Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.

What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.

Symptoms
Primary symptoms may include

Shortness of breath: This may occur while you are exercising or performing activities which are mildly exerting.
Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
Angina or chest pain: You may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
Heart attack: Heart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.
Treatment
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:

Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery.

Coronary Artery Disease -  Know the Primary Signs!

What are varicose veins? 
Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year. The raised veins just under the top layer of the skin appear to be purplish-blue.

Varicose veins are common in people who are -
  Above 50 years of age
  Long stretch sitting
  Pregnant
  Menopausal
  Obese
If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?
Varicose veins are characterized by the following symptoms -
  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discoloration of the skin of the legs and feet

Diagnosis of varicose veins -
The doctor usually diagnoses varicose veins by a physical examination. An ultrasound may determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.
You may even have to undergo a venogram. The doctor injects a colored dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins -
There are several treatment options for varicose veins-

Vascular surgery - When the other methods do not work, doctors prescribe vascular surgery.
Ligation and stripping - through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
Sclerotherapy - the doctor injects a chemical right into the varicose vein which closes it.
Radiofrequency ablation - the doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse
Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

In Detail About Varicose Vein & Its Treatment!

Peripheral vascular disease (PVD) is a circulation issue that affects the veins and blood vessels outside of the brain and heart. PVD commonly strikes the veins that supply blood to the arms, legs, and organs situated beneath the stomach. These are the veins that are located away from the heart. They are known as peripheral vessels.

In PVD, the width of the veins get limited. Narrowing is normally created by arteriosclerosis. Arteriosclerosis is a condition where plaque develops inside a vessel. It is additionally called 'solidifying of the arteries'. Plaque acts towards reducing the amount of blood and oxygen that is supplied to the arms and legs. As the plaque development advances, clumps may develop, which may further affect the vessel.

There are two main types of PVDs:

    Functional PVD: This doesn't include physical issues in the veins. It causes accidental side effects. Typically,these fits happen suddenly.
    Organic PVD: This includes changes in the vein structure. This sort of PVD causes irritation, tissue harm, and blockages.

The most well-known reasons for functional PVDs are as follows:

    Emotional stress
    Smoking
    Cold temperatures
    Operating Vibrating machinery

The common causes of such natural PVDs are given below:

    Smoking
    High circulatory strain
    Diabetes
    High cholesterol

The symptoms include the following:

    Cramps
    Achiness
    Fatigue
    Burning

Diagnosis:

PVD can be diagnosed using interventional radiology (IR).

IRis a sub-claim of radiology that gives an image-guided diagnosis, and if required, includes treatment of the organs as well.It has developed as a first-line treatment in the administration of PVD.

Advantages:

IR medications are for the most part less demanding for patients than surgery, since they include no surgical cut.They are less painful and have shorter stays at the hospital. By and large, the patients are discharged on the same day the procedure is done. This mainly includes angioplasty and stenting. The procedure is as follows:

    Utilising imaging for direction, the interventional radiologist puts a catheter through the femoral artery in the crotch to the blocked vein in the legs.
    At that point, the interventional radiologist expands a balloon to open the vein that is blocked.
    Sometimes it is opened with a tiny metallic cylinder called astent.
    This is a treatment that does not require surgery; only a scratch in the skin the extent of a pencil tip.

Alternative measure:

Angioplasty and stenting have totally replaced invasive surgical methods. Early trials have proven IR to be as successful as surgery for some blood vessel and artery impairments. Earlier, extensive clinical experience demonstrated that stenting and angioplasty are favoured as first-line treatments for more procedures all through the body .

Doctors as well as patients who have been through the same, believe that IR is much better for PVD than invasive surgery, since it reduces the risk of infection.

Diagnosing Peripheral Vascular Diseases With Interventional Radiology

What is Deep Vein Thrombosis?

Blood clots can arise anywhere in your body. They develop when blood thickens and clumps together. When a clot forms in a vein deep in the body, it's called Deep Vein Thrombosis (DVT). Deep vein blood clots typically occur in the lower leg or thigh. But if your symptoms stem from a blood clot deep in your leg, it can be dangerous. Blood clots can happen to anyone, anytime. But some people are at increased risk. Therefore, they should immediately consult with vein specialist to avoid blood clot forming in the veins which can help avoid potentially serious problems.

DVT Symptoms:

"Deep vein thrombosis has classic symptoms - for example, swelling, pain, warmth, and redness on the leg," says Dr. Rajendra Bansal, a DVT treatment expert in Jaipur.  But about 30 40% of cases go unnoticed since they don't have typical symptoms.  In fact, some people don't realize they have a deep vein clot until it causes a more serious condition.

Deep Vein Clots:

DVT symptoms include deep vein clots - especially those in the thigh - can break off and travel through the bloodstream. If a clot lodges in an artery in the lungs, it can block blood flow and lead to a sometimes-deadly condition called pulmonary embolism. This disorder can damage the lungs and reduce blood oxygen levels, which can harm other organs as well.

Some people are more at risk for deep vein thrombosis than others. "Usually people who develop deep vein thrombosis have some level of thrombophilia, which means their blood clots more rapidly or easily," Dr. Bansal says, a DVT specialist in Jaipur. Getting a blood clot is usually the first sign of this condition because it s hard to notice otherwise. In these cases, lifestyle can contribute to a blood clot forming if you don t move enough, for example. Your risk is higher if you ve recently had surgery or broken a bone if you re ill and in bed for a long time, or if you're traveling for a long time (such as during long car or airplane rides).

Other Symptoms:

Having other diseases or conditions can also raise your chances of a blood clot. These include a stroke, paralysis (an inability to move), chronic heart disease, high blood pressure, surgical procedure, or having been recently treated for cancer. Women who take hormone therapy pills or birth control pills are pregnant, or within the first 6 weeks after giving birth are also at higher risk. So are those who smoke or who are older than 60. But deep vein thrombosis can happen at any age.

Chronic vs Acute DVT:

Chronic DVT refers to long-standing venous thrombosis present for more than 28 days.  It can either permanently block the vein or it can adhere to the wall of the vein.  Chronic DVT that doesn t block the vein can still cause long-term problems known as Post Thrombotic syndrome which occurs due to pooling of blood in legs by gravity as the protective valves are damaged or destroyed. Patient symptoms are:

Leg swelling after standing for long periods
Aching pain
Varicose veins
Skin ulcers in severe cases.
Acute DVT refers to venous thrombosis for which symptoms have been present for 14 days or less. The symptoms of acute DVT are sudden limb swelling and pain. During this period the clot is soft and easily treated with clot-dissolving drugs. The period between 14-28 days is called Sub-acute DVT.

Clues of a Clot:

Seek DVT treatment if you have these symptoms. They may signal a deep vein clot or pulmonary embolism:

Swelling of the leg or along a vein in the leg
Pain or tenderness in the leg, which you may feel only when standing or walking
Increase in warmth in the area of the leg that s swollen or painful
Red or discolored skin on the leg
Unexplained shortness of breath
Pain with deep breathing
Coughing up blood
A prompt diagnosis and a proper DVT treatment can help prevent the complications of blood clots. See your doctor immediately if you have any signs or symptoms of deep vein thrombosis or pulmonary embolism. A physical exam and other tests can help doctors determine whether you ve got a blood clot.

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and the color Doppler ultrasound or sometime may require CT or MRI. He or she will identify your risk factors and rule out other causes of your symptoms. After analyzing the risk factors, the doctor will tell you whether you need an immediate DVT treatment or not.

DVT Treatment

There are many ways in Deep Vein Thrombosis treatment. DVT treatment process includes medicines, certain devices, and therapies. The main goals of DVT treatment include:

Stopping the blood clot from getting bigger
To dissolve the already formed clot
Preventing the blood clot from breaking off and moving to your lungs
Reducing your chance of having another blood clot
To prevent long-term complication known as Post Thrombotic Syndrome.
Anticoagulants (Blood Thinners):

These are the most common medicines in DVT treatment. These medicines decrease your blood s ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can t break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners are taken either as a pill, an injection under the skin, or through a needle or tube inserts into a vein (called intravenous or IV injection). There are different types of  Blood thinner. The choice of anticoagulant depends upon multiple factors, including the preference of the patient and the healthcare provider, the patient s medical history and other conditions, and cost considerations.

Initial anticoagulation is continued for 5 to 10 days. After that, long-term anticoagulation is continued for 3 to 12 months depending upon the patient profile, length of vessel involvement and risk of recurrence. In some patient where permanent risk factor like a congenital cause or cancer lifelong anticoagulation may require.

Other available treatments, which are for specific situations, include thrombolytic therapy or placing a filter in a major blood vessel (the inferior vena cava).

Thrombolysis (Clot-Busting DVT Treatment):

Minimally invasive procedures in DVT treatment are performed by an interventional radiologist under X-ray Guidance, if a patient has severe pain, difficulty in walking, significant swelling while on blood thinners, or if there is clot blocking the pelvic veins (iliac veins).  When performed early, thrombolysis is highly effective at dissolving a clot and preserving the valves in the veins.

It is designed to rapidly break up the clot, restore blood flow within the vein, and potentially preserve valve function to minimize the risk of post-thrombotic syndrome. The interventional radiologist inserts a tiny tube called catheter into the vein behind the knee or other leg vein and threads it into the vein containing the clot using x-ray guidance. The catheter tip is placed into the clot and a  clot-busting  drug is infused directly to the thrombus (clot) followed by clot removal by special devices. The fresher the clot, the faster it dissolves   one to two days. Clinical resolution of pain and swelling and restoration of blood flow in the vein is greater than 85 percent with these invasive techniques.  In patients in whom thrombolysis or blood thinners are not medically appropriate, an interventional radiologist can insert a vena cava filter, a small device that functions as an umbrella to capture blood clots that would float to the lung, but allows normal liquid blood to pass.

DEEP VEIN THROMBOSIS PREVENTION:

You can take simple steps to lower your chances for a blood clot:

Exercise your lower leg muscles if you re sitting for a long time while traveling.
Get out of bed and move around as soon as you re able after having surgery or being ill.
The more active you are, the better your chance of avoiding a blood clot.
Take any medicines your doctor prescribes to prevent clots after some types of surgery.
Wear compression stocking to prevent complication or recurrence as per instruction.
Keep regular follow-up with your doctor to avoid or prevent post DVT complication.
SPECIAL PRECAUTIONS FOR PEOPLE WITH DEEP VEIN THROMBOSIS:

Patients being treated for venous thrombosis are at an increased risk for developing another blood clot. The patient should watch for new onset leg pain or swelling. If these symptoms occur, the patient should speak to his/her health care provider or seek medical attention as soon as possible.
Risk of bleeding is high with anticoagulant so dose should not change unless the provider or clinic directs the patient to do so.
Patients may bleed easily from anywhere while taking anticoagulants. In some cases, bleeding can develop inside the body and can t notice immediately. Bleeding inside the body can cause a person to feel faint, or have pain in the back or abdomen. A healthcare provider should be notified immediately if there is any sign of this problem.

What is Deep Vein Thrombosis (DVT) - Symptoms,Treatment & Prevention

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

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?

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