Reasons for Congestive Heart Failure

Congestive Heart Failure can occur because of either the failure of the heart’s loss of strength to forward pumping following heart muscles’ weakness (systolic dysfunction) or because of impairment of heart to relax. It can also be the abnormal demand for blood by body tissues that cause heart failure.

The symptoms of Congestive Heart Failure

The symptoms vary widely depending on the organs involved and how the body has reacted to this by way of ‘adjusting’ to the new situation. However fatigue is an early indication though it is not conclusive as it is non specific. Diminished strength to exercise and even walk, short breath, edema (swelling in ankles and legs) and sweating are some of the obvious symptoms. Increased urination due to accumulated fluids, gasping for breath and sleeplessness may be noticed. You can loose appetite and in some of you nausea can be possible.

Causes of Congestive Heart Failure

The most common cause is the coronary artery disease and hyper tension (high blood pressure). More often than not, alcoholism of long standing and smoking are also the causes of heart failure. You cannot disregard palpitations, malfunctioning of heart valves too. Medications like ibuprofen and naproxen retains sodium in the body and in turn leading to Heart Failure. Role of diabetes cannot be ruled out in Heart Failure.

Congestive Heart Failure is not known to be contagious but can attack any one without age, sex or racial discrimination.

Your doctor may advice you to avoid strenuous workouts and long exposure to Sun. Smoking is one thing you will have to avoid. Especially so when your age is 50-55 years, you need to give up smoking. Foods with high fat and cholesterol levels and sodium are better avoided.

Life Expectancy of Congestive Heart Failure Patients

Life expectancy is a number obtained by dividing total number patients by new incidences diagnosed in a year. However there is no yardstick to predict a heart patient’s life expectancy accurately. But going by the

High intensity, short duration work outs like sprinting breaks down phosphocreatine into creatine and phosphate. This releases a huge amount of energy and is used to regenerate ATP – A major source of energy for cellular reactions, available in muscles. Use of creatine is increasing because of its high energy releasing abilities in a short duration. A study tells us athletes have almost consumed up $1.4 billion of creatine. Creatine helps build high muscle mass with extra energy.

Creatine and High Blood Pressure

Creatine kinase is an enzyme found in brain, muscle and other tissues that catalyzes the conversion of ADP and phosphocreatine into creatine and ATP. This enzyme regulates,transports and stores creatine to receptor cells (sites of consumption). The contraction process and active membranous transport of these sites are enhanced by the now readily available ATP. The enhanced activity can be found in cardiovascular muscle and other high activity demanding tissues. The result of this increased metabolic activity is increased trophic response and increased ability of renal tubes to retain sodium salt. However it is still a matter of controversy that creatine is directly connected to high blood pressure, the increased sodium level sure affects your blood pressure especially if your physiological level is high.

Who are suspect to higher blood pressure with creatine presence?

A random study that was recently conducted finds interesting facts. The systolic and diastolic blood pressure levels were found higher at 9 mm and 5 mm in people with high creatine presence than others. This was normal in case of people of African origin. It was also noted that those with greater metabolic activities are likely to have higher chances of blood pressure owing to their higher energetic capacity.

Symptoms of High Blood Pressure following Creatine Use

Dizziness, diarrhea, upset stomach, fatigue, weight gain, kidney damage are the usual symptoms. Urine test can uncover whether your kidneys are functioning alright or not by higher creatine presence. Long term side effects of creatine use are not still clear.

What is lecithin and what does it do to cholesterol?

Lecithin is a well tolerated surfactant used as a fat emulsifier. Lecithin is approved by FDA as
a safe additive that metabolizes entirely, so has no effect on kidneys. The major composition of
lecithin is vitamin B, inositolp, linoleic acid and choline apart from phosphoric acid.

Most researches till date have found lecithin to being helpful in emulsifying and lowering fats.
The test had been conducted by giving up to 5 spoons ful of lecithin for about 4 months. They
have been found to have reduced cholesterol. Though high pitched claims of lecithin reducing up
to 41% cholesterol are not confirmed yet, cholesterol under the influence of Lecithin emulsifies
and so looses stickiness to arterial walls. Apart from atherosclerosis it prevents thrombosis and blood clots too.

Natural sources of lecithin

Lecithin is a natural ingredient in our food. But beware, vegetable sources like the soyabeans,
have mostly (80%) unsaturated fatty acids as compared to animal sources that have high level of
saturated fatty acids. (Saturated fatty acids are sticky in nature).

What are glyconutrients?

Glyconutrients are carbohydrates that contain sugar. Glyco in Greek means sugar and just about any nutrient attached to sugar is a glyconutrient. For example glycoprotein is a glyconutrient that has sugar and protein. Glyconutrients are found adhereing to cell surfaces in our bodies as microscopic molecules of fats and proteins. These glyconutrients are essential for cell to cell communication.

Glycoforms (a form of sugar) helps keep body’s hormonal balance, encourage blood clots, motivate white blood cells in their disease fights and most of all creates a communication network between cells.

How does glyconutrients help heart disease?

As of now glyconutrients are rated as essential nutrients and till now the focus was on proteins. Glyconutrients are recently being hailed as sweet of health or law of life. And as we are all aware of the importance of balanced diet, glyconutrients are becoming a part of our nutrition.

Many have expressed hope that glycopnutrients have the potential of unraveling the secrets to heart disease and its prevention. This is being projected as the next generation invention and an all encompassing answer to diseases of heart.

Do glyconutrients hold any future?

Like amino acids, glyconutrients have some of the vital information coded in them. This mysterious information when disclosed, may unleash a lot of truth about metabolisms, growth mechanisms and most importantly about diseases. Already there are talks of glyconutrients reversing heart disease or at least having some kind of connection to it.

Scientists are excited about the possibility of all these but are treading a cautious step. There is still a long way to go and the learning has just begun to understand the ‘sweet language of life’.

Why medication for heart patients?

Medicines such as digoxin, beta blockers (atenolol and metaprolol) help reduce palpitations (rapid heart beat) in patients. Heart beat increases for various reasons and sustained rapidness needs to be normalized. This can be a warning signal.

Ibutilide is also used at times to normalize the rhythm. The drug belonging to this group needs to be used under medical supervision and is administered via IV to arms.

How do medications benefit cardiac patients?

Beta blockers are for example given to patients with angina, arrhythmias and hypertension. For example angina is a heart condition marked by paroxysms of chest pain due to reduced supply of oxygen to the heart. Arrhythmias mean abnormal rhythmic contractions of heart muscle. Both these are marked by some extreme kinds of pain with heart beat shooting up which needs to be interrupted at once. Beta blockers act by blocking the adrenalin at action points (receptor cells) so that heart beat reduces so will the pain and demand for oxygen. Some of the other medicines used here are verapamil, diltiazam and these are actually amiodarone, disopyramide and calcium antagonists.

Congestive heart failures render heart muscle rather weakened as does angina. Digitalis is useful for its effects on the conducting system and inotropic effects. It increases the strength while resetting regularity for heart beat. One popular brand name is digoxin.

Then there are nitro-glycerin based drugs that are used in the treatment of angina pectoris. These are used when blood needs to be dilated as in this case (angina pectoris), so that a cardiac patient is less likely to develop myocardial oxygen deficiency. Nitro-glycerin reduces strain on heart muscles to a great extent.

However none of these medications are OTC and self medication can be destructive rather than being helpful. While, even the common medications for cardiac ailments are used under medical advice and supervision, these are dosaged and scheduled by close observation and according to an individual patient’s severity and physiology. However common the Medications used for Cardiac Patients may be, taking liberty with them is akin to welcoming Satan home.

Causes of congestive heart failures

Congestive Heart Failures can be a result of either the failure of the heart’s loss of strength to forward pumping following systolic dysfunction (heart muscles’ weakness) or because your heart can not relax. Extraordinary demand for blood by the body some times causes heart failure.

Symptoms

The earliest symptoms are fatigue and swelling of your legs, ankles etc. Weakness to walk or exercise and frequent urination and sleeplessness are characteristic of the disease. Breaths may become shorter, loss of appetite and anxiousness may all show up warning you.

Congestive Heart Failure and Altitude

People recovering from heart disease are increasingly advised against venturing into high altitudes. For some patients as little as 3500 ft can prove difficult to sustain for long. As you go higher oxygen level dips and heart patients start choking for breath faster than anyone else. This further strains heart and giddiness and nausea, vomiting can result. Medically, though it is not proven that altitude has a connection to heart failures, especially those asymptomatic of cardiomyopathy need not worry. Logically it is the patients’ well being that is in concern.

However there are certain standard tests you can do at home. These will tell you if you can really go to altitudes. Walk about 100 yards on a plain and climb a dozen steps at a stretch in your normal speed. Gasping and increased heart beat means you should not perhaps go to altitudes.

Traveling to high altitudes or going on air may have the same effect on you. But if you are just flying a short flight you need not worry. But you are more prone to having altitude sickness than others.

Advice to congestive heart patients

Unless you are living in high altitude places, you should avoid it. Traveling without your regular medicines or for patients with pacemaker, without ECG are not exactly advisable. You can carry a list of your medicines with you.

Medicines, diet and vitamins

Digitalis, traded as ‘digoxin’ or ‘ Lanoxin’ is useful for its effects on the conducting system and inotropic effects. Congestive heart patients need to avoid salt intake as it can increase dehydration. Vitamin K is advised for you.

Mechanisms of Heart Disease in Diabetes

Our hearts are affected in many ways in diabetes. More often than not Cholesterol plays a role in bringing the heart to dangers. Cholesterol is a fatty substance produced by our liver and is carried throughout our bodies by blood stream. Cholesterol is also present in our diets. When Cholesterol travels around, it does so in small lumps of lipoproteins (a form of protein). There are two types of these lipoproteins. They are LDL (high density lipoproteins) and HDL (high density lipoproteins). The LDL carries cholesterol from liver and HDL brings back the unused cholesterol to liver.

When high levels of cholesterol are not assimilated by our bodies and they are dumped all over the arteries by LDL. This cholesterol gets combined with glucose and becomes hard to form what professionals call plaques. Gradually over a period of 3-4 years plaque builds up all over your body silently without you noticing it. In the process your arteries (blood vessels that carry from the heart) loose their flexibility and harden.

Now, with stiffened arteries and reduced passage, the heart has to pump harder to supply fresh blood and complete circulation. Additional pumping effort by heart leads to fatigue and if you fail to take reversing steps it may eventually lead to heart attack.

Who does it affect?

All diabetics above the age of 40 years need to have their cholesterol examined every three years. Diabetes affecting human heart is a common incidence to all communities though it is noticed more in African American community. Both women and men are affected.

Important Things to Do

The key to avoiding heart ailments in diabetes is maintaining blood glucose levels and cholesterol contents. Regular walking for about 40 minutes, preferably in the mornings, drinking lots of water, about 1½ to 2 a day liters and regular monitoring of sugar levels will alert you in cases of emergency. While walking helps burn away some glucose and cholesterol it forces you inhale a lot of oxygen. You cannot over emphasize the importance of oxygen to your heart. Avoiding animal fats (milk products) and meat reduces your intake of cholesterol.

Coronary plaque is by far the most frequent reason for ischemic heart disease. Who does it affect and at what age and why? Are there medicines available for dissolving the dangerous plaque? Answers to these million dollar questions bear upon them lives of millions of Americans.

Who does it affect?

Coronary plaque is in itself not a disease. It causes many a heart disease down the line. African American race and Italians are more prone to heart diseases generally, owing to their obesity, lifestyles and eating habits. The average age for plaque to develop in ones arteries is around 40 years, however deviation is not uncommon. It affects both males and females but females are more affected. This is perhaps females are more obese having sedentary habits.

Dissolving Coronary Plaque – Available medicines

Dissolving Plaque by removal is known as chelation. Chelation drugs are prescribed by your doctor; however you cannot expect it to be IV as it is not covered by insurance. The medications usually given are vitamins like vitamin E, vitamin C and vitamin B complex. Folic acid of up to 200mcg is also given.

Drugs such as tPA, (tissue type plasminogen activator, an enzyme) and streptokinase is used for dissolving clots in arteries that otherwise along with plaque can be real worry some. This is diagnosed as coronary thrombosis. The mechanisms for the formation of these plaque at blood vessels are not known, it plays its role in the development of coronary wounds.

Coronary plaques make arteries hard and inflexible. With the passage of time the arteries collapse in inner diameter because of plaque formation on the arteries’ walls.

Dissolving coronary plaque is some thing of a new concept. Documented results are not still available. Some instances where plaque has dissolved have been reported.

Playing safe is the mantra if you don’t want an angioplasty or a by-pass surgery. Avoiding fatty food and giving up smoking, alcohol and adapting good fibrous and balanced food is the diet for this. Good exercise regimen helps dissolve plaque to some extent but it prevents plaque formation completely by dissolving cholesterol.

The term cardiology is derived from the Greek word  (transliterated as kardia and meaning heart or inner self).

Basic anatomy (Structure of the heart)

* Epicardium
* Pericardium
* Myocardium
* Papillary muscle
* Endocardium
* Coronary circulation (Blood supply of the heart)
* Heart valves

Circulatory system (Blood supply of the body)

* Cardiac output
* Heart rate
* Vascular resistance
* Blood vessels

Pulmonary circulation (Oxygenation of the blood)

* Pulmonary artery
* Pulmonary vein

Cardiac pacemaker (Electrical system of the heart)

* Electrical conduction system of the heart
o Action potential
+ Ventricular action potential
* Sinoatrial node
* Atrioventricular node
* Bundle of His
* Purkinje fibers

Basic cardiac physiology

* Systole
* Diastole
* Heart sounds
* Preload
* Afterload
* Kussmaul’s sign

Disorders of the coronary circulation

* Atherosclerosis
* Restenosis
* Coronary heart disease (Ischaemic heart disease, Coronary artery disease)
* Acute coronary syndrome
o Angina
o Myocardial infarction (Heart attack)

Sudden cardiac death (The abrupt cessation of blood flow, leading to death)

* Cardiac arrest

Treatment of sudden cardiac death

* Cardiopulmonary resuscitation (CPR)

Disorders of the myocardium (muscle of the heart)

* Cardiomyopathy
o Ischemic cardiomyopathy
o Nonischemic cardiomyopathy
+ Amyloid cardiomyopathy
+ Hypertrophic cardiomyopathy (HCM)
# Hypertrophic obstructive cardiomyopathy (HOCM) (Idiopathic hypertrophic subaortic stenosis (IHSS))
# Apical hypertrophic cardiomyopathy
+ Dilated cardiomyopathy
# Alcoholic cardiomyopathy
# Tachycardia induced cardiomyopathy
# Takotsubo cardiomyopathy (Transient apical ballooning, stress-induced cardiomyopathy)
+ Arrhythmogenic right ventricular dysplasia (Arrhythmogenic right ventricular cardiomyopathy)
+ Restrictive cardiomyopathy
* Congestive heart failure
o Cor pulmonale
* Ventricular hypertrophy
o Left ventricular hypertrophy
* Primary tumors of the heart
o Myxoma

Disorders of the pericardium (outer lining of the heart)

* Pericarditis
* Pericardial tamponade
* Constrictive pericarditis

Disorders of the heart valves

* Aortic valve disorders
o Aortic insufficiency
o Aortic stenosis
o Aortic valve replacement
o Aortic valve repair
o Aortic valvuloplasty
* Mitral valve disorders
o Mitral valve prolapse
o Mitral regurgitation
o Mitral stenosis
o Mitral valve replacement
o Mitral valve repair
o Mitral valvuloplasty
* Pulmonary valve disorders
o Congenital pulmonic stenosis
* Tricuspid valve disorders

Disorders of the electrical system of the heart (Cardiac electrophysiology)

* Cardiac arrhythmias
o Supraventricular tachycardia (Fast rhythms that originate above the ventricles)
+ Atrial fibrillation
+ Atrial flutter
+ Atrial tachycardia
+ Sick sinus syndrome (Tachy-Brady syndrome)
+ AV nodal reentrant tachycardia (AVNRT)
+ AV reentrant tachycardia (AVRT)
* Bigeminy
* Premature ventricular contraction
* Ventricular tachycardia
o Monomorphic ventricular tachycardia
o Polymorphic ventricular tachycardia
+ Torsades de pointes
* Ventricular fibrillation
* Sick sinus syndrome
* Bundle branch block
o Left bundle branch block
o Right bundle branch block
* Heart block
o First degree heart block
o Second degree heart block
o Trifascicular heart block
o Third degree heart block
+ Lev’s disease
* Specific diseases of the electrical system of the heart
o Brugada syndrome
o Long QT syndrome
+ Andersen-Tawil syndrome
+ Romano-Ward syndrome
o Short QT syndrome
o Wolff-Parkinson-White syndrome (WPW syndrome)

Inflammation and infection of the heart

* Endocarditis
o Rheumatic heart disease
* Myocarditis
* Pericarditis

Congenital heart disease

* Atrial septal defect
* Ventricular septal defect
* Patent ductus arteriosus
* Bicuspid aortic valve
* Tetralogy of Fallot
* Transposition of the great vessels (TGV)

Diseases of blood vessels (Vascular diseases)

* Vasculitis
* Atherosclerosis
* Aneurysm
* Varicose veins
* Economy class syndrome
* Diseases of the aorta
o Coarctation of the aorta
o Aortic dissection
* Diseases of the carotid arteries
o Carotid artery disease
o Carotid artery dissection

Procedures done for coronary artery disease

* Atherectomy
* Angioplasty (PTCA)
o Stenting
* Coronary artery bypass surgery (CABG)
* Enhanced external counterpulsation (EECP)

Devices used in cardiology

* Stethoscope
* Devices used to maintain normal electrical rhythm
o Pacemaker
o Defibrillator
+ Automated external defibrillator
+ Implantable cardioverter-defibrillator
* Devices used to maintain blood pressure
o Artificial heart
o Heart-lung machine
o Intra-aortic balloon pump
o Ventricular assist device

Diagnostic tests and procedures

* Blood tests
* Echocardiogram
* Cardiac stress test
* Electrocardiogram (ECG or EKG)
o Ambulatory Holter monitor
* Electrophysiologic study
o Programmed electrical stimulation
* Sphygmomanometer (Blood pressure cuff)
* Cardiac enzymes
* Coronary catheterization
o Myocardial Fractional Flow Reserve (FFRmyo)
o IVUS (IntraVascular UltraSound)

Cardiac pharmaceutical agents

The followings are medications commonly prescribed in cardiology:

* Antiarrhythmic agents
o Type I (sodium channel blockers)
+ Type Ia
# Quinidine
+ Type Ib
# Lidocaine
# Phenytoin
+ Type Ic
# Propafenone
o Type II (beta blockers)
+ Metoprolol
o Type III (potassium channel blockers)
+ Amiodarone
+ Dofetilide
+ Sotalol
o Type IV (slow calcium channel blockers)
+ Diltiazem
+ Verapamil
o Type V
+ Adenosine
+ Digoxin
* ACE inhibitors
o Captopril
o Enalapril
o Perindopril
o Ramipril
* Angiotensin II receptor antagonists
o Candesartan
o Eprosartan
o Irbesartan
o Losartan
o Telmisartan
o Valsartan
* Beta blocker
* Calcium channel blocker