The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

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?

Why Do You Get Palpitations? How to Get Immediate Relief?

Palpitations is the feeling that you experience when your heart beats abnormally. Heart palpitations can be felt in the form of rapid, fluttering or pounding heartbeats. They can be frightening as when you palpate, you heart beats so hard that it even skips a beat and the sensations are so strong that they can be felt all through your chest, neck, and throat.

Palpitations are also common especially in young people because of abnormal electrical circuits in heart from birth. However, they may have normal hearts on Echo. Such palpitations are curable by a nonsurgical methods called Radiofrequency Ablation.

Palpitations can be triggered as a result of a number of reasons like stress, certain medications, exercise etc.

Here are a few prominent causes of heart palpitations.

Causes unrelated to the Heart -

- Anxiety, fear, and stress
- Consumption of alcohol and drugs like caffeine, nicotine etc.
- Consumption of street drugs likes cocaine, amphetamines etc.
- Certain medical conditions such as thyroid, anemia, dehydration, low blood pressure and low sugar levels etc.
- Hormonal changes that occur as a result of menstruation, pregnancy, menopause etc.
- Certain nutritional and herbal supplements
- Certain medications like asthma inhalers, diet pills etc.
- Abnormal levels of electrolyte
- Sensitivity to certain food items like some carbohydrates

Causes related to the Heart -

- Coronary artery disease
- Prior instances of heart attack
- Congestive heart failure (a condition wherein your heart's chambers get affected)
- Problems associated with the heart valves or the heart muscles

Immediate Relief Mechanisms-

It is crucial to go to the most easily available doctor to get an ECG done during palpitations as ECG will give an exact diagnosis, which helps in identifying the clear line of treatment.

Here are a few techniques that can help you in getting immediate relief from heart palpitations until you are able to visit a doctor in case of a serious condition.

- Cough it out
- Splash cold water on your face or take a cold shower
- Practice slow, deep breathing exercises



Why Do You Get Palpitations? How to Get Immediate Relief?

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

Cholesterol is a type of fatty acid that is produced by the liver. The body uses cholesterol to perform various activities such as synthesizing of hormones, bile acid and vitamin D. Ayurveda views it as an important component of the body in terms of lubrication. The Ayurvedic approach of balancing cholesterol is not only to curb the cholesterol amount, but also to strictly control diet so that the secretion of cholesterol can be curtailed. Here are a few Ayurvedic hat-tips that can help to lower cholesterol and restore normal body function of the body:

Medicago satina: They are better known as Alfalfa and is famous for their ability to deal with artery-related diseases. They are capable of clearing arteries that are congested with cholesterol. They can be consumed daily as a whole or by mixing them in juice.
Arjuna: Arjuna is yet another powerful Ayurvedic herb that is mighty powerful in dealing with cardiac conditions such as heart blockages, heart attacks etc. The bark of the Arjuna tree can be taken and consumed in the form of powder. They have the capability to dissolve cholesterol and prevent heart blockages. This should be consumed earlier in the morning, before breakfast with lukewarm water.
Coriander: Coriander is considered to be one of the best herbal diuretic agents. It can revitalize the kidneys and help them perform better in terms of excretion of waste. The kidney, therefore, can flush the excess cholesterol from the body. Coriander can be consumed along with food on a daily basis.
Garlic: Garlic again has been known to mankind for centuries and is extremely beneficial for people suffering from high cholesterol. Two cloves of garlic on a daily basis can completely neutralize the effect of high cholesterol in the blood. Apart from freeing up arteries, garlic has multiple other health benefits.
Guggulu: This herb is one of the popular herbs among ayurvedic practitioners for treating high blood pressure and high cholesterol in the blood. They contain guggulsterones, which is known to be an active blocker of bad cholesterol in the blood. Consumption of 25 mg of this substance can make a person totally free from high cholesterol. They can be taken after any meals.
Holy basil or tulsi: Holy basil is another popular and traditional Indian hub that is extensively used by ayurvedic practitioners to treat high cholesterol in the bloodstream. They can eliminate excess cholesterol through the kidneys. It is used for preparing multiple medicines. It is a proven medicinal herb that is very efficient in dealing with excess cholesterol in the blood. They have the ability to disintegrate cholesterol from the body. 2-3 leaves of tulsi can be consumed on a daily basis.

High Cholesterol - 6 Top Ayurvedic Remedies to Lower It!

SGLT2 (sodium-glucose-co-transporter 2) inhibitor is an oral tablet used in conjunction with exercise and diet to improve blood glucose control in Type 2 diabetes mellitus patients.

The medication works by targeting and helping prevent sodium-glucose transport proteins from allowing glucose that has been filtered by the kidneys to be reabsorbed into your bloodstream.

Who is SGLT2 Inhibitor suitable for?

This drug is not suitable for everyone. Selection of the right patients is crucial to understand the mechanism of the medication and see improvement in the condition.

SGLT2 Inhibitor is given to patients with Type 2 diabetes mellitus as a second-line drug in case the first line of treatment, metformin, fails to keep high blood sugar levels in check.

If the patient has hyperglycemia i.e. high, uncontrolled blood sugar, and a Body Mass Index (BMI) equal to or greater than 30 due to the accumulation of fat in the abdominal region (central obesity), then SGLT2 Inhibitor could be a useful medication. The drug not only works to reduce high blood glucose but also helps with weight loss. However, in patients with normal BMI, the medication does not induce weight loss.

SGLT2 Inhibitor may not be suitable for patients with a history of urinary tract infection. Hence, it is advisable for all patients to undergo a urine test before starting with the dosage. If the test results are normal, then only you can discuss the dosage with your doctor/healthcare provider and start taking the prescribed medications immediately.

Benefits of Taking SGLT2 Inhibitor :

The benefits of using SGLT2 Inhibitor are as follows  

Helps reduce excess weight if the patient is obese. If taken in the correct dosage as prescribed, you can lose up to 5 Kgs in about three months.

Helps reduce Systolic blood pressure   if a diabetic is living with hypertension, SGLT2 Inhibitor can bring down systolic blood pressure.

As an anti-diabetic drug, SGLT2 Inhibitor works to control high blood glucose and improves glycemic control. Thus, with the help of the drug, Type 2 diabetes mellitus patients can keep their HbA1c levels at 7% or less.

Side Effects

One major side effect of SGLT2 Inhibitor is urinary tract infection. SGLT2 Inhibitor drug filters excess blood sugar from the body in the form of urine. Frequent urination or filtering of wastes through the urethra may lead to infections. Therefore, it is imperative that patients are informed about the mechanism of the drug and its probable side effects before taking the medication. One way to avoid urinary tract infections is to maintain good hygiene   wash and clean your private areas after urination.

SGLT2 Inhibitor can also cause dehydration in the patient, as a lot of fluid is drained out of the body. Patients are advised to have a glass or two of water more than what they usually drink.

SGLT2 Inhibitor is an effective oral medication for Type 2 Diabetes mellitus. Speak with your doctor and get yourself thoroughly checked before you start taking the drug.

SGLT2 Inhibitor - Know Merits & Demerits Of It!

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