Cardiomyopathy includes diseases involving the heart muscle. These diseases have various causes, types, symptoms and modes of treatment.

The heart muscle gets enlarged, thick or rigid. In several cases, the heart muscle tissue is replaced with a scar tissue. As this condition worsens, the heart gets weaker and the ability to pump blood is disrupted, which can cause heart failure or irregular beating of the heart. The weakened state of the heart can lead to valvar diseases.

The different types of cardiomyopathy are:

 Hypertrophic cardiomyopathy-
This is a common form and affects people of all ages. Men and women are affected equally. This condition arises due to the enlargement and thickening of the heart muscle. The ventricles, the septum and the lower heart chamber usually thicken, which causes obstruction in pumping of blood by the heart. This disease also causes stiffness in the ventricles, and cellular changes in the tissue.
 Dilated cardiomyopathy-
This form of cardiomyopathy develops due to the enlargement and weakening of the ventricles. The issue arises from the left ventricle and develops over time. It may even affect the right ventricle. More effort is put in by the heart muscles for pumping blood and slowly the heart is unable to pump blood effectively. This condition may lead to heart failure, valve diseases or blood clots in the heart.
 Restrictive cardiomyopathy-
This disease occurs due to the stiffening of the ventricles, without thickening of the walls of the heart. The ventricles are not allowed to relax and do not receive a sufficient volume of blood supply. This condition causes heart failure and valvar problems over time.
 Arrhythmogenic right ventricular dysplasia-
This rare form of cardiomyopathy occurs when fat or fibrous tissues replace the muscle tissue of the right ventricle. This causes arrhythmias and disruption in the electrical signals of the heart. It generally affects teens and may cause cardiac arrest in athletes.
 Unclassified cardiomyopathy-
Some types of cardiomyopathy of this category include left ventricular non compaction where the ventricles develop trabeculations. Takotsubo cardiomyopathy is another disease where immense stress causes failure of the heart muscles.

Treatment-
Many cases of cardiomyopathy come and go away on their own. Treatment for other cases depends on the severity and symptoms. The major treatment methods are:
Lifestyle changes meant for a healthier heart.
Medication.
Nonsurgical methods.
Surgery and implants

Modes of surgery for treatment of cardiomyopathy include:
Septal myectomy
Heart transplant
Implant devices such as cardiac resynchronization therapy (crt) device, implantable cardioverter defibrillator (icd), left ventricular assist device and pacemakers are fitted into the heart for better performance.

Cardiomyopathy can be of many different types, each arising from different situations and conditions. The mode of treatment depends on the severity of the complication or on the basis of symptoms.

Types and Treatments of Cardiomyopathy

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?

A heart attack makes you rethink and get a double take on life. Once you survive it, you tend to realize how close your brush with death has been and how important your lifestyle choices can be. Most people go on to live a productive life after a heart attack provided they can adhere to making healthy choices. Here's what you can do if you have experienced your first attack and want to change for the better:

1. Start at the hospital: A person usually stays in the hospital for 3 days after an attack to monitor their condition. This duration increases if you have complications that involve procedures like a bypass surgery. Your first significant change will come in the form of your medication routine. Your existing dosage may be adjusted and you'll possibly be prescribed newer medicines that will treat and control your symptoms. You'll not only need to know the names of all your medicines, but when you have to take them. It's best you know exactly why you are taking each one of them, if there are other more economic alternatives since this may last a lifetime and what side effects they may have.

2. Maintaining your mental health: Once bitten, twice shy applies for heart attack victims too. Not only do they live in a constant worry about another attack, every small symptom like a harmless muscle pull can trigger the fear factor. You also get into the "heart patient" dependent mode based on how much help you need to recover. Check for support groups and other heart attack survivors in your locality to see how they are coping. Read more about your recovery and try to keep a positive frame of mind.

3. Go to a cardiac rehab: Many hospitals have a rehabilitation program that you can participate in as an outpatient or you can go to a clinic that specializes in it. Such programs help speed up your recovery. It is run by people who will hand hold you in bringing positive changes in your life to protect and strengthen your heart. You'll learn activities that positively improve heart functions and reduce your chances of developing complications or dying from heart disease. You'll also get benefit from exercises that'll be taught by a certified exercise specialist.

4. Make a change in your lifestyle: Quit smoking that is an obvious one. You'll now have to lead a more active lifestyle with daily exercise. You'll also need to actively manage your diabetes and obesity. None of these changes can happen in a day. In fact, behavioral scientists suggest that you need to practice a new activity continuously for twenty one days for it to become a habit.

How To Live After A Heart Attack

Why Do You Get Palpitations? How to Get Immediate Relief?

Palpitations is the feeling that you experience when your heart beats abnormally. Heart palpitations can be felt in the form of rapid, fluttering or pounding heartbeats. They can be frightening as when you palpate, you heart beats so hard that it even skips a beat and the sensations are so strong that they can be felt all through your chest, neck, and throat.

Palpitations are also common especially in young people because of abnormal electrical circuits in heart from birth. However, they may have normal hearts on Echo. Such palpitations are curable by a nonsurgical methods called Radiofrequency Ablation.

Palpitations can be triggered as a result of a number of reasons like stress, certain medications, exercise etc.

Here are a few prominent causes of heart palpitations.

Causes unrelated to the Heart -

- Anxiety, fear, and stress
- Consumption of alcohol and drugs like caffeine, nicotine etc.
- Consumption of street drugs likes cocaine, amphetamines etc.
- Certain medical conditions such as thyroid, anemia, dehydration, low blood pressure and low sugar levels etc.
- Hormonal changes that occur as a result of menstruation, pregnancy, menopause etc.
- Certain nutritional and herbal supplements
- Certain medications like asthma inhalers, diet pills etc.
- Abnormal levels of electrolyte
- Sensitivity to certain food items like some carbohydrates

Causes related to the Heart -

- Coronary artery disease
- Prior instances of heart attack
- Congestive heart failure (a condition wherein your heart's chambers get affected)
- Problems associated with the heart valves or the heart muscles

Immediate Relief Mechanisms-

It is crucial to go to the most easily available doctor to get an ECG done during palpitations as ECG will give an exact diagnosis, which helps in identifying the clear line of treatment.

Here are a few techniques that can help you in getting immediate relief from heart palpitations until you are able to visit a doctor in case of a serious condition.

- Cough it out
- Splash cold water on your face or take a cold shower
- Practice slow, deep breathing exercises



Why Do You Get Palpitations? How to Get Immediate Relief?

Mushroom is a type of fungi that hails from the Agaricus family. It is estimated that there are close to 1,40,000 types of mushroom, out of which science has been able to classify only 100 odd mushrooms for health benefits. From cutting down cholesterols to preventing cancers, increasing the strength of the immune system to helping in weight loss, there are numerous health benefits of mushroom. This article will explore why mushrooms are regarded so highly by health practitioners across the globe:

Cholesterol levels: Mushroom does not possess any fat or cholesterol. They are rich in lean protein, fiber, and some very important enzyme. The lean protein found in mushroom helps to burn down the LDL cholesterol. Furthermore, it creates a good balance of LDL and HDL cholesterol so that the body can refrain from stroke, atherosclerosis etc.
Preventing cancer: Mushrooms are mighty effective in blocking certain cancer types such as the breast and prostate cancer. Owing to their high linoleic acid and beta-glucans, they act as a very good anti-carcinogen. While linoleic acid can successfully suppress the excess estrogen which leads to breast cancer in women, the beta glucans can suppress the growth of cancer cells in the case of a prostate cancer.
Diabetes: Mushroom is an ideal food for a diabetic patient. They do not possess cholesterol, consists of low fat, have high protein and a lot of minerals and vitamins. Apart from this, mushrooms possess a lot of fiber and water. The most critical component, however, is the natural insulin that mushroom has within itself. They help to break down the starch found in food items. Mushrooms have certain components that help in the proper functioning of the liver, endocrine gland etc. It ensures that the proper balance of insulin is maintained in the body.
Bone health: Mushroom is a very good source of calcium. They ensure that adequate strength of various bones is maintained in the body. Regular intake of mushroom can ensure safeguard an individual from conditions such as osteoporosis, joint pain, and immobility.
Blood Pressure: Mushroom variety such as the maitake and the shitake has a high amount of potassium content. The latter can successfully relax the blood vessels thereby, reducing the blood pressure. Increased potassium content also helps in knowledge retention and an improved memory. High blood pressure, on the other hand, can cause severe damage such as strokes, heart attacks etc.
Selenium content: Selenium component is mushroom is one of the key ways to receive selenium for a vegetarian. Selenium helps in strengthening the bone, nail, tooth and hair. Selenium is also considered to be a very powerful antioxidant that can successfully get rid of free radicals in the body and strengthen the immune system.

Mushrooms - 6 Reasons Why You Should Start Eating Them Today!

Know Your Cholesterol 

Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. The term cholesterol is often directly related to a heart condition. But the truth is that not all types of cholesterols are harmful for your body. It is important that one knows about the different types of cholesterol, having healthy levels of both types of lipoproteins is important, deal with them appropriately and lower the chances of having a stroke or getting a heart disease. Bad cholesterol levels can be high in people irrespective of them being thin, if it is genetic or if they are smokers.

Types of Cholesterol.

The Bad One:

LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Lowering your cholesterol may slow down, reduce, or even stop the buildup of plaque in your arteries. It also may reduce the risk of plaque rupturing and causing dangerous blood clots.

The Good One:

HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body and  is important for the body as it reduces the risk of heart attack, disease and strokes.

Cholesterol count of the body is counted by adding the two types of cholesterols (LDL and  HDL) along with body's triglyceride level. Triglycerides are a type of fat found in your blood. Too much of this type of fat may raise the risk of coronary artery disease.

The level of your cholesterol shows the level of risk your body is in, to have a stroke or a heart condition. Other factors which determine the risk are whether the person is a smoker, diabetic, has high blood pressure along with their age, sex and race.

Cholesterol levels are affected by:

1. Genetics: Genetics have a direct effect on your cholesterol level. If the levels have been high in the previous generations, you are automatically at higher risk of this condition.An inherited condition called familial hypercholesterolemia causes very high LDL cholesterol.

2. Age and Weight: Once we cross the age of 20, our cholesterol level starts to rise. Being overweight however is also a high risk factor of increased levels of bad cholesterol in the body as well as developing heart disease.

3. Lifestyle: Less or no exercise is another reason which reduces the good cholesterol in the body, as does being overweight. Regular exercise however reduces LDL and increases HDL in the body. Also a diet rich in saturated fats makes your LDL levels shoot up and puts you to higher risk.

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


 Know Your Cholesterol: Good Vs Bad

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