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?

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

Peripheral Artery Disease (PAD) is a disease of blood vessels that are located outside the heart and brain. The condition develops due to fatty deposits in the arteries and veins that stops the blood flow to the heart and mind as the case may be. It narrows the artery and restricts the blood flow, which causes problems to other organs of the body such as kidney, liver, and stomach.


Symptoms of Peripheral Artery Disease-
Peripheral Artery Disease is the most common type of condition in people. Some people may not even notice the symptoms. The symptoms include:

Pain in the hips and lower leg area.
Brittle toenails.
Short breath while taking stairs.
Pain in the calf.
Numbness and coldness in the leg around a calf
Hair loss on legs and feet
Erectile dysfunction in men
Repeated sores and ulcers in legs
Causes of Peripheral Artery Disease-
The most common cause of Peripheral Artery Disease is the deposit of fatty substances inside the arteries. The fatty deposits build in the arteries gradually with a process called Atherosclerosis. Most of the time people do not know that they are facing the problem of Atherosclerosis. With time deposits increase and the arteries become narrow. It restricts the blood flow and causes problems for other organs.
Another cause for Peripheral Artery Disease is clot created in the arteries due to diabetes. Also, this problem is common in diabetic patients and increases with old age.

The risk factors that contribute to the development of Peripheral Artery Disease are high blood pressure, bad cholesterol, obesity, and diabetes.

Diagnosis of Peripheral Artery Disease-
The primary way to test and diagnose Peripheral Artery Disease is to check the blood pressure in the arm and ankles. If the pressure is low as compared to arm in the ankles, one might be facing Peripheral Artery Disease. It is commonly known as the ankle-brachial index. Other ways to determine Peripheral Artery Disease are CT scans, angiography, and blood tests. Since the disease is prevalent and gradually progress, most of the time it remains undetected.

It is essential that Peripheral Artery Disease gets detected and treated well in time. If the condition persists for a more extended period of time, it may result in loss of leg, increased chances of coronary artery disease and carotid atherosclerosis.

Treatment for Peripheral Artery Disease-
The only way to treat Peripheral Artery Disease is to indulge in physical activity. A regular regime of exercise and physical work will help a person to burn fat and makes the arteries fat free. Doctors suggest that daily 30 minutes of walking or gyming will help treat Peripheral Artery Disease with significant effects. One may notice the signs in just a couple of months.

Along with exercise, one also needs to monitor the weight and eating habits. Foods that are rich in fats and bad cholesterol should be avoided. Make changes in the lifestyle and eat a healthy balanced diet. Include fruits and fresh vegetables in the diet and follow a low carb diet for regular food intake. If a person is addicted to smoking and alcohol, then he/she should consider leaving the bad habits for their own good health.

Take Away-
Above are some of the common and tried treatments. However, it is advisable to consult a doctor before opting for any of these options as these treatments are depended upon the condition of the patients.


Learning In depth About Peripheral Artery Disease!

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

Automatic Implantable Cardioverter Defibrillator is an electronic device that is located in the chest of the patient suffering from arrhythmia. Arrhythmia is a condition which causes abnormal rhythm of heartbeat in the patients. It is a life-threatening condition. The device is located in the chest to correct the rhythm of a heartbeat.

AICD device works in two ways:

Firstly, it tries to correct the abnormal heartbeat rhythm and release high- speed heartbeat pace. This is called cardioversion. Patients with AICD generally do not feel the process.

However, if the effect of cardioversion is null then the device will give a mild electric shock to the patient's heart to correct arrhythmia and reset the rhythm.

This second method is called defibrillation. The patient can feel the defibrillation.

The modern-day AICD device is programmed to store the data about the patient s heart rhythm. Doctors use the programmed device which contains your condition and provides medically correct therapy.

Preparation for AICD Implantation

The patient is required to fast six hours before undergoing the surgery. On admission, prescribed medicine is given to the patient and the latest heart condition is measured by an ECG test. If the patient is on blood-thinning medication, then it will be stopped 24 hours before the surgery.

The procedure will be carried out by a cardiologist. The patient will remain under observation in the hospital for at least two days.

Procedure

The entire process of setting up the device in the chest of the patient takes about 2 hours. The patient is sedated, and the area below the collarbone is numbed for the operation. A small incision is made in the chest area. With the help of imaging techniques, cardiologist sets up the device in the chest. The device is then connected to the veins and the heart. After the surgery, the patient is kept under observation. Heart rate, blood pressure, and overall health condition are observed by the doctors to determine successful implantation of Automatic Implantable Cardioverter Defibrillator (AICD). Post Procedure After the successful recovery of the patient, doctors usually discharge the patient with AICD attached. The doctors give complete care instructions of the device along with health. Doctors also guide the patient through the list of activities that one can and cannot perform. AICD is a life-saving device. Hence, proper care and regular check-ups are recommended by the doctors. The regular check-up of the device is also essential since the device runs on a battery. The doctors also train the patient about the workings of the device. They will also explain about the mild shocks of the device one may receive to correct the arrhythmia. Before leaving, make sure the site of the surgery is dry and healing, and you do not have a fever for the past 24 hours.

AICD Implantation - Know Procedure Of It!

The heart muscle is the central pumping machine that ensures that blood flow throughout the body is maintained and all other organs have a regular supply. One of the conditions that can cause this organ to malfunction is cardiomyopathy, wherein the heart is unable to pump the blood to all parts of the body. This condition can even lead to heart failure and is something that needs to be addressed and diagnosed quickly.

Symptoms of Cardiomyopathy
Early stages of cardiomyopathy may be difficult to detect externally, although it may be slowly reducing your heart s capacity. Symptoms that start showing in later stages may include:

Constant fatigue, even without physical activity
Fluid may build up and thus cause bloating within the body
Persistent coughing while lying down
You may have irregular heartbeats that may sometimes be quite rapid
Due to the lack of blood supply, you may feel lightheaded, dizzy and might even cause you to faint
Even the slightest of exertions will cause breathlessness and exhaustion and you may even feel this symptom while at rest
Intermittent chest pain
Causes of Cardiomyopathy
Causes of this condition may vary from patient to patient, although certain common factors include:

Genetic reasons where one or both parents are susceptible to this condition
Metabolic problems such as obesity, diabetes or thyroid problems
Substance abuse such as anabolic steroids, amphetamines cocaine or even the consumption of excessive alcohol
High blood pressure for prolonged periods
Nutritional deficiencies
Side effects of drug treatments such as the use of certain chemicals in chemotherapy
Types of Cardiomyopathy
Cardiomyopathy has multiple types; depending on what causes them and also certain specific symptoms. These are:

Restrictive cardiomyopathy
Dilated cardiomyopathy
Arrhythmogenic right ventricular dysplasia
Hypertrophic cardiomyopathy
Unclassified cardiomyopathies
Treatment for cardiomyopathy
The treatment of these various forms of cardiomyopathy will vary depending on the type and also the stage and condition of the heart. Some of these treatments include:

Medications
Lifestyle changes
Surgeries such as Septal myectomy, Septal ablation and Radiofrequency ablation
Implantable devices such as Implantable cardioverter-defibrillator or ICD
Ventricular assist devices
Heart transplant in the worst case scenarios

Cardiomyopathy -  Decoding the Types + Treatment

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