The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls. 


This attracts more and more fat molecules to settle down.  This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.


This condition, known as coronary artery disease, is becoming a major cause of deaths.  While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.


Preventive measures: 
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease.  This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar.  Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.


2. Exercise:  Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management.  Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.


3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.


4. Alcohol consumption:  While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no.  Binge drinking especially is shown to cause heart attacks.


5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.


6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them.  Keep a constant check to ensure your readings are managed well. 


7. Watch out:  Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.


Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life.

Coronary Artery Disease - 7 Ways You Can Prevent it 

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?

Psychogenic breathlessness or pseudo-dyspnea is a condition where the patient suffers from shortness of breath time to time. This disease is often confused with a similar breathing disorder called Chronic Dyspnea. While there are a lot of factors involved in chronic dyspnea, like allergens and pulmonary diseases, psychogenic breathlessness has more to do with the current state of mind.

One of the most challenging factors is the diagnosis and differentiation between both conditions. Sometimes, the psychogenic breathlessness is so concentrated that there is no way to differentiate between the two.

Procedure of Diagnosis of Psychogenic Breathlessness:

Here are the steps that doctors typically follow to diagnose Psychogenic Breathlessness

To differentiate between the two diseases (Chronic Dyspnea and Psychogenic Breathlessness), the doctor will ask the patient to try breathing harder. A patient with chronic dyspnea will find it even harder to take a breath when he or she tries to. However, a person with psychogenic dyspnea will show improved conditions when they try to breathe harder

A thorough examination of the chest will be done

Blood tests and lung function test (spirometry) will also be conducted to rule out pulmonary diseases

Causes of Chronic dyspnea:

Allergens causing allergic bronchitis (also known as asthma) is the main reason behind Chronic Dyspnea. Other common causes of the true or chronic dyspnea are heart diseases, COPD which occurs because of smoking. Then there are rare disorders like ILD (sarcoidosis), neuromuscular diseases, infections, anemia, obesity/deconditioning.



Causes of Psychogenic dyspnea or psychogenic breathlessness:

Acid reflux: Acid reflux can cause certain sensation on the inner lining of the esophagus (esophagitis). The esophagus has several nerve endings on the inner linings, when the acidic reflux touches these nerve endings, a temporary breathlessness occurs.

Anxiety: People with anxiety can also develop breathlessness. Though exercises help for a short period of time, a patient needs to see a psychiatrist for this condition.

Panic Attacks: These are also a cause for breathlessness. The temporary feeling of choking is common in people who experience panic attacks.

Treatment:

Medication: Medicine for acidity is prescribed to patients having Pseudo-Dyspnea, due to acid reflux.

Anxiety pills and Talking therapy: People suffering from anxiety are recommended to see a psychiatrist for better evaluation of their problem. Medications (anxiety pills) prescribed by the psychaitrist may help in controlling the breathing pattern in a person. Psychological therapies (Talking therapy) have been effective for people suffering from breathlessness due to anxiety.

Placebo: If the problem remains unsolved and unknown, sometimes doctor prescribes placebo medication, for example sweetened aerosol. Doctors believe that if the patient thinks he/she is taking a real medication, his/her condition can be controlled by eluding the mind.

It is important to remember that Psychogenic Breathlessness is as real as chronic breathlessness and patient doesn t pretend to have this condition. When the first symptoms of it start appearing, a specialist doctor (pulmonologist) should be consulted who after confirming the diagnosis of psychogenic breathlessness, may refer you to a psychiatrist or psychologist for further treatment.

Psychogenic Breathlessness - Causes, Symptoms and Treatment of It!

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

If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.

Stages
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.

The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.

The staging is as follows:

Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.
The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema s impact on several areas of life are measured. They include the following:

Body mass index (B)
Airflow limitation or obstruction (O), which is measured by pulmonary function tests
Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes
Life expectancy
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.

The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less.

Emphysema - Know The Life Expectancy and Stages!

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