What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Breathing is life, without breathig, there is no life. Who knows this better than an asthmatic or someone with breathing problems like wheezing, coughing and shortness of breath 24/7? If you have breathing problems, read on about possible causes and treatments for them

Causes

There can be a number of causes of breathing problems. They can happen due to colds, acute sinusitis or inflammation of sinuses. This usually subsides in a week or two with the inflammation going down and the sinuses draining out.
But if you are still experiencing breathing problems, you could be in more dangerous territory.
Breathing difficulties can happen in a case of asthma, allergies, and infections of the lungs, bronchitis and even heart problems especially if you feel a shortness of breath during exertion. These can all be long-term problems that need proper management.
Symptoms
Chronic issues that cause breathing problems, especially asthma and allergies have a number of symptoms like

Nasal and chest congestion
Runny nose
Itchy or watery eyes
Cough
Wheezing
Laboured and/or shallow breathing.
A number of virus and allergens like pollen reach the lungs via the nasal passage. Any inflammation in the nasal passage due to an allergy is a major cause for concern because the number one trigger for asthma is allergies. If left undiagnosed and untreated, these can make life hell for you.

Chronic obstructive pulmonary disease or COPD, which includes emphysema and chronic bronchitis, also causes breathing problems. Breathing issues can also stem from other serious diseases like lung cancer, tuberculosis, and pneumonia. Most of these can be diagnosed by a specialist.


How are breathing problems treated?



Breathing problems caused due to asthma and allergies are usually treated by avoiding allergy triggers like air pollutants, pollen, dog hair, dust, mites or dander.
Wearing masks, avoiding peak traffic, staying indoors during low air quality days, all make a significant difference to allergy and asthma sufferers.
Medications are another way to treat breathing problems due to asthma and allergies. Allergy drugs such as antihistamines and decongestants can make it easy to breathe for some.
Inhaled steroids are also given to people with chronic allergies and sinusitis for reducing inflammation in the airways. Allergy shots to reduce sensitivity to allergens are another option.
Asthma is treated with inhaled or oral drugs that help open nasal airways and reduce inflammation. These cut down on breathing difficulties because the airways are cleared of excess mucus and inflammation.
If you have more serious issues like cancers, heart disease and lung diseases, the medication will vary according to your diagnosis. Your specialist will diagnose the problem first and set you on a proper course of medication.
The last piece of advice before we go, don t ignore breathing difficulties especially if they persist beyond 2-3 weeks, get yourself a doctor s appointment.

Breathing Problem - Common Causes Behind It!

Heart Care Tips For a Heart Patient

A heart patient has to always live with caution. This World Heart Day, let us understand what it takes to keep our heart in good health. In fact, by following certain rules, one can lead a smooth life despite being a heart patient.
The major risk factors of heart diseases are smoking, high blood pressure, diabetes, physical inactivity, obesity, and high cholesterol. In addition to these, there are factors which add to the heart condition. They are stress, alcohol, sleep apnea and C - reactive protein.

Food and exercise play a major role in the well-being of a heart patient. It is important to engage in exercises as prescribed by your heart specialist. Follow these dos and don’ts with respect to food.

Say YES To:

1. Poultry and fish for the requirement Omega 3 and Protein
2. Raw nuts, flax seeds, avocados, olive oil, fish oils etc which make up the body's need of healthy fats.
3. Fruits and vegetables for the body's nutrient needs.
4. Whole grains and legumes which provide energy and fiber to the body.
5. Protein and calcium which come from unsweetened yoghurt, egg whites, low-fat/non-fat cheese and skimmed or double toned milk.

Say NO To:

1. Fried foods, cakes and pastries, since they have trans-fats or other harmful fats.
2. Foods high in sodium and sugar, especially packaged goods.
3. Rice, pasta, white breads, sugary foods.
4. Sausage, bacon and red meat.
5. Full cream milk, whole milk cheese and sweetened yoghurt.

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

 Heart Care In Your Hands: World Heart Day Special Tips

An estimated of 10 percent or more children snore for more than 1 night. Snoring results from the obstruction of breath when the air makes its way through the mouth. The air passage of the throat through which the air goes in and out causes the tissue to vibrate causing snore. The sound of the snore totally depends on the amount of air passing through the mouth and the frequency at which the throat is vibrating. Children above the age of three years tend to snore when they are deep in sleep.

Primary and secondary snoring:
Children who are otherwise healthy should not have a snoring problem unless there is some health disorder. However, if loud snoring is observed in otherwise a perfectly healthy kid, seeking medical help is a wise thing to do. In general, primary snoring is defined as a condition which is not associated with other sleep-related disorders such as lung disorder, OASS, inability to sleep for a longer duration etc.

Other possibilities:
It is estimated that close to three percent of the children suffers from breathing problem while sleeping. OSAS is a condition which is characterised by pauses in breathing and gasps along with loud snores. There could be instances where a kids  muscle relaxes way too much obstructing the air to pass through. The body and the brain are both alerted at this stage. As soon as the brain sends a signal, the body wakes up. Thus, most kids suffering from this disorder are not able to sleep well and tend to feel tired throughout the day.

Common causes of sleep apnea:
Sleep apena is a major cause of snoring. It can be caused because of allergies, obesity, GERD etc. In children sleep, apnea can also be caused by tonsil. Since the tonsil size of children less than 7 years of age tends to be bigger than adult individuals, it causes snoring related problem. Swollen tonsils not only obstruct air but creates other health related problems as well.

Symptoms of sleep apnea during the day and night:

Loud snore
Snorts, gasps, pauses during sleep
Heavy sweat during sleep
Social and behavioural problems
Failure to get up in the morning
A nasal voice
Easily irritated, cranky and aggressive
Relief measure:
The first thing a that a doctor does is a physical exam followed by observing the symptoms of a kid. Primary snorting can be addressed by physical exercise, counselling and breathing exercise. Problems related to apnea are addressed through medicine, counselling, and exercise. Certain dietary restrictions also needed to be followed during this time. However, apena is completely treatable within a certain time frame.

Mouth Breathing - What Can Cause It?

The coronary arteries supply the heart with oxygen-enriched blood and nutrients. If these arteries become damaged or diseased; they could cause Coronary artery disease or CAD. Plaque deposits on the walls of the arteries are the most common cause of this disease. This plaque is usually the result of high cholesterol levels. As the plaque builds up, the passage of blood flow is reduced. This reduces the amount of blood that reaches the heart. In cases of a complete blockage, CAD can even cause a heart attack. Because of its slow progression, this disease is often not diagnosed until it reaches a dangerous stage. However, it can be prevented and treated if diagnosed in time.

In the early stages of CAD, symptoms are not very noticeable. Symptoms become visible only when blood flow to the heart reduces and the heart has to pump harder than normal. The most common symptoms experienced include:

Chest Pain: This is also referred to as angina. It may feel like a tightening of the chest or pressure on the chest as though someone is pressing against it. This type of chest pain may be triggered by emotional or physical stress. It is usually relieved within a few minutes of stopping the activity. Women may experience this pain as a sharp, fleeting pain in the back, arm or neck.
Breathlessness: When the heart does not receive enough blood, it has to work harder to pump blood through the body. This may be translated to breathlessness of shortness of breath when performing any type of physical activity. It can also cause extreme fatigue.
Heart Attack: A heart attack is the most severe symptom of coronary artery disease. This is caused by the complete blockage of a coronary artery. A heart attack can occur without any symptoms or be preceded by slight symptoms. The signs of an impending heart attack include pain in the chest and shoulder, shortness of breath and extreme sweating. The chest pain may also travel to the lower jaw. These symptoms are more pronounced in men as compared to women. Women have a higher tendency of experiencing atypical signs such as extreme fatigue.
Other symptoms that might indicate coronary artery disease are dizziness, nausea and an irregular heartbeat. The good news is that this disease can be prevented. Staying physically active, maintaining a healthy weight, reducing stress and eating a low fat and low salt diet can help reduce the risk of CAD.

Coronary Artery Disease (CAD) - What Are The Symptoms?

Many people know that smoking causes several problems including cancer, heart disease, and respiratory disease. However, there are other diseases occur because of smoking and chewing tobacco. Buerger's Disease is one such disease in which the blood vessels in legs and arms get blocked. This blockage will interfere in blood flow and results in forming blood clots. These clots will affect both legs and
hands.
Buerger's Disease is also known as Thromboangitis Obliterans. It is a type of vasculitis which causes inflammation in the blood vessels including thickening, narrowing, weakening, or scarring.
Buerger's Disease cannot be cured easily. However, by quitting the use of tobacco and smoking, one can limit the symptoms from getting worse. If a person is not able to quit smoking, he/she might end up
suffering from severe tissue damage. One can also even lose toes, fingers, or other parts of the limbs. This is why quitting all type of tobacco or smoking is the only way to treat Buerger's Disease.

What Causes Buerger's Disease?
As discussed earlier, smoking cigarettes or cigars and chewing any form of tobacco is one of the main causes of Buerger's Disease. Still, the exact cause of this disease is unknown, but in most cases of Buerger's Disease, the sufferer has consumed tobacco products. It is an assumption that chemicals present in tobacco, cigarettes, and cigars may affect the lining of blood vessels, causing them to swell. According to experts, the genes in the body may also cause this disease. It is suspected that this disease is caused by an autoimmune response in which the immune system of the body attacks healthy tissues mistakenly. According to this theory, some people are prone to this disease.

Symptoms of Buerger's Disease-
Some of the most common symptoms of Buerger's Disease are:
  Pain in the hands and feet while exercising
  Stiffness due to reduced blood flow
  Pain at Rest
  Skin ulcerations
  Gangrene of the fingers and toes in severe cases
  Numbness, coldness, or tingling of the feet and hand
  Pale, reddish, or blue-tinted hands or feet.

Diagnosis of Buerger s Disease-
There is a set of tests that can diagnose Buerger s disease. Doctors first ask a person about his/her lifestyle, use of tobacco, and symptoms. After seeing a few symptoms, doctors may perform a test to check the blood flow. He may also look for other diseases that cause similar symptoms. Some of the common test to diagnose Buerger s Disease are:


  Allen Test: The Allen test is a blood flow test. In this type of test, patients squeeze their hand into a firm fist, which pushes out blood from hand. The doctor presses the arteries to slow down the
blood flow of the hand. At this stage, the normal color of the skin gets pale. After that, patients open his/her hand and doctors release the pressure from both sides of the wrist one by one. If it takes a longer time to go back to the normal skin color, it may be an indication of Buerger s disease

  Angiogram: It is a type of X-ray that will help to check the blockage of the blood vessels in the legs and arms. In this test, doctor place catheter (thin tube) into an artery to pump the dye. After
that, he takes X-ray images. Doctors may also perform tomography (CT) or MRI scan for clear results.

  Blood Tests: The blood tests will help the doctor to check if there is any other disease that causes the same symptoms as most of the vascular diseases mimics the symptoms of Buerger s
Disease. The doctor may also perform tests to check for diseases like lupus, diabetes, and those that cause blood clots.

Treatment of Buerger' Disease-
Quitting smoking and use of tobacco will help a person to lower the symptoms of this disease. Doctors may also prescribe for pain killers or antibiotics to get rid of the pain in affected areas. If a person finds it difficult to quit smoking, doctors help him/her with the right program and rehabilitation techniques.

Take Away-
Buerger's Disease is one of the rare illness caused by intake of tobacco products, this is why quitting smoking is most important to treat this disease. It is also advisable to consult a doctor as soon as a person identify any of the above symptoms.

All You Need To Know About Peripheral Vascular Injuries!

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