The heart muscle is the central pumping machine that ensures that blood flow throughout the body is maintained and all other organs have a regular supply. One of the conditions that can cause this organ to malfunction is cardiomyopathy, wherein the heart is unable to pump the blood to all parts of the body. This condition can even lead to heart failure and is something that needs to be addressed and diagnosed quickly.

Symptoms of Cardiomyopathy
Early stages of cardiomyopathy may be difficult to detect externally, although it may be slowly reducing your heart s capacity. Symptoms that start showing in later stages may include:

Constant fatigue, even without physical activity
Fluid may build up and thus cause bloating within the body
Persistent coughing while lying down
You may have irregular heartbeats that may sometimes be quite rapid
Due to the lack of blood supply, you may feel lightheaded, dizzy and might even cause you to faint
Even the slightest of exertions will cause breathlessness and exhaustion and you may even feel this symptom while at rest
Intermittent chest pain
Causes of Cardiomyopathy
Causes of this condition may vary from patient to patient, although certain common factors include:

Genetic reasons where one or both parents are susceptible to this condition
Metabolic problems such as obesity, diabetes or thyroid problems
Substance abuse such as anabolic steroids, amphetamines cocaine or even the consumption of excessive alcohol
High blood pressure for prolonged periods
Nutritional deficiencies
Side effects of drug treatments such as the use of certain chemicals in chemotherapy
Types of Cardiomyopathy
Cardiomyopathy has multiple types; depending on what causes them and also certain specific symptoms. These are:

Restrictive cardiomyopathy
Dilated cardiomyopathy
Arrhythmogenic right ventricular dysplasia
Hypertrophic cardiomyopathy
Unclassified cardiomyopathies
Treatment for cardiomyopathy
The treatment of these various forms of cardiomyopathy will vary depending on the type and also the stage and condition of the heart. Some of these treatments include:

Medications
Lifestyle changes
Surgeries such as Septal myectomy, Septal ablation and Radiofrequency ablation
Implantable devices such as Implantable cardioverter-defibrillator or ICD
Ventricular assist devices
Heart transplant in the worst case scenarios

Cardiomyopathy -  Decoding the Types + Treatment

How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

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

Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

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