Bradycardia is a condition which in basic terms means slow beating of the heart. In most cases, the typical rate is 60 to 100 beats in a minute when the person is at rest. In case your heart beats less than 60 times in a minute, then it is slower than normal. But a slow heart rate is not always a health concern even though sometimes it could indicate issues with of the heart.

What could bradycardia mean?
Some people with slow heart rate or bradycardia tend to be very fit, and they have no underlying health issues. Athletes and healthy young adults often have a heart rate lower than 60. But in others, bradycardia indicates that the natural pacemaker of the heart is not working well, or the electrical pathways have been disrupted. In severe forms of the problem, the heart may beat so slowly that it fails to pump adequate blood for meeting the needs of the body. This may show some symptoms and could be fatally dangerous.

What are the causes of bradycardia?
There are various causes of bradycardia, and some of them include:

Alterations in the heart which results from aging
Health conditions that slow down the electrical impulse through the heart. This may include electrolyte imbalance, low thyroid levels, and others.
Diseases which may disrupt the electrical system of the heart including heart attack, coronary artery disease, and myocarditis.
Certain medications that are used for treating heart problems like high blood pressure or hypertension, arrhythmia, and beta-blockers, and digoxin.
What are the symptoms of bradycardia?
When a person has very slow heart rate, he or she may experience lightheadedness or dizziness, feeling short of breath, having difficulties in doing normal activities or exercising, having chest pain, feeling tired and fatigued. In some cases, it is seen that the person may have palpitations, feeling confused, trouble in concentrating and fainting.

What s worse, some people don t have any symptoms at all, or their symptoms are so negligible that they think they are caused just because of aging. The best way to understand whether you have this problem is to take the pulse, and in case, it is slow or uneven, you must talk to a doctor.

How is bradycardia diagnosed and treated?
Bradycardia tends to come and go from time to time, and therefore, a standard EKG is not always able to detect it. A standard ambulatory electrocardiogram is used for detecting the condition, and sometimes, blood tests are also necessary.

The treatment of bradycardia is entirely dependent on the cause of the problem and its symptoms. It is worthy of mention here that in case the problem is not causing any symptoms, then they would not be treated under usual circumstances.

An Effective Guide To Bradycardia!

Carotid artery disease occurs when an oily, waxy substance called plaque builds up inside the carotid arteries. These are arteries that supply oxygenated blood to your brain, face, scalp, and neck.
Carotid artery disease is very serious as it can cause a brain stroke. It, in fact, starts with damage to the inner layer of the carotid artery. To stem this damage your body starts a healing process and this leads to a build up of plaque at the point where the artery is damaged.

When this plaque ruptures, platelets are rushed in and these create an obstruction to the flow of blood to the brain. When the blood supply to the brain is cut off, which happens in carotid disease, the brain cells begin to die causing a stroke. This neural death impairs the parts of the body that these brain cells control. So, you can get paralyzed, become speech or vision impaired, have long  term effects like paralysis or even die due to a stroke.

Causes of carotid disease

Smoking
High cholesterol levels
High blood pressure
High levels of sugar in the blood due to diabetes
What s even more worrisome is that carotid artery disease may not cause any signs or symptoms until the carotid arteries are severely narrowed or blocked. And what usually happens is that a stroke becomes the first sign of the disease.

How scary is that?
So, the next question that comes to the mind is - Can this condition be cured? Let s learn more about management and prevention of the same-

Prevention
Lifestyle changes are key. Since hypertension, uncontrolled diabetes, sedentary lifestyles and imbibing too much fat are all risk factors, taking care of them minimizes the risk of carotid disease and strokes. Heart healthy lifestyle changes that include moderate exercise are a great way to prevent carotid disease.

Treatments
Treatments for carotid artery disease include:

Medicines: Sometimes lifestyle changes do not stem the rot. You need medicinal help. Doctors usually prescribe statin medications to control your cholesterol levels. These lower the bad cholesterol that can narrow your carotid arteries and cause brain strokes and damage. Statins are usually prescribed for people who have:

Heart disease
Those who ve had a stroke
Diabetes
High LDL or bad cholesterol levels
Medicines like Aspirin and Clopidogrel to prevent blood clots are the mainstay treatment if you suffer from carotid disease. They prevent platelets from clumping together inside your carotid arteries and forming blood clots. Apart from these, your doctor may also medicate you for conditions that can damage your carotid arteries and cause strokes. These medicines are for lowering your BP, blood sugar levels, preventing the formation of blood clots anywhere in your body including inside your heart, and preventing and reducing inflammation.

Medical Procedures
These are used to open narrowed or blocked carotid arteries.
The two common procedures are:
Carotid endarterectomy: It s mainly for people whose carotid arteries are blocked 50 percent or more. In this, the inner lining of the carotid artery that is blocking blood flow is removed.
Carotid artery angioplasty and stenting: Here, doctors use a procedure called angioplasty to widen the blocked carotid arteries and restore blood flow to the brain. A stent is inserted into your carotid artery to broaden the lumen. 

High Cholesterol Level - Can It Cause Carotid Disease?

Commonly people believe that you can understand your blood pressure is high if you are feeling dizzy suddenly or you are not able to sleep at night. Also sweating profusely is often related to having hypertension. But, to be honest, hypertension usually does not have any symptoms, which might help you get alert and take action to control it. This actually imposes a great threat to your well-being as you do not understand if you have hypertension. It is extremely important for you to keep checking your blood pressure level in order to avoid developing hypertension and hence developing a risk to your heart.

Although there aren't any major or very noticeable symptoms, here is a list of some rare symptoms which you can follow:

1. Headaches: If you are suffering from dull headaches almost regularly, it might be because you blood pressure has increased. The headaches can be a dull buzz or a severe migraine like ache. Keep monitoring your headaches and consult your doctor as soon as possible.

2. Dizziness: You might suddenly feel dizzy or you might feel you are about to pass out if your blood pressure increases. Make sure you refer to a doctor as soon as something like this happens.

3. Nosebleeds: A sudden occurrence of nosebleed might also be a symptom of a sudden increase in your blood pressure.

4. Severe anxiety: Severe anxiety or a panic attack is often referred to as a symptom of hypertension. If you have a sudden panic attack with no apparent reason, it may be because your blood pressure has suddenly risen.

5. Shortness of breath: High blood pressure may often cause a shortness of breath. You might experience it during various every day activity like walking, climbing stairs, etc.

6. Nausea: A sudden increase in blood pressure might make you feel nauseous. You might even vomit when this happens. Make sure you consult your doctor if this happens.

Hypertension: Symptoms that Can Control it on Time

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

Apart from its use in many Indian homes for traditional reasons, coconut has several health benefits to offer -

1) Helps diabetics by slowing sugar release into the bloodstream.
2) Boosts metabolism and increases energy because it is more likely to be burned as fuel than stored as body fat.
3) Helps treat malnutrition because it is easy to digest and absorb.
4) Kills disease-causing bacteria, fungi, yeasts and viruses because of the antimicrobial effects of its fatty acids.
5) Prevents strokes and brain disorders such as Alzheimer's and Parkinson's.
6) Prevent tooth decay - coconut oil fights bacteria responsible for tooth decay and could be a healthy, non-chemical additive in toothpaste and mouthwash.

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Why is Coconut SO good for you?

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?

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