Anemia Part-7

How is blood collected for a CBC?

Blood is collected by venipuncture (using a needle to draw blood from a vein) in a lab, hospital, or physician's office. Typically, blood is collected in a special sterile tube from an arm vein. The tube has some preservatives to prevent clotting of the blood. Results may be available in an hour or longer depending on the setting.
In some instances, a quick in office test called hemoglobin rapid test may be performed using a few drops of blood from a finger prick. The advantage of this quick test is that results may be obtained in a few minutes and only a few drops of blood may be required.

What is the red blood cell (RBC) count?

The red blood cells (RBCs or erythrocytes) are the most common type of cells in the blood. We each have millions and millions of these little disc-shaped cells. The RBC count is done to determine if the number of red blood cells is low (anemia) or high (polycythemia).
In an RBC count, the number and size of the RBCs are determined. This is usually reported as number of RBCs per a specified volume, typically in millions of RBCs in microliters (one one-thousandth of an ml) of whole blood. The shape of the RBCs is also evaluated under a microscope. All of this information, the number, size and shape of the RBCs, is useful in the diagnosis of anemia. Further, the specific type of anemia may be determined by this information.

What is hemoglobin?

Hemoglobin is a red pigment that imparts the familiar red color to red blood cells and to blood. Functionally, hemoglobin is the key chemical compound that combines with oxygen from the lungs and carries the oxygen from the lungs to cells throughout the body. Oxygen is essential for all cells in the body to produce energy.
The blood also transports carbon dioxide, which is the waste product of this energy production process, back to the lungs from which it is exhaled into the air. The transport of the carbon dioxide back to the lung is also achieved by hemoglobin. The carbon dioxide bound to hemoglobin is unloaded in the lungs in exchange for oxygen to be transported to the tissues of the body.

Anemia Part-6

What does a low hemoglobin level mean?

Low hemoglobin is called anemia. When there is a low hemoglobin level, there is often a low red blood cell count and a low hematocrit, too. Reference ranges are slightly different from one source to another, but typically hemoglobin of less than 13.5 gram/100 ml is abnormal in men and less than 12.0 gram/100 ml in women.

What is the hematocrit?

The hematocrit is specifically a measure of how much of the blood is made of red cells. The hematocrit is a very convenient way to determine whether the red blood cell count is too high, too low, or normal. The hematocrit is a measure of the proportion of blood that is composed of the red blood cells.

How is hematocrit determined?

The red blood cells in the sample of blood are packed down by spinning the tube in a centrifuge under prescribed conditions. The proportion of the tube that consists of red blood cells is then measured. Let's say that it is 45%. The hematocrit is 45%.

How is anemia treated?

The treatment of the anemia varies greatly. First, the underlying cause of the anemia should be identified and corrected. For example, anemia as a result of blood loss from a stomach ulcer should begin with medications to heal the ulcer. Likewise, surgery is often necessary to remove a colon cancer that is causing chronic blood loss and anemia.
Sometimes iron supplements will also be needed to correct iron deficiency. In severe anemia, blood transfusions may be necessary. Vitamin B12 injections will be necessary for patients suffering from pernicious anemia or other causes of B12 deficiency.
In certain patients with bone marrow disease (or bone marrow damage from chemotherapy) or patients with kidney failure, epoetin alfa (Procrit, Epogen) may be used to stimulate bone marrow red blood cell production.
If a medication is thought to be the culprit, then it should be discontinued under the direction of the prescribing doctor.

Anemia Part-5

How is anemia diagnosed?

Anemia is usually detected, or at least confirmed, by a complete blood cell (CBC) count. A CBC test may be ordered by a physician as a part of routine general checkup and screening or based on clinical signs and symptoms that may suggest anemia or other blood abnormalities.

What is a complete blood cell (CBC) count?

Traditionally, CBC analysis was performed by a physician or a laboratory technician by viewing a glass slide prepared from a blood sample under a microscope. Today, much of this work is often automated and done by machines. Six component measurements make up a CBC test:

1. Red blood cell (RBC) count
2. Hematocrit
3. Hemoglobin
4. White blood cell (WBC) count
5. Differential blood count (the "diff")
6. Platelet count

Only the first three of these tests -- the red blood cell (RBC) count, the hematocrit, and the hemoglobin -- are relevant to the diagnosis of anemia.
Additionally, mean corpuscular volume (MCV) is also often reported in a CBC, which basically measures the average volume of red blood cells in a blood sample. This is important in distinguishing the causes of anemia. Units of MCV are reported in femtoliters, a fraction of one millionth of a liter.
Other useful clues to causes of anemia that are reported in a CBC are the size, shape, and color of red blood cells.

Anemia Part-4

Yes, anemia may be genetic. Hereditary disorders can shorten the life span of the red blood cell and lead to anemia (for example, sickle cell anemia). Hereditary disorders can also cause anemia by impairing the production of hemoglobin (for example, alpha thalassemia and beta thalassemia).
Depending on the degree of the genetic abnormality, hereditary anemias may cause mild, moderate, or severe anemia. In fact, some may be too severe to be compatible with life and may result in death of the fetus (unborn infant). On the other hand, some of these anemias are so mild that they are not noticeable and are incidentally revealed during a routine blood work.

What are the symptoms of anemia?

Some patients with anemia have no symptoms. Others with anemia may feel:

• Tired
• Fatigue easily
• Appear pale
• Develop palpitations (feeling of heart racing)
• Become short of breath

Additional symptoms may include:

• Hair loss
• Malaise (general sense of feeling unwell)
• Worsening of heart problems

It is worth noting that if anemia is longstanding (chronic anemia), the body may adjust to low oxygen levels and the individual may not feel different unless the anemia becomes severe. On the other hand, if the anemia occurs rapidly (acute anemia), the patient may experience significant symptoms relatively quickly.

Anemia Part-3

What are other causes of anemia?

Some of the most common causes include:

• Vitamin B12 deficiency may cause pernicious anemia. This type of anemia could happen in people who are unable to absorb vitamin B12 from their intestines due to a number of reasons.
• Strict vegetarians are at risk if they do not take adequate vitamin supplements.
• Long-term alcoholics.
• People who have abnormal structure or function of the stomach or intestines leading to impaired B12 absorption despite adequate intake.

This typically causes macrocytic (large blood cell volume) anemia. Vitamin B12, along with folate, is involved in making the heme molecule that is an integral part of hemoglobin. Folate deficiency can be the culprit of anemia as well. This may also be caused by inadequate absorption, under-consumption of green, leafy vegetables, and also long-term heavy alcohol use.

• There can be rupture or destruction of red blood cells (hemolytic anemia) due to antibodies clinging to the surface of the red cells. Examples of hemolytic anemia include hemolytic disease of the newborn, medication induced hemolytic anemia, transfusion related hemolysis, and autoimmune hemolytic anemia.
• A wide assortment of bone marrow diseases can cause anemia.
• For example, cancers that spread (metastasize) to the bone marrow, or cancers of the bone marrow (such as leukemia or multiple myeloma) can cause the bone marrow to inadequately produce red blood cells, resulting in anemia.
• Certain chemotherapy for cancers can also cause damage to the bone marrow and decrease red blood cell production, resulting in anemia.
• Certain infections may involve the bone marrow and result in bone marrow impairment and anemia.
• Finally, patients with kidney failure may lack the hormone necessary to stimulate normal red blood cell production by the bone marrow.
• Chronic alcohol consumption may lead to anemia via different pathways and thus, anemia is commonly seen in alcoholics.
• Another common cause of anemia is called anemia of chronic disease. This could typically occur in individuals with longstanding chronic diseases.

Anemia Part-2

Can inadequate iron cause anemia?

Absolutely! As a matter of fact, iron deficiency is a very common cause of anemia. This is because iron is major component of hemoglobin and essential for its proper function. Chronic blood loss due to any reason is the main cause of low iron level in the body as it depletes the body's iron stores to compensate for the ongoing loss of iron. Anemia that is due to low iron levels is called iron deficiency anemia.
Young women are likely to have low grade iron deficiency anemia because of the loss of blood each month through normal menstruation. This is generally without any major symptoms as the blood loss is relatively small and temporary.
Another common reason for iron deficiency anemia can be due to recurring or small ongoing bleeding, for instance from colon cancer or from stomach ulcers. Stomach ulcer bleeding may be induced by medications, even very common over-the-counter drugs such as aspirin and ibuprofen (Advil, Motrin). Slow and chronic oozing from these ulcers can lead to loss of iron. Gradually, this could result in anemia. In infants and young children, iron deficiency anemia is most often due to a diet lacking iron.
Interpretation of CBC may lead to clues to suggest this type of anemia. For instance, iron deficiency anemia usually presents with low mean corpuscular volume (microcytic anemia) in addition to low hemoglobin.

What about acute (sudden) blood loss as a cause of anemia?

Acute blood loss from internal bleeding (as from a bleeding ulcer) or external bleeding (as from trauma) can produce anemia in an amazingly short span of time. This type of anemia could result in severe symptoms and consequences if not addressed promptly. Dizziness, lightheadedness, fatigue, confusion, shortness of breath, and even loss of consciousness can occur with severe, sudden blood loss anemia.

Anemia Part-1

Anemia facts*

*Anemia facts medical author: William C. Shiel Jr., MD, FACP, FACR

• Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal.
• For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml.
• Anemia is caused by either a decrease in production of red blood cells or hemoglobin, or an increase in loss or destruction of red blood cells.
• Some patients with anemia have no symptoms. Others may feel tired, easily fatigued, appear pale, a feeling of heart racing, short of breath, and/or worsening of heart problems.
• Anemia can be detected by a simple blood test called a complete blood cell count (CBC).
• The treatment of the anemia varies greatly and very much depends on the particular cause.

What is anemia?

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml. These definitions may vary slightly depending on the source and the laboratory reference used.

What causes anemia?

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood cell is typically around 120 days. Red blood cells are made in the bone marrow.
Anemia is caused essentially through two basic pathways. Anemia is caused by either:

1. a decrease in production of red blood cells or hemoglobin, or
2. an increase in loss or destruction of red blood cells.

A more common classification of anemia (low hemoglobin) is based on the Mean Corposcular Volume (MCV) which signifies the average volume of individual red blood cells.

1. If the MCV is low (less than 80), the anemia is categorized as microcytic anemia (low cell volume).
2. If the MCV is in the normal range (80-100), it is called a normocytic anemia (normal cell volume).
3. If the MCV is high, then it is called a macrocytic anemia (large cell volume).

Looking at each of the components of a complete blood count (CBC), especially the MCV, a physician can gather clues as to what could be the most common reason for anemia in each patient.

Picture of Red Blood Cells

Reviewed by William C. Shiel Jr., MD, FACP, FACR on 3/26/2012

GastritisPart-3

 

GastritisPart-3

What are the treatment medications and home remedies for gastritis?

Treating the underlying cause of gastritis is the most effective way to reduce or resolve gastritis. For example, if the cause of gastritis is Helicobacter pylori, then treatment with appropriate antibiotics (usually a combination of amoxicillin and clarithromycin [Biaxin, Biaxin XL] plus bismuth subsalicylate [Pepto-Bismol]) should be effective.
If NSAIDs are the cause, then stopping the drug should be effective. However, other treatments are often used in addition to those that treat the specific cause. These treatments may reduce or stop symptoms of gastritis and allow gastric mucosal healing to begin regardless of the underlying cause. These medications include antacids (Maalox , Rolaids, and Alka-Seltzer), histamine (H2) blockers (famotidine [Pepcid AC], ranitidine [Zantac 75]) and PPI's or proton pump inhibitors (omeprazole [Prilosec], pantoprazole [Protonix], esomeprazole [Nexium]). They all function by different mechanisms to reduce acid in the stomach but usually do not treat the underlying cause of gastritis.

Gastritis Part-4

Gastritis Part-4

 

What are the complications of gastritis?

The complications of gastritis may occur over time, especially if gastritis becomes chronic and the underlying causes are not treated. Complications may include peptic ulcer, bleeding ulcers, anemia, gastric cancers, MALT lymphoma, gastric scarring, and strictures with outlet obstruction, dehydration, renal problems, and even death.

What is the prognosis of gastritis?

Most people that get gastritis have few or short-term symptoms and recover completely. Those people with underlying causes that are appropriately treated often recover completely. The prognosis of individuals with chronic disease and those who develop serious complications like bleeding ulcers, obstruction and cancer is more guarded.

How is gastritis prevented?

If the underlying cause of gastritis is preventable, then gastritis can be prevented. For example, if alcohol consumption or NSAIDs cause an individual's gastritis, prevention is accomplished by stopping the consumption of these agents. Avoidance may be preventive in situations where chemicals, radiation or some toxin ingestion could occur. It may be more difficult to prevent some infectious causes, but proper hygiene, hand washing, and eating and drinking only adequately cleaned or treated foods and fluids are healthy ways to decrease your risk of getting gastritis from infectious agents.

Gastritis

 

Gastritis

What is gastritis?

Gastritis is inflammation of the lining of the stomach. Unfortunately, the term "gastritis" has been misused to include many different upper abdominal problems, but true gastritis refers to the stomach lining (gastric mucosa) that is inflamed. All or part of the gastric mucosa may be involved. Gastritis may be classified as acute or chronic. Acute gastritis maybe characterized as erosive (damaged areas where mucosal cells are disrupted or missing) and nonerosive. Chronic gastritis is determined by histopathology (appearance of the gastric mucosa). This article will focus on true gastritis. Gastritis has many causes, but most causes result in similar symptoms. This has leads to some confusion and is the reason why many health care professionals now consider the term "gastritis" as a non-specific description of a cluster of symptoms.

What causes gastritis?

A major cause of both acute and chronic gastritis is infection of the stomach mucosa by a bacterial species named Helicobacter pylori. Usually, this bacterium first infects the stomach antrum (stomach mucosa without acid-producing cells) acutely and may progress to infect most or all of the stomach's mucosa over time (chronic gastritis) and remain there for years. This infection generates an initial strong inflammatory response and eventually, a long-term chronic inflammation with intestinal cell changes may develop. Another major cause of acute and chronic gastritis is the use (and overuse) of nonsteroidal anti-inflammatory drugs (NSAIDs).
However, there are many other causes of gastritis; the following is a list of common causes of both acute and chronic gastritis; chronic gastritis may occur with repeated or continual presence of most of these causes:

• Bacterial, viral and parasitic infections
• Certain drugs (cocaine)
• Alcohol
• Bile reflux
• Fungal infections
• Allergic reactions
• Stress reaction
• Radiation
• Certain food poisonings (infectious and chemical)
• Trauma

In general, infectious agents, especially Helicobacter pylori, and NSAIDs are responsible for the majority of gastritis patients.


 

Gastritis Part-2

Gastritis Part-2

 

What are the symptoms of gastritis?

Surprisingly in many people, gastritis often produces no symptoms and is diagnosed only when samples of the stomach mucosa are examined for other suspected diseases. However, when gastritis symptoms occur, the most common symptoms include abdominal pain (intermittent or constant burning, gripping or gnawing pain), often accompanied by nausea and vomiting and occasionally, diarrhea. Other symptoms such as loss of appetite, bloating, and burping or belching may occur. These latter symptoms come and go over time especially with chronic gastritis. Indigestion (dyspepsia) is another term that encompasses this cluster of symptoms.

How is gastritis diagnosed?

Gastritis is presumptively diagnosed by the patient's symptoms and history of a previous diagnosis and treatment of gastritis, alcohol consumption, and use of NSAIDs. Definitive diagnosis is made by identifying the underlying cause of the gastric mucosal inflammation and/or by tissue (gastric) biopsy. For example, the major infective cause of gastritis is Helicobacter pylori (H. pylori). This bacterium can be detected by breath, blood, stool, immunological and biopsy tests. Although the bacterium can be cultured from the patient, this is seldom attempted. Other pathogens can be identified using culture, stool and immunological tests.
Biopsy of the stomach mucosa, done during endoscopy examinations, is often used in patients to identify the causes of chronic gastritis and may allow visualization of mucosal erosions and other stomach mucosal changes. Abdominal X-rays or barium studies (upper or lower) may demonstrate the presence of thickened mucosa and folds that are signs of inflammation in the stomach.
Your doctor can help determine which tests should be done, including ancillary tests that may help identify other causes of the non-specific symptoms commonly found with gastritis.

Heart Disease Part-7

Heart Disease Part-7

Angioplasty and stenting

If the coronary angiogram (coronary=heart + angio=artery + gram=record) shows significant blockage in an artery, the cardiologist may attempt an angioplasty, in which a balloon is placed via a catheter (as with angiography) at the area of narrowing and when quickly inflated, compresses the offending plaque into the wall of the artery. Often a stent, or a metal cage, is placed at the site of angioplasty to keep the blood vessel from narrowing again. Should a stent be placed, patients are usually started on antiplatelet medication to prevent clot formation. Clopidogrel (Plavix) and prasugrel (Effient) are the two most common medications prescribed.

Surgery

For those patients with multiple coronary artery blockages, coronary artery bypass grafting may be a consideration.

Heart Disease Part-6

Heart Disease Part-6

Modifying risk factors for heart disease

While patients cannot choose their family and alter their genetic predisposition to coronary artery disease, the rest of the risk factors are under control of the patient. Keeping blood pressure, cholesterol and other lipid levels, and diabetes under control needs to become a life-long goal. Smoking cessation is highly encouraged.

Medications

The purpose of medications for coronary artery disease is to allow more efficient heart muscle function to overcome any blockage that might exist.
Aspirin is one of the cornerstones of coronary artery disease treatment. It prevents platelets from clumping together when blood becomes turbulent, like when it flows past a narrowing in an artery.
Beta blockers prevent the action of adrenaline on the heart and allow the heart to beat a more efficiently by reducing the heart rate and causing the heart muscle to contract less aggressively. Examples of beta blockers include:

• atenolol (Tenormin)
• metoprolol (Lopressor, Toprol XL)
• propranolol (Inderal, Inderal LA)
• carvedilol (Coreg)
• labetalol (Normodyne, Trandate)

Calcium channel blockers can also be used to control heart rate and allow the heart to beat more efficiently. Examples of calcium channel blockers include:

• diltiazem (Cardizem, Dilacor, Tiazac)
• verapamil (Calan, Verelan, Verelan PM, Isoptin, Covera-HS)

Nitroglycerin dilates blood vessels and may be used sublingually, under the tongue, to treat angina. Some patients may be prescribed long-acting nitroglycerin to help control anginal symptoms.

Heart Disease Part-5

 

Heart Disease Part-5

Heart catheterization or coronary angiography

This test is the gold standard for the diagnosis of coronary artery disease. A cardiologist inserts and then threads a small tube through the groin or arm into the coronary arteries, where dye is injected to directly visualize the arteries on an x-ray. This test defines the anatomy of the coronary arteries. At the time of the catheterization, if blockages are found, they may be potentially treated with angioplasty in which a balloon is inflated to squash the plaque into the blood vessel wall and the insertion of a stent (wire cage that prevents the blood vessel from narrowing again).
CT coronary angiogram may be used test to diagnose coronary artery disease. During this procedure, intravenous dye containing iodine is injected into the patient and CT scanning is performed to image the coronary arteries.
Prior to the angiogram, a calcium score may be obtained. The calcium CT scan can measure the amount of calcium within heart blood vessels. If the score is 0, meaning that there is no calcium present, the risk of having heart disease is zero. The higher the score, the increased risk of narrowed coronary arteries.

What is the treatment for heart disease?

Coronary artery disease is usually treated in a multi-step approach depending upon a patient's symptoms. The patient and healthcare provider need to work together to return the patient to a normal lifestyle.

Prevention of heart disease

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The key to the treatment is prevention. A healthy lifestyle includes exercise, proper nutrition, and smoking cessation. Moreover, controlling diabetes and high blood pressure to minimize contribution risk for heart disease is a major aspect of prevention.
An aspirin a day is recommended to decrease the risk for heart disease and should be started with the recommendation of a health care practitioner.
A little alcohol (one drink per day for women or two drinks per day for men) decreases the risk of heart disease compared to nondrinkers. However, it is not recommended that nondrinkers begin drinking.

Heart Disease Part-4

 

Heart Disease Part-4

Echocardiography

Used with or without exercise, echocardiography can assess how the heart works. Using sound waves to generate an image, a cardiologist can evaluate many aspects of the heart. Echocardiograms can examine the structure of the heart including the heart valves, the thickness of the heart muscle, the septum (the tissues that separate the four heart chambers from each other) and the pericardial sac (the outside lining of the heart).
The test can indirectly assess blood flow to parts of the heart muscle. If there is decreased blood flow, then segments of the heart wall may not beat as strongly as adjacent heart muscle. These wall motion abnormalities signal the potential for coronary artery disease.
The echocardiogram can also assess the efficiency of the heart by measuring ejection fraction. Normally when the heart beats, it pushes more than 60% of the blood in the ventricle out to the body. Many diseases of the heart, including coronary artery disease, can decrease this percentage (the ejection fraction).

Perfusion studies

Radioactive chemicals like thallium or technetium can be injected into a vein and their uptake measured in heart muscle cells. Abnormally decreased uptake can signify decreased blood flow to parts of the heart because of coronary artery narrowing. This test may be used when the patient's baseline EKG is not normal and is less reliable when used to monitor a stress test.

Computerized tomography

The latest generation of CT scanners can take detailed images of blood vessels and may be used as an adjunct to determine whether coronary artery disease is present. In some institutions, the heart CT is used as a negative predictor. That means that the test is done to prove that the coronary arteries are normal rather than to prove that the disease is present.

Heart Disease Part-3

 Heart Disease Part-3

How is heart disease diagnosed?

The diagnosis of heart disease begins with obtaining a history that the potential for coronary artery disease exists. Risk factors need to be assessed and risk stratification occurs. The type of testing that is recommended, if any, depends upon the potential that the patient's symptoms actually represent angina and are coming from the heart.
Heart disease tests
Not every patient with chest pain needs heart catheterization (the most invasive test). Instead, the healthcare provider will try to choose the testing modality that will best provide the diagnosis, and if coronary artery disease is present, decide what impairment, if any, is present.

Electrocardiogram (ECG or EKG)

The heart is an electrical pump, and the electrical impulses it generates can be detected on the surface of the skin. Normal muscle conducts electricity in a reproducible fashion. Muscle that has decreased blood supply conducts electricity poorly. Muscle that has lost its blood supply and has been replaced with scar tissue cannot conduct electricity. The electrocardiogram (EKG) is a noninvasive test used to reflect underlying heart conditions by measuring the electrical activity of the heart.
Some people have "abnormal" EKGs at baseline but this may be normal for them. It is important that an electrocardiogram be compared to previous tracings if one is available. If a patient has a baseline abnormal EKG, they should consider carrying a copy with them for reference should they ever need another EKG.

Stress testing

If the baseline EKG is relatively normal, then monitoring the EKG tracing while the patient exercises may uncover electrical changes that may indicate the presence of coronary artery disease. There are a variety of testing protocols used to determine whether the exercise intensity is high enough to prove that the heart is normal.
Some patients are unable to exercise on a treadmill, but they can still undergo cardiac stress testing by using intravenous medication that causes the heart to work harder.
Stress testing is done under the supervision of medical personnel because of the potential of provoking angina, shortness of breath, abnormal heart rhythms, and heart attack.

Heart Disease- Part-2

Heart Disease- Part-2

What are the symptoms of heart disease?

The typical symptoms of coronary artery disease are chest pain associated with shortness of breath. Classically, the pain of angina is described as a pressure or heaviness behind the breast bone with radiation to the jaw and down the arm accompanied by shortness of breath and sweating. Unfortunately, angina has a variety of signs and symptoms, and there may not even be specific chest pain. Other locations of pain and other symptoms may include shoulder or back ache, upper abdominal pain, nausea, and indigestion.
Women, the elderly, and people with diabetes may have different perceptions of pain or have no discomfort at all. Instead, they may complain of malaise or fatigue and generalized weakness and the inability to complete routine physical tasks such as walking or climbing stairs.
Health care practitioners and patients may have difficulty understanding each other when symptoms of angina are described. Patients may experience pressure or tightness but may deny any complaints of pain. Health care practitioners may misinterpret these symptoms when patient answers "no" to the question whether "pain is present," even though the patient is experiencing other types of discomfort.
People with coronary artery disease usually have gradual progression of their symptoms. As an artery narrows over time, the symptoms of decreased blood flow to part of the heart muscle may increase in frequency and/or severity. Health care practitioners may inquire about changes in exercise tolerance (How far can you walk before getting symptoms? Is it to the mailbox? Up a flight of stairs?), and whether there has been an acute change in the symptoms.
Once again, patients may be asymptomatic until a heart attack occurs. Of course, some patients also may be in denial as to their symptoms and procrastinate in seeking care.

Heart Disease- Part-1

Heart Disease- Part-1

Heart disease facts

• Heart disease refers to several conditions that affect the heart and blood vessels. Arrhythmias, heart valve disease, congenital heart defects, and inflammation of the heart or its lining (the pericardium) are all diseases that affect the heart. However, this article will focus on the most common type of heart disease, coronary artery disease (CAD), also known as atherosclerotic heart disease (ASHD).
• Coronary artery disease is the most common cause of death in the United States. Over a million people each year will have a heart attack and 25% will die before they get to the hospital while or in the Emergency Department.
• Prevention is the key to treatment of heart disease.
• Diagnosis of heart disease is often made by careful history taken by a health care practitioner. Some individuals may have atypical symptoms, including almost none at all.
• The testing strategy to confirm the diagnosis and plan appropriate treatment needs to be individualized for each patient diagnosed with heart disease.
• Treatment of heart disease depends upon the severity of disease, and is often directed by the symptoms experienced by the affected individual.

Introduction to heart disease

The heart is like any other muscle, requiring oxygen and nutrient-rich blood for it to function. The coronary arteries that supply blood to the heart muscle spread across the surface of the heart, beginning at the base of the aorta and branching out to all areas of the heart muscle.
The coronary arteries are at risk for narrowing as cholesterol deposits, called plaques, build up inside the artery. If the arteries narrow enough, blood supply to the heart muscle may be compromised (slowed down), and this slowing of blood flow to the heart causes pain, or angina.