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

An estimated of 10 percent or more children snore for more than 1 night. Snoring results from the obstruction of breath when the air makes its way through the mouth. The air passage of the throat through which the air goes in and out causes the tissue to vibrate causing snore. The sound of the snore totally depends on the amount of air passing through the mouth and the frequency at which the throat is vibrating. Children above the age of three years tend to snore when they are deep in sleep.

Primary and secondary snoring:
Children who are otherwise healthy should not have a snoring problem unless there is some health disorder. However, if loud snoring is observed in otherwise a perfectly healthy kid, seeking medical help is a wise thing to do. In general, primary snoring is defined as a condition which is not associated with other sleep-related disorders such as lung disorder, OASS, inability to sleep for a longer duration etc.

Other possibilities:
It is estimated that close to three percent of the children suffers from breathing problem while sleeping. OSAS is a condition which is characterised by pauses in breathing and gasps along with loud snores. There could be instances where a kids  muscle relaxes way too much obstructing the air to pass through. The body and the brain are both alerted at this stage. As soon as the brain sends a signal, the body wakes up. Thus, most kids suffering from this disorder are not able to sleep well and tend to feel tired throughout the day.

Common causes of sleep apnea:
Sleep apena is a major cause of snoring. It can be caused because of allergies, obesity, GERD etc. In children sleep, apnea can also be caused by tonsil. Since the tonsil size of children less than 7 years of age tends to be bigger than adult individuals, it causes snoring related problem. Swollen tonsils not only obstruct air but creates other health related problems as well.

Symptoms of sleep apnea during the day and night:

Loud snore
Snorts, gasps, pauses during sleep
Heavy sweat during sleep
Social and behavioural problems
Failure to get up in the morning
A nasal voice
Easily irritated, cranky and aggressive
Relief measure:
The first thing a that a doctor does is a physical exam followed by observing the symptoms of a kid. Primary snorting can be addressed by physical exercise, counselling and breathing exercise. Problems related to apnea are addressed through medicine, counselling, and exercise. Certain dietary restrictions also needed to be followed during this time. However, apena is completely treatable within a certain time frame.

Mouth Breathing - What Can Cause It?

There are two primary factors that are more likely to cause a stroke in a person i.e age and a family history. While both are inevitable, this necessarily doesn t have to be the fate of a person. Brain stroke is entirely preventable as with the case of other diseases. By working on the potential health risk factors, a stroke can be prevented. Here is a list of few such steps which, when followed can pay rich dividends to a person facing the risk of a brain stroke:

Blood Pressure: Blood pressure is the single most important factor that can increase the chance of a brain stroke. If a perfect blood pressure reading seems too difficult to achieve, a more realistic blood pressure target of 140/190 should be aimed for. Some of the common steps in order to achieve an acceptable blood pressure figure include reducing salt in the diet, exercising on a daily basis, regular intake of fresh fruits & vegetables and fast processed food containing processed fats. Finally, quitting drinking and smoking goes a long way in ensuring that a person is safe from strokes.

Losing Weight: Obesity increases the risk of diabetes and blood pressure subsequently increasing the risk of a stroke. Being overweight, therefore greatly increases the odds of a stroke. A BMI of 25 should be maintained by engaging in activities such as walking, running and playing on a daily basis.

Regular Exercise: Exercise is a clear mandate for people facing an increased risk of brain strokes. A moderate intensity exercise schedule for a minimum of 5 days per week is necessary. Some simple steps in order to achieve this include taking the stairs while climbing, joining a fitness club, 30 minutes of daily walk in a day etc.

Moderate Drink: Surprising as it may sound, moderate drinking on a daily basis can dramatically reduce the risk of a brain stroke. Red wine should be the choice of preference in this case. It should be ensured that the level of drinking does not surpass more than a glass. Regular drinking in excessive quantity can increase the chance of brain stroke.

Check For Atrial Fibrillation: This is a disease that is related to the heart due to an irregular heartbeat. There is a possibility of the clots travelling to the brain causing a brain stroke. Certain possible symptoms of this disease such as palpitation of heart and shortness of breath should be checked with a doctor to negate the chance of brain stroke. Certain blood thinners like warfarin and aspirin can shield against atrial fibrillation. A doctor has to be consulted before starting any medication related to the heart.

Top Ways To Prevent A Brain Stroke

The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls. 


This attracts more and more fat molecules to settle down.  This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.


This condition, known as coronary artery disease, is becoming a major cause of deaths.  While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.


Preventive measures: 
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease.  This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar.  Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.


2. Exercise:  Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management.  Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.


3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.


4. Alcohol consumption:  While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no.  Binge drinking especially is shown to cause heart attacks.


5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.


6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them.  Keep a constant check to ensure your readings are managed well. 


7. Watch out:  Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.


Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life.

Coronary Artery Disease - 7 Ways You Can Prevent it 

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.

Hypertension and High Blood Pressure

Neurosurgery mainly deals with treating of functional disorders that affect the nerves, brain and muscles through major or minor surgery. The field of neurosurgery makes use of advanced surgical procedures. The different techniques are used to treat brain tumors, trauma to the head, cerebral hemorrhages, spinal disc herniation, brain aneurysms and peripheral neuropathy.

Neurosurgery Treatment
The main aim of neurosurgery treatment in patients suffering from stoke is to prevent neurologic deterioration as well as the recurrence of stroke. The advancement in medical treatment has increased to a great extent, however the mortality and morbidity in stroke patients is very high. The second leading cause of death all over the world is stroke, and hence, through neurosurgery stroke can be managed. Each year in the U.S there are about 800,000 people who suffer from stroke which causes disability.

Symptoms of Stroke and its Effects
The main symptoms of stroke are not identified easily by people. However, the symptoms that are caused on delay of treatment include difficulty in speaking, weakness on one side of the body, drooping on one side of the face and difficulty in walking.

Stroke at times is life threatening and it is also referred to as brain attack and can occur at any time to an individual. It is caused when the flow of blood supply to the brain is cut off and oxygen is deprived to the brain cells. Brain dysfunction occurs due to the dead brain cells and hence some patients lose their memory and control over their muscle movement. The treatment of stroke in such cases includes a neurosurgery by a neurological specialist.

Types of Stroke
The abrupt interruption to the flow of blood that causes hindrance in the neurological function can be best treated if detected early and by accurate diagnosis by a neurosurgeon. There are 3 different types of stroke that can occur and these include Hemorrhagic stroke, Ischemic stroke and Transient ischemic attack. The Ischemic stroke mainly occurs when blood vessels that supply blood to the brain are blocked. It is a common form of stroke and its underlying cause is known as atherosclerosis. The main procedures that are used for treating ischemic stroke include tissue plasminogen activator and endovascular procedure.

In the tissue plasminogen activator procedure, the patient is given medicine intravenously. The blood flow to the affected area of the brain is improved when the blood clot dissolves through this method. The medication is given immediately after 3-4 hours on occurrence of the stroke symptoms. In the second procedure, a catheter is used, which is injected in the area of the obstructed blood vessel. The blood flow to the area is restored by the endovascular procedure. Even anticoagulants are given to thin the blood and prevent clogging.

Neurosurgery In Management Of Stroke!

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