In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

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!

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

Cardiac or Heart Arrhythmia is a condition which results in disruption of heart s normal rhythm. Due to this, the heart may beat too quickly, too slowly or have an irregular rhythm. Though most of the arrhythmias are not harmful but at times they can have serious consequences, which might turn to be fatal. Differences in heart beats can lead to the restriction of blood, that gets pumped around the body, hence causing damage to the brain, heart and other organs of an individual.

Now we would take into account the causes behind the occurrence of this heart condition.

Causes

Interruption to the electrical impulses in any form that lets the heart to contract can result in arrhythmia. A person with a healthy heart should have a heart rate of anywhere between 60-100 beats per minute while the body is at rest.

There are a number of factors which can cause the heart to work inefficiently, which include:

Alcohol Consumption: If you are used to drinking alcohol varying from light to moderate, the chance of irregular heartbeat increases. A recent study has shown that with every drink consumed per day, the risk of atrial fibrillation increased by 8 percent. Men and women both are at equal risk for irregular heartbeat. Irregular heartbeat is caused because drinking leads to damage of the cells, which in turn leads to causing damage in small areas of fibrous tissue within the heart.

Anxiety: Arrhythmia from anxiety is when the heart feels like something happened due to which it tries to overcompensate and beat quickly. This leads to heart skipping a beat, getting squeezed or undergoing heartbeats at a rapid pace.

Excessive Cosumption of Coffee: Caffeine is a stimulant and tends to speed up heart rate, so consuming too much coffee can lead to the problem of arrhythmia.

Deficiency of Magnesium and Potassium: Magnesium and Potassium deficiencies in one s body can cause Arrhythmia. The deficiencies can be caused due to less intake of citrus fruits and vegetables like potatoes, kiwi, papaya etc.

Symptoms

Arrhythmia can produce a broad range of symptoms which affect the proper functioning of heart. Some of the most serious symptoms are:

Fatigue: If you feel that you are getting fatigued quite easily, then it s a clear symptom of arrhythmia.

Dizziness: A sense of dizziness creeps in when you are having the problem of irregular heartbeat.

Lightheadedness: Feeling light on the head is another symptom of Cardiac Arrhythmia, as there is fluctuation in the amount of blood that reaches the brain through the heart.

Treatment Options

Problem of irregular heartbeats, especially if it s on the slower side, can be solved through the placement of certain devices like pacemaker, which can speed up one s heart rate.
Faster heartbeats can be treated through blood-thinning medications, which would help keep threatening blood clots from getting formed.
Doctors can even go for Catheter ablation, wherein they would thread one or more catheters through the blood vessels of one s heart. Electrodes at the catheter tips can make use of extreme heat, cold or radiofrequency energy to damage a small sport of heart tissue and create an electrical block along the path, that s causing one s arrhythmia.

Cardiac Arrhythmia - Factors That Can Lead To It!

Language plays a very important role in our everyday life. Language disorders are common in neurological practices. A stroke directly affects one s brain and can cause neurological problems.

The consequences of neurological stroke language disorders are alexia, aphasia, alexia, acalculia, and agraphia. A large number of deaths worldwide are caused due to stroke. A severe stroke may impair a patient for life and cause communication disorders. The brain refuses to function properly after a stroke, thus accurate description and recognition become a challenging task.

Understanding the types of language disorders post-stroke

Stroke can severely damage a certain portion of your brain and hamper its proper functioning. One of the most common symptoms following a stroke is language loss. There can be different types of language loss, partial or even complete. Below are the types:

Aphasia

It means complete loss of language functioning. The patient s verbal communication is impaired and it results in difficulty in understanding both written and spoken language, repetition, naming, comprehension and other abnormalities. The blood vessels of the brain are affected causing its dysfunction. One-third of patients in the acute phase undergo this condition.

Alexia

A disconnection syndrome caused due to brain damage or trauma affects the patient s reading ability. It is also known as visual aphasia, text blindness, or word blindness. It is very different from dyslexia.

Agraphia

It is the inability to write unlike in the past. The motor control that allows you to write is disrupted and the patient writes wrong spellings or imaginary words and confuses the meanings.

Acalculia

This is also an acquired syndrome in case of which the patient cannot perform any mathematical calculations. Simple addition, subtraction, numbers and columns are a difficult task and go beyond understanding.

Language recovery

The process of recovery is difficult, slow and does not guarantee results. The severity of language impairment needs to be considered before going for therapy. Rehabilitation is necessary to avoid any depression or frustration in the patient.

Communication is essential. If a patient is suffering from aphasia, begin with simple words like  yes  or  no , hand gestures and nodding to address the basic needs.

Be patient and try to connect with the person emotionally.

Return to the daily routine. The homely environment can be beneficial and make sure you have an everyday list of words to learn or write.

The patient must be active and repeat words until you have the perfect pronunciation.

Keep a notepad handy. For patients who cannot talk and has difficulty in talking can write and express their feelings.

It is very important to stay stimulated. Motivation from friends and family relieves anxiety and can help the patient recover quickly. No two affected person goes through the same process, that s why understand and approach accordingly.

Early therapy is effective and patients may respond very well in groups and a safe environment. Visit the doctor at regular intervals to test your improvements, reflexes and language skills. Post-stroke, the patient s well-being should be a priority.

Know More About Neurological Stroke Language Disorders!

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