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2010-08-09T02:10:00.000-07:00

Open Heart Surgery --- Heart Attack

2009-01-12T03:19:00.003-08:00

Open Heart Surgery --- Heart Attack

Open Heart surgery is a surgery that requires opening the chest to perform the surgery of the heart. Open Heart generally denotes opening of the chest to perform surgery and not the heart as the heart may or may not be opened since many alternative methods of surgeries are available. Surgery of the heart muscle, arteries, valves and other structures are included in open-heart surgery. With the advancement of medical science and technological growth doctors are more equipped and competent to handle open-heart surgeries. Indiaprofile.com offers information regarding heart surgeries in association with the best medical facilities of Apollo Hospitals.

Open Heart Surgery

During a conventional open-heart surgery, a heart lung machine is used to provide blood to the brain and other vital organs of the body. It supplies oxygen and removes carbon dioxide from the body. New procedures of heart surgery which are minimal invasive surgery done through small cuts made on the heart or robotic assisted heart surgery, are also included in open heart surgery which is confusing. However these surgeries are performed on patients as an alternative to the open-heart surgery that also requires the heart-lung machine.

Heart surgery is a surgery of the heart or of primary blood vessels like Vena cavae, Pulmonary artery, Pulmonary veins, Aorta. Reduced blood supply to the heart includes Heart diseases also include Ischaemic heart disease. Congenital heart disease, heart disease that exists at birth and other problems caused by endocarditis, which leads to treating valves, and includes heart transplantation are other serious heart disorders.

The following are the open-heart surgeries that are performed with the heart lung machine as the support system :
Bypass (cardiac revascularization)
Valve replacements
Heart transplants

Coronary Artery Bypass Surgery
Fat, cholesterol and other substances clog the coronary arteries and so the flow of blood to the heart vessels becomes slow leading to chest pain or heart attack. Increasing the blood flow can reduce the risk of heart attack.
Around the blocked part of the coronary artery the surgeon make a bypass by using a healthy blood vessel from another part of the body.
-The open end of an artery detached from the chest wall can be attached below the blocked area of the coronary artery.
-A large vein is taken from the leg, one end of which is attached to the aorta of the heart while the other end is grafted just below the blocked area of the coronary artery.
-These two bypasses ensure free flow of blood to the heart muscle.
Depending on the blockage of the coronary artery one, two, three or more bypass grafts can de done on a patient.

Heart Valve Surgery
Heart Valve surgery includes the repair or the replacement of the four valves inside the heart that pass blood unidirectional. These valves may become narrowed causing obstruction to the flow of the blood or it may allow blood to flow back to the heart. This leads to the inefficient functioning of the heart. Infection or endocarditis also cause damage to these valves. Aortic and mitral valves are the most commonly involved valves. The surgery involves the replacement of these valves.

Aortic Surgery
Aorta is the main blood vessel passing through the heart that provides blood to all the other parts of the body. It may become diseased by enlargement or by separating into outer and inner layer. The diseased segment is replaced through surgery.

Atrail Septal Defect
This is a congenital or birth defect. The atrail defect is a hole in the wall between the left atrium and the right atrium. This usually results in the mixing of the blood across the hole which causes symptoms of breathlessness. The atrail defect can be repaired by closing the patch.

Heart Transplant
Removing a diseased heart and replacing it with a healthy heart is heart transplantation. Healthy heart can be obtained from donors who are brain dead but on life support system. The healthy heart when removed is preserved in a solution. With the patient in deep anesthetic sleep, a cut is made on his breastbone. The heart-lung bypass machine is used for the oxygen rich blood to be supplied to the brain and other important organs of the body. The diseased heart is removed and the donor’s heart is stitched in place. The heart-lung machine is removed and the blood flows through the transplanted heart.

There are major risks attached to heart transplantation. Drug infection is one of the infections that have to be looked into with great care. Heart transplantation gives life to the patient for a period of two years after the operation. The graft rejection is the major cause of the short span of life expectancy after surgery.

Heart Attack Symptoms and Warning Signs

2009-01-12T03:19:00.001-08:00

Heart Attack Symptoms and Warning Signs

A blockage in the heart's arteries may reduce or completely cut off the blood supply to a portion of the heart. This can cause a blood clot to form and totally stop blood flow in a coronary artery, resulting in a heart attack (also called an acute myocardial infarction or MI).

Irreversible injury to the heart muscle usually occurs if medical help is not received promptly. Unfortunately, it is common for people to dismiss heart attack symptoms.
What are the warning signs of a heart attack?

The American Heart Association and other medical experts say the body likely will send one or more of these warning signals of a heart attack:
* Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes.
* Pain spreading to the shoulders, neck or arms. The pain may be mild to intense. It may feel like pressure, tightness, burning, or heavy weight. It may be located in the chest, upper abdomen, neck, jaw, or inside the arms or shoulders.
* Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
* Anxiety, nervousness and/or cold, sweaty skin.
* Paleness or pallor.
* Increased or irregular heart rate.
* Feeling of impending doom.

Not all of these signs occur in every attack. Sometimes they go away and return. If some occur, get help fast. IF YOU NOTICE ONE OR MORE OF THESE SIGNS IN YOURSELF OR OTHERS, DON'T WAIT. CALL EMERGENCY MEDICAL SERVICES (9-1-1) RIGHT AWAY! In the event of cardiopulmonary arrest (no breathing or pulse), call 9-1-1 and begin cardiopulmonary resuscitation (CPR) immediately.
How does the doctor know if I've had a heart attack?

The actual diagnosis of a heart attack must be made by a doctor who has studied the results of several tests. The doctor may:

* Review the patient's complete medical history.
* Give a physical examination.
* Use an electrocardiogram (or EKG) to discover any abnormalities caused by damage to the heart.
* Use a blood test to detect abnormal levels of certain enzymes in the bloodstream.

Heart failure Treatments and drugs

2009-01-12T03:18:00.001-08:00

Heart failure Treatments and drugs

Heart failure is a chronic disease needing lifelong management. However, with treatment, a failing heart can become stronger and signs and symptoms of heart failure can improve. Doctors sometimes can correct heart failure by treating the underlying cause. For example, repairing a heart valve or controlling a fast heart rhythm may reverse heart failure. But for most people, the treatment of heart failure involves a balance of the right medications, and in some cases, devices that help the heart beat properly.

Medications
Doctors usually treat heart failure with a combination of medications. Depending on your symptoms, you might take one, two or more of these drugs. Several types of drugs have proved useful in the treatment of heart failure. They include:

Angiotensin-converting enzyme (ACE) inhibitors. These drugs help people with heart failure live longer and feel better. ACE inhibitors are a type of vasodilator, a drug that widens or dilates blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten). ACE inhibitors also blunt some of the effects of hormones that promote salt and water retention. ACE inhibitors can cause an irritating cough in some people. It may be best to put up with the cough, if you can, to gain the medication's benefits. But be sure to discuss this with your doctor. Switching to another ACE inhibitor or an angiotensin II receptor blocker (ARB) may relieve the problem.
Angiotensin II (A-II) receptor blockers (ARBs). These drugs, which include losartan (Cozaar) and valsartan (Diovan), have many of the beneficial effects of ACE inhibitors, but they don't cause a persistent cough. They may be an alternative for people who can't tolerate ACE inhibitors.
Digoxin (Lanoxin). This drug, also referred to as digitalis, increases the strength of your heart muscle contractions. It also tends to slow the heartbeat. Digoxin reduces heart failure symptoms and improves your ability to live with the condition.
Beta blockers. This class of drug slows your heart rate and reduces blood pressure. Examples include carvedilol (Coreg), metoprolol (Lopressor) and bisoprolol (Zebeta). These medicines also reduce the risk of some abnormal heart rhythms. Beta blockers may reduce signs and symptoms of heart failure and improve heart function.
Diuretics. Often called water pills, diuretics make you urinate more frequently and keep fluid from collecting in your body. Commonly prescribed diuretics for heart failure include bumetanide (Bumex) and furosemide (Lasix). The drugs also decrease fluid in your lungs, so you can breathe more easily. Because diuretics make your body lose potassium and magnesium, your doctor may also prescribe supplements of these minerals. If you're taking a diuretic, your doctor will likely monitor levels of potassium and magnesium in your blood through regular blood tests.
Aldosterone antagonists. These drugs include spironolactone (Aldactone) and eplerenone (Inspra). They're primarily potassium-sparing diuretics, but they have additional properties that help the heart work better, may reverse scarring of the heart and may help people with severe heart failure live longer. Unlike some other diuretics, spironolactone can raise the level of potassium in your blood to dangerous levels.

A medication called BiDil is a single pill that combines hydralazine and isosorbide dinitrate — both of which dilate and relax the blood vessels. BiDil increases survival when added to standard therapy in black people with advanced heart failure. This is the first drug studied and approved for a specific racial group. Further studies will be necessary to determine if this combination medicine will be helpful for others with heart failure.

You'll probably need to take two or more medications to treat heart failure. Your doctor may prescribe other heart medications as well — such as nitrates for chest pain, a statin to lower cholesterol or blood-thinning medications to help prevent blood clots - along with heart failure medications.

You may be hospitalized for a few days if you have a flare-up of heart failure symptoms. While in the hospital, you may receive additional medications to help your heart pump better and relieve your symptoms. You may also receive supplemental oxygen through a mask or small tubes placed in your nose. If you have severe heart failure, you may need to use supplemental oxygen long term.

Surgery and medical devices
In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. For example, a damaged heart valve may be repaired or, if necessary, replaced with a new one. Doctors recommend coronary bypass surgery to treat severely narrowed coronary arteries that are contributing to heart failure.

How can coronary atherosclerosis and heart attacks be prevented?

2009-01-12T03:17:00.000-08:00

How can coronary atherosclerosis and heart attacks be prevented?
One can prevent atherosclerosis and reduce heart attack risks by:

* Controlling high blood pressure and diabetes mellitus;
* Never smoking or stopping cigarette smoking;
* Exercising regularly;
* Losing excess weight;
* Lowering blood levels of LDL cholesterol;
* Increasing blood levels of HDL cholesterol;
* Lowering blood levels of lipoprotein A cholesterol and triglycerides;
* Increasing LDL cholesterol particle sizes;
* Taking anti-platelet medications (such as low dose aspirin) to prevent blood clots;
* Consuming antioxidants to prevent blood vessel damage;
* Consuming folic acid and other B vitamins to decrease blood levels of homocysteine; and
* Taking ace inhibitors (such as ramipril, Altace) to prevent arthrosclerosis.

Many of the measures that prevent coronary atherosclerosis also benefit other arteries such as carotid arteries and cerebral arteries (arteries that supply blood to the brain). Therefore, these measures also prevent strokes.
How can coronary atherosclerosis and heart attacks be prevented?