Best Cardiologist in Kolkata | Heart Specialist - AMRI Hospital










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Available Diagnostic & Therapeutic Services

  • All kinds of Angiography including Cerebral Angiography
  • All kinds of Angioplasty
  • Balloon Mitral Valvotomy
  • Permanent Pacemaker Implantation
  • Electrophysiology Study with RF Ablation 
  • ICD and CRT Implantation Diagnostic (Non-invasive)
  •  ECG (12-lead, computerized) 
  • Echocardiography (Colour Doppler, trans-oesophageal and 4D) 
  • 64 slice Cardiac CT with Cardiac Angio facility
  •  SPECT CT enabled for Myocardial Perfusion scan
  •  MR Angio facility with TIM-DOT 1.5 MRI machine
  •  TMT • Holter Monitor • Stress Echo
  • Tilt-table test 
  • Preventive cardiology (lifestyle modification, control of risk factors) Therapeutic intervention 
  • Elective Coronary Angioplasty and stent implant
  •  Primary or emergency Coronary Angioplasty (during early hours of Ml)
  • Renal Angioplasty
  • Carotid Angioplasty 
  • Limb artery Angioplasty
  •  Aorta intervention
  •  PTSMA
  • Balloon Valvuloplasty (Mitral, Aortic, Pulmonary, Tricuspid valve ballooning)
  • Device (ASD, VSD, PDA) closure of holes in the heart
  • Acute intervention after birth (TGA, PDA opening)
  •  Closure of abnormal arterial channels in children
  •  Pericardial fluid aspiration

Best Cardiologist in Kolkata & Bhubaneswar

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.

Technology

  • Congenital heart surgery
  •  ASD Closure
  •  VSD Closure
  •  PDA Ligation
  •  BT Shunt
  •  BD Glenn Shunt
  • Fontan's Procedure
  •  TAPVC Repair
  • Total Correction of TOF
  •  Restelli's Procedure
  •  Senning's Operation
  •  Arterial Switch for DTGA
  •  Double Switch for CCTGA
  •  Norwood Procedure
  •  Minimally Invasive Cardiac Surgery Surgical intervention CABG
  •  Off-Pump
  • Multi-Vessel Total Arterial Bypass (LIMA-RIMA Y) Valve surgery
  •  Aortic Valve Replacement/Repair
  •  Mitral Valve Replacement/Repair
  •  Double Valve Replacement
  •  Tricuspid Valve Repair
  •  Stent-less Aortic Valve Replacement
  •  Aortic Root Surgery (Bentalls Operation)
  •  ROSS Procedure Pacing modalities group
  •  Pacemaker implantation (single/dual chamber, bi-ventricular)
  •  A Multi-site pacing
  •  Ablation therapy for SBT, VT, AF, WPW
  •  Stent valve implantation

Our Specialists
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Dr Saumitra Ray
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MD(Cal), FRCP, (Edin), FCSI, FESC, FACC

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Dr MONOTOSH PANJA
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MD (Med), DM (Card), F.I.C.P

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Dr Prakash Kumar Hazra
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MD, DNB, DM

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Dr Raja Ray
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DIP CARD, MD, MRCP, FRCP

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Dr Subhasis RoyChowdhury
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MD, DM(CARDIO)

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Dr Susmit Bhattacharya
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MS, DNB, MCH

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Dr Avishek Saha
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MBBS, DM (Cardio),MD Med (PGI)

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Dr Dhritabrata Das
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MBBS,DCH,DNB(Pal)

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Dr Pradip Bhowmik
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MD (Medicine), DM (Cardiology), MRCP

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Dr Arijit Ghosh
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MD, DM ( Cardio )

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Dr Soumya Kanti Dutta
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MD, DM (Cardiology)

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Dr Vijay Shankar Sharma
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MD, DM (Cardiology)

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Dr Supratip Kundu
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MD, DM (Cardiology)

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Dr Madhumanti Panja
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MD(Medicine), DNB (Cardiology), MNAMS

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Dr Sumanta Chatterjee
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MD. DM (Cardiology)

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Dr Kaushik Mukherjee
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MS (PGIMER Chandigarh), Mch (GB Pant Hospital, Delhi)

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Dr Sudeb Mukherjee
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MD (Gen. Med.), DM (Cardio.)

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Dr SIDDHARTHA MUKHERJEE
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MS, MCh (CVTS), DNB (CVTS)

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Dr Arijit Datta
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MBBS, DMRT,MS(Gen Surgery),DNB(Gen Surgery),FRCS, DNB(CTVS)

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Dr Uttam Kumar Saha
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DCH, MD, DM (Cardio.), FTRI, FACC, FESC

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Dr ARNAB ROY
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MD, DM

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Dr KAJAL GANGULY
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MD , DM

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Dr AMAL KUMAR KHAN
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MD, DM

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Dr ANINDYA SARKAR
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MD,DM (Cardiology)

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Dr. Mainak Mukhopadhyay
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MD (Medicine), MRCP (Ireland), DM (Cardiology)

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Dr. Alok Majumdar
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MD Dip Card,DM(Cardio),FICC,FSCAI(USA),FESC(EUR)

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Dr TANMAY MUKHERJEE
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Dr Amit Bhauwala
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DM (Cardio),MD Med (PGI)

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Dr Sumit Acharyya
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MD, DNB (Cardio)MRCP, MRCPS

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Dr Sandip Sardar
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MS, M.ch (CTVS)

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Dr Santanu Dutta
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MS, M.ch (CTVS)

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Dr Parijat Deb Choudhury
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MD, DNB (Cardio.)

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Dr Soumitra Dey
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MD, DM

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Dr PINKY MISHRA
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Dr Bishnu Prasad Mishra
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Dr MAHESH AGRAWALA
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MD(2000), DM(2008)

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Dr LINGARAJ NATH
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MBBS, MD(1999), DM 2004 MD DM FICC FSCAI FESC

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Dr J K Padhi
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MBBS,MD, DM CMC Vellore, FACC, FSCAI

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Dr Pradyumna Jeh
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Dr Braja Mohan Rath
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Dr Jitendra Nath Patnaik
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MCH

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Dr Biswajeet Mohapatra
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MS (April 2010), M.Ch (CTVS) 2014

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Dr Srikant Mohapatra
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Dr Manoj Kumar Mohapatra
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Dr Chandrabhanu Parija
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MBBS,MS, M. Ch.

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Dr Dibya Ranjan Behera
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Dr Pradeep Kumar Dash
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Dr Binayak Chanda
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MRCS (Glasgow) FRCS Cardiothoracic Surgery (Glasgow

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Diseases & Procedures
Diseases | Procedures
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Reset
A
Aortic aneurysm

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:

  • Abdominal aortic aneurysm
  • Thoracic aortic aneurysm

Causes

Symptoms

Diagnosis

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.
 

Treatment

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.

Prevention

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:

  • Discarding  tobacco products
  • Keeping the blood pressure under control
  • Regular exercise

Controlling cholesterol and fat in one’s diet

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S
Sick sinus syndrome

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. 

Symptoms

Signs and symptoms may include:

  • Extreme tiredness 
  • Dizziness 
  • Losing consciousness 
  • Shortness of breath
  • Chest pain or discomfort
  • Confusion
  • Slower than normal pulse (bradycardia)
  • A sensation of rapid, fluttering heartbeats (palpitations)

Causes

Problems of the sinus node may be due to the following reasons:

  • Age-related wear and tear of heart tissues
  • Heart disease
  • Inflammatory diseases affecting the heart
  • Damage to the sinus node or scarring from heart surgery
  • Medications to treat high blood pressure, including calcium channel blockers and beta blockers
  • Drugs to treat irregular heartbeats (arrhythmias)
  • Some  medications  for Alzheimer's disease 
  • Neuromuscular diseases
  • Obstructive sleep apnea
  • Rare genetic mutations

Risk factors

Common heart disease risk factors may increase the risk of sick sinus syndrome:

  • High blood pressure
  • High cholesterol
  • Obesity  
  • Sedentary life style

Complications

When  the heart's natural pacemaker, that is sinus node isn't working properly, the heart can't work efficiently. This can lead to:

  • Atrial fibrillation, a chaotic rhythm of the upper chambers of the heart
  • Heart failure
  • Stroke
  • Cardiac arrest

Diagnosis

The following tests may be advised by the doctor:

  • ECG
  • Holter monitor
  • Event recorder and  Other monitors
  • Implantable loop recorder

Treatment

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.

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R
Raynaud's disease

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

  1. Primary  Raynaud’s disease –occurs without any co-existing illness and it is often mild.
  2. Secondary Raynaud’s disease – results from another illness like Rheumatoid Arthritis, Lupus etc. It may cause serious health problem.

Symptoms

  • Cold fingers or toes
  • Change of skin colour in response to cold or stress
  • Numb, prickly feeling or stinging pain upon warming or stress relief

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.

Causes

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:

  • Connective tissue diseases
  • Diseases of the arteries
  • Carpal tunnel syndrome
  • Repetitive action or vibration
  • Smoking
  • Injuries to the hands or feet
  • Certain medications

Risk factors

  • More women than men are affected.
  • Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30.
  • Living in colder climates.
  • A first-degree relative - a parent, sibling or child having this condition appears to increase the risk of primary Raynaud's.

Risk factors for secondary Raynaud's include:

  • Associated diseases -  These include existing illnesses  like Scleroderma and Lupus.
  • Certain occupations - These include jobs that cause repetitive trauma, such as operating tools that vibrate.
  • Exposure to certain substances - This includes smoking, taking medications that affect the blood vessels and being exposed to certain chemicals.

Complications

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.

Diagnosis

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:

  • Antinuclear antibodies test
  • Erythrocyte sedimentation rate

Actually,  no one blood test can diagnose Raynaud's, it will depend on patient’s symptoms and medical history.

Treatment

The treatment aims at

  • Reducing the number and severity of attacks
  • Preventing  tissue damage
  • Treating  the underlying condition

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 :

  • Nerve Surgery
  • Chemical Injections

Prevention

  • To put on specially  heavy winter wears for going outdoors in cold weather.  Also use chemical hand warmers. Wear ear pads and a face mask if the tip of one’s nose and the earlobes are sensitive to cold.
  • To warm one’s car. Run your car heater for a few minutes before driving in cold weather.
  • To take precautions indoors. Wear socks. Some people find it helpful to wear mittens and socks to bed during winter.

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M
Myocardial ischemia

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.

Symptoms

  • Neck or jaw pain
  • Chest pain – usually on left side
  • Shoulder or arm pain
  • A fast heartbeat
  • Shortness of breath when you are physically active
  • Nausea and vomiting
  • Sweating
  • Fatigue

Causes

  • Myocardial ischemia occurs when the blood flow through the coronary arteries reduces. The low blood flow also decreases the amount of oxygen in the heart muscle.
  • Myocardial ischemia can develop slowly as arteries become blocked over time. Or it can occur quickly when an artery becomes blocked suddenly.
  • The following conditions can cause myocardial ischemia:
  • Coronary artery disease (atherosclerosis)
  • Blood clot
  • Coronary artery spasm

Diagnosis

  • ECG
  • Echocardiogram
  • Stress test
  • Stress Echocardiogram
  • Nuclear stress test
  • Cardiac CT Scan
  • Angiography

Treatment

  • Medication
  • Including Aspirin, Beta blockers, Calcium Channel blockers
  • Surgery & Procedures
  • Angioplasty and Stenting
  • Coronary Artery Bypass Grafting (CABG)
  • Enhanced external counter pulsation

Prevention and life style modification

  • Giving  up smoking
  • Control underlying health conditions
  • Eating  heart healthy diet
  • Exercise
  • Avoid excess weight
  • Efforts to lower stress level

 

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A
Aortic Stenosis

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.

Symptoms

  • Abnormal heart sound when checked by a stethoscope
  • Palpitations
  • Chest pain (angina) or feeling of tightness
  • Feeling faint or dizzy or fainting with exertion
  • Shortness of breath, especially when one is active
  • Fatigue, especially during times of increased activity
  • Not  eating adequately (mainly children)
  • Not gaining enough weight (mainly in children )

 

Causes

The causes of Aortic Stenosis include:

  • Congenital heart defect
  • Calcium buildup on the valve
  • Rheumatic fever

Risk Factors

  • Ageing
  • Congenital heart disease
  • History of infections that can affect the heart
  • Having cardiovascular risk factors like diabetes, high cholesterol and high blood pressure
  • Chronic kidney disease
  • History of radiation therapy to the chest

Complications

  • Heart failure
  • Stroke
  • Blood clots
  • Bleeding
  • Heart rhythm problems (arrhythmia)
  • Infections that affect the heart, such as endocarditis

Diagnosis

In order to diagnose doctor reviews the symptoms and orders several tests to confirm. It may include the following:

  • Echocardiogram
  • ECG
  • Chest X ray
  • Stress tests
  • CT Scan
  • Cardiac MRI
  • Cardiac Cathetaerization

Treatment

Treatment for aortic valve stenosis depends on the signs and symptoms and the severity of the condition.

Surgery and other procedures

  • Aortic valve repair
  • Balloon valvuloplasty
  • Aortic valve replacement
  • Transcatheter aortic valve replacement (TAVR)

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C
Cardiomyopathy

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.

Symptoms

In the beginning there might be no signs or symptoms. But as the disease advances, signs and symptoms appear.

  • Breathlessness with activity or even at rest
  • Swelling of the legs, ankles and feet
  • Bloating of the abdomen due to fluid buildup
  • Cough while lying down
  • Difficulty lying flat to sleep
  • Fatigue
  • Heartbeats that feel rapid, pounding or fluttering
  • Chest discomfort or pressure
  • Dizziness, lightheadedness and fainting

 

 

 

Causes

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:

  • Hypertension for many years
  • Heart tissue damage due to a heart attack
  • Long-term rapid heart rate
  • Heart valve complications
  • COVID-19 infection
  • Some infections that cause heart inflammation
  • Metabolic disorders like obesity, thyroid disease or diabetes
  • Defficiency of essential vitamins or minerals like Thiamin (vitamin B-1)
  • Pregnancy complications
  • Iron accumulation in heart muscle (hemochromatosis)
  • The growth of tiny lumps of inflammatory cells (granulomas) in any part of the body, including heart and lungs (sarcoidosis)
  • The buildup of abnormal proteins in the organs (amyloidosis)
  • Connective tissue disorders
  • Excessive alcohol drinking over many years
  • Taking cocaine, amphetamines or anabolic steroids
  • After effect of some chemotherapy drugs and radiation to treat cancer

 

Types of Cardiomyopathy

  • Dilated cardiomyopathy – Enlargement of heart’s blood pumping chambers
  • Hypertrophic cardiomyopathy – Thickening of heart muscles
  • Restrictive cardiomyopathy – Heart muscles scars, stiffens or both
  • Arrythmogenic ventricular displesia –Heart’s irregular rhythms
  • Transthyretin amyloid cardiomyopathy(ATTR –CM) – Abnormal Protein build up in heart’s left ventricle
  • Unclassified cardiomyopathy – stress induced or Chemotherapy induced etc.

 

Diagnosis

Detection is usually based on the following investigations:

  • Chest X-ray
  • Echocardiogram
  • ECG
  • Treadmill test
  • Cardiac Cathetarization
  • Cardiac MRI
  • Blood test like checking the blood level of BNP
  • Genetic screening

Treatment

The treatment depends on the types of Cardiomyopathy. The basic aims of cardiomyopathy treatment are :

  • Controlling the signs and symptoms
  • Preventing the condition from worsening
  • Reducing the r risk of complications

Medications

There are different types of medications to treat cardiomyopathy. The medications help to

  • Improve the heart's capacity to pump blood
  • Improve blood flow
  • Lower blood pressure
  • Slow heart rate
  • Remove extra fluid from the body
  • Prevent blood clots

Non surgical procedures

  • Septal ablation
  • Radiofrequency ablation

Surgery and device implants

Various types of devices are surgically implanted in the heart to improve its function and control  the symptoms. It includes -

  • Implantable cardioverter-defibrillator (ICD)
  • Ventricular assist device (VAD)
  • Pacemaker

Types of surgeries include:

  • Septal myectomy -  An  open-heart surgery
  • Heart transplant – at end-stage heart failure

 

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A
Atherosclerosis

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.

Symptoms

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.

  • Atherosclerosis in the arteries leading to kidneys  -  high blood pressure or kidney failure.

Causes

Although the exact cause is unknown, it may develop due to the following reasons:

  • High blood pressure
  • High cholesterol
  • High triglycerides
  • Smoking and other forms of tobacco use
  • Diabetes
  • Obesity – specially abdominal
  • Inflammation from an unknown cause or from diseases such as arthritis, lupus, psoriasis or inflammatory bowel disease

Risk factors

  • High levels of C-reactive protein (CRP), a marker of inflammation
  • Sleep apnea
  • A family history of early heart disease
  • Lack of exercise
  • High alcohol intake
  • Excessive stress
  • An unhealthy diet

Complications

  • Aneurysms
  • Angina
  • Chronic kidney disease
  • Coronary or carotid heart disease
  • Heart attack
  • Heart failure
  • Peripheral artery disease
  • Stroke
  • Unusual heart rhythms

Diagnosis

There are several diagnostic procedures:

  • ECG / EKG
  • Blood tests like diabetes and Lipid profile
  • Exercise stress test
  • Doppler Ultra sound
  • Ankle Brachial Index
  • Angiography
  • CT Scan Magnetic Resonance Angiography
  • Coronary calcium scan

Treatment 

  1. Medications
  2. Procedures and surgery like:
  • Angioplasty and Stenting
  • Endarterectomy – surgical removal of plaques
  • Fibrinolytic therapy 
  • Coronary Artery Bypass Grafting (CABG) surgery

Prevention

Some of these improved life style methods may help:

  • Giving up tobacco use or smoking
  • Abstain from heavy drinking of alcohol
  • Regular exercise
  • Eating healthy diet
  • Control diabetes and Lipid
  • Practice stress relief techniques like meditation
     

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C
Coronary Artery Disease

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.

Symptoms

  • Chest pain
  • Shortness of breath
  • Heart Attack

Causes
Coronary artery disease begins with damage of the arteries which is usually caused by various factors, including:

  • Smoking
  • High blood pressure
  • High cholesterol 
  • Diabetes 
  • Not living an active life

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.
Risk Factors

  • Age
  • Tobacco use
  • Obesity  
  • Less physical activity  
  • High Blood pressure
  • Diabetes
  • High levels of Cholesterol and Triglyceride

Diagnosis

  • ECG
  • Echocardiogram
  • Exercise Stress Test
  • Nuclear Stress Test 
  • Cardiac CT 
  • Cardiac Catheterization and Angiogram

Treatment
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.
Prevantion
The following life style changes can help - 

  • No tobacco use
  • Controlled alcohol intake
  • Controlled diabetes and lipid profile
  • Maintaining healthy weight
  • Heart healthy diet 
  • Moderate exercise
  • Stress management by meditation or Yoga
  • Regular medical check up

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H
Heart Attack

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,

Symptoms
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:

  • Pressure, tightness, pain, or a squeezing sensation in the chest or arms that may spread to neck, jaw or back
  • Nausea, indigestion, heartburn or abdominal pain
  • Shortness of breath
  • Cold sweat
  • Fatigue
  • Lightheadedness or sudden dizziness

Causes
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.
Risk Factors
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.

  • Age
  • Tobacco use
  • Obesity  
  • Less physical activity  
  • High Blood pressure
  • Diabetes
  • High levels of Cholesterol and Triglyceride
  • Family history of heart attack
  • Extreme Stress
  • Autoimmune condition

Diagnosis

  • ECG
  • Echocardiogram
  • Blood tests
  • Cardiac CT or MRI
  • Angiogram

Treatment
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.

Prevention
The following life style changes should be practiced :

  • No tobacco use
  • Controlled alcohol intake
  • Controlled diabetes and lipid profile
  • Maintaining healthy weight
  • Heart healthy diet 
  • Moderate exercise
  • Stress management by meditation or Yoga
  • Regular medical check up

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H
Heart Valve Disease

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.
Symptoms
Some people may not experience any symptom for long time. 

  • Heart murmur when checked by Stethoscope 
  • Chest pain
  • Abdominal swelling 
  • Fatigue
  • Shortness of breath
  • Swelling of ankles and feet
  • Dizziness
  • Fainting
  • Irregular heartbeat

Causes
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:

  • Regurgitation. The valve flaps don't close properly, causing blood to leak backward in your heart. 
  • Stenosis. The valve flaps become thick or stiff resulting in a narrowed valve opening and reduced blood flow. 
  • Atresia. The valve isn't properly formed, and a solid sheet of tissue blocks the blood flow between the heart chambers.

Risk Factors

  • Ageing
  • History of certain infections 
  • History of certain forms of heart disease or heart attack
  • High blood pressure, high cholesterol, diabetes and other heart disease risk factors
  • Heart conditions present at birth (congenital heart disease)

Complications
Heart valve disease can cause many complications like: 

  • Heart failure
  • Stroke
  • Blood clots
  • Heart rhythm abnormalities
  • Death

Diagnosis
Several tests may be prescribed for a diagnosis including: 

  • Chest X Ray
  • ECG
  • Echocardiography
  • Cardiac MRI
  • Stress test
  • Cardiac Catheterization

Treatment
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.
 

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P
Popliteal artery aneurysm

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.
Symptoms

  • Knee pain
  • Lower leg pain
  • Swelling behind the knee
  • Pulsing sensation behind the knee

Causes

  • Wear and tear of the popliteal artery due to repetitive use of the knee joint
  • Clogged arteries (atherosclerosis)
  • High blood pressure
  • Weakening of the artery wall

Risk Factors

  • Ageing
  • High blood pressure 
  • Smoking
  • Narrowing of a heart valve 
  • Having three or more aneurysms anywhere in the body

Diagnosis
Imaging tests like Duplex USG, CT  Angiography or MRI Angiography
Treatment
Depending on the size of the Aneurysm treatment options are monitoring, medication and surgery.
 

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P
Popliteal artery entrapment

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.
Symptoms
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:

  • Cold feet after exercise
  • Tingling or burning in the calf
  • Numbness in the calf area

Cause
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.
Diagnosis

  • Ankle-brachial index (ABI) measurement  
  • Duplex ultrasound of the calf  
  • Magnetic resonance angiography (MRA) 
  • CT angiography 
  • Catheter-based angiography 

Treatment
Surgery is the only way to correct the abnormal calf muscle and free the trapped artery. 
 

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A
Aortic valve disease

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).

Symptoms

  • Heart murmur
  • Chest pain
  • Dizziness
  • Fainting
  • Extreme fatigue
  • Irregular heartbeat
  • Shortness of breath
  • Eating  less (mainly in children with aortic valve stenosis)
  • Not gaining enough weight (mainly in children with aortic valve stenosis)

Causes

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:

  • Age
  • Infections
  • High blood pressure
  • Injury to the heart

Risk Factors

  • Rheumatic fever
  • Inflammation of the lining of the heart's chambers and valves (endocarditis)
  • History of radiation therapy to the chest
  • Other health conditions like Chronic kidney disease or  Lupus

Complications

  • Some complications of aortic valve disease may include:
  • Blood clots
  • Stroke
  • Heart failure
  • Heart rhythm problems (heart arrhythmias)
  • Death due to sudden cardiac arrest

Diagnosis

Diagnostic investigations include – ECG, Echocardiography, Chest Xray, Cardiac CT Scan, Cardiac MRI, Exercise Stress Test, Cardiac Catheterization.

Treatment

  • Treatment for aortic valve disease depends on:
  • The severity (stage) of aortic valve disease
  • Whether the disease is causing symptoms
  • Whether the condition is getting worse
  • The treatment includes medication, surgery, aortic valve repair or replacement.

 

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A
Arrhythmia

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.

Causes

•   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

•   Diabetes

•   High blood pressure

•   Stress and anxiety

•   Hyper or Hypothyroidism

•   Sleep Apnea

•   Drug abuse

•   Alcoholism

•   Infection with COVID-19

Symptoms

•   Pounding in the chest

•   Rapid heartbeat (tachycardia)

•   Slow heartbeat (bradycardia)

•   Chest pain

•   Shortness of breath

•   Anxiety

•   Fatigue

•   Light headedness or dizziness

•   Sweating

•   Fainting (syncope) or near fainting

Complications

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

•   Echocardiogram

•   Implantable loop recorder  

Treatment

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.

Risk factors

•   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

Prevention

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



 

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B
Bradycardia

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.

The signs

•   Breathlessness

•   Tired without exertion

•   Dizziness

•   Loss of memory

•   Weakness

•   Chest pain

•   Confusion

•   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

Risk factors

Some reasons that adversely affect the heart  can escalate the risk of Bradycardia.

•   Aging

•   Smoking

•   Hypertension

•   Excessive alcohol intake

•   Mental Stress

•   Already existing heart disease

Complications

•   Fainting frequently

•   Heart cannot pump blood adequately leading to Congestive heart failure

•   Sudden heart attack

Diagnosis

•   Electrocardiogram (ECG)

•   Echocardiogram

•   Holter Monitoring

•   Cardiac Event Monitoring

•   Stress Test

•   Electrophysiological test  (EP Study)

Treatment

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.

Prevention

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


 

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C
Congenital heart disease

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.

Symptoms

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

•   Dizziness

•   Trouble breathing

•   Fainting

•   Swelling

•   Fatigue

Causes

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

Diagnosis

A congenital heart defect is often detected during a pregnancy ultrasound. These may include an echocardiogram, a chest X-ray, or an MRI scan.

Treatment Options

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:

Medications

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.

Catheter Procedures

Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart.

Open-Heart Surgery

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.

Heart Transplant

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:

  • Talk to the doctor about any prescription or over-the-counter medications before taking it.
  • In case of a diabetic mother blood sugar levels are  to be always under control.
  • If you weren’t vaccinated against rubella, or German measles, avoid exposure to the disease and speak with your doctor about prevention options.
  • If there is a family history of congenital heart defects genetic screening is required. Certain genes may contribute to abnormal heart development.
  • To avoid drinking alcohol and using illegal drugs during pregnancy.

 

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D
Deep Vein Thrombosis

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).

Symptoms

  • Swelling in the affected leg. Rarely, there's swelling in both legs.
  • Pain in the leg. The pain often starts in your calf and can feel like cramping or soreness.
  • Red or discolored skin on the leg.
  • A feeling of warmth in the affected leg.

Causes

  • Anything that prevents your blood from flowing or clotting normally can cause a blood clot.
  • The main causes of DVT are damage to a vein from surgery or trauma and inflammation due to infection or injury.

Risk factors

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:

  • Age.  Being older than 60 increases your risk of DVT, though it can occur at any age.
  • Sitting for long periods of time, such as when driving or flying.  When your legs remain still for hours, your calf muscles don't contract. Muscle contractions normally help blood circulate.
  • Prolonged bed rest, such as during a long hospital stay, or paralysis. Blood clots can form in the calves of your legs if your calf muscles don't move for long periods.
  • Injury or surgery. Injury to your veins or surgery can increase the risk of blood clots.
  • Pregnancy. Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
  • Birth control pills (oral contraceptives) or hormone replacement therapy. Both can increase your blood's ability to clot.
  • Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs.
  • Smoking. Smoking affects blood clotting and circulation, which can increase your risk of DVT.
  • Cancer. Some forms of cancer increase substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots.
  • Heart failure. This increases your risk of DVT and pulmonary embolism. Because people with heart failure have limited heart and lung function, the symptoms caused by even a small pulmonary embolism are more noticeable.
  • Inflammatory bowel disease. Bowel diseases, such as Crohn's disease or ulcerative colitis, increase the risk of DVT.
  • A personal or family history of DVT or PE. If you or someone in your family has had one or both of these, you might be at greater risk of developing DVT.
  • Genetics. Some people inherit genetic risk factors or disorders, such as factor V Leiden, that make their blood clot more easily. An inherited disorder on its own might not cause blood clots unless combined with one or more other risk factors.
  • No known risk factor. Sometimes, a blood clot in a vein can occur with no apparent underlying risk factor. This is called an unprovoked VTE.

Complications

Complications of DVT can include:

  • Pulmonary embolism (PE). PE is a potentially life-threatening complication associated with DVT. It occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lung from another part of your body, usually your leg. It's important to get immediate medical help if you have signs and symptoms of PE. Sudden shortness of breath, chest pain while inhaling or coughing, rapid breathing, rapid pulse, feeling faint or fainting, and coughing up blood may occur with a PE.
  • Postphlebitic syndrome. Damage to your veins from the blood clot reduces blood flow in the affected areas, causing leg pain and swelling, skin discoloration and skin sores.
  • Treatment complications. Complications may result from blood thinners used to treat DVTs. Bleeding (hemorrhage) is a worrisome side effect of blood thinners. It's important to have regular blood tests while taking such medications.

Prevention

Measures to prevent deep vein thrombosis include the following:

  • Avoid sitting still. If you have had surgery or have been on bed rest for other reasons, try to get moving as soon as possible. If you're sitting for a while, don't cross your legs, which can block blood flow. If you're traveling a long distance by car, stop every hour or so and walk around. If you're on a plane, stand or walk occasionally. If you can't do that, exercise your lower legs. Try raising and lowering your heels while keeping your toes on the floor, then raising your toes with your heels on the floor.
  • Don't smoke. Smoking increases your risk of getting DVT.
  • Exercise and manage your weight. Obesity is a risk factor for DVT. Regular exercise lowers your risk of blood clots, which is especially important for people who sit a lot or travel frequently.

Diagnosis

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:

  • D-dimer blood test. D dimer is a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D dimer. A normal result on a D-dimer test often can help rule out PE.
  • Duplex ultrasound. This noninvasive test uses sound waves to create pictures of how blood flows through your veins. It's the standard test for diagnosing DVT. For the test, a technician gently moves a small hand-held device (transducer) on your skin over the body area being studied. Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to check for a new one.
  • Venography. A dye is injected into a large vein in your foot or ankle. An X-ray creates an image of the veins in your legs and feet, to look for clots. The test is invasive, so it's rarely performed. Other tests, such as ultrasound, often are done first.
  • Magnetic resonance imaging (MRI) scan. This test may be done to diagnose DVT in veins of the abdomen.

Treatment

 There are three main goals to DVT treatment.

  • Prevent the clot from getting bigger.
  • Prevent the clot from breaking loose and traveling to the lungs.
  • Reduce your chances of another DVT.

DVT treatment options include:

  • Blood thinners. DVT is most commonly treated with anticoagulants, also called blood thinners. These drugs don't break up existing blood clots, but they can prevent clots from getting bigger and reduce your risk of developing more clots. Blood thinners may be taken by mouth or given by IV or an injection under the skin. Heparin is typically given by IV. The most commonly used injectable blood thinners for DVT are enoxaparin (Lovenox) and fondaparinux (Arixtra). After taking an injectable blood thinner for a few days, your doctor may switch you to a pill. Examples of blood thinners that you swallow include warfarin (Jantoven) and dabigatran (Pradaxa). Certain blood thinners do not need to be given first with IV or injection. These drugs are rivaroxaban (Xarelto), apixaban (Eliquis) or edoxaban (Savaysa). They can be started immediately after diagnosis. You might need to take blood thinner pills for three months or longer. It's important to take them exactly as prescribed to prevent serious side effects. If you take warfarin, you'll need regular blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
  • Clot busters. Also called thrombolytics, these drugs might be prescribed if you have a more serious type of DVT or PE, or if other medications aren't working. These drugs are given either by IV or through a tube (catheter) placed directly into the clot. Clot busters can cause serious bleeding, so they're usually only used for people with severe blood clots.
  • Filters. If you can't take medicines to thin your blood, you might have a filter inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.
  • Compression stockings. These special knee socks reduce the chances that your blood will pool and clot. To help prevent swelling associated with deep vein thrombosis, wear them on your legs from your feet to about the level of your knees. You should wear these stockings during the day for at least two years, if possible.

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H
Heart Failure

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.

  • Coronary  Artery  Disease : It’s one of the most common reason. Narrowed arteries due to accumulation of plaques (fatty deposits) is a constraint for heart's normal functioning and leads to weakening of heart muscles.
  • Heart  Attack :  A  sudden heart attack is a form of coronary artery disease  and damages  heart muscle. As a result the heart cannot pump perfectly as before.
  • High blood pressure : For a high blood pressure patient the heart has to work harder. This  extra exertion over a prolonged period becomes a risk factor.
  • Dysfunction of Heart Valves : Improper functioning of  heart valves arising out of many reasons makes the heart to work harder and increases the risk of heart failure.
  • Congenital Heart Disease: Some people are born with heart defects that affect the proper functioning of their heart and can lead to heart failure in later years.
  • Damage of  the heart muscle: Heart muscle damage can be caused by  many reasons. including  some infection, excessive alcohol intake, and the side effect of  certain drugs like Chemotherapy medicines.
  • Arrhythmia (Abnormal heart rhythms):  If the heart always  beats faster than normal or irregularly,  it is an over exercise for the heart and can lead to heart failure.
  • Long standing health issues — Some long standing health issues like Diabetes, HIV, Hyper or Hypo Thyroid, may lead to heart failure.

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

  • Blood clots blocking the artery
  • Severe infections that attack heart muscles like Covid 19 virus
  • Internal Allergy
  • Side effect of certain medicines
  • A  disease that affects the entire body

Risk factors for Heart Failure

  • Diabetes  
  • Uncontolled Lifestyle including unhealthy food habit or no exercise
  • Smoking
  • Obesity
  • Certain infections causing  damage to the heart muscle.
  • Effects of some medications like Non Steroidal Anti –Inflammatory drugs (NSAID), Blood Pressure,  Nervous system disease, or Cancer medicines.

Complications

A heart failure patient can experience the following complications:

  • Kidney damage or failure - Heart failure decreases the blood flow to the kidneys, which may lead to  potential kidney damage.
  • Liver damage - Heart failure that leads to fluid accumulation which becomes a factor for liver damage.
  • Valve complications – For excessive pressure on the heart arising out of heart failure the Valves in the heart cannot work properly.

Diagnosis

Diagnosis include both physical exam and tests.

  • ECG (Electrocardiography)
  • BNP (Brain Natriuretic Peptide ) or N-terminal pro-BNP (NT-proBNP) blood tests. A heart failure patient’s BNP or NT-proBNP level is high.
  • Chest Xray
  • Echo Cardiogram
  • Stress Test/ Treadmill
  • Angiography

Treatment

To control heart failure symptoms proper medication and life style changes both are required.

  • Medications as prescribed by the Cardiologist.
  • The treatment may also include Implant of devices like Defribilator, Ventricular Assist Device (VAD),Cardiac resynchronization therapy (CRT) and in extreme cases Heart Transplant depending on many other parameters.

Lifestyle improvment

  • Quitting tobacco and  smoking
  • Getting rid of extra weight
  • Discarding or minimizing Caffeine intake
  • Always eating heart healthy diet
  • Regular Exercise
  • Practicing stress management   with Yoga, meditation, music therapy
  • Proper control of high blood pressure  and blood sugar
  • Availing Counselor’s  help to reduce stress
  • Getting enough Sleep
  • Getting vaccinated for viral diseases like Pneumonia



 



 

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M
Myocarditis

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.

Symptoms

The symptoms of Myocarditis vary from person to person, depending on the cause Common Myocarditis symptoms include:

  • Chest pain
  • Rapid or irregular heartbeat (arrhythmias)
  • Shortness of breath even while in rest
  • Fluid buildup with swelling of the legs, ankles and feet
  • Fatigue
  • Other signs and symptoms of a viral infection such as a headache, body aches, joint pain, fever, a sore throat or diarrhea.

Cause

 

The cause of Myocarditis isn't identified. There are many potential causes including the following:

  • Viruses
  • Bacteria
  • Parasites
  • Fung

Myocarditis also sometimes occurs for these reasons -

  • Medications or illegal drugs that might cause an allergic or toxic reaction
  • Exposure to Chemicals or radiation
  • Underlying  diseases like Lupus

Diagnosis

Early diagnosis of Myocarditis is important for preventing major heart damage.

The following Investigations may be ordered:

  • ECG or EKG
  • Chest X-ray
  • Cardiac MRI
  •  Echocardiogram.
  •  Blood tests
  •  Cardiac catheterization and heart muscle biopsy

Treatment

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.

Prevention

No specific way can be advised to prevent Myocarditis. The following steps to prevent infections might help:

  • Avoid people who have a viral or flu-like illness until they've recovered.
  • Follow good hygiene.
  • Avoid the risk of getting an HIV-related myocardial infection
  • Minimize exposure to ticks. .
  • Stay up to date on the recommended vaccines.

 

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O
Orthostatic Hypotension

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

Symptoms usually last  for a few minutes.

  • Lightheadedness or dizziness upon standing
  • Blurry vision
  • Weakness
  • Fainting (syncope)
  • Confusion
  • Nausea

Causes

Orthostatic hypotension occurs when something interrupts the body's natural process of counteracting low blood pressure. Many conditions can cause orthostatic hypotension, including:

  • Dehydration
  • Heart problems
  • Endocrine problems
  • Nervous system disorders

Risk  Factors

  • Age
  • Reactions of some medications
  • Certain diseases
  • Long bed rest
  • Exposure to extreme heat
  • Alcohol
  • Pregnancy

Complications

Orthostatic hypotension can cause serious complications if it becomes chronic, especially in aged persons. These include:

  • Sudden fall
  • Stroke
  • Heart diseases

Diagnosis

The investigations for detection include  - Blood tests, ECG / EKG, Echocardiogram, Stress test, Tilt table test, Valsava Maneuver to name a few.

Treatment

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:

  • Lifestyle changes
  • Medications
  • Compression stockings


 

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Pericardial Effusion

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.

Symptoms

  • Shortness of breath
  • Discomfort in breathing even while lying down
  • Chest pain
  • Feeling of fullness in chest
  • Lightheadedness or fainting
  • Swelling in the abdomen or legs

Causes

  • Autoimmune disorders like rheumatoid arthritis or lupus
  • Cancer of the heart or pericardium
  • Spread of cancer (metastasis), particularly lung cancer, breast cancer or Hodgkin's lymphoma
  • Radiation therapy for cancer if the heart was in the area of the radiation
  • Chest trauma
  • Inflammation of the pericardium following a heart attack or after heart surgery or a procedure where the heart's lining is injured
  • Underactive thyroid (hypothyroidism)
  • Use of certain drugs or exposure to toxins
  • Viral, bacterial, fungal or parasitic infections
  • Waste products in the blood due to kidney failure (uremia)

Diagnosis

The following tests may be ordered – ECG/EKG, Echocardiogram, Chest X-ray, CT Scan or MRI.

Treatment

Treatment for pericardial effusion depends on the following factors:

  • Amount of fluid buildup
  • Cause of pericardial effusion
  • The presence or risk of cardiac tamponade
  • The treatment options include medication, surgery like open heart surgery to repair any damage or removal of Pericardium (Pericardiectomy) and procedures like Fluid drainage (Pericardiocentesis).


 

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Peripheral Artery disease

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.

Symptoms

  • Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other side
  • Sores on your toes, feet or legs that won't heal
  • A change in the color of your legs
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • Shiny skin on your legs
  • No pulse or a weak pulse in your legs or feet
  • Erectile dysfunction in men
  • Pain when using your arms, such as aching and cramping when knitting, writing or doing other manual tasks

Causes

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.

Risk Factors

  • Smoking
  • Diabetes
  • Obesity (a body mass index over 30)
  • High blood pressure
  • High cholesterol
  • Increasing age, especially after age 65 or after 50 if you have risk factors for atherosclerosis
  • A family history of peripheral artery disease, heart disease or stroke
  • High levels of homocysteine, an amino acid that helps your body make protein and to build and maintain tissue

Complictions

If your peripheral artery disease is caused by a buildup of plaque in your blood vessels, you're also at risk of developing:

  • Critical limb ischemia. This condition begins as open sores that don't heal, an injury, or an infection of your feet or legs. Critical limb ischemia occurs when the injuries or infections progress and cause tissue death, sometimes requiring amputation of the affected limb.
  • Stroke and heart attack. The atherosclerosis that causes the signs and symptoms of peripheral artery disease isn't limited to your legs. Fat deposits also build up in arteries supplying blood to your heart and brain.

 

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Rheumatic heart disease

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.

Symptoms

  • Fever
  • Painful and tender joints  including knees, ankles, elbows and wrists
  • Red, hot or swollen joints
  • Small, painless bumps beneath the skin
  • Chest pain
  • Heart murmur
  • Fatigue
  • Flat or slightly raised, painless rash
  • Jerky, uncontrollable body movements (Sydenham chorea) most often in the hands, feet and face
  • Outbursts of unusual behavior, such as crying or inappropriate laughing, that is associated with Sydenham chorea

Causes

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.

Risk factors

  • Family history
  • Type of strep bacteria
  •  Environmental factors
  • Complications
  • Narrowing of the valve
  •  Leak in the valve
  • Damage to heart muscle

Diagnosis

  • Other than reviewing the patient’s medical history and physical examination, the following tests may be ordered :
  • Specific Blood tests
  • ECG
  • Echocardiogram

Treatment

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.

Medications

  • Antibiotics
  • Anti-inflammatory treatment
  • Anticonvulsant medications.

Surgery

Severe rheumatic heart disease may need heart valve surgery. A surgeon repairs or replaces damaged heart valves.






 

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Tachycardia

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.

Symptoms

  • Shortness of breath
  • Palpitation
  • Chest pain
  • Lightheadedness
  • Dizziness
  • Irregular heartbeat
  • Fainting

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.

  • Anemia
  • Side effect of any medication
  • Heart-health issues like Hypertension, Coronary  Artery Disease or Congestive Heart Failure
  • Imbalance of electrolytes,
  • Medical conditions like overactive thyroid (hyperthyroidism)
  • Excessive alcohol intake
  • Sudden stress and anxiety
  • Fever
  • Smoking

Risk factors

Some factors that increase the risk of Tachycardia  include:

  • Heart disease
  • Diabetes
  • Anaemia
  • Excessive drinking
  • Heavy caffeine use
  • High blood pressure
  • Overactive or underactive thyroid
  • Mental stress or anxiety
  • Sleep apnea
  • Smoking
  • Taking stimulant drugs

Complications

 Complications vary depending  on the type of Tachycardia. Possible complications include:

  • Blood clots that can lead to a stroke or heart attack
  • Chronic Heart Failure
  • Frequent fainting
  • Sudden death,

Diagnosis

The following procedures can detect and specify Tachycardia.

  • Electrocardiogram (ECG)
  • Echocardiogram
  • imaging tests like Chest X-ray, MRI, CT scan
  • Holter Monitoring
  • Cardiac Event Monitoring
  • Stress Test
  • Electrophysiological test  (EPStudy)
  • Coronary Angiogram

Treatment

The Tachycardia treatment aims at

  • Decreasing rapid heart beats
  • Minimizing related complications
  • Controlling  associated factors causing Tachycardia
  • Preventing   repeated episodes

Treatment options

To control Tachycardia the following treatment options are available:

  • Catheter Ablation -  It is a non surgical procedure to bring relief.
  • Medications - Medicines that control rapid heart beat.
  • Pacemaker - It is a small device implanted surgically in the chest to help normalize the heart rate.
  • Cardioverter - Defibrillator (ICD) - This is surgically inserted in the patient’s chest. It helps in restoring normal heart rate.
  • Surgery-  In a few rare cases Open-heart surgery may be the only optiob.

Prevention

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:

  • Regular Exercise
  • Always eating healthy diet
  • No over weight
  • Controlled blood pressure, blood sugar and Lipid levels like cholesterol
  • Giving up smoking
  •  No excessive drinking
  • Not to use stimulants, such as cocaine.
  • No over-the-counter medicines without consultation with doctor
  •  Limit drinking caffeinated beverages like coffee
  • Stress needs to be managed in a healthy way like meditation
  • Regular health checkups


 

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Takayasu's Arteritis

 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.

Symptoms

The signs and symptoms of Takayasu's Arteritis often occur in two stages.

Stage 1  - In the first stage the following symptoms may occur

  • Fatigue
  • Weight loss
  • Pains in muscles and joints
  • Low grade fever  - sometimes accompanied by night sweats

Stage  2 - During the second stage, inflammation causes arteries to narrow. Stage 2 symptoms are:

  • Weakness or pain in limbs
  • A weak pulse
  • Lightheadedness, dizziness or fainting
  • Headaches or vision problems
  • Memory problems or trouble thinking
  • Chest pain and  breathlessness
  • High blood pressure
  • Diarrhea or blood in the stool

Causes

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.

Complications

  • Hardening and narrowing of blood vessels
  • High blood pressure
  • Inflammation of the heart
  • Heart failure
  • Stroke
  • Transient ischemic attack (TIA)
  • Aneurysm in the aorta
  • Heart attack

Diagnosis

  • Blood tests
  • Imaging tests to get the blood vessel images like Angiography, Magnetic Resonance Angiography, CTAngiography, Doppler Ultrasound, PET.

Treatment

Treatment options include medications and surgeries like Bypass surgery, Blood vessel widening (percutaneous angioplasty) or Surgical repair or replacement of the aortic valve.


 

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Tetralogy of Fallot (TOF)

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:

  • Ventricular Septral Defect (VSD) Between the right and left chambers of the heart there is a hole.
  • Overriding Aorta –In normal heart the aortic valve arises out of left ventricle, which in this case arise wrongly from the both right and left ventricles and is enlarged.
  •  Pulmonary Valve Stenosis – Due to narrowing of the Pulmonary Valve the blood flow from the right ventricle to the pulmonary artery is reduced. Sometimes pulmonary valve is not formed perfectly.
  • Right Ventricular Hypertrophy − Since the right ventricle is over exerted it causes thickening of the muscular walls of the right ventricle. It makes the heart stiff and weak.

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:

  • Mother’s Viral illness during pregnancy
  • Alcoholism in mother
  • A family history of congenital heart defect
  • Poor nutrition during pregnancy
  • Pregnancy at older age

Signs of TOF in a baby

  • Breathing difficulty
  • Bluish skin and nails
  • Heart murmur
  • Low weight gain
  • Very feeble
  • Prolonged crying
  • Irritability  
  • Seizure

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:

  • Oxygen level measurement (Pulse Oxymeter)
  • Chest Xray
  • ECG
  • Echcardiogram
  • Cardiac Catheterization

Treatment

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

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.

Continuous Care

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.











 

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Thrombocytosis

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.

Symptoms

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:

  • Headache
  • Dizziness or lightheadedness
  • Chest pain
  • Weakness
  • Numbness or tingling of the hands and feet

Causes

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.

Types

Reactive thrombocytosis

This is the more common type of thrombocytosis. Usually it occurs due to an underlying condition, like:

  • Acute bleeding and blood loss
  • Cancer
  • Infections
  • Iron deficiency
  • Removal of spleen
  • Hemolytic anemia — a type of anemia in which the body destroys red blood cells faster than it produces them, often due to autoimmune disorders.
  • Inflammatory disorders, such as rheumatoid arthritis, sarcoidosis or inflammatory bowel disease
  • Surgery or other type of trauma

Essential thrombocythemia

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.

Diagnosis

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:

  • Abnormal levels of iron in the blood
  • Markers of inflammation
  • Undiagnosed cancer
  • Associated gene mutations

Treatment

Reactive thrombocytosis

  • Treatment for this condition depends on the causes.
  • The elevated platelet count might resolve on its own If the patient has significant blood loss from a recent surgery or injury.
  • Due to a chronic infection or an inflammatory disease the platelet count may remain high until the condition is under control.
  • After one’s spleen is removed (splenectomy), the patient may have lifelong thrombocytosis.

Essential thrombocythemia

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.

Prevention

Lifestyle and home remedies

  1. Healthy diet  - containing  whole grains, vegetables and fruits, low in saturated fats.
  2. Enhanced physical activity. At least 30 minutes of moderate physical activity per day.
  3. Stop smoking because smoking  increases the risk of blood clots.


 

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Vasculitis

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.

Symptoms

  • Fever
  • Headache
  • Fatigue
  • Weight loss
  • General aches and pains

 

If different parts of the body gets affected the following symptoms develop:

  1. Digestive system - One  may experience pain after eating. AlsoUlcers and blood in stool.
  2. Ears  - Dizziness, ringing in the ears and abrupt hearing loss.
  3. Eyes - It can make the eyes look red and itchy.
  4. Hands or feet -  It  can cause numbness or weakness or swelling in hands or feet.
  5. Lungs - It may cause shortness of breath.
  6.  Skin - Bleeding under the skin can show up as red spots. It also causes lumps or open sores on skin.

Causes

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:

  • Infections, such as hepatitis B and hepatitis C
  • Blood cancers
  • Diseases of  immune system like rheumatoid arthritis, lupus and scleroderma
  • Certain drug reactions

Complications

  • Vasculitis complications depend on the type and severity of one’s  condition. Some of these are –
  • Organ damage
  • Blood clots and aneurysms
  • Vision loss
  • Infections

Diagnosis

It includes –

  • Blood test such as anti-neutrophil cytoplasmic antibody (ANCA) test
  • Imaging tests like CT Scan, MRI or PET CT
  • Angiography for the status of the blood vessels
  • Biopsy

Treatment

Treatment options include medication and surgery depending on the type of Vasculitis and its severity.

 

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Vasovagal Syncope

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.

Causes

Some of these factors may  trigger Vasovagal Syncope

  • Extreme emotional stress
  • Anxiety
  • Dehydration
  • Not eating for a long time
  • Use of alcohol or drugs

Symptoms

  • Lightheadedness
  • Dizziness
  • Drowsiness
  • Headaches
  • Sudden blackout
  • Weakness
  • Feeling too weak to continue standing
  • Some people who experienced it before can  feel that this condition is going to occur.. These are premonitory symptoms  like feeling lightheadedness , mild nausea palpitations, sweating to name a few. If one lies down or sit comfortably it can save him/her from fainting or falling down.

Diagnosis

Some investigations are done to confirm that  this is not caused by any heart related major problem. These are:

  • Electrocardiogram
  • Echocardiogram
  • Exercise stress test
  • Blood tests
  • Tilt table test

Treatment

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:

Medications

  • Surgery – In some very rare cases when other options do not help , a Pacemaker implant might give relief.
  • Therapies -  to stop the accumulation of  blood in your legs while standing.. These may include foot exercises, compression stockings when standing. To name a few.
  • Precautionary measures - like not to keep on standing for long time. Never to get dehydrated.

Prevention

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.



 

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Varicose veins

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.

Symptoms

  • Veins that turn dark purple or blue
  • Veins looking twisted and protruding
  • Pain and heavy feeling in the legs
  • Burning sensation, muscle cramps and swelling below the knees
  • Pain aggravates after prolonged sitting and standing
  • Itching
  • Skin discoloration around a varicose vein

Causes

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.

Risk factors

Vein walls and valves can become weak for several reasons, including:

Aging process which causes wear and tear on the valves in the veins

  • Hormones
  • Family history
  • Tight clothing
  •  Obesity
  • Pressure inside the vein due to standing for long periods.

Complications

Complications of varicose veins  include:

  1. Ulcers - Painful ulcers may form on the skin near varicose veins, particularly near the ankles. A discolored spot on the skin appears before an ulcer forms.
  2. Blood clots - Occasionally, a blood clot, medically termed as thrombophlebitis can form in the veins deep within the leg. The affected leg may become painful and swollen.
  3. Bleeding – In some cases veins very close to the skin may rapture which will cause bleeding and  requires immediate medical attention.

Prevention

Improving blood circulation and muscle tone may reduce the risk of developing varicose veins. The following measures can help -

  • Exercising
  • Reducing weight
  • Eating a high-fiber and low-salt diet
  • Avoiding high heels and tight hosiery
  • Changing the sitting or standing position repeatedly

Diagnosis

Physical examination by the doctor is most important.

Imaging tests like Ultra Sonograph can give a clear picture


Treatment

Varicose veins can generally be treated in home care.

Self-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.

Compression stockings

Wearing Compression stockings is often found effective. They help the veins and leg muscles move blood more efficiently.

More treatment options

  • Sclerotherapy -  Injections to close the varicose veins.
  • Laser treatment -  Laser treatment is applied to close off smaller varicose veins. No incisions or needles are used.
  • Catheter-assisted procedures using radiofrequency or laser energy -  This procedure,  which is a preferred method for larger varicose veins,  completely shuts and destroys the vein.
  • Ambulatory phlebectomy – An out patient procedure to remove smaller varicose veins through a series of tiny skin punctures. Scarring is minimal.
  • Endoscopic vein surgery – This surgery is required in advanced cases involving leg ulcers.

 

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Stories of grit & miracles
Stories of grit & miracles
Endoscopic Vain Harvesting Bypass surgery

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.

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