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

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

Coronary Artery Disease - Symptoms and Causes

Coronary artery disease is the disease in which the major blood vessels (coronary arteries) that supply blood, nutrients and oxygen to your heart get damaged or disease stricken. It is mostly caused due to the coronary artery getting plagued or inflamed. The consequent reduction in blood flow to the heart causes the various symptoms of coronary artery disease like angina (chest pain), short breath etc.

Symptoms:

Here is a list of a few symptoms that help in identification of the coronary artery disease.

1. Angina

Pressure or tightness may be felt in or near the area of the chest that results in pain. It is mostly felt in the middle or left side of the chest.

2. Shortness of breath

Another symptom of coronary artery disease is short breath, fatigue and a feeling of exertion.

3. Heart attack

Complete blockage of the coronary artery results in a heart attack that is a prominent symptom of coronary artery disease. A person may feel heavy pressure in the chest, pain in the shoulder or arm, sweating etc. prior to getting a heart attack.

Causes:

Coronary artery disease occurs when damage or injury is done to the inner layer of the coronary artery. This damage causes plaque, which are deposits made of fat, cholesterol and other cellular waste materials to accumulate near the damaged area of the artery. This process is known as atherosclerosis.

The various causes that result in coronary artery damage are listed below.

- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- High stress
- Physical inactivity

Knowing Coronary Artery Disease - Symptoms and Causes

Egg yolk and cholesterol - is there a link?

Although egg is considered one of the most nutritious foods, people with high cholesterol avoid its consumption as they believe that eggs may increase cholesterol and risk heart diseases.

Is there a link between egg yolk and cholesterol?

Egg yolk is rich in dietary cholesterol. One large egg contains 185 milligrams of cholesterol. People with normal cholesterol levels require about 300 milligrams of dietary cholesterol and people with high cholesterol need 200 milligrams of dietary cholesterol from food.

Dietary cholesterol has the minimum impact on blood cholesterol as compared to saturated and trans fats which contain bad cholesterol. Hence dietary cholesterol present in egg yolk has minimal or no effects on increasing your cholesterol levels.

If you would like to consult with me privately, please click on'consult.

Egg Yolk and Cholesterol - Is There Really a Link?

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!

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