During breathing activity, chest wall moves out & in, lungs expand & relax. For the smooth movement of the lungs inside the chest cavity, they are lined by pleura.

Pleura includes two thin linings, the layer lining lungs is called visceral pleura and the one lining chest wall is called parietal pleura. The cavity formed between these two layers is called Pleural cavity. It contains a small amount of lubricant called Pleural fluid which helps smooth sliding of two pleural surfaces. Any condition which results in inflammation of the pleural surfaces or accumulation of excessive fluid in the pleural cavity gives rise to symptoms attributable to pleural involvement or disease.

Pleural effusion is nothing but the collection of excess fluid in the pleural cavity. Excess fluid in the pleural space is not normal and can occur due to a variety of reasons. Depending on the chemical composition it is broadly divided into two categories, transudate and exudate. 


What Causes Pleural Effusion?

1. Transudate pleural effusions 

Transudate pleural effusion is formed when fluid leaks from blood vessels into the pleural space. Chemically, transudates contain less protein and LDH than exudates. It is generally seen in the following conditions.

Congestive heart failure

Liver failure or cirrhosis

Kidney failure or nephrotic syndrome

Peritoneal dialysis

2. Exudate pleural effusions 

Exudate pleural effusion is caused by inflammation of the pleura itself and are often due to diseases involving the lung. Following are some common illnesses giving rise to exudate pleural effusion.

Tuberculosis
Pneumonia
Lung or breast cancer
Lymphoma
Pulmonary embolism
Post chest wall trauma or surgery
Asbestosis and mesothelioma
Secondary to intra-abdominal pathology 
Pancreatic pseudocyst, etc
Symptoms of Pleural Effusion -

Chest Pain: Chest pain is mainly due to irritation of the pleural lining. The pain is sharp, localized and worsens with a deep breath, yawning, coughing which is usually described as pleuritic. If the effusion causes inflammation of the diaphragm the pain may be referred to the shoulder or the upper abdomen. As the pleural effusion increases in size, the pain may increase or disappear altogether due to the separation of inflamed pleural surfaces.

Shortness of breath: As the effusion grows larger with more fluid, the harder it is for the lung to expand and the more difficult it is for the patient to breathe resulting in shortness of breath.

Other Symptoms: Other symptoms are generally attributable to the underlying disease process.

Diagnosis of Pleural Effusion -

Patient s Detailed History and Clinical Examination are the mainstays of diagnosing pleural effusion and it s the underlying cause. Following investigative modalities are generally opted for working out the final diagnosis before instituting appropriate therapy.

Chest X-ray: X-ray will help indicate the presence of fluid. 
Chest Ultrasound(USG): will help in confirming the presence of the fluid and it s localization which in turn can guide the physician about its quantity and its capability.
CT Scan: CT scan of the chest may at times be required to ascertain the underlying cause or to know about any other co-morbid conditions.
Thoracentesis: Thoracentesis is a procedure used to sample the fluid from the pleural effusion. Using a long thin needle, fluid can be removed and sent for testing to confirm the diagnosis.
This can be just for diagnostic purposes or can even be used as a therapeutic procedure.
Chemical analysis of the fluid will help determine the type of pleural effusion.
Treatment of Pleural Effusion -

Treatment of underlying Disease: The treatment of a pleural effusion usually requires that the underlying illness or disease is treated and controlled to prevent the accumulation of the pleural fluid. Like anti-TB therapy for Tubercular etiology or treatment of Cancer in malignant pleural effusion, etc.

Thoracentesis: As discussed earlier Thoracentesis can be used as a therapeutic procedure to remove excess fluid and help lung expand and function properly.

Tube thoracostomy: Thoracostomy or chest tube insertion may be done to drain and treat fluids which cannot be removed by needle aspirations, e.g. empyemas (pus collections).

Pleurodesis: Some pleural effusions reoccur multiple times; sclerosing agents that induce scarring such as talc or tetracycline was used to prevent a recurrence.

Decortication: If sclerosing agents fail, surgery may be required, called Decortication.

Pleural Effusion - What Is It?

Low blood pressure is also known as hypotension. Low blood pressure can be characterized by extreme fatigue, constant recurrence of headache and drowsiness throughout the day. It can also cause severe vertigo, nausea and even fainting. Low blood pressure can be caused due to dehydration, anaemia, hypothyroidism, lack of essential nutrients in diet, extreme stress or heart conditions. Homeopathy is a safe, natural method of treating low blood pressure. It is an effective remedy without causing detrimental consequences or adverse side effects.

Homeopathic medicines start by providing  symptomatic  relief. It eases vertigo, nausea, fatigue and provides relief so that the patient can carry on with daily activities without hindrance. The next step is to normalise the blood circulation in the body, which also includes an improvement in the pulse rate and heart functions. This is done to maintain the normal blood pressure range. The third step involves treating the cause of low blood pressure. This includes a detailed study and analysis of the medical history of the patient. There are different causes of low blood pressure and different age groups are affected. Therefore, medicines are prescribed accordingly. 

Some highly recommended Homeopathic medicines for low blood pressure:

Gelsemiun and Viscum Album are effective homeopathic medicines mostly prescribed for patients with low blood pressure, which is accompanied by extreme vertigo and nausea. Sometimes the patients also suffer from a constant dull aching head and feelings of stress. The pulse is usually slow and weak, causing persistent fatigue.
Glonoine and Natrum Mur help to maintain the blood pressure when it unexpectedly falls due to prolonged sun exposure. Heavy headedness, vertigo, nausea, fainting spells are common in such cases.
Carbo veg and China are highly potent medicines in case of an abnormal fall in blood pressure caused by severe diarrhoea and dehydration. The body has marked signs of exhaustion and the pulse is so weak that it is often imperceptible.
China and Ferrum Met are prescribed when the blood pressure falls due to heavy blood loss. Irregular, feeble purse, anaemia, exhaustion are common symptoms occurring from blood loss due to haemorrhage.
It is important to include nutrients, dairy products and increase intake of iron-containing food along with the homeopathic medicines prescribed to speed up the health improvement process.

Homeopathic Remedies For Low Blood Pressure!

What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Many people know that smoking causes several problems including cancer, heart disease, and respiratory disease. However, there are other diseases occur because of smoking and chewing tobacco. Buerger's Disease is one such disease in which the blood vessels in legs and arms get blocked. This blockage will interfere in blood flow and results in forming blood clots. These clots will affect both legs and
hands.
Buerger's Disease is also known as Thromboangitis Obliterans. It is a type of vasculitis which causes inflammation in the blood vessels including thickening, narrowing, weakening, or scarring.
Buerger's Disease cannot be cured easily. However, by quitting the use of tobacco and smoking, one can limit the symptoms from getting worse. If a person is not able to quit smoking, he/she might end up
suffering from severe tissue damage. One can also even lose toes, fingers, or other parts of the limbs. This is why quitting all type of tobacco or smoking is the only way to treat Buerger's Disease.

What Causes Buerger's Disease?
As discussed earlier, smoking cigarettes or cigars and chewing any form of tobacco is one of the main causes of Buerger's Disease. Still, the exact cause of this disease is unknown, but in most cases of Buerger's Disease, the sufferer has consumed tobacco products. It is an assumption that chemicals present in tobacco, cigarettes, and cigars may affect the lining of blood vessels, causing them to swell. According to experts, the genes in the body may also cause this disease. It is suspected that this disease is caused by an autoimmune response in which the immune system of the body attacks healthy tissues mistakenly. According to this theory, some people are prone to this disease.

Symptoms of Buerger's Disease-
Some of the most common symptoms of Buerger's Disease are:
  Pain in the hands and feet while exercising
  Stiffness due to reduced blood flow
  Pain at Rest
  Skin ulcerations
  Gangrene of the fingers and toes in severe cases
  Numbness, coldness, or tingling of the feet and hand
  Pale, reddish, or blue-tinted hands or feet.

Diagnosis of Buerger s Disease-
There is a set of tests that can diagnose Buerger s disease. Doctors first ask a person about his/her lifestyle, use of tobacco, and symptoms. After seeing a few symptoms, doctors may perform a test to check the blood flow. He may also look for other diseases that cause similar symptoms. Some of the common test to diagnose Buerger s Disease are:


  Allen Test: The Allen test is a blood flow test. In this type of test, patients squeeze their hand into a firm fist, which pushes out blood from hand. The doctor presses the arteries to slow down the
blood flow of the hand. At this stage, the normal color of the skin gets pale. After that, patients open his/her hand and doctors release the pressure from both sides of the wrist one by one. If it takes a longer time to go back to the normal skin color, it may be an indication of Buerger s disease

  Angiogram: It is a type of X-ray that will help to check the blockage of the blood vessels in the legs and arms. In this test, doctor place catheter (thin tube) into an artery to pump the dye. After
that, he takes X-ray images. Doctors may also perform tomography (CT) or MRI scan for clear results.

  Blood Tests: The blood tests will help the doctor to check if there is any other disease that causes the same symptoms as most of the vascular diseases mimics the symptoms of Buerger s
Disease. The doctor may also perform tests to check for diseases like lupus, diabetes, and those that cause blood clots.

Treatment of Buerger' Disease-
Quitting smoking and use of tobacco will help a person to lower the symptoms of this disease. Doctors may also prescribe for pain killers or antibiotics to get rid of the pain in affected areas. If a person finds it difficult to quit smoking, doctors help him/her with the right program and rehabilitation techniques.

Take Away-
Buerger's Disease is one of the rare illness caused by intake of tobacco products, this is why quitting smoking is most important to treat this disease. It is also advisable to consult a doctor as soon as a person identify any of the above symptoms.

All You Need To Know About Peripheral Vascular Injuries!

The heart muscle is the central pumping machine that ensures that blood flow throughout the body is maintained and all other organs have a regular supply. One of the conditions that can cause this organ to malfunction is cardiomyopathy, wherein the heart is unable to pump the blood to all parts of the body. This condition can even lead to heart failure and is something that needs to be addressed and diagnosed quickly.

Symptoms of Cardiomyopathy
Early stages of cardiomyopathy may be difficult to detect externally, although it may be slowly reducing your heart s capacity. Symptoms that start showing in later stages may include:

Constant fatigue, even without physical activity
Fluid may build up and thus cause bloating within the body
Persistent coughing while lying down
You may have irregular heartbeats that may sometimes be quite rapid
Due to the lack of blood supply, you may feel lightheaded, dizzy and might even cause you to faint
Even the slightest of exertions will cause breathlessness and exhaustion and you may even feel this symptom while at rest
Intermittent chest pain
Causes of Cardiomyopathy
Causes of this condition may vary from patient to patient, although certain common factors include:

Genetic reasons where one or both parents are susceptible to this condition
Metabolic problems such as obesity, diabetes or thyroid problems
Substance abuse such as anabolic steroids, amphetamines cocaine or even the consumption of excessive alcohol
High blood pressure for prolonged periods
Nutritional deficiencies
Side effects of drug treatments such as the use of certain chemicals in chemotherapy
Types of Cardiomyopathy
Cardiomyopathy has multiple types; depending on what causes them and also certain specific symptoms. These are:

Restrictive cardiomyopathy
Dilated cardiomyopathy
Arrhythmogenic right ventricular dysplasia
Hypertrophic cardiomyopathy
Unclassified cardiomyopathies
Treatment for cardiomyopathy
The treatment of these various forms of cardiomyopathy will vary depending on the type and also the stage and condition of the heart. Some of these treatments include:

Medications
Lifestyle changes
Surgeries such as Septal myectomy, Septal ablation and Radiofrequency ablation
Implantable devices such as Implantable cardioverter-defibrillator or ICD
Ventricular assist devices
Heart transplant in the worst case scenarios

Cardiomyopathy -  Decoding the Types + Treatment

A heart attack does not always have obvious symptoms, such as pain in your chest, shortness of breath and cold sweats. In fact, a heart attack can actually happen without a person knowing it. This condition is known as a  silent heart attack , medically known as  silent ischemia , occurring due to the shortage of oxygen supply to the heart muscle. The causes of a silent heart attack are similar to that of a heart attack. 

They include- 

Conditions like: 
Obesity or excess weight 
Diabetes 
High Blood pressure 
High cholesterol 
Heart Diseases 
Lack of exercise 
Age, usually above 65 
Consumption of tobacco or smoking 
High consumption of alcohol 
A silent cardiac arrest makes one more vulnerable to another heart attack that could be fatal. Diagnosis: The only method to diagnose if you had a silent heart attack is through imaging tests, such as echocardiogram, electrocardiogram, Holter Monitoring or others. These tests can show certain changes which might be indicative of a heart attack. An analysis of one s overall health and the symptoms can aid in deciding whether few more tests are required. 

How would you prevent a silent heart attack? 
1.   Get your cholesterol and blood pressure count tested regularly. 
2.   Refrain from smoking. 
3.   Get your VO2 max checked regularly. 
4.   Live a healthy lifestyle: Refrain from smoking and excessive alcohol consumption; exercise daily, eat healthy. 
5.   Control high blood pressure, cholesterol, and diabetes 
6.   Be aware of your body and call on a doctor if you feel there s anything which is bothering you. 

If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Know Everything About Silent Heart Attacks

Don't wait any longer, manage your Cardiac Anesthesiologist online with a Lybrate doctor today

Consult for Cardiac Anesthesiologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES