cause for the Atrial Fibrillation has been reversed there is a strong  chance  that  this  Atrial  Fibrillation  can  revert  back  to  normal  sinus  so  the  atrium  will  start  contracting at a much lower rate.

Chronic  Atrial  Fibrillation: The  other  type  of  Atrial  Fibrillation  is  a  Chronic  Atrial  Fibrillation  or  a  Chronic Persistent Atrial Fibrillation where the Atrial Fibrillation is present for more than a week in  duration and continues to persist. So that means that the Atrial Fibrillation does not come back to  sinus rhythm but in fact is present for beyond a week and continue to remain so for rest of the life so  that is what we call as Chronic Atrial Fibrillation or a long standing Atrial Fibrillation.

Paroxysmal  Atrial  Fibrillation: There  is  another  type  of  Atrial  Fibrillation  called  Paroxysmal  Atrial  Fibrillation that means Atrial Fibrillation is present for certain duration of time and then reverts back  to  sinus  rhythm  and  once  again  might  come  up again.  It  comes  and  goes  that  is  what  we  call  as  Paroxysmal Atrial Fibrillation.

 

Which type of Atrial Fibrillation is dangerous? 

All types of Atrial Fibrillation are dangerous.

 

Why they are dangerous?  

Atrial Fibrillation as we  understood  reduces  the  pumping ability  of  the  heart  by  20% in addition a  prolonged and fast rate of the heart fatigues the heart and reduces the heart pumping ability again  that is called left ventricular dysfunction

The most dreaded complication of Atrial Fibrillation is brain stroke because the atria are chaotically  contracting  or  they  are  inefficiently  contracting  there  is  pooling  of  blood  within  atrium  and  this  pooling of blood or stasis or stagnation of blood in the atrium leads to promotion of blood clots in  the atrial chambers. These blood clots which are present in  the atrial chambers because  the heart  continues to beat every minute every second so what happens is these small clots which are present  in  the atrial chambers get dislodged and potentially lead  to a brain stroke  these dislodge and  they  gets lodged in the brain vessels so that is called a brain stroke. So a patient with Atrial Fibrillation can  develop a heart dysfunction they can develop a brain stroke they can develop a sudden reduction in  the cardiac output so these are the various complications of Atrial Fibrillation.

 

How can we detect Atrial Fibrillation? 

We have seen that if the Atrial Fibrillation is chronic and persistent that can be easily detected by an  ECG or an Electrocardiogram. This is  the simplest inexpensive  test  to detect  the presence of Atrial  Fibrillation.

But if it is a Paroxysmal Atrial Fibrillation that means it comes and goes then we might have to use a  long  term  ECG  recording  technology  to  identify  or  diagnose  or  detect  the  presence  of  Atrial  Fibrillation.  So  there  are  numerous  technologies  to  identify  Atrial  Fibrillation  on  a  long  standing  basis. Some of them are external that means we put as a patch ECG outside or we connect multiple  electrodes  as  in  the  form  of a  Holter  monitoring  or  we  have  got  a  lot  of  novel  devices  like  the  Alivecor where you can just touch with the fingertips of the thumb to identify Atrial Fibrillation. So  number of technological advances have appeared to detect the presence of Atrial Fibrillation. Even  our Apple watch also  has got an Atrial Fibrillation  detection algorithm so an apple watch also  can

detect the  presence  of  Atrial  Fibrillation.  Quite  a  few  of  my  patients  tend  to  identify  their  Atrial  Fibrillation  from  their  apple  watch  so  you  have  got  simple  technologies  you  have  got  complex  technologies

The most complex technologies like where you can put an implantable loop recorder.  A small device  is implanted into the subcutaneous tissue that means beneath the skin and the muscle or the fat and  then this recorder will continue to record the heartbeat.

So you have got the simple technology like the ECG and a moderately complex technology like the  ECG  patch  or  the  Holter  recording  or  a  14  day  ECG  patch  is  also  available  and  finally  for  those  patients where the Atrial Fibrillation is very rare you can put an implantable loop recorder that can  last for about 2 years of the time.

So what happens is if these patients tend to have one episode of Atrial Fibrillation which is persistent  for more than 30 seconds then we can say that this patient has got an Atrial Fibrillation which could  be Paroxysmal in nature.

In  conclusion  lot  of  new  technologies  are  there  one  of  the  easiest  technology  is  the  apple  watch  somebody who is a patient you can use a Alivecor type of monitor. If the patient is newly diagnosed  or you want to confirm or make a diagnosis of Atrial Fibrillation you can use a Holter monitoring, a  patch ECG  for atleast 14 days. For one to diagnose Atrial Fibrillation atleast 14 days of recording is  required before we can say that this patient does not have Atrial Fibrillation.


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Women especially at young age are experiencing an unprecedented increase in heart attacks and strokes. We attempt In this article to make the reader aware of the reasons for this.

How are women different from men for developing heart attack?

Women tend to develop cardiac disease 7-10 years later compared to men that is attributed to the protective effect of estrogen hormone, which is present till menopause.

What are the traditional risk factors for developing heart disease?

Both men and women are prone to develop cardiac problems if they have one or multiple risk factors listed below. They are called traditional because they have been in practice for the past 6 decades.

Non-modifiable risk factors Modifiable risk factors
·         Age

·         Male gender

·         Family history of cardiac disease (< 60 years)

·         Smoking

·         Diabetes

·         Hypertension

·         Hyperlipidemia

·         Obesity

 Despite the absence of many of these risk factors, women worldwide are increasingly dying due to cardiac ailments.

Do traditional risk factors confer a disparate risk for developing cardiac problems in women?

Women are sensitive than men for the development of heart diseases when they have associated traditional risk factors.

For example:

  • Diabetes: Women with diabetes have a 7-fold increase in cardiac events compared to only 3-fold increase in diabetic men.
  • Smoking and tobacco use has been shown to enhance the risk by an additional 25% in women compared to men for development of heart attacks. In fact tobacco use has been responsible for 50% of cardiac events in women and confers a 3-fold increased events. Normally women develop heart attacks 7-10 years later than men due to the protective benefits of estrogen hormone. This protective effect is lost with tobacco use and if they develop diabetes.

Unique risk factors for cardiac problems in female gender include: 

  • Pre-eclampsia (High BP during pregnancy associated with complications)
  • Diabetes during pregnancy
  • Polycystic Ovary syndrome
  • Early menopause
  • Autoimmune diseases

Early menopause and risk of heart attack:

 About 10% of women experience menopause naturally before the age of 45 years. This is called early menopause. Because of lack of estrogen in post menopausal women, it predisposes to cardiac events.

Compared to women of similar age, those who attain natural or surgical menopause (removal of uterus – Hysterectomy) less than 45 years are at 50% higher risk of developing heart attack and 20% increased risk of death.  Those women who attained surgical menopause tend to have higher cardiac events compared to natural menopause. So women should be dissuaded to undergo uterus removal surgery unless there is a clear evidence that the procedure is definitely required. Hormone replacement therapy has been tried to mitigate this risk but in vain. Current guidelines are against hormone replacement therapy for early menopause.

What can we do to prevent these cardiac events in women?

Targeting traditional risk factors – diabetes, hypertension, lipids, sedentary life styles, inappropriate food choices and obesity form the bedrock strategy for reducing the risk of developing heart attacks.

But for women further measures are needed to address the unique risk factors for women. The American College of Cardiology in its 2019 guidelines notified pre eclampsia, early menopause and autoimmune disease as “risk enhancers” for cardiac disease. They also added that physicians should have a low threshold to treat those patients with risk enhancers by life style measures and cholesterol lowering drugs to reduce the risk of developing heart attacks.

Finally women should realize that they are no longer at low risk for developing cardiac ailments and need to understand there are new risk factors that put them at “enhanced risk” for developing heart attacks.


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Carotid artery disease is a condition that arises when the fat deposits accumulate and block the blood vessels that deliver blood to the brain. People with carotid artery disease are at higher risk of developing stroke. So, to determine the risk and prevent the associated complications, a procedure known as cerebral angiography is recommended.

Cerebral angiography is a diagnostic procedure that uses X-rays to evaluate the blockage or any brain abnormalities in the carotid arteries (blood vessels in the brain and neck).

When is cerebral angiography recommended?

Cerebral angiography is recommended if the doctor suspects any of the following abnormalities within the brain:

  • An aneurysm
  • A dilated blood vessel in the brain
  • Brain tumour
  • Brain clot
  • Stroke

It is also used to evaluate arteries in the head and neck before undergoing any surgery; to provide additional information regarding any abnormalities that are not visible on other imaging tests, and as a minimally invasive procedure to treat vessel abnormalities.

In some cases, it is done to determine the underlying cause of the following symptoms:

  • Severe headache
  • Memory loss
  • Dizziness
  • Blurred vision
  • Loss of balance or coordination
  • Weakness or numbness

Before the procedure:

Specific instructions are given before undergoing the procedure. These instructions may include:.

  • Any allergies
  • The use of current medicines, vitamins, and mineral supplement
  • The current medical conditions
  • Any food or dietary restrictions before the procedure.

What happens in the procedure?

Before initiating the procedure, the patient’s head is stabilized by using a strap, tape, or sandbags. Based on the age of the person, either local or general anaesthesia, is administered. Once the anaesthesia sets, the doctor will sterilize the groin region and make an incision. Under the guidance of X-rays, the catheter is passed into an artery in the neck.

Once the catheter is placed in the correct position, the contrast dye is injected to highlight the blockage. After the X-rays are done, the catheter is removed, and the incision is closed.

What to expect after the procedure?

Once the procedure is done, the vitals are monitored in a recovery room. The person would be instructed to keep the leg straight if the catheter is administered through the groin region. Pain and inflammation at the site of incision are common, which can be relieved by applying ice packs and taking the prescribed medicines.

What considerations should be taken after the test?

Cerebral angiography is a diagnostic procedure, so there are not much considerations. However, following the below-given tips may ease the discomfort associated with the test:

  • Have a healthy and well-balanced diet.
  • Do not lift heavyweight for a few days or as suggested by the doctor.
  • Perform normal activities 8 to 12 hours after the procedure.

Talk to the doctor:

Call the doctor immediately on noticing any of the following symptoms:

  • Chest pain
  • Dizziness
  • Infection at the catheter site
  • Shortness of breath
  • Skin rash
  • Slurred speech
  • Vision problems
  • Numbness in the face, arms, or leg muscles

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Cardiac catheterization is one of the most extensively performed cardiac procedures. If you have chest pain or irregular heartbeat, your doctor may recommend cardiac catheterization.

Cardiac catheterization is a minimally invasive procedure used to detect and treat cardiovascular diseases. This procedure involves the insertion of a catheter (a thin hollow tube) into the large arteries or veins present in the neck, arm or groin, which is then guided to the heart using a special X-ray. Once the catheter reaches the location, diagnostic tests or treatment procedures are carried out.

Why perform Cardiac Catheterization?

Cardiac catheterization is done to find the cause of the signs and symptoms of a heart problem or to treat or repair the heart damage.

This procedure is performed to:

  • Determine the pressure levels in the chambers of the heart.
  • Determine the heart function after a cardiac intervention.
  • Detect blockages in the coronary arteries (coronary angiography) or valve dysfunction.
  • Perform procedures such as angioplasty, ablation therapy or valve repair.
  • Obtain a small piece of heart tissue to examine under a microscope for detecting conditions affecting the heart muscle (cardiac biopsy).

What is the difference between Cardiac Catheterization and Coronary Angiography?

Catheterization is a procedure used to diagnose and treat various conditions. It involves the insertion of a catheter into the arteries and veins to reach the heart and to measure how much blood the heart pumps out, the pressure in each heart chamber, and to detect any defects in the heart. Also, various small instruments can be inserted into the catheter to view the interior of the blood vessels, to remove a tissue sample from the heart for further examination, etc.

Coronary angiography is a type of catheterization procedure, which involves analysing the arteries that supply the heart with oxygen-rich blood. This procedure involves the insertion of a catheter in the arm or the groin, which is threaded to reach the coronary arteries. During insertion, fluoroscopy (a continuous x-ray procedure) is used to guide the catheter to reach the precise position. After the catheter tip is at the right location, a contrast dye is injected into the coronary arteries. This dye can be seen on x-rays, and the outline of the arteries is viewed on a video screen.

How do I prepare for the procedure?

Inform your doctor about:

  • The medications that you are taking, especially blood-thinners or anti-inflammatory medications
  • Any medical conditions that you have
  • Allergies to any dyes or specific medications

Before the procedure:

  • Fast for at least 6 hours, as food and liquid increase the possibility of complications with general anaesthesia.
  • Empty your bladder before heading to the procedure.
  • Remove dentures and jewellery, as they may interfere with the imaging procedures.
  • Your general health status and vital signs will be monitored.

What happens during the procedure?

During cardiac catheterization, an IV cannula is inserted in your arm to administer medications. You will be given a mild sedative to help you relax during the procedure.

The general procedure of cardiac catheterization is given below:

  • The site of catheter insertion (usually the groin) is cleaned and shaved.
  • Usually, local anaesthesia is administered. General anaesthesia may be given before surgical procedures such as valve repair or ablation.
  • When the site of catheter insertion becomes numb, an incision is made, and the catheter is inserted using a catheter sheath.
  • Once the catheter reaches the heart, a dye is administered which outlines the vessels, valves and chambers of the heart.
  • The diagnostic tests or surgical procedures will then be performed for treating the condition.

Vital signs and electrocardiogram will be continuously monitored during the procedure.

Cardiac catheterization usually lasts for about 30 minutes. It may be longer if you are undergoing any other test or intervention using this procedure.

After the procedure is done, the catheter will be removed, and the incision will be closed by stitches. A sterile dressing will be used to prevent infection in the incision site.

What happens after the procedure?

Once the procedure is done, you will be asked to lie flat on the bed for 2-6 hours after the procedure. Your heart rate and blood pressure will be continuously monitored.

Once the anaesthesia wears off, you will be given pain medications. You will be asked to drink plenty of water to eliminate the dye that was administered. Usually, you will be asked to stay in the hospital for a few hours or a day.

After leaving the hospital, follow all the post-procedural instructions given by your doctor. You may resume your normal activities in a day’s time. Some soreness at the incision site is normal; it may reduce within a week.

What are the risks of Cardiac Catheterization?

Cardiac catheterization is a relatively safe procedure. However, like any other invasive procedure, some uncommon risks of this procedure are:

  • Infection
  • Blood clotting
  • Bruising at the incision site
  • Allergic reaction to dye
  • Arrhythmia
  • Air embolism
  • Stroke

Call your doctor if you experience:

  • Severe pain at the incision site
  • Signs of infection: redness, warmth, pus oozing or excessive swelling around the incision site
  • Numbness or tingling sensation in your limbs

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When a blood clot (thrombus) is formed in one or more of the deep veins of your body (usually in the legs), it is known as deep vein thrombosis (DVT). Sometimes this clot becomes detached from the inner walls of the blood vessel and travels to another part inside the body. DVT may develop due to an underlying medical condition particularly the one which affects the clotting of the blood.

Causes and risk factors:

It can be caused by the factors which prevent the normal circulation of the blood and it’s clotting, such as long periods of rest (during a particular medical condition), injury to the vein, surgery and certain medications.

The risk factors are as follows:

  • Inherited blood clotting disorder
  • Prolonged bed rest
  • Surgery
  • Pregnancy
  • Contraceptives or hormone replacement therapy
  • Obesity
  • Smoking
  • Cancer
  • Heart failure
  • Inflammatory bowel disease
  • Age (usually older than 60 years but can also occur at any age)

Complications:

The following are the complications which may arise due to DVT:

Pulmonary embolism: In this, a thrombus present in another part of your body usually a leg, travels to the blood vessel of the lung and blocks the blood circulation, leading to a life-threatening condition.

Post-phlebetic syndrome (post thrombotic syndrome): set of signs and symptoms seen after a blood clot has formed.

Symptoms:

The person may be asymptomatic during the formation of the thrombus, however, during post thrombotic period when it has caused damage to the veins, the blood flow to the affected body part may be compromised. The following symptoms are observed:

  • Persistent swelling of the leg or arm (edema)
  • Leg pain or tenderness while standing
  • Skin discoloration in the affected arm or leg
  • Veins in the arm or leg appearing larger than normal

Sometimes the development of a serious health complication such as pulmonary embolism is responsible for the symptoms in the DVT patients which are as follows:

  • Shortness of breath
  • Chest pain
  • Cough (blood may be coughed out as well)
  • Back pain
  • Profuse sweating
  • Lightheadedness
  • Blue nails or lips

These symptoms appear suddenly, and an immediate medical attention is required.

Diagnosis:

The diagnosis is initiated by a thorough clinical examination and involves review of the patient’s medical history. Based upon these findings, the physician will categorize the patient into low or high risk DVT. Further tests may be considered to rule out other health problems and to confirm the diagnosis, which are as follows:

  • Blood tests: These are considered to evaluate any blood disorders that increase risk of DVT.
  • D- dimer test: In this test, the levels of a protein called D-dimer is assessed. In patients with DVT, high levels of this protein can be found in the blood.
  • Duplex ultrasonography: It is a non-invasive evaluation of the blood flow in the arteries and the veins of a patient. But this test is not preferred for a thrombus located very deep inside the body such as pelvis.
  • Venography: It is a specialized type of an x-ray procedure wherein a dye is injected into a vein of the foot, and the blood clot if present is detected.
  • Magnetic resonance imaging (MRI)- It is performed in patients for whom ultrasound examination is inappropriate or unfeasible. It can even detect a thrombus present in the patient’s pelvis and the thigh.

Prevention:

A recent World Thrombosis Day Ipsos survey showed that there is less awareness of DVT in countries around the world. Thus, the first step in prevention is making the public aware of DVT. The preventive measures are different depending on the person’s condition who are at risk of developing DVT:

During pregnancy

In pregnant women, certain medication may be prescribed if she has risk factors such as likelihood of having a cesarean birth, bed rest, history of DVT, and inherited thrombophilia.

During travel or in longer hours of sitting posture:

  • Drink lots of fluids.
  • Wear loose fitting clothes.
  • Walk and stretch at regular intervals.
  • Use special stockings to improve blood flow and to prevent blood clots but consult your health care provider before using it.

Treatment:

Treatment for DVT includes certain medicines and therapies, which are as follows:

Medications:

  • Anticoagulants: They prevent further formation of blood clots but don’t dissolve the already existing ones. Most common anticoagulants used are heparin and warfarin. Warfarin is not recommended during pregnancy.
  • Thrombin inhibitors: These are recommended for people who can’t take heparin.
  • Thrombolytic medicines: These are recommended only during life threatening condition.

Compression stockings:

It may be recommended to prevent swelling and to avoid post-thrombotic symptoms in the patients.

Surgical treatment:

Surgical treatment may be performed when medications fail to dissolve the clots.


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Thromboembolism refers to a condition where a blood clot formed in the blood vessel unplugs itself and flows in the blood stream to block another blood vessel leading to obstruction of blood flow. Although clotting is a normal bodily function, if a clot occurs where it is not required, it may lead to serious problems.

Types of Thromboembolism:

The type of thromboembolism differs depending on the area in which the clot may appear. It can obstruct the blood flow in the veins, arteries, brain, gastrointestinal tract or kidneys.

Thromboembolism can be further classified as below:

Venous Thromboembolism:

A venous thromboembolism is a thrombus (blood clot) formed in a vein. The blood flow in the veins is slow when compared to arteries which can increase the likelihood of the blood clots forming in these vessels.

It can be categorized into three different types

  • Superficial Vein Thrombosis
    The clot may occur in a superficial vein, close to the surface of the body. Usually, it is not serious until it enters the deep veins.
  • Deep Vein Thrombosis (DVT)
    Deep vein thrombosis occurs within the deep veins, and mostly occurs within the legs.
  • Pulmonary embolism (PE)
    It is a medical emergency in which the thrombus blocks the blood vessel in the lungs.

Renal Vein Thrombosis (RVT)

A renal vein thrombosis is a thrombosis that occurs in the veins that drain blood away from the kidneys. These clots reduce the ability of the kidneys to clean and filter the blood.

Arterial Thrombosis (atherothrombosis)

Arterial thrombosis is much less common than venous thrombosis. It can have similar risks. Usually arterial thrombosis may lead to necrosis of the tissue.

A thromboembolism in the coronary artery can cause a heart attack. If blood supply to the brain is disrupted, the patient may suffer a stroke.

Symptoms:

Signs and symptoms of venous thromboembolism include the following

DVT

  • Pain in arm or leg, usually in the thigh or calf
  • Swollen leg or arm
  • Reddening or warming of the skin
  • Red streaks on the skin

PE

  • Shortness of breath
  • Chest pain under your rib cage that can get worse when you take a deep breath
  • Rapid heart rate
  • Feeling lightheaded or passing out
  • Accentuated second heart sound

Arterial Thrombosis

  • Muscle pain or spasm in the affected area
  • Numbness and tingling in the arm or leg
  • Pale color of the arm or leg (pallor)
  • Weakness of an arm or leg

If the condition is severe, it may lead to blister formation and shedding of the skin, leading to tissue necrosis.

Symptoms of a clot in an organ vary with the organ involved but may include:

  • Pain in the part of the body that is involved
  • Temporary decrease in organ function

Causes:

The blood clots can occur due to injury to a vein, consequence of a surgery, use of certain medications and lack of movement of the limbs.

In the case of PE, the blood clot may block the blood vessels of the lungs. The affected portion of the lung may die due to loss of blood supply, the condition is called as pulmonary infraction, making it difficult to provide oxygen to the rest of the body.

Occasionally, the blood vessels can be blocked by substances other than blood like collagen, part of a tumour, air bubbles etc.

Risk factors:

The common risk factors include

  • Inheriting a blood-clotting disorder
  • Prolonged immobility which may be due to bed rest or long trips
  • Injury or surgery
  • Pregnancy
  • Birth control pills or hormone replacement therapy
  • Being overweight or obese
  • Smoking
  • Cancer
  • Heart failure
  • Inflammatory bowel disease
  • Family history of deep vein thrombosis or pulmonary embolism

Diagnosis:

The diagnosis of thromboembolism includes the following tests which could be considered depending on the type:

D-dimer: The blood sample is tested for the presence of D-dimer which is a marker for the presence of blood clots.

Duplex Ultrasound: This is an imaging test in which the presence of clots is identified using ultrasound waves.

Pulse oximetry: In this test, a sensor attached on the end of the finger of the patient helps to measure the level of oxygen in the blood.

Arterial blood gas: The blood drawn from the artery is checked for oxygen levels present in it.

Chest X-ray: This test may not be useful in finding the presence of clots, but can help to rule out a clot.

Other diagnostic tests may include ELISA, pulmonary angiography, venography, echocardiography, helical computed tomography of pulmonary vessels etc.

Treatment:

Treatment of thromboembolism includes:

Blood thinners: These are anticoagulant drugs which prevent formation of new clots while the body works to break up the previous clots present. They include heparin, low-molecular-weight heparin, apixaban, edoxaban, rivaroxaban, and warfarin.

Clot-busting drugs: These are intravenous injections to dissolve the clots in the case of life-threatening situations. They include drugs belonging to the class of tissue plasminogen activators.

Surgical and other procedures:

  • Removal of clot: Surgery is considered only if the condition is life threatening. The clot is removed using a catheter threaded through the blood vessel.
  • Vein filter: A catheter can also be used to position a filter in the inferior vena cava which helps to stop the clots from being carried into the lungs.

Prevention:

If the patient is at a risk of the condition, the following preventive measures may be considered to reduce the occurrence:

  • Use of blood thinners
  • Use of compression stockings
  • Use of intermittent pneumatic compression devices that automatically squeeze the legs to keep blood flowing

Other preventive measures include

  • Regular exercise
  • Maintaining healthy weight
  • Cessation of smoking

Consideration during travel include

  • Walk every 1 to 2 hours
  • Stretch legs and move around on the seat
  • Drink lots of fluids
  • Avoid smoking and consumption of alcohol before journey


Your heart needs to work 24/7 to keep your body systems working. Like any other body tissue, the heart too needs oxygen and nutrients to function efficiently. For this, we have a network of arteries that supply blood to the heart muscles which are called the coronary arteries. There are two chief coronary arteries:

the left and right coronary arteries, that branch out from the aorta near the point where the aorta and the left ventricle meet.

The right coronary artery supplies blood to the right atrium, the right ventricle, a small bottom area of the left ventricle and the back portion of the septum.

The left coronary artery supplies blood to the left atrium and ventricles and the front portion of the septum.

These coronary arteries give out various branches that supply blood to different parts of the heart.

Coronary artery disease:

When there is high level of unhealthy fats in the blood, they gradually start depositing in the insides of the coronary artery vessel wall and form a fatty plaque(atherosclerosis). This gradually narrows the lumen of the coronary arteries which obstructs blood supply to the heart. This condition is called as coronary artery disease. disruption of blood supply to the heart gives rise to a cluster of symptoms, the most important being chest pain or angina.

  • Warning signs of heart disease
  • Risk factors for heart disease
  • Possible complications of heart disease


Your lifestyle, age, family history and your other health condition can dictate your risk to develop a heart disease. However, the three key risk factors are- smoking, high blood pressure and high cholesterol. Learn about the risk factors and see if you are at risk:

  1. High blood pressure: It is an important factor for many diseases. Blood pressure, if not controlled, can lead to heart disease, stroke, kidney failure and other organ system disorders. Decreasing blood pressure by lifestyle changes and medication can greatly reduce your risk for heart disease.
  2. High cholesterol: Did you know that our hardworking liver can generate all the cholesterol that our bodies need? But we all do take in extra bad cholesterol from diet. These bad cholesterol tend to get deposited in our blood vessels and cause heart disease.
  3. Smoking: Cigarette smoking damages your heart and blood vessels. Nicotine present in cigarette smoke also reduces the amount of oxygen that your blood can carry. Not only that, if you smoke, the people around you are also at a higher risk of getting heart disease.
  4. Obesity: Obesity is linked with high level of bad cholesterol level and low levels of good cholesterol levels. Obesity is not only a risk factor for heart disease, but also increases risk of diabetes and high blood pressure.
  5. Diabetes: People with diabetes or high blood sugars are at greater risk of having heart disease than those who don’t have diabetes.
  6. Unhealthy diet: Oily, junk foods which are high in bad cholesterol, saturated fats and trans fats an can increase your risk of heart disease. Foods that are very salty(have high sodium levels) can also increase your risk of high blood pressure and heart disease.
  7. Physical inactivity: Physical inactivity increase your risk of having high blood pressure and diabetes and eventually heart disease.
  8. Alcohol: Excess and frequent alcohol intake can increase the risk of high blood pressure and hypercholesterolemia. Ideally, women shouldn’t have more than 1 drink a day and men shouldn’t have more than 2 drinks a day.
  9. Family history: Genetic factors seem to play a role in conditions like high blood pressure and heart diseases. However, it is also likely that the members of the family sharing common external environments and culture may be exposed to the same set of risk factors for heart diseases.
  10. Age: The risk of heart disease increases as the a person ages.


There are an array of heart diseases but they do share some common symptoms. If you experience any of these symptoms, it is perhaps a good idea to get yourself tested. Check these out here:

  1. Angina or chest pain described as heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest.It is often accompanied by pain in the n the neck, jaw, throat, upper abdomen or back
  2. Shortness of breath
  3. Easy fatiguability
  4. Palpitation and rapid heartbeat
  5. Weakness/dizziness
  6. Sweating
  7. Nausea and vomiting
  8. Swelling in the lower extremities
  9. Fainting(syncope)
  10. Coughing and wheezing











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