Coronary Artery Disease - Symptoms and Causes

Coronary artery disease is the disease in which the major blood vessels (coronary arteries) that supply blood, nutrients and oxygen to your heart get damaged or disease stricken. It is mostly caused due to the coronary artery getting plagued or inflamed. The consequent reduction in blood flow to the heart causes the various symptoms of coronary artery disease like angina (chest pain), short breath etc.

Symptoms:

Here is a list of a few symptoms that help in identification of the coronary artery disease.

1. Angina

Pressure or tightness may be felt in or near the area of the chest that results in pain. It is mostly felt in the middle or left side of the chest.

2. Shortness of breath

Another symptom of coronary artery disease is short breath, fatigue and a feeling of exertion.

3. Heart attack

Complete blockage of the coronary artery results in a heart attack that is a prominent symptom of coronary artery disease. A person may feel heavy pressure in the chest, pain in the shoulder or arm, sweating etc. prior to getting a heart attack.

Causes:

Coronary artery disease occurs when damage or injury is done to the inner layer of the coronary artery. This damage causes plaque, which are deposits made of fat, cholesterol and other cellular waste materials to accumulate near the damaged area of the artery. This process is known as atherosclerosis.

The various causes that result in coronary artery damage are listed below.

- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- High stress
- Physical inactivity

Knowing Coronary Artery Disease - Symptoms and Causes

Blood flows through the tubes called as blood vessels. There are two networks of blood vessels   the arteries and the veins. The arteries carry pure or oxygenated blood from the heart to the various parts of the body. The veins, on the other hand, collect impure blood from all over the body and reach it to the heart. Blood flow in the veins is controlled via valves, which ensure blood does not flow in the reverse direction (against its desired direction of flow). The veins in the legs, which are farther from the heart, are quite thick and exert extra pressure to pump blood into the heart. They need to transport blood against gravity and so in people who are prone to stand for long hours, they can become thicker, swollen, twisted, and engorged. In severe cases, there could even lead to bleeding.

Some common causes for varicose veins are:

Damaged valves which are not able to control the flow of blood in the required direction.
Veins with a thin wall that are unable to control blood flow.
Risk factors: Though these are the suspected causes, there are specific risk factors which aggravate the condition of varicose veins.

Family history
Smoking
Occupations which require prolonged standing (construction jobs, painters, etc.)
Pregnancy
Obesity
Age, which reduces the elasticity of the veins
Surgery in the leg, which could have hampered the values or veins
There are quite a few symptoms of varicose veins. These are quite distinct and present as:

Swollen, ropy leg veins which can be blue
Pain, especially with prolonged standing
Tenderness on touching the veins
Itching and heaviness along the veins
Skin changes like scaling and dryness
Night cramps around the area
Susceptibility to bleed from these veins
While varicose veins are easy to diagnose given their distinct clinical presentation, some additional testing can involve the following:

Doppler ultrasound
Scanning
MRI
As said, prevention is better than cure; here are some preventive measures that can be really helpful:

Elevate legs as much as possible. When working, take short breaks to reduce stagnation and promote blood circulation
Quit smoking
Avoiding alcohol, as it causes venous dilation
Weight management
Avoid tight clothing and sitting with cross-legs for prolonged periods as they put a lot of pressure on the veins and valves
Follow a regular exercise regimen to improve blood flow in the legs, like walking or running
Starting from the least invasive to the most, this condition can be treated by:

Compression stocking (Ted hose or Jobst stocking) which improves circulation and reducing pain
Surgical options include sclerotherapy, laser treatment, and stripping off the vein. These are done in very severe cases, but quite rare.

Varicose Veins - How Best It Can Diagnosed?

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

It is said that if all the veins of the human body were laid out in a single line, it would stretch over 60000 miles. We don t usually think of our veins or notice them unless an intravenous injection is to be administered or the person suffers from varicose veins. These veins are usually benign and can be described as enlarged veins that rise to the surface, and become prominently visible. The varicose veins can usually be seen on the feet and calves. For most people, it is simply a cosmetic problem but for others it can be the cause of pain and discomfort. The good news is that in either case, varicose veins can be treated.

EVLT refers to Endovenous Laser Therapy, which is also known as EVLA or Endovenous Laser Ablation. This is a type of laser therapy that can be used to destroy veins from within. The procedure is performed while the patient is under local anesthesia and hospitalization is not required. Know the steps in which it is carried out:

The first stage involves mapping the veins and identifying the problem veins. A Duplex Ultrasound is usually used to create this map. It is important to note that this procedure cannot treat bulging veins on the surface of the skin. The veins that can be treated include the Great Saphenous Vein (GSV), Small Saphenous Vein (SSV) and their major tributaries.
Once the veins have been identified a needle is inserted into the vein near the ankle or knee with the help of ultrasound controls. A wire is then passed into the vein and a long sheath is then passed to the top, and positioned with the help of the ultrasound.
Ultrasound is again used to then inject local anesthetic into the area around the vein. This numbs the vein and surrounding tissue. The adrenaline in it also makes the vein contract, so as to fit the sheath perfectly. This technique is called  Tumescent anesthesia .
This is followed by passing a laser fiber inside the sheath and switching the laser on. The laser and sheath are then pulled back simultaneously so as to destroy the vein without damaging any of the surrounding tissues.
Once done, you should be able to get back to work and your normal lifestyle, the day after the surgery. But it is advisable to take good rest for few days, before you get back to your regular routine. Your doctor may advise you to wear compression stockings for up to 2 weeks. You should also avoid letting your legs come in contact with water. To avoid getting varicose veins in future, exercise regularly and have a balanced diet to control your weight.

EVLT Endovenous Laser Treatment For Varicose Veins!

Hypertension is a condition where the blood has to exert extra pressure to flow through the blood vessels. While there is a genetic component to it, the more strong contributing factors are modified lifestyle and dietary changes. There are also a lot of environmental changes that have contributed to this new epidemic. While earlier people in their 50s and 60s would be diagnosed with hypertension, now there are people in 30s and 40s taking hypertension pills. Excess fat accumulation is the major cause of hypertension in younger patients.

There begins the complexity of the issue. Hypertension which requires medications to control it, they lead to side effects and bring in a host of other diseases like diabetes, and obesity which in turn bring in a whole lot of complications. A more easy way to manage would be to prevent and of course, after onset, look at how naturally it can be managed.

Ayurveda has numerous substances that have been proven to have beneficial effects in controlling blood pressure over the past 1000s of years.

1. Celery or ajwain helps blood vessels to dilate and reduces concentration of stress hormones in the blood.

2. Ashwagandha has a wide range of actions and improves the body's ability to handle physical and mental stress. This in turn improves blood pressure, obesity, and depression.

3. Citrus fruits contain vitamin c which prevents fragility of the capillaries (thinner blood vessels).

4. Cow's urine prevents hardening of blood vessels and is of curative value in those who have blood pressure due to hardening of blood vessels. 

5. Triphala which is a combination of amla, haritaki, and bibhitaki helps reduce inflammation that leads to blood pressure, thereby helping to control it.

6. Jatamansi - by helping the free radical damage on the arteries, it protects the arteries and prevents cholesterol accumulation. It also is a very well-proven stress reliever and has additional benefits on hypertension.

7. Arjuna - by helping the metabolism of the bad cholesterol in the liver, this protects the inner lining of the heart and thereby helps control hypertension.

8. Calcium and potassium containing substances help remove sodium and thereby improve blood pressure.

9. Natural herbs like brahmi, sarpagandha, shankhpushpi, and chandana are effective ayurvedic cure and treatment for hypertension.

10. Rasayana treatment from ayurveda is having excellent results, however everyone requires unique rasayan as per their body types.

11. Watermelon helps in dilation of the blood vessels.

12. Aloe gel, barberry, calamus, valerian, skullcap, gotu kola cayenne, myrrh, motherwort, hawthorn and jatamansi have all been shown to help manage hypertension over thousands of years.

13. A glass of warm milk mixed with saraswat powder is also helpful for patients with high blood pressure.

These are natural remedies which were a part of diet since times immemorial. Including them in the diet, reducing processed foods, regular exercise, avoiding alcohol and smoking can be some natural ways to prevent and if required control hypertension. Stress is here to stay, but can definitely be managed with a little conscious effort.

Control Blood Pressure With Ayurveda

Ways to identify and treat Angina pain

Angina or angina pectoris is the pain, discomfort or tightness in the chest that occurs when the blood flow to the heart muscle cells is not enough to meet its energy needs. It is not a disease itself but rather a symptom of the coronary heart disease.

What are the different types of angina?

1. Stable angina: It is the commonest form of angina. It can be triggered by stress or physical activity and usually only lasts a few minutes.

2. Unstable angina: It happens when you're resting or aren't very active. The pain is strong and long lasting, and may keep recurring. It may be a signal of an impending heart attack.

3. Variant angina: This might take place when you're asleep or at rest. This sudden tightening or narrowing of the heart's arteries causes a lot of pain.

How u know what your are experiencing is an angina pain?

You might be having angina pain if you suffer from one or more of these symptoms:

- Chest pain
- Heartburn
- Breathlessness
- Nausea
- Dizziness
- Restlessness
- Fatigue
- Pain in your arm, neck, jaw and back
- Numbness or loss of feeling in your arms, shoulders or wrists

Immediate Relief from Angina

If previously advised by a certified doctor, patients can take antiplatelet medicines which are blood thinners and prevent unstable angina. Final treatments include angioplasty (repair of a blocked blood vessel through surgery), insertion of a coronary artery stent (a tube that is used to treat weakened arteries) or a heart bypass surgery for serious complications.



Ways to Identify and Treat ANGINA PAIN?

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