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?

Coronary Artery Disease - Symptoms and Causes

Coronary artery disease is the disease in which the major blood vessels (coronary arteries) that supply blood, nutrients and oxygen to your heart get damaged or disease stricken. It is mostly caused due to the coronary artery getting plagued or inflamed. The consequent reduction in blood flow to the heart causes the various symptoms of coronary artery disease like angina (chest pain), short breath etc.

Symptoms:

Here is a list of a few symptoms that help in identification of the coronary artery disease.

1. Angina

Pressure or tightness may be felt in or near the area of the chest that results in pain. It is mostly felt in the middle or left side of the chest.

2. Shortness of breath

Another symptom of coronary artery disease is short breath, fatigue and a feeling of exertion.

3. Heart attack

Complete blockage of the coronary artery results in a heart attack that is a prominent symptom of coronary artery disease. A person may feel heavy pressure in the chest, pain in the shoulder or arm, sweating etc. prior to getting a heart attack.

Causes:

Coronary artery disease occurs when damage or injury is done to the inner layer of the coronary artery. This damage causes plaque, which are deposits made of fat, cholesterol and other cellular waste materials to accumulate near the damaged area of the artery. This process is known as atherosclerosis.

The various causes that result in coronary artery damage are listed below.

- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- High stress
- Physical inactivity

Knowing Coronary Artery Disease - Symptoms and Causes

Blood pressure is the measure of the resistance to the natural flow of blood in the blood vessels. The major, minor and few smaller blood vessels themselves have a thin muscular lining that keeps the vessel supple and aids the flow of nutritious blood within its tube-like structure. The vessel walls resist the free flow causing a reverse pressure that is referred to as Blood Pressure. This pressure strains the heart muscles (Left Ventricle more) to contract strongly to push the nutritious blood into the body circulation system.

Due to numerous factors, there is an increase of resistance within the blood vessels that leads to an increase in blood pressure. At a later stage, this results in lack of adequate blood flow to the end tissues and an accumulation of fluids in the various tissues/organs and a mismanagement of the nutrition-detoxification rhythmic cycle of the body. This takes a long time to develop and unless the last stage hampers body functions, it is not detected. Hence, blood pressure is known as a silent disease.

Systolic and diastolic are the two rhythms corresponding to the expansion and contraction of the heart chambers during pumping of blood into the body. This rhythm creates two distinct pressures within the blood vessels. Systolic is when the heart ventricular chamber contract to pump blood into the body, so the pressure is higher. This indicated the force or strain on the heart to push blood into the circulatory system. Hence, this count is considered significant in evaluating health parameters.

High BP as a disease is declared when three or more readings taken at different times of a day or on consecutive days shows increase in BP. Higher the BP, more strain is exerted by the heart. Since the heart is essentially a muscular organ, the muscles of the heart get affected. Sometimes, the heart muscles increase in mass and size making the heart chambers smaller in volume. This further deteriorates the circulation capability leading to numerous diseases. The strain of pumping nutrition to different body organs is also felt by the heart itself. Lack of nutrition can lead to death of cardiac tissue leading to heart failure. High blood pressure makes the heart walls thicken and becomes stiffer which makes it even more difficult to pump blood. Thickening of the heart muscles is also known as left ventricular hypertrophy and cause heart failure.

A systolic blood pressure reading that is higher than 140 mm Hg or a diastolic blood pressure higher than 90 mm Hg characterizes by high blood pressure. High blood pressure is said to be responsible for 50% of the recorded cases of ischemic strokes and also increases the risk of hemorrhagic strokes.

When heart cannot pump with enough force, there is a mismanagement in the intra-cellular and tissue fluid restoration. This puts a great strain on the kidney function. In due course of time, numerous organs of the body suffer and depending on the body constitution, immunity for rejuvenation and restoration of order, the person suffer from numerous diseases.

Diabetes worsens the situation of BP and adds to the deterioration of heart health, blood vessel health. Poor heart functioning leads to different symptoms like:

Shortness of breath
Swollen ankles or feet
Difficulty lying flat on your back
Bloating and nausea
Irregular pulse
Frequent urge to urinate at night
Fatigue
Due to disturbances in BP and other factors leading to lacking of nutrition to the heart tissue. Heart Disease complications are commonly seen with symptoms as follows:

Radiating or dull pain, especially in the chest, radiating in the arms, especially left arm, neck, back and in the stomach especially in women.

Shortness of breath; change in breathing patterns and heaviness in chest
Dizziness and fainting sometimes
Irregular pulse and palpitations
Sudden onset of excessive sweating
Unexplained fatigue, weakness and depression
Heart Disease can be treated with natural ayurvedic medicaments successfully in more than 80% of patients. Numerous ayurvedic medicines have been clinically evaluated to show positive changes supported with clinical investigation. Since ayurvedic medicines are targeted to reaching the root cause of the disturbances and to reduce the burden of the disease they go beyond the relief of symptoms.

Natural Ayurvedic medicines also participate in the rejuvenation of the heart muscles, the blood vessels, the detoxification of the body and re-balancing of health parameters, Ayurvedic treatment options are gaining great relevance and patient opt for such treatment in greater numbers from all over the world. These treatments are non-invasive and very cost effective. They are good to be taken from prevention to after angioplasty, stent or bye-pass to treat the cause of disease.

Ayurveda is a health science that takes into consideration lifestyle modifications, adequate detoxification, re-balancing body element and strengthening the system from all aspects. Ayurvedic medicines have proved useful in the treatment of Blood Pressure, Diabetes, Vascular disease (leading to atherosclerosis, blockages, wear-tear of blood vessels) and Heart disease. Today, these treatment options are gaining importance and acceptance in our society.

Link Between Heart Diseases and High Blood Pressure

Chest pain may be caused by multiple problems within the body and while being a problem in itself, may also be a symptom of a bigger underlying problem. Chest pain may be caused by anything from simple chest congestion due to a cold to something far more serious such as the onset of a heart attack. While it is important that life style changes be made to prevent major issues, homeopathy can provide relief for many symptoms till extensive medical steps are taken to correct the problem.

Some causes of chest pain
1. Angina
2. Onset of a heart attack
3. Atherosclerosis
4. Weakness of the arteries
5. Weakness of the heart muscle
6. Palpitations
7. Bradycardia
8. Chest congestion or cold

Symptoms associated with chest pain

Stable angina   Vice like constriction or choking, pain may be spread to right or left arm or both, dyspnoea before pain.
Unstable angina   Chest pain occurs at rest.
Pericarditis   Pain radiates to the left side of the shoulder which gets worse by lying in a flat position.
Pneumothorax   Severe chest pain along with shortness of breath, cyanosis, restlessness and collapse.
Pneumonia   Sharp pain which, gets worse by taking deep breath and coughing.
Pulmonary embolism   Short rapid breathing, sharp pain in middle of the chest that is worse by deep breathing.
Gastroesophagial reflux disease   Difficult painful swallowing, pain in the middle of chest which, extends to neck, back and shoulders.
Myocardial  Vomiting, dyspnoea features of shock, profuse sweating, fever, low blood pressure, pulse small rapid and irregular
Homeopathic remedies for various kinds of chest pain

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which a patient is suffering.

The aim of homeopathy is not only to treat chest pain, but to address its underlying cause and individual susceptibility of the patient. For this patient s current symptoms, past medical history and family history are taken into account. There are many homeopathic remedies which cover the symptoms of chest pain and can be selected on the basis of cause, location, sensation, modalities and extension of the pain. For individualized remedy selection and treatment of chest pain, the patient should consult a qualified homeopathic doctor in person. In medical emergencies like myocardial infarction and pulmonary embolism, immediate hospitalization is usually required. Some important remedies are given below for the treatment of chest pain:

Arnica mont.   Chest pain with sore and bruised feeling.
Ranunculus b.   Good remedy for intercostal rheumatism, sharp stitching pain in the chest along with dyspnoea.
Kali carb.   Stitching pain in the chest,  which gets worse between 2-3 A.M
Actea racemosa.   Pain worse on the right side.
Bryonia   Chest pain is of stitching, burning and stabbing in nature, is worse by motion and better by rest and pressure. Thirst for large quantities of water and dryness of mucous membranes often accompanies.
Rumex c.   Sharp stitching pain through the left lung, often with cough.
Stannum   Knife like stitches, worse on bending forward and left side.
Phosphorus   Violent tickling cough, chest pain due to tuberculosis of lungs or pneumonia along with oppression of the chest.
Aconite   Chest pain due to pneumonia of first stage along with anxiety and restlessness.
Robinia   Burning pain behind sternum due to hyperacidity.
Strophanthus   Chest pain is of stitching and twitching in nature and often of cardiac origin.

Chest Pain - Can Homeopathic Remedies Treat it?

Blood pressure is one of the vital life signs in medicine, which, along with other vitals is widely used to assess the overall health of the patient. High blood pressure is very dangerous as normally it has no symptoms or signs and can fluctuate almost instantly. But, it could be managed. High blood pressure is said to be of higher than 120 (systolic) and 80 (diastolic).

A nap in a day might help in lowering blood pressure. According to certain research findings, people who sleep in the daytime had regular blood pressure as compared to people who do not sleep or do not have a short nap. Napping can effectively help lowering blood pressure. It helps the blood to control stress hormones and also helps the nervous system to keep a person healthy.

Daytime napping surely helps in boosting energy levels and efficiency throughout the day. Blood pressure increases after a nap caused by the body s normal circadian rhythm (for influencing and regulating sleep-wake pattern for a healthy cycle in a day). At the time of the morning, the body releases hormones such as noradrenaline and adrenaline. If the blood pressure increases too high, it could cause harmful effects. Blood pressure is usually lower at night while a person is sleeping. The blood pressure begins to increase a few hours before a person wakes up. The blood pressure continues to increase during the day, normally extreme in the mid of the afternoon. The blood pressure starts dropping again in the evening and late afternoon. Sleep helps the blood to regulate stress hormones.

Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of Sleeping for about seven to eight hours in the night might play a vital role in the prevention of high blood pressure. New research suggests that an afternoon nap is as productive as consuming a pill for lowering the blood pressure. Scientists have found that the people who take a midday nap are more likely to drop their blood pressure as compared to adults who don t take a midday nap and stay awake. Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of cardiovascular events like a stroke or a heart attack. It is as effective as other lifestyle changes, according to credible researches in medicine. It is interesting to note that napping, even when it reduces the blood pressure by 2 mm Hg only, reduces the risk of cardiovascular events by 10%.

Napping is a sort of shortcut and an effective method for lowering the blood pressure and could also be easily adopted and does not cost anything. Short midday sleep is important for our well-being. And, we can utilize this simple information very effectively for its potential health-related benefits simply by managing our daily schedule.

Napping & Low Blood Pressure - How Can Former Help Latter?

Psychogenic breathlessness or pseudo-dyspnea is a condition where the patient suffers from shortness of breath time to time. This disease is often confused with a similar breathing disorder called Chronic Dyspnea. While there are a lot of factors involved in chronic dyspnea, like allergens and pulmonary diseases, psychogenic breathlessness has more to do with the current state of mind.

One of the most challenging factors is the diagnosis and differentiation between both conditions. Sometimes, the psychogenic breathlessness is so concentrated that there is no way to differentiate between the two.

Procedure of Diagnosis of Psychogenic Breathlessness:

Here are the steps that doctors typically follow to diagnose Psychogenic Breathlessness

To differentiate between the two diseases (Chronic Dyspnea and Psychogenic Breathlessness), the doctor will ask the patient to try breathing harder. A patient with chronic dyspnea will find it even harder to take a breath when he or she tries to. However, a person with psychogenic dyspnea will show improved conditions when they try to breathe harder

A thorough examination of the chest will be done

Blood tests and lung function test (spirometry) will also be conducted to rule out pulmonary diseases

Causes of Chronic dyspnea:

Allergens causing allergic bronchitis (also known as asthma) is the main reason behind Chronic Dyspnea. Other common causes of the true or chronic dyspnea are heart diseases, COPD which occurs because of smoking. Then there are rare disorders like ILD (sarcoidosis), neuromuscular diseases, infections, anemia, obesity/deconditioning.



Causes of Psychogenic dyspnea or psychogenic breathlessness:

Acid reflux: Acid reflux can cause certain sensation on the inner lining of the esophagus (esophagitis). The esophagus has several nerve endings on the inner linings, when the acidic reflux touches these nerve endings, a temporary breathlessness occurs.

Anxiety: People with anxiety can also develop breathlessness. Though exercises help for a short period of time, a patient needs to see a psychiatrist for this condition.

Panic Attacks: These are also a cause for breathlessness. The temporary feeling of choking is common in people who experience panic attacks.

Treatment:

Medication: Medicine for acidity is prescribed to patients having Pseudo-Dyspnea, due to acid reflux.

Anxiety pills and Talking therapy: People suffering from anxiety are recommended to see a psychiatrist for better evaluation of their problem. Medications (anxiety pills) prescribed by the psychaitrist may help in controlling the breathing pattern in a person. Psychological therapies (Talking therapy) have been effective for people suffering from breathlessness due to anxiety.

Placebo: If the problem remains unsolved and unknown, sometimes doctor prescribes placebo medication, for example sweetened aerosol. Doctors believe that if the patient thinks he/she is taking a real medication, his/her condition can be controlled by eluding the mind.

It is important to remember that Psychogenic Breathlessness is as real as chronic breathlessness and patient doesn t pretend to have this condition. When the first symptoms of it start appearing, a specialist doctor (pulmonologist) should be consulted who after confirming the diagnosis of psychogenic breathlessness, may refer you to a psychiatrist or psychologist for further treatment.

Psychogenic Breathlessness - Causes, Symptoms and Treatment of It!

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