Our well-integrated ‘Cardiac Care Center’ at AMRI Hospitals, offers a comprehensive and multidisciplinary approach for treating patients suffering from chronic heart diseases. We have a team of highly experienced and qualified cardiologists, surgeons, paramedics, and dedicated nursing staff, and advanced infrastructure to offer accurate and precise treatment suitable for patients of all ages. Our pioneering contribution for preventing, diagnosing, and treating complex cardiac diseases has led to the achievement of providing improved quality of life to numerous cardiac patients. At AMRI Hospitals, we are committed to provide the highest standards of post-surgery care & excellent rehabilitation facilities under the supervision of the country’s best & leading doctors having international level expertise.
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An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso. Aortic aneurysms can dissect or rupture. The force of blood pumping can split the layers of the artery wall, allowing blood to leak.
Aneurysms occur in the aorta and also brain, back of the knee, intestine or spleen. A ruptured aneurysm can result in internal bleeding and stroke. It can sometimes be fatal.
Aneurysms often have no symptoms until they rupture.
Emergency surgery may be required. The choice depends on the location, size and condition of the aneurysm.
Aortic aneurysm include:
In many cases it is detected during routine medical tests. Based on the symptoms and family history doctor may order ECG, Echocardiogram, chest Xray, CTScan, MRI, ultrasound of the heart to name a few.
The goal of treatment is to prevent the aneurysm from increasing further and to treat it before it dissects or ruptures. Depending on the size and growth rate of the patient’s aortic aneurysm, treatment may vary from cautious monitoring to surgery.
Basically treatment options are – Medication, Surgery including endovascular surgery and emergency surgery.
The most appropriate way to prevent aortic aneurysm is to control it from worsening by keeping one’s blood vessels as healthy as possible. The following steps might help:
Controlling cholesterol and fat in one’s diet
Sick sinus syndrome is the inability of the heart's sinus node to create the right heart rate. It causes irregular heart rhythms (arrhythmias). Sick sinus syndrome is also known as sinus node dysfunction or sinus node disease.
The sinus node is an area of specialized cells in the upper right chamber of the heart. This area controls one’s heartbeat. In sick sinus syndrome, the electrical signals are abnormally paced. The patient’s heartbeat can be too fast, too slow, interrupted by long pauses — or an alternating combination of these rhythm problems. Sick sinus syndrome is relatively uncommon, but the risk of developing it increases with age. Many people with sick sinus syndrome eventually need a pacemaker.
Signs and symptoms may include:
Problems of the sinus node may be due to the following reasons:
Common heart disease risk factors may increase the risk of sick sinus syndrome:
When the heart's natural pacemaker, that is sinus node isn't working properly, the heart can't work efficiently. This can lead to:
The following tests may be advised by the doctor:
The primary treatment goals are to reduce or eliminate symptoms and to manage and treat any other health conditions that may be contributing to sick sinus syndrome. The treatment options include - medication, pacemaker implant and procedures like AV node ablation. AV node ablation, Cardiac ablation for atrial fibrillation.
This condition is named after the French doctor who first identified it in 1862. In Raynaud's disease smaller arteries that supply blood to the skin become excessively narrow in response to cold temperature or stress, limiting blood supply to the affected area(vasospasm). The fingers, toes, ears and tip of the nose are commonly involved. It's often accompanied by changes in the colour of the skin. It is more common in people in colder climates. Treatment of Raynaud's disease depends on its severity. Raynaud's disease isn't disabling for most people, but it can affect one’s quality of life.
Types of Raynaud’s disease
During an attack the affected areas of the skin usually first turn white. Then, they often turn blue and feel cold and numb. As the area gets warmth and circulation improves, the affected areas may turn red, throb, tingle or swell.
The cause of this phenomenon is not exactly known. Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting one’s hands in cold water or being in cold air will most likely trigger. For some people, emotional stress can trigger the symptoms.
Causes of Secondary Raynaud’s disease include:
Risk factors for secondary Raynaud's include:
If Secondary Raynaud's is severe it can cause tissue damage due to reduced blood flow. Rarely, extreme untreated cases might require removing the affected part of the body.
To determine whether the patient has primary or secondary Raynaud's, the doctor might advise a test called nailfold capillaroscopy. If the doctor thinks that another condition, such as an autoimmune disorder or a connective tissue disease, may be causing Raynaud's, then the following blood test may be ordered:
Actually, no one blood test can diagnose Raynaud's, it will depend on patient’s symptoms and medical history.
The treatment aims at
There are treatment options like -
Medication - Depending on the cause of the patient’s symptoms, medications might help to widen blood vessels and increase blood flow.
Surgeries and medical procedures – In cases of severe Raynaud's the following treatments may be advised :
In Myocardial ischemia blood flow to the heart muscle (myocardium) is obstructed by a partial or complete blockage of a coronary artery due to build up of plaques (atherosclerosis). Myocardial ischemia, also called cardiac ischemia, decreases the heart muscle's ability to pump blood. A severe blockage can lead to a heart attack. Myocardial ischemia is common among women, older people and diabetics.
Treatment for myocardial ischemia involves improving blood flow to the heart muscle. It may include medications and procedures like angioplasty.
Prevention and life style modification
It is a condition that occurs when the heart's aortic valve narrows. The valve doesn't open fully, which reduces or blocks blood flow from the heart into the main artery (Aorta) and to the rest of the body. The treatment depends on the severity of one’s condition. Surgery to repair or replace the valve may be required.
The causes of Aortic Stenosis include:
In order to diagnose doctor reviews the symptoms and orders several tests to confirm. It may include the following:
Treatment for aortic valve stenosis depends on the signs and symptoms and the severity of the condition.
Surgery and other procedures
Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure. The main types of cardiomyopathy include dilated, hypertrophic and restrictive cardiomyopathy. Treatment includes medications, surgically implanted devices, heart surgery or in severe cases, a heart transplant depending on the type of cardiomyopathy and its severeness.
In the beginning there might be no signs or symptoms. But as the disease advances, signs and symptoms appear.
Usually the cause of the cardiomyopathy is unknown. In some patients it can be the result of another condition (acquired) or inherited. Some of the reasons for developing Cardiomyopathy can be as follows:
Types of Cardiomyopathy
Detection is usually based on the following investigations:
The treatment depends on the types of Cardiomyopathy. The basic aims of cardiomyopathy treatment are :
There are different types of medications to treat cardiomyopathy. The medications help to
Non surgical procedures
Surgery and device implants
Various types of devices are surgically implanted in the heart to improve its function and control the symptoms. It includes -
Types of surgeries include:
Atherosclerosis is a condition when there is buildup of fats, cholesterol and other substances termed as plaque inside the artery walls. The plaque narrows the arteries blocking the smooth blood flow. The plaque is also responsible for forming a blood clot.
Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in one’s body. Atherosclerosis can be treated. Healthy lifestyle habits can help prevent atherosclerosis.
Usually atherosclerosis symptoms are not felt until an artery is very narrowed or clogged. Sometimes a blood clot completely blocks blood flow, or even breaks apart and can trigger a heart attack or stroke.
Symptoms of moderate to severe atherosclerosis depend on which arteries are affected.
Atherosclerosis in heart arteries - chest pain or pressure (angina).
Atherosclerosis in the arteries leading to brain - sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face.
Atherosclerosis in the arteries in arms and legs - leg pain when walking (claudication) or decreased blood pressure in an affected limb.
Although the exact cause is unknown, it may develop due to the following reasons:
There are several diagnostic procedures:
Some of these improved life style methods may help:
Coronary Artery Disease
In Coronary artery disease the heart's major blood vessels are damaged due to buildup of plaque that cause blockage and limit the supply of blood to the heart. A complete blockage may result in a heart attack. Coronary artery disease often develops over decades, one might not notice a problem until there is a significant blockage or a heart attack.
Coronary artery disease often has symptoms like chest pain and shortness of breath. Treatments include medication, angioplasty or surgery and lifestyle changes, . A healthy lifestyle can make a big impact.
Coronary artery disease begins with damage of the arteries which is usually caused by various factors, including:
When the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to accumulate. This process is called atherosclerosis. If the plaque surface ruptures, blood cells called platelets stick together at the site to try to repair the artery. This clump can block the artery and cause a heart attack.
Depending on the condition of the patient the treatment options include medication, Angioplasty and Coronary bypass surgery. Cardiac rehabilitation also plays an important role. It helps prevent heart attack and lead to a longer healthy life.
The following life style changes can help -
A heart attack, also called a myocardial infarction, occurs when a blood clot blocks blood flow to the heart. It is a medical emergency. Without immediate hospitalization to restore blood flow, the damage to the heart muscle will be detrimental.
Symptoms include pain in the chest, neck, back or arms, as well as fatigue, lightheadedness, abnormal heartbeat and anxiety. Women are more likely to have atypical symptoms than men.
Treatment ranges from stenting, bypass surgery to medication, cardiac rehabilitation and lifestyle changes,
Heart attack symptoms vary. Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days or weeks in advance.
Some common indications are the following:
A heart attack occurs when one or more coronary arteries become blocked. Over time, a buildup of fatty deposits, including cholesterol form plaques, which narrows the arteries. This condition, called coronary artery disease, causes most heart attacks.
During a heart attack, a plaque can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If the clot is large, it can block blood flow through the coronary artery, starving the heart of oxygen and nutrients.
One might have a complete or partial blockage of the coronary artery.
Certain factors contribute to accumulation of fatty deposits (atherosclerosis) that narrows arteries throughout the body. These risk factors can be reduced to avoid chances of heart attack.
Each minute after a heart attack, more heart tissues deteriorate or die. Restoring blood flow quickly helps prevent heart damage. Immediate hospitalization is required. Depending on the condition of the patient medication and surgical procedures like Angioplasty and even Coronary bypass surgery are the options. Cardiac rehabilitation also plays an important role. It helps lead a longer and healthy life.
The following life style changes should be practiced :
In heart valve disease, one or more of the valves in the heart doesn't work properly. The heart has four valves that keep blood flowing in the correct direction. When one or more of the valves don't open or close properly it can disrupt the blood flow to the body.
The heart valve disease treatment depends on which heart valve is affected and the type and severity of the disease. Sometimes it requires surgery to repair or replace the heart valve.
Some people may not experience any symptom for long time.
Heart valve disease may be present at birth (congenital). It can also occur in adults due to many causes and conditions. Heart valve problems include:
Heart valve disease can cause many complications like:
Several tests may be prescribed for a diagnosis including:
Treatment options depend on the patient’s symptoms, the severity of the condition, and whether it is worsening. Apart from medication and life style changes, surgery and procedures like heart valve repair and replacement may be required.
Popliteal artery aneurysm is an irregular bulge that occurs in the wall of the artery located behind the knee joint. It is a type of lower extremity aneurysm. An aneurysm is a ballooning in a weak spot in an artery wall. Many different things can cause the popliteal artery wall to become weak.
Imaging tests like Duplex USG, CT Angiography or MRI Angiography
Depending on the size of the Aneurysm treatment options are monitoring, medication and surgery.
Popliteal artery entrapment syndrome (PAES) is an uncommon condition in which an abnormally positioned or enlarged calf muscle presses on the main artery behind the knee (popliteal artery). The artery becomes trapped, making it harder for blood to flow to the lower leg and foot.
The main symptom of popliteal artery entrapment is pain or cramps in the back of the lower leg (the calf) that occurs during exercise and goes away with rest. Other signs and symptoms may include:
Popliteal artery entrapment syndrome (PAES) is caused by an abnormal calf muscle, usually the gastrocnemius muscle. The condition may occur from birth (congenital) or develop later in life. The abnormal calf muscle presses on the main artery behind the knee (popliteal artery), reducing blood flow to the lower leg. The lack of blood flow results in pain and cramping in the back of the lower leg during times of activity.
Surgery is the only way to correct the abnormal calf muscle and free the trapped artery.
Aortic valve disease is a type of heart valve disease. In aortic valve disease, the valve between the lower left heart chamber (left ventricle) and the main artery to the body (aorta) doesn't work properly.
The aortic valve helps keep blood flowing in the correct direction through the heart. A damaged or diseased aortic valve can affect blood flow to the rest of the heart and body.
Aortic valve disease includes:
Aortic valve stenosis - The flaps of the aortic valve become thick and narrows the valve openings to hamper proper blood flow.
Aortic valve regurgitation - The aortic valve doesn't close properly, causing blood to flow backward into the left lower heart chamber (ventricle).
Aortic valve disease may be caused by a heart defect present at birth (congenital heart defect). Other causes of aortic valve disease later in life include:
Diagnostic investigations include – ECG, Echocardiography, Chest Xray, Cardiac CT Scan, Cardiac MRI, Exercise Stress Test, Cardiac Catheterization.
Arrhythmia indicates improper heart beat or rhythm. It may be irregular or too rapid or too slow. When electrical impulses in the heart do not function properly Cardiac Arrhythmia occurs.
Symptoms may include pounding in the chest, chest pain, dizziness or becoming senseless. There may be no apparent symptom also.
It has a number of treatment options such as anti-arrhythmic drugs, implantable devices or surgery.
• Heart attack or scarring from a previous heart attack.
• Blocked arteries in the heart (Coronary Heart Disease)
• Changes in the heart's structure, such as from Cardiomyopathy
• Effects of certain medications
• High blood pressure
• Stress and anxiety
• Hyper or Hypothyroidism
• Sleep Apnea
• Drug abuse
• Infection with COVID-19
• Pounding in the chest
• Rapid heartbeat (tachycardia)
• Slow heartbeat (bradycardia)
• Chest pain
• Shortness of breath
• Light headedness or dizziness
• Fainting (syncope) or near fainting
Complications occur depending on the type of arrhythmia. Usually complications of arrhythmia are stroke, sudden cardiac arrest and heart failure. Heart arrhythmias is responsible for the risk of blood clots which leads to life threatening conditions like stroke. Doctors opt for various treatment methods depending on the complications of the patient,
Methods of Diagnosis
• Electrocardiogram (ECG)
• Holter monitor
• Event recorder
• Implantable loop recorder
Heart arrhythmia treatment is required when irregular heartbeat is causing significant symptoms and the condition is leading the patient to a high risk heart problem. Treatment includes medications, therapies, catheter procedures and Cardiac surgery.
• Medications - Arrhythmia medications depend on the type of arrhythmia and its complications. Anti – Arrhythmic drugs help control the heart rate and restore a normal heart rhythm. Blood thinners are advised to prevent blood clots for patients having Atrial fibrillation.
• Catheter Ablation - is done to block abnormal electrical signals and restore a normal heartbeat.
• Pacemaker - This device is implanted to improve low heartbeat (Bradycardia)
• Implantable Cardioverter-Defibrillator (ICD) - This device is implanted when the patient is at high risk of having a cardiac arrest. The ICD continuously monitors the heart rhythm.
• Age – the risk increases with aging
• Genes – if it is in family history
• Lifestyle – unhealthy food habit, excessive drinking and smoking
• Medical conditions - like diabetes, autoimmune disorders, Thyroid problem to name a few
• Environment – factors like air pollution
To prevent having Arrhythmia one has to eliminate the risk factors from life. A changed life style is very much needed, which should include:
• Eating heart healthy food always
• Discard smoking
• Moderate drinking
• Controlling blood pressure and blood sugar
• Maintain good lipid profile
• No overweight
• Regular exercise
When a person’s heart rate is much slower than normal, it is medically termed as Bradycardia. In Bradycardia the heart beats less than 60 times per minute. Bradycardia is an alarming problem because the heart can't supply adequate blood to the body. As a consequence it can damage the brain and other organs.Bradycardia patient feels easily exhausted, feeble and breathless. A severe Bradycardia patient may require a Pacemaker implant to safeguard his life.
• Tired without exertion
• Loss of memory
• Chest pain
• Loss of consciousness
Why Bradycardia occurs?
• Decay of heart tissues due to age
• Damages of heart Tissues due to heart attack
• In born heart defect
• Inflammation of the heart called myocardia
• Underactive or over active Thyroid
• Effect of certain medications
• Electrolyte imbalance
• Obstructive sleep apnea
Some reasons that adversely affect the heart can escalate the risk of Bradycardia.
• Excessive alcohol intake
• Mental Stress
• Already existing heart disease
• Fainting frequently
• Heart cannot pump blood adequately leading to Congestive heart failure
• Sudden heart attack
• Electrocardiogram (ECG)
• Holter Monitoring
• Cardiac Event Monitoring
• Stress Test
• Electrophysiological test (EP Study)
In mild cases treatment may not be required except close monitoring by the doctor But in severe cases Pacemaker implant would be necessary to give relief and minimize the life risk. Treatment also depends on the type of the cause for which the low heart rate occurs. Sometimes treating the underlying issue like Thyroid or Sleep Apnea can reduce the problem.
Living a healthy life is always advised to prevent any heart problem and Bradycardia is no exception. As certain medications if taken in high dozes, can lead to this particular problem, one should always seek doctor’s advice before taking any medicine. Some of the healthy heart steps include:
• Healthy food habit
• Daily exercise
• No excess weight
• Controlled blood pressure, blood sugar and lipids
• Smoking to be given up
• Alcohol in moderation.
• Stress managed in a healthy way
• Existing heart problems monitored closely
Congenital heart disease indicates birth defects that affect the normal functioning of the heart. Congenital heart disease is one of the most common types of birth defect. There are numerous types of congenital heart defects. It can range from a simple condition that does not cause symptoms to a complex problem that cause life-threatening symptoms. These days with the advanced treatment facilities most of the children with heart defects grow up to lead normal life.
Types of Congenital Heart Disease
Though there are many different types of congenital heart defects, the three main categories are :
• Heart valve defects
• Heart wall defects
• Blood vessel defects
Cyanotic and Acyanotic Congenital Heart Disease
Congenital heart disease has been classified as cyanotic congenital heart disease or acyanotic congenital heart disease. In both types, the heart isn’t pumping blood as efficiently as it should. The main difference is that cyanotic congenital heart disease causes low levels of oxygen in the blood and acyanotic congenital heart disease doesn’t.
Newborns with heart defects may have the following symptoms -
• Bluish lips, skin, fingers, and toes
• Breathlessness or trouble breathing
• Feeding difficulties
• Low birth weight
• Chest pain
• Delayed growth
In some cases, the symptoms appear many years after birth. In such cases symptoms include:
• Abnormal heart rhythms
• Trouble breathing
Congenital heart disease occurs as a result of an early developmental problem in the heart’s structure. The defect typically interferes with the normal flow of blood through the heart, which may affect breathing. Although it is not sure why the heart fails to develop correctly, suspected causes include the following:
• The heart defect in family history
• Mother taking certain prescription drugs during pregnancy
• Mother drinking excessive alcohol or illegal drugs during pregnancy
• Mothers who had a viral infection during the first trimester of pregnancy are more likely to give birth to a child with a heart defect.
• Increased blood sugar levels/ diabetes of the mother
A congenital heart defect is often detected during a pregnancy ultrasound. These may include an echocardiogram, a chest X-ray, or an MRI scan.
The treatment for a congenital heart defect depends on the type and severity of the defect. Some babies have mild heart defects that heal on their own with time. Others may have severe defects that require extensive treatment. In these cases, treatment may include the following:
There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.
Implantable Heart Devices
Some of the complications associated with congenital heart defects can be prevented with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.
Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart.
This surgery may be needed if catheter procedures aren’t enough to repair a congenital heart defect. A surgeon may perform open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.
In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. In this procedure the child’s heart is replaced with a healthy heart from a donor.
Congenital Heart Disease in Adults
Some congenital heart defects don’t show up any symptom until the child becomes an adult, so diagnosis and treatment may be delayed. In these cases, the symptoms of a newly discovered congenital heart defect may include:
• Shortness of breath
• Chest pain
• A reduced ability to exercise
• Being easily fatigued
Treatment for CHD in adults
The treatment for congenital heart disease in adults also varies depending on the severity of the heart defect. Some people may only need to monitor their condition closely, and others may require medications and surgeries.
Treatment in some such cases may not cure the condition, but it can help the patient maintain an active, productive life. It will also reduce the risk for serious complications, such as heart infections, heart failure, and stroke.
How to prevent Congenital Heart Disease ?
Women who are pregnant or plan for a baby can take certain precautions to lower their risk of giving birth to a baby with a congenital heart defect:
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in one’s body, usually in the legs. Deep vein thrombosis can cause leg pain or swelling but also can occur with no symptoms. A person can get DVT if he has certain medical conditions that affect how blood clotting. A blood clot in one’s legs can also happen if one doesn't move for a long time, such as after a surgery / an accident or when one is traveling a long distance, or when on bed rest.
Deep vein thrombosis can be very serious because blood clots in the veins can break loose, travel through the bloodstream and get stuck in one’s lungs, blocking the blood flow (pulmonary embolism). However, pulmonary embolism can occur with no evidence of DVT. When DVT and pulmonary embolism occur together, it's called venous thrombo embolism (VTE).
Many things can increase your risk of developing DVT. The more risk factors you have, the greater your risk of DVT. Risk factors for DVT include:
Complications of DVT can include:
Measures to prevent deep vein thrombosis include the following:
To diagnose DVT, your doctor will ask you about your symptoms. You'll also have a physical exam so that your doctor can check for areas of swelling, tenderness or changes in skin color.
The tests you have depend on whether your doctor thinks you are at a low or a high risk of DVT. Tests used to diagnose or rule out a blood clot include:
There are three main goals to DVT treatment.
DVT treatment options include:
Heart Failure or Congestive Heart Failure is a chronic condition when the heart cannot pump blood properly. Certain heart complications like narrowed arteries (coronary artery disease) or prolonged years of high blood pressure, gradually weaken the heart muscles or make them stiff to function efficiently. Usually Heart Failure is chronic but sometimes it occurs suddenly and with a severity that requires immediate hospitalization for life saving treatment.
Difference between Heart Attack and Heart Failure
There may be a confusion between heart attack and heart failure. Heart Failure is heart’s decreased ability to pump blood properly. But Heart Attack happens suddenly when the blood flow to the heart gets blocked.
Usually Heart Failure patients can live many years with proper treatment and change of life style. But Heart attack needs emergency medical support at the hospital to save life, otherwise it can be fatal.
Heart Failure symptoms
• Shortness of breath even without exertion
• Weakness and tiredness
• Irregular or faster heartbeat
• Lessened capability to exercise normally
• Swollenness in legs and feet
• Sometimes swollen abdomen
• Persistent cough
• Faster weight gain due to fluid accumulation in the body
• Less appetite or nausea
• Less alertness and decreased ability to concentrate
• Chest pain where heart failure is a consequence of heart attack
Why it occurs
Different health complications can damage the heart and lead to heart failure. A single cause or a combination of a few may be responsible.
Acute Heart Failure
Sometimes acute heart failure can occur suddenly which is life threatening and demands immediate hospitalization. It can happen due to the following causes
Risk factors for Heart Failure
A heart failure patient can experience the following complications:
Diagnosis include both physical exam and tests.
To control heart failure symptoms proper medication and life style changes both are required.
Myocarditis is an inflammation of the heart muscle (myocardium). The inflammation reduces the heart's capacity to pump and cause rapid or irregular heart beats (Arrythmia).
Mainly a viral infection in the body, or sometimes bacterial or fungal also can lead to Myocarditis. A severe case can damage the heart. Symptoms include chest pain, abnormal heartbeat and shortness of breath.
Treatment may include medication to regulate the heartbeat and improve heart function. In rare but severe cases, a device may be required to help the heart function.
The symptoms of Myocarditis vary from person to person, depending on the cause Common Myocarditis symptoms include:
The cause of Myocarditis isn't identified. There are many potential causes including the following:
Myocarditis also sometimes occurs for these reasons -
Early diagnosis of Myocarditis is important for preventing major heart damage.
The following Investigations may be ordered:
The treatment options include -
Medication - People with mild Myocarditis may only need rest and medication.
Surgery and devices / procedures – In severe cases of Myocarditis patients may need medications through IV Injections, Ventricular assist devices (VAD), intra-aortic balloon pump and finally Heart Transplant in some cases.
No specific way can be advised to prevent Myocarditis. The following steps to prevent infections might help:
Orthostatic hypotension which is also called postural hypotension, is a sudden drop of blood pressure when one stands up from sitting or lying down. Orthostatic hypotension can make one feel dizzy or lightheaded, and may even cause a person to lose consciousness. Orthostatic hypotension can have causes that aren't due to any underlying disease. Examples include dehydration, standing up too quickly, medication side effects or ageing.
Occasional (acute) Orthostatic hypotension may be mild, and the condition can last for less than a few minutes. But long-lasting or chronic orthostatic hypotension is usually a sign of another health problem, so medical intervention is necessary.
Symptoms usually last for a few minutes.
Orthostatic hypotension occurs when something interrupts the body's natural process of counteracting low blood pressure. Many conditions can cause orthostatic hypotension, including:
Orthostatic hypotension can cause serious complications if it becomes chronic, especially in aged persons. These include:
The investigations for detection include - Blood tests, ECG / EKG, Echocardiogram, Stress test, Tilt table test, Valsava Maneuver to name a few.
The goal of treatment for orthostatic hypotension is to restore normal blood pressure. Treatment often manages the underlying cause for orthostatic hypotension such as dehydration or heart failure. Mild orthostatic hypotension goes away after sitting for a while. When low blood pressure is caused by medications, treatment usually involves changing the doze of the medication or stopping it.
The management of Orthostatic hypotension include:
Pericardial Effusion occurs when there is excessive fluid in the double-layered, saclike structure around the heart (pericardium). The space between these layers contains a thin layer of fluid. But any disease or injury can cause inflammation which may result in accumulation of excess fluid. Fluid can also build up around the heart without inflammation, such as from cancer related bleeding or after a chest trauma.
Pericardial effusion can put pressure on the heart, affecting how the heart works. If untreated, it may lead to heart failure or death in extreme cases.
The following tests may be ordered – ECG/EKG, Echocardiogram, Chest X-ray, CT Scan or MRI.
Treatment for pericardial effusion depends on the following factors:
A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.
Peripheral vascular disease is a sign of fatty deposits and calcium building up in the walls of the arteries (atherosclerosis). Risk factors include ageing, diabetes and smoking.
Symptoms may include leg pain, particularly when walking.
Tobacco cessation, exercise and a healthy diet are often successful treatments. When these changes aren't enough, medication or surgery can help.
Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.
When you develop peripheral artery disease (PAD), your legs or arms — usually your legs — don't receive enough blood flow to keep up with demand. This may cause symptoms, such as leg pain when walking (claudication).
Peripheral artery disease is also likely to be a sign of a buildup of fatty deposits in your arteries (atherosclerosis). This condition may narrow your arteries and reduce blood flow to your legs and, occasionally, your arms.
You often can successfully treat peripheral artery disease by exercising, eating a healthy diet and quitting tobacco in any form.
Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, fatty deposits build up on your artery walls and reduce blood flow.
Although discussions of atherosclerosis usually focus on the heart, the disease can and usually does affect arteries throughout your body. When it occurs in the arteries supplying blood to your limbs, it causes peripheral artery disease.
Less commonly, the cause of peripheral artery disease may be blood vessel inflammation, injury to your limbs, unusual anatomy of your ligaments or muscles, or radiation exposure.
If your peripheral artery disease is caused by a buildup of plaque in your blood vessels, you're also at risk of developing:
In Rheumatic heart disease the heart valves become permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated Streptococcal infection such as strep throat. Rheumatic fever causes inflammation, especially of the heart, blood vessels and joints. Symptoms include fever and painful, tender joints. Signs of heart damage can develop years after the infection and fever are gone.
Rheumatic fever most often affects children and teenagers. It’s more common in low-income or developing parts around the world.
Treatments can reduce damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever.
Rheumatic fever can occur after a throat infection from a bacteria called Group A Streptococcus. Heart valve inflammation from rheumatic fever causes rheumatic heart disease. The damage may occur right away. Or it can develop over time from repeated strep infections. Continuing inflammation leads to heart valve scarring and narrowing. Finally Heart failure may appear.
The goals of treatment for rheumatic fever are to destroy remaining Group A Streptococcal bacteria, relieve symptoms, control inflammation and prevent the condition from returning.
Severe rheumatic heart disease may need heart valve surgery. A surgeon repairs or replaces damaged heart valves.
A very rapid heart beat which is more than 100 beats per minute at resting condition is medically termed as Tachycardia.
Sometimes a fast heart rate may occur not due to any disease, but for the factors like over exertion, anxiety, anger, fear to name a few. But Tachycardia occurs not out of any sudden physical or mental conditions but the heart beats are unusually fast and sometimes irregular. A heart rhythm disorder (Arrhythmia) can cause Tachycardia. This can occur in the heart's lower chambers (ventricles) or in upper chambers (atria). Due to increased beats, the heart cannot function properly.
Tachycardia, in certain cases may not show up any symptoms or complications. But if Tachycardia is not diagnosed and treated in time it may bring about life threatening complications like Stroke, Heart failure or sudden Cardiac Arrest.
Proper treatment helps control Tachycardia and manages the conditions that lead to it.
Various Types of Tachycardia
Tachycardia has different categories. Some of these are as follows:
Atrial fibrillation : It occurs in the upper chambers of the heart (Atria). One of the most common types of Tachycardia. This irregularity brings about fast and feeble contractions of the atria.
Atrial flutter: Atrial flutter indicates quick but orderly heart beats at the heart's Atria. It sometimes go away naturally but in some cases it calls for medical management.
Ventricular Tachycardia : It occurs in the lower chambers of the heart (Ventricles). If Ventricular Tachycardia lasts more than a few seconds it would be life threatening and immediate hospitalization is necessary.
Ventricular fibrillation: It occurs when rapid, disorderly electrical impulses cause the lower heart chambers (ventricles) to quiver. It hinders the blood supply to the body. If the heart cannot come back to normal rhythm within minutes, it would be fatal. It is a medical emergency.
Supraventricular Tachycardia (SVT) It begins in the upper chambers (Ventricles) It is common among children and young people. It may last for a minute to a few hours. In some cases it turns fatal.
Tachycardia may not always show up any symptom. This complication is sometimes detected at the time of check ups like ECG.
Why Tachycardia occurs?
A number of factors can be responsible for accelerated heart rate.
Some factors that increase the risk of Tachycardia include:
Complications vary depending on the type of Tachycardia. Possible complications include:
The following procedures can detect and specify Tachycardia.
The Tachycardia treatment aims at
To control Tachycardia the following treatment options are available:
The best way to prevent Tachycardia is to maintain a heart healthy life style. The patients of heart diseases ,need to follow the treatment protocol strictly to keep away Tachycardia.
The following initiatives can help reduce the risk factors:
Takayasu's Arteritis is a rare form of Vasculitis, which causes blood vessel inflammation. In Takayasu's arteritis the inflammation damages the large artery that carries blood from the heart to the rest of the body. The disease can cause narrowed or blocked arteries, or weakened artery walls that may bulge (aneurysm) and tear. One may develop chest pain, high blood pressure, and eventually heart failure or stroke. Most people with the disease need medications to control inflammation in the arteries and to prevent complications. Relapses are common even with treatment.
The signs and symptoms of Takayasu's Arteritis often occur in two stages.
Stage 1 - In the first stage the following symptoms may occur
Stage 2 - During the second stage, inflammation causes arteries to narrow. Stage 2 symptoms are:
With Takayasu's Arteritis, the aorta and other major arteries, including those leading to head and kidneys, can become inflamed. This inflammation causes thickening, narrowing and scarring in arteries.
No one knows exactly what causes the initial inflammation in Takayasu's Arteritis. The condition is mostly a consequence of autoimmune disease. Takayasu's Arteritis may be triggered also by a virus or other infection.
Treatment options include medications and surgeries like Bypass surgery, Blood vessel widening (percutaneous angioplasty) or Surgical repair or replacement of the aortic valve.
Some babies are born with a rare combination of four heart defects together. It is termed as Tetralogy of Fallot (TOF).
Due to this major defect\ not only the heart’s structure is impaired but it becomes responsible for oxygen-poor blood to flow to the rest of the body. Babies with Tetralogy of Fallot commonly have bluish skin and bluish nails because of the poor flow of oxygen. Tetralogy of Fallot or TOF in short, is usually detected in the infancy. In certain cases depending on the degree of the defects, Tetralogy of Fallot remains undiagnosed till adulthood.
The combination of four defects that form together:
What causes this congenital heart defect?
During pregnancy Tetralogy of Fallot forms in the baby's heart. The exact cause cannot be specified, But there are some risk factors:
Signs of TOF in a baby
Sign of Tet spell
Some TOF babies may suddenly turn blue especially their nails and lips after feeding or crying. This is called Tet spell. Tet spells occur due to a quick drop in the oxygen level in the blood due to their heart’s abnormal functioning. It happens to babies who are 2 to 4 months old.
Some Methods of Diagnosis:
This major birth defect requires corrective Open Heart Surgery. Without surgery it cannot be rectified. The doctor will decide the timing of the surgery based on the baby’s health parameters. Usually TOF Surgery is performed approximately between the baby’s 11 months to 3 years of age.
Short term procedures
Before the main Open Heart Surgery, temporary procedures like intra cardiac repair is done to give immediate relief.
Intracardiac repair involving several repair is usually done during the baby’s first 12 months. Grown ups whose TOF problem remained undetected in childhood may undergo this surgical repair.
Temporary shunt surgery
Sometimes infants have to undergo a palliative surgery before the major for short term relief. This is opted by the doctor in case a baby is prematurely born or has undeveloped (Hypoplastic) pulmonary arteries.
Even after Open Heart Surgery for TOF continuous monitoring and treatment follw up will help the child recover properly and live an active healthy life.
Thrombocytosis is a disorder in which the body produces excessive number of platelets. Large number of platelets can lead to stroke, heart attack or a clot in the blood vessels. Platelets play an important role in the process of forming blood clots.
When thrombocytosis has no underlying condition as a cause, the disorder is called primary thrombocythemia or essential thrombocythemia.
This disease may be detected by a routine blood test that shows a high platelet level. If the blood test indicates thrombocytosis, it's important to determine whether it's reactive thrombocytosis or essential thrombocythemia to decide the treatment options.
People with thrombocytosis usually don't have signs or symptoms. Signs and symptoms of reactive thrombocytosis occur due to an underlying condition.
In the cases of essential thrombocythemia patients might have symptoms related to blood clots and bleeding:
Platelets stick together, helping the blood to form a clot that stops bleeding when there is a blood vessel rapture. Thrombocytosis occurs when the body produces too many platelets.
This is the more common type of thrombocytosis. Usually it occurs due to an underlying condition, like:
The cause of this disorder is not certain, but it is often connected to mutations in a variety of genes. This has a higher risk of clotting or bleeding complications than reactive thrombocytosis.
During a routine check up the doctor might find that the patient’s spleen is enlarged or he has the signs or symptoms of an infection or another condition. In that case doctor might order a complete blood count test. This test can determine whether the platelet count is higher than normal. But a number of conditions can cause a temporary rise in one’s platelet count. So the following investigations might be ordered:
Patients with this condition who do not have any symptoms usually do not require treatment as long as the condition is stable. The doctor might recommend a blood thinner if one is at risk of blood clots like a history of blood clots and bleeding, has risk factors for heart disease, older than sixty years or one’s platelet count is greater than 1 million.
Lifestyle and home remedies
Vasculitis is an inflammation of the blood vessels. It can cause blood vessel walls to thicken and narrow, restricting the blood flow through the vessel and can result in organ and tissue damage. It happens when the body's immune system disorder attacks the blood vessel. It may also happen due to an infection, a medicine reaction, or another disease. Some forms of vasculitis improve on their own. Others require medication.
There are many types of vasculitis, and most of them are rare. Vasculitis might affect just one organ, or several. The condition can be short term or long lasting. Vasculitis can affect anyone, though some types are more common among certain age groups.
If different parts of the body gets affected the following symptoms develop:
The actual cause of Vasculitis is still not clear. Some variants are due to a person's genetic structure. Others result from the immune system problems. Such trigger factors include:
It includes –
Treatment options include medication and surgery depending on the type of Vasculitis and its severity.
Vasovagal Syncope is a quite common occurrence which is usually known as black out. Syncope is the medical term for fainting which can happen by a sudden drop in the blood pressure which reduces blood flow to the brain for a short time. Vasovagal syncope usually is not a life threatening health problem. But in certain cases, though rarely, it can be detrimental.
It affects a number of men and women in various phases of life. But it happens to older people more.
Some Vasovagal Syncope patients have a condition called orthostatic hypotension. This causes blood to accumulate in the legs and leads to a quick drop in blood pressure.
Some of these factors may trigger Vasovagal Syncope
Some investigations are done to confirm that this is not caused by any heart related major problem. These are:
Vasovagal syncope in most of the cases does not require any particular treatment. According to doctor’s advice one has to avoid the reasons that triggers Vasovagal Syncope. But repeated experience of fainting may disrupt the quality of life and one can be at risk of getting badly injured due to sudden fall. The following measures can be opted for:
With the proper diagnosis and treatment, syncope can be managed and controlled.
In order to avoid the experience of Vasovagal Syncope one has to stay away from hot and crowded places and prolonged standing. If one feels unwell while standing one must lie down immediately. For occasional Vasovagal Syncope the lifestyle changes like drinking plenty of liquids will work well.
When the veins usually in legs become swollen, protruding and twisted having blue or deep purple colour, it is called Varicose Veins. This condition occurs when the valves in the veins do not work properly impairing effective blood flow. It mostly occurs in the legs because standing and walking increase the stress on the veins of one’s lower body.
For many people varicose veins does not cause painful symptoms except the cosmetic issue. But many others experience pain and discomfort, sometimes leading to severe complications.
Usually self care measures are adequate but for patients having complications need to opt for other treatment methods like surgically closing or removing varicose veins.
Varicose veins occur when the walls of veins become weakened. As blood pressure in the vein increases, the weakened walls allow the vein to get bigger. As the vein stretches, the valves in the vein can’t work like they used to. Sluggish blood backs up or pools in the vein, causing the vein to swell, bulge and twist.
Vein walls and valves can become weak for several reasons, including:
Aging process which causes wear and tear on the valves in the veins
Complications of varicose veins include:
Improving blood circulation and muscle tone may reduce the risk of developing varicose veins. The following measures can help -
Physical examination by the doctor is most important.
Imaging tests like Ultra Sonograph can give a clear picture
Varicose veins can generally be treated in home care.
Some self-care measures help decrease the discomfort of Varicose Veins symptoms and prevent from getting it worse. These are - exercising, losing weight, not wearing tight clothes, keeping the feet up whenever possible and avoiding prolonged standing or sitting.
Wearing Compression stockings is often found effective. They help the veins and leg muscles move blood more efficiently.
More treatment options
Attendant of PT Bhairab Mahanta, a patient of cardiac arrest talks about his experience at #AMRIHospitalsBhubaneswar. He expresses his satisfaction with the treatment facilities offered by the hospital and the care provided by the staff. The son of Bhairab Mahanta is content with his decision of choosing AMRI Hospitals.
Nawal Kishore Agarwal, a patient of heart disease talks about his overall experience at AMRI Hospitals Saltlake during heart surgery, under the observation of Dr. Sushmit Bhattacharya, He appreciates the staff for taking good care of him and recommends AMRI Hospitals to the patients suffering from heart diseases.
Hear it from Binesha’s Mother, Father & Grandfather about how Dr. Dibya Ranjan Behera (Cardiologist - Adult & Pediatric), Dr. Janaki Ballav Pradhan (MBBS, MD Pediatrics, DM Neonatologist, FIAP) & Dr. Vivek Chowdhury (MD, PDCC, FICCC, FIAE, FIECMO & Head, Cardiac Anaesthesiology & Cardiac Critical Care), for saving their 6 month’s old baby.
by Dr. Jitendra Nath Patnaik, Senior Cardiac Surgeon, AMRI Hospitals Bhubaneswar
Varicose vein is a condition presents as prominent dilated leg veins over single or both legs. Very common now-a-days, associated with prolonged standing, heavy physical work and obese persons. More often neglected and ignored in early stages but may lead to worrisome complications like excessive bleeding and non healing ulcer over leg.
The traditional treatment was surgery, laser ablation and RF ablation.
The latest modality of treatment is Venaseal implant( Glue) injection.
Advantages being Patient can come and go home driving after the procedure . Procedure includes only a small puncture in the leg, No cuts, No anesthesia, No pain, No scar and No Hospital stay. As no scar, cosmetically acceptable for young females. No post procedure medications is required.
This procedure is being done for the First time in Odisha by Our team in AMRI Hospital, Bhubaneswar in a 39 yr old male, He was suffering with a non healing venous ulcer since last few years. Thankful to Dr Vivek, Dr Smruti, Br Anuroop and his team, Technician team Prakash, Srikant for all the support. Special thanks To Medtronics team Dr Jayant and Mr Animesh for technical and logistic support.
Hoping that this should be accepted as common modality of treatment of Varicose vein.
A 53 year old gentleman who was suffering from acute chest pain for about four hours came to AMRI Dhakuria’s Emergency in the midnight.
The ECG showed a massive heart attack. The patient was immediately admitted for a Primary Angioplasty, when an Angiogram revealed a huge blood clot in the arteries of the heart.
The clot was very efficiently removed with the help of Penumbra thrombosuction and the blood flow was restored followed by placing a stent. A precious life was saved in the most rapid process.
The super hero of this rescue operation was Penumbra Device. It is a latest generation instrument to address the challenging medical conditions related to huge clots in the arteries.Penumbra thrombectomy device is a specialized mechanical thrombus aspiration system which consists of a motorized pump and a special type catheter. This system works very effectively in cases of large thrombus (clot) because the specialized catheter disintegrates large
chunk of thrombus into small parts and the mechanical pump aspirates the clot. Generally it is used in large arteries like brain or arteries of legs or in pulmonary arteries. It is not commonly used in coronary arteries,
because CAT catheter may cause damage when rotating in a small sized coronary artery. But with a modified technique our cardiology experts connected normal thrombo aspiration catheter with Penumbra mechanical pump. This leads to outstanding results as the thrombo suction flow improves significantly and the stent insertion becomes
smooth and faster. This technique gave outstanding end result in previous cases too. Cudos to our Cardiology team.
A 78-year-old patient from Paradip, Odisha, underwent successful heart Aortic valve replacement with TAVR (Transcatheter Aortic Valve Replacement) without open- Heart surgery by a team of doctors led by Interventional Cardiologist and structural Heart Disease specialist, Dr J K Padhi, Director, Cardiology, AMRI hospitals Bhubaneswar.
The patient was suffering from Severe Aortic stenosis. Due to the above heart problems, he was finding difficulty in doing his Daily activities and would become short of breath on minimal exertion. The patient was advised Surgical Aortic valve replacement (SAVR). But due to high risk surgery was denied and patient was plan for onsurgical treatment doing TAVR.
He was also hospitalized for heart failure at his home town. Due to the severe narrowing of the Aortic valve, medicines were not working for his disease, and the only treatment offered was valve replacement. Dr Padhi replaced Aortic valve by performing TAVR, non-surgically at AMRI Hospitals Bhubaneswar.
“This transcatheter native Aortic valve replacement now performed worldwide and is the first case in AMRI Hospitals Bhubaneswar. This treatment has brought a new ray of hope for the patient and his family.” Said, Ms Nilanjana Mukherjee, Vice President & Unit Head, AMRI Hospitals Bhubaneswar.
“Aortic stenosis refers to the narrowing of the Aortic valve. Aortic valve is the outflow valve that controls the oxygenated blood flow from the heart to the body.
Narrowing of Aortic valve creates a life-threatening situation called Aortic stenosis and heart failure.”, said Dr. Sidharth Mishra, Medical Superintendent, AMRI Hospitals Bhubaneswar.
The patient was admitted to the hospital with the condition of heart failure, a history of shortness-of-breath, difficulty in walking, and carrying out daily activities.
Traditionally such patients are treated with open-heart surgery.
“Whether TAVR or SAVR is more appropriate for a given individual depends on multiple factors and is discussed with each patient by a heart team comprising of both an interventional cardiologist and a cardiac surgeon. Now-a-days, TAVR is mostly recommended in elderly frail individuals having previous history of heart surgery, brain stroke and comorbid systemic disease involving lungs, liver and kidney.
TAVR when compared to surgery is safer in selected patients.” Said, Dr. J K Padhi, Director, Cardiology, AMRI hospitals Bhubaneswar.
What is TAVR?
Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure to replace the Aortic Valve in patients with diseased Aortic valve. The development TAVR has emerged as a lifeline for patients considered to be inoperable by open heart surgery also called as surgical Aortic Valve Replacement (SAVR).
How to prepare for TAVR
The heart team will access the patient’s general condition through various imaging (TVAR CT protocol / Coronary angiography) and blood tests before TAVR surgery, to confirm the condition of the patient’s lungs and heart. The team will also advise a heart ultrasound to the patient to estimate aortic valve.
How TVR Works?
During TAVR, interventional cardiologist inserted a catheter through a small cut in the skin over the blood vessel in the groin to deliver and implant the artificial valve which anchors over the diseased valve. TAVR procedure typically takes less than one hour and usually done under mild sedation or general anaesthesia.
Recommendations post TAVR recovery
After the procedure, the patient will be transferred to the intensive care unit (ICU), so as to closely monitor the patient for any redness, swelling or bleeding from the groin site. They are prescribed blood thinners during discharge. Most patients go home the next day and are allowed to resume their normal activities.
An elderly man got successful TAVI at AMRI Hospitals Bhubaneswar
An 83-years-old man was admitted with recurrent fainting (loss of consciousness) and breathlessness. On evaluation he was found to have severe calcific aortic stenosis. The treating doctor, Dr. Dibya Ranjan Behera, Cardiologist, AMRI Hospitals Bhubaneswar said, “This is a heart disease where one of the valves, which connect the left ventricle with the aorta was tightly stenosed. In simple words, the exit gate of the left side of heart was almost blocked so that oxygenated blood was unable to go the major blood pipe at the speed which is required. When such patient do slightest exertion blood flow to the brain decreases and he will get fainting attack, which is sometimes deadly. Coronary arteries also got less blood flow and he will get chest pain (angina) and even heart attack. The blood in the lungs get stuck and causes breathlessness.”
This is one of the very fatal (deadly) diseases which should be immediately treated. The treatment is simply replacing the damaged aortic valve called "Aortic Valve Replacement (AVR)". This was usually done by open heart surgery.
He also said, "But in many patients like very elderly, with other severe comorbidities open heart surgery is considered as high risk. Recently with the advancement of science, this procedure can be done by catheter intervention only, without need of open heart surgery. This is called Transcatheter Aortic Valve Implantation/Replacement ( TAVI/ TAVR).
“TAVI has revolutionized modern day cardiac intervention in terms of its usefulness and benefits in elderly high risk patients."
A cardiac team led by Dr. Behera did TAVI successfully using balloon expandable valve- MyVal in this 83-years-old gentleman. Needless to say that he was discharged home within 2 to 3 days of the procedure. Now he was able to do all his works without any symptoms.
The patient and the patient family are very happy and expressed their gratitude to AMRI Hospitals management as well as the treating doctors Dr. Biswajit Mohapatra (CTVS surgeon), Dr. Vivek Chowdhury and Dr B. Rath, Cardiac anesthesiologists and entire Cathlab team, CCU team for this remarkable accomplishment.