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Introduction:
World Heart Day
on 30 September 2007
World Heart Day was established to create public awareness of risk factors for heart diseases and stroke and to promote
prevention. Cardio-vascular diseases - including heart attacks and strokes - are the world’s largest killer, claiming 17.5 million lives a year. There are 155 million overweight and obese children globally.
The WHO (World
Health Organisation) estimates that in 2006, 3 millions people die
of cardiovascular (CVD) disease such as heart disease and stoke in
India. A heart attack is an event that results in permanent heart damage or death. It is also known as a myocardial infarction, because part of the heart muscle (myocardium) may literally die (infarct). A heart attack occurs when one of the coronary arteries becomes severely or totally blocked, usually by a blood clot. When the heart muscle does not receive the oxygen-rich blood that it needs, it will begin to die. The severity of a heart attack usually depends on how much of the heart muscle is injured or dies during the heart attack.
Heart attacks can occur both with and without warning signals.
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Basics of Heart
The heart is the pump station of the body and is responsible for circulating blood throughout the body. It is about the size of your clenched fist and
lying in the chest cavity between two lungs. Its walls are made up of muscle that can squeeze or pump blood out every time that the organ "beats" or contracts. Fresh, oxygen-rich air is brought to the lungs through the trachea
or windpipe every time that you take a breath. The lungs are responsible for delivering oxygen to the blood, and the heart circulates the blood to the lungs and different parts of the body.
The heart is divided into 4 chambers like a duplex apartment that is made up of a right and a left unit, separated from each other by
a partition wall known as a Septum. Each "duplex" is subdivided into an upper and a lower chamber. The upper chamber is known as an ATRIUM
while the lower chamber is referred to as a VENTRICLE
The right atrium (RA) sits on top of the right ventricle (RV) on the right side of the heart while the left atrium (LA) sits atop the left ventricle (LV) on the left.
The right side of the heart is responsible for sending blood to the lungs, where the red blood cells pick up fresh oxygen. This
oxygenated blood is then returned to the left side of the heart. From here the oxygenated blood is transported to the whole body supplying the fuel that the body cells need to function.
The blood cells of the body extract or removes oxygen from the blood. The oxygen-poor blood is returned to the right atrium, where the journey began. This round trip is known as the
circulation of blood.
There is an opening between the right atrium (RA) and the right ventricle
(RV) is actually a valve known as the Tricuspid valve. It has three flexible thin parts, known as leaflets, that open and shut.
The tricuspid valve serves as a trapdoor valve that allows blood to move only in one direction - from RA to RV. The MITRAL valve
allows blood to flow only from the left atrium to the left ventricle.
Thus oxygenated blood is pumped by the left ventricle to all parts of the body, other than the lungs. The body tissue removes much of the oxygen for its own need. The blood, which is now carrying less oxygen, returns to the heart. Blood from the head, neck and arms return to the right atrium (RA) via the SVC or SUPERIOR VENA CAVA. On the other hand, blood from the lower portion of the body returns to the RA via the IVC or INFERIOR VENA CAVA.
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The aorta is the main "highway" blood vessel that supplies blood to
all parts of the body. The cells within each part of the body pick up oxygen and nutrients from the blood. The oxygen-poor blood then returns to the RA, via the superior and inferior vena cava, and
in this way beats goes on.
What is Heart disease?
A heart disease or heart attack occurs when the supply of oxygen-rich blood to the heart is disrupted, usually by a blood clot in one of the coronary arteries that supply the heart with blood. The heart is composed of a special kind of muscle that never rests and therefore has high oxygen requirements. When the heart muscle is deprived of oxygen for even a brief period of time, the myocardial tissue begins to die (infarct). Medically, heart attacks are known as myocardial infarctions.
Coronary artery disease is the leading cause of heart attacks called "hardening of the arteries,"
characterized by fatty plaque deposits that gradually block
arteries. Studies have shown that elderly people who have elevated CRP levels (above 3 milligram/liter, or 3 mg/L) have about a 45 percent increase in the risk of developing coronary artery disease.
C-reactive protein (CRP) is produced in response to inflammation.
Higher CRP levels correspond with increasing age, body mass index, blood pressure and smoking status. There is also some evidence to suggest that CRP actually damages arterial walls by itself.
Similarly to CRP, high levels of IL-6 are associated with excess alcohol intake, diabetes and lack of exercise. Heart disease can arise from congenital
defects, infection, narrowing of the coronary arteries, high blood pressure, or disturbances.
The first stages of heart disease are lesions and cracks forming in the blood vessel walls normally at the points of highest pressure or stress (near the heart). The second stage is the body trying to repair itself by depositing fatty substances (cholesterol, lipoproteins) inside the blood vessels to fill the
cracks. Over time, without the proper body nutrient, vitamin C, to help keep the blood vessel walls
from cracking and requiring constant repair, these fatty substances can begin to build up and clog the
blood vessels causing stroke and heart attack.
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Types of Heart disease
The major types of heart disease are (i) atherosclerosis,
(ii) coronary, (iii) rheumatic, (iv) congenital, (v) myocarditis, (vi) angina and
(vii) arrhythmia.
Atherosclerosis: Atherosclerosis means "hardening of the
arteries" which is build up of cholesterol and other fat substances within the walls of the arteries.
It is a common disorder of the arteries caused by fatty deposits called plaque, build up on the inner wall of the coronary arteries.
Plaque is composed of a porridge-like accumulation of cholesterol and their compounds within a fibrous
coat which is very hazardous. Atherosclerosis affects medium and large sized arteries in the body. It
frequently affects the aorta, the coronary arteries, the cerebral arteries (which supply the brain) and sometimes arteries in the legs and
abdomen. If the blood supply to the heart muscle is reduced, a heart attack can
occur and when the blood supply to the brain is cut off, a stroke can occur.
Symptoms of atherosclerosis vary between individuals. They include shortness of breath and tightening pain in the chest.
Coronary Heart Disease: Coronary heart disease is the most common form of heart disease.
Coronary heart disease occurs when some of the arteries that carry blood to the heart muscle
become narrowed with fatty deposits. In this condition fatty deposits called plaque, composed of
cholesterol and fats, build up on the inner wall of the coronary arteries. When arteries are narrowed, the heart is not fully supplied with the oxygen and other nutrients it needs.
When an artery is completely blocked, a heart attack occurs.
Faulty lifestyle such as fatty diet, lack of physical exercise, smoking, and stress
are the major factors responsible for this type of heart disease. The risk of
coronary heart disease increases as blood cholesterol levels increase.
To diagnose and measure the extent of coronary heart disease is through the use of coronary
angiography.
Rheumatic Heart Disease: Rheumatic fever causes rheumatic heart disease. Rheumatic fever
results from an untreated strep throat. Rheumatic fever can damage the heart
valves. If the heart valves are damaged, they will fail to open and close properly. When this damage is permanent, the condition is called Rheumatic Heart Disease.
To prevent rheumatic heart disease is to seek immediate medical
treatment to a strep throat and not let it progress to rheumatic fever.
Congenital heart Disease: Congenital heart defects are heart defects that are present at birth.
Some infants with congenital heart disease may fail to thrive and may have breathing difficulties.
Myocarditis heart Disease: Myocarditis is a caused by inflammation of the muscle of the heart.
It may be a complication during or after various viral, bacterial, or parasitic infectious diseases, such as polio, influenza, rubella, or rheumatic fever.
These infection in the heart can lead to irreversible heart muscle damage and heart failure.
Angina heart Disease: Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).
Angina usually indicates a partial blockage in blood flow to the
heart and the pain in the chest occurs when the heart muscle isn't getting as much blood as it needs to function.
Angina can also be a warning sign of heart attack. Increased heart rate, increased blood pressure, chest pain described as a feeling of
tightness, pressure, heaviness, squeezing, or burning are the symptoms
of Angina. Other symptoms include burning in throat, feelings of indigestion and shortness of breath.
Arteriosclerosis is the leading cause of angina. There are different types of angina. The two major types are Variant
angina pectoris and Micro vascular angina.
Arrhythmia heart Disease: Arrhythmias are abnormal rhythms of the heart. They cause the heart to pump blood less effectively. Arrhythmias can be divided into two main categories ventricular and supraventricular. Supraventricular arrhythmias occur in the heart's two upper chambers called the
artium. Ventricular arrhythmias occur in the heart's two lower chambers called the
ventricles. Supraventricular and Ventricular arrhythmias are again
defined according to the speed of the heartbeats of
heart. A normal heart beats between 60 and 100 times a minute.
A very slow heart rate is called bradycardia. In bradycardia, the heart
rate is less than 60 beats per minute. A very fast heart rate is called Tachycardia
when the heart beats faster than 100 beats per minute. A fast uncoordinated heart rate is called Fibrillation.
Risk factors and Causes
Several factors
responsible to
promote heart disease process are known as risk factors.
Risk factors can be either controllable (e.g., diet, exercise and smoking) or uncontrollable (e.g., age, gender).
Researchers have found that: Patients with unstable plaque deposits are at greater risk for a heart attack than those with compact, calcified plaque deposits. Some researchers have tried to develop methods to determine the degree of calcification, which may help predict the risk of heart attack.
People with chronic kidney disease tend to have high blood pressure, which places added stress on waste-removing filters in the kidney. Uncontrolled high blood pressure also contributes to heart disease.
People with high levels of a certain type of lipoprotein called Lp (a) in the blood may be at increased risk of heart attack.
The risk of heart disease increases due to metabolic syndrome that
are elevated fasting blood glucose levels, abdominal obesity, high LDL
cholesterol levels, high triglyceride levels and high blood pressure.
The risk also increases due to infectious diseases, such as influenza, destabilize plaque and increase risk of plaque rupture.
Sign and Symptoms
The majority of people who suffer a heart attack experience symptoms that are often severe and frightening.
Some of the symptoms of a heart attack are:
(i) Chest pain that is unrelieved by rest and often spreads or radiates through the upper body to the arms, neck, shoulders or jaw.
(ii) Chest-area pressure, discomfort or squeezing sensation that may be either constant or
intermittent.
(iii) Shortness of breath or shallow breathing.
(iv) Heart palpitations, in which the heartbeat is fast, strong or obviously irregular.
(v) Abnormally weak and/or fast pulse.
(vi) Fainting (syncope) or loss of consciousness.
(vii) Feeling tired or fatigued, sweating, often heavy and often cold,
nausea or upset stomach, gray facial color etc.
Women may not experience chest pain during heart attack , but may experience shortness of breath, weakness, unusual fatigue and cold
sweats. They may instead feel pain high in the abdomen or chest, or in the back, neck or jaw.
Some people experience no symptoms and can have a silent heart attack without knowing it.
What is cholesterol?
Cholesterol is a soft, waxy and fatty lipid found in the body tissues and blood plasma of
men and animals. It is sparingly soluble in water, but much more soluble in some organic solvents.
Cholesterol is a natural and necessary component of your body cells and many hormones.
It is produced in the liver, the adrenal glands and reproductive organs.
Cholesterol is a natural and necessary component of your body cells and many hormones.
Cholesterol becomes harmful when high levels are present because
its high levels in the bloodstream are associated with hardening of the arteries, premature coronary heart disease and many other vascular disease problems.
Excess of blood cholesterol levels are one of the major risk factors for heart disease.
To control Cholesterol reduce high-fat dairy products. High fat dairy products are sour cream, cream cheese, hard cheese, processed cheese, butter, whipped cream and whole milk. Some low-fat dairy products are: yogurt, cottage cheese, low-fat or non-fat milk.
Reduce the amount of fat you use in your food. Steam vegetables instead of frying them.
Eat more fruits and vegetables. Vegetables and fruits contain very little fat. They are full of nutrients, fiber, and antioxidants.
Green vegetables like spinach, broccoli and leafy vegetables contain substantial amounts of a substance called lutein. High levels of lutein in the blood are associated with a reduced buildup of cholesterol.
Be aware of the hidden fat in your diet. Danish, pastries and cookies have large amounts of oil and fat.
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Diagnosis methods
When a patient has symptoms of a heart attack, the physician will promptly evaluate the patient's
medical history and run tests such as:
Electrocardiogram (EKG): A recording of the heart's
electrical activity as a graph, or series of wave lines, on a moving strip of paper or video monitor. The highly sensitive electrocardiograph machine helps detect heart irregularities, disease and damage by measuring the heart's rhythms and electrical impulses.
Blood tests: Blood tests can be used to detect the presence of certain markers
that are released following a heart attack. These include troponin,
myoglobin, creatine phosphokinase (CPK) and creatine kinase MB.
Radionuclide imaging: A branch of nuclear medicine that introduces small, harmless amounts of radioactive materials
into the body. A special gamma camera is then used to scan the radioactive tracers and create visual images of the heart.
Echocardiogram of the heart. This test uses sound waves to track the structure and function of the heart. A moving image of the patients beating heart is played on a video monitor, allowing the physician to study the heart's
thickness, size and function. The image also shows the motion pattern and structure of the four heart valves.
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Treatment Options
The chance of surviving a heart attack depends on the treatment that is given within the first hour of the heart attack.
Most of heart attack patients who reach the hospital alive survive the event.
If the patient goes into cardiac arrest, immediate death may be avoided if someone on the scene can administer CPR (cardiopulmonary resuscitation) within the first five minutes following the attack.
In most cases CPR can keep a victim alive until help arrives.
If a patient experiencing a heart attack it should be taken to hospital
immediately rather than to wait. While on the way to the hospital, patients are often told to begin chewing aspirin, which inhibits blood clots and has been shown to reduce the risk of death.
In a hospital or other emergency care facility, patients experiencing a heart attack may be given medications to prevent further blood clots and to take the strain off the heart. These medications include beta
blockers, calcium channel blockers, anticoagulants and nitrates. The patient may also be given
medications known as clot busters, the only medications able to dissolve an existing blood clot.
Physicians determine the type of treatment needed based on the patients current condition and the underlying cause of his or her heart attack.
Treatment for a heart attack may include one or more procedures to open any blocked coronary arteries, including:
Balloon angioplasty, implanting stents, Coronary artery bypass graft (CABG),
Off-Pump Coronary Artery Bypass and the new technique infusing stem
cells.
Prevention methods
Adopt healthy
lifestyle habits that have been shown to prevent heart attacks, such as exercising,
eating a heart-healthy diet, smoking etc. The most effective
preventive methods are:
1. Improving your cholesterol ratio
2. Exercising regularly. Exercise can be an excellent tool in the both prevention of heart disease and improving quality of life for heart
patients.
3. Maintaining a healthy weight. Obesity and being overweight are major risk factors for a host of serious health conditions, including coronary artery disease, high blood pressure, diabetes, heart
attack and stroke.
4. Eating a healthy diet. Health is largely determined by what people choose to eat. Certain B-vitamins and minerals have been shown to be helpful to heart health.
Include maximum amount of fruits and green vegetables in your diet. Never
use fast food or junky food.
5. Quitting smoking: Tobacco smoking is a major cause of coronary artery disease and cardiac arrest.
6. Controlling blood pressure: . Individuals with high blood pressure
are at greater risk of heart attack and other problems resulting from cardiovascular disease.
7. Controlling diabetes: People with diabetes may be more likely to develop heart-related diseases. Good glucose control is essential for all diabetics, as well as weight loss and a healthy diet.
8. Anxiety and stress management: Stress, excessive anger and fatigue can lead to high-risk practices such as overeating, smoking, high blood pressure
and a lack of exercise.
9.Treatment of chronic depression: Depression has been linked with a higher risk of developing high blood pressure, heart disease and having a heart attack.
10. Lifestyle modifications: Lifestyle style changes have a major impact on
patient heart health. Sound sleep, regular work time, anxiety free
life, regular exercise, positive thinking, laughing (join a laughing
club), no alcohol consumption, simple and truthful living, observing
principle of Ahimsa are the practical ways to get rid of your heart
disease.
What is a stroke?
A stroke, also called cerebrovascular or
CVA, is damage to the brain due either to blockage in blood flow or to loss of blood from blood vessels in the brain. Blockage in blood flow or loss of blood causes the brain to lack oxygen and blood nutrients.
A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or becomes blocked. Vessels can be blocked by blood clots or other particles.
Several different mechanisms may result in stroke such as thrombus formation, embolus, and hemorrhage.
Thrombosis formation is an obstruction within an artery resulting from the gradual accumulation of plaque.
Embolus is an obstruction of an artery due to material formed elsewhere in the body
or heart. Hemorrhage results from a rupture of a blood vessel located in the brain.
A stroke may also develop paralysis in one or both sides of the body.
Stroke affects different people in different ways. It depends
on the type of stroke, the area of the brain affected and the extent of the brain injury. Brain injury from a stroke can affect the senses, motor activity,
speech and the ability to understand speech, behavioral patterns, thought patterns, memory and
emotions. Paralysis or weakness on one side of the body is common. A stroke can also affect seeing, touching, moving and
thinking. Stroke affects the ability to talk, listen, read and write.
This type of stroke's weakens the body's right side. A stroke can affect muscles used in talking
as the tongue, palate and lips.
The major signs of stroke are facial weakness, inability to talk, loss of bladder control, difficulty in breathing and swallowing, and paralysis or weakness, particularly on one side of the body.
High blood pressure, heart disease, smoking, atherosclerosis, diabetes, migraine headaches, high levels of tryglycerides
and use of birth control pills will increase the risk of having a stroke.
For the immediate treatment of stroke needs immediate hospitalization, possibly including intensive care and life support.
There is no known cure for a stroke.
Ayurvedic Medicines
In Ayurvedic cure, Arjuna (Terminalia
arjuna) is the drug of choice for the treatment of heart disease. Arjuna
is a big tree and its bark is used as medicine. The powder or decoction of
its bark is given to the patient during and even after the attack. The
powder is given to the patient in a dose of 1 gm., four times a day.
There are many preparations of this drug, arjuna, Arjunarishta is commonly
used by physicians.
At the time of acute attacks, Mrigamadasava s the ideal drug. It is
a liquid medicine and given to the patient in a dose of 1/2 to 1
teaspoonful mixed with equal quantity of water.
Yoga can cure heart disease
Regular yogic
asana, pranayam will reduce the risk of heart disease.
Continue...
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