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?

If you are concerned about your heart s health, it is important for you to make some dietary modifications. Simple changes in your everyday diet may offer benefits, which help in preventing future heart problems. If you suffer from high blood pressure or high cholesterol or have atrial fibrillation.

Here are some tips regarding the best diet for protecting your heart:

Believe in the food hype: Having healthy meals is certainly beneficial and makes a big difference to your heart health. Consuming meals which contain vegetables, grains, low fat dairy and lean meat will allow you to live a longer and healthier life.
Avoid crash diets: A crash diet may be effective, if you want to fit in a dress within one month. However, for improving your heart health, undertaking different fad diets is not useful. Meals in which a certain type of nutrients such as carbohydrates or fats are ruled out are not beneficial as well. You should have a sensible approach towards your diet and focus on food products such as vegetables, whole grains and lean meat.
Do not overeat: Overeating will lead to weight gain and commonly, many people get heart attack after taking a big meal.
Eat less salt: You should consume less amount of salt in your diet and do not eat more than one teaspoon of salt a day. Avoid any food item which contains high amounts of sodium. Salt is responsible for increasing blood pressure.
Limit your intake of alcohol and caffeine: In case you suffer from atrial fibrillation, you should avoid caffeine and any other stimulant as they tend to trigger the symptoms. You must drink moderately as consuming more than one drink a day increases your risks of having heart problems.
Choose meat wisely: You should avoid red meat, which contains large amount of saturated fats as these are not good for the heart. You should choose the leanest cuts of meats and trim all fat from it. You should opt for cuts such as flank, rump roast, tenderloin and sirloin. Pork tenderloin, chicken and turkey breast are other alternatives.
Add fish to your diet: Fish is essential for improving your heart health. Try to avoid having deep fried fish and choose grilled fish or roasted fish, which are rich in Omega-3 fatty acids. Consume fishes like tuna, salmon, trout and sardines.
You should also add whole grains to your diet. They are effective in controlling blood sugar and lower the chances of diabetes. Hence, the risks of heart diseases are less if you do not have diabetes. Whole grains also help with weight loss, which is beneficial for the heart.

7 Tips for a Healthy Heart

Over the last few decades, the word cholesterol has assumed a different connotation. It has come to be known as a silent killer that spells doom for health. However, what we need to realize is that a certain amount of cholesterol is essential for the proper functioning of the body. The liver produces about 85% of the cholesterol that is required by the body normally. The ever changing food habits have introduced a lot of processed foods that are loaded with saturated fats. Along with this, reduced physical activity has led to accumulation of cholesterol in the blood.

The types of cholesterol are based on the density and we have 2 types of density that is Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). LDL is more dangerous than HDL, called as bad and good cholesterol respectively. In addition, the triglycerides and lipoprotein are also critical indicators of overall cholesterol levels. Depending on a person's age, height and weight, normal levels are derived for each of these four.

Because of their density of the cholesterol molecules, as they are circulating in the blood stream, they tend to get sluggish and settle down along the walls of the blood vessels, referred to as plaque. This plaque attracts more and more cholesterol from the blood and the layer gets gradually thicker. This reduces the thickness of the blood vessels and in severe cases even completely blocks blood flow to important organs like the brain and heart, leading to severe conditions like stroke and heart attack respectively.

However, it is not always that all cholesterol is bad. It is one of the essential things for the proper body functions with the main functions listed below.

1. Each cell in the body requires it to form the cell membrane, the protective layer around the cells
2. Synthesis of vitamin D is done with the help of cholesterol, which is very essential for skin health
3. It also helps in hormone formation. In addition to steroids, other hormones like testosterone, estrogen, cortisol require cholesterol as a main ingredient
4. Formation of neurotransmitters and overall nerve function requires cholesterol. This ensures optimal neurological functioning.

So, as noted above, there are, both good and bad aspects to cholesterol. It is not all that dangerous a thing that it is made out to be. The trick is to maintain a good level of cholesterol so that the body's requirements are met, and at the same time, the harmful effects are kept at bay. Some important parameters to manage, include the percentage of bad cholesterol in the blood and the ratio of triglycerides to HDL in the blood. These are considered fair indicators of heart health and if need be, lifestyle changes and/or medications can be undertaken to manage overall health and reduce risk of heart disease and stroke.

Cholesterol: Good and Bad of 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

Postural Tachycardia Syndrome or POTS, what this condition entails is a sudden and abnormal increase in the heart beat of an individual, causing them difficulty in breathing, dizziness, and even blackouts.
There are some factors that can trigger the situation and stem the sudden rise in the heart beat. Meeting with a medical expert may help bring the situation under control.

What is Postural Tachycardia Syndrome?
Postural Tachycardia Syndrome or POTS is a cardiovascular condition that is caused due to the sudden shift from an upright position to a supine position or vice versa. It is this sudden increase in heartbeat of an individual that is referred to as Tachycardia.

The longer you overlook this condition, the bigger is the trouble you are putting your health in. This is when it becomes extremely important for you to get in touch with a medical expert, who can offer you perfect consultancy, diagnose the causes and also find a result for the same.

What Causes POTS?
According to medical specialists, there are some factors that this condition stems from and it all differs from one person to the other. Some of the most common causes of the condition are-

Joint Hypermobility Syndrome
Faulty Gene
Poisoning
Amyloidosis
Lupus
Diabetes
Sarcoidosis
Siogren s Syndrome
Cancer
Signs of Postural Tachycardia Syndrome:
There are multiple signs that indicate that an individual is stricken by Postural Tachycardia Syndrome. Some of the more common signs and symptoms include:

Orthostatic Hypotension: Orthostatic Hypotension refers to the sudden increase in the heart beat by at least 30 beats per minute, within or after 10 minutes of rising up from a sitting or lying down position. Though the condition increases the heart rate, it does not trigger any drop or rise in blood pressure. Certain medications used to diminish this effect often extend some side effects, such as lightheadedness, palpitation, difficulty to breath, discomfort in the chest, weakness, heaviness in the chest area, nausea, cognitive difficulties and also stain on the vision.
Effects in Response to Postural Change: Almost one-third of the people with Postural Tachycardia Syndrome are noticed to faint as a result of the increased heartbeat, almost 40 beats minutes, instead of the chance in postural position. Other symptoms under this head include a headache, migraine, disturbance in sleep, fatigue, acrocyanosis or blood pooling in feet, etc.
Ehlers- Danlos Syndrome (EDS): Sometimes POTS is found to coexist in an individual with other conditions, such as EDS. This condition makes an individual prone to dislocation of bones, greater laxity in skin, loose- clicking joints, chronic fatigue, reduced level of tolerance towards any exercise, etc. According to medical specialists, though these are common symptoms of POTS, there might also be other signs. These signs and symptoms differ from one person to the other.
When Should You Consult a Doctor?
The moment you experience a POTS attack or for that matter notice some of the symptoms of the condition, it is time for you to consult a medical expert. The doctor will give you valued consultation, as well as diagnose the condition properly, thus finding the best treatment and suitable medication for you.

Postural Tachycardia Syndrome - All You Need To Know About It?

The heart may sometimes face excessive fluttering or a throbbing sensation, which may make you feel uncomfortable. Such sudden throbbing sensations resulting in discomfort are called 'palpitations'. Homeopathy has some great remedies depending on the cause of these problems.

Let s have a look at these:

Palpitations caused by anxiety: This is one of the top causes for palpitations which occur before sitting for an exam, interview or before important events of your life. However, they may tend to stay longer and it is advisable that you control them with the use of Aconite or Arsenic Album.
Palpitations caused by Physical exertion: If you have a weakened heart or if you smoke and thus tend to feel a lot of exertion even with the slightest of physical efforts, then Spigelia, Iberis and Digitalis are good medications. Digitalis is especially good for palpitations caused by the slightest of movements, while spigelia is very good with palpitations that cause arm pain as well.
Anemia: Anemia or the lack of red blood cells can be very dangerous for your health as it can damage your vital organs. It can also cause palpitations along with other symptoms such as paleness, lack of strength and drowsiness. Natrum Mur and Ferrum Met are two of the most effective remedies in such cases.
Use of tobacco products: Another reason for palpitations developing is the use of tobacco products, such as cigarettes or chewing tobacco. In such cases, palpitations may occur even with the slightest of exertions or at rest. Medications effective in such situations are Kalmia, Tabacum and Convallaria. These variations may be required depending on the types of symptoms you may show such as a quick heart rate or a slow heart rate.
A palpitation caused by hyperthyroidism: Excessive secretion of thyroid is called hyperthyroidism and can cause a host of problems within the body including palpitation. Iodum and Spongia are two excellent medications in treating variations of palpitations caused by an over active thyroid gland.
Palpitations caused by acidity or gastric problems: This is possibly the most common cause for palpitations and Lycopodium as well as Abies Can are two very effective homeopathic medications, which can easily remedy the situation, depending on the type of problems you are having.

Palpitations - How Homeopathic Remedies Can Help You Manage Them?

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