Condition - Arrhythmia

Cardiac dysrhythmia (also known as arrhythmia and irregular heartbeat) is a condition in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, which is considered as irregular. When a heart beats too fast, it is called tachycardia; when it becomes too slow, it is called bradycardia. If not managed properly, these heart palpitations can sometimes result in cardiac arrest.

AICD & Pacemaker keep in management of malignant tachycardia & bradycardia.

Palpitations can occur at any time - while you're simply sitting or walking normally as you carry out your daily activities.

Signs and Symptoms

At first, most of the patients may have no symptoms at all. Only a doctor can detect a sign of arrhythmia during a health examination. Even if a patient notices symptoms, it does not necessarily mean there is a serious problem. Ironically, some patients with life-threatening arrhythmias may have no symptoms, while others with symptoms may not have a serious problem. Some of the most common symptoms of arrhythmia are:

  • Breathlessness
  • Dizziness
  • Syncope (fainting, or near-fainting)
  • Fluttering in the chest
  • Lightheadedness
  • Sudden weakness
  • Angina (chest pain)
  • Concentration problems
  • Confusion
  • Difficulties when exercising

Causes of Arrhythmia

There is no single cause for this. Many things can lead to, or cause, an arrhythmia, including:

  • Anxiety, stress, fear, panic
  • Exercise
  • Pregnancy
  • Caffeine found in coffee, tea, chocolate, colas, some sports drinks
  • Certain medical conditions: overactive thyroid, low blood sugar, low potassium level, low oxygen level or low carbon dioxide level in the blood, fever, anemia, dehydration, loss of blood, shock
  • Certain medications: asthma inhalers and decongestants, beta blockers (taken for high blood pressure or heart disease), thyroid and anti-arrhythmic medications, and some medications that act as stimulants, such as cough and cold medicines, and some herbal or nutritional supplements
  • Illegal street drugs: cocaine and amphetamines (speed)
  • Nicotine found in tobacco products

Treatment

Most arrhythmias are considered harmless and left untreated. After your doctor determines that you have arrhythmia, he checks its severity whether it's abnormal or a regular heart process. If your arrhythmia is abnormal and clinically significant, your doctor will set a treatment plan. Below are the treatment options available to treat arrhythmia:

  • Antiarrhythmics - They are used to treat heart beat related disorders, called arrhythmias. Antiarrhythmics work in a variety of ways to slow the electrical impulses in the heart so that the heart can regain a regular rhythm.
  • Automated External Defibrillator – It is a kind of portable device that inspects the heart rhythm. If required, it can send an electric shock to the heart to restore a normal rhythm. It is commonly used to treat sudden cardiac arrest.
  • Calcium Channel Blockers - CCBs are effective medicines that have been shown to lower blood pressure and help prevent and treat the symptoms of angina (chest pain).
  • Cardioversion – It is procedure followed to restore a fast or irregular heart rhythm to a normal rhythm.
  • Catheter Ablation – It is a safe medical procedure to treat some types of arrhythmia and involves the use of radiofrequency (RF) energy.
Condition - Atrial septal defect

Atrial septal defect (ASD) is a kind of congenital heart defect that enables blood flow between the left and right atria via the interatrial septum. The interatrial septum is the tissue that divides the right and left atria. Without this septum, or if there is a defect in this septum, it is possible for blood to travel from the left side of the heart to the right side of the heart, or vice versa. This results in the mixing of arterial and venous blood, which may or may not be clinically significant. This mixture of blood may or may not result in what is known as a "shunt".

There are different types of atrial septal defects such as

  • Ostium secundum atrial septal defect
  • Sinus venosus atrial septal defect
  • Common or single atrium
  • Mixed atrial septal defect

Signs and Symptoms

Symptoms that do occur may begin at any time after birth through childhood, and can include:

  • Difficulty breathing (dyspnea)
  • Frequent respiratory infections in children
  • Sensation of feeling the heart beat in adults
  • Shortness of breath

Causes

While the baby is in the womb, there is normally an opening between the upper chambers of the heart (atria) to allow blood to flow around the lungs. This opening usually closes around the time when the baby is born. If the opening does not close, the hole is called an atrial septal defect, or ASD.

Treatment

The very first thing doctors do is to wait for a period of time to see if it closes on its own, while using medications. Many atrial septal defects close their own during childhood. For those that don't close, some small atrial septal defects don't cause any problems and may not require any treatment. But many persistent atrial septal defects eventually require surgery to be corrected.

  • Paediatric cardiology department at Max Healthcare provides all non-invasive diagnostic and paediatric cardiac interventional services.
  • Cardiac catheterization. A thin tube (catheter) is inserted into a blood vessel in the groin and guided to the heart. Through the catheter, a mesh patch or plug is put into place to close the hole. The heart tissue grows around the mesh, permanently sealing the hole.
  • Open-heart surgery. This type of surgery is done under general anesthesia and requires the use of a heart-lung machine. Through an incision in the chest, surgeons use patches or stitches to close the hole.
Condition - Cholesterol

Cholesterol is a type of fat, one which is a major building block of various substances including the cell membrane of every cell in our body, digestive juices released by the gall bladder and the sex hormones. Not all cholesterol is bad. We need some cholesterol for our bodily functions and the liver can make that easily in our body. But the problem starts when the level goes beyond necessary.

High cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack, and stroke. The higher your blood cholesterol is, the greater your chance of developing coronary heart disease.

Bad Cholesterol is scientifically referred to as LDL or Low Density Lipoprotein. The Bad cholesterol tends to block the arteries.

Good Cholesterol also known as the HDL or the High Density Lipoprotein acts as a cleansing agent cleaning up the bad cholesterol from the arteries.

Causes of high cholesterol

Like high blood pressure, high cholesterol (hypercholesterolemia) itself is not a disease, but a condition that can lead to some very important consequences-

  • Diseases like diabetes, some forms of thyroid, liver, and kidney diseases cause high cholesterol.
  • It's also most frequently caused by a combination of diet and genetic factors.
  • Even patients with great genes for cholesterol metabolism can overwhelm the system by pursuing an inactive lifestyle, gaining an imprudent amount of weight, and eating a high fat diet.

Signs and Symptoms

Most of the times there are no symptoms and this is the reason why it is advised to get your cholesterol levels checked by a doctor regularly. People who do not suffer from any heart disease or high cholesterol; it is recommended that the level be checked every 2 years.

Treatment

High blood cholesterol is primarily treated with lifestyle changes and medicines. The major objective of treatment is to lower your low-density lipoprotein (LDL) cholesterol level enough to reduce your risk for coronary heart disease, heart attack, and other related health problems.

  • Consuming whole-grain cereals such as oatmeal and oat bran, fruits such as apples, bananas, oranges, pears, and prunes, legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans
  • Including daily physical activity such as walking, running, swimming etc.
  • Maintaining low weight can help lower cholesterol
  • Consumption of drugs like STAIN
Condition - Heart Attack

A heart attack (Myocardial Infarction (MI) or Acute Myocardial Infarction (AMI)) is the interruption of blood supply to a part of the heart which causes heart cells to die. It generally occurs when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. The blood clot that causes the heart attack usually forms at the site of rupture of an atherosclerotic, cholesterol plaque on the inner wall of a coronary artery. The most common symptom of heart attack is chest pain. The risk factors for heart attack include high cholesterol levels, elevated blood pressure, tobacco use, diabetes, male gender, and a family history of heart attacks at an early age.

Signs and Symptoms

Although chest pain is the most common symptom of a heart attack, there are a variety of symptoms including:

  • Pain, fullness, or squeezing sensation of the chest
  • Jaw paint, toothache, headache
  • Shortness of breath
  • Nausea, vomiting
  • Sweating
  • Heartburn
  • Arm pain

Causes of Heart Attack

A heart attack happens due to the sudden blockage of the coronary artery carrying oxygen-rich blood to a section of heart. Most heart attacks occur as a result of coronary heart disease (CHD). The most common causes of heart attack include:

  • Coronary Atherothrombosis
  • Intake of certain drugs, such as cocaine
  • Emotional stress or pain
  • Exposure to extreme cold
  • Cigarette smoking

Treatment

The treatment for a heart attack should start as early as possible in order to ensure minimum damage to heart and brain. In most of the cases, medical professionals begin diagnosis and treatment even before the patient gets to the hospital. Treatment procedures for heart attack include:

  • Primary PTCA (Ballooning of occluded artery) is the treatment of choice for heart attack.
  • Oxygen Therapy is a kind of therapy that provides patient with extra oxygen, which in turn helps his body to work well. Oxygen is supplied to lungs through nasal cannula, face mask, or a small tube inserted into your windpipe.
  • Aspirin is given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac tissue.
  • Nitroglycerin is given to reduce your heart's workload and improve blood flow through the coronary arteries.
  • Medicines such as Beta blockers, ACE inhibitors, Anticoagulants, Anticlotting medicines etc.
  • Coronary artery bypass grafting (CABG) is used to treat heart attack in which a surgeon removes a healthy artery or vein from the body and connects it to the blocked vein or artery.
  • Angioplasty is a non-surgical procedure which aims at the opening of blocked or narrowed coronary arteries. This procedure is also called percutaneous (per-ku-TA-ne-us) coronary intervention, or PCI.
Condition - Heart Failure
Heart failure means the heart is:
  • Weakened
  • Unable to pump enough blood to supply the body's needs.

The effect on the body when heart is failed
  • Not enough blood circulates.
  • Fluid builds up, creating congestion.

Symptoms of Heart failure Think FACES
  • Fatigue
  • Activities limited
  • Chest congestion
  • Edema or ankle swelling
  • Shortness of breath

Ejection Fraction- Ejection Fraction refers to the fraction of blood the heart pumps out with each beat.
  • Healthy heart = 60% or more.
  • Heart failure = 40% or less.
  • Ejection fraction less than 20% means your survival is limited.

Treatment
The candidates for heart transplant
  • Patient already undergone other cardiac surgery like CABG or valve replacement and Still Symptomatic.
  • Patient has weak heart like Dilated Cardiomayopathy or restrictive CMP and Low Ejection Fraction.
  • Other surgeries can not give benefit like CABG or Valve replacement.

When to go for transplant
  • Patients should receive maximal medical therapy before being considered for transplantation.
  • Patient should also be considered for alternative surgical therapies including CABG, valve repair / replacement, cardiac septalplasty, etc.
  • Transplant is the only option for greatest survival benefit.
  • Other is LVAD (Left ventricular assist device) if heart is not available for transplant.

LVAD - Left ventricular assist device

The left ventricular assist device, LVAD helps the heart pump oxygen-rich blood throughout the body. Heart is not replaced by LVAD as it is a mechanical device which pumps the blood and restores the normal blood flow to a person whose heart has been weakened.

Condition - Hypertension

Hypertension or High blood pressure is a chronic medical condition in which the blood pressure in the arteries increases. This requires the heart to work harder than usual to circulate blood through the blood vessels. Blood pressure is determined by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxing between beats (diastole). Normal blood pressure at rest is within the range of 100-140mmHg systolic (top reading) and 60-90mmHg diastolic (bottom reading). High blood pressure is said to be present if it is persistently at or above 140/90 mmHg. Hypertension is a major risk factor for stroke, myocardial infarction (heart attacks), heart failure, aneurysms of the arteries (e.g. aortic aneurysm), and peripheral arterial disease.

Signs and Symptoms

In today's hectic lifestyle, a large number of people are suffering from high blood pressure. Most of the time, high blood pressure goes untreated and damages arteries and vital organs throughout the body. This is why it is called the "silent killer". Some of the most common symptoms are:

  • Headache
  • Dizziness
  • Blurred Vision
  • Nausea and vomiting
  • Chest paint and shortness of breath

Causes

In most of the cases, the cause of high blood pressure is not known and is often referred to as primary or essential hypertension. However, some major causes of high blood pressure include:

  • Age - The older a person is, the greater the possibility that he or she will develop high blood pressure. This is due to arteriosclerosis, or "hardening of the arteries."
  • Family history - The problem of high blood pressure tends to run in families.
  • Obesity - Being overweight increases the risk of high blood pressure. Health care professionals recommend that all obese people with high blood pressure lose weight until they are within 15% of their healthy body weight.
  • Alcohol consumption - Drinking more than two drinks of alcohol per day increases the chances of high blood pressure.
  • Lack of exercise.
  • Medications - Certain drugs, such as amphetamines (stimulants), diet pills, and pseudoephedrine tend to raise blood pressure.
  • Young patients can have high BP due to kidney disease.

Treatment

The best treatment for high blood pressure is to make healthy changes to your lifestyle. One needs to take a stepwise approach beginning with diet, weight loss, and lifestyle changes along with medications as required.

  • Medications – if you occasionally feel that you have elevated high blood pressure, your doctor would suggest few medicines that will bring down the blood pressure to normal.
  • Avoid tobacco smoke
  • Maintain a healthy weight
  • Take a healthy diet
  • Limit your salt intake
  • Do regular physical activity
Condition - Lymphedema

Lymphatic obstruction or Lymphedema is typically a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed. Lymphatic obstruction may cause lymphedema, which means swelling due to a blockage of the lymph passages.

Signs and Symptoms

The main symptom of lymphedema is persistent swelling, usually of the arm or leg.

Causes

Causes of lymphatic obstruction include:

  • Infections with parasites such as filariasis
  • Injury
  • Radiation therapy
  • Skin infections such as cellulitis
  • Surgery
  • Tumors

Treatment

Treatment for lymphedema includes:

  • Compression (usually with multilayered bandages)
  • Manual lymph drainage (MLD)
  • Range of motion exercises
Condition - Patent Ductus Arteriosus

This is actually a condition in which the ductus arteriosus does not close. The ductus arteriosus is a blood vessel that allows blood to go around the baby's lungs before birth. Soon after the infant is born and the lungs fill with air, the ductus arteriosus is no longer needed. It usually closes in a couple of days after birth.

Signs and Symptoms

A small PDA may not show any symptoms. Some infants may have symptoms such as:

  • Fast breathing
  • Poor feeding habits
  • Rapid pulse
  • Shortness of breath
  • Sweating while feeding
  • Tiring very easily
  • Poor growth

Causes

This is true that PDA affects girls more often than boys. This condition is more common in premature infants and those with neonatal respiratory distress syndrome. Its causes are:

  • Infants with genetic disorders such as Down syndrome
  • Mothers with rubella during pregnancy
  • Babies with congenital heart problems such as hypoplastic left heart syndrome transposition of the great vessels, and pulmonary stenosis

Treatment

In premature babies, PDA closes within the first 2 years of life. If a child is full-term, a PDA rarely closes on its own after the first few weeks.

  • Medications are primarily used to treat PDA as they work very well for some newborns, with few side effects. The earlier treatment is given, the more likely it is to succeed.
  • A medical procedure is used if medications don’t work well or can’t be used.
  • Catheter procedure is carried out in which a thin, hollow tube placed into a blood vessel. The doctor passes a small metal coil or other blocking device through the catheter to the site of the PDA. This blocks blood flow through the vessel. These coils can help the baby avoid surgery.