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!

Varicose veins are large veins that appear on the legs of some patients. Usually, blood travels to the legs from the heart through the arteries, and the veins take it back to the heart. The valves in the veins allow the blood to travel from the legs to the heart against gravity. During this process, the valves may leak and blood may collect in the veins, making them appear enlarged.
EVLT (Endovenous laser therapy) is the latest method for curing varicose veins without surgery. It heats the affected veins them through a laser instead of removing them.
Process
In this process, at first, an ultrasound scan is carried out to locate the veins that have to be treated. After marking them, the doctor applies local anaesthetic on the skin and a needle is inserted into it. A wire is then passed through the needle up to the target vein. Over this wire, a catheter is passed after removing the needle. After that, the wire is removed.
Through the catheter, a laser fibre is placed whose tip usually reaches up to the groin crease. Using tiny needles, a large amount of local anaesthetic solution is applied in the region surrounding the vein. The laser is then applied for 5 minutes on the veins. You might hear a buzz or feel a burning sensation but won t feel any pain. The catheter and the laser are then removed and the incision is covered.
The process takes about 30 minutes to complete. After the treatment, you will be advised to wear compressions stockings and can go back to your normal routine immediately.
Benefits
The different benefits of the surgery are:
The skin does not have to be stitched 
There is no pain in the process and patients can go back to work right after the treatment
The process is free from complications 
No scars are left after the treatment

Common uses of the process
EVLT is also used for treating the following:
Swelling of the veins 
Discolouration of the skin
The heaviness of the leg
Skin ulcers and irritation
Precautions
These are the precautions that you must take:
A week before the process, avoid taking arthritis medications, aspirin, and Ibuprofen as they can increase the chances of bruising 
Avoid alcohol and tobacco 2 days before the procedure
After the treatment, ask someone to drive you back home and do not use public transport
Avoid activities like swimming, running, jogging and weightlifting for at least 2 weeks after the procedure

The varicosities fade away after the process but rarely disappear completely. You might require further treatment for improving the appearance of the veins. 


EVLT Varicose Veins Treatment!

Varicose veins is a medical condition where the veins become large and swollen and begin to appear so especially on the legs and feet though any vein can become varicose. This happens when the valves do not function properly and allow the blood to flow in the opposite direction or to pool. Due to this, the veins enlarge, and they begin to appear blue or dark purple on the skin. Legs and feet are the most commonly affected areas because standing or walking increases the pressure on the veins in the lower part of the body.

Symptoms of Varicose Veins
Apart from the twisted and bulging appearance like cords in blue and dark purple, varicose veins may include other painful symptoms as well such as-

Throbbing feeling and aching, heavy feeling in the legs.
Muscle cramping and swelling in the legs.
Severe pain after sitting or standing for a long period of time.
Bleeding varicose pains.
Treatment for Varicose Veins
In severe cases, varicose veins may rupture and form varicose ulcers on the skin. To avoid complications, it is best to get varicose veins treated before it worsens. Varicose veins can be treated in two ways- either by surgeries or by non-surgical methods, that is, by home remedies, medicines or non-invasive methods.

Surgical methods to treat Varicose Veins
Vein Stripping - Under general anesthesia, two cuts are made one below the groin and one behind the knee joint. The affected vein is then tied or clamped off at the top incision using a technique called vein ligation
Phlebotomy is another method where smaller incisions are made along the vein and using surgical instruments, the vein is pulled out.
Though treating varicose veins by surgeries is the most effective method, it involves several risks. Patients take a longer time to recover from surgeries than non-surgical methods. The sedation may cause complications. Chances of nerve injuries cannot be negated which may lead to fatal conditions such as deep vein thrombosis.

Non-surgical methods to treat Varicose Veins

Radiofrequency ablation is a method in which heat generated electromagnetic waves are used to close off the veins.
Endogenous laser ablation- in this case, lasers are used to close off veins.
Sclerotherapy is another method where a liquid or foam is injected into the affected vein to close it off.
Although big veins cannot be treated by these methods or additional treatments may be required, these methods are not only effective but also free from cuts and stitches or anesthesia. Performance of these treatments need not always take place in hospitals, special clinics can cure varicose veins using these methods. It is always advisable to consult doctors for treating varicose veins who can suggest the best treatment needed to cure varicose veins.


Surgical & Non-Surgical Treatment Options For Varicose Veins - Which Is Better?

Varicose veins are superficial, swollen, enlarged and twisting veins, often appearing dark purple or blue on the feet and legs. The condition occurs when blood through the veins flow in the wrong direction and starts accumulating.

Although varicose veins is not a serious condition, you should seek treatment if it causes symptoms like swelling and pain in the extremities. In severe cases, where a varicose vein ruptures or develops to form skin ulcers, your doctor may recommend laser treatment.

Can laser treatment cure varicose veins?

Laser surgery can effectively treat varicose veins. The procedure involves using a high-intensity beam of light to reduce enlarged, bulging veins that are observed usually on the calves or thighs.

How does the procedure work?

The heat emitted from the laser damages a vein, which causes scar tissues to form. This scar tissue shrinks and closes the vein. A closed vein gradually loses its source of blood and dies. After some time, usually in a year or two, the vein disappears on its own.

Two types of laser surgery are performed, namely  

  Simple Laser Treatment   This is done on the outer layers of your skin. It can cure small varicose veins and spider veins under the skin surface. Normally, more than one session, scheduled every 6-12 weeks is needed.
  Endovenous Laser Treatment   This particular procedure is used to cure large varicose veins that appear on the legs.
The steps of the procedure are as follows  
  Your healthcare provider will administer local anaesthesia to numb the area. You may be provided with an eyeglass to protect your eyes
  The surgeon will make a small incision on the skin and pass a laser fibre through a catheter into the veins while closely monitoring the vein on a screen
  As he/she pulls out the catheter, the length of the vein will heat up and shrink, and eventually close

This outpatient procedure is less painful than stripping and litigation. It has a shorter recovery period and can be performed under local anaesthesia or mild sedatives.

What to Expect

After the laser treatment, you can walk around without much complication. The recovery period is typically brief. You can expect to return to your daily activities following simple laser surgery. However, you might need to wear a compression stocking for a week or so after the endovenous laser procedure.
You may notice redness, bruising or burns on the skin after the treatment. That is only normal, so you need not worry. Do follow up with your doctor to see if the vein has closed.


Laser Treatment For Varicose Veins!

Varicose veins are known to be a very common problem, which result in the inflammation of veins in the body. Veins are the blood vessels, which are responsible for the transfer of deoxygenated blood from the different parts of the body to the heart. Because the blood does not contain oxygen, it has a bluish tinge. As a result varicose veins are most likely to appear bluish when swollen. 
This condition is quite common in old people and some are even likely to develop slight ulcers in the vein. 
Homeopathic treatment for varicose veins
Certain homeopathic drugs are said to work wonders for this condition, as they not only offer pain relief, but also make the veins more elastic. This helps with effective circulation and thus, the swelling reduces. The following is a list of some homeopathic medicines that work best to cure varicose veins.
1. Hamamelis
It is known to be the best cure for varicose veins. It effectively stops any sort of bleeding from the veins. It also offers relief from pain and from a sensation of heaviness of the legs. 

2. Pulsatilla
This medicine is greatly recommended for women who develop varicose veins during the course of their pregnancy. It immediately does away with the pain. The medicine especially works well for swollen veins of the legs and the hands. Application of a cold pack also helps relieve the pain and reduce swelling. 

3. Calcarea
It is generally recommended to patients who have varicose veins, but do not suffer from any pain. In case the patient feels chilly and suffers from various other symptoms like some sort of burning sensation in the veins or cold hand and feet, calcarea is a good cure. 

4. Graphites
It is known to be a great cure for varicose veins that is accompanied with some amount of itching and cramping. 

5. Arnica
This homeopathic medicine effectively deals with varicose veins accompanied with symptoms like soreness and bruising.

5 Best Homeopathic Remedies for Varicose Veins Ulcers

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

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