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?

Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

It is true that most people are aware of the fact that  angina  is a term which has something or the other to do with the heart. That being said, very few would be able to answer a question regarding what exactly it is, in a satisfactory manner. So would it not make sense to know more about it and become one of the few?

The term is derived from the ancient language of Latin and refers to a tightness that is felt or a squeezing of the chest. This happens when there is not enough oxygen-rich blood which is reaching the area of the heart muscle. While many people think that angina is a disease, it is actually not true to think that it is! As a matter of fact, it is a symptom of coronary artery disease. It is this disease which is the most common disease which affects the heart.

But why exactly does a person experience angina? Well, the lack of blood which is rich in oxygen occurs when it so happens that the coronary arteries become narrower than they normally should be. This generally happens due to the build-up of plaque. The condition in which this happens is known as atherosclerosis.

When it comes to the sort of people who are at a higher risk of developing angina, it can be said that those who smoke tobacco really do increase their risk, as do those who are overweight or obese and have other lifestyle diseases such as diabetes.

In order to avoid angina, the most important thing a person can possibly control is his or her lifestyle. In fact, a lot of the risk factors related to angina are attributable to the lifestyle a person chooses to lead. Cholesterol levels can be controlled if a person puts enough attention and effort in. Also, avoiding a lifestyle that is sedentary by exercise can not only help with cutting the risk of angina but also the risks of other conditions such as high blood pressure. It is ironic that high blood pressure is one of the potential signals of angina!

It is to be noted that while most people just call angina as it is, there are various types-

Stable angina is when the heart is working harder than usual and medicine helps improve this.

Unstable angina occurs even at rest and is unpredictable. It may also be a signal of a coming heart attack.

Variant and microvascular angina is relievable by medicine and is generally rare.

What Is Angina?

The heart may sometimes face excessive fluttering or a throbbing sensation, which may make you feel uncomfortable. Such sudden throbbing sensations resulting in discomfort are called 'palpitations'. Homeopathy has some great remedies depending on the cause of these problems.

Let s have a look at these:

Palpitations caused by anxiety: This is one of the top causes for palpitations which occur before sitting for an exam, interview or before important events of your life. However, they may tend to stay longer and it is advisable that you control them with the use of Aconite or Arsenic Album.
Palpitations caused by Physical exertion: If you have a weakened heart or if you smoke and thus tend to feel a lot of exertion even with the slightest of physical efforts, then Spigelia, Iberis and Digitalis are good medications. Digitalis is especially good for palpitations caused by the slightest of movements, while spigelia is very good with palpitations that cause arm pain as well.
Anemia: Anemia or the lack of red blood cells can be very dangerous for your health as it can damage your vital organs. It can also cause palpitations along with other symptoms such as paleness, lack of strength and drowsiness. Natrum Mur and Ferrum Met are two of the most effective remedies in such cases.
Use of tobacco products: Another reason for palpitations developing is the use of tobacco products, such as cigarettes or chewing tobacco. In such cases, palpitations may occur even with the slightest of exertions or at rest. Medications effective in such situations are Kalmia, Tabacum and Convallaria. These variations may be required depending on the types of symptoms you may show such as a quick heart rate or a slow heart rate.
A palpitation caused by hyperthyroidism: Excessive secretion of thyroid is called hyperthyroidism and can cause a host of problems within the body including palpitation. Iodum and Spongia are two excellent medications in treating variations of palpitations caused by an over active thyroid gland.
Palpitations caused by acidity or gastric problems: This is possibly the most common cause for palpitations and Lycopodium as well as Abies Can are two very effective homeopathic medications, which can easily remedy the situation, depending on the type of problems you are having.

Palpitations - How Homeopathic Remedies Can Help You Manage Them?

Symptoms of heart attack

A heart attack (myocardial infarction) should not be confused with stroke or heart failure. It is the condition which causes major damage to heart muscles because of sudden blockage by a blood clot. The most common symptom of heart attack happens to be chest pain. Heart failure and ventricular fibrillation are probably the most common complications in this condition. 

Clear symptoms of heart attack are:

1. Feeling vaguely ill - very vague feeling of illness is one symptom. You cannot really put your finger on what is wrong with you, but you do feel unwell.

2. Pain in left arm - pain in the arm, mainly the left arm is also one of the symptoms of an impending heart attack.

3. Sweating and heartburn - a lot of people have reported experiencing sweating, indigestion and heartburn before a heart attack. If you are sweating profusely and without any particular reasons, or having an unbearable heartburn, consult a medical specialist immediately.

4. Chest pain - feeling of fullness or tightness in the chest followed by pain is also a symptom of a heart attack. A lot of people have reported to ignore it; kindly don't.

5. Breathlessness - sudden shortness of breath and inability to do a lot of work at one point of time is not a good thing. This could be an indication of a heart attack.

6. Silent attack - the scariest of all is silent heart attack. At times, it comes with no symptoms at all. A person could be visibly physically fit, and suddenly have an attack. This usually happens with those who are suffering from diabetes mellitus.

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All You Need To Know About Heart Attack Symptoms

Cardiomyopathy is a serious heart disease. It is a disease associated with the heart muscle or myocardium. In this disease, the heart muscles get weak and fails to pump blood to the organs of the body. It has several categories. The categorization depends upon the range of factors. In this disease, irregular heartbeat is observed. These irregularities can lead to heart failure or attack or can trigger problems in the valves. It is important to take care of your heart to avoid such a condition. It is also advisable to see a doctor as soon as the symptoms are noticed to avoid greater damage.

Types of Cardiomyopathy
This disease can be divided into four categories. These are as follows:

Dilated Cardiomyopathy: It is the most common type. It occurs at a time when the heart muscle gets too weak to pump blood properly. The muscles of the heart get thinner and weak. In fact, this also leads to the expansion of the heart chambers. In common terms, it is also referred to as enlarged heart. In most cases, this is inherited or caused by some coronary artery disease.
Hypertrophic Cardiomyopathy: This is genetically transferred to the patient. In this condition, the heart walls get thicker and this hinders the smooth flow of blood. It is one of the most common types of Cardiomyopathy.
Arrhythmogenic Right Ventricular Dysplasia (ARVD): This is a very rare form. It can cause sudden death, especially in young athletes. In this disease, fat and fibrous tissues are responsible for replacing the muscles in the right ventricle. This leads to an abnormal rhythm.
Restrictive Cardiomyopathy: It occurs as the ventricles of the heart get stiff and are unable to relax. This prevents them from getting filled up with blood. Under this situation, you might have to go for a heart transplant.
Other Types: Some of the other types include Peripartum Cardiomyopathy (the one which occurs after pregnancy), Alcoholic Cardiomyopathy (happens due to excessive intake of alcohol) and Ischemic Cardiomyopathy.
Treatment of Cardiomyopathy

The treatment of Cardiomyopathy depends upon the extent of damage caused. It might not require treatment if symptoms are not very troublesome or prominent. It may be dealt with certain lifestyle changes, adjustments and medications, in cases those needs to be addressed.

Tips to deal with Cardiomyopathy
1. Maintain a healthy lifestyle by getting an adequate amount of night sleep. Go to bed early and wake up early too.
2. Don t spend long hours in watching television or work till late night
3. Eat a lot of fresh and green-leafy vegetables daily.
4. Avoid the intake of spicy, oily and fast foods.
5. Consume home-cooked food only. Avoid eating out at restaurants or street-side joints.
6. Don t drink excess coffee, tea or aerated drinks.
7. Don t consume alcohol or smoke up cigarettes.
8. Don t live a sedentary life and be a couch potato. Workout and exercise on regular basis.
9. Avoid emotional outburst and try to keep a control over your reactions.

Cardiomyopathy - Tips To Help You Deal With It!

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