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Congenital Heart Defects in Children – an Overview | Cardiology

What are congenital heart defects in children?

Congenital heart defects in children (CHDs) are the most well-known sort of birth deformity. With advances in medical care and treatment, children with CHD live longer and healthier lives. Find out more facts about coronary heart disease below.

What are congenital heart defects (CHDs)?

Coronary artery disease is present at birth and can affect the structure and functioning of a baby’s heart. It can affect how blood flows through the heart and out to the rest of the body. Coronary artery disease can vary from mild (such as a small hole in the heart) to severe (such as missing or poorly formed parts of the heart).

About 1 in 4 babies born with a heart defect suffer from critical coronary heart disease (also known as a serious congenital heart defect). Babies with critical coronary heart disease need surgery or other procedures in the first year of life.

Types of congenital heart defects in children

Babies and children with all types of congenital heart defects receive expert diagnosis and treatment from specialists at the Pediatric Congenital Heart Program. Congenital heart defects in children occur at birth and affect the heart or blood vessels. Hundreds of heart defects can arise as a baby develops in the womb, and some infants may have more than one. Some defects cause no health challenges for years; in fact, some may never pose a health risk.

However, many infants require treatment with surgery or catheter procedures to repair congenital heart defects in children immediately or in the first few months of life. Others may need medication as a bridge to surgery or other procedures, or as the only therapy to manage symptoms.

Our experts treat babies and children with all types of congenital heart defects in children, including:

  • Aortic valve stenosis
  • Atrial septal defect
  • Ebstein’s anomaly
  • Hypoplastic left heart syndrome
  • Interrupted aortic arch
  • Coarctation of the aorta
  • Complete atrioventricular canal defect
  • Patent ductus arteriosus
  • Total anomalous pulmonary venous return
  • Transposition of the great arteries
  • Tricuspid atresia
  • Pulmonary valve stenosis
  • Tetralogy of Fallot
  • Truncus arteriosus
  • Ventricular septal defect

Symptoms of congenital heart defects in children

Serious congenital heart defects in children usually appear soon after birth or within the first few months of life. They can include signs and symptoms:

  • Pale gray or blue skin color (cyanosis)
  • Rapid breathing
  • Swelling in the legs, abdomen, or areas around the eyes
  • Shortness of breath during feeding, resulting in poor weight

Less serious congenital heart defects in children may not be diagnosed until later in childhood, because your child may not show any noticeable signs of a problem. If signs and symptoms occur in older children, they may include:

  • Feeling short of breath easily during exercise or activity
  • Fatigue easily during exercise or activity
  • Fainting during exercise or activity
  • Swelling in the hands, ankles, or feet

Causes of congenital heart defects in children

Doctors don’t always know why a child has a congenital heart defect. It tends to run in families. Things that make congenital heart defects in children more likely include:

  • Genetic or chromosomal problems in a child, such as Down syndrome
  • Taking certain medications or alcohol or drug abuse during pregnancy
  • A viral infection, such as rubella (rubella) in the mother in the first trimester of pregnancy

How are heart defects treated?

Youngsters with minor heart deformities may not require any treatment. However, some children suffer from severe symptoms that require medical or surgical treatment during the first year of life. They will be taken care of:

  • Pediatric cardiologists: Doctors who specialize in treating children’s heart problems
  • Pediatric heart surgeons: Specialists in pediatric heart surgery

Procedures performed through cardiac catheterization – such as balloon angioplasty or valvuloplasty – can dilate blood vessels or a blocked valve. Another procedure, blockage of the catheter device, can close abnormal openings or holes in the heart or blood vessels without surgery.

Some problems, such as small or medium-sized ventricular septal defects, may close or get smaller as the child grows. While waiting for the hole to close, the child may have to take medications. Complex Congenital heart defects in children detected early may need a series of processes ending when the child is approximately 3 years old.

Testing and diagnosis of congenital heart disease

Several serious congenital heart diseases are detected during pregnancy, during a routine ultrasound examination. Other conditions may be diagnosed soon after birth. Less serious heart conditions may not be diagnosed until children get older and begin to show certain signs or symptoms of congenital heart disease.

During pregnancy, if your doctor thinks your baby may have CHD, you will likely be referred to a pediatric cardiologist for further testing. The type of diagnostic tests performed will depend on the form of coronary heart disease your child may have. Examples of tests used include a fetal echocardiogram, electrocardiogram (EKG), magnetic resonance imaging of the heart (MRI), and cardiac catheterization. If you are referred to the Children’s Hospital of Philadelphia, you will be seen through the Heart Center’s Fetal Heart Program.

Risk factors for congenital heart defects in children

Most Congenital heart defects in children are caused by problems early in the development of your baby’s heart, and the cause is unknown. However, some environmental and genetic risk factors may play a role. They include:

  • Rubella (German measles): German measles infection during pregnancy can cause problems with the development of your baby’s heart. Your doctor can test for immunity to this viral disease before pregnancy and vaccinate you against it if you are not immune.
  • You can reduce the risk of Congenital heart defects in children by carefully controlling diabetes before trying to conceive and during pregnancy. Gestational diabetes generally does not increase your baby’s risk of developing a heart defect.
  • Some medications taken during pregnancy may cause birth defects, including congenital heart defects. Provide your doctor with a complete list of all medications you take before trying to conceive.
  • Medicines known to increase the risk of congenital heart defects include thalidomide (Thalomide), angiotensin-converting enzyme (ACE) inhibitors (ACE), statins, acne medication isotretinoin (Absorica, Amnstim, and Claravis), and lithium.
  • Drinking alcohol during pregnancy: Avoid drinking alcohol during pregnancy because it increases the risk of Congenital heart defects in children.
  • Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby.
  • Congenital heart defects in children sometimes run in families and may be associated with an inherited syndrome. Many children with Down syndrome – which is caused by an extra chromosome 21 (trisomy 21) – have heart defects. A missing (deleted) piece of genetic material on chromosome 22 also causes heart defects.
  • Genetic testing can detect such disturbances during fetal development. If you already have a baby with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have it.

Complications of congenital heart defects in children

Complications depend on the type of congenital heart defect you have. Include some potential complications:

  • Arrhythmia
  • Blood clots
  • Developmental disorders and delays: Children with congenital heart defects are more likely to have behavior problems. They are also more likely to have speech and attention-deficit / hyperactivity disorder.
  • Emotional health issues: Depression, anxiety, and PTSD are common among people with congenital heart defects.
  • Endocarditis: A type of heart inflammation
  • Endocrine disorders: Include thyroid problems, bone health problems, and diabetes. Problems with the hormones that deal with calcium can cause bone problems.
  • Heart failure: Heart failure is the leading cause of death in adults with congenital heart defects. Some children with congenital heart defects develop heart failure.
  • Kidney disease
  • Liver disease
  • Pneumonia: Pneumonia is a leading cause of death in adults with congenital heart disease.
  • Pregnancy complications: Women with congenital heart defects are at increased risk of developing complications during pregnancy and childbirth. Read more in the Living With section.
  • Pulmonary hypertension
  • Stroke

Outlook and follow-up care for congenital heart disease

Children with congenital heart disease are monitored by specialists called pediatric cardiologists. These doctors diagnose heart disease and help manage children’s health before and after surgical repair of a heart problem. The specialists who correct heart problems in the operating room are known as pediatric cardiovascular surgeons or cardiothoracic surgeons.

It is imperative that individuals born with congenital heart disease who have reached adulthood transition to the appropriate type of heart care. The type of care required depends on the type of CHD the person has. Generally, people with mild types of Congenital heart defects in children can be cared for by a community adult cardiologist. People with more complex types of coronary heart disease will need care at a center that specializes in adult congenital heart disease, such as the Philadelphia Adult Congenital Heart Center.

How can congenital heart disease be prevented?

Women who are pregnant or planning to become pregnant can take certain precautions to reduce the risk of having a baby with a congenital heart defect:

  • If you are planning to become pregnant, talk to your doctor about any prescription or over-the-counter medicines you are taking.
  • If you have diabetes, make sure your blood sugar levels are controlled before pregnancy. It is also important to work with your doctor to manage illness during pregnancy.
  • If you have not been vaccinated against rubella or rubella, avoid exposure to the disease and talk to your doctor about prevention options.
  • If you have a family history of congenital heart defects, ask your doctor about genetic testing. Certain genes may contribute to abnormal heart development.
  • Avoid drinking alcohol and using drugs during pregnancy.

Overview of Cardiothoracic Surgeon | Cardiology

What is a cardiothoracic surgeon?

The cardiothoracic surgeon performed a type of specialized surgery that involves procedures on the organs of the chest, such as the heart, lungs, and esophagus. According to the Society of Thoracic Surgeons (STS), the term “cardiothoracic surgeons” is an inclusive term.

The terms “cardiac surgeon” and “thoracic surgeon” are interchangeable.

The cardiothoracic surgeon can be used to treat many conditions, including:

  • Coronary artery disease (blockage of the arteries)
  • Lung cancer
  • Emphysema
  • Hyoid hernia
  • Swallowing disorders

The cardiothoracic surgeon involves a variety of procedures, including open chest operations, laparoscopic procedures, and robot-assisted surgery.

Treatments are performed by a cardiothoracic surgeon

Coronary artery bypass graft (CABG): During this procedure, arteries or veins from other parts of the body join with the coronary arteries to relieve angina and reduce the risk of death from coronary artery disease. The grafts bypass narrow or clogged sections of arteries to improve the blood supply to the heart muscle.

This procedure can save lives in patients who do not have good candidates for percutaneous catheter techniques (coronary angioplasty and stenting) or ongoing medical treatment. The cardiothoracic surgeons can also perform minimally invasive and “off-pump” procedures (no cardiopulmonary bypass machine).

Mitral and aortic valve repair and replacement: Cardiothoracic surgeons are highly trained in the repair of blocked or leaking heart valves. The first option is always to preserve the local valve, but when the patient’s heart valve is severely damaged, the cardiothoracic surgeon use mechanical or tissue prostheses (including tissue implants from a human donor).

Cardiothoracic surgeons specialize in minimally invasive valve repair procedures that involve two to three-inch incisions rather than large chest incisions. For patients, these minimally invasive procedures provide an increased risk of infection, a faster recovery time, and less blood loss.

Nationally, studies have shown that only 50 percent of the mitral valves can be repaired.

Surgical treatment of aortic aneurysms and amputations: The walls of the aorta, the largest blood vessel in the body, can weaken and develop an aneurysm (dilation or bursa), leading to the rapture or rupture of the vessel walls, also known as rupture. Anyone could be a fatal emergency.

When an aneurysm or dissection is found on a chest x-ray, echocardiogram, or computed tomography (CT) scan, and magnetic resonance imaging (MRI), cardiothoracic surgeons repair the damaged area with a special tissue graft (also known as a stent).

Cardiac support devices: The implantable tandem heart pump can also be used in patients with high-risk percutaneous coronary interventions (coronary angioplasty or stenting). This small semi-portable device can be inserted through the groin or into an artery during open-heart surgery.

Such implantable devices are in various stages of development and testing, but they provide temporary support for cardiac function and often save lives.

Lung and esophageal dissection: Both the esophagus and the lungs are affected by benign or malignant diseases that require surgical removal of damaged tissue. These procedures are less painful with very few incisions and can speed recovery time.

Radiofrequency ablation for atrial fibrillation: Atrial fibrillation is a normal but abnormal heart rhythm that causes a fast and irregular heartbeat. These heartbeats can cause discomfort and dizziness. If left untreated, patients are at increased risk of having a stroke.

Some patients can be treated with medications or catheter procedures, while others are resistant to these interventions. Cardiothoracic surgeons minimally invasive surgery on the surface of the heart with small incisions in radio frequency waves (modified electrical energy), creating precise scar lines to avoid transient electrical impulses that cause irregular heartbeats.

How is cardiothoracic surgery done?

Your surgical team will tailor it to your health needs and the type of surgery you are performing. Here are some common types of heart surgery:

  • It keeps you awake and pain-free: The anesthesiologist will prescribe special medications to help you stay awake and pain-free during surgery.
  • Keep the airways open: The endotracheal tube (ET) is inserted into your throat and windpipe and connected to the ventilator. The fan “flutters” while you sleep. There may also be an ET tube several hours after surgery to make sure you are breathing well.
  • Reaching your heart: To obtain your heart, your surgeon will make an incision (cut) in the middle of your chest and separate your breastbone. After surgery, your surgeon will reattach your chest bones with wires or heavy stitches, followed by an incision.
  • Maintains blood circulation: For open-heart surgeries, the heart stops during the surgery and restarts when the procedure is complete. A heart-lung bypass (pump) machine is needed to do the work of the heart and lungs during surgery. However, some heart surgeries can now be performed on a beating heart. In such cases, the procedure is performed “off-pump” without the use of a CPR machine.

What should I expect during recovery?

  • Follow your doctor’s advice for pain control: Your neck may hurt and swallowing may be difficult. Your doctor can prescribe pain medication. Eating soft foods helps.
  • Take all the medications prescribed by your doctor: It may contain an antiplatelet medicine (which helps prevent blood clots).
  • Limit swelling and pain: For the first week, keep your head supported by pillows while you sleep to limit swelling.
  • Don’t drive until your doctor says it’s okay.
  • Limit strenuous activity for a few weeks: Don’t lift heavy objects and don’t exercise vigorously until your doctor says it’s okay. You can go back to work and go back to your normal activities when your doctor says it’s okay.
  • Look for features: Pay attention to some changes in how you feel, especially neck swelling or headaches on the side where the procedure was performed. Tell your doctor if you notice any of the symptoms listed below.
  • If you have a stroke: You may need additional treatment, such as medication or rehabilitation from a stroke. Ask your doctor or nurse about the Intermountain Life of Stroke Guide or TIA for more information.

Overview of Electrophysiologist | Cardiology

What is an electrophysiologist?

An electrophysiologist is eligible to perform specialized tests of your heart’s electrical system, such as electrophysiology or ablation. Blood pumping is a mechanical problem that involves the heart muscle and vessels. Many cardiologists deal with the mechanical function of the heart. Remembering to pump blood is an electrical problem. The heart has an electrical system that sends impulses for muscle contraction.

When there are problems with the electrical signals in the heart, the result is an arrhythmia-irregular heartbeat. These problems are treated by electrophysiologists.

Electrophysiologists can use many tests and treatments just like other cardiologists. However, electrophysiologists can also perform specialized tests called electrophysiology studies (EPS), which can also allow procedures such as pacemaker placement, insertion of an implantable cardioverter-defibrillator (ICD), or catheter ablation to treat arrhythmia.

Difference between a cardiologist and an electrophysiologist?

The heart has two main functions: to pump blood throughout the body and to do it efficiently and rhythmically. The actual pumping of blood is very mechanical and the problems that arise in this area are of a circulatory or structural nature.

Cardiologists are medical professionals who treat and correct problems such as coronary heart disease, congestive heart failure, cardiac arrest, or peripheral artery disease.

Heart rhythm disorders, on the other hand, arise from problems in the heart’s electrical system that controls the heartbeat. When there is a problem here called arrhythmia, the heart beats too fast, too slow, or with inconsistent manipulations.

Due to the nature of electricity, treating arrhythmias requires additional and specialized training by the physician, who must complete one to two years of additional training beyond the standard cardiology scholarship. Cardiac electrophysiologists are doctors who have completed this unique cardiovascular workout.

What does an electrophysiologist do?

The heart muscle produces electrical signals that travel through the heart muscle to contract. These signals are small but can be taken on an EKG machine. The electrocardiogram (ECG) can help, but often the signs that doctors need to see are so small that they cannot be seen or hidden on the ECG. The electrophysiologist can perform ablation studies and/or procedures on your heart’s electrical system and timing.

When do you need an electrophysiologist?

In a normal, healthy heart, the upper chambers (atria) and the lower chambers (ventricles) work together, alternately contracting and pumping blood. Sometimes your rhythm shoots up and you have an irregular heartbeat, either too fast (more than 100 beats per minute) or too slow (less than 60 beats per minute). An electrophysiologist can help you cope with arrhythmia, the most common of which is atrial fibrillation, where the upper two chambers shake without coordinating their contractions.

Purpose of electrophysiologists

A cardiologist may recommend an EP study when a standard EKG, Holter monitor, event recorder, stress test, echocardiogram, or angiogram do not provide adequate information to evaluate an abnormal heart rhythm known as an arrhythmia.

The EP study may also help diagnose suspected arrhythmia in a patient with arrhythmia symptoms, but this has not been found in other tests.

The purpose and great value of the EP study are that it provides the physician with more detailed information about the electrical activity of the heart than the non-invasive tests mentioned above because the electrodes are placed directly on the heart tissue.

EP studies may help assess:

  • Some tachycardia or bradycardia of unknown cause
  • Resuscitated patients after experiencing sudden cardiac death
  • Various symptoms of unknown causes such as chest pain, shortness of breath, fatigue, or syncope
  • Response to antiarrhythmic therapy

Conditions of electrophysiology

Common conditions that we treat in our laboratory, including atrial fibrillation and other types of arrhythmias. Using cardiac maps, our electrophysiologists can identify the cause of irregular heartbeat and often correct it by ablation. This procedure corrects electrical conduction problems that cause a problematic and abnormally fast heart rate.

Our electrophysiologists can perform additional treatments as needed in the laboratory. For example, if you are experiencing a cardiac defibrillator that provides a slow heart rate or electrical impulses, pacemakers can be set to help the patient’s heart return to a normal rhythm after experiencing a severe arrhythmia.

Electrophysiologists procedure

The EP study is an invasive test similar to angiography and is performed in a catheterization laboratory. After the patient is operated on under local anesthesia (or in some cases, general anesthesia), the catheter is inserted into a blood vessel through a site in the groin or neck and guided through the catheter and images of the myocardial fluoroscopy.

Once the catheter reaches the heart, the electrodes on its tip collect data and a variety of electrical measurements are made. This “electrical mapping” helps the cardiac arrhythmia specialist to locate the area where the current is interfering.

The electrophysiologist then administers various medications or electrical stimuli to determine the ability to terminate the arrhythmia and restore normal heart rhythm. Sometimes a specialist will perform cardiac ablation or insert an implanted cardioversion device (ICD) or pacemaker. The procedure usually takes about two hours.

Treatments of electrophysiologists

  • Atrial fibrillation ablation
  • Device interrogation
  • Electrical cardioversion
  • Monitoring
  • Implantable cardioverter-defibrillator (ICD)
  • Pacemaker implantation

Study of electrophysiologists

When an abnormal heartbeat is found, your doctor or cardiologist may recommend an electrophysiology study (EPS).

This study is performed by an electrophysiologist who inserts one or more specialized electrode catheters in the groin or neck into the blood vessel leading to the heart.

Using catheters, the electrophysiologist sends electrical signals to your heart and records the electrical activity of your heart.

The EPS will help determine:

  • Source of abnormal heartbeat
  • What medicines work to treat your arrhythmia
  • If you need an ICD (implantable cardioverter-defibrillator) or pacemaker
  • If you need catheter ablation (using a catheter to destroy a very small part of the heart that causes arrhythmia).
  • Your risk of complications such as cardiac arrest

New technology and Innovative procedures

Our ability to perform 3-D models of the heart in real-time can help us determine the best treatment options, such as medications, surgical procedures, or devices such as defibrillators or pacemakers with remote monitoring by specialized personnel.


Diagnosis and Causes of Dravet Syndrome | Neurology

What is dravet syndrome?

Dravet syndrome is rare drug-resistant epilepsy that begins in the first year of life in an otherwise healthy baby. It is for life. It usually offerings with a prolonged seizure with a fever that affects one side of the body.

  • Most cases are due to severe mutations in the SCN1A gene.
  • Most children progress varying degrees of developmental disability.
  • Treatment involves finding the best combination of medications to treat seizures and prevent seizure emergencies. Diet therapy and vagus nerve stimulation can also be helpful.
  • The FDA approved two new drugs specifically for dravet syndrome. These include Epidiolex (cannabadiol, CBD) oral explanation approved in June 2018 and Stiripentol approved in August 2018. Fenfluramine (Fintepla) was approved in June 2020.
  • A multidisciplinary team and a primary developmental calculation are needed to address the many ways that Dravet syndrome can affect a child and their family.

Alternate name

Dravet syndrome, before known as severe myoclonic epilepsy of infancy (SMEI)

Types of dravet syndrome

Dravet syndrome is an unadorned form of epilepsy characterized by prolonged seizures that usually appear in the first year of life. As the disease develops, different types of seizures start to occur.

Seizures are classified into three main types depending on the part of the brain they affect: focal onset or partial seizures, widespread seizures, and unknown onset seizures. Focal start seizures start on one side of the brain while widespread seizures affect both sides of the brain simultaneously. In unknown onset seizures, the location in the brain where the seizure starts are not known.

Seizures also may be secret based on their cause such as, for instance, febrile seizures, or seizures caused by high temperature, as well as symptoms they cause, myoclonic seizures, clonic seizures, tonic seizures, tonic-clonic seizures, absence seizures, atonic seizures, principal impaired-awareness seizures.

Febrile seizures

Febrile seizures usually are generalized seizures. They are a convulsion activated by a fever that often accompanies childhood illnesses. In children with dravet syndrome, they typically occur within the first year after birth and often are much more severe than those seen in children with other diseases.

Most febrile seizures are brief and do not typically cause long-term health problems. However, repetitive prolonged febrile seizures increase children’s risk of emerging epilepsy and are the first sign that a child may have dravet syndrome.

Myoclonic seizures

Myoclonic seizures are another type of generalized seizure. This type of seizure causes children’s muscles to rapidly agree and relax, resulting in jerky movements. In children with dravet syndrome and other epilepsy disorders, these jerking movements happen on both sides of the body. These seizures usually do not affect the child’s consciousness, leave-taking them aware and able to think during the episode. When these seizures are current in children with dravet syndrome they usually occur by the age of two.

Clonic seizures

Clonic seizures can be either focal onset or widespread onset in origin. This type of seizure causes jerky movements in which the person’s muscles stiffen and relax. It often is difficult to differentiate a myoclonic seizure from a clonic seizure, but clonic seizures usually involve a more rhythmic jerky movement. This type of seizure most commonly occurs in babies and may last from a few seconds to one minute. These seizures cannot be stationary by restraining the child.

Tonic seizures

Tonic seizures can be also focal onset or generalized onset in origin. This type of seizure causes a person’s body to develop unexpectedly stiff. They usually happen while the person is sleeping and last less than 60 seconds. A person experiencing a tonic seizure may be completely aware of the episode or their awareness may be slightly impaired. They may feel tired or disordered after the event and have a headache. Tonic seizures are very rare in dravet syndrome.

Tonic-clonic seizures

Tonic-clonic seizures usually are widespread onset, but also can be focal onset. This type of seizure involves a combination of symptoms from tonic and clonic seizures. The tonic stage of the convulsion begins first with the person’s body abruptly becoming stiff, followed by the clonic phase in which the person’s body jerks rhythmically. These seizures typically last one to three minutes. Toward the end of the seizure, the jerky actions slow to a stop and the person’s body relaxes. During this time, the person may lose the switch of the bladder or bowels. A tonic-clonic seizure permanent for more than five minutes requires immediate medical help.

Absence seizures

Absence seizures are a type of generalized onset seizure. This kind of seizure causes children to have lapses of consciousness where they have no recollection of the incident afterward. These seizures are abrupt and previous only a few seconds. They are considered by non-motor symptoms, although brief twitches may be present. A common symptom of this type of seizure is blank staring that is often mistaken for daydreaming. Once diagnosed, absence seizures can be controlled with anti-seizure medications. It is possible for children to enlarge absence seizures and this commonly happens in their teenage years.

Children with dravet syndrome also can have an additional type of absence seizure known as atypical absenteeism seizure. These seizures also are a kind of generalized onset seizures and usually happen after age two. Unlike regular absence seizures, children experiencing atypical absence seizures may be able to respond to external stimuli.

Atonic seizures

Atonic seizures can be focal onset or generalized onset. These seizures are also known as falling attacks because there is a loss of muscle control that results in flabby muscles. They usually last less than 15 seconds. They do not cause direct damage but can cause indirect injuries from falls. Head protection is often recommended for children with these types of seizures.

Focal seizures of altered consciousness

Focal deficient consciousness seizures usually occur after the age of two years and generally lasts one to two minutes. They originate on one side of the brain. The patient loses consciousness, so the main symptoms are lack of response and confusion. In addition, children can have automaticities such as lip-smacking or clumsiness.

Status epilepticus

Status epilepticus can occur in children with dravet syndrome. This is when a seizure lasts more than five minutes or when several seizures occur together with no recovery time in between. There are two types of rank epilepticus: convulsive and non-convulsive. Convulsive status epilepticus usually results from a prolonged tonic-clonic seizure. This type needs emergency medical treatment because it is life-threatening. Non-convulsive status epilepticus is usually caused by the prolonged absence or by seizures of focal altered consciousness. These seizures are harder to recognize because the symptoms are subtler.

What causes dravet syndrome?

Dravet syndrome is a genetic condition. In 80 percent of Dravet patients, the disease is caused by changes in the SCN1A gene. The remaining 20% of cases are believed to be the result of mutations in other genes, some of which have yet to be identified.

Most disease-causing mutations occur de novo, which means they are new and are not passed down from parents. But up to 10% of the time, mutations that cause dravet syndrome are inborn from parents in an autosomal dominant manner, meaning that just one defective copy of the disease-causing gene is enough for the condition to develop.

Dravet syndrome risk factors

As children with dravet syndrome grow older, their decline in cognitive function stabilizes. The degree of intellectual disability varies widely from mild to profound, however, most adolescents and adults with dravet syndrome are dependent on caregivers. Gait abnormalities appear to worsen during adolescence. Seizures tend to decrease in amount and duration with age. People with dravet syndrome are at higher risk than the general population for a sudden and unexpected death, but that risk remains low.

Dravet syndrome symptoms

The following list includes the most mutual signs and symptoms in persons with dravet syndrome. These characteristics can vary from one person to another. Some persons may have more symptoms than others, and symptoms can range from slight to severe. This list does not include all the symptoms or characteristics that have been described in this condition.

Signs and symptoms include:

  • Many different types of seizures.
  • Sudden muscle jerks (myoclonus)
  • Loss of developmental skills.
  • Intellectual disability
  • Trouble walking
  • Speech disability
  • Autistic-like behavior

The first seizures appear before one year of age and are often associated with fevers. In childhood, other types of seizures develop, and the incidence of seizures increases. Loss of cognitive and developmental skills can occur along with speech problems and difficulty walking. In adulthood, the number of seizures may decrease and nocturnal seizures may occur. More serious complications include the risk of ongoing seizures (status epilepticus) and sudden unexplained death.

This table lists the symptoms that people with this disease may have. For most diseases, symptoms vary from person to person. People with the same disease may not have all of the listed symptoms. This information originates from a database called Human Phenotype Ontology (HPO). The HPO collects information around symptoms that have been labeled in medical resources. The HPO is periodically updated. Use the HPO ID to access more detailed information about a symptom.

Dravet syndrome diagnosis

Dravet syndrome is a clinical diagnosis that was recently determined to affect 1: 15,700 babies born in the US. Approximately 80% of those diagnosed with dravet syndrome have an SCN1A change (1: 20,900), but the attendance of a mutation alone is not sufficient for the diagnosis, nor does the absence of a mutation exclude the diagnosis. Dravet syndrome is at the more severe end of the spectrum of SCN1A-related disorders, but it can also be associated with other mutations.

In the 2015 study, the clinical diagnostic criteria included at least 4 of the following:

  • Normal or near-normal cognitive and motor development before the onset of seizures
  • Two or more seizures with or without fever before one year of age
  • History of seizures consisting of generalized myoclonic, hemiclonic, or tonic-clonic seizures
  • Two or more seizures lasting more than 10 minutes
  • Lack of response to first-line antiepileptic drug therapy with continuous seizures after 2 years of age

Other hallmarks of the syndrome include seizures associated with vaccinations, hot baths, or warm temperatures; developmental slowdown, stagnation or regression after the first year of life; behavior problems; and speech delay.

Genetic test

Because many of these criteria are not apparent in the first year of life, and babies with dravet syndrome initially experience typical development, the study determined that genetic testing through an epilepsy panel should be considered in patients with either of the following:

  • 2 or more prolonged seizures per year of age
  • 1 prolonged seizure and any hemiclonic seizure (sustained rhythmic jerking of one side of the body) at 1 year of age
  • 2 seizures of any duration that appear to affect alternate sides of the body
  • History of seizures before 18 months of age and subsequent onset of myoclonic and/or absence seizures

If you suspect that your loved one might have dravet syndrome, ask your neurologist about the tests, which are available finished by your doctor or commercially. An epilepsy panel will test for SCN1A, as well as many other genes commonly related to epilepsy. After testing, it is optional to consult with a genetic counselor.

Dravet syndrome treatment options

Seizures in dravet syndrome can be difficult to control but can be reduced with anti-seizure medications such as clobazam, stiripentol, topiramate, and valproate. Because the course of the disorder varies from one individual to another, treatment protocols may vary. A high-fat, low carbohydrate diet can also be beneficial, known as a ketogenic diet. Although adjusting your diet can help, it does not eliminate symptoms. Until a better form of treatment or cure is discovered, people with this disease will have myoclonic epilepsy for the rest of their lives.

It is now known that certain anti-seizure medications that are classified as sodium channel blockers make seizures worse in most dravet patients. These medications include carbamazepine, gabapentin, lamotrigine, and phenytoin. Treatments include cognitive rehabilitation through psychomotor and speech therapy. In addition, valproate is often given to prevent the recurrence of febrile seizures, and benzodiazepine is used for long-lasting seizures, but these treatments are often insufficient.

Stiripentol was the only drug for which a randomized, double-blind, placebo-controlled trial was conducted, and this drug showed efficacy in trials. It acts as a GABAergic agent and as a positive allosteric modulator of the GABAA receptor. Stiripentol, which can improve refractory focal epilepsy as well as dravet syndrome, supplemented with clobazam and valproate, was approved in Europe in 2007 as a therapy for dravet syndrome and has been found to reduce the overall rate of seizures by 70%. For more drug-resistant seizures, topiramate and the ketogenic diet are used as alternative treatments.

Cannabidiol (CBD) was approved in the United States for the treatment of dravet syndrome in 2018. A 2017 study showed that the frequency of seizures per month decreased from 12 to 6 with the use of cannabidiol, compared to a decrease from 15 to 14 with placebo.

Dravet syndrome complications

  • Although the decline in cognitive function stabilizes with age in some people with dravet syndrome, most adolescents and adults with the disorder have mild to profound intellectual disability and require 24-hour supervision. This disability, along with seizures and other comorbidities, can also cause severe anxiety and social isolation, which inevitably affects the quality of life of caregivers as well.
  • Gait and balance problems associated with dravet syndrome can lead to falls. These falls, along with an increased risk of osteopenia (low bone mass), can cause bones to break. A survey study found that 70 percent of respondents use a wheelchair or adaptive stroller sometimes.
  • Seizures can cause drowning if they occur while a person is in or near water. Seizures can also increase the risk of lung complications, such as aspiration pneumonia, which occurs when you breathe in food, stomach acid, or saliva into your lungs, which can lead to sepsis.

Causes and Diagnosis of Tricuspid Atresia | Cardiology

What is tricuspid atresia?

Tricuspid atresia is a congenital heart defect in which the valve (tricuspid valve) does not form between the two chambers of the heart. Instead, there is optic tissue between the chambers, restricting blood flow and preventing the development of the lower right heart chamber (ventricle).

A baby, child, or adult with tricuspid atresia may not be able to get enough oxygen through their body. This condition is more common in people with tires, shortness of breath, and bluish skin. Tricuspid atresia can be treated with multiple surgeries. Most children with surgical tricuspid atresia live well into adolescence, although more surgeries may be necessary.

Who gets tricuspid atresia?

A child is more likely to have tricuspid atresia:

  • The baby has Down syndrome (trisomy 21)
  • Parents have congenital heart defects
  • The mother has a rubella infection (German measles) or another viral infection during pregnancy
  • Maternal diabetes or lupus (an autoimmune disease) are not adequately controlled
  • The mother uses some acne medications or cesarean section during pregnancy.

But having one or more risk factors does not mean that the baby will have tricuspid atresia. Tricuspid atresia occurs without any risk factors.

What are the risk factors for tricuspid atresia?

Risk factors can cause a person to develop symptoms of a disease or condition. Risk factors for tricuspid atresia:

  • Down’s Syndrome
  • Parents with congenital heart disease
  • Who is a mother
  • Having a viral illness (including German measles) in early pregnancy.
  • You drank too much alcohol during pregnancy.
  • There is diabetes that is not adequately controlled.
  • Some medications, such as cesarean section or acne medications, were used during pregnancy.

What are the symptoms of tricuspid atresia?

In most cases, babies born with tricuspid atresia show symptoms within a week of birth. A baby with tricuspid atresia shows the following symptoms:

  • Blue skin and lips (cyanosis)
  • Difficulty feeding
  • Shortness of breath and rapid breathing
  • Slow growth
  • Heart murmur (abnormal heart sounds)

Also, some children with this condition can develop symptoms of heart failure. In addition to:

  • Rapid weight gain due to fluid retention
  • Swelling in the abdomen
  • Swelling of the legs, ankles, and feet.
  • Weakness and fatigue
  • Irregular or rapid heartbeat

Causes of tricuspid atresia

Tricuspid atresia is an abnormal form of congenital heart disease. It affects 5 out of every 100,000 live births. One in five people with this condition will also have other heart problems. Normally, blood flows from the body into the right atrium, then through the tricuspid valve into the right ventricle and into the lungs. If the tricuspid valve does not open, blood will not flow from the right atrium to the right ventricle. Due to a problem with the tricuspid valve, the blood eventually does not enter the lungs. This is where you go to pick up oxygen (get oxygenated).

Instead, the blood passes through a hole between the right and left atria. In the left atrium, it mixes with oxygen-rich blood and returns from the lungs. This oxygen-depleted, oxygen-rich blood mixture is pumped into the body from the left ventricle. This makes the oxygen level in the blood lower than normal. In those with tricuspid atresia, the lungs receive blood through a hole between the right and left ventricles (described above) or through a fetal vessel called the ductus arteriosus. The ductus arteriosus connects the pulmonary artery (artery to the lungs) to the aorta (the main artery in the body). It occurs when a baby is born but usually shuts down immediately after birth.

How is tricuspid atresia diagnosed?

She suffers from a prenatal ultrasound exam for tricuspid atresia. Otherwise, symptoms appear immediately after birth. A pediatric cardiologist or neonatologist will help you care for your child. These are doctors who are specially trained to treat problems in children. One or more healthcare providers will examine your child. They will listen to your baby’s heart and lungs with a stethoscope and notice any abnormal sounds from the heart (heart murmur).

Congenital heart disease tests may include:

  • Pulse oximetry: A simple test that uses a small probe to check the amount of oxygen in the blood.
  • Lab tests: Blood and urine samples are reviewed.
  • Chest x-ray: Chest radiography often shows visible changes with tricuspid atresia.
  • Electrocardiogram (ECG): An ECG records the electrical activity of the heart. Shows abnormal rhythms and detects heart muscle tension.
  • Echocardiogram (Echo): It uses resonant sound waves to create a moving image of the heart and heart valves. Tricuspid atresia is diagnosed based on the detection of abnormal heart structures.
  • Cardiac catheterization: This procedure provides very detailed information about the internal structures of the heart. Your child will be given medicine to rest (intoxicated). Then a thin, flexible tube (catheter) is inserted into your baby’s groin. Guide the heart. Blood pressure and oxygen measurements are taken in the chambers of the heart, pulmonary artery, and aorta. Contrast dye is also injected to see the structures inside the heart more clearly. Cardiac catheterization is not often done to diagnose this condition, but it can be done before surgery and in the early treatment of the defect.

Treatment of tricuspid atresia

In tricuspid atresia, there is no way to replace the tricuspid valve. Treatment includes surgery to ensure adequate blood flow through the heart and into the lungs. This often requires more than one surgery. Medications may also be given before surgery to strengthen the heart muscle, lower blood pressure, and remove excess fluid and associated oxygen from the baby’s body.


Some methods used to treat tricuspid atresia include temporary relief (palliative surgery) to increase blood flow. Required procedures:

  • Atrial septostomy: This creates or widens the opening between the upper chambers of the heart to allow more blood to flow from the right atrium to the left.
  • Maneuvers: Creates a shunt (shunt) from the main blood vessel leading from the heart to the blood vessel leading to the lungs (pulmonary artery), which improves oxygen levels. Surgeons usually implant a shunt in the first two weeks of life. However, children usually outgrow this shunt and may need another surgery to replace it.
  • Placement of a pulmonary artery band: If your baby is flowing more blood from the heart to the lungs, a surgeon may place a band around the pulmonary artery to reduce the flow.
  • Operation Glen: When children outgrow the first bypass, they often need this surgery, which sets the stage for a more permanent corrective surgery called the Fontan procedure. Doctors usually perform a glen operation when the baby is between 3 and 6 months old. Doctors first remove the shunt and then connect it to the pulmonary artery instead of one of the large veins (superior vena cava) that returns blood to the heart. This procedure allows blood to flow directly to the lungs and reduces the workload on the left ventricle, thus reducing the risk of damage.
  • Fonton approach: Variation from this standard treatment of tricuspid atresia usually occurs in children 2 to 3 years of age. Typically, the surgeon creates a path for blood returning to the heart (inferior vena cava) to flow directly to the pulmonary arteries, which then carry the blood to the lungs. Sometimes doctors leave an opening between the pathway and the right atrium (fenestration).


Before surgery, your pediatric cardiologist may recommend that your child take prostaglandins.

Lifestyle and home remedies

Here are some tips for caring for your child with tricuspid atresia:

  • Strive for good nutrition: Your baby may not get enough calories due to fatigue and high-calorie intake while eating. It is often helpful to give your baby small, frequent feedings.
  • Breast milk is an excellent source of nutrition, but the formula works well too. Your doctor may prescribe a special high-calorie formula.
  • Preventive antibiotics: Your cardiologist or pediatrician may recommend preventive antibiotics before certain dental and other procedures to prevent a bacterial infection of the lining of the heart (infective endocarditis).
  • Following good oral hygiene (brushing and floating, getting regular dental checkups) can also help prevent infection.
  • Be active: Encourage regular play and activities as much as you or your child can tolerate or have enough opportunities to relax as recommended by your doctor. Being active can help you maintain your or your child’s heart health.
  • Continue with regular medical and pediatric care: Children with congenital heart defects, as well as standard vaccinations, are encouraged to get vaccinated against influenza, pneumonia, and respiratory syncytial virus infections. Your child must take all prescription medications.
  • Continue with other appointments with yourself or your pediatrician. Your baby needs at least yearly appointments with a doctor trained in congenital heart conditions. Your pediatrician will likely recommend several tests to evaluate your / your child’s heart condition.

Adults with tricuspid atresia

If you are an adult with tricuspid atresia, you should see a trained doctor throughout your life regularly for heart conditions that present with childbirth in adulthood. During these appointments, your doctor may recommend routine tests to assess your condition. Your doctor may recommend that you take preventive antibiotics before certain medical or dental procedures to prevent infective endocarditis. Ask your doctor what activities are best for you and what sports or activities to limit or avoid.

Tricuspid atresia: Results

  • This tiered approach is generally good for children with tricuspid atresia, as three individuals can survive 75 to 95 percent in three stages, depending on the exact deformities and surgery.
  • Long-term quality of life after Fontan operation is now better in patients older than 30 years. However, many problems can arise. These include heart rhythm problems that require medication or pacemaker placement.
  • Patients also experience lung and lung problems, leading to decreased oxygen in the blood or digestive problems caused by loss of protein in the stool, inflammation, and water retention. For minority patients, heart, lung, and lung transplants may be necessary later in life.

Prevention of Chronic Fatigue Syndrome (CFS) | Neurology

What is chronic fatigue syndrome?

  • Chronic fatigue syndrome (CFS) is a disorder considered by extreme fatigue or tiredness that does not go away with rest and cannot be explained by an underlying medical condition.
  • CFS may also be called myalgic encephalomyelitis (MS) or systemic stress intolerance disease (SEID).
  • The causes of chronic fatigue syndrome are not yet fully understood. Some theories include viral infection, psychological stress, or a mixture of factors.
  • Because no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be problematic to diagnose.
  • There is no testing for CFS. Your doctor will have to rule out other causes of your fatigue when determining a diagnosis.
  • While CFS was previously a controversial diagnosis, it is now widely accepted as a medical condition.
  • Chronic fatigue syndrome can affect anyone, although it is most common among women in their 40s and 50s. There is currently no cure, but treatment can relieve symptoms.

Causes of chronic fatigue syndrome

The cause of CFS is unknown. There may be more than one cause. It is possible that two or more triggers work together to cause the disease.

Symptoms of chronic fatigue syndrome

Myalgic encephalomyelitis / chronic fatigue syndrome (ME / CFS) is about more than feeling tired all the time. It comes with many other symptoms that can make managing daily life difficult. Even simple things like walking to the mailbox or writing a letter can make things worse. Fatigue and symptoms can last 6 months or they can last for years. Sleep and rest don’t make it better either. A doctor can help relieve your symptoms, but you must first receive a diagnosis.

If you have ME / CFS, you will have these three “core” symptoms:

  • Reduced ability to perform usual activities for six months or more due to fatigue
  • Worsening of symptoms (difficulty thinking, trouble sleeping, sore throat, headaches, feeling dizzy or very tired). after regular physical or mental activity
  • Difficulty falling asleep or staying asleep

Along with all three symptoms, you must have one of these for a chronic fatigue syndrome diagnosis:

  • Problems with thinking and memory
  • Worsening of symptoms when standing or sitting upright; You may feel lightheaded, dizzy, or weak, and you may have blurred vision or see spots.

Diagnosis of  chronic fatigue syndrome

There is no specific test for CFS / ME, so it is diagnosed based on your symptoms and ruling out other conditions that could be causing your symptoms.

  • Your GP will ask about your symptoms and medical history. You may also have blood and urine tests.
  • Since the symptoms of CFS / ME are similar to those of many common illnesses that generally improve on their own, a diagnosis of CFS / ME may be considered if it does not improve as quickly as expected.

Treatment of chronic fatigue syndrome (CFS / ME)

Treatment for ME / CFS aims to relieve symptoms. Your treatment will depend on how CFS / ME affects you.

Treatments include:

  • Cognitive-behavioral therapy (CBT)
  • A structured exercise program called graded exercise therapy (GET)
  • Medicine to control pain, nausea, and trouble sleeping
  • Most people with CFS get better over time, although some people do not fully recover.

There are also likely to be periods when your symptoms get better or worse. Children and youth with CFS / ME are more likely to make a full recovery.

Risk factors

Factors that can increase your risk of chronic fatigue syndrome include:

  • Years: Chronic fatigue syndrome can occur at any age, but it most often affects young and middle-aged adults.
  • Sex: Women are diagnosed with chronic fatigue syndrome much more frequently than men, but women may just be more likely to report their symptoms to a doctor.


Possible complications of chronic fatigue syndrome include:

  • Lifestyle restrictions
  • Increase in absences from work
  • Social isolation
  • Depression

Prevention of chronic fatigue syndrome

10 tips to prevent Chronic fatigue syndrome:

  • Avoid overexertion
  • Get your Zzzz
  • Calm stress
  • Zap root diseases
  • Include an extra break at special events
  • Calculate your limits
  • Adopt a reasonable schedule
  • Increase your energy level with food
  • Exercise, but do it wisely
  • Keep your head up

Treatments of Dyspraxia (Developmental Coordination Disorder) | Neurology

What is dyspraxia?

Dyspraxia is a brain-based movement disorder. It influences fine and gross motor skills, motor planning, and coordination. It is not related to intelligence, but it can sometimes affect cognitive skills.

Dyspraxia is sometimes used interchangeably with Developmental Coordination Disorder (DCD). While some clinicians may consider these terms separate, since there is no formal definition, others consider them to be the same. Children born with dyspraxia may be late in reaching developmental milestones. They also have a problem with balance and coordination.

In adolescence and adulthood, symptoms of dyspraxia can lead to learning difficulties and low self-esteem. It is a lifelong condition. There is currently no cure, but there are treatments that can help you manage this disorder effectively.

Symptoms of dyspraxia

Symptoms tend to vary with the individual’s age. Later, we’ll look at each age group in more detail. Some of the general symptoms of this disease include:

  • Poor posture
  • Fatigue
  • Differences in speech
  • Perception problems
  • Poor balance
  • Clumsiness
  • Poor hand-eye coordination

Causes of dyspraxia

Making coordinated movements is a complex process that involves many different nerves and parts of the brain. Any problem with this process may lead to difficulties with movement and coordination.

It is not usually clear why coordination does not develop like other abilities in children with dyspraxia. However, a number of risk factors have been identified that can increase a child’s likelihood of developing dyspraxia.

These include:

  • Premature labour, before the 37th week of pregnancy
  • Being born with a low birth weight
  • Having a family background of dyspraxia, in spite of the fact that it isn’t clear precisely which qualities might be associated with the condition
  • The mother drinks alcohol or does drugs during pregnancy

How is dyspraxia diagnosed?

In the event that you are worried that your kid has dyspraxia, counsel your primary care physician for exhortation, and referral to other specialists.

Your child may be referred to, for example:

  • Speech pathologists for oral and verbal dyspraxia
  • Occupational therapists for oral and motor dyspraxia
  • Physiotherapists for motor dyspraxia

Every doctor will utilize an assortment of appraisal instruments. Your doctor will likely coordinate the evaluation and diagnosis process.

Risk factors

Dyspraxia is more normal in guys than in females. It also tends to run in families.

It may include risk factors for developmental coordination disorders:

  • Premature birth
  • Low birth weight
  • Drug or alcohol abuse from the mother during pregnancy
  • A family history of developmental coordination disorders

It is not unusual for a child with dyspraxia to have other conditions with overlapping symptoms. Some of these:

  • Attention deficit hyperactivity disorder (ADHD), This causes hyperactive behaviours, difficulty concentrating, and difficulty sitting for long periods
  • Autism spectrum disorder, A neurodevelopmental problem that meddles with social connection and correspondence
  • Youth apraxia of discourse, Which makes it hard to talk plainly
  • Dyscalculia, A disorder that makes it difficult to understand numerology and understand concepts of value and quantity
  • Dyspraxia, Which affects reading and reading comprehension

Although some of the symptoms are similar, these other conditions do not involve the same problems with fine and gross motor skills for dyspraxia. Other conditions such as cerebral palsy, muscular dystrophy, and stroke can cause physical symptoms similar to indigestion. This is why it is so important to visit a doctor to get a correct diagnosis.

Dyspraxia treatments

The treatment for dyspraxia depends on the child’s symptoms. It aims to support or help your child build skills in the areas he is struggling in.

It may include occupational therapy, motor-perceptual training, and speech therapy. Your child may also be eligible for help at school, and your child’s therapist can teach you ways to help your child at home. There are even fun applications that can support your kid.

Occupational Therapy

Your child will learn to improve coordination for doing daily tasks. They may hold a pencil or walk around objects. An occupational therapist may use special devices to support your child as he learns to improve coordination.

Perceptual motor training

This training can be occupational or physical therapy. Through exercises, your child will build their skills in:

  • Movement and coordination
  • Visual perception
  • Listening and following directions
  • Language

Speech therapy

A speech-language pathologist can help your child with speech and other speech problems. They will have explicit activities that will fabricate your youngster’s abilities. Numerous youngsters with developmental coordination disorder create typical discourse with assistance.

School-based therapy

Numerous schools offer speech therapy, occupational therapy, or both. Your child will need to be evaluated for these special services so that the school therapist can create a plan to help your child.

Your kid may profit by being in a little gathering to work on composing, social abilities, or physical instruction. Your child’s teacher can help, too. They can break homework into smaller tasks or allow your child to use a computer to type in their work.


The outlook for people with developmental coordination disorder depends on the severity of the disorder, its cause, and the availability of early intervention. People with developmental coordination disorder may be able to learn the skills needed to circumvent difficulties and lead normal, productive lives.


Since the cause of developmental coordination disorder is unknown, it is difficult to prevent it. It may be possible to reduce your baby’s chance of developing dyspraxia by not using tobacco, illegal drugs, or alcohol during pregnancy.


Overview of Peripheral Vascular Disease | Cardiology

What is peripheral vascular disease?

Peripheral vascular disease (PVD) is a circulatory disorder that causes blood vessels outside the heart and brain to narrow, block, or contract. It can occur in your arteries or veins. The peripheral vascular disease generally causes pain and fatigue, often in the legs and especially when exercising. The pain usually improves with rest.

Signs/symptoms of peripheral vascular disease

People with the peripheral vascular disease do not have any symptoms. Possible symptoms include:

  • Hair loss on the feet and legs.
  • The thigh or calf muscles may feel pain when walking or climbing stairs, some individuals complain of painful hips.
  • Leg weakness.
  • A foot or the lower leg may feel cold.
  • Numbness in the legs.
  • Brittle toenails.
  • Toenails grow slowly.
  • Sores or ulcers on the legs and feet that take a long time to heal (or never heal).
  • The skin on the legs becomes shiny or turns pale or bluish.
  • Difficulty in finding a pulse in the leg or foot.
  • Erectile dysfunction (impotence in men, problems achieving or sustaining an erection).

Causes of peripheral vascular disease

Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, fatty deposits (plaques) form on the walls of the arteries and reduce blood flow. Although discussions of atherosclerosis generally focus on the heart, the disease affects arteries throughout the body.

When it occurs in the arteries that supply blood to the organs, it can cause peripheral artery disease. Less commonly, peripheral artery disease can be caused by inflammation of the blood vessels, injury to organs, abnormal anatomy of tendons or muscles, or exposure to radiation.

Risk Factors of peripheral vascular disease

You’re at higher risk for peripheral vascular disease if you:

  • Are over age 50
  • Are overweight
  • Have abnormal cholesterol
  • Have a history of cerebrovascular disease or stroke
  • Have heart disease
  • Have diabetes
  • Have a family history of high cholesterol, high blood pressure, or peripheral vascular disease
  • Have high blood pressure
  • Have kidney disease on hemodialysis

Lifestyle choices that can increase your risk of developing the peripheral vascular disease include:

  • Not engaging in physical exercise
  • Poor eating habits
  • Smoking
  • Drug use

Diagnosis of peripheral vascular disease

The differential diagnosis of the peripheral vascular disease includes musculoskeletal and neurological factors. Spinal stenosis also causes compression of each equine, resulting in pain that radiates to both legs. The pain occurs when walking (i.e., pseudocopulation) or standing for a long time and does not subside quickly with rest.

Additional conditions to consider include acute embolism, deep or superficial vein thrombosis, restless leg syndrome, systemic vasculitis, nocturnal leg cramps, muscle or tendon strains, peripheral neuropathy, and arthritis. Some tests your doctor relies on to diagnose peripheral artery disease are:

Physical exam: Your doctor may find signs of peripheral vascular disease on physical examination, a weak or absent pulse below the narrow area of ​​your artery, sounds (fruit) in your arteries that can be heard with a stethoscope, evidence of poor wound healing in an area where your blood flow is restricted and the blood pressure in your affected organ is low.

Ankle-brachial index (ITB): This is a simple test used to diagnose peripheral vascular disease. Compare the blood pressure in your ankle with the blood pressure in your hand. To obtain a blood pressure reading, your doctor will use a simple blood pressure cuff and a special ultrasound device to assess blood pressure and flow. You can walk on a treadmill and take readings before and immediately after exercise to capture the severity of your narrow arteries during your walk.

Ultrasound: Specialized ultrasound imaging techniques, such as doppler ultrasound, can help your doctor evaluate blood flow through blood vessels and identify blocked or narrow arteries.

Angiography: Using a dye (contrast material) inserted into your blood vessels, this test allows you to watch your doctor while watching the flow of blood through your arteries. Your doctor can detect the flow of contrast material using imaging techniques such as X-ray imaging or magnetic resonance angiography (MRA) or computed tomography angiography (CTA).

Catheter angiography: Catheter angiography is a more serious procedure that involves guiding the catheter through the artery in the groin to the affected area and injecting color that way. Despite the aggression, this type of angiography allows simultaneous diagnosis and treatment. After finding the narrow area of ​​the blood vessel, your doctor may inflate it by inserting and inflating a small balloon or by administering medications that improve blood flow.

Blood test: You can use a blood sample to measure your cholesterol and triglycerides and check for diabetes.

Treatments of peripheral vascular disease

Goals of treatment for peripheral arterial disease:

  • Relief of pain from intermittent claudication.
  • Improve exercise endurance by increasing walking distance before the start of the liner.
  • Avoid the development of a complex artery that can lead to foot ulcers, gangrene, and amputation.
  • Avoid heart attacks and strokes.

Treatment for peripheral arterial disease includes lifestyle measures, supervised exercises, medications, angioplasty, and surgery.

Changes in lifestyle: Quitting smoking removes a major risk factor for disease progression and reduces the incidence of pain at rest and dissection. Quitting smoking is also important to prevent heart attacks and strokes.

Supervised exercise: Proper exercise allows the muscles to use oxygen more efficiently and accelerates the development of collateral circulation. Clinical trials have shown that regularly controlled exercise reduces symptoms of intermittent claudication and allows people to walk longer before the onset of claudication. Ideally, your healthcare provider should prescribe an exercise program tailored to your specific needs.

Rehabilitation programs can help under the supervision of health professionals, such as nurses or physical therapists. Exercise at least three times a week, with each session lasting no more than 30 to 45 minutes for the best results. Exercise generally involves walking on a treadmill with a monitor until the lining develops; The walking time increases gradually with each session. Patients are also monitored for the development of chest pain or heart rhythm disturbances during exercise.

Complications of peripheral vascular disease

Complications of peripheral vascular disease are often caused by reduced or no blood flow. Such problems can include:

  • Amputation (loss of a limb)
  • Poor wound healing
  • Limited consciousness due to pain or discomfort
  • Severe pain in the affected limbs
  • Stroke (3 times more common in people with the peripheral vascular disease)

Prevention of peripheral vascular disease

The best way to prevent peripheral vascular disease is to maintain an active and healthy lifestyle:

  • Stop smoking: Tobacco smoke is a major risk factor for peripheral vascular disease and your risk of heart attack and stroke. It can help slow the progression of peripheral vascular disease and other heart-related diseases.
  • Work to control your blood pressure, cholesterol, and glucose levels. Working with a coordinated health care team and making the lifestyle changes needed to better manage diabetes can reduce organ-related problems.
  • Get regular exercise: The most effective treatment for peripheral vascular disease symptoms is regular physical activity. Your doctor may recommend a program of exercise training to monitor for you, also known as cardiac rehabilitation. You need to start slowly, but regular walking rules, leg exercises, and treadmill exercise programs can reduce symptoms.
  • Intermittent exercise for cladding: Taking into account the fact that plaque formation causes poor circulation in the arteries of the leg – can lead to gait pain. This program has alternative functionality and increases the amount of time you can walk before the pain starts. It is a good idea to take this exercise program to the rehab center on the treadmill. If going to a rehabilitation center is not possible, your healthcare professional may recommend a structured community or home-based program that best suits your situation. You may want to speak with your doctor to find out which exercise program is right for you.
  • Follow a diet low in fat and cholesterol and eat more fruits and vegetables. If you are overweight or behind, plan a weight loss plan with your doctor. Many peripheral vascular disease patients have elevated cholesterol levels. A diet low in saturated and trans fat can help lower blood cholesterol levels, but cholesterol-lowering medications may be needed to maintain proper cholesterol levels.



Symptoms, Causes, and Treatments of Stroke | Neurology

What is a Stroke?

A stroke occurs when the blood supply to a part of the brain is cut off or reduced, preventing the brain tissue from receiving oxygen and nutrients. Brain cells die in minutes. It is a medical emergency and prompt treatment is very important. Proactive action reduces brain damage and other problems.

Other names

  • Brain attack
  • Cerebrovascular accident (CVA)
  • Hemorrhagic stroke (includes intracerebral hemorrhage and subarachnoid hemorrhage)
  • Ischemic stroke (includes thrombotic stroke and embolic stroke)

Signs/symptoms of stroke

  • Unexpected numbness or weakness in the face, arms, or legs, especially on one side of the body.
  • Sudden confusion, trouble speaking, or trouble understanding speech.
  • Sudden trouble seeing with one or both eyes.
  • Sudden trouble walking, loss of balance, dizziness, or lack of coordination.
  • Sudden, severe headache for no apparent reason.

Types of strokes

The treatment for stroke depends on its type. The three main types of stroke are:

  • Ischemic attack: It is one of the three types of strokes. It is also known as cerebral ischemia and cerebral ischemia. This type of attack is caused by a blockage in the artery that supplies blood to the brain. The blockage reduces blood flow and oxygen to the brain, leading to damage or death of brain cells. If circulation is not restored quickly, brain damage can be permanent.
  • Hemorrhagic attack: Hemorrhagic attack when blood from an artery begins to bleed into the brain. This occurs when weak blood vessels break and bleed into the surrounding brain. The pressure of the filtered blood damages the brain cells, and as a result, the damaged area becomes unable to function properly.
  • Transient ischemic attack (a warning or “mini-stroke”): Transient ischemic attack (TIA) is an attack that lasts only a few minutes. This occurs when the blood supply to a part of the brain is briefly blocked. Symptoms of TIA are similar to other stroke symptoms, but they don’t last long. They happen suddenly.

Causes of stroke

It can treat certain conditions for which you can have a stroke. Other things that put you at risk will not change:

Hypertension: Your doctor calls this blood pressure. If your blood pressure is usually 140/90 or higher, your doctor will discuss treatments with you.

Tobacco: Smoking or chewing can increase your chances of having a stroke. Nicotine makes your blood pressure go up. Cigarette smoke increases fat in the main cervical artery. It also makes your blood thicker and more likely to clot. Secondhand smoke can affect you too.

Heart disease: This condition includes defective heart valves, as well as atrial fibrillation or irregular heartbeat, which account for about a quarter of all strokes in most adults. You can also have arteries clogged by fatty deposits.

Diabetes: People who suffer from it tend to have high blood pressure and are overweight. Diabetes can damage your blood vessels, making you more likely to have an attack. If you have a stroke when your blood sugar levels are high, your brain injury is high.

Risk factors of stroke

Main risk factors:

  • Hypertension
  • Diabetes
  • Cardiovascular diseases- Coronary heart disease, atrial fibrillation, heart valve disease, and carotid artery disease.
  • High levels of LDL cholesterol
  • Smoking
  • Brain aneurysms or arteriovenous deformities (AVM). AVMs are malformed arteries and veins that open to the brain.
  • Inflammatory infections or conditions such as lupus or rheumatoid arthritis.
  • A stroke can occur at any age, but the risk is higher in children and adults younger than 1 year. In adults, the risk increases with age.
  • At a younger age, it is more common in women than in men. But women live longer, so the risk of stroke is higher during their lifetime. birth control pills or use hormone replacement therapy can cause a stroke. Women are also at higher risk during pregnancy and during the postpartum weeks. High blood pressure during pregnancy, due to pre-eclampsia, increases the risk of stroke later in life.
  • Race and ethnicity: It is more common in African American, Alaska Native, American Indian, and Hispanic adults than in white adults.
  • Family history and genetics: If your parents or other family members have had a stroke, you are at special risk of having a stroke at a young age. Certain genes can affect your risk of stroke, including those that determine your blood type. People with blood type AB (which is not normal) are at higher risk.

Other risk factors that can be controlled, including:

  • Anxiety, depression, and high levels of stress. Working long hours and not having much contact with friends, family, or others outside the home also increases the risk of this disease.
  • Living or working in areas with air pollution.
  • Other medical conditions such as bleeding disorders, sleep apnea, kidney disease, migraine, and sickle cell anemia.
  • Other medicines that cause blood thinning or bleeding.
  • Other unhealthy lifestyle habits such as eating unhealthy foods, not engaging in regular physical activity, drinking alcohol, sleeping too much (more than 9 hours), and using illicit drugs such as cocaine.
  • Excess weight and delays or extra weight load around the waist and abdomen.

Diagnosis of stroke

The first step in evaluating the patient is to determine whether the patient is experiencing an ischemic or hemorrhagic attack so that appropriate treatment can begin. Head CT or MRI is usually the first test done.

Physical exam: Your doctor will perform various tests, such as listening to your heart and checking your blood pressure. They will also do a neurological exam to see how a possible stroke affects your nervous system.

Blood test: You may have several blood tests, including tests to see if your blood clots quickly, if your blood sugar is too high or too low, and if you have an infection.

Computed tomography (CT): A CT scan is done to view a detailed image of your brain. The CT scan shows bleeding, ischemic attack, tumor, or other conditions in the brain. Doctors can inject a dye into the bloodstream (CT angiography) to see the blood vessels in the neck and brain in more detail.

Magnetic resonance imaging (MRI): An MRI is done to create a detailed view of your brain. MRI can detect brain tissue damaged by ischemic attack and brain hemorrhage. Your doctor may inject a dye into a blood vessel (magnetic resonance angiography or magnetic resonance venography) to view the arteries and veins and enhance blood flow.

Carotid ultrasound: This test uses sound waves to create detailed images of the inside of the carotid arteries in your neck. This test increases fatty deposits (plaques) in the carotid arteries and increases blood flow.

Cerebral angiogram: In this abnormally used test, your doctor will make a small incision, usually in the groin, inserting a thin, flexible tube (catheter) through your main arteries and into your carotid or vertebral artery. Your doctor will then inject a dye into your blood vessels and make them visible under X-ray images. This procedure provides a detailed view of your brain and the arteries in your neck.

Echocardiogram: An echocardiogram can detect the source of clots in your heart, which can travel from your heart to your brain and cause your stroke.

Treatments for stroke

Treatment is based on the type of stroke.

Ischemic stroke: Treatment for this disease focuses on the restoration of blood to the brain.

  • You can get a freeze-thaw medicine called tissue plasminogen activator (TPA). This medicine improves recovery from a stroke. Doctors try to give this medicine within 3 hours of the start of symptoms. Some people can get help if they can get this medicine within 40 hours of the first symptoms.
  • You can also get aspirin or another antiplatelet medicine.
  • In some cases, a procedure may be done to restore blood flow. The doctor uses a thin, flexible tube (catheter) and a small cage to remove the blood clot. This procedure is called a thrombectomy.

Hemorrhagic stroke: Treatment focuses on controlling bleeding, reducing stress on the brain, and stabilizing important signals, especially blood pressure.

  • To stop the bleeding, you may receive a blood transfusion, such as medicine or plasma. These are administered intravenously.
  • Look closely for signs of increased stress on the brain. These signs include restlessness, confusion, trouble following orders, and headaches. Excessive coughing, vomiting, or other measures taken to avoid lifting or crossing stools or straining to change position.
  • If the bleeding is from a ruptured brain aneurysm, surgery may be done to repair the aneurysm.
  • In some cases, medications may be given to control blood pressure, meningitis, blood sugar levels, fever, and seizures.
  • If a large amount of bleeding occurs and symptoms quickly get worse, you may need surgery. Surgery can remove the blood that collects inside the brain and reduce the pressure inside the head.

Complications of stroke

Deep vein thrombosis (DVT): If the blood is moving too slowly through your veins, it can cause a clot or a lump in the blood vessels. When blood clots in a vein, it can cause deep vein thrombosis. DVT is more likely to occur in the lower leg or thigh, but can also occur in other parts of the body. The DVT case can be fatal if the blood clots and goes to an important organ. Medications and early mobilization treatment after stroke can prevent DVT and help a person return to walking and other activities quickly.

Convulsions: It can injure the brain, resulting in scar tissue. This scar tissue interferes with the electrical activity of the brain. Interruption of electrical activity can cause seizures. Epilepsy is one of the most common complications of ischemic attack, affecting 22% of survivors.

Pneumonia: Pneumonia is a leading cause of illness and death. According to the Indiana University School of Medicine, pneumonia is the most common cause of hospitalization. In the case of a stroke, difficulty swallowing may cause aspiration, or food or fluids may enter the airways, leading to a chest infection or pneumonia.

Cerebral edema: Inflammation is part of the body’s natural response to injury. Edema refers to inflammation due to trapped fluid. If edema occurs in the brain, it can cause serious problems. Cerebral edema restricts blood supply to the brain, resulting in brain tissue death. Inflammation of the brain is one of the major complications of ischemic attack. Getting medical treatment as soon as the symptoms of a stroke are noticed reduces the chance of developing severe brain edema.

Bladder problems: There is a lot of bladder-related problems that can arise from a stroke. Often, stroke survivors have a strong urge or need to urinate frequently. When stroke survivors are unable to reach the bathroom or relieve themselves adequately because of the inability to remove clothing, this is called functional incontinence. Consequently, when a stroke survivor is unable to empty their bladder completely, this is called urinary retention. If this happens, the person will need a catheter to make sure the bladder is completely empty.

Clinical depression: Clinical depression often occurs after a major health crisis. One in four stroke survivors suffers from severe depression. Depression can cause sadness, irritability, difficulty concentrating, helplessness, apathy, changes in appetite and sleep patterns, and sometimes even suicidal thoughts. It is important to treat depression with the help of mental health providers.

Pressure sores: When the soft tissue is pressed too hard on a hard surface such as a chair or bed, the blood supply to that area decreases. This causes the skin tissue to be damaged or die. When this happens, a sore throat can occur. Prevention with pressure sores is crucial: proper positioning and appropriate equipment are needed to prevent them. Stroke survivors should discuss appropriate equipment such as air mattresses and wheelchair cushions with their physician or therapist.

Contracts: Loss of movements over time contracts due to the abnormal reduction of soft tissue structures that extend into one or more joints. These include skin, tendons, ligaments, muscles, and joint capsules. Loss of movement in any of these structures restricts joint movement, leading to pain, stiffness, and eventually a contraction. Low-load, long-term stretch is the preferred method for contracture resolution. Such a product, Cybo Stretch, uses a revolutionary stretch technique to maintain or improve movement, while at the same time reducing joint damage and pain.

Shoulder pain: 80% of patients suffer from shoulder pain. Subluxation or partial dislocation of the shoulder, spasticity of the shoulder, tendon, and rotating cuff tears are the causes of shoulder pain. Shoulder pain can be treated by proper positioning, including joint support with orthotics, as well as early occupational and/or physical therapy intervention. In some cases, if the pain becomes chronic, the doctor may prescribe oral corticosteroids.

Waterfalls and accidents: Common impairments such as imbalance, sensory impairment, weakness, visual problems, and coordination disorder naturally increase the risk of falls and accidents. Physical and occupational therapy can help reduce this risk and restore stability and lost function. Home modifications and assistive devices can be purchased to help prevent falls and accidents while performing routine daily activities.

Prevention of stroke

The best way to help prevent a stroke is to eat a healthy diet, exercise regularly, smoke, and drink heavily.

These lifestyle changes lower your risk for problems:

  • Atherosclerosis (atherosclerosis)
  • Hypertension
  • High cholesterol levels

If you already have a stroke, making these changes can lower your risk of having another stroke in the future.

Diet: Stroke with diabetes has specific health problems that must be addressed through your diet under the guidance of a doctor. In general, the dietary recommendations for stroke recovery are similar to those for diabetics. Stroke patients are often advised to focus on eating lean protein and nutrient-rich fruits and vegetables while limiting sugar, salt, and fat. Most liquid meal replacements contain large amounts of sugar, including many yogurts, puddings, and jellies, which are delicious and very bland foods. If you have a stroke and diabetes patient, watch out for these and choose sugar-free versions.

Exercise: Exercise is a valuable component that is not yet used for post-stroke care. The American Heart Association / American Stroke Association recommends that survivors recommend exercise because they experience physical degeneration and often lead a sedentary lifestyle after a stroke.

This reduces your ability to carry out activities of daily living and increases your risk of having another stroke. Heart fitness, walking ability, and upper arm strength, as well as depression, cognitive function, memory, and memory. quality of life after a stroke can be improved by physical activity.

Stop smoking: Smoking or chewing tobacco increases your chances of having a stroke. Nicotine makes your blood pressure go up. Cigarette smoke increases fat in the main cervical artery. It also makes your blood thicker and more likely to clot. Secondhand smoke can affect it too.

Alcohol: Alcoholic beverages are high in calories and have no nutritional value. Reducing the amount of alcohol you drink can help you achieve and maintain a healthy weight.

Cut down on alcohol: Excessive alcohol consumption contributes to many risk factors for stroke. If you already have a stroke or transient ischemic attack (TIA), drinking only safe alcohol can help lower your risk of having another stroke.

High blood pressure: It is a major risk factor for stroke, and drinking too much alcohol can increase your blood pressure. Atrial fibrillation, a type of irregular heartbeat, is triggered by excessive alcohol consumption.

Diabetes: Being diabetic and being overweight increases your risk of having a stroke. Both risk factors are associated with excessive alcohol consumption.


Symptoms, Causes and Risks of Heart attack | Cardiology

What is a heart attack?

Heart attack means the death of a part of the heart muscle due to loss of blood supply. Blood is usually cut off when a blood clot blocks the artery that supplies the heart muscle. When part of the heart muscle dies, a person experiences chest pain and electrical instability of the heart muscle tissue.

Other names

  • Myocardial infarction (MI)
  • Acute myocardial infarction (AMI)
  • Acute coronary syndrome
  • Coronary thrombosis
  • Coronary occlusion

Signs, symptoms, and Complications

If you experience these heart attack warning signs do not wait to get help. Some heart attacks are sudden and severe. Take care of your body and call a physician if you experience it.

Chest discomfort: Most heart attacks have discomfort in the middle of the chest for more than a few minutes, or it may go away and come back. It can feel like uncomfortable stress, squeezing, fullness, or pain.

Discomfort in other parts of the body: Symptoms include pain or discomfort in one or both arms, back, neck, jaw, or abdomen.

Shortness of breath: It occurs with or without chest discomfort.

Other signs: There are other signs such as cold sweats, nausea, or a mild headache.

Damage to the heart during a heart attack often leads to complications, which can lead to further complications. Arrhythmia (abnormal heart rhythms), heart failure, cardiogenic shock, and valve problems are the most common complications.

Causes of heart attack

When one or more of your coronary arteries become blocked it leads to a heart attack. Over time, fatty deposits, including cholesterol, form substances called plaques, which can narrow the arteries (atherosclerosis). This condition, called coronary artery disease, causes many heart attacks.

  • During a heart attack, a plaque breaks down and leaks cholesterol and other substances into the bloodstream. Blood clots at the site of the break. If the clot is large, it can block blood flow through the coronary artery, depriving the heart of oxygen and nutrients (ischemia).
  • You may have a partial or complete blockage of the coronary artery.
  • Complete inhibition means you have an ST-elevation myocardial infarction (STEMI).
  • Partial occlusion means you have a non-ST elevation myocardial infarction (NSTEMI).
  • Diagnosis and treatment can vary depending on what type you have.
  • Another cause of heart attack is a narrowing of the coronary artery, which blocks blood flow to the heart muscle. Using tobacco and illicit drugs such as cocaine can lead to fatal seizures.
  • COVID-19 infection can also damage your heart and lead to a heart attack.

Risk factors of heart attack

The risk factors of a heart attack include:

Smoking: Chemicals in tobacco smoke can damage blood cells. They can also damage the function of your heart and the structure and function of your blood vessels. This damage increases your risk of atherosclerosis. Atherosclerosis is the formation of a waxy substance called plaque in the arteries. Over time, the plaque hardens and narrows the arteries.

It restricts the flow of oxygen-rich blood to your organs and other parts of your body. Ischemic heart disease occurs when plaque forms in the arteries that supply blood to the heart, called the coronary arteries. Over time, heart disease can lead to chest pain, heart attack, heart failure, arrhythmia, or death. Smoking increases the risk of heart disease when combined with unhealthy blood cholesterol levels, high blood pressure, and other risk factors such as being overweight or the esophagus.

High blood pressure: Blood pressure is measured by estimating the pressure of the blood flowing through your arteries against the walls of those arteries. During a heart attack, blood flow to some part of the heart muscle is restricted or cut off because the blood clot blocks the artery. Without the necessary blood supply, the affected part of your heart will not receive the oxygen it needs to function properly.

High blood cholesterol: When you have high cholesterol in your blood, it forms on the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries are narrow and slow or block blood flow to the heart muscle. Blood carries oxygen to the heart and if not enough blood and oxygen get to the heart, you can experience chest pain. If the blood supply to part of the heart is completely cut off, the result is a heart attack.

There are two forms of cholesterol known to most people low-density lipoprotein (LDL or “bad” cholesterol) and high-density lipoprotein (HDL or “good” cholesterol). These are the ways that cholesterol travels through the blood. The main source of arterial occlusion plaque is LDL. HDL works to remove cholesterol from the blood.

Overweight and obesity: His arrhythmia appears to be associated with a fatal heart attack. Inflammation is a major factor in cardiovascular disease, researchers say, and esophagitis is now increasingly recognized as an inflammatory condition.

An unhealthy diet: When it comes to heart disease risk, what you eat is yourself. Poor diet contributes to cholesterol and triglycerides, high blood pressure, diabetes, and balance. Several important studies provide compelling evidence that diet also affects the risk of complete coronary heart disease and heart attack.

Lack of routine physical activity: Not getting enough physical activity can lead to heart disease even for people who do not have other risk factors. It also increases the risk of developing other heart disease risk factors, including esophagitis, high blood pressure, high blood cholesterol, and type 2 diabetes.

High blood sugar due to insulin resistance or diabetes: The blood vessels and the nerves that control your heart and blood vessels can be damaged by high blood glucose from diabetes. If you have diabetes for a long time, you are more likely to get heart disease. People with heart disease are more prone to heart attack than with diabetes.

The most common causes of death in adults with diabetes are heart disease and stroke. Adults with diabetes are almost twice as likely to die of heart disease or stroke than those with diabetes. The good news is that the steps you take to manage your diabetes can also help reduce your risk of heart disease or stroke.

Risk factors such as arrears, high blood pressure, and high blood sugar can occur together. When they do, it is called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to have heart disease, and a person five times more likely to have diabetes than a person without metabolic syndrome.

Diagnosis of heart attack

Tests to diagnose a heart attack include:

  • Electrocardiogram (ECG): This first test done to diagnose a heart attack records electrical signals as they pass through your heart. Adhesive patches (electrodes) are attached to your chest and limbs. Signals are recorded as waves displayed on the monitor or printed on paper. Because the injured heart muscle does not normally conduct electrical impulses, an ECG shows that a heart attack has occurred or is in progress.
  • Blood tests: Some heart proteins will slowly leak into your bloodstream after a heart attack from a heart attack. Emergency room doctors take samples of your blood to check for these proteins or enzymes.

Treatments for heart attack

If your doctor suspects a heart attack, you can treat it immediately:

  • Aspirin to prevent blood clots
  • Nitroglycerin to relieve chest pain and improve blood flow
  • Oxygen therapy

Once your doctor has diagnosed a heart attack, they will prescribe medication. They may recommend surgery if necessary.

  • Give your medicine: The medicine drug is called thrombolytic. It helps to clot the blood that clogs the coronary artery.
  • Do a coronary angiography: X-ray of the blood vessels.
  • Do an angioplasty or stent: Angioplasty involves inserting a small balloon into an artery in your arm or leg. The balloon threads the artery to the heart. The balloon pushes the open black coronary arteries. A small metal rod called a stent can be placed in the clogged artery to keep the artery open.
  • Do coronary artery bypass surgery: If angioplasty and/or stenting is not appropriate, you may need this major surgery. Your doctor will remove a healthy vein from your leg or artery from your upper body. He or she will bypass around the blockage in your coronary artery. This allows blood to flow around the blockage.

Cardiac screening

  • If screening tests reveal coronary artery disease, there are steps you can take to reduce your risk for heart attack or exacerbated heart disease. Your doctor may recommend lifestyle changes such as a healthy diet, exercise, and smoking cessation. Medications may also be required. Medications can treat risk factors for coronary artery diseases (CAD) such as high cholesterol, high blood pressure, irregular heartbeat, and low blood flow.
  • A negative cardiac CT for calcium scoring means that no calcification has been found in your coronary arteries, indicating that there is no coronary artery disease or not being seen by this technique. Under these conditions, you are less likely to have a heart attack in the next two to five years.
  • A positive cardiac CT for calcium scoring means you have CAD regardless of what symptoms you are experiencing. Calcification is expressed as the total calcium score. A score of 1 to 10 indicates minimal evidence of CAD, 11 to 100 indicates mild evidence, 101 to 400 indicates moderate evidence of disease, and a score of more than 500 indicates extensive evidence of disease.
  • Your calcium score can help assess the likelihood of myocardial infarction (heart attack) in the years to come and help your doctor decide whether you should take preventative medicine or take other measures such as diet and exercise to reduce your risk of a heart attack.
  • If there is coronary artery disease, lifestyle changes, medications, and if necessary, medical or surgical procedures in stages to reduce the person’s risk of heart attack and manage symptoms.
  • Angioplasty and stenting: In an angioplasty procedure, a balloon-tipped catheter is used to guide a long, thin plastic tube into the coronary artery and to propel the vessel into a narrow or obstructed area. The balloon is then inflated, inflated, and removed to open the vessel. During angioplasty, a small wire mesh tube called a stent can be placed permanently in the newly opened artery to help keep it open. There are two types of stents: bare stents (wire mesh) and drug-eluting stents.
  • Coronary artery bypass graft surgery (CABG): CABG is a surgical instrument used to re-circulate blood around diseased vessels. During this surgery, a healthy artery or vein from other parts of the body connects or sticks to the coronary artery, bypassing the barrier, creating a new way for oxygen-rich blood to flow to the heart muscle.

Prevention of heart attack

  • Control your blood pressure: It is important to check your blood pressure regularly, once a year for most adults, and if you have high blood pressure. Take measures, including lifestyle changes to prevent or control high blood pressure.
  • Keep your cholesterol and triglyceride levels under control: High cholesterol clogs your arteries and increases the risk of coronary artery disease and heart attack. Lifestyle changes and medications (if needed) can lower your cholesterol. High levels of triglycerides increase the risk of coronary artery disease, especially in women.
  • Stay at a healthy weight: Obesity increases your risk of heart disease. They are associated with high blood cholesterol and triglyceride levels, as well as other heart disease risk factors, including high blood pressure and diabetes. Controlling your weight will reduce these risks.
  • Eat a healthy diet: Foods high in sodium, saturated fats, and added sugars should be consumed in limited quantities. Eat plenty of fresh fruits, vegetables, and whole grains. The dash diet is an example of an eating plan that can help you lower your blood pressure and cholesterol, which can reduce your risk of heart disease.
  • Get regular exercise: Exercise has many benefits such as strengthening your heart and improving your circulation. It can help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can reduce your risk of heart disease.
  • Limit alcohol: Excessive alcohol consumption can increase your blood pressure. It also adds extra calories, which can lead to weight gain. Both of these increase your risk of heart disease. Men should not have more than two alcoholic beverages per day and women should not have more than one.
  • Don’t smoke: Cigarette smoking raises your blood pressure and increases your risk of heart attack and stroke. If you do not smoke, do not start. If you smoke, quitting will reduce your heart disease. You can talk to your healthcare provider to help to find the best way to exit.
  • Manage stress: Stress is one of the causes of to increase in the risk of heart disease. It raises your blood pressure. Severe stress can “trigger” a heart attack. Also, some common ways to deal with stress, such as overeating, overeating, and smoking, are bad for your heart. Some of the ways that can help you manage your stress are exercise, listening to music, focusing on those who are calm or relaxed, and meditating.
  • Manage diabetes: Having diabetes doubles the risk of diabetic heart disease. This is because, over time, Blood vessels and the nerves that control your heart and blood vessels can be damaged by high blood sugar. So, it is important to get tested for diabetes, and if you have it, you need to keep it under control.
  • Make sure that you get enough sleep: If you do not get enough sleep, you will increase your risk of high blood pressure, esophagus, and diabetes. Those three things increase the risk of heart disease. 7 to 9 hours of sleep a night is required for adults. Make sure you have good sleep habits. If you have frequent sleep problems, consult your healthcare provider. One problem, sleep apnea, is that people often stop breathing during sleep. It can impair your ability to relax well and increase your risk of heart disease. If you think you may have it, ask your doctor about a sleep study. If you have sleep apnea, make sure you get treatment for it.