A sensation of pain in the chest is almost automatically associated with having a heart attack. While it is true that it is one of the best indicators of a heart attack, there are quite a few other things which can cause one s chest to pain and not all need to necessarily be as time critical as a heart attack. So, what are the various things one should be aware of when it comes to pain in the chest? In order to understand chest pain better, it is first very important to understand the various types of chest pain better! So, there is a sharp pain, its opposite which happens to be a dull pain, burning, aching, stabbing pain, as well as a crushing sensation.

Let s start with the elephant in the room, which is medically known as myocardial infarction or referred to as the infamous heart attack. This occurs when the muscle cells, which are located in the heart die on account of not enough blood flowing through the heart. In simple terms, the best way to get to know that one is having a heart attack is when the person feels a seriously crushing pain in the centre or the left side of the chest. What could be said to be unique about this type of pain is that resting does not make it better.

Another condition of the heart which is often mistaken by the layman for a heart attack happens to be myocarditis. Inflammation of the heart muscle leads to fatigue and a fast beating of the heart. The person would also experience some difficulty breathing.
Heart disease can come in multiple forms and one of those is known as CAD or Coronary Artery Disease. When there is a blockage in the blood vessels of the heart, the pain [which is known as angina] is caused by this blockage. The probably solitary source of good news is that permanent damage to the heart is not caused by CAD!
That being said, a heart attack is a greater possibility. The pain in the chest could spread to the jaw or the back, or even the arm. The sensation is that of the body part being squeezed. The first thing to be done when angina occurs is to rest in order to lower the pain.
While these conditions have focused on the heart, pneumonia affecting the lungs can cause deep chest ache. It causes a cough and chills. There is also likely to be pus from the respiratory tract which is coughed up!
Asthma is yet another respiratory issue which could cause chest pain!

Chest Pain - Reasons Behind It!

How Do You Recognise a Stroke?

Strokes occur when blood to the brain gets interrupted or reduced. When this occurs, brain cells begin to die as they don't get enough nutrients and oxygen. Such life-threatening episodes can strike you anytime.

There are certain signs that can help you to clearly recognise an occurrence of stroke:

Face drooping on one side
Weakness or numbness on one side of the body, usually a leg or an arm
You're unable to think or say anything clearly
You experience slurred speech
Difficulty in moving your tongue
You get a sudden and severe headache

What Tests can be Done to Identify the Stroke?

There are certain tests that you can do to identify these warning signs.

To identify facial weakness, the smile test is used wherein you're simply asked to show your teeth to check for any changes in this facial expression - a lopsided smile.

To check for weakness in the body, the arm test is performed in which you raise both your arms to the same height. In case you're unable to do so, you may be experiencing arm weakness, a sign of stroke.

For slurring of speech, you may be asked to repeat sentences such as 'Don't cry over spilt milk' or 'The pen is mightier than the sword'.

Stroke can also be identified through the walk test wherein with the help of another person, you walk across the room to check for changes in your step.

If not treated in time, strokes can cause permanent brain damage. More importantly, unlike heart attacks, anxiety may not always be the cause of your stroke symptoms. That's why, being aware of these symptoms and recognising them on time can help you to quickly seek medical assistance.

How To Recognise a STROKE, Before it's Too Late!

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 

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

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

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

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