In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart. 

When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.

This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.

Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.

Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.

Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches   lifestyle changes, medications, and surgery.

Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
Medications: A number of medications would be used depending on patient s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.
In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.

Predictable Chest Pain Pattern - What Does It Indicate?

5 Symptoms that Indicate Your Heart is in Trouble!

Your heart gives you warning signs before the onset of a major problem. You may not even know that you are at risk of one or more heart diseases if you fail to notice these small signs that your heart sends out. Even a minor symptom, like chest pain, can indicate that your heart may be in trouble. While there could be many causal factors for a heart condition, here some symptoms, which are possible indications of a heart disease and should not be ignored in any case.

1. Chest pain or discomfort

This symptom is the most common one, which indicates that your heart is not healthy. It usually comes in the form of a pain, pressure or tightness in the chest and may happen due to a blocked artery. This may be an early warning sign of a heart attack and you should seek professional advice before it turns into a major problem.

2. Excessive sweating

If you often sweat without any valid reason, it might be a sign to be concerned for. The sweating experienced will feel more like the one that arises due to stress rather than common perspiration experienced due to any vigorous physical activity.

3. Difficulty in breathing

Shortness of breath is an indication that you are at high risk of getting a heart attack. The symptom includes having difficulty in breathing and feels similar to the panting experienced after a long run.

4. Nausea and frequent stomach problems

If you experience nausea, heartburn, indigestion or abdominal pain frequently, it may be the result of an unhealthy heart. Of course, these signs may be due to other diseases as well, but if you experience any of the other symptoms of heart problems too, it's highly probable that your heart is in trouble.

5. Exhaustion

If you fall into the high-risk zone of being a potential heart patient, you may feel exhausted after doing some simple chores, which didn't tire you earlier. Common examples may be climbing the stairs or carrying something from your doorstep inside the house to name a few.



5 Symptoms That Indicate Your Heart Is in Trouble!

What Happens When the Electrical Activity of Your Heart Changes?

The heart's electrical conduction system plays a very important role in cardiovascular functioning. Also known as the atrioventricular (AV) conduction system, it regulates and controls the timing of the heartbeat.

How does the heart's electrical conduction system work?

There is a collection of electrical cells in the upper right atrium of the heart known as the sinoatrial (SA) node which acts as a natural pacemaker and generates electrical signals. These signals travel through specialized electrical pathways and stimulate the muscular walls of the heart to contract in a rhythmic manner. This gives rise to the heartbeat that pulses at a specific frequency every minute.

What is the effect of fluctuations in electrical activity on the heart?

The standard heart rate in human being ranges from 60 to 100 beats per minute. It slows down when a person sleeps and speeds up when one experiences physical or emotional heightening. These fluctuations are triggered by the brain or other systems of the body and signal the SA node to generate charges more rapidly or slowly. This leads to spikes and drops in the heart rate, depending on the nature of the situation.

What happens when there is dysfunction in the heart's electrical activity?

When the heart's electrical conduction system does not function properly, it leads to the occurrence of a condition known as arrhythmia or abnormal heart rhythm. This happens when electrical impulses are generated in an irregular manner and causes tachycardia (rapid heartbeats) or bradycardia (slow heartbeats) which takes place in jarring infrequent tempos.

What causes fluctuations in the heart's electrical activity?

There are various kinds of triggers that cause the heart rate to fluctuate. The exact nature of fluctuation also depends on the type of trigger. A few everyday examples of these causes are as follows:
- Exercise and strenuous physical activity increases electrical activity as the heart is required to beat faster so as to increase the supply of blood and oxygen to the muscles.
- Sleep and rest reduce heart rate as the body is not needed to exert itself.
- Release of adrenaline into the bloodstream causes the heart rate to spike up.



What Happens When the Electrical Activity of Your Heart Changes?

SGLT2 (sodium-glucose-co-transporter 2) inhibitor is an oral tablet used in conjunction with exercise and diet to improve blood glucose control in Type 2 diabetes mellitus patients.

The medication works by targeting and helping prevent sodium-glucose transport proteins from allowing glucose that has been filtered by the kidneys to be reabsorbed into your bloodstream.

Who is SGLT2 Inhibitor suitable for?

This drug is not suitable for everyone. Selection of the right patients is crucial to understand the mechanism of the medication and see improvement in the condition.

SGLT2 Inhibitor is given to patients with Type 2 diabetes mellitus as a second-line drug in case the first line of treatment, metformin, fails to keep high blood sugar levels in check.

If the patient has hyperglycemia i.e. high, uncontrolled blood sugar, and a Body Mass Index (BMI) equal to or greater than 30 due to the accumulation of fat in the abdominal region (central obesity), then SGLT2 Inhibitor could be a useful medication. The drug not only works to reduce high blood glucose but also helps with weight loss. However, in patients with normal BMI, the medication does not induce weight loss.

SGLT2 Inhibitor may not be suitable for patients with a history of urinary tract infection. Hence, it is advisable for all patients to undergo a urine test before starting with the dosage. If the test results are normal, then only you can discuss the dosage with your doctor/healthcare provider and start taking the prescribed medications immediately.

Benefits of Taking SGLT2 Inhibitor :

The benefits of using SGLT2 Inhibitor are as follows  

Helps reduce excess weight if the patient is obese. If taken in the correct dosage as prescribed, you can lose up to 5 Kgs in about three months.

Helps reduce Systolic blood pressure   if a diabetic is living with hypertension, SGLT2 Inhibitor can bring down systolic blood pressure.

As an anti-diabetic drug, SGLT2 Inhibitor works to control high blood glucose and improves glycemic control. Thus, with the help of the drug, Type 2 diabetes mellitus patients can keep their HbA1c levels at 7% or less.

Side Effects

One major side effect of SGLT2 Inhibitor is urinary tract infection. SGLT2 Inhibitor drug filters excess blood sugar from the body in the form of urine. Frequent urination or filtering of wastes through the urethra may lead to infections. Therefore, it is imperative that patients are informed about the mechanism of the drug and its probable side effects before taking the medication. One way to avoid urinary tract infections is to maintain good hygiene   wash and clean your private areas after urination.

SGLT2 Inhibitor can also cause dehydration in the patient, as a lot of fluid is drained out of the body. Patients are advised to have a glass or two of water more than what they usually drink.

SGLT2 Inhibitor is an effective oral medication for Type 2 Diabetes mellitus. Speak with your doctor and get yourself thoroughly checked before you start taking the drug.

SGLT2 Inhibitor - Know Merits & Demerits Of It!

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 

Shortness of breath, medically known as dyspnea, is the sensation of tightening of chest accompanied by a feeling of suffocation. Most of us would have experienced this while doing intensive exercise, while in extreme temperature or high altitude to a certain extent. But when the breathlessness is severe, it is due to a lung or heart ailment. The lungs and the heart play the most important role in transporting oxygen to our tissues and removes carbon dioxide. And so, any kind of problem in either of the organs can affect our breathing.

Causes:
Numerous underlying conditions can lead to a shortness of breath. An insight into the most common causes are enumerated below.

Asthma: One of the common reason for shortness of breath is asthma. It is a serious condition in which the passage of air becomes narrow and swells up and produces extra mucus. This can result in shortness of breath, triggers wheezing, coughing and also makes breathing difficult. It cannot be cured but the symptoms can be controlled, and it is also necessary to consult with the doctor to track the symptoms and adjust the treatment.
Carbon monoxide poisoning: Another leading cause of shortness of breath is carbon monoxide poisoning. It is caused when carbon monoxide builds up in our blood stream. When there is excessive carbon monoxide in the surrounding air, our body replaces the oxygen in our red blood cells or RBCs with the carbon monoxide in the air. Appliances that are improperly ventilated and engines, especially in a sealed or tightly enclosed space might allow carbon monoxide to accumulate in our blood stream to a dangerous level.
A hiatal hernia: This is caused when part of our stomach pushes upward through your diaphragm. Our diaphragm usually has a small opening through which our esophagus or food pipe passes and connects the stomach. The stomach pushes up through this opening in case of a hiatal hernia and results in shortness of breath. In most of the cases it can be cured by medications, but in some situations, surgery is required.
Pulmonary embolism: It is a blockage in one of the pulmonary arteries in the lungs. In 95% of the cases of pulmonary embolism, it is caused due to blood clots that travel to the lungs from the legs or some other parts of the body. As the clot blocks the flow of blood to the lungs, it can also be life threatening besides causing a shortage of breath.
Apart from these conditions, others such as bronchitis, pneumonia, lung cancer, COPD, arrhythmia, hypertension, and many other lung and heart ailments can result in shortness of breath and can lead to dire consequences in certain cases. Thus, it becomes paramount to consult a pulmonologist when you frequently experience such breathing difficulty.

Shortness Of Breath - 4 Most Common Reasons Of It!

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