Heart Symptoms

 












Heart Symptoms that affects millions of people
Heart attack, coronary artery disease, heart valve disease, heart palpitation – each type of heart disease may have the same symptoms, and can appear together or individual.
How the heart looks like and how does it work?
Heart has 4 chambers: right and left atrium, and right and left ventricles. Between the atrium and ventricle are the mitral valve and tricuspid valve which regulates blood flow in one sense from atrium to ventricle. From left ventricle starts Aorta and from right starts the pulmonary artery.  On the outside, heart has its own vessel named coronary artery and coronary veins, which gets blood with oxygen to the heart muscle and makes it work well.
Heart symptoms causes:
Atherosclerosis
Stress
Alcohol
Drugs
Caffeine
Smoking
Diabetes
Obesity
Family history
Sedentary life
Anemia
Hyperthyroidism
High blood pressure
Heart symptoms and mechanisms:
Chest pain (angina): appears because some of the heart coronary artery is partially blocked by atherosclerosis or spasm correlated with anxiety and fatigue.
Heart attack: appears because one of the principal heart coronary artery is totally blocked and stops blood flow to the heart muscle making that part of heart to die. Heart symptoms are: sensation of imminent death, chest pain with irradiation to the neck, both arm, medial part of the left arm going to the last two fingers, or upper part of the stomach, more than 20 minutes, shortness of breath, nausea, vomiting, syncope, swelling.
Heart palpitation: appears because the heart electrical system is over stressed and decreases the heart ability to pump blood to the organism and itself. This is correlated with abnormal levels of electrolytes, caffeine, anemia, illicit drugs, caffeine, alcohol, tobacco, and hyperthyroidism.
Heart symptoms inside valves: appears because blood can go back in lungs or in liver causing edema (water accumulation), shortness of breath, chest discomfort, weakness, palpitations, fatigue.
Heart failure: appears when heart muscle is overworked, in situations like diabetes, coronary heart disease, high blood pressure, arrhythmias, and obstructive sleep apnea. Symptoms are: tiredness, shortness of breath, edema, swelling in ankles and legs associated with superficial lesion.
Fluttering heart symptoms : angina pectoris, rapid heartbeat or a feeling that heart just stopped shortness of breath, syncope, fatigue, anxiety.
Heart symptoms related to sex:
Heart symptoms in children : one of the first heart symptoms in children is cyanosis (blue color of the extremities like fingers from hand and feet, mouth, ears, nose), chest pain, edema, syncope, palpitation.
Heart symptoms in women : in comparison with men, the chest pain appears only on 30% of women, the rest of women have no chest pain. Most women accused indigestion, sleep disorder, weakness in the left arm, shortness of breath, fatigue, sweat, anxiety, pain in the upper part of stomach.
Heart symptoms in men : chest pain irradiating to arm, neck, upper part of stomach, fatigue, shortness of breath, anxiety, nausea, vomiting
When to call the doctor:
Chest pain is more than 5 minutes after you take under tongue nitroglycerin (be very carefull that nitroglycerin is still valid, if you are not sure put it on your tongue and if it stings  it may be ok), if chest pain does not decrease you can take another nitroglycerin after 5 minutes, maximum three doses, after you must call an ambulance.
Chest pain associated with sensation of imminent death, irregular heart beating, sweating, nausea or vomiting, high pressure levels.
Heart palpitation associated with angina, fatigue, syncope, anxiety.
A respiratory infection plus tachycardia (fast heart rate over 90 beats per minutes when still), palpitation, shortness of breath while you are resting or during easy daily activities, insomnia or needing to sleep more than usual, confusion, headaches, nausea.

Heart symptoms diagnoses:

Diagnosis can be made by medical doctor after some tests like:
Electrocardiogram which registers the heart activities.
Stress test: this test registers the heart activities to.
Chest X-ray
Echocardiogram: doctors can see all the cavities and valves of the heart, or if there are some clots.
Coronary angiogram: doctors are running a catheter into the heart to see blocked coronary vessels and other heart symptoms.
CT heart scan: can visualize heart anatomy.
MRI heart scan: shows how heart is working and a lot of heart symptoms .

Heart symptoms treatment:

Treatment is prescribed by doctors and can include:
Nitrates for chest pain.
ACE helps heart to pump blood better, in case that a part of the heart is injured. It can reduce some heart symptoms like blood pressure.
Beta blockers are used in heart symptoms like chest pain, tachycardia (cardiac frequency over 90 beats per minute), and decrease blood pressure, preventing a heart attack.
Digitalis reduces heart rhythm and chest pain.
Calcium channel blockers are used to decrease blood pressure and in chest pain, because they relax blood vessel muscle.
Diuretics are used in blood pressure by decreasing fluid in the body (edema).
Antiplatelet drugs stops blood clots from forming, and this should be used by all the people with risk factors like obesity, hypercholesterolemia, diabetes, chest pain, smokers.
Thrombolytic agents are given in the forth hour after a heart attack, for breaking up a blood clot in a coronary artery, making the blood flow again.
Blood cholesterol- lowering agents decrease bad cholesterol (LDL cholesterol) levels in the blood, lowering the risk for  clots in blood vessels.

Heart symptoms prevention:

Because heart attack and stroke is the first killer in the world, a lot of people are asking what to do to avoid them. Here you can see some advices:
Stop smoking, one cigarette can move a blood clot which produce and heart attack or stroke, and chemicals are affecting you blood vessels and heart, leading to the atherosclerosis.
Exercise at least 30 minutes per day, and you can reduce the risk of heart disease and helps you to control weight, blood pressure, lower cholesterol and diabetes value.
Have a good diet by eating foot which contains low fat, cholesterol and salt and a lot of vegetables, fruits, fish, and cereals.
Avoid psycho stimulants like drugs, caffeine in excess.

Taking this advices you can avoid  bad heart symptoms and you can enjoy a good life.

Heart attack arm pain

Heart attack is a disease that sometimes can be fatal and some trivial symptoms such heart attack arm pain must make the patient to address to the doctor.
Heart attack is a condition in which the oxygen-rich blood flow is reduced or completely stopped, due to obstruction of an artery from the heart. Thus, after the obstruction occurs necrosis (premature death of cells or tissues) of a part of the heart. The most common reasons of heart attack are the excess of cholesterol in the body, obesity and stress.

Heart attack arm pain symptoms

Onset symptoms of heart attack may be different in women than in men. If symptoms of heart attack are not recognized in time the patient could die. Chest pain is the most common heart attack symptom that occurs in both men and women. Chest pain may occur both at rest and during exercise. There is no relationship between exercise level and a heart attack. Pain is initially located in the heart and spreads to the arms, neck and back.  As pain is higher and irradiation more distant, heart attack is more serious.

Heart attack arm pain

Heart attack arm pain occurs as discomfort in one or both arms, especially on the medial side of the arm.  Pain may be felt also in the last two fingers, the patient felt as numbness or tingling. Heart attack pain lasts longer than half an hour and the pain from angina pectoris (is a medical term used for temporary chest pain that occurs when the heart does not receive enough blood, but does not cause irreversible damage) takes a few minutes (2-5 minutes). Heart attack arm pain intensity in older adults is lower than in other because their heart structure shows changes. This makes patients to not go to the doctor and a possible heart attack to be discovered much later.
Heart attack arm pain can also be a symptom onset of heart attack. Heart attack arm pain especially in the left arm is the most common symptoms in women.  In addition to heart attack arm pain, women may also accuse shortness of breath (feeling like patient can’t get enough air), loss of appetite, asthenia, adinamie (patient feeling tired),   coughing or heart flutters. Sometimes the symptoms or signs as heart attack arm pain may occur suddenly and it can also develop slowly even hours or days before a heart attack occurs.
Heart attack pain does not disappear at rest or after administration of vasodilators      (for example nitrate administration). It may decrease in intensity, but reappears after a few minutes. Usually pain recedes to the administration of opioid (morphine, mialgin). But after the administration of opioid the pain may persist, but with lower intensity.
Sometimes arm pain may have another cause than heart attack. Heart attack arm pain appears from the shoulder to the finger tips, is continuous and lasts over half an hour. Stress or attack panic may cause chest pain with radiation in left arm. Other causes of arm pain may be arthritis, muscle cramps or spasms, damage to the nerve or to the disc or bad circulation of blood.

In conclusion, patients with cardiovascular risk who have pain in the arm must go to the doctor or call an ambulance immediately because it can be a heart attack arm pain.

High triglycerides symptoms

Triglycerides are a form of blood fat and high triglycerides symptoms can occur at any person who have increased their level.

High triglycerides symptoms specifics

Triglycerides are the main components of vegetable oil and animal oils. Triglycerides from plasma are derived from food fats and carbohydrates. Calories ingested in a meal and not “burned” or used immediately by tissues, are converted into triglycerides and transported to cells to be stored as fat. Triglycerides and cholesterol can not dissolve in the blood circulating throughout your body with the help of proteins that carry lipids. Triglycerides play an important role in metabolism as energy sources. Excess of plasma triglycerides is called hypertriglyceridemia. High triglycerides levels usually do not causes symptoms so patients with hypertriglyceridemia do not go to the doctor for this problem. But sometimes can appear high triglycerides symptoms. People with high triglycerides (over 200 mg/dl) have an increased risk of cardiovascular disease. People with diabetes or who are obese are also likely to have high triglycerides.

High triglycerides

The most common causes of occurrence of high triglycerides symptoms are the unhealthy food that individuals consume in daily life. One of the high triglycerides symptoms are eruptive xanthomas. These are deposits of lipids that appear on the skin especially on the skin around the eyes, elbows and knees in triglyceride levels over 1000 mg/dL. They often appear in groups and may cause pain at acute levels. Another high triglycerides symptoms is acute pancreatitis. Pancreas is an organ located in the abdominal cavity and which is behind the stomach. It has two functions: exocrine and endocrine function. Exocrine pancreas produces enzymes for digesting fats, proteins and carbohydrates, so they can be absorbed by the intestine.
If levels of triglycerides are very high for an extended period of time, high triglycerides symptoms may be abdominal pain because of liver or spleen enlargement.They can be discovered at a routine abdominal ultrasound. Doctors must seek the cause of hepatomegaly or splenomegaly.
High triglycerides symptoms can be treated by non-pharmacological methods or with drugs. Non-pharmacological methods refer mainly to lifestyle changes. First, if the patient with high triglycerides symptoms consumed excess alcohol, he must reduce alcohol to lower triglyceride levels. Patients should also reduce the consumption of fatty foods (butter, cream, margarine, bacon but other foods that contain high levels of fat). Another method of non-pharmacological treatment of high triglycerides symptoms refers to the practice of physical exercise. Patients with hypertriglyceridemia and hypercholesterolemia may be overweight and then doctors recommend them to lose weight and thus decrease of triglycerides and cholesterol levels.

Treatment of high triglycerides symptoms

Doctors may also prescribe drugs to disappear high triglycerides symptoms. These are gemfibrozil or nicotinic acid. Gemfibrozil is a medicine that lowers blood cholesterol levels and that decreases the production of triglycerides from the liver. Nicotinic acid may also lower cholesterol and triglycerides levels.

 Conclusion

When patients go to the doctor for high triglycerides symptoms, they should be treated because in time can lead to several complications.

Rapid heart beats after eating -worry or not

Rapid heart beats after eating - what should we be worried about?

Rapid heart beats

Some people experience rapid heart beats after eating and this can create an important discomfort as they begin to be afraid or avoid eating in order to prevent these irregular heart beats to occur. Others are worried they might have a heart disease that causes palpitations and sick medical help. In the next part of the article we will find out what is the meaning of these palpitation and how can we prevent them.
After a meal, the digestion process requires more blood in the stomach and intestine and that’s why the heart has to pump more blood in these organs. The process consisting in increasing the amount of blood in the abdominal area after a meal is very important as it helps the body to assimilate food. This routine activity can determine palpitations, because heart has to work harder then usually. Until now, heart palpitation after eating seems to be a normal manifestation that can occur during a daily physiological process of our body.
Along with palpitation, after eating there are other manifestations that can also occur:

• nausea
•  dizziness-it occurs because cerebral blood flow is reduced, as the stomach needs more blood then usually in order to digest the food.
•  fatigue or even exhaustion (the blood will accumulate in the digestive system, while other organs and among them, the brain, will receive a smaller amount of blood)
• chest pain after eating- many times, patient with coronary disease (chronic heart ischemia determined by deprivation of oxygen) can have a chest pains after eating
•  sweating
• insomnia-if you sleep immediately after a meal, you may have problems to fall asleep. Because during night digestion and digestive secretion used in this process are diminished, you may get indigestion with abdominal discomfort, nausea and vomiting.
•  shortness of breath-the stomach is full of food and presses against diaphragma, restricting lung expansion during breathing
•  abdominal discomfort-if we eat too much or meals which are difficult to digest

If we experience rapid heart beats after eating should we seek for medical help?

Even if sometimes, heart palpitation after eating it is a normal manifestation, there are other causes for this condition, which need to be evaluated and treated. The answer is yes, if we experience heart palpitation after eating we should pay a visit to our doctor and check if there is something wrong.
What is the cause for heart palpitations after eating?

•  sudden consumption of food after a long period of starvation. This is often seen in patients suffering from anorexia nervosa, when after a long time of not eating, they start the consumption of food, the level of blood sugar increases rapidly, followed by increased secretion of insulin, which can create arrhythmia and also decreases blood sugar. The rapid decrease of blood sugar will stimulate the secretion of adrenaline, which will stimulate heart activity and create palpitation (it is like when you hurry up a person and it is obviously that in some point she will do mistakes)
•  hiatal hernia– a small portion of the stomach protrudes into the chest through diaphragm (the muscle that separates chest from abdomen and looks like a roof). This condition is usually associated with gastroesophageal reflux disease and may lead to chest pain and palpitations.
•  obesity- usually these persons have a diet with lot of sugar and caffeine, with a sedentary lifestyle and they can experience palpitation and chest pain. Their body has a lot of fats and these fats will deposit on the blood vessels wall, blocking them and generating heart disease (coronary arteries disease-with deprivation of blood and oxygen in the heart tissues). Also, the heart has to work extra hard to pump blood into their stomach.
•  hormonal imbalance could be a possible cause of heart palpitation after eating. For example hyperthyroidism (a thyroid disorder with high level of hormones) determines heart palpitation, tachycardia, chest pain, shortness of breath etc.
•  Severe anemia can affect heart and determine tachycardia (rapid heart rate) or irregular heart beats. Because there is a small number of oxygen carriers, heart will try to pump the blood faster and faster in order to satisfy the tissues need for blood and oxygen. In the same time, heart needs oxygen for itself, working harder with less oxygen it is a very good condition for palpitation to occur. Persons that avoid eating meat, can have anemia, as the meat is the main source of iron.

How can we treat rapid heart beats after eating?

Preventing heart palpitation after eating should first start with a moderate diet and by this we mean to eat moderate amounts of food at regular intervals. It is not advisable to eat one meal after we starved ourselves an entire day. Regular meals in small proportion, regular exercise, losing weight and periodically check of the hormones level (since hormonal imbalance can determine heart dysfunction) are the solution to this medical issue.

Pinched nerve symptoms

Pinched nerve symptoms may result after injury or damage to a nerve and can occur in any part of the human body. Pinched nerve may result from direct pressure or compression on a nerve. Nerves are some organs that transmit information from the brain in our body and from our body in the brain. Nerves are distributed throughout entire the body and they are of two types: motor nerves and sensory nerves. Motor nerves allow the brain to send information to the body and command organs of the body. Sensory nerves transmit information from the body to the brain for processing and then to give an answer. Thus, patients may feel pain, numbness or burning feeling. This may be some pinched nerve symptoms.

Pinched nerve symptoms and locations

Pinched nerve symptoms depend on the location of nerves in human body. These appear in the part of the body that is affected. There are some pinched nerve symptoms that are common regardless of the nerves. This are pain (patient feels pain in the region innervated by that nerve), burning feeling (patients complain of burning sensation in the affected region) and change in symptoms based on body position (if the patient changes position the pain may disappear). Another pinched nerve symptoms are fecal incontinence (patient can control the stool) and urinary incontinence (inability to control urination). Also may appear decreased sensation in the affected area or numbness (patients feel affected region with tingling, feel that region asleep) and weakness (loss of strength). Feeling of weakness may occur in the whole body or a part of the body.

Other locations of pinched nerve symptoms

This may occur in the upper limb and can be caused by carpal tunnel syndrome (compression of the median nerve) or by cubital tunnel syndrome (compression of the cubital nerve). They are two nerves that innervate the upper limbs. Sometimes the pain may be to the neck and then the pinched nerve symptoms appear in the arm. If the nerve affected is in the low back, the pain can usually down to the leg. Usually can identify which nerve is affected because of where the pain occurs. One of the affected nerves is the sciatic nerve and this is a disease called sciatica.
When a person has some of the symptoms that have been discussed above, he must go to the doctor to diagnose a possible pinched nerve. The doctor will begin by asking the patient about the symptoms, work history and family medical history. Then the doctor will exam the affected part of the body involved for more information. Depending on these results the doctor can do additional tests.  If the pain is on the back or in the neck, the patient must make an X-ray of the spine for a possible differential diagnosis of arthritis.
Pinched nerve symptoms may be treated with rest or ice applied to the affected region. Various medications can be used for treatment of pinched nerve. Anti-inflammatory medications may reduce the inflammation. Another treatment for pinched nerve symptoms is physical therapy and as an extreme solution is surgery
Pinched nerve symptoms may persist and can give severe complications. These are peripheral neuropathy, carpal tunnel syndrome or cubital tunnel syndrome and tennis elbow (commonly found in tennis players and that is a condition in which the outer part of the elbow becomes painful).

              In conclusion pinched nerve symptoms may appear in different situations and patients with  this condition can be totally recovered.

What is cardiovascular disease?

We read very often about cardiovascular disease, about heart failure, heart attack, stroke and many other disorders, but we don’t know for sure what is cardiovascular disease, why and how it occurs and what changes occur in our body. Next, we will try to explain what is cardiovascular disease in the society of nowadays and how much did medicine advanced in this research field.

What is cardiovascular disease

A question that scientists succeeded to answer but failed to cure.

Nowadays, when more and more people are suffering from heart disease we may wonder what is cardiovascular disease and why is it the first cause of death in most of the countries. We invest millions of dollars on research, looking and testing a lot of drugs, we even found out what is causing AIDS (and we succeeded to transform it in a „chronic” disease) and many other disease with strange names. But all the time there is a new disease, a new virus or bacteria that gives us trouble to treat and sometimes it feels that the more drugs we discover, the more diseases occur. Even so, the most frequent cause of death are
cardiovascular disease, a group of diseases that seem to be entirely understood, with lots of article and medical research, that could make some wonder what else is left to discover. The truth it is far from being so, as with the medical treatment we have at this moment we can only slow down these disease and not cure. Even the prophylaxis of cardiovascular disease is not very promising as we live in the century of unhealthy foods, McDonald’s food, alcohol consumption, smoking, stress, sedentariness and we spend all out time watching TV and working on computer.
After we established how important these diseases are, now let’s finally find out what is cardiovascular disease.

What is cardiovascular disease? A group of disorders that affect heart, brain and blood vessels.

The most frequent cardiovascular diseases:

• hypertension: high blood pressure affects both brain and heart as it can determine bleeding (stroke) or small infarcts in the brain and also determine or worsen heart failure. Beside heart and brain, hypertension also affects eyes and kidneys.
• heart valve disease: valves fail to close or open properly and in time they can cause heart failure,
• irregular heart beats can cause fainting, shortness of breath, chest pain, fatigue or even heart failure,
• other heart tissues disorders: infection, metabolic disorders that affect heart (different disorders that can determine deposits of some substances in heart tissues like iron, copper etc)
• strokes: a blood cloth can block one of the brain blood vessels and make a variable brain area to die or a blood vessel may break and let blood flow into the brain (this usually occurs in patients with hypertension or with blood vessel malformations).
• atherosclerosis: fat deposits in the blood vessels wall that in time can determine strokes, heart attack, chest pain, arterial disorder with legs pain during walking and even during rest, in advanced cases, neurologic symptoms: dizziness, fatigue, fainting, drowsiness, memory and concentration dysfunction etc.

Now that we found out what is cardiovascular disease, let’s see how is treated. As we’ve seen, it is easy to answer what is cardiovascular disease, but is difficult to treat it. Treatment has two parts and two partners: the patient and the doctor. The patient should respect a healthy diet, with no salt, fats and sweets, attend regular exercise (jogging, running or any kind of sport), no smoking or alcohol consumption, keep a normal weight, control blood pressure and blood sugar. Doctors have a large number of drugs they can use, the purpose of this treatment is to slow down the disease and treat other disorders that may worsen cardiovascular diseases like high blood pressure, diabetes, high level of fats in the blood, infections, irregular heart beats etc. It is also important to prevent other cardiovascular events from happening, that’s why antiplatelet medication like aspirin is prescribed in patients that are suffering from cardiovascular disease.
We hope this article can offer a brief answer to the question what is cardiovascular disease and why this medical problem is so important in nowadays society.

Flu symptoms in adults

Flu symptoms in adults- different faces of the same disease

In the last years more and more people complain from flu symptoms and every year new vaccines are elaborated. People started to be very worried about flu symptoms in adults especially after the outbreaks of avian flu and AH1N1 virus, even if the “common” flu virus could cause death too. Because of the large number of people vaccinated, contradictory opinions about the efficiency and possible complications coming from the vaccination began to appear  and the result was that many people refused the vaccine.
People also searched for ways to strengthen the immunity system and they choose to use different types of medication based on plants. In clinical practice, because of the large number of patients that died even if they had no risk factors associated, doctors started to treat pneumonia with antiviral and antibiotic medication. But the more the antiviral medication is used, the more the risk of developing resistance to this treatment increases.

Next we will talk about flu symptoms in adults and its complication.

Why are we so concerned about flu symptoms in adults? For many of us, flu is just a common disease; we all had it at some point and as some use to say it lasts 7 days if you treated or one week if you don’t. But are flu symptoms in adults so insignificant that doesn’t worth talking about? This is a false idea among us that flu symptoms in adults are common manifestations. The truth is that in some people flu symptoms in adults can be as devastating as cancer or heart disease.
The main flu symptoms in adults:

• fever-some wrongly believe that fever is determined only by bacterial infection. It is a wrong idea, both viruses and bacteria can determine high fever and they can disseminate to other organs through blood,
• shivers- the feeling of body shaking
• sweating-the body tries to lose some water in order to decrease the temperature,
• headaches
• rhinorhea-water discharge from the nose as we call it
• cough-first it can start as a dry cough, but  in a few days expectoration can appear, considering that even viral infection can determine a secondary bacterial infection,
• sore throat with pains that increase while trying to swallow
• severe aches and pains in muscle and joints
• generalized weakness and fatigue, feeling the need of lying down,
• being unable to eat,
• nausea and vomiting.

Flu symptoms in adults usually last a few days (about a week), but in some cases other complication can occur:

• pneumonia- a flu symptom in adults that seems simple to deal, can  get complicated with a lower respiratory tract infection like pneumonia. In patient with reduced immunity as are those suffering from AIDS, these infections can be fatal, even if for many of us it can be a common disorder.
• invasion of the virus in other organs through blood flow, which leads to a condition called septicemia, one of the worst flu symptoms in adults and an important threat to patient’s life,
• meningitis-if the viruses reach the nervous system, they can determine meningitis, which is an infection of the tissues layers that cover the brain and are called meninges.
• shortness of breath or fast breathing, bluish skin color (the blood hasn’t enough oxygen)
• neurologic symptoms: dizziness, drowsiness, confusion
• fulminant myocarditis
• pulmonary embolism (blood clots in the pulmonary arteries) seems to be linked to the infection determined by AH1N1 virus,

Complications are more common in people suffering from respiratory, cardiac disease obesity and of course, those with diminished immunity (like patients with AIDS).
As we saw, flu symptoms in adults can be common or can be very serious, depending of the aggressiveness of the virus, the immunity system of the host, the risk factors associated, but it is important to remember that it can be fatal (about 40.000 people died every year, in USA, in the past 20 years, because of the flu).

Stents in the heart

Stents in the heart are small medical devices (small mesh tubes) used to treat narrowed arteries (arteries are blood vessels that carry blood from heart to the tissues). The procedure of placing stents in the heart is called angioplasty. Angioplasty alone, without stent placement is associated with a high risk of recurrence of the arterial blockage, in months or years after the procedure. That is why placing stents in the heart solved this disadvantage of the angioplasty, maintaining blood vessels opened and avoiding heart surgery. The risk that the arteries will renarrow is 10-20%  in the first year after angioplasty, while in the absence of a stent the risk is twice as much.

Stents in the heart are usually made of metal mesh or fabric (these ones are used in larger arteries). Some of these stents contain a special substance that prevent blood from coagulating and are called drug-eluting stents.

How are stents in the heart placed? 

Doctors use a balloon inside the artery to compress the plaque (deposits of fats in the arteries wall, also called atherosclerosis) and widen the passage (the arterial lumen through which will flow blood). After this, they place the stent in order to maintain the passage (the artery lumen) opened.

How do we prepare patients before placing stents in the heart?

Patients should be well informed about the stents in the heart procedure, about the risks and the special precautions. These are a few questions u must always ask your doctor about:

•  Why is it performed?
•  How is it performed?
•  What are the risks and precautions of this procedure?
•  Is there any other alternative?
•  What happens if I refuse this procedure?
•  Always sign a consent paper.

Why are stents in the heart placed for?

The purpose for stents in the heart placement is to keep the arterial lumen opened and allow blood to flow, in this way tissues will receive enough blood and the symptoms of ischemia (oxygen deprivation) will be relieved.

• For carotid arteries blockage: fat deposits in carotid arteries wall (also called plaques, they are a manifestation of the disease named atherosclerosis) can determine neurologic symptoms like dizziness, fainting, headache, memory and concentration problems and in severe cases even stroke.
• For coronary vessels (blood vessels that supply blood for heart tissues): a special tube called catheter is introduced in the femoral artery (the main artery of the lower limb) and it is conducted in the arterial system until it reaches the coronary arteries. In that moment, a special substance is pumped into the catheter in order to view the arteries and the blockage. This catheter has a tiny balloon on its tip, which is inflated in the narrowed area, compressing the atheroma (the plaque of fats from the artery wall that blocks blood flow) and enlarging the lumen. After this a stent may be placed to keep the lumen opened.
• For kidney or leg arteries, aneurysm of the aorta.
  

What are the common precautions after placing stents in the heart?

•  blood clotting precautions: in order to prevent blood clotting, patients with stents in the heart have to take antiplatelet medication (aspirin, clopidogrel)
•  if the stent is made of metal, than the patient can’t have MRI (magnetic resonance imaging)
•  avoid vigorous effort early after the stent placement procedure.
  

What risks are related to stents in the heart?

•  restenosis- blood vessel becomes blocked and narrow again, despite the angioplasty procedure
•  about 1 or 2 percent of the patients with a stented artery are at risk of developing a cloth at the stent site; the consequence of this complication can be a heart attack. This complication is more frequent in the first year after stent placement and can be prevented by antiplatelet medication (like aspirin, clopidogrel).
•  bleeding at the site of the catheter insertion into the skin
•  damage of the blood vessel produced by the catheter
•  irregular heart beats
•  infection or allergic reaction (due to the substance used to view the arterial lumen)

Stents in the heart brought a significant contribution in cardiology, saving and improving life in patients with heart attack and coronary disease.

Heart palpitations at night

Why do we have heart palpitations at night?

Before we discuss the matter of heart palpitations at night, we have to clarify the meaning of the word “palpitation” in general. Palpitations refer to irregular heart beats, usually the heart beats to fast, or with pauses from time to time and gives us an abnormal sensation, sometimes associated with dizziness, light-headed sensation, shortness of breath, chest pain etc.
We all had palpitation at least once in our life, and this doesn’t mean we have a heart disease, because these symptoms occur in healthy people during exercise or associated to stress, smoking, coffee. Even so, if the palpitation persist or are associated with shortness of breath, chest pain, fainting, dizziness, a doctor should be consulted as soon as possible.
Some patients complain they have heart palpitations at night, which prevent them from falling asleep or wake them up in the middle of the night.

Heart palpitations at night -causes:

Normal heart rate for an adult is 60-90 beats/minute. If the heart rate is higher the 90 beats per minute, then the condition is called tachycardia and can provoke palpitation. Not only rapid heart rate can cause palpitation but also irregular heart beats, known as arrhythmia, which is the main cause behind palpitation. Why some patients experience heart palpitations at night, during rest, when heart labor is smaller?
Heart palpitations at night can be determined by one of the following cause:

• too much stress and anxiety gathered during the daytime. It is a habit now that every time we go to sleep, we think again at the daily problems and try to find a solution, as it is said night is a good adviser. If your mind is concerned about certain problems happening in your life, you may be lying down and think about it over and over again, but the emotions and the psychical tension can generate palpitation.
• excessive consumption of caffeine before sleeping can generate insomnia and palpitation, if you drink a lot of coffee, especially before sleeping, you may consider giving up.
• smoking
• alcohol consumption
• medication-some drugs used to treat different diseases (like asthma, heart diseases, high blood pressure, cold) can determine palpitation: pseudoephedrine used in cold medication, theophylline for asthma etc.
• pregnancy
• fever-it is well known that body temperature elevation is associated with rapid heart beats and sometimes with palpitations
• vigorous exercise before sleeping
• breathing problems determined by lung diseases determine a low level of oxygen in the body, which can lead to heart palpitations at night
• heart problem-patients with heart failure may develop paroxysmal nocturnal dyspnea (shortness of breath that occurs suddenly during night in patient with left heart failure) and palpitations, forcing them to wake up and search for an open window to get fresh air
• hyperthyroidism (a higher level of thyroid hormones can determine irregular or rapid heart beats)
• elevated blood pressure

If I have heart palpitations at night-how can my doctor discover if there is something wrong in my body?
Yes it is possible. For patients that have these symptoms only during night it is difficult to  diagnose them during a simple medical visit, but if a special device called holter ecg is used, then this is no longer a problem. Holter ECG is a portable medical device that the patient “wears” for 24 hours and it records heart activity during this period of time.
Heart palpitations at night-treatment
Heart palpitations at night can be treated only after proper tests are made in order to establish the correct diagnosis. In many cases, palpitations have no serious cause and a short time treatment associated with a life style change can be the “cure”.
Special precaution in patients with heart palpitations at night:

• avoid consumption of alcohol, coffee, drugs (marijuana, cocaine) or smoking
• avoid stress and anxiety-there are many types of techniques used against anxiety (psychotherapy, sports, taking vacation, travelling etc.)
• sometimes medication is needed in order to control anxiety
• respect your hours of sleep
• avoid if possible the intake of medication that stimulate palpitations

Heart palpitations at night can be very uncomfortable, but sometimes a simple change in the  daily habits can make them disappear.

Heart pain in women

Heart pain in women: a symptom that begins to trouble most frequently after menopause, when due to the absence of  estrogen hormones, women lose their „natural” protection against cardiovascular events. According to the studies made among patients with heart attack, heart pain in women is not a hallmark symptom as it is in men. This means that during a heart attack, heart pain in women is less likely to occur and we must pay attention to other signs and symptoms if we don’t want to miss a heart disorder. Although women lose their protection against cardiovascular disease after menopause, estrogen replacement must be indicated only in well selected cases, because this treatment can determine breast or endometrial cancer, blood cloths and stroke etc.

How can estrogen hormones prevent heart pain in women?

It is simple. Estrogen has an important role in lipid metabolism: these hormones decrease the level of LDL-cholesterol and increase the HDL cholesterol (also called „the healthy” cholesterol as it protects against atherosclerosis). Estrogens tend to decrease serum cholesterol concentrations and to increase serum triglyceride concentrations. The overall effect of these changes, together with the effects on blood vessels, is to protect against atherosclerosis and heart pain in women before menopause. As atherosclerosis is the most important cause for heart attacks and chronic heart ischemia (heart disease caused by insufficient oxygenation of the heart tissues, which occurs when blood vessels are blocked by atherosclerosis) it is clear now why estrogen is so important and how can this hormone prevent heart pain in women.

Heart pain in women, what does it mean?

Heart pain in women or chest pain are very often among old patients and challenge the doctor to consider a lot of differential diagnosis, although sometimes it is almost impossible to separate them. For example, a pathology of the spine that presses nerve roots can determine an intense pain, sometimes unbearable, radiating towards the abdomen or chest and can easily mimic a heart pain. An esophagitis with burning sensation in the chest, can be mistaken as a heart symptom, but it responds well to the medication used in ulcer treatment and the duration of symptoms is variable. Heart pain in women doest mean necessary that it is a heart attack, sometimes it is caused by a heart muscle infection or disorder. Other causes for heart pain are abnormal dilated blood vessels called aneurism or chest trauma. In some patients, during heart attack, the pain is felt in the upper part of the abdomen and it can be confused with a stomach or liver disease (like ulcer, gastritis etc.).

How do we manage heart pain?

Heart pain it is always a very disturbing symptom, described by patients as a sensation of pressure on the chest or constriction, but sometimes, associated with palpitations (irregular heart beats), shortness of breath, fatigue, sweating, agitation or even fainting. In conclusion, heart pain in women and men  can be treated with beta-blockers (drugs that increase heart tissues oxygenation, an example of such a drug is metoprolole), calcium channels blockers (make heart blood vessels larger; e.g. amlodipine) or the well known nitroglycerin.

Replacement heart valve surgery

Valvular diseases (lesions of the four valves of the heart) in general have some common characteristics in terms of etiology, symptoms, clinical investigations but also others such as replacement heart valve surgery used in treatment.

Replacement heart valve surgery basics

There are four valves in our heart: mitral valve, aortic valve, pulmonary valve and tricuspid valve. These valves may have opening of valve problems (stenosis) or closing of valve problems (regurgitation). Interventional treatment (especially replacement heart valve surgery) is necessary when patients have symptoms for these lesions.
We can not expect that valve lesions consists have a spontaneously regressive evolution and therefore the most common method of treatment is the replacement hear valve surgery. There are cases when multiple heart valves are affected. The surgery is performed by repairing or replacing the heart valve. Replacement heart valve surgery is surgery that is performed when the valve can not be repaired and the heart valve is replaced with a prosthetic valve. Before replacement heart valve surgery patients will receive general anesthesia during which they will be asleep and will not feel pain. The most replaced valves are mitral valve and aortic valve. There two kinds of valves used for the replacement heart valve: mechanical valves and biological valves. Biological valves may come from pigs, cows or human donor. Biological valves from human donor may be heart valves or pulmonary valve especially for aortic valve replacement. Mechanical valves are much better then biological valves. After replacement heart valve surgery with mechanical valve patients must follow treatment with anticoagulants or with aspirin for the rest of his life.
Mitral stenosis and mitral regurgitation
Replacement heart valve surgery for mitral stenosis is indicated in patients suffering from medium or large stenosis (mitral valve orifice of less than 1 inch or symptomatic patients and mitral valve opening more than 1 inch).  The most common cause of mitral stenosis is rheumatic disease. Prophylactic replacement heart valve surgery for mitral stenosis may be made to women who want to have a child.
Replacement heart valve surgery can also be done for mitral regurgitation. But this can have some disadvantages: first because replaced valve can not function as original valve and second because may be some complications of surgery (embolism, infection in the body, coagulation changes or endocarditis – infections of heart valve).
Aortic stenosis and aortic regurgitation
Aortic valves are different from mitral valves such as structure and function. Replacement heart valve surgery is done both for congenital aortic stenosis and for acquired aortic stenosis. Indications for surgery can be done to symptomatic patients or to patients with moderate aortic stenosis who have other heart surgery.
Replacement heart valve surgery for aortic regurgitation is an easy surgery to replace aortic valve. Mortality of this intervention is quite high.
Complications related to valve replacement are increasingly rare lately and when they occur is necessary a new surgery.

In conclusion replacement heart valve surgery is a very good technique to solve valvular heart problems.