With recent lifestyle changes, more and more people, younger in age, are falling prey to heart attacks. While some silently suffer the attack during their sleep and never wake up, others have symptoms which they dismiss as acidity or muscular pain and ignore them. There are multiple media programs that are trying to create awareness about how to identify a heart attack. If done at the right time, there is a good chance that the person can be saved.

What is a Heart Attack?

The blood vessels gradually narrow, reducing the blood flow to the target organs. This reduces the efficiency of the target organ, and if this happens to be the heart, it is known as a heart attack. The area that should ideally receive blood does not, leading to its  death.  If the damage is not severe, it can be reversed. However, if this attack happens in one of the critical areas of the heart, it can even be fatal.

Symptoms To Watch For: Very few attacks happen suddenly. Most start slowly and progress, and if identified on time, a life can be saved. The episode takes about an hour, and if you are well-versed with the symptoms, it could help identify the condition correctly and save a life. Most people use antacids and muscle relaxants to ease the situation, which does provide immediate relief, but not a proper cure.

There is a central pain which is constant, nagging, and has a squeezing like sensation. This causes discomfort and most often, this pain is in the center of the chest area, which lasts for just a few minutes. Sometimes the pain can go and come back. This pain radiates down into the arm, up into the neck area, and also into the jaw and is almost always indicative of a heart attack.

With chest pain, there is always shortness of breath which the person will experience. This is due to reduced oxygen levels in the body.

Associated symptoms include fatigue, exhaustion, nausea, dizziness, light-headedness.

There is almost always profused sweating where the person breaks into a cold sweat.

If the attack happens during sleep, the person may be snoring and may feel, as if something is choking his airway.

Due to reduced return of blood from the peripheral organs, there could be swelling of the feet and ankles.

If there is irregular heart beat (palpitations) very often, talk to your doctor about it.

When you suspect a person of having a heart attack, check for these signs. Very often, a heart attack is detectable and can be managed with timely intervention.

Signs Of A Heart Attack

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?

Carotid artery disease occurs when an oily, waxy substance called plaque builds up inside the carotid arteries. These are arteries that supply oxygenated blood to your brain, face, scalp, and neck.
Carotid artery disease is very serious as it can cause a brain stroke. It, in fact, starts with damage to the inner layer of the carotid artery. To stem this damage your body starts a healing process and this leads to a build up of plaque at the point where the artery is damaged.

When this plaque ruptures, platelets are rushed in and these create an obstruction to the flow of blood to the brain. When the blood supply to the brain is cut off, which happens in carotid disease, the brain cells begin to die causing a stroke. This neural death impairs the parts of the body that these brain cells control. So, you can get paralyzed, become speech or vision impaired, have long  term effects like paralysis or even die due to a stroke.

Causes of carotid disease

Smoking
High cholesterol levels
High blood pressure
High levels of sugar in the blood due to diabetes
What s even more worrisome is that carotid artery disease may not cause any signs or symptoms until the carotid arteries are severely narrowed or blocked. And what usually happens is that a stroke becomes the first sign of the disease.

How scary is that?
So, the next question that comes to the mind is - Can this condition be cured? Let s learn more about management and prevention of the same-

Prevention
Lifestyle changes are key. Since hypertension, uncontrolled diabetes, sedentary lifestyles and imbibing too much fat are all risk factors, taking care of them minimizes the risk of carotid disease and strokes. Heart healthy lifestyle changes that include moderate exercise are a great way to prevent carotid disease.

Treatments
Treatments for carotid artery disease include:

Medicines: Sometimes lifestyle changes do not stem the rot. You need medicinal help. Doctors usually prescribe statin medications to control your cholesterol levels. These lower the bad cholesterol that can narrow your carotid arteries and cause brain strokes and damage. Statins are usually prescribed for people who have:

Heart disease
Those who ve had a stroke
Diabetes
High LDL or bad cholesterol levels
Medicines like Aspirin and Clopidogrel to prevent blood clots are the mainstay treatment if you suffer from carotid disease. They prevent platelets from clumping together inside your carotid arteries and forming blood clots. Apart from these, your doctor may also medicate you for conditions that can damage your carotid arteries and cause strokes. These medicines are for lowering your BP, blood sugar levels, preventing the formation of blood clots anywhere in your body including inside your heart, and preventing and reducing inflammation.

Medical Procedures
These are used to open narrowed or blocked carotid arteries.
The two common procedures are:
Carotid endarterectomy: It s mainly for people whose carotid arteries are blocked 50 percent or more. In this, the inner lining of the carotid artery that is blocking blood flow is removed.
Carotid artery angioplasty and stenting: Here, doctors use a procedure called angioplasty to widen the blocked carotid arteries and restore blood flow to the brain. A stent is inserted into your carotid artery to broaden the lumen. 

High Cholesterol Level - Can It Cause Carotid Disease?

If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.

Stages
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.

The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.

The staging is as follows:

Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.
The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema s impact on several areas of life are measured. They include the following:

Body mass index (B)
Airflow limitation or obstruction (O), which is measured by pulmonary function tests
Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes
Life expectancy
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.

The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less.

Emphysema - Know The Life Expectancy and Stages!

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?

Cholesterol is either ingested in the food (about 25% ) we eat and some of it is produced by our body (remaining 75%). Cholesterol is needed by the body to produce steroid hormones and bile acids. It is an aspect that is required by the body and if in too much quantity, the same can cause havoc in the body. The best is to maintain the right balance of cholesterol in our diet. The same requires lifestyle and dietary modifications.

The first step in creating your low cholesterol diet plan is to eliminate foods high in saturated fat and bad cholesterol.

Low cholesterol foods diet mainly includes:

1. High-Fiber Diet- Soluble fiber reduces bad cholesterol. Good food sources are oatmeal, fruits and vegetables.

2. Cooking oil- Fats makes about 30 % of your days intake. A combination of oils works the best. Foods rich in saturated fats are butter, ghee, cream, and cheese. These need to be taken in moderation or avoided. Avoid fried foods. Not more than 10% of total calories should be from Polyunsaturated Fatty Acids (PUFA) and the remaining should be from Monounsaturated Fatty Acids (MUFA). The best sources of PUFA are plant based oils, sunflower, corn, soybean, cottonseed and safflower. MUFA are found in the largest amounts in olive, canola, mustard, almond and peanut oils.

3. Avoid Trans fats- Read labels carefully and do not reuse oil used for frying.

4. Go lean- Choose lean meat and fish. Fish is a good source of omega-3 fatty acids. Foods high in omega 3 help you lower down the risk of cardiovascular disease. Tuna and salmon are a good source of omega-3 to name a few.

5. Eat a wide range of fruits and vegetables- This will help ensure that your body meets all the vitamins and nutrient requirement. Fruits and vegetables are relatively low in calories. Apples and pears are known for soluble fiber, which reduces bad cholesterol levels. It is best that you eat good quantities of the same.

6. Include low-fat dairy products- avoid ghee, cheese, cream, paneer and butter. Opt for lighter and healthier options.

7. Exercise well - Exercise at least 30 mins per day. Workout will help you burn extra fat resulting in lowering cholesterol levels.

Cholesterol - How To Manage It?

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