Dr. Chetan Gandhi

Cholesterol is a vital component, which helps the body to make healthy cells. This wax like component is found in the lipid of the blood. An increased cholesterol count elevates the risk of heart diseases in a person. It thickens the vessels of the arteries resulting in less oxygen flow in the heart. This, in turn, increases the chances of a stroke. High cholesterol can happen from lifestyle habits and inheritance. It is completely treatable and preventable.

What causes high cholesterol?
The blood carries the cholesterol which is attached to the proteins. The combination of cholesterol and protein is known as the lipoprotein. Primarily there are two different kinds of cholesterol that the lipoprotein carries:

• Low-density lipoprotein: LDL is the bad guy that carries all kinds of cholesterol present in the body. It eventually rests on the walls of the arteries, making it narrow and hard.
• High-density lipoprotein: This is the good guy which scans the excess cholesterol and take them back to the liver.

Ideally, the body should have low LDL and high HDL. But often the reverse happens, resulting in high cholesterol and cardiac diseases. Factors such as unhealthy diet, inactivity for most of the day and obesity is responsible for the same. Even the genetic set up can play a hand in a high count of LDL in the body. There is nothing that can be done in this case except to seek medical help.

6 factors that put you at risk:

1. Poor diet: Cholesterol levels are dramatically increased when baked products and saturated fats are consumed in an excess amount. Other high cholesterol food products include dairy products, processed fats and red meat. Refraining from this food items will drastically reduce the chances of getting high cholesterol in the body.
2. Obesity: Obesity results from too much of fat storage in the body. It not only fatigues a person faster, but puts a person at high risk of getting cholesterol. The body mass index should be always lesser than 30 to abstain the risk of cholesterol.
3. Waist circumference: A waist circumference of more than 40 inches in men and 35 inches in women can increase the risk of cholesterol.
4. Diabetes: This is one of the major causes of high cholesterol. It not only damages the artery lining, but results in higher LDL and lower HDL.
5. Less workout: Leading a life which is devoid of exercise and jogging can increase the chances of getting high cholesterol. Exercise boost HDL count in the body and mitigates the risk of low HDL.
6. Smoking: The blood vessel walls get damaged with smoking. The blood vessels start accumulating fatty acids thereby increasing the chances of getting high cholesterol.

Aortic valve stenosis is a heart condition in which the valve to the biggest artery- the one which provides oxygen-rich blood to our body, called aorta, is narrowed. This prevents the valve from opening fully, obstructing the blood flow from your heart into your body.

When the aortic valve doesn’t open, your heart needs to work harder to pump blood to your body making the heart muscle weak. If left undiagnosed aortic stenosis is fatal.

Symptoms

These symptoms should spur you on to seek medical care right away:

1. Chest pain or tightness

2. Feeling faint with exertion

3. Shortness of breath

4. Fatigue after increased activity

5. Heart palpitations — rapid, fluttering heartbeat

6. Heart murmur

The disorder doesn’t produce symptoms right away and is usually diagnosed during routine physical exams when your doctor listens to your heart with a stethoscope. He usually hears a heart murmur resulting from turbulent blood flow through the narrowed aortic valve.

Diagnostic Tests

There are other ways to diagnose aortic valve stenosis and gauge the severity of the problem, like:

1. Echocardiogram – This produces an image of your heart using sound. It is the primary test to diagnose a heart valve problem. Sound waves are directed at your heart here and these bounce off your heart and are processed electronically to provide images of your heart. This test helps your doctor check diagnose aortic valve stenosis and its severity plus chalk out a treatment plan.

2. Electrocardiogram (ECG) –  In this test, patches with electrodes are attached to your chest to measure electrical impulses given out by your heart. These are then recorded as waves on a monitor and printed on paper. Though this can’t diagnose aortic stenosis directly, it can tell you that the left ventricle in your heart is thickened which normally happens due to aortic stenosis.

3. Chest X-ray – This allows the doctor to see the shape and size of your heart directly. If the left ventricle is thickened, it points to aortic stenosis. It also helps doctor check the lungs. Aortic stenosis leads to fluid and blood in the lungs, causing congestion.

4. Exercise Tests – Exercise is used to increase your heart rate and make your heart work harder. This test is done to see how your heart reacts to exertion.

5. Computerised Tomography (CT) Scan –  This means a series of X-rays to create images of your heart and observes the heart valves. It is also used to measure the size of aorta and the aortic valve.

6. Magnetic Resonance Imaging (MRI) –  This uses powerful magnets and radio waves to create images of your heart and valves.

Once aortic valve stenosis is confirmed, you may have to go in for monitoring or heart valve surgery according to your doctor’s advice.

Bradycardia is a condition which in basic terms means slow beating of the heart. In most cases, the typical rate is 60 to 100 beats in a minute when the person is at rest. In case your heart beats less than 60 times in a minute, then it is slower than normal. But a slow heart rate is not always a health concern even though sometimes it could indicate issues with of the heart.

What could bradycardia mean?
Some people with slow heart rate or bradycardia tend to be very fit, and they have no underlying health issues. Athletes and healthy young adults often have a heart rate lower than 60. But in others, bradycardia indicates that the natural pacemaker of the heart is not working well, or the electrical pathways have been disrupted. In severe forms of the problem, the heart may beat so slowly that it fails to pump adequate blood for meeting the needs of the body. This may show some symptoms and could be fatally dangerous.

What are the causes of bradycardia?
There are various causes of bradycardia, and some of them include:

1. Alterations in the heart which results from aging
2. Health conditions that slow down the electrical impulse through the heart. This may include electrolyte imbalance, low thyroid levels, and others.
3. Diseases which may disrupt the electrical system of the heart including heart attack, coronary artery disease, and myocarditis.
4. Certain medications that are used for treating heart problems like high blood pressure or hypertension, arrhythmia, and beta-blockers, and digoxin.

What are the symptoms of bradycardia?
When a person has very slow heart rate, he or she may experience lightheadedness or dizziness, feeling short of breath, having difficulties in doing normal activities or exercising, having chest pain, feeling tired and fatigued. In some cases, it is seen that the person may have palpitations, feeling confused, trouble in concentrating and fainting.

What’s worse, some people don’t have any symptoms at all, or their symptoms are so negligible that they think they are caused just because of aging. The best way to understand whether you have this problem is to take the pulse, and in case, it is slow or uneven, you must talk to a doctor.

How is bradycardia diagnosed and treated?
Bradycardia tends to come and go from time to time, and therefore, a standard EKG is not always able to detect it. A standard ambulatory electrocardiogram is used for detecting the condition, and sometimes, blood tests are also necessary.

The treatment of bradycardia is entirely dependent on the cause of the problem and its symptoms. It is worthy of mention here that in case the problem is not causing any symptoms, then they would not be treated under usual circumstances.