problem
stringlengths 16
191
| explanation
stringlengths 6
29k
⌀ | type
stringlengths 3
136
⌀ |
|---|---|---|
How to diagnose Fanconi Anemia ?
|
People who have Fanconi anemia (FA) are born with the disorder. They may or may not show signs or symptoms of it at birth. For this reason, FA isn't always diagnosed when a person is born. In fact, most people who have the disorder are diagnosed between the ages of 2 and 15 years.
The tests used to diagnose FA depend on a person's age and symptoms. In all cases, medical and family histories are an important part of diagnosing FA. However, because FA has many of the same signs and symptoms as other diseases, only genetic testing can confirm its diagnosis.
Specialists Involved
A geneticist is a doctor or scientist who studies how genes work and how diseases and traits are passed from parents to children through genes.
Geneticists do genetic testing for FA. They also can provide counseling about how FA is inherited and the types of prenatal (before birth) testing used to diagnose it.
An obstetrician may detect birth defects linked to FA before your child is born. An obstetrician is a doctor who specializes in providing care for pregnant women.
After your child is born, a pediatrician also can help find out whether your child has FA. A pediatrician is a doctor who specializes in treating children and teens.
A hematologist (blood disease specialist) also may help diagnose FA.
Family and Medical Histories
FA is an inherited disease. Some parents are aware that their family has a medical history of FA, even if they don't have the disease.
Other parents, especially if they're FA carriers, may not be aware of a family history of FA. Many parents may not know that FA can be passed from parents to children.
Knowing your family medical history can help your doctor diagnose whether you or your child has FA or another condition with similar symptoms.
If your doctor thinks that you, your siblings, or your children have FA, he or she may ask you detailed questions about:
Any personal or family history of anemia
Any surgeries youve had related to the digestive system
Any personal or family history of immune disorders
Your appetite, eating habits, and any medicines you take
If you know your family has a history of FA, or if your answers to your doctor's questions suggest a possible diagnosis of FA, your doctor will recommend further testing.
Diagnostic Tests and Procedures
The signs and symptoms of FA aren't unique to the disease. They're also linked to many other diseases and conditions, such as aplastic anemia. For this reason, genetic testing is needed to confirm a diagnosis of FA. Genetic tests for FA include the following.
Chromosome Breakage Test
This is the most common test for FA. It's available only in special laboratories (labs). It shows whether your chromosomes (long chains of genes) break more easily than normal.
Skin cells sometimes are used for the test. Usually, though, a small amount of blood is taken from a vein in your arm using a needle. A technician combines some of the blood cells with certain chemicals.
If you have FA, the chromosomes in your blood sample break and rearrange when mixed with the test chemicals. This doesn't happen in the cells of people who don't have FA.
Cytometric Flow Analysis
Cytometric flow analysis, or CFA, is done in a lab. This test examines how chemicals affect your chromosomes as your cells grow and divide. Skin cells are used for this test.
A technician mixes the skin cells with chemicals that can cause the chromosomes in the cells to act abnormally. If you have FA, your cells are much more sensitive to these chemicals.
The chromosomes in your skin cells will break at a high rate during the test. This doesn't happen in the cells of people who don't have FA.
Mutation Screening
A mutation is an abnormal change in a gene or genes. Geneticists and other specialists can examine your genes, usually using a sample of your skin cells. With special equipment and lab processes, they can look for gene mutations that are linked to FA.
Diagnosing Different Age Groups
Before Birth (Prenatal)
If your family has a history of FA and you get pregnant, your doctor may want to test you or your fetus for FA.
Two tests can be used to diagnose FA in a developing fetus: amniocentesis (AM-ne-o-sen-TE-sis) and chorionic villus (ko-re-ON-ik VIL-us) sampling (CVS). Both tests are done in a doctor's office or hospital.
Amniocentesis is done 15 to 18 weeks after a pregnant woman's last period. A doctor uses a needle to remove a small amount of fluid from the sac around the fetus. A technician tests chromosomes (chains of genes) from the fluid sample to see whether they have faulty genes associated with FA.
CVS is done 10 to 12 weeks after a pregnant woman's last period. A doctor inserts a thin tube through the vagina and cervix to the placenta (the temporary organ that connects the fetus to the mother).
The doctor removes a tissue sample from the placenta using gentle suction. The tissue sample is sent to a lab to be tested for genetic defects associated with FA.
At Birth
Three out of four people who inherit FA are born with birth defects. If your baby is born with certain birth defects, your doctor may recommend genetic testing to confirm a diagnosis of FA.
For more information about these defects, go to What Are the Signs and Symptoms of Fanconi Anemia?
Childhood and Later
Some people who have FA are not born with birth defects. Doctors may not diagnose them with the disorder until signs of bone marrow failure or cancer occur. This usually happens within the first 10 years of life.
Signs of bone marrow failure most often begin between the ages of 3 and 12 years, with 7 to 8 years as the most common ages. However, 10 percent of children who have FA aren't diagnosed until after 16 years of age.
If your bone marrow is failing, you may have signs of aplastic anemia. FA is one type of aplastic anemia.
In aplastic anemia, your bone marrow stops making or doesn't make enough of all three types of blood cells: red blood cells, white blood cells, and platelets.
Aplastic anemia can be inherited or acquired after birth through exposure to chemicals, radiation, or medicines.
Doctors diagnose aplastic anemia using:
Family and medical histories and a physical exam.
A complete blood count (CBC) to check the number, size, and condition of your red blood cells. The CBC also checks numbers of white blood cells and platelets.
A reticulocyte (re-TIK-u-lo-site) count. This test counts the number of new red blood cells in your blood to see whether your bone marrow is making red blood cells at the proper rate.
Bone marrow tests. For a bone marrow aspiration, a small amount of liquid bone marrow is removed and tested to see whether it's making enough blood cells. For a bone marrow biopsy, a small amount of bone marrow tissue is removed and tested to see whether it's making enough blood cells.
If you or your child is diagnosed with aplastic anemia, your doctor will want to find the cause. If your doctor suspects you have FA, he or she may recommend genetic testing.
For more information, go to the Health Topics Aplastic Anemia article.
|
Fanconi Anemia
|
What are the treatments for Fanconi Anemia ?
|
Doctors decide how to treat Fanconi anemia (FA) based on a person's age and how well the person's bone marrow is making new blood cells.
Goals of Treatment
Long-term treatments for FA can:
Cure the anemia. Damaged bone marrow cells are replaced with healthy ones that can make enough of all three types of blood cells on their own.
Or
Treat the symptoms without curing the cause. This is done using medicines and other substances that can help your body make more blood cells for a limited time.
Screening and Short-Term Treatment
Even if you or your child has FA, your bone marrow might still be able to make enough new blood cells. If so, your doctor might suggest frequent blood count checks so he or she can watch your condition.
Your doctor will probably want you to have bone marrow tests once a year. He or she also will screen you for any signs of cancer or tumors.
If your blood counts begin to drop sharply and stay low, your bone marrow might be failing. Your doctor may prescribe antibiotics to help your body fight infections. In the short term, he or she also may want to give you blood transfusions to increase your blood cell counts to normal levels.
However, long-term use of blood transfusions can reduce the chance that other treatments will work.
Long-Term Treatment
The four main types of long-term treatment for FA are:
Blood and marrow stem cell transplant
Androgen therapy
Synthetic growth factors
Gene therapy
Blood and Marrow Stem Cell Transplant
A blood and marrow stem cell transplant is the current standard treatment for patients who have FA that's causing major bone marrow failure. Healthy stem cells from another person, called a donor, are used to replace the faulty cells in your bone marrow.
If you're going to receive stem cells from another person, your doctor will want to find a donor whose stem cells match yours as closely as possible.
Stem cell transplants are most successful in younger people who:
Have few or no serious health problems
Receive stem cells from a brother or sister who is a good donor match
Have had few or no previous blood transfusions
During the transplant, you'll get donated stem cells in a procedure that's like a blood transfusion. Once the new stem cells are in your body, they travel to your bone marrow and begin making new blood cells.
A successful stem cell transplant will allow your body to make enough of all three types of blood cells.
Even if you've had a stem cell transplant to treat FA, youre still at risk for some types of blood cancer and cancerous solid tumors. Your doctor will check your health regularly after the procedure.
For more information about stem cell transplantsincluding finding a donor, having the procedure, and learning about the risksgo to the Health Topics Blood and Marrow Stem Cell Transplant article.
Androgen Therapy
Before improvements made stem cell transplants more effective, androgen therapy was the standard treatment for people who had FA. Androgens are man-made male hormones that can help your body make more blood cells for long periods.
Androgens increase your red blood cell and platelet counts. They don't work as well at raising your white blood cell count.
Unlike a stem cell transplant, androgens don't allow your bone marrow to make enough of all three types of blood cells on its own. You may need ongoing treatment with androgens to control the effects of FA.
Also, over time, androgens lose their ability to help your body make more blood cells, which means you'll need other treatments.
Androgen therapy can have serious side effects, such as liver disease. This treatment also can't prevent you from developing leukemia (a type of blood cancer).
Synthetic Growth Factors
Your doctor may choose to treat your FA with growth factors. These are substances found in your body, but they also can be man-made.
Growth factors help your body make more red and white blood cells. Growth factors that help your body make more platelets still are being studied.
More research is needed on growth factor treatment for FA. Early results suggest that growth factors may have fewer and less serious side effects than androgens.
Gene Therapy
Researchers are looking for ways to replace faulty FA genes with normal, healthy genes. They hope these genes will make proteins that can repair and protect your bone marrow cells. Early results of this therapy hold promise, but more research is needed.
Surgery
FA can cause birth defects that affect the arms, thumbs, hips, legs, and other parts of the body. Doctors may recommend surgery to repair some defects.
For example, your child might be born with a ventricular septal defecta hole or defect in the wall that separates the lower chambers of the heart. His or her doctor may recommend surgery to close the hole so the heart can work properly.
Children who have FA also may need surgery to correct digestive system problems that can harm their nutrition, growth, and survival.
One of the most common problems is an FA-related birth defect in which the trachea (windpipe), which carries air to the lungs, is connected to the esophagus, which carries food to the stomach.
This can cause serious breathing, swallowing, and eating problems and can lead to lung infections. Surgery is needed to separate the two organs and allow normal eating and breathing.
|
Fanconi Anemia
|
How to prevent Fanconi Anemia ?
|
ou can't prevent Fanconi anemia (FA) because it's an inherited disease. If a child gets two copies of the same faulty FA gene, he or she will have the disease.
If you're at high risk for FA and are planning to have children, you may want to consider genetic counseling. A counselor can help you understand your risk of having a child who has FA. He or she also can explain the choices that are available to you.
If you're already pregnant, genetic testing can show whether your child has FA. For more information on genetic testing, go to "How Is Fanconi Anemia Diagnosed?"
In the United States, Ashkenazi Jews (Jews of Eastern European descent) are at higher risk for FA than other ethnic groups. For Ashkenazi Jews, it's recommended that prospective parents get tested for FA-related gene mutations before getting pregnant.
Preventing Complications
If you or your child has FA, you can prevent some health problems related to the disorder. Pneumonia, hepatitis, and chicken pox can occur more often and more severely in people who have FA compared with those who don't. Ask your doctor about vaccines for these conditions.
People who have FA also are at higher risk than other people for some cancers. These cancers include leukemia (a type of blood cancer), myelodysplastic syndrome (abnormal levels of all three types of blood cells), and liver cancer. Screening and early detection can help manage these life-threatening diseases.
|
Fanconi Anemia
|
What is (are) Antiphospholipid Antibody Syndrome ?
|
Antiphospholipid (AN-te-fos-fo-LIP-id) antibody syndrome (APS) is an autoimmune disorder. Autoimmune disorders occur if the body's immune system makes antibodies that attack and damage tissues or cells.
Antibodies are a type of protein. They usually help defend the body against infections. In APS, however, the body makes antibodies that mistakenly attack phospholipidsa type of fat.
Phospholipids are found in all living cells and cell membranes, including blood cells and the lining of blood vessels.
When antibodies attack phospholipids, cells are damaged. This damage causes blood clots to form in the body's arteries and veins. (These are the vessels that carry blood to your heart and body.)
Usually, blood clotting is a normal bodily process. Blood clots help seal small cuts or breaks on blood vessel walls. This prevents you from losing too much blood. In APS, however, too much blood clotting can block blood flow and damage the body's organs.
Overview
Some people have APS antibodies, but don't ever have signs or symptoms of the disorder. Having APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.
APS can lead to many health problems, such as stroke, heart attack, kidney damage, deep vein thrombosis (throm-BO-sis), and pulmonary embolism (PULL-mun-ary EM-bo-lizm).
APS also can cause pregnancy-related problems, such as multiple miscarriages, a miscarriage late in pregnancy, or a premature birth due to eclampsia (ek-LAMP-se-ah). (Eclampsia, which follows preeclampsia, is a serious condition that causes seizures in pregnant women.)
Very rarely, some people who have APS develop many blood clots within weeks or months. This condition is called catastrophic antiphospholipid syndrome (CAPS).
People who have APS also are at higher risk for thrombocytopenia (THROM-bo-si-to-PE-ne-ah). This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets (PLATE-lets). Antibodies destroy the platelets, or theyre used up during the clotting process. Mild to serious bleeding can occur with thrombocytopenia.
APS can be fatal. Death may occur as a result of large blood clots or blood clots in the heart, lungs, or brain.
Outlook
APS can affect people of any age. However, it's more common in women and people who have other autoimmune or rheumatic (ru-MAT-ik) disorders, such as lupus. ("Rheumatic" refers to disorders that affect the joints, bones, or muscles.)
APS has no cure, but medicines can help prevent its complications. Medicines are used to stop blood clots from forming. They also are used to keep existing clots from getting larger. Treatment for APS is long term.
If you have APS and another autoimmune disorder, it's important to control that condition as well. When the other condition is controlled, APS may cause fewer problems.
|
Antiphospholipid Antibody Syndrome
|
What causes Antiphospholipid Antibody Syndrome ?
|
Antiphospholipid antibody syndrome (APS) occurs if the body's immune system makes antibodies (proteins) that attack phospholipids.
Phospholipids are a type of fat found in all living cells and cell membranes, including blood cells and the lining of blood vessels. What causes the immune system to make antibodies against phospholipids isn't known.
APS causes unwanted blood clots to form in the body's arteries and veins. Usually, blood clotting is a normal bodily process. It helps seal small cuts or breaks on blood vessel walls. This prevents you from losing too much blood. In APS, however, too much blood clotting can block blood flow and damage the body's organs.
Researchers don't know why APS antibodies cause blood clots to form. Some believe that the antibodies damage or affect the inner lining of the blood vessels, which causes blood clots to form. Others believe that the immune system makes antibodies in response to blood clots damaging the blood vessels.
|
Antiphospholipid Antibody Syndrome
|
Who is at risk for Antiphospholipid Antibody Syndrome? ?
|
Antiphospholipid antibody syndrome (APS) can affect people of any age. The disorder is more common in women than men, but it affects both sexes.
APS also is more common in people who have other autoimmune or rheumatic disorders, such as lupus. ("Rheumatic" refers to disorders that affect the joints, bones, or muscles.)
About 10 percent of all people who have lupus also have APS. About half of all people who have APS also have another autoimmune or rheumatic disorder.
Some people have APS antibodies, but don't ever have signs or symptoms of the disorder. The mere presence of APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.
However, people who have APS antibodies but no signs or symptoms are at risk of developing APS. Health problems, other than autoimmune disorders, that can trigger blood clots include:
Smoking
Prolonged bed rest
Pregnancy and the postpartum period
Birth control pills and hormone therapy
Cancer and kidney disease
|
Antiphospholipid Antibody Syndrome
|
What are the symptoms of Antiphospholipid Antibody Syndrome ?
|
The signs and symptoms of antiphospholipid antibody syndrome (APS) are related to abnormal blood clotting. The outcome of a blood clot depends on its size and location.
Blood clots can form in, or travel to, the arteries or veins in the brain, heart, kidneys, lungs, and limbs. Clots can reduce or block blood flow. This can damage the body's organs and may cause death.
Major Signs and Symptoms
Major signs and symptoms of blood clots include:
Chest pain and shortness of breath
Pain, redness, warmth, and swelling in the limbs
Ongoing headaches
Speech changes
Upper body discomfort in the arms, back, neck, and jaw
Nausea (feeling sick to your stomach)
Blood clots can lead to stroke, heart attack, kidney damage, deep vein thrombosis, and pulmonary embolism.
Pregnant women who have APS can have successful pregnancies. However, they're at higher risk for miscarriages, stillbirths, and other pregnancy-related problems, such as preeclampsia (pre-e-KLAMP-se-ah).
Preeclampsia is high blood pressure that occurs during pregnancy. This condition may progress to eclampsia. Eclampsia is a serious condition that causes seizures in pregnant women.
Some people who have APS may develop thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets.
Mild to serious bleeding causes the main signs and symptoms of thrombocytopenia. Bleeding can occur inside the body (internal bleeding) or underneath or from the skin (external bleeding).
Other Signs and Symptoms
Other signs and symptoms of APS include chronic (ongoing) headaches, memory loss, and heart valve problems. Some people who have APS also get a lacy-looking red rash on their wrists and knees.
|
Antiphospholipid Antibody Syndrome
|
How to diagnose Antiphospholipid Antibody Syndrome ?
|
Your doctor will diagnose antiphospholipid antibody syndrome (APS) based on your medical history and the results from blood tests.
Specialists Involved
A hematologist often is involved in the care of people who have APS. This is a doctor who specializes in diagnosing and treating blood diseases and disorders.
You may have APS and another autoimmune disorder, such as lupus. If so, a doctor who specializes in that disorder also may provide treatment.
Many autoimmune disorders that occur with APS also affect the joints, bones, or muscles. Rheumatologists specialize in treating these types of disorders.
Medical History
Some people have APS antibodies but no signs or symptoms of the disorder. Having APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.
APS can lead to many health problems, including stroke, heart attack, kidney damage, deep vein thrombosis, and pulmonary embolism.
APS also can cause pregnancy-related problems, such as multiple miscarriages, a miscarriage late in pregnancy, or a premature birth due to eclampsia. (Eclampsia, which follows preeclampsia, is a serious condition that causes seizures in pregnant women.)
Blood Tests
Your doctor can use blood tests to confirm a diagnosis of APS. These tests check your blood for any of the three APS antibodies: anticardiolipin, beta-2 glycoprotein I (2GPI), and lupus anticoagulant.
The term "anticoagulant" (AN-te-ko-AG-u-lant) refers to a substance that prevents blood clotting. It may seem odd that one of the APS antibodies is called lupus anticoagulant. The reason for this is because the antibody slows clotting in lab tests. However, in the human body, it increases the risk of blood clotting.
To test for APS antibodies, a small blood sample is taken. It's often drawn from a vein in your arm using a needle. The procedure usually is quick and easy, but it may cause some short-term discomfort and a slight bruise.
You may need a second blood test to confirm positive results. This is because a single positive test can result from a short-term infection. The second blood test often is done 12 weeks or more after the first one.
|
Antiphospholipid Antibody Syndrome
|
What are the treatments for Antiphospholipid Antibody Syndrome ?
|
Antiphospholipid antibody syndrome (APS) has no cure. However, medicines can help prevent complications. The goals of treatment are to prevent blood clots from forming and keep existing clots from getting larger.
You may have APS and another autoimmune disorder, such as lupus. If so, it's important to control that condition as well. When the other condition is controlled, APS may cause fewer problems.
Research is ongoing for new ways to treat APS.
Medicines
Anticoagulants, or "blood thinners," are used to stop blood clots from forming. They also may keep existing blood clots from getting larger. These medicines are taken as either a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).
Warfarin and heparin are two blood thinners used to treat APS. Warfarin is given in pill form. (Coumadin is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.
Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.
Aspirin also thins the blood and helps prevent blood clots. Sometimes aspirin is used with warfarin. Other times, aspirin might be used alone.
Blood thinners don't prevent APS. They simply reduce the risk of further blood clotting. Treatment with these medicines is long term. Discuss all treatment options with your doctor.
Side Effects
The most common side effect of blood thinners is bleeding. This happens if the medicine thins your blood too much. This side effect can be life threatening.
Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually need regular blood tests, called PT and PTT tests, to check how well their blood is clotting.
These tests also show whether you're taking the right amount of medicine. Your doctor will check to make sure that you're taking enough medicine to prevent clots, but not so much that it causes bleeding.
Talk with your doctor about the warning signs of internal bleeding and when to seek emergency care. (For more information, go to "Living With Antiphospholipid Antibody Syndrome.")
Treatment During Pregnancy
Pregnant women who have APS can have successful pregnancies. With proper treatment, these women are more likely to carry their babies to term.
Pregnant women who have APS usually are treated with heparin or heparin and low-dose aspirin. Warfarin is not used as a treatment during pregnancy because it can harm the fetus.
Babies whose mothers have APS are at higher risk for slowed growth while in the womb. If you're pregnant and have APS, you may need to have extra ultrasound tests (sonograms) to check your babys growth. An ultrasound test uses sound waves to look at the growing fetus.
Treatment for Other Medical Conditions
People who have APS are at increased risk for thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets. Platelets help the blood clot.
If you have APS, you'll need regular complete blood counts (a type of blood test) to count the number of platelets in your blood.
Thrombocytopenia is treated with medicines and medical procedures. For more information, go to the Health Topics Thrombocytopenia article.
If you have other health problems, such as heart disease or diabetes, work with your doctor to manage them.
|
Antiphospholipid Antibody Syndrome
|
What is (are) Mitral Valve Prolapse ?
|
Mitral valve prolapse (MVP) is a condition in which the hearts mitral valve doesnt work well. The flaps of the valve are floppy and may not close tightly. These flaps normally help seal or open the valve.
Much of the time, MVP doesnt cause any problems. Rarely, blood can leak the wrong way through the floppy valve. This can lead topalpitations, shortness of breath, chest pain, and other symptoms. (Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast.)
Normal Mitral Valve
The mitral valve controls blood flow between the upper and lower chambers of the left side of the heart. The upper chamber is called the left atrium. The lower chamber is called the left ventricle.
The mitral valve allows blood to flow from the left atrium into the left ventricle, but not back the other way. The heart also has a right atrium and ventricle, separated by the tricuspid valve.
With each heartbeat, the atria contract and push blood into the ventricles. The flaps of the mitral and tricuspid valves open to let blood through. Then, the ventricles contract to pump the blood out of the heart.
When the ventricles contract, the flaps of the mitral and tricuspid valves close. They form a tight seal that prevents blood from flowing back into the atria.
For more information, go to the Health TopicsHow the Heart Worksarticle. This article contains animations that show how your heart pumps blood and how your hearts electrical system works.
Mitral Valve Prolapse
In MVP, when the left ventricle contracts, one or both flaps of the mitral valve flop or bulge back (prolapse) into the left atrium. This can prevent the valve from forming a tight seal. As a result, blood may leak from the ventricle back into the atrium. The backflow of blood is called regurgitation.
MVP doesnt always cause backflow. In fact, most people who have MVP dont have backflow and never have any related symptoms or problems. When backflow occurs, it can get worse over time and itcan change the hearts size and raise pressure in the left atrium and lungs. Backflow also raises the risk of heart valve infections.
Medicines can treat troublesome MVP symptoms and help prevent complications. Some people will need surgery to repair or replace their mitral valves.
Mitral Valve Prolapse
|
Mitral Valve Prolapse
|
What causes Mitral Valve Prolapse ?
|
The exact cause of mitral valve prolapse (MVP) isn't known. Most people who have the condition are born with it. MVP tends to run in families. Also, it's more common in people who are born with connective tissue disorders, such as Marfan syndrome.
In people who have MVP, the mitral valve may be abnormal in the following ways:
The valve flaps may be too large and thick.
The valve flaps may be "floppy." The tissue of the flaps and their supporting "strings" are too stretchy, and parts of the valve flop or bulge back into the atrium.
The opening of the valve may stretch.
These problems can keep the valve from making a tight seal. Some people's valves are abnormal in more than one way.
|
Mitral Valve Prolapse
|
Who is at risk for Mitral Valve Prolapse? ?
|
Mitral valve prolapse (MVP) affects people of all ages and both sexes; however, aging raises the risk of developing the disease.
Certain conditions have been associated with MVP, including:
A history of rheumatic fever
Connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome
Graves disease
Scoliosis and other skeletal problems
Some types of muscular dystrophy
|
Mitral Valve Prolapse
|
What are the symptoms of Mitral Valve Prolapse ?
|
Most people who have mitral valve prolapse (MVP) aren't affected by the condition. They don't have any symptoms or major mitral valve backflow.
When MVP does cause signs and symptoms, they may include:
Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast)
Shortness of breath
Cough
Fatigue (tiredness), dizziness, or anxiety
Migraine headaches
Chest discomfort
MVP symptoms can vary from one person to another. They tend to be mild but can worsen over time, mainly when complications occur.
Mitral Valve Prolapse Complications
MVP complications are rare. When present, they're most often caused by the backflow of blood through the mitral valve.
Mitral valve backflow is most common among men and people who have high blood pressure. People who have severe backflow may need valve surgery to prevent complications.
Mitral valve backflow causes blood to flow from the left ventricle back into the left atrium. Blood can even back up from the atrium into the lungs, causing shortness of breath.
The backflow of blood strains the muscles of both the atrium and the ventricle. Over time, the strain can lead to arrhythmias. Backflow also increases the risk of infective endocarditis (IE). IE is an infection of the inner lining of your heart chambers and valves.
Arrhythmias
Arrhythmias are problems with the rate or rhythm of the heartbeat. The most common types of arrhythmias are harmless. Other arrhythmias can be serious or even life threatening, such as ventricular arrhythmias.
If the heart rate is too slow, too fast, or irregular, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart, and other organs.
One troublesome arrhythmia that MVP can cause is atrial fibrillation (AF). In AF, the walls of the atria quiver instead of beating normally. As a result, the atria aren't able to pump blood into the ventricles the way they should.
AF is bothersome but rarely life threatening, unless the atria contract very fast or blood clots form in the atria. Blood clots can occur because some blood "pools" in the atria instead of flowing into the ventricles. If a blood clot breaks off and travels through the bloodstream, it can reach the brain and cause a stroke.
Infection of the Mitral Valve
A deformed mitral valve flap can attract bacteria in the bloodstream. The bacteria attach to the valve and can cause a serious infection called infective endocarditis (IE). Signs and symptoms of a bacterial infection include fever, chills, body aches, and headaches.
IE doesn't happen often, but when it does, it's serious. MVP is the most common heart condition that puts people at risk for this infection.
If you have MVP, you can take steps to prevent IE. Floss and brush your teeth regularly. Gum infections and tooth decay can cause IE.
|
Mitral Valve Prolapse
|
How to diagnose Mitral Valve Prolapse ?
|
Mitral valve prolapse (MVP) most often is detected during a routine physical exam. During the exam, your doctor will listen to your heart with a stethoscope.
Stretched valve flaps can make a clicking sound as they shut. If the mitral valve is leaking blood back into the left atrium, your doctor may heart a heart murmur or whooshing sound.
However, these abnormal heart sounds may come and go. Your doctor may not hear them at the time of an exam, even if you have MVP. Thus, you also may have tests and procedures to diagnose MVP.
Diagnostic Tests and Procedures
Echocardiography
Echocardiography (echo) is the most useful test for diagnosing MVP. This painless test uses sound waves to create a moving picture of your heart.
Echo shows the size and shape of your heart and how well your heart chambers and valves are working. The test also can show areas of heart muscle that aren't contracting normally because of poor blood flow or injury to the heart muscle.
Echo can show prolapse of the mitral valve flaps and backflow of blood through the leaky valve.
There are several types of echo, including stress echo. Stress echo is done before and after a stress test. During a stress test, you exercise or take medicine (given by your doctor) to make your heart work hard and beat fast.
You may have stress echo to find out whether you have decreased blood flow to your heart (a sign of coronary heart disease).
Echo also can be done by placing a tiny probe in your esophagus to get a closer look at the mitral valve. The esophagus is the passage leading from your mouth to your stomach.
The probe uses sound waves to create pictures of your heart. This form of echo is called transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiography, or TEE.
Doppler Ultrasound
A Doppler ultrasound is part of an echo test. A Doppler ultrasound shows the speed and direction of blood flow through the mitral valve.
Other Tests
Other tests that can help diagnose MVP include:
A chest x ray. This test is used to look for fluid in your lungs or to show whether your heart is enlarged.
An EKG (electrocardiogram). An EKG is a simple test that records your heart's electrical activity. An EKG can show how fast your heart is beating and whether its rhythm is steady or irregular. This test also records the strength and timing of electrical signals as they pass through your heart.
|
Mitral Valve Prolapse
|
What are the treatments for Mitral Valve Prolapse ?
|
Most people who have mitral valve prolapse (MVP) dont need treatment because they dont have symptoms and complications.
Even people who do have symptoms may not need treatment. The presence of symptoms doesnt always mean that the backflow of blood through the valve is significant.
People who have MVP and troublesome mitral valve backflow may be treated with medicines, surgery, or both.
The goals of treating MVP include:
Correcting the underlying mitral valve problem, if necessary
Preventinginfective endocarditis,arrhythmias, and other complications
Relieving symptoms
Medicines
Medicines called beta blockers may be used to treatpalpitationsand chest discomfort in people who have little or no mitral valve backflow.
If you have significant backflow and symptoms, your doctor may prescribe:
Blood-thinning medicines to reduce the risk of blood clots forming if you haveatrial fibrillation.
Digoxin to strengthen your heartbeat.
Diuretics (fluidpills) to remove excess sodium and fluid in your body and lungs.
Medicines such as flecainide and procainamide to regulate your heart rhythms.
Vasodilators to widen your blood vessels and reduce your hearts workload. Examples of vasodilators are isosorbide dinitrate and hydralazine.
Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to.
Surgery
Surgery is done only if the mitral valve is very abnormal and blood is flowing back into the atrium. The main goal of surgery is to improve symptoms and reduce the risk ofheart failure.
The timing of the surgery is important. If its done too early and your leaking valve is working fairly well, you may be put at needless risk from surgery. If its done too late, you may have heart damage that can't be fixed.
Surgical Approaches
Traditionally, heart surgeons repair or replace a mitral valve by making an incision (cut) in the breastbone and exposing the heart.
A small but growing number of surgeons are using another approach that involves one or more small cuts through the side of the chest wall. This results in less cutting, reduced blood loss, and a shorter hospital stay. However, not all hospitals offer this method.
Valve Repair and Valve Replacement
In mitral valve surgery, the valve is repaired or replaced. Valve repair is preferred when possible. Repair is less likely than replacement to weaken the heart. Repair also lowers the risk of infection and decreases the need for lifelong use of blood-thinning medicines.
If repair isnt an option, the valve can be replaced. Mechanical and biological valves are used as replacement valves.
Mechanical valves are man-made and can last a lifetime. People who have mechanical valves must take blood-thinning medicines for the rest of their lives.
Biological valves are taken from cows or pigs or made from human tissue. Many people who have biological valves dont need to take blood-thinning medicines for the rest of their lives. The major drawback of biological valves is that they weaken over time and often last only about 10 years.
After surgery, youll likely stay in the hospitals intensive care unit for 2 to 3 days. Overall, most people who have mitral valve surgery spend about 1 to 2 weeks in the hospital. Complete recovery takes a few weeks to several months, depending on your health before surgery.
If youve had valve repair or replacement, you may need antibiotics before dental work and surgery. These procedures can allow bacteria to enter your bloodstream. Antibiotics can help prevent infective endocarditis, a serious heart valve infection. Discuss with your doctor whether you need to take antibiotics before such procedures.
Transcatheter Valve Therapy
Interventional cardiologists may be able to repair leaky mitral valves by implanting a device using a catheter (tube) inserted through a large blood vessel. This approach is less invasive and can prevent a person from havingopen-heart surgery. At present, the device is only approved for people with severe mitral regurgitation who cannot undergo surgery.
|
Mitral Valve Prolapse
|
How to prevent Mitral Valve Prolapse ?
|
You can't prevent mitral valve prolapse (MVP). Most people who have the condition are born with it.
Complications from MVP, such as arrhythmias (irregular heartbeats) and infective endocarditis (IE), are rare. IE is an infection of the inner lining of your heart chambers and valves.
People at high risk for IE may be given antibiotics before some types of surgery and dental work. Antibiotics can help prevent IE. Your doctor will tell you whether you need this type of treatment.
People at high risk for IE may include those who've had valve repair or replacement or who have some types of underlying heart disease.
|
Mitral Valve Prolapse
|
What is (are) Cough ?
|
A cough is a natural reflex that protects your lungs. Coughing helps clear your airways of lung irritants, such as smoke and mucus (a slimy substance). This helps prevent infections. A cough also can be a symptom of a medical problem.
Prolonged coughing can cause unpleasant side effects, such as chest pain, exhaustion, light-headedness, and loss of bladder control. Coughing also can interfere with sleep, socializing, and work.
Overview
Coughing occurs when the nerve endings in your airways become irritated. The airways are tubes that carry air into and out of your lungs. Certain substances (such as smoke and pollen), medical conditions, and medicines can irritate these nerve endings.
A cough can be acute, subacute, or chronic, depending on how long it lasts.
An acute cough lasts less than 3 weeks. Common causes of an acute cough are a common cold or other upper respiratory (RES-pi-rah-tor-e) infections. Examples of other upper respiratory infections include the flu, pneumonia (nu-MO-ne-ah), and whooping cough.
A subacute cough lasts 3 to 8 weeks. This type of cough remains even after a cold or other respiratory infection is over.
A chronic cough lasts more than 8 weeks. Common causes of a chronic cough are upper airway cough syndrome (UACS); asthma; and gastroesophageal (GAS-tro-eh-so-fa-JE-al) reflux disease, or GERD.
"UACS" is a term used to describe conditions that inflame the upper airways and cause a cough. Examples include sinus infections and allergies. These conditions can cause mucus to run down your throat from the back of your nose. This is called postnasal drip.
Asthma is a long-term lung disease that inflames and narrows the airways. GERD occurs if acid from your stomach backs up into your throat.
Outlook
The best way to treat a cough is to treat its cause. For example, asthma is treated with medicines that open the airways.
Your doctor may recommend cough medicine if the cause of your cough is unknown and the cough causes a lot of discomfort. Cough medicines may harm children. If your child has a cough, talk with his or her doctor about how to treat it.
|
Cough
|
What causes Cough ?
|
Coughing occurs when the nerve endings in your airways become irritated. Certain irritants and allergens, medical conditions, and medicines can irritate these nerve endings.
Irritants and Allergens
An irritant is something you're sensitive to. For example, smoking or inhaling secondhand smoke can irritate your lungs. Smoking also can lead to medical conditions that can cause a cough. Other irritants include air pollution, paint fumes, or scented products like perfumes or air fresheners.
An allergen is something you're allergic to, such as dust, animal dander, mold, or pollens from trees, grasses, and flowers.
Coughing helps clear your airways of irritants and allergens. This helps prevent infections.
Medical Conditions
Many medical conditions can cause acute, subacute, or chronic cough.
Common causes of an acute cough are a common cold or other upper respiratory infections. Examples of other upper respiratory infections include the flu, pneumonia, and whooping cough. An acute cough lasts less than 3 weeks.
A lingering cough that remains after a cold or other respiratory infection is gone often is called a subacute cough. A subacute cough lasts 3 to 8 weeks.
Common causes of a chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD). A chronic cough lasts more than 8 weeks.
"UACS" is a term used to describe conditions that inflame the upper airways and cause a cough. Examples include sinus infections and allergies. These conditions can cause mucus (a slimy substance) to run down your throat from the back of your nose. This is called postnasal drip.
Asthma is a long-term lung disease that inflames and narrows the airways. GERD is a condition in which acid from your stomach backs up into your throat.
Other conditions that can cause a chronic cough include:
Respiratory infections. A cough from an upper respiratory infection can develop into a chronic cough.
Chronic bronchitis (bron-KI-tis). This condition occurs if the lining of the airways is constantly irritated and inflamed. Smoking is the main cause of chronic bronchitis.
Bronchiectasis (brong-ke-EK-tah-sis). This is a condition in which damage to the airways causes them to widen and become flabby and scarred. This prevents the airways from properly moving mucus out of your lungs. An infection or other condition that injures the walls of the airways usually causes bronchiectasis.
COPD (chronic obstructive pulmonary disease). COPD is a disease that prevents enough air from flowing in and out of the airways.
Lung cancer. In rare cases, a chronic cough is due to lung cancer. Most people who develop lung cancer smoke or used to smoke.
Heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Fluid can build up in the body and lead to many symptoms. If fluid builds up in the lungs, it can cause a chronic cough.
Medicines
Certain medicines can cause a chronic cough. Examples of these medicines are ACE inhibitors and beta blockers. ACE inhibitors are used to treat high blood pressure (HBP). Beta blockers are used to treat HBP, migraine headaches, and glaucoma.
|
Cough
|
Who is at risk for Cough? ?
|
People at risk for cough include those who:
Are exposed to things that irritate their airways (called irritants) or things that they're allergic to (called allergens). Examples of irritants are cigarette smoke, air pollution, paint fumes, and scented products. Examples of allergens are dust, animal dander, mold, and pollens from trees, grasses, and flowers.
Have certain conditions that irritate the lungs, such as asthma, sinus infections, colds, or gastroesophageal reflux disease.
Smoke. Smoking can irritate your lungs and cause coughing. Smoking and/or exposure to secondhand smoke also can lead to medical conditions that can cause a cough.
Take certain medicines, such as ACE inhibitors and beta blockers. ACE inhibitors are used to treat high blood pressure (HBP). Beta blockers are used to treat HBP, migraine headaches, and glaucoma.
Women are more likely than men to develop a chronic cough. For more information about the substances and conditions that put you at risk for cough, go to "What Causes Cough?"
|
Cough
|
What are the symptoms of Cough ?
|
When you cough, mucus (a slimy substance) may come up. Coughing helps clear the mucus in your airways from a cold, bronchitis, or other condition. Rarely, people cough up blood. If this happens, you should call your doctor right away.
A cough may be a symptom of a medical condition. Thus, it may occur with other signs and symptoms of that condition. For example, if you have a cold, you may have a runny or stuffy nose. If you have gastroesophageal reflux disease, you may have a sour taste in your mouth.
A chronic cough can make you feel tired because you use a lot of energy to cough. It also can prevent you from sleeping well and interfere with work and socializing. A chronic cough also can cause headaches, chest pain, loss of bladder control, sweating, and, rarely, fractured ribs.
|
Cough
|
How to diagnose Cough ?
|
Your doctor will diagnose the cause of your cough based on your medical history, a physical exam, and test results.
Medical History
Your doctor will likely ask questions about your cough. He or she may ask how long you've had it, whether you're coughing anything up (such as mucus, a slimy substance), and how much you cough.
Your doctor also may ask:
About your medical history, including whether you have allergies, asthma, or other medical conditions.
Whether you have heartburn or a sour taste in your mouth. These may be signs of gastroesophageal reflux disease (GERD).
Whether you've recently had a cold or the flu.
Whether you smoke or spend time around others who smoke.
Whether you've been around air pollution, a lot of dust, or fumes.
Physical Exam
To check for signs of problems related to cough, your doctor will use a stethoscope to listen to your lungs. He or she will listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds.
Diagnostic Tests
Your doctor may recommend tests based on the results of your medical history and physical exam. For example, if you have symptoms of GERD, your doctor may recommend a pH probe. This test measures the acid level of the fluid in your throat.
Other tests may include:
An exam of the mucus from your nose or throat. This test can show whether you have a bacterial infection.
A chest x ray. A chest x ray takes a picture of your heart and lungs. This test can help diagnose conditions such as pneumonia and lung cancer.
Lung function tests. These tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. Lung function tests can help diagnose asthma and other conditions.
An x ray of the sinuses. This test can help diagnose a sinus infection.
|
Cough
|
What are the treatments for Cough ?
|
The best way to treat a cough is to treat its cause. However, sometimes the cause is unknown. Other treatments, such as medicines and a vaporizer, can help relieve the cough itself.
Treating the Cause of a Cough
Acute and Subacute Cough
An acute cough lasts less than 3 weeks. Common causes of an acute cough are a common cold or other upper respiratory infections. Examples of other upper respiratory infections include the flu, pneumonia, and whooping cough. An acute cough usually goes away after the illness that caused it is over.
A subacute cough lasts 3 to 8 weeks. This type of cough remains even after a cold or other respiratory infection is over.
Studies show that antibiotics and cold medicines can't cure a cold. However, your doctor may prescribe medicines to treat another cause of an acute or subacute cough. For example, antibiotics may be given for pneumonia.
Chronic Cough
A chronic cough lasts more than 8 weeks. Common causes of a chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD).
"UACS" is a term used to describe conditions that inflame the upper airways and cause a cough. Examples include sinus infections and allergies. These conditions can cause mucus (a slimy substance) to run down your throat from the back of your nose. This is called postnasal drip.
If you have a sinus infection, your doctor may prescribe antibiotics. He or she also may suggest you use a medicine that you spray into your nose. If allergies are causing your cough, your doctor may advise you to avoid the substances that you're allergic to (allergens) if possible.
If you have asthma, try to avoid irritants and allergens that make your asthma worse. Take your asthma medicines as your doctor prescribes.
GERD occurs if acid from your stomach backs up into your throat. Your doctor may prescribe a medicine to reduce acid in your stomach. You also may be able to relieve GERD symptoms by waiting 3 to 4 hours after a meal before lying down, and by sleeping with your head raised.
Smoking also can cause a chronic cough. If you smoke, it's important to quit. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. The Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart" booklet have more information about how to quit smoking.
Other causes of a chronic cough include respiratory infections, chronic bronchitis, bronchiectasis, lung cancer, and heart failure. Treatments for these causes may include medicines, procedures, and other therapies. Treatment also may include avoiding irritants and allergens and quitting smoking.
If your chronic cough is due to a medicine you're taking, your doctor may prescribe a different medicine.
Treating the Cough Rather Than the Cause
Coughing is important because it helps clear your airways of irritants, such as smoke and mucus (a slimy substance). Coughing also helps prevent infections.
Cough medicines usually are used only when the cause of the cough is unknown and the cough causes a lot of discomfort.
Medicines can help control a cough and make it easier to cough up mucus. Your doctor may recommend medicines such as:
Prescription cough suppressants, also called antitussives. These medicines can help relieve a cough. However, they're usually used when nothing else works. No evidence shows that over-the-counter cough suppressants relieve a cough.
Expectorants. These medicines may loosen mucus, making it easier to cough up.
Bronchodilators. These medicines relax your airways.
Other treatments also may relieve an irritated throat and loosen mucus. Examples include using a cool-mist humidifier or steam vaporizer and drinking enough fluids. Examples of fluids are water, soup, and juice. Ask your doctor how much fluid you need.
Cough in Children
No evidence shows that cough and cold medicines help children recover more quickly from colds. These medicines can even harm children. Talk with your child's doctor about your child's cough and how to treat it.
|
Cough
|
What is (are) Coronary Heart Disease Risk Factors ?
|
Coronary heart disease risk factors are conditions or habits that raise your risk of coronary heart disease (CHD) and heart attack. These risk factors also increase the chance that existing CHD will worsen.
CHD, also called coronary artery disease, is a condition in which a waxy substance called plaque (plak) builds up on the inner walls of the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
Plaque narrows the arteries and reduces blood flow to your heart muscle. Reduced blood flow can cause chest pain, especially when you're active. Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque.
If the clot becomes large enough, it can block the flow of oxygen-rich blood to the portion of heart muscle fed by the artery. Blocked blood flow to the heart muscle causes a heart attack.
Overview
There are many known CHD risk factors. You can control some risk factors, but not others. Risk factors you can control include:
High blood cholesterol and triglyceride levels (a type of fat found in the blood)
High blood pressure
Diabetes and prediabetes
Overweight and obesity
Smoking
Lack of physical activity
Unhealthy diet
Stress
The risk factors you can't control are age, gender, and family history of CHD.
Many people have at least one CHD risk factor. Your risk of CHD and heart attack increases with the number of risk factors you have and their severity. Also, some risk factors put you at greater risk of CHD and heart attack than others. Examples of these risk factors include smoking and diabetes.
Many risk factors for coronary heart disease start during childhood. This is even more common now because many children are overweight and dont get enough physical activity.
Researchers continue to study and learn more about CHD risk factors.
Outlook
Following a healthy lifestyle can help you and your children prevent or control many CHD risk factors.
Because many lifestyle habits begin during childhood, parents and families should encourage their children to make heart healthy choices. For example, you and your children can lower your risk of CHD if you maintain a healthy weight, follow a healthy diet, do physical activity regularly, and don't smoke.
If you already have CHD, lifestyle changes can help you control your risk factors. This may prevent CHD from worsening. Even if you're in your seventies or eighties, a healthy lifestyle can lower your risk of dying from CHD.
If lifestyle changes aren't enough, your doctor may recommend other treatments to help control your risk factors.
Your doctor can help you find out whether you have CHD risk factors. He or she also can help you create a plan for lowering your risk of CHD, heart attack, and other heart problems.
If you have children, talk with their doctors about their heart health and whether they have CHD risk factors. If they do, ask your doctor to help create a treatment plan to reduce or control these risk factors.
|
Coronary Heart Disease Risk Factors
|
Who is at risk for Coronary Heart Disease Risk Factors? ?
|
High Blood Cholesterol and Triglyceride Levels
Cholesterol
High blood cholesterol is a condition in which your blood has too much cholesterola waxy, fat-like substance. The higher your blood cholesterol level, the greater your risk of coronary heart disease (CHD) and heart attack.
Cholesterol travels through the bloodstream in small packages called lipoproteins. Two major kinds of lipoproteins carry cholesterol throughout your body:
Low-density lipoproteins (LDL). LDL cholesterol sometimes is called "bad" cholesterol. This is because it carries cholesterol to tissues, including your heart arteries. A high LDL cholesterol level raises your risk of CHD.
High-density lipoproteins (HDL). HDL cholesterol sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk of CHD.
Many factors affect your cholesterol levels. For example, after menopause, women's LDL cholesterol levels tend to rise, and their HDL cholesterol levels tend to fall. Other factorssuch as age, gender, diet, and physical activityalso affect your cholesterol levels.
Healthy levels of both LDL and HDL cholesterol will prevent plaque from building up in your arteries. Routine blood tests can show whether your blood cholesterol levels are healthy. Talk with your doctor about having your cholesterol tested and what the results mean.
Children also can have unhealthy cholesterol levels, especially if they're overweight or their parents have high blood cholesterol. Talk with your child's doctor about testing your child' cholesterol levels.
To learn more about high blood cholesterol and how to manage the condition, go to the Health Topics High Blood Cholesterol article.
Triglycerides
Triglycerides are a type of fat found in the blood. Some studies suggest that a high level of triglycerides in the blood may raise the risk of CHD, especially in women.
High Blood Pressure
"Blood pressure" is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.All levels above 120/80 mmHg raise your risk of CHD. This risk grows as blood pressure levels rise. Only one of the two blood pressure numbers has to be above normal to put you at greater risk of CHD and heart attack.
Most adults should have their blood pressure checked at least once a year. If you have high blood pressure, you'll likely need to be checked more often. Talk with your doctor about how often you should have your blood pressure checked.
Children also can develop high blood pressure, especially if they're overweight. Your child's doctor should check your child's blood pressure at each routine checkup.
Both children and adults are more likely to develop high blood pressure if they're overweight or have diabetes.
For more information about high blood pressure and how to manage the condition, go to the Health Topics High Blood Pressure article.
Diabetes and Prediabetes
Diabetes is a disease in which the body's blood sugar level is too high. The two types of diabetes are type 1 and type 2.
In type 1 diabetes, the body's blood sugar level is high because the body doesn't make enough insulin. Insulin is a hormone that helps move blood sugar into cells, where it's used for energy. In type 2 diabetes, the body's blood sugar level is high mainly because the body doesn't use its insulin properly.
Over time, a high blood sugar level can lead to increased plaque buildup in your arteries. Having diabetes doubles your risk of CHD.
Prediabetes is a condition in which your blood sugar level is higher than normal, but not as high as it is in diabetes. If you have prediabetes and don't take steps to manage it, you'll likely develop type 2 diabetes within 10 years. You're also at higher risk of CHD.
Being overweight or obese raises your risk of type 2 diabetes. With modest weight loss and moderate physical activity, people who have prediabetes may be able to delay or prevent type 2 diabetes. They also may be able to lower their risk of CHD and heart attack. Weight loss and physical activity also can help control diabetes.
Even children can develop type 2 diabetes. Most children who have type 2 diabetes are overweight.
Type 2 diabetes develops over time and sometimes has no symptoms. Go to your doctor or local clinic to have your blood sugar levels tested regularly to check for diabetes and prediabetes.
For more information about diabetes and heart disease, go to the Health Topics Diabetic Heart Disease article. For more information about diabetes and prediabetes, go to the National Institute of Diabetes and Digestive and Kidney Diseases' (NIDDK's) Introduction to Diabetes.
Overweight and Obesity
The terms "overweight" and "obesity" refer to body weight that's greater than what is considered healthy for a certain height. More than two-thirds of American adults are overweight, and almost one-third of these adults are obese.
The most useful measure of overweight and obesity is body mass index (BMI).You can use the National Heart, Lung, and Blood Institute's (NHLBI's) online BMI calculator to figure out your BMI, or your doctor can help you.
Overweight is defined differently for children and teens than it is for adults. Children are still growing, and boys and girls mature at different rates. Thus, BMIs for children and teens compare their heights and weights against growth charts that take age and gender into account. This is called BMI-for-age percentile.
Being overweight or obese can raise your risk of CHD and heart attack. This is mainly because overweight and obesity are linked to other CHD risk factors, such as high blood cholesterol and triglyceride levels, high blood pressure, and diabetes.
For more information, go to the Health Topics Overweight and Obesity article.
Smoking
Smoking tobacco or long-term exposure to secondhand smoke raises your risk of CHD and heart attack.
Smoking triggers a buildup of plaque in your arteries. Smoking also increases the risk of blood clots forming in your arteries. Blood clots can block plaque-narrowed arteries and cause a heart attack.Some research shows that smoking raises your risk of CHD in part by lowering HDL cholesterol levels.
The more you smoke, the greater your risk of heart attack. The benefits of quitting smoking occur no matter how long or how much you've smoked. Heart disease risk associated with smoking begins to decrease soon after you quit, and for many people it continues to decrease over time.
Most people who smoke start when they're teens. Parents can help prevent their children from smoking by not smoking themselves. Talk with your child about the health dangers of smoking and ways to overcome peer pressure to smoke.
For more information, including tips on how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI's "Your Guide to a Healthy Heart."
For more information about children and smoking, go to the U.S. Department of Health and Human Services' (HHS') Kids and Smoking Web page and the CDC's Smoking and Tobacco Use Web page.
Lack of Physical Activity
Inactive people are nearly twice as likely to develop CHD as those who are active. A lack of physical activity can worsen other CHD risk factors, such as high blood cholesterol and triglyceride levels, high blood pressure, diabetes and prediabetes, and overweight and obesity.
It's important for children and adults to make physical activity part of their daily routines. One reason many Americans aren't active enough is because of hours spent in front of TVs and computers doing work, schoolwork, and leisure activities.
Some experts advise that children and teens should reduce screen time because it limits time for physical activity. They recommend that children aged 2 and older should spend no more than 2 hours a day watching TV or using a computer (except for school work).
Being physically active is one of the most important things you can do to keep your heart healthy. The good news is that even modest amounts of physical activity are good for your health. The more active you are, the more you will benefit.
For more information, go to HHS' "2008 Physical Activity Guidelines for Americans," the Health Topics Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."
Unhealthy Diet
An unhealthy diet can raise your risk of CHD. For example, foods that are high in saturated and trans fats and cholesterol raise LDL cholesterol. Thus, you should try to limit these foods.
It's also important to limit foods that are high in sodium (salt) and added sugars. A high-salt diet can raise your risk of high blood pressure.
Added sugars will give you extra calories without nutrients like vitamins and minerals. This can cause you to gain weight, which raises your risk of CHD. Added sugars are found in many desserts, canned fruits packed in syrup, fruit drinks, and nondiet sodas.
Stress
Stress and anxiety may play a role in causing CHD. Stress and anxiety also can trigger your arteries to tighten. This can raise your blood pressure and your risk of heart attack.
The most commonly reported trigger for a heart attack is an emotionally upsetting event, especially one involving anger. Stress also may indirectly raise your risk of CHD if it makes you more likely to smoke or overeat foods high in fat and sugar.
Age
In men, the risk for coronary heart disease (CHD) increases starting around age 45. In women, the risk for CHD increases starting around age 55. Most people have some plaque buildup in their heart arteries by the time theyre in their 70s. However, only about 25 percent of those people have chest pain, heart attacks, or other signs of CHD.
Gender
Some risk factors may affect CHD risk differently in women than in men. For example, estrogen provides women some protection against CHD, whereas diabetes raises the risk of CHD more in women than in men.
Also, some risk factors for heart disease only affect women, such as preeclampsia, a condition that can develop during pregnancy. Preeclampsia is linked to an increased lifetime risk of heart disease, including CHD, heart attack, heart failure, and high blood pressure. (Likewise, having heart disease risk factors, such as diabetes or obesity, increases a womans risk of preeclampsia.)
Family History
A family history of early CHD is a risk factor for developing CHD, specifically if a father or brother is diagnosed before age 55, or a mother or sister is diagnosed before age 65.
|
Coronary Heart Disease Risk Factors
|
How to prevent Coronary Heart Disease Risk Factors ?
|
You can prevent and control many coronary heart disease (CHD) risk factors with heart-healthy lifestyle changes and medicines. Examples of risk factors you can control include high blood cholesterol, high blood pressure, and overweight and obesity. Only a few risk factorssuch as age, gender, and family historycant be controlled.
To reduce your risk of CHD and heart attack, try to control each risk factor you can. The good news is that many lifestyle changes help control several CHD risk factors at the same time. For example, physical activity may lower your blood pressure, help control diabetes and prediabetes, reduce stress, and help control your weight.
Heart-Healthy Lifestyle Changes
A heart-healthy lifestyle can lower the risk of CHD. If you already have CHD, a heart-healthy lifestyle may prevent it from getting worse. Heart-healthy lifestyle changes include:
Heart-healthy eating
Maintaining a healthy weight
Managing stress
Physical activity
Quitting smoking
Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make heart-healthy choices, such as following a healthy diet and being physically active. Make following a healthy lifestyle a family goal. Making lifestyle changes can be hard. But if you make these changes as a family, it may be easier for everyone to prevent or control their CHD risk factors.
For tips on how to help your children adopt healthy habits, visit We Can! Ways to Enhance Childrens Activity & Nutrition.
Heart-Healthy Eating
Your doctor may recommend heart-healthy eating, which should include:
Fat-free or low-fat dairy products, such as skim milk
Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
Fruits, such as apples, bananas, oranges, pears, and prunes
Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
Vegetables, such as broccoli, cabbage, and carrots
Whole grains, such as oatmeal, brown rice, and corn tortillas
When following a heart-healthy diet, you should avoid eating:
A lot of red meat
Palm and coconut oils
Sugary foods and beverages
Two nutrients in your diet make blood cholesterol levels rise:
Saturated fatfound mostly in foods that come from animals
Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats.
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
1,200 calories a day
8 grams of saturated fat a day
1,500 calories a day
10 grams of saturated fat a day
1,800 calories a day
12 grams of saturated fat a day
2,000 calories a day
13 grams of saturated fat a day
2,500 calories a day
17 grams of saturated fat a day
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.
Some sources of monounsaturated and polyunsaturated fats are:
Avocados
Corn, sunflower, and soybean oils
Nuts and seeds, such as walnuts
Olive, canola, peanut, safflower, and sesame oils
Peanut butter
Salmon and trout
Tofu
Sodium
You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Dietary Approaches to Stop Hypertension
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.
Alcohol
Try to limit alcohol intake. Too much alcohol canraise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.
Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:
12 ounces of beer
5 ounces of wine
1 ounces of liquor
Maintaining a Healthy Weight
Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out NHLBIs online BMI calculator or talk to your doctor. A BMI:
Below 18.5 is a sign that you are underweight.
Between 18.5 and 24.9 is in the normal range.
Between 25 and 29.9 is considered overweight.
Of 30 or more is considered obese.
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.
If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.
Managing Stress
Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
A stress management program.
Meditation
Physical activity
Relaxation therapy
Talking things out with friends or family
Physical Activity
Routine physical activity can lower many CHD risk factors, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent CHD.
Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.
Read more about physical activity at:
Physical Activity and Your Heart
U.S. Department of Health and Human Services 2008 Physical Activity Guidelines for Americans
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
Quitting Smoking
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
Read more about quitting smoking at Smoking and Your Heart.
Medicines
Sometimes lifestyle changes arent enough to control your blood cholesterol levels. For example, you may need statin medications to control or lower your cholesterol. By lowering your cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:
Coronary heart disease, peripheral artery disease, or had a prior stroke
Diabetes
High LDL cholesterol levels
Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke.
Your doctor also may prescribe other medications to:
Decrease your chance of having a heart attack or dying suddenly.
Lower your blood pressure.
Prevent blood clots, which can lead to heart attack or stroke.
Prevent or delay the need for a procedure or surgery, such as percutaneous coronary intervention or coronary artery bypass grafting.
Reduce your hearts workload and relieve CHD.
Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to.You should still follow a heart-healthy lifestyle, even if you take medicines to treat your CHD.
|
Coronary Heart Disease Risk Factors
|
What is (are) Congenital Heart Defects ?
|
Congenital (kon-JEN-ih-tal) heart defects are problems with the heart's structure that are present at birth. These defects can involve:
The interior walls of the heart
The valves inside the heart
The arteries and veins that carry blood to the heart or the body
Congenital heart defects change the normal flow of blood through the heart.
There are many types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.
Congenital heart defects are the most common type of birth defect. They affect 8 out of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects.
Many of these defects are simple conditions. They need no treatment or are easily fixed. Some babies are born with complex congenital heart defects. These defects require special medical care soon after birth.
The diagnosis and treatment of complex heart defects has greatly improved over the past few decades. As a result, almost all children who have complex heart defects survive to adulthood and can live active, productive lives.
Most people who have complex heart defects continue to need special heart care throughout their lives. They may need to pay special attention to how their condition affects issues such as health insurance, employment, birth control and pregnancy, and other health issues.
In the United States, more than 1 million adults are living with congenital heart defects.
|
Congenital Heart Defects
|
What causes Congenital Heart Defects ?
|
If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur.
Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect.
Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects.
Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.
Researchers continue to search for the causes of congenital heart defects.
|
Congenital Heart Defects
|
What are the symptoms of Congenital Heart Defects ?
|
Many congenital heart defects cause few or no signs and symptoms. A doctor may not even detect signs of a heart defect during a physical exam.
Some heart defects do cause signs and symptoms. They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include:
Rapid breathing
Cyanosis (a bluish tint to the skin, lips, and fingernails)
Fatigue (tiredness)
Poor blood circulation
Congenital heart defects don't cause chest pain or other painful symptoms.
Heart defects can cause heart murmurs (extra or unusual sounds heard during a heartbeat). Doctors can hear heart murmurs using a stethoscope. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs.
Normal growth and development depend on a normal workload for the heart and normal flow of oxygen-rich blood to all parts of the body. Babies who have congenital heart defects may have cyanosis and tire easily while feeding. As a result, they may not gain weight or grow as they should.
Older children who have congenital heart defects may get tired easily or short of breath during physical activity.
Many types of congenital heart defects cause the heart to work harder than it should. With severe defects, this can lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Symptoms of heart failure include:
Shortness of breath or trouble breathing
Fatigue with physical activity
A buildup of blood and fluid in the lungs
Swelling in the ankles, feet, legs, abdomen, and veins in the neck
|
Congenital Heart Defects
|
How to diagnose Congenital Heart Defects ?
|
Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older.
Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason.
Specialists Involved
Pediatric cardiologists are doctors who specialize in the care of babies and children who have heart problems. Cardiac surgeons are specialists who repair heart defects using surgery.
Physical Exam
During a physical exam, the doctor will:
Listen to your child's heart and lungs with a stethoscope
Look for signs of a heart defect, such as cyanosis (a bluish tint to the skin, lips, or fingernails), shortness of breath, rapid breathing, delayed growth, or signs of heart failure
Diagnostic Tests
Echocardiography
Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen.
Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.
Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed.
During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb.
Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born.
EKG (Electrocardiogram)
An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart.
An EKG can detect if one of the heart's chambers is enlarged, which can help diagnose a heart problem.
Chest X Ray
A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged. It also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure.
Pulse Oximetry
For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of how much oxygen is in the blood.
Cardiac Catheterization
During cardiac catheterization (KATH-e-ter-ih-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart.
Special dye is injected through the catheter into a blood vessel or one of the hearts chambers. The dye allows the doctor to see blood flowing through the heart and blood vessels on an x-ray image.
The doctor also can use cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart.
Cardiac catheterization also is used to repair some heart defects.
|
Congenital Heart Defects
|
What are the treatments for Congenital Heart Defects ?
|
Although many children who have congenital heart defects don't need treatment, some do. Doctors repair congenital heart defects with catheter procedures or surgery.
Sometimes doctors combine catheter and surgical procedures to repair complex heart defects, which may involve several kinds of defects.
The treatment your child receives depends on the type and severity of his or her heart defect. Other factors include your child's age, size, and general health.
Some children who have complex congenital heart defects may need several catheter or surgical procedures over a period of years, or they may need to take medicines for years.
Catheter Procedures
Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter (thin, flexible tube) is inserted into a vein or an artery.
Doctors don't have to surgically open the chest or operate directly on the heart to repair the defect(s). This means that recovery may be easier and quicker.
The use of catheter procedures has increased a lot in the past 20 years. They have become the preferred way to repair many simple heart defects, such as atrial septal defect (ASD) and pulmonary valve stenosis.
For ASD repair, the doctor inserts a catheter into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter.
When the catheter reaches the septum, the device is pushed out of the catheter. The device is placed so that it plugs the hole between the atria. Its secured in place and the catheter is withdrawn from the body.
Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows.
For pulmonary valve stenosis, the doctor inserts a catheter into a vein and threads it to the hearts pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or "doors," of the valve.
Then, the balloon is deflated and the catheter and ballon are withdrawn. This procedure can be used to repair any narrowed valve in the heart.
To help guide the catheter, doctors often use echocardiography (echo), transesophageal (tranz-ih-sof-uh-JEE-ul) echo (TEE), and coronary angiography (an-jee-OG-rah-fee).
TEE is a special type of echo that takes pictures of the heart through the esophagus. The esophagus is the passage leading from the mouth to the stomach. Doctors also use TEE to examine complex heart defects.
Surgery
A child may need open-heart surgery if his or her heart defect can't be fixed using a catheter procedure. Sometimes one surgery can repair the defect completely. If that's not possible, the child may need more surgeries over months or years to fix the problem.
Cardiac surgeons may use open-heart surgery to:
Close holes in the heart with stitches or a patch
Repair or replace heart valves
Widen arteries or openings to heart valves
Repair complex defects, such as problems with the location of blood vessels near the heart or how they are formed
Rarely, babies are born with multiple defects that are too complex to repair. These babies may need heart transplants. In this procedure, the child's heart is replaced with a healthy heart from a deceased child. The heart has been donated by the deceased childs family.
|
Congenital Heart Defects
|
What is (are) Aplastic Anemia ?
|
Aplastic anemia (a-PLAS-tik uh-NEE-me-uh) is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. Bone marrow is a sponge-like tissue inside the bones. It makes stem cells that develop into red blood cells, white blood cells, and platelets (PLATE-lets).
Red blood cells carry oxygen to all parts of your body. They also carry carbon dioxide (a waste product) to your lungs to be exhaled. White blood cells help your body fight infections. Platelets are blood cell fragments that stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.
It's normal for blood cells to die. The lifespan of red blood cells is about 120 days. White blood cells live less than a day. Platelets live about 6 days. As a result, your bone marrow must constantly make new blood cells.
If your bone marrow can't make enough new blood cells, many health problems can occur. These problems include irregular heartbeats called arrhythmias (ah-RITH-me-ahs), an enlarged heart, heart failure, infections, and bleeding. Severe aplastic anemia can even cause death.
Overview
Aplastic anemia is a type of anemia. The term "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). This iron-rich protein helps carry oxygen to your body.
In people who have aplastic anemia, the body doesn't make enough red blood cells, white blood cells, and platelets. This is because the bone marrow's stem cells are damaged. (Aplastic anemia also is called bone marrow failure.)
Many diseases, conditions, and factors can damage the stem cells. These conditions can be acquired or inherited. "Acquired" means you aren't born with the condition, but you develop it. "Inherited" means your parents passed the gene for the condition on to you.
In many people who have aplastic anemia, the cause is unknown.
Outlook
Aplastic anemia is a rare but serious disorder. It can develop suddenly or slowly. The disorder tends to get worse over time, unless its cause is found and treated. Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and medicines.
With prompt and proper care, many people who have aplastic anemia can be successfully treated. Blood and marrow stem cell transplants may offer a cure for some people who have aplastic anemia.
|
Aplastic Anemia
|
What causes Aplastic Anemia ?
|
Damage to the bone marrow's stem cells causes aplastic anemia. When stem cells are damaged, they don't grow into healthy blood cells.
The cause of the damage can be acquired or inherited. "Acquired" means you aren't born with the condition, but you develop it. "Inherited" means your parents passed the gene for the condition on to you.
Acquired aplastic anemia is more common, and sometimes it's only temporary. Inherited aplastic anemia is rare.
In many people who have aplastic anemia, the cause is unknown. Some research suggests that stem cell damage may occur because the body's immune system attacks its own cells by mistake.
Acquired Causes
Many diseases, conditions, and factors can cause aplastic anemia, including:
Toxins, such as pesticides, arsenic, and benzene.
Radiation and chemotherapy (treatments for cancer).
Medicines, such as chloramphenicol (an antibiotic rarely used in the United States).
Infectious diseases, such as hepatitis, Epstein-Barr virus, cytomegalovirus (si-to-MEG-ah-lo-VI-rus), parvovirus B19, and HIV.
Autoimmune disorders, such as lupus and rheumatoid arthritis.
Pregnancy. (Aplastic anemia that occurs during pregnancy often goes away after delivery.)
Sometimes, cancer from another part of the body can spread to the bone and cause aplastic anemia.
Inherited Causes
Certain inherited conditions can damage the stem cells and lead to aplastic anemia. Examples include Fanconi anemia, Shwachman-Diamond syndrome, dyskeratosis (DIS-ker-ah-TO-sis) congenita, and Diamond-Blackfan anemia.
|
Aplastic Anemia
|
Who is at risk for Aplastic Anemia? ?
|
Aplastic anemia is a rare but serious blood disorder. People of all ages can develop aplastic anemia. However, it's most common in adolescents, young adults, and the elderly. Men and women are equally likely to have it.
The disorder is two to three times more common in Asian countries.
Your risk of aplastic anemia is higher if you:
Have been exposed to toxins
Have taken certain medicines or had radiation or chemotherapy (treatments for cancer)
Have certain infectious diseases, autoimmune disorders, or inherited conditions
For more information, go to "What Causes Aplastic Anemia?"
|
Aplastic Anemia
|
What are the symptoms of Aplastic Anemia ?
|
Lower than normal numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.
Signs and Symptoms of Low Blood Cell Counts
Red Blood Cells
The most common symptom of a low red blood cell count is fatigue (tiredness). A lack of hemoglobin in the blood causes fatigue. Hemoglobin is an iron-rich protein in red blood cells. It helps carry oxygen to the body.
A low red blood cell count also can cause shortness of breath; dizziness, especially when standing up; headaches; coldness in your hands or feet; pale skin; and chest pain.
If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to move the reduced amount of oxygen in your blood. This can lead to arrhythmias (irregular heartbeats), a heart murmur, an enlarged heart, or even heart failure.
White Blood Cells
White blood cells help fight infections. Signs and symptoms of a low white blood cell count include fevers, frequent infections that can be severe, and flu-like illnesses that linger.
Platelets
Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding. People who have low platelet counts tend to bruise and bleed easily, and the bleeding may be hard to stop.
Common types of bleeding associated with a low platelet count include nosebleeds, bleeding gums, pinpoint red spots on the skin, and blood in the stool. Women also may have heavy menstrual bleeding.
Other Signs and Symptoms
Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include nausea (feeling sick to your stomach) and skin rashes.
Paroxysmal Nocturnal Hemoglobinuria
Some people who have aplastic anemia have a condition called paroxysmal (par-ok-SIZ-mal) nocturnal hemoglobinuria (HE-mo-glo-bi-NOO-re-ah), or PNH. This is a red blood cell disorder. Most people who have PNH don't have any signs or symptoms.
If symptoms do occur, they may include:
Shortness of breath
Swelling or pain in the abdomen or swelling in the legs caused by blood clots
Blood in the urine
Headaches
Jaundice (a yellowish color of the skin or whites of the eyes)
In people who have aplastic anemia and PNH, either condition can develop first.
|
Aplastic Anemia
|
How to diagnose Aplastic Anemia ?
|
Your doctor will diagnose aplastic anemia based on your medical and family histories, a physical exam, and test results.
Once your doctor knows the cause and severity of the condition, he or she can create a treatment plan for you.
Specialists Involved
If your primary care doctor thinks you have aplastic anemia, he or she may refer you to a hematologist. A hematologist is a doctor who specializes in treating blood diseases and disorders.
Medical and Family Histories
Your doctor may ask questions about your medical history, such as whether:
You've had anemia or a condition that can cause anemia
You have shortness of breath, dizziness, headaches, or other signs and symptoms of anemia
You've been exposed to certain toxins or medicines
You've had radiation or chemotherapy (treatments for cancer)
You've had infections or signs of infections, such as fever
You bruise or bleed easily
Your doctor also may ask whether any of your family members have had anemia or other blood disorders.
Physical Exam
Your doctor will do a physical exam to check for signs of aplastic anemia. He or she will try to find out how severe the disorder is and what's causing it.
The exam may include checking for pale or yellowish skin and signs of bleeding or infection. Your doctor may listen to your heart and lungs for abnormal heartbeats and breathing sounds. He or she also may feel your abdomen to check the size of your liver and feel your legs for swelling.
Diagnostic Tests
Many tests are used to diagnose aplastic anemia. These tests help:
Confirm a diagnosis of aplastic anemia, look for its cause, and find out how severe it is
Rule out other conditions that may cause similar symptoms
Check for paroxysmal nocturnal hemoglobinuria (PNH)
Complete Blood Count
Often, the first test used to diagnose aplastic anemia is a complete blood count (CBC). The CBC measures many parts of your blood.
This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is an iron-rich protein in red blood cells. It carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.
The normal range of these levels varies in certain racial and ethnic populations. Your doctor can explain your test results to you.
The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of aplastic anemia, an infection, or another condition.
Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. The results may be a clue as to the cause of your anemia.
Reticulocyte Count
A reticulocyte (re-TIK-u-lo-site) count measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. People who have aplastic anemia have low reticulocyte levels.
Bone Marrow Tests
Bone marrow tests show whether your bone marrow is healthy and making enough blood cells. The two bone marrow tests are aspiration (as-pi-RA-shun) and biopsy.
Bone marrow aspiration may be done to find out if and why your bone marrow isn't making enough blood cells. For this test, your doctor removes a small amount of bone marrow fluid through a needle. The sample is looked at under a microscope to check for faulty cells.
A bone marrow biopsy may be done at the same time as an aspiration or afterward. For this test, your doctor removes a small amount of bone marrow tissue through a needle.
The tissue is checked for the number and types of cells in the bone marrow. In aplastic anemia, the bone marrow has a lower than normal number of all three types of blood cells.
Other Tests
Other conditions can cause symptoms similar to those of aplastic anemia. Thus, other tests may be needed to rule out those conditions. These tests may include:
X ray, computed tomography (CT) scan, or an ultrasound imaging test. These tests can show enlarged lymph nodes in your abdomen. Enlarged lymph nodes may be a sign of blood cancer. Doctors also may use these tests to look at the kidneys and the bones in the arms and hands, which are sometimes abnormal in young people who have Fanconi anemia. This type of anemia can lead to aplastic anemia.
Chest x ray. This test creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray may be used to rule out infections.
Liver tests and viral studies. These tests are used to check for liver diseases and viruses.
Tests that check vitamin B12 and folate levels in the blood. These tests can help rule out anemia caused by vitamin deficiency.
Your doctor also may recommend blood tests for PNH and to check your immune system for proteins called antibodies. (Antibodies in the immune system that attack your bone marrow cells may cause aplastic anemia.)
|
Aplastic Anemia
|
What are the treatments for Aplastic Anemia ?
|
Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and medicines. These treatments can prevent or limit complications, relieve symptoms, and improve quality of life.
Blood and marrow stem cell transplants may cure the disorder in some people who are eligible for a transplant. Removing a known cause of aplastic anemia, such as exposure to a toxin, also may cure the condition.
Who Needs Treatment
People who have mild or moderate aplastic anemia may not need treatment as long as the condition doesn't get worse. People who have severe aplastic anemia need medical treatment right away to prevent complications.
People who have very severe aplastic anemia need emergency medical care in a hospital. Very severe aplastic anemia can be fatal if it's not treated right away.
Blood Transfusions
Blood transfusions can help keep blood cell counts at acceptable levels. A blood transfusion is a common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels.
Transfusions require careful matching of donated blood with the recipient's blood.
Blood transfusions help relieve the symptoms of aplastic anemia, but they're not a permanent treatment.
Blood and Marrow Stem Cell Transplants
A blood and marrow stem cell transplant replaces damaged stem cells with healthy ones from another person (a donor).
During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein in your chest. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.
Blood and marrow stem cell transplants may cure aplastic anemia in people who can have this type of treatment. The transplant works best in children and young adults with severe aplastic anemia who are in good health and who have matched donors.
Older people may be less able to handle the treatments needed to prepare the body for the transplant. They're also more likely to have complications after the transplant.
If you have aplastic anemia, talk with your doctor about whether a blood and marrow stem cell transplant is an option for you.
Medicines
If you have aplastic anemia, your doctor may prescribe medicines to:
Stimulate your bone marrow
Suppress your immune system
Prevent and treat infections
Medicines To Stimulate Bone Marrow
Man-made versions of substances that occur naturally in the body can stimulate the bone marrow to make more blood cells. Examples of these types of medicines include erythropoietin and colony-stimulating factors.
These medicines have some risks. You and your doctor will work together to decide whether the benefits of these medicines outweigh the risks. If this treatment works well, it can help you avoid the need for blood transfusions.
Medicines To Suppress the Immune System
Research suggests that aplastic anemia may sometimes occur because the body's immune system attacks its own cells by mistake. For this reason, your doctor may prescribe medicines to suppress your immune system.
These medicines allow your bone marrow to start making blood cells again. They also may help you avoid the need for blood transfusions.
Medicines that suppress the immune system don't cure aplastic anemia. However, they can relieve its symptoms and reduce complications. These medicines often are used for people who can't have blood and marrow stem cell transplants or who are waiting for transplants.
Three medicinesoften given togethercan suppress the body's immune system. They are antithymocyte globulin (ATG), cyclosporine, and methylprednisolone.
It may take a few months to notice the effects of these medicines. Most often, as blood cell counts rise, symptoms lessen. Blood cell counts in people who respond well to these medicines usually don't reach normal levels. However, the blood cell counts often are high enough to allow people to do their normal activities.
People who have aplastic anemia may need long-term treatment with these medicines.
Medicines that suppress the immune system can have side effects. They also may increase the risk of developing leukemia (lu-KE-me-ah) or myelodysplasia (MI-e-lo-dis-PLA-ze-ah; MDS). Leukemia is a cancer of the blood cells. MDS is a condition in which the bone marrow makes too many faulty blood cells.
Medicines To Prevent and Treat Infections
If you have aplastic anemia, you might be at risk for infections due to low white blood cell counts. Your doctor may prescribe antibiotic and antiviral medicines to prevent and treat infections.
|
Aplastic Anemia
|
What is (are) Disseminated Intravascular Coagulation ?
|
Disseminated intravascular coagulation (ko-ag-u-LA-shun), or DIC, is a condition in which blood clots form throughout the body's small blood vessels. These blood clots can reduce or block blood flow through the blood vessels, which can damage the body's organs.
In DIC, the increased clotting uses up platelets (PLATE-lets) and clotting factors in the blood. Platelets are blood cell fragments that stick together to seal small cuts and breaks on blood vessel walls and stop bleeding. Clotting factors are proteins needed for normal blood clotting.
With fewer platelets and clotting factors in the blood, serious bleeding can occur. DIC can cause internal and external bleeding.
Internal bleeding occurs inside the body. External bleeding occurs underneath or from the skin or mucosa. (The mucosa is the tissue that lines some organs and body cavities, such as your nose and mouth.)
DIC can cause life-threatening bleeding.
Overview
To understand DIC, it helps to understand the body's normal blood clotting process. Your body has a system to control bleeding. When small cuts or breaks occur on blood vessel walls, your body activates clotting factors. These clotting factors, such as thrombin and fibrin, work with platelets to form blood clots.
Blood clots seal the small cuts or breaks on the blood vessel walls. After bleeding stops and the vessels heal, your body breaks down and removes the clots.
Some diseases and conditions can cause clotting factors to become overactive, leading to DIC. These diseases and conditions include:
Sepsis (an infection in the bloodstream)
Surgery and trauma
Cancer
Serious complications of pregnancy and childbirth
Examples of less common causes of DIC are bites from poisonous snakes (such as rattlesnakes and other vipers), frostbite, and burns.
The two types of DIC are acute and chronic. Acute DIC develops quickly (over hours or days) and must be treated right away. The condition begins with excessive blood clotting in the small blood vessels and quickly leads to serious bleeding.
Chronic DIC develops slowly (over weeks or months). It lasts longer and usually isn't recognized as quickly as acute DIC. Chronic DIC causes excessive blood clotting, but it usually doesn't lead to bleeding. Cancer is the most common cause of chronic DIC.
Treatment for DIC involves treating the clotting and bleeding problems and the underlying cause of the condition.
People who have acute DIC may need blood transfusions, medicines, and other life-saving measures. People who have chronic DIC may need medicines to help prevent blood clots from forming in their small blood vessels.
Outlook
The outlook for DIC depends on its severity and underlying cause. Acute DIC can damage the body's organs and even cause death if it's not treated right away. Chronic DIC also can damage the body's organs.
Researchers are looking for ways to prevent DIC or diagnose it early. They're also studying the use of various clotting proteins and medicines to treat the condition.
|
Disseminated Intravascular Coagulation
|
What causes Disseminated Intravascular Coagulation ?
|
Some diseases and conditions can disrupt the body's normal blood clotting process and lead to disseminated intravascular coagulation (DIC). These diseases and conditions include:
Sepsis (an infection in the bloodstream)
Surgery and trauma
Cancer
Serious complications of pregnancy and childbirth
Examples of less common causes of DIC are bites from poisonous snakes (such as rattlesnakes and other vipers), frostbite, and burns.
The two types of DIC are acute and chronic. Acute DIC begins with clotting in the small blood vessels and quickly leads to serious bleeding. Chronic DIC causes blood clotting, but it usually doesn't lead to bleeding. Cancer is the most common cause of chronic DIC.
Similar Clotting Conditions
Two other conditions cause blood clotting in the small blood vessels. However, their causes and treatments differ from those of DIC.
These conditions are thrombotic thrombocytopenic purpura (throm-BOT-ik throm-bo-cy-toe-PEE-nick PURR-purr-ah), or TTP, and hemolytic-uremic syndrome (HUS). HUS is more common in children than adults. It's also more likely to cause kidney damage than TTP.
|
Disseminated Intravascular Coagulation
|
Who is at risk for Disseminated Intravascular Coagulation? ?
|
Disseminated intravascular coagulation (DIC) is the result of an underlying disease or condition. People who have one or more of the following conditions are most likely to develop DIC:
Sepsis (an infection in the bloodstream)
Surgery and trauma
Cancer
Serious complications of pregnancy and childbirth
People who are bitten by poisonous snakes (such as rattlesnakes and other vipers), or those who have frostbite or burns, also are at risk for DIC.
|
Disseminated Intravascular Coagulation
|
What are the symptoms of Disseminated Intravascular Coagulation ?
|
Signs and symptoms of disseminated intravascular coagulation (DIC) depend on its cause and whether the condition is acute or chronic.
Acute DIC develops quickly (over hours or days) and is very serious. Chronic DIC develops more slowly (over weeks or months). It lasts longer and usually isn't recognized as quickly as acute DIC.
With acute DIC, blood clotting in the blood vessels usually occurs first, followed by bleeding. However, bleeding may be the first obvious sign. Serious bleeding can occur very quickly after developing acute DIC. Thus, emergency treatment in a hospital is needed.
Blood clotting also occurs with chronic DIC, but it usually doesn't lead to bleeding. Sometimes chronic DIC has no signs or symptoms.
Signs and Symptoms of Excessive Blood Clotting
In DIC, blood clots form throughout the body's small blood vessels. These blood clots can reduce or block blood flow through the blood vessels. This can cause the following signs and symptoms:
Chest pain and shortness of breath if blood clots form in the blood vessels in your lungs and heart.
Pain, redness, warmth, and swelling in the lower leg if blood clots form in the deep veins of your leg.
Headaches, speech changes, paralysis (an inability to move), dizziness, and trouble speaking and understanding if blood clots form in the blood vessels in your brain. These signs and symptoms may indicate a stroke.
Heart attack and lung and kidney problems if blood clots lodge in your heart, lungs, or kidneys. These organs may even begin to fail.
Signs and Symptoms of Bleeding
In DIC, the increased clotting activity uses up the platelets and clotting factors in the blood. As a result, serious bleeding can occur. DIC can cause internal and external bleeding.
Internal Bleeding
Internal bleeding can occur in your body's organs, such as the kidneys, intestines, and brain. This bleeding can be life threatening. Signs and symptoms of internal bleeding include:
Blood in your urine from bleeding in your kidneys or bladder.
Blood in your stools from bleeding in your intestines or stomach. Blood in your stools can appear red or as a dark, tarry color. (Taking iron supplements also can cause dark, tarry stools.)
Headaches, double vision, seizures, and other symptoms from bleeding in your brain.
External Bleeding
External bleeding can occur underneath or from the skin, such as at the site of cuts or an intravenous (IV) needle. External bleeding also can occur from the mucosa. (The mucosa is the tissue that lines some organs and body cavities, such as your nose and mouth.)
External bleeding may cause purpura (PURR-purr-ah) or petechiae (peh-TEE-key-ay). Purpura are purple, brown, and red bruises. This bruising may happen easily and often. Petechiae are small red or purple dots on your skin.
Purpura and Petechiae
Other signs of external bleeding include:
Prolonged bleeding, even from minor cuts.
Bleeding or oozing from your gums or nose, especially nosebleeds or bleeding from brushing your teeth.
Heavy or extended menstrual bleeding in women.
|
Disseminated Intravascular Coagulation
|
How to diagnose Disseminated Intravascular Coagulation ?
|
Your doctor will diagnose disseminated intravascular coagulation (DIC) based on your medical history, a physical exam, and test results. Your doctor also will look for the cause of DIC.
Acute DIC requires emergency treatment. The condition can be life threatening if it's not treated right away. If you have signs or symptoms of severe bleeding or blood clots, call 911 right away.
Medical History and Physical Exam
Your doctor will ask whether you have or have had any diseases or conditions that can trigger DIC. For more information about these diseases and conditions, go to "What Causes Disseminated Intravascular Coagulation?"
Your doctor will ask about signs and symptoms of blood clots and bleeding. He or she also will do a physical exam to look for signs and symptoms of blood clots and internal and external bleeding. For example, your doctor may look for bleeding from your gums.
Diagnostic Tests
To diagnose DIC, your doctor may recommend blood tests to look at your blood cells and the clotting process. For these tests, a small amount of blood is drawn from a blood vessel, usually in your arm.
Complete Blood Count and Blood Smear
A complete blood count (CBC) measures the number of red blood cells, white blood cells, and platelets in your blood.
Platelets are blood cell fragments that help with blood clotting. Abnormal platelet numbers may be a sign of a bleeding disorder (not enough clotting) or a thrombotic disorder (too much clotting).
A blood smear is a test that may reveal whether your red blood cells are damaged.
Tests for Clotting Factors and Clotting Time
The following tests examine the proteins active in the blood clotting process and how long it takes them to form a blood clot.
PT and PTT tests. These tests measure how long it takes blood clots to form.
Serum fibrinogen. Fibrinogen is a protein that helps the blood clot. This test measures how much fibrinogen is in your blood.
Fibrin degradation. After blood clots dissolve, substances called fibrin degradation products are left behind in the blood. This test measures the amount of these substances in the blood.
|
Disseminated Intravascular Coagulation
|
What are the treatments for Disseminated Intravascular Coagulation ?
|
Treatment for disseminated intravascular coagulation (DIC) depends on its severity and cause. The main goals of treating DIC are to control bleeding and clotting problems and treat the underlying cause.
Acute Disseminated Intravascular Coagulation
People who have acute DIC may have severe bleeding that requires emergency treatment in a hospital. Treatment may include blood transfusions, medicines, and oxygen therapy. (Oxygen is given through nasal prongs, a mask, or a breathing tube.)
A blood transfusion is a safe, common procedure. You receive blood through an intravenous (IV) line in one of your blood vessels. Blood transfusions are done to replace blood loss due to an injury, surgery, or illness.
Blood is made up of various parts, including red blood cells, white blood cells, platelets, and plasma. Some blood transfusions involve whole blood (blood with all of its parts). More often though, only some parts of blood are transfused.
If you have DIC, you may be given platelets and clotting factors, red blood cells, and plasma (the liquid part of blood).
Chronic Disseminated Intravascular Coagulation
People who have chronic DIC are more likely to have blood clotting problems than bleeding. If you have chronic DIC, your doctor may treat you with medicines called anticoagulants, or blood thinners.
Blood thinners help prevent blood clots from forming. They also keep existing blood clots from getting larger.
|
Disseminated Intravascular Coagulation
|
What causes Heart Disease in Women ?
|
Research suggests thatcoronary heart disease(CHD) begins with damage to the lining and inner layers of the coronary (heart) arteries. Several factors contribute to this damage. They include:
Smoking, including secondhand smoke
High amounts of certain fats andcholesterol in the blood
High blood pressure
High amounts of sugar in the blood due to insulin resistance or diabetes
Blood vessel inflammation
Plaque may begin to build up where the arteries are damaged. The buildup of plaque in the coronary arteries may start in childhood.
Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort calledangina.
If the plaque ruptures, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots.
Blood clots can further narrow the coronary arteries and worsenangina. If a clot becomes large enough, it can mostly or completely block a coronary artery and cause a heart attack.
In addition to the factors above, low estrogen levels before or after menopause may play a role in causingcoronary microvascular disease(MVD). Coronary MVD is heart disease that affects the heart's tiny arteries.
The cause of broken heart syndrome isn't yet known. However, a sudden release of stress hormones may play a role in causing the disorder. Most cases of broken heart syndrome occur in women who have gone through menopause.
|
Heart Disease in Women
|
Who is at risk for Heart Disease in Women? ?
|
Certain traits, conditions, or habits may raise your risk forcoronary heart disease(CHD). These conditions are known as risk factors. Risk factors also increase the chance that existing CHD will worsen.
Women generally have the same CHD risk factors as men. However, some risk factors may affect women differently than men. For example, diabetes raises the risk of CHD more in women. Also, some risk factors, such as birth control pills and menopause, only affect women.
There are many known CHD risk factors. Your risk for CHD andheart attackrises with the number of risk factors you have and their severity. Risk factors tend to "gang up" and worsen each other's effects.
Having just one risk factor doubles your risk for CHD. Having two risk factors increases your risk for CHD fourfold. Having three or more risk factors increases your risk for CHD more than tenfold.
Also, some risk factors, such as smoking and diabetes, put you at greater risk for CHD and heart attack than others.
More than 75 percent of women aged 40 to 60 have one or more risk factors for CHD. Many risk factors start during childhood; some even develop within the first 10 years of life. You can control most risk factors, but some you can't.
For more information about CHD risk factors, go to the Health Topics Coronary Heart Disease Risk Factorsarticle. To find out whether you're at risk for CHD, talk with your doctor or health care provider.
Risk Factors You Can Control
Smoking
Smoking is the most powerful risk factor that women can control. Smoking tobacco or long-term exposure to secondhand smoke raises your risk for CHD and heart attack.
Smoking exposes you to carbon monoxide. This chemical robs your blood of oxygen and triggers a buildup of plaque in your arteries.
Smoking also increases the risk of blood clots forming in your arteries. Blood clots can block plaque-narrowed arteries and cause a heart attack. The more you smoke, the greater your risk for a heart attack.
Even women who smoke fewer than two cigarettes a day are at increased risk for CHD.
High Blood Cholesterol and High Triglyceride Levels
Cholesterol travels in the bloodstream in small packages called lipoproteins (LI-po-pro-teens). The two major kinds of lipoproteins are low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
LDL cholesterol is sometimes called "bad" cholesterol. This is because it carries cholesterol to tissues, including your heart arteries. HDL cholesterol is sometimes called "good" cholesterol. This is because it helps remove cholesterol from your arteries.
A blood test called a lipoprotein panel is used to measure cholesterol levels. This test gives information about your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides (a type of fat found in the blood).
Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. A woman's risk for CHD increases if she has a total cholesterol level greater than 200 mg/dL, an LDL cholesterol level greater than 100 mg/dL, or an HDL cholesterol level less than 50 mg/dL.
A triglyceride level greater than 150 mg/dL also increases a woman's risk for CHD. A woman's HDL cholesterol and triglyceride levels predict her risk for CHD better than her total cholesterol or LDL cholesterol levels.
High Blood Pressure
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.
Women who have blood pressure greater than 120/80 mmHg are at increased risk for CHD. (The mmHg is millimeters of mercurythe units used to measure blood pressure.)
High blood pressure is defined differently for people who have diabetes or chronic kidney disease. If you have one of these diseases, work with your doctor to set a healthy blood pressure goal.
Diabetes and Prediabetes
Diabetes is a disease in which the body's blood sugar level is too high. This is because the body doesn't make enough insulin or doesn't use its insulin properly.
Insulin is a hormone that helps move blood sugar into cells, where it's used for energy. Over time, a high blood sugar level can lead to increased plaque buildup in your arteries.
Prediabetes is a condition in which your blood sugar level is higher than normal, but not as high as it is in diabetes. Prediabetes puts you at higher risk for both diabetes and CHD.
Diabetes and prediabetes raise the risk of CHD more in women than in men. In fact, having diabetes doubles a woman's risk of developing CHD.
Before menopause, estrogen provides women some protection against CHD. However, in women who have diabetes, the disease counters the protective effects of estrogen.
Overweight and Obesity
The terms "overweight" and "obesity" refer to body weight that's greater than what is considered healthy for a certain height.
The most useful measure of overweight and obesity is body mass index (BMI). BMI is calculated from your height and weight. In adults, a BMI of 18.5 to 24.9 is considered normal. A BMI of 25 to 29.9 is considered overweight. A BMI of 30 or more is considered obese.
You can use the National Heart, Lung, and Blood Institute's (NHLBI's) online BMI calculator to figure out your BMI, or your doctor can help you.
Studies suggest that where extra weight occurs on the body may predict CHD risk better than BMI. Women who carry much of their fat around the waist are at greatest risk for CHD. These women have "apple-shaped" figures.
Women who carry most of their fat on their hips and thighsthat is, those who have "pear-shaped" figuresare at lower risk for CHD.
To fully know how excess weight affects your CHD risk, you should know your BMI and waist measurement. If you have a BMI greater than 24.9 and a waist measurement greater than 35 inches, you're at increased risk for CHD.
If your waist measurement divided by your hip measurement is greater than 0.9, you're also at increased risk for CHD.
Studies also suggest that women whose weight goes up and down dramatically (typically due to unhealthy dieting) are at increased risk for CHD. These swings in weight can lower HDL cholesterol levels.
Metabolic Syndrome
Metabolic syndromeis the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke. A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors:
A large waistline. Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips.
A higher than normal triglyceride level (or you're on medicine to treat high triglycerides).
A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol).
Higher than normal blood pressure (or you're on medicine to treat high blood pressure).
Higher than normal fasting blood sugar (or you're on medicine to treat diabetes)
Metabolic syndrome is more common in African American women and Mexican American women than in men of the same racial groups. The condition affects White women and men about equally.
Birth Control Pills
Women who smoke and take birth control pills are at very high risk for CHD, especially if they're older than 35. For women who take birth control pills but don't smoke, the risk of CHD isn't fully known.
Lack of Physical Activity
Inactive people are nearly twice as likely to develop CHD as those who are physically active. A lack of physical activity can worsen other CHD risk factors, such as high blood cholesterol and triglyceride levels, high blood pressure, diabetes and prediabetes, and overweight and obesity.
Unhealthy Diet
An unhealthy diet can raise your risk for CHD. For example, foods that are high in saturated and trans fats and cholesterol raise your LDL cholesterol level. A high-sodium (salt) diet can raise your risk for high blood pressure.
Foods with added sugars will give you extra calories without nutrients, such as vitamins and minerals. This can cause you to gain weight, which raises your risk for CHD.
Too much alcohol also can cause you to gain weight, and it will raise your blood pressure.
Stress or Depression
Stress may play a role in causing CHD. Stress can trigger your arteries to narrow. This can raise your blood pressure and your risk for a heart attack.
Getting upset or angry also can trigger a heart attack. Stress also may indirectly raise your risk for CHD if it makes you more likely to smoke or overeat foods high in fat and sugar.
People who are depressed are two to three times more likely to develop CHD than people who are not. Depression is twice as common in women as in men.
Anemia
Anemia (uh-NEE-me-eh) is a condition in which your blood has a lower than normal number of red blood cells.
The condition also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). Hemoglobin is an iron-rich protein that carries oxygen from your lungs to the rest of your organs.
If you have anemia, your organs don't get enough oxygen-rich blood. This causes your heart to work harder, which may raise your risk for CHD.
Anemia has many causes. For more information, go to the Health Topics Anemiaarticle.
Sleep Apnea
Sleep apneais a common disorder that causes pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour.
Typically, normal breathing starts again after the pause, sometimes with a loud snort or choking sound. Major signs of sleep apnea are snoring and daytime sleepiness.
When you stop breathing, the lack of oxygen triggers your body's stress hormones. This causes blood pressure to rise and makes the blood more likely to clot.
Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke.
Women are more likely to develop sleep apnea after menopause.
Risk Factors You Can't Control
Age and Menopause
As you get older, your risk for CHD and heart attack rises. This is due in part to the slow buildup of plaque inside your heart arteries, which can start during childhood.
Before age 55, women have a lower risk for CHD than men. Estrogen provides women with some protection against CHD before menopause. After age 55, however, the risk of CHD increases in both women and men.
You may have gone through early menopause, either naturally or because you had your ovaries removed. If so, you're twice as likely to develop CHD as women of the same age who aren't yet menopausal.
Another reason why women are at increased risk for CHD after age 55 is that middle age is when you tend to develop other CHD risk factors.
Women who have gone through menopause also are at increased risk for broken heart syndrome. (For more information, go to the section on emerging risk factors below.)
Family History
Family history plays a role in CHD risk. Your risk increases if your father or a brother was diagnosed with CHD before 55 years of age, or if your mother or a sister was diagnosed with CHD before 65 years of age.
Also, a family history of strokeespecially a mother's stroke historycan help predict the risk of heart attack in women.
Having a family history of CHD or stroke doesn't mean that you'll develop heart disease. This is especially true if your affected family member smoked or had other risk factors that were not well treated.
Making lifestyle changes and taking medicines to treat risk factors often can lessen genetic influences and prevent or delay heart problems.
Preeclampsia
Preeclampsia (pre-e-KLAMP-se-ah) is a condition that develops during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine.
These signs usually occur during the second half of pregnancy and go away after delivery. However, your risk of developing high blood pressure later in life increases after having preeclampsia.
Preeclampsia also is linked to an increased lifetime risk of heart disease, including CHD, heart attack, and heart failure. (Likewise, having heart disease risk factors, such as diabetes or obesity, increases your risk for preeclampsia.)
If you had preeclampsia during pregnancy, you're twice as likely to develop heart disease as women who haven't had the condition. You're also more likely to develop heart disease earlier in life.
Preeclampsia is a heart disease risk factor that you can't control. However, if you've had the condition, you should take extra care to try and control other heart disease risk factors.
The more severe your preeclampsia was, the greater your risk for heart disease. Let your doctor know that you had preeclampsia so he or she can assess your heart disease risk and how to reduce it.
Emerging Risk Factors
Research suggests that inflammation plays a role in causing CHD. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow.
High blood levels of a protein called C-reactive protein (CRP) are a sign of inflammation in the body. Research suggests that women who have high blood levels of CRP are at increased risk for heart attack.
Also, some inflammatory diseases, such as lupus and rheumatoid arthritis, may increase the risk for CHD.
Some studies suggest that women who have migraine headaches may be at greater risk for CHD. This is especially true for women who have migraines with auras (visual disturbances), such as flashes of light or zig-zag lines.
Low bone density and low intake of folate and vitamin B6 also may raise a woman's risk for CHD.
More research is needed to find out whether calcium supplements with or without vitamin D affect CHD risk. You may want to talk with your doctor to find out whether these types of supplements are right for you.
Researchers are just starting to learn about broken heart syndrome risk factors. Most women who have this disorder are White and have gone through menopause.
Many of these women have other heart disease risk factors, such as high blood pressure, high blood cholesterol, diabetes, and smoking. However, these risk factors tend to be less common in women who have broken heart syndrome than in women who have CHD.
|
Heart Disease in Women
|
What are the symptoms of Heart Disease in Women ?
|
The signs and symptoms ofcoronary heart disease(CHD) may differ between women and men. Some women who have CHD have no signs or symptoms. This is called silent CHD.
Silent CHD may not be diagnosed until a woman has signs and symptoms of aheart attack, heart failure, or an arrhythmia(irregular heartbeat).
Other women who have CHD will have signs and symptoms of the disease.
Heart Disease Signs and Symptoms
A common symptom of CHD isangina.Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood.
In men, angina often feels like pressure or squeezing in the chest. This feeling may extend to the arms. Women can also have these angina symptoms. But women also tend to describe a sharp, burning chest pain. Women are more likely to have pain in the neck, jaw, throat, abdomen, or back.
In men, angina tends to worsen with physical activity and go away with rest. Women are more likely than men to have angina while they're resting or sleeping.
In women who havecoronary microvascular disease, angina often occurs during routine daily activities, such as shopping or cooking, rather than while exercising. Mental stress also is more likely to trigger angina pain in women than in men.
The severity of angina varies. The pain may get worse or occur more often as the buildup of plaque continues to narrow the coronary (heart) arteries.
Signs and Symptoms Coronary Heart Disease Complications
Heart Attack
The most common heart attack symptom in men and women is chest pain or discomfort. However, only half of women who have heart attacks have chest pain.
Women are more likely than men to report back or neck pain, indigestion, heartburn, nausea (feeling sick to the stomach), vomiting, extreme fatigue (tiredness), or problems breathing.
Heart attacks also can cause upper body discomfort in one or both arms, the back, neck, jaw, or upper part of the stomach. Other heart attack symptoms are light-headedness and dizziness, which occur more often in women than men.
Men are more likely than women to break out in a cold sweat and to report pain in the left arm during a heart attack.
Heart Failure
Heart failure is a condition in which your heart can't pump enough blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop working. It means that your heart can't cope with the demands of everyday activities.
Heart failure causes shortness of breath and fatigue that tends to increase with physical exertion. Heart failure also can cause swelling in the feet, ankles, legs, abdomen, and veins in the neck.
Arrhythmia
An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.
Some people describe arrhythmias as fluttering or thumping feelings or skipped beats in their chests. These feelings are calledpalpitations.
Some arrhythmias can cause your heart to suddenly stop beating. This condition is calledsudden cardiac arrest(SCA). SCA causes loss of consciousness and death if it's not treated right away.
Signs and Symptoms of Broken Heart Syndrome
The most common signs and symptoms of broken heart syndrome are chest pain and shortness of breath. In this disorder, these symptoms tend to occur suddenly in people who have no history of heart disease.
Arrhythmias orcardiogenic shockalso may occur. Cardiogenic shock is a condition in which a suddenly weakened heart isn't able to pump enough blood to meet the body's needs.
Some of the signs and symptoms of broken heart syndrome differ from those of heart attack. For example, in people who have broken heart syndrome:
Symptoms occur suddenly after having extreme emotional or physical stress.
EKG (electrocardiogram) results don't look the same as the EKG results for a person having a heart attack. (An EKG is a test that records the heart's electrical activity.)
Blood tests show no signs or mild signs of heart damage.
Tests show no signs of blockages in the coronary arteries.
Tests show ballooning and unusual movement of the lower left heart chamber (left ventricle).
Recovery time is quick, usually within days or weeks (compared with the recovery time of a month or more for a heart attack).
|
Heart Disease in Women
|
How to diagnose Heart Disease in Women ?
|
Your doctor will diagnosecoronary heart disease(CHD) based on your medical and family histories, your risk factors, a physical exam, and the results from tests and procedures.
No single test can diagnose CHD. If your doctor thinks you have CHD, he or she may recommend one or more of the following tests.
EKG (Electrocardiogram)
An EKGis a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart.
An EKG can show signs of heart damage due to CHD and signs of a previous or current heart attack.
Stress Testing
Duringstress testing,you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicines to increase your heart rate.
When your heart is working hard and beating fast, it needs more blood and oxygen. Plaque-narrowed coronary (heart) arteries can't supply enough oxygen-rich blood to meet your heart's needs.
A stress test can show possible signs and symptoms of CHD, such as:
Abnormal changes in your heart rate or blood pressure
Shortness of breath or chest pain
Abnormal changes in your heart rhythm or your heart's electrical activity
If you can't exercise for as long as what is considered normal for someone your age, your heart may not be getting enough oxygen-rich blood. However, other factors also can prevent you from exercising long enough (for example, lung diseases,anemia, or poor general fitness).
As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in your heart and how well your heart pumps blood when it beats.
Echocardiography
Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working.
Echo also can show areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.
Chest X Ray
Achest x raycreates pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels.
A chest x ray can reveal signs ofheart failure, as well as lung disorders and other causes of symptoms not related to CHD.
Blood Tests
Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for CHD. Blood tests also help detectanemia,a risk factor for CHD.
During a heart attack, heart muscle cells die and release proteins into the bloodstream. Blood tests can measure the amount of these proteins in the bloodstream. High levels of these proteins are a sign of a recent heart attack.
Coronary Angiography and Cardiac Catheterization
Your doctor may recommendcoronary angiography(an-jee-OG-rah-fee) if other tests or factors suggest you have CHD. This test uses dye and special x rays to look inside your coronary arteries.
To get the dye into your coronary arteries, your doctor will use a procedure calledcardiac catheterization(KATH-eh-ter-ih-ZA-shun).
A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.
Special x rays are taken while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.
Coronary angiography detects blockages in the large coronary arteries. However, the test doesn't detectcoronary microvascular disease(MVD). This is because coronary MVD doesn't cause blockages in the large coronary arteries.
Even if the results of your coronary angiography are normal, you may still have chest pain or other CHD symptoms. If so, talk with your doctor about whether you might have coronary MVD.
Your doctor may ask you to fill out a questionnaire called the Duke Activity Status Index. This questionnaire measures how easily you can do routine tasks. It gives your doctor information about how well blood is flowing through your coronary arteries.
Your doctor also may recommend other tests that measure blood flow in the heart, such as acardiac MRI (magnetic resonance imaging) stress test.
Cardiac MRI uses radio waves, magnets, and a computer to create pictures of your heart as it beats. The test produces both still and moving pictures of your heart and major blood vessels.
Other tests done during cardiac catheterization can check blood flow in the heart's small arteries and the thickness of the artery walls.
Tests Used To Diagnose Broken Heart Syndrome
If your doctor thinks you have broken heart syndrome, he or she may recommend coronary angiography. Other tests are also used to diagnose this disorder, including blood tests, EKG, echo, and cardiac MRI.
|
Heart Disease in Women
|
What are the treatments for Heart Disease in Women ?
|
Treatment forcoronary heart disease (CHD) usually is the same for both women and men. Treatment may include lifestyle changes, medicines, medical and surgical procedures, andcardiac rehabilitation(rehab).
The goals of treatment are to:
Relieve symptoms.
Reduce risk factors in an effort to slow, stop, or reverse the buildup of plaque.
Lower the risk of blood clots forming. (Blood clots can cause aheart attack.)
Widen or bypass plaque-clogged coronary (heart) arteries.
Prevent CHD complications.
Lifestyle Changes
Making lifestyle changes can help prevent or treat CHD. These changes may be the only treatment that some people need.
Quit Smoking
If you smoke or use tobacco, try to quit. Smoking can raise your risk for CHD and heart attack and worsen other CHD risk factors. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke.
If you find it hard to quit smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart."
Follow a Healthy Diet
A healthy diet is an important part of a healthy lifestyle. A healthy diet includes a variety of vegetables and fruits. These foods can be fresh, canned, frozen, or dried. A good rule is to try to fill half of your plate with vegetables and fruits.
A healthy diet also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, poultry without skin, seafood, processed soy products, nuts, seeds, beans, and peas.
Choose and prepare foods with little sodium (salt). Too much salt can raise your risk for high blood pressure. Studies show that following the Dietary Approaches to Stop Hypertension (DASH) eating plan can lower blood pressure.
Try to avoid foods and drinks that are high in added sugars. For example, drink water instead of sugary drinks, like soda.
Also, try to limit the amount of solid fats and refined grains that you eat. Solid fats are saturated fat and trans fatty acids. Refined grains come from processing whole grains, which results in a loss of nutrients (such as dietary fiber).
If you drink alcohol, do so in moderation. Research suggests that regularly drinking small to moderate amounts of alcohol may lower the risk of CHD. Women should have no more than one alcoholic drink a day.
One drink a day can lower your CHD risk by raising your HDL cholesterol level. One drink is a glass of wine, beer, or a small amount of hard liquor.
If you don't drink, this isn't a recommendation to start using alcohol. Also, you shouldn't drink if you're pregnant, if you're planning to become pregnant, or if you have another health condition that could make alcohol use harmful.
Too much alcohol can cause you to gain weight and raise your blood pressure and triglyceride level. In women, even one drink a day may raise the risk of certain types of cancer.
For more information about following a healthy diet, go to the NHLBI's "Your Guide to Lowering Your Blood Pressure With DASH" and the U.S. Department of Agriculture's ChooseMyPlate.gov Web site. Both resources provide general information about healthy eating.
Be Physically Active
Regular physical activity can lower many CHD risk factors, including high LDL cholesterol,high blood pressure, and excess weight.
Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. (HDL cholesterol helps remove cholesterol from your arteries.)
Talk with your doctor before you start a new exercise plan. Ask him or her how much and what kinds of physical activity are safe for you.
People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. Walking is an excellent heart healthy exercise. The more active you are, the more you will benefit.
For more information about physical activity, go to the U.S. Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans," the Health Topics Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."
Maintain a Healthy Weight
Overweight and obesity are risk factors for CHD. If you're overweight or obese, try to lose weight. Cut back your calorie intake and do more physical activity. Eat smaller portions and choose lower calorie foods. Your health care provider may refer you to a dietitian to help you manage your weight.
A BMI of less than 25 and a waist circumference of 35 inches or less is the goal for preventing and treating CHD. BMI measures your weight in relation to your height and gives an estimate of your total body fat. You can use the NHLBI's online BMI calculator to figure out your BMI, or your doctor can help you.
To measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out. Make sure the tape is snug but doesn't squeeze the flesh.
For more information about losing weight or maintaining a healthy weight, go to the NHLBI's Aim for a Healthy Weight Web site.
Stress and Depression
Research shows that getting upset or angry can trigger a heart attack. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingaren't heart healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress. Physical activity, yoga, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.
Depression can double or triple your risk for CHD. Depression also makes it hard to maintain a heart healthy lifestyle.
Talk with your doctor if you have symptoms of depression, such as feeling hopeless or not taking interest in daily activities. He or she may recommend counseling or prescribe medicines to help you manage the condition.
Medicines
You may need medicines to treat CHD if lifestyle changes aren't enough. Medicines can help:
Reduce your heart's workload and relieve CHD symptoms
Decrease your chance of having a heart attack or dying suddenly
Lower your LDL cholesterol, blood pressure, and other CHD risk factors
Prevent blood clots
Prevent or delay the need for a procedure or surgery, such asangioplasty (AN-jee-oh-plas-tee) or coronary artery bypass grafting (CABG)
Women who havecoronary microvascular disease and anemiamay benefit from taking medicine to treat the anemia.
Women who have broken heart syndrome also may need medicines. Doctors may prescribe medicines to relieve fluid buildup, treat blood pressure problems, prevent blood clots, and manage stress hormones. Most people who have broken heart syndrome make a full recovery within weeks.
Take all of your medicines as prescribed. If you have side effects or other problems related to your medicines, tell your doctor. He or she may be able to provide other options.
Menopausal Hormone Therapy
Recent studies have shown that menopausal hormone therapy (MHT) doesn't prevent CHD. Some studies have even shown that MHT increases women's risk for CHD, stroke, and breast cancer.
However, these studies tested MHT on women who had been postmenopausal for at least several years. During that time, they could have already developed CHD.
Research is ongoing to see whether MHT helps prevent CHD when taken right when menopause starts. While questions remain, current findings suggest MHT shouldn't routinely be used to prevent or treat CHD.
Ask your doctor about other ways to prevent or treat CHD, including lifestyle changes and medicines. For more information about MHT, go to the NHLBI's Postmenopausal Hormone Therapy Web site.
Procedures and Surgery
You may need a procedure or surgery to treat CHD. Both angioplasty and CABG are used as treatments. You and your doctor can discuss which treatment is right for you.
Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI), commonly known as angioplasty (AN-jee-oh-plas-tee), is a nonsurgical procedure that opens blocked or narrowed coronary arteries.
A thin, flexible tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery.
PCI can improve blood flow to your heart and relieve chest pain. A small mesh tube called a stent usually is placed in the artery to help keep it open after the procedure.
For more information, go to the Health Topics PCI article.
Coronary Artery Bypass Grafting
CABG is a type of surgery. During CABG, a surgeon removes arteries or veins from other areas in your body and uses them to bypass (that is, go around) narrowed or blocked coronary arteries.
CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
For more information, go to the Health Topics Coronary Artery Bypass Grafting article.
Cardiac Rehabilitation
Your doctor may prescribe cardiac rehab foranginaor after angioplasty, CABG, or a heart attack. Almost everyone who has CHD can benefit from cardiac rehab.
Cardiac rehab is a medically supervised program that can improve the health and well-being of people who have heart problems.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Cardiac rehab has two parts:
Exercise training. This part of rehab helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.
Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to lower your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and with your fears about the future.
For more information, go to the Health Topics Cardiac Rehabilitation article.
|
Heart Disease in Women
|
How to prevent Heart Disease in Women ?
|
Taking action to control your risk factors can help prevent or delaycoronary heart disease(CHD). Your risk for CHD increases with the number of CHD risk factors you have.
One step you can take is to adopt a heart healthy lifestyle. A heart healthy lifestyle should be part of a lifelong approach to healthy living.
For example, if you smoke, try to quit. Smoking can raise your risk for CHD andheart attackand worsen other CHD risk factors. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke.
For more information about quitting smoking, go to the Health Topics Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart."
Following a healthy diet also is an important part of a healthy lifestyle. A healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, poultry without skin, seafood, processed soy products, nuts, seeds, beans, and peas.
A healthy diet is low in sodium (salt), added sugars, solid fats, and refined grains. Solid fats are saturated fat and trans fatty acids. Refined grains come from processing whole grains, which results in a loss of nutrients (such as dietary fiber).
The NHLBI's Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH) are two programs that promote healthy eating.
If you'reoverweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control CHD risk factors.
Be as physically active as you can. Physical activity can improve your fitness level and your health. Talk with your doctor about what types of activity are safe for you.
For more information about physical activity, go to the Health Topics Physical Activity and Your Heart article and the NHLBI's "Your Guide to Physical Activity and Your Heart."
Know your family history of CHD. If you or someone in your family has CHD, be sure to tell your doctor.
If lifestyle changes aren't enough, you also may need medicines to control your CHD risk factors. Take all of your medicines as prescribed.
For more information about lifestyle changes and medicines, go to "How Is Heart Disease Treated?"
|
Heart Disease in Women
|
What is (are) Heart Attack ?
|
Espaol
A heart attack happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart cant get oxygen. If blood flow isnt restored quickly, the section of heart muscle begins to die.
Heart attack treatment works best when its given right after symptoms occur. If you think you or someone else is having a heart attack, even if youre not sure, call 911 right away.
Overview
Heart attacks most often occur as a result of coronary heart disease (CHD), also called coronary artery disease. CHD is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Heart With Muscle Damage and a Blocked Artery
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
Heart attacks can be associated with or lead to severe health problems, such as heart failure and life-threatening arrhythmias.
Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Arrhythmias are irregular heartbeats. Ventricular fibrillation is a life-threatening arrhythmia that can cause death if not treated right away.
Don't Wait--Get Help Quickly
Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment works best when it's given right after symptoms occur.
Many people aren't sure what's wrong when they are having symptoms of a heart attack. Some of the most common warning symptoms of a heart attack for both men and women are:
Chest pain or discomfort.Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
Upper body discomfort.You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).
Shortness of breath.This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity.
Other possible symptoms of a heart attack include:
Breaking out in a cold sweat
Feeling unusually tired for no reason, sometimes for days (especially if you are a woman)
Nausea (feeling sick to the stomach) and vomiting
Light-headedness or sudden dizziness
Any sudden, new symptom or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual)
Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies, or other common symptoms such as chest discomfort. The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one.
Quick Action Can Save Your Life: Call 911
If you think you or someone else may be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 911 for emergency medical care. Acting fast can save your life.
Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. Take a nitroglycerin pill if your doctor has prescribed this type of treatment.
|
Heart Attack
|
What causes Heart Attack ?
|
Coronary Heart Disease
A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).
CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Coronary Artery Spasm
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
What causes a coronary artery to spasm isn't always clear. A spasm may be related to:
Taking certain drugs, such as cocaine
Emotional stress or pain
Exposure to extreme cold
Cigarette smoking
|
Heart Attack
|
Who is at risk for Heart Attack? ?
|
Certain risk factors make it more likely that you'll develop coronary heart disease (CHD) and have a heart attack. You can control many of these risk factors.
Risk Factors You Can Control
The major risk factors for a heart attack that you can control include:
Smoking
High blood pressure
High blood cholesterol
Overweight and obesity
An unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium)
Lack of routine physical activity
High blood sugar due to insulin resistance or diabetes
Some of these risk factorssuch as obesity, high blood pressure, and high blood sugartend to occur together. When they do, it's called metabolic syndrome.
In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn't have metabolic syndrome.
For more information about the risk factors that are part of metabolic syndrome, go to the Health Topics Metabolic Syndrome article.
Risk Factors You Can't Control
Risk factors that you can't control include:
Age. The risk of heart disease increases for men after age 45 and for women after age 55 (or after menopause).
Family history of early heart disease. Your risk increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.
Preeclampsia (pre-e-KLAMP-se-ah). This condition can develop during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine. Preeclampsia is linked to an increased lifetime risk of heart disease, including CHD, heart attack, heart failure, and high blood pressure.
|
Heart Attack
|
What are the symptoms of Heart Attack ?
|
Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies. In one study, for example, one-third of the patients who had heart attacks had no chest pain. These patients were more likely to be older, female, or diabetic.
The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one. It is important for you to know the most common symptoms of a heart attack and also remember these facts:
Heart attacks can start slowly and cause only mild pain or discomfort. Symptoms can be mild or more intense and sudden. Symptoms also may come and go over several hours.
People who have high blood sugar (diabetes) may have no symptoms or very mild ones.
The most common symptom, in both men and women, is chest pain or discomfort.
Women are somewhat more likely to have shortness of breath, nausea and vomiting, unusual tiredness (sometimes for days), and pain in the back, shoulders, and jaw.
Some people don't have symptoms at all. Heart attacks that occur without any symptoms or with very mild symptoms are called silent heart attacks.
Most Common Symptoms
The most common warning symptoms of a heart attack for both men and women are:
Chest pain or discomfort.Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion. The feeling can be mild or severe.
Upper body discomfort.You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).
Shortness of breath.This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity.
The symptoms of angina (an-JI-nuh or AN-juh-nuh) can be similar to the symptoms of a heart attack. Angina is chest pain that occurs in people who have coronary heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and goes away with rest.
Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack.
All chest pain should be checked by a doctor.
Other Common Signs and Symptoms
Pay attention to these other possible symptoms of a heart attack:
Breaking out in a cold sweat
Feeling unusually tired for no reason, sometimes for days (especially if you are a woman)
Nausea (feeling sick to the stomach) and vomiting
Light-headedness or sudden dizziness
Any sudden, new symptoms or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual)
Not everyone having a heart attack has typical symptoms. If you've already had a heart attack, your symptoms may not be the same for another one. However, some people may have a pattern of symptoms that recur.
The more signs and symptoms you have, the more likely it is that you're having a heart attack.
Quick Action Can Save Your Life: Call 911
The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowlysometimes within hours, days, or weeks of a heart attack.
Any time you think you might be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 911 for emergency medical care, even if you are not sure whether you're having a heart attack. Here's why:
Acting fast can save your life.
An ambulance is the best and safest way to get to the hospital. Emergency medical services (EMS) personnel can check how you are doing and start life-saving medicines and other treatments right away. People who arrive by ambulance often receive faster treatment at the hospital.
The 911 operator or EMS technician can give you advice. You might be told to crush or chew an aspirin if you're not allergic, unless there is a medical reason for you not to take one. Aspirin taken during a heart attack can limit the damage to your heart and save your life.
Every minute matters. Never delay calling 911 to take aspirin or do anything else you think might help.
|
Heart Attack
|
How to diagnose Heart Attack ?
|
Your doctor will diagnose a heart attack based on your signs and symptoms, your medical and family histories, and test results.
Diagnostic Tests
EKG (Electrocardiogram)
An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through each part of the heart.
An EKG can show signs of heart damage due to coronary heart disease (CHD) and signs of a previous or current heart attack.
Blood Tests
During a heart attack, heart muscle cells die and release proteins into the bloodstream. Blood tests can measure the amount of these proteins in the bloodstream. Higher than normal levels of these proteins suggest a heart attack.
Commonly used blood tests include troponin tests, CK or CKMB tests, and serum myoglobin tests. Blood tests often are repeated to check for changes over time.
Coronary Angiography
Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries. This test often is done during a heart attack to help find blockages in the coronary arteries.
To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-e-ter-ih-ZA-shun).
A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.
Special x rays are taken while the dye is flowing through the coronary arteries. The dye lets your doctor study the flow of blood through the heart and blood vessels.
If your doctor finds a blockage, he or she may recommend a procedure calledpercutaneous (per-ku-TA-ne-us) coronary intervention (PCI), sometimes referred to ascoronary angioplasty(AN-jee-oh-plas-tee). This procedure can help restore blood flow through a blocked artery. Sometimes a small mesh tube called a stent is placed in the artery to help prevent blockages after the procedure.
|
Heart Attack
|
What are the treatments for Heart Attack ?
|
Early treatment for a heart attack can prevent or limit damage to the heart muscle. Acting fast, by calling 911 at the first symptoms of a heart attack, can save your life. Medical personnel can begin diagnosis and treatment even before you get to the hospital.
Immediate Treatment
Certain treatments usually are started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:
Aspirin to prevent further blood clotting
Nitroglycerin to reduce your hearts workload and improve blood flow through the coronary arteries
Oxygen therapy
Treatment for chest pain
Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are clot-busting medicines and percutaneous coronary intervention, also known as coronary angioplasty, a procedure used to open blocked coronary arteries.
Clot-Busting Medicines
Thrombolytic medicines, also called clot busters, are used to dissolve blood clots that are blocking the coronary arteries. To work best, these medicines must be given within several hours of the start of heart attack symptoms. Ideally, the medicine should be given as soon as possible.
Percutaneous Coronary Intervention
Percutaneous coronary intervention is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube (catheter) with a balloon or other device on the end is threaded through a blood vessel, usually in the groin (upper thigh), to the narrowed or blocked coronary artery. Once in place, the balloon located at the tip of the catheter is inflated to compress the plaque and related clot against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps to keep the blood vessel open to prevent blockages in the artery in the months or years after the procedure.
Other Treatments for Heart Attack
Other treatments for heart attack include:
Medicines
Medical procedures
Heart-healthy lifestyle changes
Cardiac rehabilitation
Medicines
Your doctor may prescribe one or more of the following medicines.
ACE inhibitors. ACE inhibitors lower blood pressure and reduce strain on your heart. They also help slow down further weakening of the heart muscle.
Anticlotting medicines. Anticlotting medicines stop platelets from clumping together and forming unwanted blood clots. Examples of anticlotting medicines include aspirin and clopidogrel.
Anticoagulants. Anticoagulants, or blood thinners, prevent blood clots from forming in your arteries. These medicines also keep existing clots from getting larger.
Beta blockers. Beta blockers decrease your hearts workload. These medicines also are used to relieve chest pain and discomfort and to help prevent another heart attack. Beta blockers also are used to treat arrhythmias (irregular heartbeats).
Statin medicines. Statins control or lower your blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having another heart attack orstroke.
You also may be given medicines to relieve pain and anxiety, and treat arrhythmias.Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to.
Medical Procedures
Coronary artery bypass grafting also may be used to treat a heart attack. During coronary artery bypass grafting, a surgeon removes a healthy artery or vein from your body. The artery or vein is then connected, or grafted, to bypass the blocked section of the coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart muscle.
Heart-Healthy Lifestyle Changes
Treatment for a heart attack usually includes making heart-healthy lifestyle changes. Your doctor also may recommend:
Heart-healthy eating
Maintaining a healthy weight
Managing stress
Physical activity
Quitting smoking
Taking these steps can lower your chances of having another heart attack.
Heart-Healthy Eating
Your doctor may recommend a heart-healthy eating plan, which should include:
Fat-free or low-fat dairy products, such as skim milk
Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
Fruits, such as apples, bananas, oranges, pears, and prunes
Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
Vegetables, such as broccoli, cabbage, and carrots
Whole grains, such as oatmeal, brown rice, and corn tortillas
When following a heart-healthy diet, you should avoid eating:
A lot of red meat
Palm and coconut oils
Sugary foods and beverages
Two nutrients in your diet make blood cholesterol levels rise:
Saturated fatfound mostly in foods that come from animals
Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats.
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
If you eat:
Try to eat no more than:
1,200 calories a day
8 grams of saturated fat a day
1,500 calories a day
10 grams of saturated fat a day
1,800 calories a day
12 grams of saturated fat a day
2,000 calories a day
13 grams of saturated fat a day
2,500 calories a day
17 grams of saturated fat a day
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.
Some sources of monounsaturated and polyunsaturated fats are:
Avocados
Corn, sunflower, and soybean oils
Nuts and seeds, such as walnuts
Olive, canola, peanut, safflower, and sesame oils
Peanut butter
Salmon and trout
Tofu
You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.
Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.
Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:
12 ounces of beer
5 ounces of wine
1 ounces of liquor
Maintaining a Healthy Weight
Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease and heart attack. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) online BMI calculator or talk to your doctor. A BMI:
Below 18.5 is a sign that you are underweight.
Between 18.5 and 24.9 is in the normal range.
Between 25 and 29.9 is considered overweight.
Of 30 or more is considered obese.
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.
Managing Stress
Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
A stress management program
Meditation
Physical activity
Relaxation therapy
Talking things out with friends or family
Physical Activity
Routine physical activity can lower many risk factors for coronary heart disease, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent another heart attack.
Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10minutes at a time spread throughout the week.
Read more about physical activity at:
Physical Activity and Your Heart
U.S. Department of Health and Human Services 2008 Physical Activity Guidelines for Americans
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
Quitting Smoking
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhandsmoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
Read more about quitting smoking at Smoking and Your Heart.
Cardiac Rehabilitation
Your doctor may recommend cardiac rehabilitation (cardiac rehab) to help you recover from a heart attack and to help prevent another heart attack. Nearly everyone who has had a heart attack can benefit from rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Rehab has two parts:
Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and how to deal with your fears about the future.
Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.
|
Heart Attack
|
How to prevent Heart Attack ?
|
Lowering your risk factors for coronary heart disease can help you prevent a heart attack. Even if you already have coronary heart disease, you still can take steps to lower your risk for a heart attack. These steps involve following a heart-healthy lifestyle and getting ongoingmedical care.
Heart-Healthy Lifestyle
A heart-healthy lifestyle can help prevent a heart attack and includes heart-healthy eating, being physically active, quitting smoking, managing stress, and managing your weight.
Ongoing Care
Treat Related Conditions
Treating conditions that make a heart attack more likely also can help lower your risk for a heart attack. These conditions may include:
Diabetes (high blood sugar). If you have diabetes, try to control your blood sugar level through diet and physical activity (as your doctor recommends). If needed, take medicine as prescribed.
High blood cholesterol. Your doctor may prescribe a statin medicine to lower your cholesterol if diet and exercise arent enough.
High blood pressure. Your doctor may prescribe medicine to keep your blood pressure under control.
Have an Emergency Action Plan
Make sure that you have an emergency action plan in case you or someone in your family has a heart attack. This is very important if youre at high risk for, or have already had, a heart attack.
Write down a list of medicines you are taking, medicines you are allergic to, your health care providers phone numbers (both during and after office hours), and contact information for a friend or relative. Keep the list in a handy place (for example, fill out this wallet card) to share in a medical emergency.
Talk with your doctor about the signs and symptoms of a heart attack, when you should call 911, and steps you can take while waiting for medical help to arrive.
|
Heart Attack
|
What is (are) Coronary Microvascular Disease ?
|
Coronary microvascular disease (MVD) is heart disease that affects the tiny coronary (heart) arteries. In coronary MVD, the walls of the heart's tiny arteries are damaged or diseased.
Coronary MVD is different from traditional coronary heart disease (CHD), also called coronary artery disease. In CHD, a waxy substance called plaque (plak) builds up in the large coronary arteries.
Plaque narrows the heart's large arteries and reduces the flow of oxygen-rich blood to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can mostly or completely block blood flow through a coronary artery.
In coronary MVD, however, the heart's tiny arteries are affected. Plaque doesn't create blockages in these vessels as it does in the heart's large arteries.
Coronary Microvascular Disease
Overview
Both men and women who have coronary microvascular disease often have diabetes or high blood pressure. Some people who have coronary microvascular disease may have inherited heart muscle diseases.
Diagnosing coronary microvascular disease has been a challenge for doctors. Standard tests used to diagnose coronary heart disease arent designed to detect coronary microvascular disease. More research is needed to find the best diagnostic tests and treatments for thedisease.
Outlook
Most of what is known about coronary MVD comes from the National Heart, Lung, and Blood Institute's Wise study (Women's Ischemia Syndrome Evaluation).
The WISE study started in 1996. The goal of the study was to learn more about how heart disease develops in women.
Currently, research is ongoing to learn more about the role of hormones in heart disease and to find better ways to diagnose coronary MVD.
Studies also are under way to learn more about the causes of coronary MVD, how to treat the disease, and the expected health outcomes for people with coronary MVD.
|
Coronary Microvascular Disease
|
What causes Coronary Microvascular Disease ?
|
The same risk factors that cause atherosclerosis may cause coronary microvascular disease. Atherosclerosis is a disease in which plaque builds up inside the arteries.
Risk factors for atherosclerosis include:
Diabetes. It is a disease in which the bodys blood sugar level is too high because the body doesnt make enough insulin or doesnt use its insulin properly.
Family history of early heart disease. Your risk of atherosclerosis increases if your father or a brother was diagnosed with heart disease before age 55, or if your mother or a sister was diagnosed with heart disease before age 65.
High blood pressure. Blood pressure is considered high if it stays at or above 140/90mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercurythe units used to measure blood pressure.)
Insulin resistance. This condition occurs if the body cant use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where its used for energy. Overtime, insulin resistance can lead to diabetes.
Lack of physical activity. Physical inactivity can worsen some other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight or obesity.
Older age. As you age, your risk for atherosclerosis increases. The process of atherosclerosis begins in youth and typically progresses over many decades before disease develops.
Overweight and obesity. The terms overweight and obesity refer to body weight thats greater than what is considered healthy for a certain height.
Smoking. Smoking can damage and tighten blood vessels, lead to unhealthy cholesterol levels, and raise blood pressure. Smoking also doesnt allow enough oxygen to reach the bodys tissues.
Unhealthy blood cholesterol levels. This includes high LDL (bad) cholesterol and low HDL (good) cholesterol.
Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other risk factors for atherosclerosis.
In women, coronary microvascular disease also may be linked to low estrogen levels occurring before or after menopause. Also, the disease may be linked to anemia or conditions that affect blood clotting. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.
Researchers continue to explore other possible causes of coronary microvascular disease.
|
Coronary Microvascular Disease
|
Who is at risk for Coronary Microvascular Disease? ?
|
Coronary microvascular disease can affect both men and women. However, women may be at risk for coronary microvascular disease if they have lower than normal levels of estrogen at any point in their adult lives. (This refers to the estrogen that the ovaries produce, not the estrogen used in hormone therapy.) Low estrogen levels before menopause can raise younger womens risk for the disease. Causes of low estrogen levels in younger women can be mental stress or a problem with the function of theovaries.
The causes of coronary microvascular disease and atherosclerosis are also considered risk factors for the disease.
|
Coronary Microvascular Disease
|
What are the symptoms of Coronary Microvascular Disease ?
|
The signs and symptoms of coronary microvascular disease (MVD) often differ from the signs and symptoms of traditional coronary heart disease (CHD).
Many women with coronary MVD have angina (an-JI-nuh or AN-juh-nuh). Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood.
Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
Angina also is a common symptom of CHD. However, the angina that occurs in coronary MVD may differ from the typical angina that occurs in CHD. In coronary MVD, the chest pain usually lasts longer than 10 minutes, and it can last longer than 30 minutes. Typical angina is more common in women older than 65.
Other signs and symptoms of coronary MVD are shortness of breath, sleep problems, fatigue (tiredness), and lack of energy.
Coronary MVD symptoms often are first noticed during routine daily activities (such as shopping, cooking, cleaning, and going to work) and times of mental stress. It's less likely that women will notice these symptoms during physical activity (such as jogging or walking fast).
This differs from CHD, in which symptoms often first appear while a person is being physically activesuch as while jogging, walking on a treadmill, or going up stairs.
|
Coronary Microvascular Disease
|
How to diagnose Coronary Microvascular Disease ?
|
Your doctor will diagnose coronary microvascular disease (MVD) based on your medical history, a physical exam, and test results. He or she will check to see whether you have any risk factors for heart disease.
For example, your doctor may measure your weight and height to check for overweight or obesity. He or she also may recommend tests for high blood cholesterol, metabolic syndrome, and diabetes.
Your doctor may ask you to describe any chest pain, including when it started and how it changed during physical activity or periods of stress. He or she also may ask about other symptoms, such as fatigue (tiredness), lack of energy, and shortness of breath. Women may be asked about their menopausal status.
Specialists Involved
Cardiologists and doctors who specialize in family and internal medicine might help diagnose and treat coronary MVD. Cardiologists are doctors who specialize in diagnosing and treating heart diseases and conditions.
Diagnostic Tests
The risk factors for coronary MVD and traditional coronary heart disease (CHD) often are the same. Thus, your doctor may recommend tests for CHD, such as:
Coronary angiography (an-jee-OG-rah-fee). This test uses dye and special x rays to show the insides of your coronary arteries. Coronary angiography can show plaque buildup in the large coronary arteries. This test often is done during a heart attack to help find blockages in the coronary arteries.
Stress testing. This test shows how blood flows through your heart during physical stress, such as exercise. Even if coronary angiography doesn't show plaque buildup in the large coronary arteries, a stress test may still show abnormal blood flow. This may be a sign of coronary MVD.
Cardiac MRI (magnetic resonance imaging) stress test. Doctors may use this test to evaluate people who have chest pain.
Unfortunately, standard tests for CHD aren't designed to detect coronary MVD. These tests look for blockages in the large coronary arteries. Coronary MVD affects the tiny coronary arteries.
If test results show that you don't have CHD, your doctor might still diagnose you with coronary MVD. This could happen if signs are present that not enough oxygen is reaching your heart's tiny arteries.
Coronary MVD symptoms often first occur during routine daily tasks. Thus, your doctor may ask you to fill out a questionnaire called the Duke Activity Status Index (DASI). The questionnaire will ask you how well you're able to do daily activities, such as shopping, cooking, and going to work.
The DASI results will help your doctor decide which kind of stress test you should have. The results also give your doctor information about how well blood is flowing through your coronary arteries.
Your doctor also may recommend blood tests, including a test for anemia. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.
Research is ongoing for better ways to detect and diagnose coronary MVD. Currently, researchers have not agreed on the best way to diagnose the disease.
|
Coronary Microvascular Disease
|
What are the treatments for Coronary Microvascular Disease ?
|
Relieving pain is one of the main goals of treating coronary microvascular disease (MVD). Treatments also are used to control risk factors and other symptoms. Treatments may include medicines, such as:
ACE inhibitors and beta blockers to lower blood pressure and decrease the hearts workload
Aspirin to help prevent blood clots or control inflammation
Nitroglycerin to relax blood vessels, improve blood flow to the heart muscle, and treat chest pain
Statin medicines to control or lower your blood cholesterol.
Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to.
If youre diagnosed with coronary MVD and also haveanemia, you may benefit from treatment for that condition. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.
If youre diagnosed with and treated for coronary MVD, you should get ongoing care from your doctor. Research is under way to find the best treatments for coronary MVD.
|
Coronary Microvascular Disease
|
How to prevent Coronary Microvascular Disease ?
|
No specific studies have been done on how to prevent coronary microvascular disease.
Researchers dont yet know how or in what way preventing coronary microvascular disease differs from preventing coronary heart disease. Coronary microvascular disease affects the tiny coronary arteries; coronary heart disease affects the large coronary arteries.
Taking action to control risk factors for heart disease can help prevent or delay coronary heart disease. You cant control some risk factors, such as older age and family history of heart disease. However, you can take steps to prevent or control other risk factors, such as high blood pressure, overweight and obesity, high blood cholesterol, diabetes, and smoking.
Heart-healthy lifestyle changes and ongoing medical care can help you lower your risk for heartdisease.
Heart-Healthy Lifestyle Changes
Your doctor may recommend heart-healthy lifestyle changes if you have coronary microvascular disease. Heart-healthy lifestyle changes include:
Heart-healthy eating
Maintaining a healthy weight
Managing stress
Physical activity
Quitting smoking
Heart-Healthy Eating
Your doctor may recommend a heart-healthy eating plan, which should include:
Fat-free or low-fat dairy products, such as skim milk
Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
Fruits, such as apples, bananas, oranges, pears, and prunes
Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
Vegetables, such as broccoli, cabbage, and carrots
Whole grains, such as oatmeal, brown rice, and corn tortillas.
When following a heart-healthy diet, you should avoid eating:
A lot of red meat
Palm and coconut oils
Sugary foods and beverages
Two nutrients in your diet make blood cholesterol levels rise:
Saturated fatfound mostly in foods that come from animals
Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats.
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
1,200 calories a day
8 grams of saturated fat a day
1,500 calories a day
10 grams of saturated fat a day
1,800 calories a day
12 grams of saturated fat a day
2,000 calories a day
13 grams of saturated fat a day
2,500 calories a day
17 grams of saturated fat a day
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterollevels.
Some sources of monounsaturated and polyunsaturated fats are:
Avocados
Corn, sunflower, and soybean oils
Nuts and seeds, such as walnuts
Olive, canola, peanut, safflower, and sesame oils
Peanut butter
Salmon and trout
Tofu
Sodium
You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Dietary Approaches to Stop Hypertension
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.
Alcohol
Try to limit alcohol intake. Too much alcohol canraise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.
Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:
12 ounces of beer
5 ounces of wine
1 ounces of liquor
Maintaining a Healthy Weight
Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) online BMI calculator or talk to your doctor. A BMI:
Below 18.5 is a sign that you are underweight.
Between 18.5 and 24.9 is in the normal range.
Between 25 and 29.9 is considered overweight.
Of 30 or more is considered obese.
A general goal to aim for is a BMI below 25. Your doctor or health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.
If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.
Managing Stress
Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
A stress management program
Meditation
Physical activity
Relaxation therapy
Talking things out with friends or family
Physical Activity
Routine physical activity can lower many coronary heart disease risk factors, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease.
Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10minutes at a time spread throughout the week.
Read more about physical activity at:
Physical Activity and Your Heart
U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
Quitting Smoking
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
Read more about quitting smoking at Smoking and Your Heart.
Ongoing Medical Care
Learn more about heart disease and the traits, conditions, and habits that can raise your risk for developing it. Talk with your doctor about your risk factors for heart disease and how to controlthem.
If lifestyle changes arent enough, your doctor may prescribe medicines to control your risk factors. Take all of your medicines as your doctor advises. Visit your doctor regularly and have recommended testing.
Know your numbers. Ask your doctor for these three tests and have the results explained toyou:
Blood pressure measurement.
Fasting blood glucose. This test is for diabetes.
Lipoprotein panel. This test measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides (a type of fat in the blood).
Finally, know your family history of heart disease. If you or someone in your family has heart disease, tell your doctor.
|
Coronary Microvascular Disease
|
What is (are) Sleep Deprivation and Deficiency ?
|
Sleep deprivation (DEP-rih-VA-shun) is a condition that occurs if you don't get enough sleep. Sleep deficiency is a broader concept. It occurs if you have one or more of the following:
You don't get enough sleep (sleep deprivation)
You sleep at the wrong time of day (that is, you're out of sync with your body's natural clock)
You don't sleep well or get all of the different types of sleep that your body needs
You have a sleep disorder that prevents you from getting enough sleep or causes poor quality sleep
This article focuses on sleep deficiency, unless otherwise noted.
Sleeping is a basic human need, like eating, drinking, and breathing. Like these other needs, sleeping is a vital part of the foundation for good health and well-being throughout your lifetime.
Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death.
Overview
To understand sleep deficiency, it helps to understand how sleep works and why it's important. The two basic types of sleep are rapid eye movement (REM) and non-REM.
Non-REM sleep includes what is commonly known as deep sleep or slow wave sleep. Dreaming typically occurs during REM sleep. Generally, non-REM and REM sleep occur in a regular pattern of 35 cycles each night.
Your ability to function and feel well while you're awake depends on whether you're getting enough total sleep and enough of each type of sleep. It also depends on whether you're sleeping at a time when your body is prepared and ready to sleep.
You have an internal "body clock" that controls when you're awake and when your body is ready for sleep. This clock typically follows a 24-hour repeating rhythm (called the circadian rhythm). The rhythm affects every cell, tissue, and organ in your body and how they work. (For more information, go to "What Makes You Sleep?")
If you aren't getting enough sleep, are sleeping at the wrong times, or have poor quality sleep, you'll likely feel very tired during the day. You may not feel refreshed and alert when you wake up.
Sleep deficiency can interfere with work, school, driving, and social functioning. You might have trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in social situations.
The signs and symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.
Outlook
Sleep deficiency is a common public health problem in the United States. People in all age groups report not getting enough sleep.
As part of a health survey for the Centers for Disease Control and Prevention, about 719 percent of adults in the United States reported not getting enough rest or sleep every day.
Nearly 40 percent of adults report falling asleep during the day without meaning to at least once a month. Also, an estimated 50 to 70 million Americans have chronic (ongoing) sleep disorders.
Sleep deficiency is linked to many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity, and depression.
Sleep deficiency also is associated with an increased risk of injury in adults, teens, and children. For example, driver sleepiness (not related to alcohol) is responsible for serious car crash injuries and death. In the elderly, sleep deficiency might be linked to an increased risk of falls and broken bones.
In addition, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.
A common myth is that people can learn to get by on little sleep with no negative effects. However, research shows that getting enough quality sleep at the right times is vital for mental health, physical health, quality of life, and safety.
|
Sleep Deprivation and Deficiency
|
Who is at risk for Sleep Deprivation and Deficiency? ?
|
Sleep deficiency, which includes sleep deprivation, affects people of all ages, races, and ethnicities. Certain groups of people may be more likely to be sleep deficient. Examples include people who:
Have limited time available for sleep, such as caregivers or people working long hours or more than one job
Have schedules that conflict with their internal body clocks, such as shift workers, first responders, teens who have early school schedules, or people who must travel for work
Make lifestyle choices that prevent them from getting enough sleep, such as taking medicine to stay awake, abusing alcohol or drugs, or not leaving enough time for sleep
Have undiagnosed or untreated medical problems, such as stress, anxiety, or sleep disorders
Have medical conditions or take medicines that interfere with sleep
Certain medical conditions have been linked to sleep disorders. These conditions include heart failure, heart disease, obesity, diabetes, high blood pressure, stroke or transient ischemic attack (mini-stroke), depression, and attention-deficit hyperactivity disorder (ADHD).
If you have or have had one of these conditions, ask your doctor whether you might benefit from a sleep study.
A sleep study allows your doctor to measure how much and how well you sleep. It also helps show whether you have sleep problems and how severe they are. For more information, go to the Health Topics Sleep Studies article.
If you have a child who is overweight, talk with the doctor about your child's sleep habits.
|
Sleep Deprivation and Deficiency
|
What are the symptoms of Sleep Deprivation and Deficiency ?
|
Sleep deficiency can cause you to feel very tired during the day. You may not feel refreshed and alert when you wake up. Sleep deficiency also can interfere with work, school, driving, and social functioning.
How sleepy you feel during the day can help you figure out whether you're having symptoms of problem sleepiness. You might be sleep deficient if you often feel like you could doze off while:
Sitting and reading or watching TV
Sitting still in a public place, such as a movie theater, meeting, or classroom
Riding in a car for an hour without stopping
Sitting and talking to someone
Sitting quietly after lunch
Sitting in traffic for a few minutes
Sleep deficiency can cause problems with learning, focusing, and reacting. You may have trouble making decisions, solving problems, remembering things, controlling your emotions and behavior, and coping with change. You may take longer to finish tasks, have a slower reaction time, and make more mistakes.
The signs and symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.
Sleep-deficient children may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation.
You may not notice how sleep deficiency affects your daily routine. A common myth is that people can learn to get by on little sleep with no negative effects. However, research shows that getting enough quality sleep at the right times is vital for mental health, physical health, quality of life, and safety.
To find out whether you're sleep deficient, try keeping a sleep diary for a couple of weeks. Write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel during the day.
Compare the amount of time you sleep each day with the average amount of sleep recommended for your age group, as shown in the chart in "How Much Sleep Is Enough?" If you often feel very sleepy, and efforts to increase your sleep don't help, talk with your doctor.
You can find a sample sleep diary in the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."
|
Sleep Deprivation and Deficiency
|
What is (are) Varicose Veins ?
|
Espaol
Varicose (VAR-i-kos) veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body.
Varicose veins are a common condition. They usually cause few signs and symptoms. Sometimes varicose veins cause mild to moderate pain, blood clots, skin ulcers (sores), or other problems.
Overview
Veins are blood vessels that carry blood from your body's tissues to your heart. Your heart pumps the blood to your lungs to pick up oxygen. The oxygen-rich blood then is pumped to your body through blood vessels called arteries.
From your arteries, the blood flows through tiny blood vessels called capillaries, where it gives up its oxygen to the body's tissues. Your blood then returns to your heart through your veins to pick up more oxygen. For more information about blood flow, go to the Health Topics How the Heart Works article.
Veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.
Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.
Outlook
Varicose veins usually don't cause medical problems. If they do, your doctor may simply suggest making lifestyle changes.
Sometimes varicose veins cause pain, blood clots, skin ulcers, or other problems. If this happens, your doctor may recommend one or more medical procedures. Some people choose to have these procedures to improve the way their veins look or to relieve pain.
Many treatments for varicose veins are quick and easy and don't require a long recovery.
|
Varicose Veins
|
What causes Varicose Veins ?
|
Weak or damaged valves in the veins can cause varicose veins. After your arteries and capillaries deliver oxygen-rich blood to your body, your veins return the blood to your heart. The veins in your legs must work against gravity to do this.
One-way valves inside the veins open to let blood flow through, and then they shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell.
Weak vein walls may cause weak valves. Normally, the walls of the veins are elastic (stretchy). If these walls become weak, they lose their normal elasticity. They become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it causes the flaps of the valves to separate.
When the valve flaps separate, blood can flow backward through the valves. The backflow of blood fills the veins and stretches the walls even more. As a result, the veins get bigger, swell, and often twist as they try to squeeze into their normal space. These are varicose veins.
Normal Vein and Varicose Vein
Figure A shows a normal vein with a working valve and normal blood flow. Figure B shows a varicose vein with a deformed valve, abnormal blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg.
Older age or a family history of varicose veins may raise your risk for weak vein walls. You also may be at higher risk if you have increased pressure in your veins due to overweight or obesity or pregnancy.
|
Varicose Veins
|
Who is at risk for Varicose Veins? ?
|
Many factors may raise your risk for varicose veins, including family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.
Family History
Having family members who have varicose veins may raise your risk for the condition. About half of all people who have varicose veins have a family history of them.
Older Age
Getting older may raise your risk for varicose veins. The normal wear and tear of aging may cause the valves in your veins to weaken and not work well.
Gender
Women tend to get varicose veins more often than men. Hormonal changes that occur during puberty, pregnancy, and menopause (or with the use of birth control pills) may raise a woman's risk for varicose veins.
Pregnancy
During pregnancy, the growing fetus puts pressure on the veins in the mother's legs. Varicose veins that occur during pregnancy usually get better within 3 to 12 months of delivery.
Overweight or Obesity
Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins. For more information about overweight and obesity, go to the Health Topics Overweight and Obesity article.
Lack of Movement
Standing or sitting for a long time, especially with your legs bent or crossed, may raise your risk for varicose veins. This is because staying in one position for a long time may force your veins to work harder to pump blood to your heart.
Leg Trauma
Previous blood clots or traumatic damage to the valves in your veins can weaken their ability to move blood back to the heart, increasing the risk for varicose veins.
|
Varicose Veins
|
What are the symptoms of Varicose Veins ?
|
The signs and symptoms of varicose veins include:
Large veins that you can see just under the surface of your skin.
Mild swelling of your ankles and feet.
Painful, achy, or "heavy" legs.
Throbbing or cramping in your legs.
Itchy legs, especially on the lower leg and ankle. Sometimes this symptom is incorrectly diagnosed as dry skin.
Discolored skin in the area around the varicose vein.
Signs of telangiectasias are clusters of red veins that you can see just under the surface of your skin. These clusters usually are found on the upper body, including the face. Signs of spider veins are red or blue veins in a web or tree branch pattern. Often, these veins appear on the legs and face.
See your doctor if you have these signs and symptoms. They also may be signs of other, more serious conditions.
Complications of Varicose Veins
Varicose veins can lead to dermatitis (der-ma-TI-tis), an itchy rash. If you have varicose veins in your legs, dermatitis may affect your lower leg or ankle. Dermatitis can cause bleeding or skin ulcers (sores) if the skin is scratched or irritated.
Varicose veins also can lead to a condition called superficial thrombophlebitis (THROM-bo-fleh-BI-tis). Thrombophlebitis is a blood clot in a vein. Superficial thrombophlebitis means that the blood clot occurs in a vein close to the surface of the skin. This type of blood clot may cause pain and other problems in the affected area.
|
Varicose Veins
|
How to diagnose Varicose Veins ?
|
Doctors often diagnose varicose veins based on a physical exam alone. Sometimes tests or procedures are used to find out the extent of the problem or to rule out other conditions.
Specialists Involved
If you have varicose veins, you may see a vascular medicine specialist or vascular surgeon. These doctors specialize in blood vessel conditions. You also may see a dermatologist. This type of doctor specializes in skin conditions.
Physical Exam
To check for varicose veins in your legs, your doctor will look at your legs while you're standing or sitting with your legs dangling. He or she may ask you about your signs and symptoms, including any pain you're having.
Diagnostic Tests and Procedures
Duplex Ultrasound
Your doctor may recommend duplex ultrasound to check blood flow in your veins and to look for blood clots. Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create apicture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through theveins. The two types of ultrasound together paint a picture that helps your doctor diagnose your condition.
During this test, a handheld device will be placed on your body and passed back and forth over the affected area. The device sends and receives sound waves. A computer will convert the sound waves into a picture of the blood flow in your arteries and veins.
Angiogram
Although it is not very common, your doctor may recommend an angiogram to get a more detailed look at the blood flow through your veins.
For this procedure, dye is injected into your veins. The dye outlines your veins on x-ray images.
An angiogram can help your doctor confirm whether you have varicose veins or another condition.
|
Varicose Veins
|
What are the treatments for Varicose Veins ?
|
Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.
If varicose veins cause few symptoms, your doctor may simply suggest making lifestyle changes. If your symptoms are more severe, your doctor may recommend one or more medical procedures. For example, you may need a medical procedure if you have a lot of pain, blood clots, or skin disorders caused by your varicose veins.
Some people who have varicose veins choose to have procedures to improve how their veins look.
Although treatment can help existing varicose veins, it can't keep new varicose veins from forming.
Lifestyle Changes
Lifestyle changes often are the first treatment for varicose veins. These changes can prevent varicose veins from getting worse, reduce pain, and delay other varicose veins from forming. Lifestyle changes include the following:
Avoid standing or sitting for long periods without taking a break. When sitting, avoid crossing your legs. Keep your legs raised when sitting, resting, or sleeping. When you can, raise your legs above the level of your heart.
Do physical activities to get your legs moving and improve muscle tone. This helps blood move through your veins.
If you're overweight or obese, try to lose weight. This will improve blood flow and ease the pressure on your veins.
Avoid wearing tight clothes, especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse.
Avoid wearing high heels for long periods. Lower heeled shoes can help tone your calf muscles. Toned muscles help blood move through the veins.
Your doctor may recommend compression stockings. These stockings create gentle pressure up the leg. This pressure keeps blood from pooling and decreases swelling in the legs.
There are three types of compression stockings. One type is support pantyhose. These offer the least amount of pressure. A second type is over-the-counter compression hose. These stockings give a little more pressure than support pantyhose. Over-the-counter compression hose are sold in medical supply stores and pharmacies.
Prescription-strength compression hose are the third type of compression stockings. These stockings offer the greatest amount of pressure. They also are sold in medical supply stores and pharmacies. However, you need to be fitted for them in the store by a specially trained person.
Medical Procedures
Medical procedures are done either to remove varicose veins or to close them. Removing or closing varicose veins usually doesn't cause problems with blood flow because the blood starts moving through other veins.
You may be treated with one or more of the procedures described below. Common side effects right after most of these procedures include bruising, swelling, skin discoloration, and slight pain.
The side effects are most severe with vein stripping and ligation (li-GA-shun). Rarely, this procedure can cause severe pain, infections, blood clots, and scarring.
Sclerotherapy
Sclerotherapy (SKLER-o-ther-ah-pe) uses a liquid chemical to close off a varicose vein. The chemical is injected into the vein to cause irritation and scarring inside the vein. The irritation and scarring cause the vein to close off, and it fades away.
This procedure often is used to treat smaller varicose veins and spider veins. It can be done in your doctor's office, while you stand. You may need several treatments to completely close off a vein.
Treatments typically are done every 4 to 6 weeks. Following treatments, your legs will be wrapped in elastic bandaging to help with healing and decrease swelling.
Microsclerotherapy
Microsclerotherapy (MI-kro-SKLER-o-ther-ah-pe) is used to treat spider veins and other very small varicose veins.
A small amount of liquid chemical is injected into a vein using a very fine needle. The chemical scars the inner lining of the vein, causing it to close off.
Laser Surgery
This procedure applies light energy from a laser onto a varicose vein. The laser light makes the vein fade away.
Laser surgery mostly is used to treat smaller varicose veins. No cutting or injection of chemicals is involved.
Endovenous Ablation Therapy
Endovenous ablation (ab-LA-shun) therapy uses lasers or radiowaves to create heat to close off a varicose vein.
Your doctor makes a tiny cut in your skin near the varicose vein. He or she then inserts a small tube called a catheter into the vein. A device at the tip of the tube heats up the inside of the vein and closes it off.
You'll be awake during this procedure, but your doctor will numb the area around the vein. You usually can go home the same day as the procedure.
Endoscopic Vein Surgery
For endoscopic (en-do-SKOP-ik) vein surgery, your doctor will make a small cut in your skin near a varicose vein. He or she then uses a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein.
Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers (sores). After the procedure, you usually can return to your normal activities within a few weeks.
Ambulatory Phlebectomy
For ambulatory phlebectomy (fle-BEK-to-me), your doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.
You'll be awake during the procedure, but your doctor will numb the area around the vein. Usually, you can go home the same day that the procedure is done.
Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.
You'll be given medicine to temporarily put you to sleep so you don't feel any pain during the procedure.
Vein stripping and ligation usually is done as an outpatient procedure. The recovery time from the procedure is about 1 to 4 weeks.
|
Varicose Veins
|
How to prevent Varicose Veins ?
|
You can't prevent varicose veins from forming. However, you can prevent the ones you have from getting worse. You also can take steps to delay other varicose veins from forming.
Avoid standing or sitting for long periods without taking a break. When sitting, avoid crossing your legs. Keep your legs raised when sitting, resting, or sleeping. When you can, raise your legs above the level of your heart.
Do physical activities to get your legs moving and improve muscle tone. This helps blood move through your veins.
If you're overweight or obese, try to lose weight. This will improve blood flow and ease the pressure on your veins.
Avoid wearing tight clothes, especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse.
Avoid wearing high heels for long periods. Lower heeled shoes can help tone your calf muscles. Toned muscles help blood move through the veins.
Wear compression stockings if your doctor recommends them. These stockings create gentle pressure up the leg. This pressure keeps blood from pooling in the veins and decreases swelling in the legs.
|
Varicose Veins
|
What is (are) ARDS ?
|
ARDS, or acute respiratory distress syndrome, is a lung condition that leads to low oxygen levels in the blood. ARDS can be life threatening because your body's organs need oxygen-rich blood to work well.
People who develop ARDS often are very ill with another disease or have major injuries. They might already be in the hospital when they develop ARDS.
Overview
To understand ARDS, it helps to understand how the lungs work. When you breathe, air passes through your nose and mouth into your windpipe. The air then travels to your lungs' air sacs. These sacs are called alveoli (al-VEE-uhl-eye).
Small blood vessels called capillaries (KAP-ih-lare-ees) run through the walls of the air sacs. Oxygen passes from the air sacs into the capillaries and then into the bloodstream. Blood carries the oxygen to all parts of the body, including the body's organs.
In ARDS, infections, injuries, or other conditions cause fluid to build up in the air sacs. This prevents the lungs from filling with air and moving enough oxygen into the bloodstream.
As a result, the body's organs (such as the kidneys and brain) don't get the oxygen they need. Without oxygen, the organs may not work well or at all.
People who develop ARDS often are in the hospital for other serious health problems. Rarely, people who aren't hospitalized have health problems that lead to ARDS, such as severe pneumonia.
If you have trouble breathing, call your doctor right away. If you have severe shortness of breath, call 911.
Outlook
More people are surviving ARDS now than in the past. One likely reason for this is that treatment and care for the condition have improved. Survival rates for ARDS vary depending on age, the underlying cause of ARDS, associated illnesses, and other factors.
Some people who survive recover completely. Others may have lasting damage to their lungs and other health problems.
Researchers continue to look for new and better ways to treat ARDS.
|
ARDS
|
What causes ARDS ?
|
Many conditions or factors can directly or indirectly injure the lungs and lead to ARDS. Some common ones are:
Sepsis. This is a condition in which bacteria infect the bloodstream.
Pneumonia. This is an infection in the lungs.
Severe bleeding caused by an injury to the body.
An injury to the chest or head, like a severe blow.
Breathing in harmful fumes or smoke.
Inhaling vomited stomach contents from the mouth.
It's not clear why some very sick or seriously injured people develop ARDS and others don't. Researchers are trying to find out why ARDS develops and how to prevent it.
|
ARDS
|
Who is at risk for ARDS? ?
|
People at risk for ARDS have a condition or illness that can directly or indirectly injure their lungs.
Direct Lung Injury
Conditions that can directly injure the lungs include:
Pneumonia. This is an infection in the lungs.
Breathing in harmful fumes or smoke.
Inhaling vomited stomach contents from the mouth.
Using a ventilator. This is a machine that helps people breathe; rarely, it can injure the lungs.
Nearly drowning.
Indirect Lung Injury
Conditions that can indirectly injure the lungs include:
Sepsis. This is a condition in which bacteria infect the bloodstream.
Severe bleeding caused by an injury to the body or having many blood transfusions.
An injury to the chest or head, such as a severe blow.
Pancreatitis (PAN-kre-a-TI-tis). This is a condition in which the pancreas becomes irritated or infected. The pancreas is a gland that releases enzymes and hormones.
Fat embolism (EM-bo-lizm). This is a condition in which fat blocks an artery. A physical injury, like a broken bone, can lead to a fat embolism.
Drug reaction.
|
ARDS
|
What are the symptoms of ARDS ?
|
The first signs and symptoms of ARDS are feeling like you can't get enough air into your lungs, rapid breathing, and a low blood oxygen level.
Other signs and symptoms depend on the cause of ARDS. They may occur before ARDS develops. For example, if pneumonia is causing ARDS, you may have a cough and fever before you feel short of breath.
Sometimes people who have ARDS develop signs and symptoms such as low blood pressure, confusion, and extreme tiredness. This may mean that the body's organs, such as the kidneys and heart, aren't getting enough oxygen-rich blood.
People who develop ARDS often are in the hospital for other serious health problems. Rarely, people who aren't hospitalized have health problems that lead to ARDS, such as severe pneumonia.
If you have trouble breathing, call your doctor right away. If you have severe shortness of breath, call 911.
Complications From ARDS
If you have ARDS, you can develop other medical problems while in the hospital. The most common problems are:
Infections. Being in the hospital and lying down for a long time can put you at risk for infections, such as pneumonia. Being on a ventilator also puts you at higher risk for infections.
A pneumothorax (collapsed lung). This is a condition in which air or gas collects in the space around the lungs. This can cause one or both lungs to collapse. The air pressure from a ventilator can cause this condition.
Lung scarring. ARDS causes the lungs to become stiff (scarred). It also makes it hard for the lungs to expand and fill with air. Being on a ventilator also can cause lung scarring.
Blood clots. Lying down for long periods can cause blood clots to form in your body. A blood clot that forms in a vein deep in your body is called a deep vein thrombosis. This type of blood clot can break off, travel through the bloodstream to the lungs, and block blood flow. This condition is called pulmonary embolism.
|
ARDS
|
How to diagnose ARDS ?
|
Your doctor will diagnose ARDS based on your medical history, a physical exam, and test results.
Medical History
Your doctor will ask whether you have or have recently had conditions that could lead to ARDS. For a list of these conditions, go to "Who Is at Risk for ARDS?"
Your doctor also will ask whether you have heart problems, such as heart failure. Heart failure can cause fluid to build up in your lungs.
Physical Exam
ARDS may cause abnormal breathing sounds, such as crackling. Your doctor will listen to your lungs with a stethoscope to hear these sounds.
He or she also will listen to your heart and look for signs of extra fluid in other parts of your body. Extra fluid may mean you have heart or kidney problems.
Your doctor will look for a bluish color on your skin and lips. A bluish color means your blood has a low level of oxygen. This is a possible sign of ARDS.
Diagnostic Tests
You may have ARDS or another condition that causes similar symptoms. To find out, your doctor may recommend one or more of the following tests.
Initial Tests
The first tests done are:
An arterial blood gas test. This blood test measures the oxygen level in your blood using a sample of blood taken from an artery. A low blood oxygen level might be a sign of ARDS.
Chest x ray. This test creates pictures of the structures in your chest, such as your heart, lungs, and blood vessels. A chest x ray can show whether you have extra fluid in your lungs.
Blood tests, such as a complete blood count, blood chemistries, and blood cultures. These tests help find the cause of ARDS, such as an infection.
A sputum culture. This test is used to study the spit you've coughed up from your lungs. A sputum culture can help find the cause of an infection.
Other Tests
Other tests used to diagnose ARDS include:
Chest computed tomography (to-MOG-rah-fee) scan, or chest CT scan. This test uses a computer to create detailed pictures of your lungs. A chest CT scan may show lung problems, such as fluid in the lungs, signs of pneumonia, or a tumor.
Heart tests that look for signs of heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. This condition can cause fluid to build up in your lungs.
|
ARDS
|
What are the treatments for ARDS ?
|
ARDS is treated in a hospital's intensive care unit. Current treatment approaches focus on improving blood oxygen levels and providing supportive care. Doctors also will try to pinpoint and treat the underlying cause of the condition.
Oxygen Therapy
One of the main goals of treating ARDS is to provide oxygen to your lungs and other organs (such as your brain and kidneys). Your organs need oxygen to work properly.
Oxygen usually is given through nasal prongs or a mask that fits over your mouth and nose. However, if your oxygen level doesn't rise or it's still hard for you to breathe, your doctor will give you oxygen through a breathing tube. He or she will insert the flexible tube through your mouth or nose and into your windpipe.
Before inserting the tube, your doctor will squirt or spray a liquid medicine into your throat (and possibly your nose) to make it numb. Your doctor also will give you medicine through an intravenous (IV) line in your bloodstream to make you sleepy and relaxed.
The breathing tube will be connected to a machine that supports breathing (a ventilator). The ventilator will fill your lungs with oxygen-rich air.
Your doctor will adjust the ventilator as needed to help your lungs get the right amount of oxygen. This also will help prevent injury to your lungs from the pressure of the ventilator.
You'll use the breathing tube and ventilator until you can breathe on your own. If you need a ventilator for more than a few days, your doctor may do a tracheotomy (tra-ke-OT-o-me).
This procedure involves making a small cut in your neck to create an opening to the windpipe. The opening is called a tracheostomy (TRA-ke-OS-to-me). Your doctor will place the breathing tube directly into the windpipe. The tube is then connected to the ventilator.
For more information, go to the Health Topics Oxygen Therapy article.
Supportive Care
Supportive care refers to treatments that help relieve symptoms, prevent complications, or improve quality of life. Supportive approaches used to treat ARDS include:
Medicines to help you relax, relieve discomfort, and treat pain.
Ongoing monitoring of heart and lung function (including blood pressure and gas exchange).
Nutritional support. People who have ARDS often suffer from malnutrition. Thus, extra nutrition may be given through a feeding tube.
Treatment for infections. People who have ARDS are at higher risk for infections, such as pneumonia. Being on a ventilator also increases the risk of infections. Doctors use antibiotics to treat pneumonia and other infections.
Prevention of blood clots. Lying down for long periods can cause blood clots to form in the deep veins of your body. These clots can travel to your lungs and block blood flow (a condition called pulmonary embolism). Blood-thinning medicines and other treatments, such as compression stocking (stockings that create gentle pressure up the leg), are used to prevent blood clots.
Prevention of intestinal bleeding. People who receive long-term support from a ventilator are at increased risk of bleeding in the intestines. Medicines can reduce this risk.
Fluids. You may be given fluids to improve blood flow through your body and to provide nutrition. Your doctor will make sure you get the right amount of fluids. Fluids usually are given through an IV line inserted into one of your blood vessels.
|
ARDS
|
What is (are) Narcolepsy ?
|
Narcolepsy (NAR-ko-lep-se) is a disorder that causes periods of extreme daytime sleepiness. The disorder also may cause muscle weakness.
Most people who have narcolepsy have trouble sleeping at night. Some people who have the disorder fall asleep suddenly, even if they're in the middle of talking, eating, or another activity.
Narcolepsy also can cause:
Cataplexy (KAT-ah-plek-se). This condition causes a sudden loss of muscle tone while you're awake. Muscle weakness can affect certain parts of your body or your whole body. For example, if cataplexy affects your hand, you may drop what you're holding. Strong emotions often trigger this weakness. It may last seconds or minutes.
Hallucinations (ha-lu-sih-NA-shuns). These vivid dreams occur while falling asleep or waking up.
Sleep paralysis (pah-RAL-ih-sis). This condition prevents you from moving or speaking while waking up and sometimes while falling asleep. Sleep paralysis usually goes away within a few minutes.
Overview
The two main phases of sleep are nonrapid eye movement (NREM) and rapid eye movement (REM). Most people are in the NREM phase when they first fall asleep. After about 90 minutes of sleep, most people go from NREM to REM sleep.
Dreaming occurs during the REM phase of sleep. During REM, your muscles normally become limp. This prevents you from acting out your dreams. (For more information about sleep cycles, go to the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep.")
People who have narcolepsy often fall into REM sleep quickly and wake up directly from it. As a result, they may have vivid dreams while falling asleep and waking up.
Hypocretin (hi-po-KREET-in), a chemical in the brain, helps promote wakefulness. Most people who have narcolepsy have low levels of this chemical. What causes these low levels isn't well understood.
Researchers think that certain factors may work together to cause a lack of hypocretin. These factors may include heredity, infections, brain injuries, and autoimmune disorders. (Autoimmune disorders occur if the body's immune system mistakenly attacks the body's cells and tissues.)
Outlook
Narcolepsy symptoms usually begin during the teen or young adult years. People who have narcolepsy may find it hard to function at school, work, home, and in social situations because of extreme tiredness.
Narcolepsy has no cure, but medicines, lifestyle changes, and other therapies can improve symptoms. Research is ongoing on the causes of narcolepsy and new ways to treat it.
|
Narcolepsy
|
What causes Narcolepsy ?
|
Most people who have narcolepsy have low levels of hypocretin. This is a chemical in the brain that helps promote wakefulness. What causes low hypocretin levels isn't well understood.
Researchers think that certain factors may work together to cause a lack of hypocretin. These factors may include:
Heredity. Some people may inherit a gene that affects hypocretin. Up to 10 percent of people who have narcolepsy report having a relative who has the same symptoms.
Infections.
Brain injuries caused by conditions such as brain tumors, strokes, or trauma (for example, car accidents or military-related wounds).
Autoimmune disorders. With these disorders, the body's immune system mistakenly attacks the body's cells and tissues. An example of an autoimmune disorder is rheumatoid arthritis.
Low levels of histamine, a substance in the blood that promotes wakefulness.
Some research suggests that environmental toxins may play a role in triggering narcolepsy. Toxins may include heavy metals, pesticides and weed killers, and secondhand smoke.
Heredity alone doesn't cause narcolepsy. You also must have at least one other factor, such as one of those listed above, to develop narcolepsy.
|
Narcolepsy
|
Who is at risk for Narcolepsy? ?
|
Narcolepsy affects men and women. Symptoms usually begin during the teen or young adult years. The disorder also can develop later in life or in children, but it's rare before age 5.
Researchers think that certain factors may work together to cause narcolepsy. If these factors affect you, you may be at higher risk for the disorder. (For more information, go to "What Causes Narcolepsy?")
|
Narcolepsy
|
What are the symptoms of Narcolepsy ?
|
The four major signs and symptoms of narcolepsy are extreme daytime sleepiness, cataplexy (muscle weakness) while awake, and hallucinations and sleep paralysis during sleep.
If you have narcolepsy, you may have one or more of these symptoms. They can range from mild to severe. Less than one-third of people who have narcolepsy have all four symptoms.
Extreme Daytime Sleepiness
All people who have narcolepsy have extreme daytime sleepiness. This often is the most obvious symptom of the disorder.
During the day, you may have few or many periods of sleepiness. Each period usually lasts 30minutes or less. Strong emotionssuch as anger, fear, laughter, or excitementcan trigger this sleepiness.
People who have daytime sleepiness often complain of:
Mental cloudiness or "fog"
Memory problems or problems focusing
Lack of energy or extreme exhaustion
Depression
Some people who have narcolepsy have episodes in which they fall asleep suddenly. This is more likely to happen when they're not activefor example, while reading, watching TV, or sitting in a meeting.
However, sleep episodes also may occur in the middle of talking, eating, or another activity. Cataplexy also may occur at the same time.
Cataplexy
This condition causes loss of muscle tone while you're awake. Muscle weakness affects part or all of your body.
Cataplexy may make your head nod or make it hard for you to speak. Muscle weakness also may make your knees weak or cause you to drop things you're holding. Some people lose all muscle control and fall.
Strong emotionssuch as anger, surprise, fear, or laughteroften trigger cataplexy. It usually lasts a few seconds or minutes. During this time, you're usually awake.
Cataplexy may occur weeks to years after you first start to have extreme daytime sleepiness.
Hallucinations
If you have narcolepsy, you may have vivid dreams while falling asleep, waking up, or dozing. These dreams can feel very real. You may feel like you can see, hear, smell, and taste things.
Sleep Paralysis
This condition prevents you from moving or speaking while falling asleep or waking up. However, you're fully conscious (aware) during this time. Sleep paralysis usually lasts just a few seconds or minutes, but it can be scary.
Other Symptoms
Most people who have narcolepsy don't sleep well at night. They may have trouble falling and staying asleep. Vivid, scary dreams may disturb sleep. Not sleeping well at night worsens daytime sleepiness.
Rarely, people who fall asleep in the middle of an activity, such as eating, may continue that activity for a few seconds or minutes. This is called automatic behavior.
During automatic behavior, you're not aware of your actions, so you don't do them well. For example, if you're writing before falling asleep, you may scribble rather than form words. If you're driving, you may get lost or have an accident. Most people who have this symptom don't remember what happened while it was going on.
Children who have narcolepsy often have trouble studying, focusing, and remembering things. Also, they may seem hyperactive. Some children who have narcolepsy speed up their activities rather than slow them down.
Children who have narcolepsy may have severe sleepiness. They may fall asleep while talking or eating, or during sporting events and social activities.
|
Narcolepsy
|
How to diagnose Narcolepsy ?
|
It can take as long as 10 to 15 years after the first symptoms appear before narcolepsy is recognized and diagnosed. This is because narcolepsy is fairly rare. Also, many narcolepsy symptoms are like symptoms of other illnesses, such as infections, depression, and sleep disorders.
Narcolepsy sometimes is mistaken for learning problems, seizure disorders, or laziness, especially in school-aged children and teens. When narcolepsy symptoms are mild, the disorder is even harder to diagnose.
Your doctor will diagnose narcolepsy based on your signs and symptoms, your medical and family histories, a physical exam, and test results.
Signs and Symptoms
Tell your doctor about any signs and symptoms of narcolepsy that you have. This is important because your doctor may not ask about them during a routine checkup.
Your doctor will want to know when you first had signs and symptoms and whether they bother your sleep or daily routine. He or she also will want to know about your sleep habits and how you feel and act during the day.
To help answer these questions, you may want to keep a sleep diary for a few weeks. Keep a daily record of how easy it is to fall and stay asleep, how much sleep you get at night, and how alert you feel during the day.
For a sample sleep diary, go to the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."
Medical and Family Histories
Your doctor may ask whether:
You're affected by certain factors that can lead to narcolepsy. Examples of these factors include infections, brain injuries, and autoimmune disorders. Some research suggests that environmental toxins may play a role in triggering narcolepsy.
You take medicines and which ones you take. Some medicines can cause daytime sleepiness. Thus, your symptoms may be due to medicine, not narcolepsy.
You have symptoms of other sleep disorders that cause daytime sleepiness.
You have relatives who have narcolepsy or who have signs or symptoms of the disorder.
Physical Exam
Your doctor will check you to see whether another condition is causing your symptoms. For example, infections, certain thyroid diseases, drug and alcohol use, and other medical or sleep disorders may cause symptoms similar to those of narcolepsy.
Diagnostic Tests
Sleep Studies
If your doctor thinks you have narcolepsy, he or she will likely suggest that you see a sleep specialist. This specialist may advise you to have sleep studies to find out more about your condition.
Sleep studies usually are done at a sleep center. Doctors use the results from two tests to diagnose narcolepsy. These tests are a polysomnogram (PSG) and a multiple sleep latency test (MSLT).
Polysomnogram. You usually stay overnight at a sleep center for a PSG. The test records brain activity, eye movements, heart rate, and blood pressure. A PSG can help find out whether you:
Fall asleep quickly
Go into rapid eye movement (REM) sleep soon after falling asleep
Wake up often during the night
Multiple sleep latency test. This daytime sleep study measures how sleepy you are. It's often done the day after a PSG. During the test, you're asked to nap for 20minutes every 2 hours throughout the day. (You will nap a total of four or five times.)
A technician checks your brain activity during this time. He or she notes how quickly you fall asleep and how long it takes you to reach various stages of sleep.
An MSLT finds out how quickly you fall asleep during the day (after a full night's sleep). It also shows whether you go into REM sleep soon after falling asleep.
Other Tests
Hypocretin test. This test measures the level of hypocretin in the fluid that surrounds your spinal cord. Most people who have narcolepsy have low levels of hypocretin. Hypocretin is a chemical that helps promote wakefulness.
To get a sample of spinal cord fluid, a spinal tap (also called a lumbar puncture) is done. For this procedure, your doctor inserts a needle into your lower back area and then withdraws a sample of your spinal fluid.
|
Narcolepsy
|
What are the treatments for Narcolepsy ?
|
Narcolepsy has no cure. However, medicines, lifestyle changes, and other therapies can relieve many of its symptoms. Treatment for narcolepsy is based on the type of symptoms you have and how severe they are.
Not all medicines and lifestyle changes work for everyone. It may take weeks to months for you and your doctor to find the best treatment.
Medicines
You may need one or more medicines to treat narcolepsy symptoms. These may include:
Stimulants to ease daytime sleepiness and raise your alertness.
A medicine that helps make up for the low levels of hypocretin in your brain. (Hypocretin is a chemical that helps promote wakefulness.) This medicine helps you stay awake during the day and sleep at night. It doesn't always completely relieve daytime sleepiness, so your doctor may tell you to take it with a stimulant.
Medicines that help you sleep at night.
Medicines used to treat depression. These medicines also help prevent cataplexy, hallucinations, and sleep paralysis.
Some prescription and over-the-counter medicines can interfere with your sleep. Ask your doctor about these medicines and how to avoid them, if possible. For example, your doctor may advise you to avoid antihistamines. These medicines suppress the action of histamine, a substance in the blood that promotes wakefulness.
If you take regular naps when you feel sleepy, you may need less medicine to stay awake.
Lifestyle Changes
Lifestyle changes also may help relieve some narcolepsy symptoms. You can take steps to make it easier to fall asleep at night and stay asleep.
Follow a regular sleep schedule. Go to bed and wake up at the same time every day.
Do something relaxing before bedtime, such as taking a warm bath.
Keep your bedroom or sleep area quiet, comfortable, dark, and free from distractions, such as a TV or computer.
Allow yourself about 20 minutes to fall asleep or fall back asleep after waking up. After that, get up and do something relaxing (like reading) until you get sleepy.
Certain activities, foods, and drinks before bedtime can keep you awake. Try to follow these guidelines:
Exercise regularly, but not within 3 hours of bedtime.
Avoid tobacco, alcohol, chocolate, and drinks that contain caffeine for several hours before bedtime.
Avoid large meals and beverages just before bedtime.
Avoid bright lights before bedtime.
For more tips on sleeping better, go to the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."
Other Therapies
Light therapy may help you keep a regular sleep and wake schedule. For this type of therapy, you sit in front of a light box, which has special lights, for 10 to 30 minutes. This therapy can help you feel less sleepy in the morning.
|
Narcolepsy
|
What is (are) Bronchitis ?
|
Espaol
Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.)
People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.
Bronchitis
Overview
The two main types of bronchitis are acute (short term) and chronic (ongoing).
Acute Bronchitis
Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed).
Sometimes bacteria cause acute bronchitis.
Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone.
Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.
Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care.
Chronic Bronchitis
Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis.
Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual.
Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis.
|
Bronchitis
|
What causes Bronchitis ?
|
Acute Bronchitis
Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition.
Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to tobacco smoke, dust, fumes, vapors, or air pollution raises your risk for the condition. These lung irritants also can make symptoms worse.
Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis.
Chronic Bronchitis
Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of the condition.
Breathing in air pollution and dust or fumes from the environment or workplace also can lead to chronic bronchitis.
People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis.
|
Bronchitis
|
Who is at risk for Bronchitis? ?
|
Bronchitis is a very common condition. Millions of cases occur every year.
Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups.
People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45. Also, many adults who develop chronic bronchitis are smokers. Women are more than twice as likely as men to be diagnosed with chronic bronchitis.
Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with dust, chemical fumes, and vapors from certain jobs also increases your risk for the condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming.
Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke.
|
Bronchitis
|
What are the symptoms of Bronchitis ?
|
Acute Bronchitis
Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea.
The main symptom of acute bronchitis is a persistent cough, which may last 10 to 20 days. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks.
Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain.
If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity.
Chronic Bronchitis
The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough often is called a smoker's cough.
|
Bronchitis
|
How to diagnose Bronchitis ?
|
Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you've had it, what you're coughing up, and how much you cough.
Your doctor also will likely ask:
About your medical history
Whether you've recently had a cold or the flu
Whether you smoke or spend time around others who smoke
Whether you've been exposed to dust, fumes, vapors, or air pollution
Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may:
Look at your mucus to see whether you have a bacterial infection
Test the oxygen levels in your blood using a sensor attached to your fingertip or toe
Recommend a chest x ray, lung function tests, or blood tests
|
Bronchitis
|
What are the treatments for Bronchitis ?
|
The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier.
If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever.
Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against virusesthe most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics.
A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs.
Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists).
If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form).
If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen.
One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit.
Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution.
For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking.
|
Bronchitis
|
How to prevent Bronchitis ?
|
You can't always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both conditions. The most important step is to quit smoking or not start smoking.
For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking.
Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other substances with strong fumes. This will help protect your lungs.
Wash your hands often to limit your exposure to germs and bacteria. Your doctor also may advise you to get a yearly flu shot and a pneumonia vaccine.
|
Bronchitis
|
What is (are) Broken Heart Syndrome ?
|
Broken heart syndrome is a condition in which extreme stress can lead to heart muscle failure. The failure is severe, but often short-term.
Most people who experience broken heart syndrome think they may be having a heart attack, a more common medical emergency caused by a blocked coronary (heart) artery. The two conditions have similar symptoms, including chest pain and shortness of breath. However, theres no evidence of blocked coronary arteries in broken heart syndrome, and most people have a full and quick recovery.
Overview
Broken heart syndrome is a recently recognized heart problem. It was originally reported in the Asian population in 1990 and named takotsubo cardiomyopathy (KAR-de-o-mi-OP-ah-thee). In this condition, the heart is so weak that it assumes a bulging shape (tako tsubo is the term for an octopus trap, whose shape resembles the bulging appearance of the heart during this condition). Cases have since been reported worldwide, and the first reports of broken heart syndrome in the United States appeared in 1998. The condition also is commonly called stress-induced cardiomyopathy.
The cause of broken heart syndrome is not fully known. In most cases, symptoms are triggered by extreme emotional or physical stress, such as intense grief, anger, or surprise. Researchers think that the stress releases hormones that stun the heart and affect its ability to pump blood to the body. (The term stunned is often used to indicate that the injury to the heart muscle is only temporary.)
People who have broken heart syndrome often have sudden intense chest pain and shortness of breath. These symptoms begin just a few minutes to hours after exposure to the unexpected stress. Many seek emergency care, concerned they are having a heart attack. Often, patients who have broken heart syndrome have previously been healthy.
Women are more likely than men to have broken heart syndrome. Researchers are just starting to explore what causes this disorder and how to diagnose and treat it.
Broken Heart Syndrome Versus Heart Attack
Symptoms of broken heart syndrome can look like those of a heart attack.
Most heart attacks are caused by blockages and blood clots forming in the coronary arteries, which supply the heart with blood. If these clots cut off the blood supply to the heart for a long enough period of time, heart muscle cells can die, leaving the heart with permanent damage. Heart attacks most often occur as a result of coronary heart disease (CHD), also called coronary artery disease.
Broken heart syndrome is quite different. Most people who experience broken heart syndrome have fairly normal coronary arteries, without severe blockages or clots. The heart cells are stunned by stress hormones but not killed. The stunning effects reverse quickly, often within just a few days or weeks. In most cases, there is no lasting damage to the heart.
Because symptoms are similar to a heart attack, it is important to seek help right away. You, and sometimes emergency care providers, may not be able to tell that you have broken heart syndrome until you have some tests.
All chest pain should be checked by a doctor. If you think you or someone else may be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 911 for emergency medical care. In the case of a heart attack, acting fast at the first sign of symptoms can save your life and limit damage to your heart.
Outlook
Research is ongoing to learn more about broken heart syndrome and its causes.
The symptoms of broken heart syndrome are treatable, and most people who experience it have a full recovery, usually within days or weeks. The heart muscle is not permanently damaged, and the risk of broken heart syndrome happening again is low.
|
Broken Heart Syndrome
|
What causes Broken Heart Syndrome ?
|
The cause of broken heart syndrome isnt fully known. However, extreme emotional or physical stress is believed to play a role in causing the temporary disorder.
Although symptoms are similar to those of a heart attack, what is happening to the heart is quite different. Most heart attacks are caused by near or complete blockage of a coronary artery. In broken heart syndrome, the coronary arteries are not blocked, although blood flow may be reduced.
Potential Triggers
In most cases, broken heart syndrome occurs after an intense and upsetting emotional or physical event. Some potential triggers of broken heart syndrome are:
Emotional stressorsextreme grief, fear, or anger, for example as a result of the unexpected death of a loved one, financial or legal trouble, intense fear, domestic abuse, confrontational argument, car accident, public speaking, or even a surprise party.
Physical stressorsan asthma attack, serious illness or surgery, or exhausting physical effort.
Potential Causes
Researchers think that sudden stress releases hormones that overwhelm or stun the heart. (The term stunned is often used to indicate that the injury to the heart muscle is only temporary.) This can trigger changes in heart muscle cells or coronary blood vessels, or both. The heart becomes so weak that its left ventricle (which is the chamber that pumps blood from your heart to your body) bulges and cannot pump well, while the other parts of the heart work normally or with even more forceful contractions. As a result the heart is unable to pump properly. (For more information about the hearts pumping action and blood flow, go to the Health Topics How the Heart Works article.)
Researchers are trying to identify the precise way in which the stress hormones affect the heart. Broken heart syndrome may result from a hormone surge, coronary artery spasm, or microvascular dysfunction.
Hormone Surge
Intense stress causes large amounts of the fight or flight hormones, such as adrenaline and noradrenaline, to be released into your bloodstream. The hormones are meant to help you cope with the stress. Researchers think that the sudden surge of hormones overwhelms and stuns the heart muscle, producing symptoms similar to those of a heart attack.
Coronary Artery Spasm
Some research suggests that the extreme stress causes a temporary, sudden narrowing of one of the coronary arteries as a result of a spasm. The spasm slows or stops blood flow through the artery and starves part of the heart of oxygen-rich blood.
Microvascular Dysfunction
Another theory that is gaining traction is that the very small coronary arteries (called microvascular arteries) do not function well due to low hormone levels occurring before or after menopause. The microvascular arteries fail to provide enough oxygen-rich blood to the heart muscle.
|
Broken Heart Syndrome
|
Who is at risk for Broken Heart Syndrome? ?
|
Broken heart syndrome affects women more often than men. Often, people who experience broken heart syndrome have previously been healthy. Research shows that the traditional risk factors for heart disease may not apply to broken heart syndrome.
People who might be at increased risk for broken heart syndrome include:
Women who have gone through menopause, particularly women in their sixties and seventies
People who often have no previous history of heart disease
Asian and White populations
Although these are the characteristics for most cases of broken heart syndrome, the condition can occur in anyone.
Research is ongoing to learn more about broken heart syndrome and its causes.
|
Broken Heart Syndrome
|
What are the symptoms of Broken Heart Syndrome ?
|
All chest pain should be checked by a doctor. Because symptoms of broken heart syndrome are similar to those of a heart attack, it is important to seek help right away. Your doctor may not be able to diagnose broken heart syndrome until you have some tests.
Common Signs and Symptoms
The most common symptoms of broken heart syndrome are sudden, sharp chest pain and shortness of breath. Typically these symptoms begin just minutes to hours after experiencing a severe, and usually unexpected, stress.
Because the syndrome involves severe heart muscle weakness, some people also may experience signs and symptoms such as fainting, arrhythmias (ah-RITH-me-ahs) (fast or irregular heartbeats), cardiogenic (KAR-de-o-JEN-ik) shock (when the heart cant pump enough blood to meet the bodys needs), low blood pressure, and heart failure.
Differences From a Heart Attack
Some of the signs and symptoms of broken heart syndrome differ from those of a heart attack. For example, in people who have broken heart syndrome:
Symptoms (chest pain and shortness of breath) occur suddenly after having extreme emotional or physical stress.
EKG(electrocardiogram) results dont look the same as the results for a person having a heart attack. (An EKG is a test that records the hearts electrical activity.)
Blood tests show no signs or mild signs of heart damage.
Tests show enlarged and unusual movement of the lower left heart chamber (the left ventricle).\
Tests show no signs of blockages in the coronary arteries.
Recovery time is quick, usually within days or weeks (compared with the recovery time of a month or more for a heart attack).
Complications
Broken heart syndrome can be life threatening in some cases. It can lead to serious heart problems such as:
Heart failure, a condition in which the heart cant pump enough blood to meet the bodys needs
Heart rhythm problems that cause the heart to beat much faster or slower than normal
Heart valve problems
The good news is that most people who have broken heart syndrome make a full recovery within weeks. With medical care, even the most critically ill tend to make a quick and complete recovery.
|
Broken Heart Syndrome
|
How to diagnose Broken Heart Syndrome ?
|
Because the symptoms are similar, at first your doctor may not be able to tell whether you are experiencing broken heart syndrome or having a heart attack. Therefore, the doctors immediate goals will be:
To determine whats causing your symptoms
To determine whether youre having or about to have a heart attack
Your doctor will diagnose broken heart syndrome based on your signs and symptoms, your medical and family histories, and the results from tests and procedures.
Specialists Involved
Your doctor may refer you to a cardiologist. A cardiologist is a doctor who specializes in diagnosing and treating heart diseases and conditions.
Physical Exam and Medical History
Your doctor will do a physical exam and ask you to describe your symptoms. He or she may ask questions such as when your symptoms began, where you are feeling pain or discomfort and what it feels like, and whether the pain is constant or varies.
To learn about your medical history, your doctor may ask about your overall health, risk factors for coronary heart disease (CHD) and other heart disease, and family history. Your doctor will ask whether you've recently experienced any major stresses.
Diagnostic Tests and Procedures
No single test can diagnose broken heart syndrome. The tests and procedures for broken heart syndrome are similar to those used to diagnose CHD or heart attack. The diagnosis is made based on the results of the following standards tests to rule out heart attack and imaging studies to help establish broken heart syndrome.
Standard Tests and Procedures
EKG (Electrocardiogram)
AnEKGis a simple, painless test that detects and records the hearts electrical activity. The test shows how fast your heart is beating and whether its rhythm is steady or irregular. An EKG also records the strength and timing of electrical signals as they pass through each part of the heart.
The EKG may show abnormalities in your heartbeat, a sign of broken heart syndrome as well as heart damage due to CHD.
Blood Tests
Blood tests check the levels of certain substances in your blood, such as fats, cholesterol, sugar, and proteins. Blood tests help greatly in diagnosing broken heart syndrome, because certain enzymes (proteins in the blood) may be present in the blood to indicate the condition.
Imaging Procedures
Echocardiography
Echocardiography(echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can show areas of heart muscle that aren't contracting well because of poor blood flow or previous injury.
The echo may show slowed blood flow in the left chamber of the heart.
Chest X Ray
A chest x rayis a painless test that creates pictures of the structures in your chest, such as your heart, lungs, and blood vessels. Your doctor will need a chest x ray to analyze whether your heart has the enlarged shape that is a sign of broken heart syndrome.
A chest x ray can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to broken heart syndrome.
Cardiac MRI
Cardiac magnetic resonance imaging (MRI) is a common test that uses radio waves, magnets, and a computer to make both still and moving pictures of your heart and major blood vessels. Doctors use cardiac MRI to get pictures of the beating heart and to look at its structure and function. These pictures can help them decide the best way to treat people who have heart problems.
Coronary Angiography and Cardiac Catheterization
Your doctor may recommend coronary angiography (an-jee-OG-rah-fee) if other tests or factors suggest you have CHD. This test uses dye and special x rays to look inside your coronary arteries.
To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun). A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.
Special x rays are taken while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.
Ventriculogram
Ventriculogram is another test that can be done during a cardiac catheterization that examines the left ventricle, which is the hearts main pumping chamber. During this test, a dye is injected into the inside of the heart and x ray pictures are taken. The test can show the ventricles size and how well it pumps blood. It also shows how well the blood flows through the aortic and mitral values.
|
Broken Heart Syndrome
|
What are the treatments for Broken Heart Syndrome ?
|
Even though broken heart syndrome may feel like a heart attack, its a very different problem that needs a different type of treatment.
The good news is that broken heart syndrome is usually treatable, and most people make a full recovery. Most people who experience broken heart syndrome stay in the hospital for a few days to a week.
Initial treatment is aimed at improving blood flow to the heart, and may be similar to that for a heart attack until the diagnosis is clear. Further treatment can include medicines and lifestyle changes.
Medicines
Doctors may prescribe medicines to relieve fluid buildup, treat blood pressure problems, prevent blood clots, and manage stress hormones. Medicines are often discontinued once heart function has returned to normal.
Your doctor may prescribe the following medicines:
ACE inhibitors (or angiotensin-converting enzyme inhibitors), to lower blood pressure and reduce strain on your heart
Beta blockers, to slow your heart rate and lower your blood pressure to decrease your hearts workload
Diuretics (water or fluid pills), to help reduce fluid buildup in your lungs and swelling in your feet and ankles
Anti-anxiety medicines, to help manage stress hormones
Take all of your medicines as prescribed. If you have side effects or other problems related to your medicines, tell your doctor. He or she may be able to provide other options.
Treatment of Complications
Broken heart syndrome can be life threatening in some cases. Because the syndrome involves severe heart muscle weakness, patients can experience shock, heart failure, low blood pressure, and potentially life-threatening heart rhythm abnormalities.
The good news is that this condition improves very quickly, so with proper diagnosis and management, even the most critically ill tend to make a quick and complete recovery.
Lifestyle Changes
To stay healthy, its important to find ways to reduce stress and cope with particularly upsetting situations. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress. Physical activity, medicine, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.
Treatments Not Helpful for Broken Heart Syndrome
Several procedures used to treat a heart attack are not helpful in treating broken heart syndrome. These procedurespercutaneous coronary intervention (sometimes referred to as angioplasty), stent placement, and surgerytreat blocked arteries, which is not the cause of broken heart syndrome.
|
Broken Heart Syndrome
|
How to prevent Broken Heart Syndrome ?
|
Researchers are still learning about broken heart syndrome, and no treatments have been shown to prevent it. For people who have experienced the condition, the risk of recurrence is low.
An emotionally upsetting or serious physical event can trigger broken heart syndrome. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress. Physical activity, medicine, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.
Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy. Learning to manage stress includes adopting healthy habits that will keep your stress levels low and make it easier to deal with stress when it does happen. A healthy lifestyle includes following a healthy diet, being physically active, maintaining a healthy weight, and quitting smoking.
|
Broken Heart Syndrome
|
What is (are) Bronchiectasis ?
|
Bronchiectasis (brong-ke-EK-ta-sis) is a condition in which damage to the airways causes them to widen and become flabby and scarred. The airways are tubes that carry air in and out of your lungs.
Bronchiectasis usually is the result of an infection or other condition that injures the walls of your airways or prevents the airways from clearing mucus. Mucus is a slimy substance that the airways produce to help remove inhaled dust, bacteria, and other small particles.
In bronchiectasis, your airways slowly lose their ability to clear out mucus. When mucus can't be cleared, it builds up and creates an environment in which bacteria can grow. This leads to repeated, serious lung infections.
Each infection causes more damage to your airways. Over time, the airways lose their ability to move air in and out. This can prevent enough oxygen from reaching your vital organs.
Bronchiectasis can lead to serious health problems, such as respiratory failure, atelectasis (at-eh-LEK-tah-sis), and heart failure.
Bronchiectasis
Overview
Bronchiectasis can affect just one section of one of your lungs or many sections of both lungs.
The initial lung damage that leads to bronchiectasis often begins in childhood. However, symptoms may not occur until months or even years after you start having repeated lung infections.
In the United States, common childhood infectionssuch as whooping cough and measlesused to cause many cases of bronchiectasis. However, these causes are now less common because of vaccines and antibiotics.
Now bronchiectasis usually is due to a medical condition that injures the airway walls or prevents the airways from clearing mucus. Examples of such conditions include cystic fibrosis and primary ciliary (SIL-e-ar-e) dyskinesia (dis-kih-NE-ze-ah), or PCD.
Bronchiectasis that affects only one part of the lung may be caused by a blockage rather than a medical condition.
Bronchiectasis can be congenital (kon-JEN-ih-tal) or acquired. Congenital bronchiectasis affects infants and children. It's the result of a problem with how the lungs form in a fetus.
Acquired bronchiectasis occurs as a result of another condition or factor. This type of bronchiectasis can affect adults and older children. Acquired bronchiectasis is more common than the congenital type.
Outlook
Currently, bronchiectasis has no cure. However, with proper care, most people who have it can enjoy a good quality of life.
Early diagnosis and treatment of bronchiectasis are important. The sooner your doctor starts treating bronchiectasis and any underlying conditions, the better your chances of preventing further lung damage.
|
Bronchiectasis
|
What causes Bronchiectasis ?
|
Damage to the walls of the airways usually is the cause of bronchiectasis. A lung infection may cause this damage. Examples of lung infections that can lead to bronchiectasis include:
Severe pneumonia (nu-MO-ne-ah)
Whooping cough or measles (uncommon in the United States due to vaccination)
Tuberculosis
Fungal infections
Conditions that damage the airways and raise the risk of lung infections also can lead to bronchiectasis. Examples of such conditions include:
Cystic fibrosis. This disease leads to almost half of the cases of bronchiectasis in the United States.
Immunodeficiency disorders, such as common variable immunodeficiency and, less often, HIV and AIDS.
Allergic bronchopulmonary aspergillosis (AS-per-ji-LO-sis). This is an allergic reaction to a fungus called aspergillus. The reaction causes swelling in the airways.
Disorders that affect cilia (SIL-e-ah) function, such as primary ciliary dyskinesia. Cilia are small, hair-like structures that line your airways. They help clear mucus (a slimy substance) out of your airways.
Chronic (ongoing) pulmonary aspiration (as-pih-RA-shun). This is a condition in which you inhale food, liquids, saliva, or vomited stomach contents into your lungs. Aspiration can inflame the airways, which can lead to bronchiectasis.
Connective tissue diseases, such as rheumatoid arthritis, Sjgrens syndrome, and Crohns disease.
Other conditions, such as an airway blockage, also can lead to bronchiectasis. Many things can cause a blockage, such as a growth or a noncancerous tumor. An inhaled object, such as a piece of a toy or a peanut that you inhaled as a child, also can cause an airway blockage.
A problem with how the lungs form in a fetus may cause congenital bronchiectasis. This condition affects infants and children.
|
Bronchiectasis
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.