Sri Naraina Children and Women Clinic

High blood pressure is a condition which occurs when the pressure of the blood flow through the arteries increases, resulting in intense pressure. Hypertension occurs when the systolic pressure (pressure at which the heart pumps blood) and the diastolic pressure (pressure at which the heart relaxes) is more than 140 and 90 respectively.

Symptoms of high blood pressure are: 

1. Shortness of breath: If you have high blood pressure, then you may experience regular shortness of breath.
2. Headaches: You may experience headaches on a regular basis.
3. Weakness of the heart muscles: Hypertension results in a weak heart which may not be able to pump blood properly.
4. Narrowing of blood vessels: Narrowing of blood vessels may lead to other complications such as failure of the kidneys, heart, and brain.
5. Vision problems: It may lead to vision problems as blood vessels in the eye may be affected.

The various causes of blood pressure are: 

1. Tobacco: If you smoke on a regular basis, you put yourself at an increased risk of getting affected by blood pressure.
2. Lifestyle: Not exercising regularly, eating a sodium-rich diet are all factors which can increase the chances of hypertension.
3. Age: The chances of getting affected by hypertension increase as you age.
4. Weight: Being excessively obese also increases your risk of getting affected by hypertension.
5. Diabetes: Being diabetic makes you more prone to getting affected by diabetes.
6. Hyperthyroidism: If you have an overactive thyroid gland, then it may result in hypertension.

Hypertension may result in various health complications in the body such as:

1. Aneurysm: This is a disorder of the blood vessels which causes the blood vessels to bulge and weaken.
2. Heart attack: High blood pressure causes the arteries to harden and thicken which may lead to a heart attack.
3. Metabolic syndrome: This syndrome refers to a group of complications such as high bad cholesterol levels and insulin levels in the body.
4. Impaired brain functioning: It may also impair your ability to learn and impact your cognitive skills.

Some heart defects are present right from birth. We discuss the role of your genes in making you vulnerable to heart disease.
 

A heart attack can be fatal for any person, and it is necessary for you to know about the signs and symptoms of a heart attack. This will enable you to act early in case you experience the symptoms. Heart attack, also known as myocardial infarction, is a severe condition defined by the death of the heart muscles due to the loss of blood supply. Blood loss commonly occurs due to the blockage of a coronary artery.

Signs of a heart attack
There are many symptoms and signs of a heart attack which you should know. The symptoms usually vary from person to person. Here is a list of the common signs of a heart attack:

1. Chest pain and discomfort: Chest pain is the basic heart attack symptom which occurs in different forms. The chest pain is likely to cause pressure, fullness and a squeezing sensation. It starts from the centre of the chest and may spread to other limbs of the body, such as the head, upper abdomen, back, shoulder, neck or throat. It may reoccur in the chest again.
2. Shortness of breath: A gasping sensation or feeling of shortness of breath may be experienced. Such difficult or laboured breathing is known as dyspnea. The shortness of breath may occur before or after the chest pain.
3. Nausea and vomiting: A feeling of nausea or sickness in the stomach may be experienced. It may be accompanied by belching or burping. In some cases, the heart attack may be associated with a feeling of indigestion. Nausea is commonly experienced by women. The nausea may lead to vomiting.
4. Sweating: Perspiration or sweating occurs during a heart attack and the patient experiences cold sweats in excessive amounts. The sweat will appear in spite of not being active or working out. Due to the clogged arteries, the heart needs to make extra efforts to pump the blood. This produces extra sweat for keeping the body temperature low. Cold sweats and night sweats are also likely symptoms, which indicate a heart attack.
5. Fatigue: Fatigue is another symptom of a heart attack. Exhaustion is caused by a heart attack because of the added stress on the heart for pumping of blood. Feeling tired without any reason might indicate some trouble. Fatigue is more common in women. Light-headedness and dizziness may also be associated with a heart attack.

Heart palpitations may also be experienced sometimes. You should consult a doctor immediately after experiencing any of these symptoms of heart attack.

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

Why it's done

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by several conditions, including:

1. A weakening of the heart muscle (cardiomyopathy)
2. Coronary artery disease
3. Heart valve disease
4. A heart problem you're born with (congenital heart defect)
5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
6. Amyloidosis
7. Failure of a previous heart transplant
8. In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.

Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include:

1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

1. Are an advanced age that would interfere with the ability to recover from transplant surgery
2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
3. Have an active infection
4. Have a recent personal medical history of cancer
5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening.

There are many people worldwide who suffer from heart problems (irrespective of their age and sex). While in most cases, the condition improves with proper treatment and medications, in few, the condition is beyond treatment. A heart transplant comes as a savior for such people. It gives them a new lease of life. The transplant involves replacing a heart that has stopped functioning normally (damaged or may be diseased) with a healthy heart (from the donor).

Over the years, heart transplant has undergone a sea of change. With the advancement of science and technology, the success rate in a heart transplant has seen an exponential rise.

People who need a heart transplant:
A heart transplant may be essential in the following cases.

• A congenital heart disorder (a person born with a heart problem).
• Defective or diseased heart valves.
• Amyloidosis (a condition where amyloid fibrils get deposed in the tissues and organs of the body intracellularly or extracellularly).
• Problems in the coronary artery.
• Cardiomyopathy (A condition where the muscles of the heart become weak, thereby affecting the normal functioning of the heart).
• A heart transplant that failed previously.
• Ventricular Arrhythmias (a condition that originates in the ventricles, in ventricular arrhythmias, the heart rhythms are abnormally rapid).

However, under the following circumstances, a heart transplant may not be a wise idea

• People with infections or chronic lung or kidney disorders.
• A case of cancer in the past.
• Age may be a deciding factor.The recovery from a heart transplant may not be 100% in an aged person.

The heart transplant procedure:
The first step in heart transplant is the availability of a suitable donor. In this case, a donor is a person whose brain is dead but the other organs, including the heart, is healthy and functioning properly. A surgeon performs three operations in a heart transplant.

• The first operation is essentially the removal of the healthy heart from the donor body. The heart is kept in a cool place, preferably ice (to keep the heart alive and in good condition until the heart transplant takes place).
• In the second operation, the recipient's damaged or diseased heart is operated out.The situation may, however, be complicated if the patient had a heart surgery in the past.
• The third and the final surgery involves implanting the donor heart into the recipient body (the recipient's upper heart chambers and the atrial back wall are however not removed).
• Once the implantation takes place (without any complications), the surgeons sew the heart into place.
• The blood vessels are then connected back to the heart and the lungs. The heart starts beating again once it is warmed up.
• To enable the patient to receive the nutrients and oxygen (during the heart transplant), the patient is put on a heart-lung machine.
• If no complications develop after the transplant, the patient is discharged within a fortnight.

In some unfortunate cases, there may be organ rejection. The condition arises when the recipient's immune cells see the transplanted heart as non-self (foreign agents). If left unattended, it may damage the heart. Immunosuppressant drugs can help avert the rejection. However, it is important to monitor the patient closely for any infections that may arise to the administration of the immunosuppressants. If you wish to discuss about any specific problem, you can consult a Cardiologist.

High blood pressure, which is often a result of hypertension, is the leading risk factor for a stroke, which in turn leads to severe and long-term disability, including death. Managing your blood sugar levels is the most critical thing you can do to lessen your risk of a stroke, and you should leave no stone unturned in keeping your blood pressure at optimum levels.

What causes a stroke

A stroke, which is often referred to as a brain attack, takes place when the supply of blood to a particular region of the brain is cut off. The brain cells which are deprived of the oxygen and glucose die, and when the ailment is not caught early, a permanent damage to the brain can follow.

How is high blood pressure related to a stroke

Uncontrolled blood pressure levels can increase the risk of a stroke by about four to six times. With the passage of time, hypertension causes atherosclerosis as well as hardening of major arteries. This often results in blockages of small blood vessels present in the brain. With high blood pressure for a long period of time, the blood vessels of the brain become weak and burst. This way the risk of a stroke is directly related to the high levels of blood pressure.

What can you do to keep your blood pressure under control

There is a  lot you can do to keep the chance of a stroke at bay. But the first thing you should try doing is keeping your blood pressure level normal. Some simple lifestyle changes can help you to lead a risk-free life and therefore, you should first aim at shedding off those extra pounds along your waistline.

In general, a man with a waistline measuring over 40 inches and a woman with that over 35 inches is at a higher risk of suffering from high blood pressure as well as a stroke. You should exercise regularly for at least half an hour and eat a well-regulated diet loaded with fibre, proteins, potassium and Omega-3 fatty acids. Stay away from junk food and maintain a food diary where you can jot down your honest food habits.

It is very important to lower down your high blood pressure in order to avoid risks of stroke. But if you fail to do so even after following a healthy routine, then it is crucial to consult a doctor who can help you by prescribing medications that are right for your medical condition.

Cholesterol is generally regarded as something bad for the health. As a part of diet, everyone tries to avoid anything that has cholesterol in it. What needs to be understood is that not all cholesterol is bad. There is also good cholesterol, which is actually very essential for body functions. This is required for the production of essential hormones. Inadequate amounts of good cholesterol can lead to problems ranging from simple hormonal imbalances to severe issues like infertility.

The following are some food items, which contain sufficient amounts of good cholesterol and should find a place in your plate. They are essential for various body functions including hormone formation.

1. Avocado oil: Most oil is considered bad, but avocado oil contains about 70% of good cholesterol and should be used for its heart-healthy benefits. Being a great antioxidant, it protects the heart by reducing inflammation and by improving blood pressure. Eating whole avocado is also beneficial for the heart and the body as a whole.

2. Buckwheat: This whole grain is rich in many vitamins, quite a few minerals, and is a good provider of dietary fiber. It is also gluten-free and is rich in antioxidants, making it extremely cardio-friendly.

3. Soy: Too much saturated fat in the diet cannot be digested and the liver converts these and stores it, which adds to obesity. Soy which is a good replacement for animal fat and even dairy products can help improve cholesterol levels and prevent fat accumulation.

4. Salmon: This is one of the most heart-friendly food items, which is loaded with omega-3 fatty acids and good cholesterol. It lowers triglyceride levels and provides a good amount of protein for the body.

5. Spinach: The cholesterol which settles against the blood vessels is washed off by consuming spinach – in regular quantities at regular intervals. It is also the richest source of lutein, which is known as guardian against aging diseases including hypertension.

6. Go the nutty way: While most would consider nuts as rich in oils, truth is they are loaded with good cholesterol. Therefore, whether it is almonds or pecans, ground nuts or walnuts, nuts are great for the heart. They are also rich in minerals including calcium, copper, magnesium, and potassium and contain various vitamins. So about a teaspoon of chopped nuts should be on your plate on any given day.

7. Dark chocolate: Again, like nuts, most of us tend to avoid chocolate, but these restrictions are only for the white ones with sugar. The dark one is extremely healthy for the heart with loaded antioxidants, which prevents clogging of arteries. It is also rich in flavonoids, which are useful in controlling blood pressure and other heart diseases. If you wish to discuss about any specific problem, you can consult a General Physician.