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Chronic Obstructive Pulmonary Disease. Copd

Chronic Obstructive Pulmonary Disease. Copd

Plan of Attack
Goals of Management
Managing Stable COPD
Managing Acute Exacerbations of COPD

A disease state characterized by airflow limitation that is not fully reversible. Airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Symptoms, functional abnormalities, and complications of COPD can all be explained on the basis of this underlying inflammation and the resulting pathology.
Chronic Bronchitis (clinical)
Sputum production more days than not for at least 3 months a year for at least 2 years
Emphysema (pathologic)
Parenchymal destruction airspace walls distal to terminal bronchioles, without fibrosis
Important: You can have either, but to have COPD you MUST demonstrate obstruction (thus the O in COPD)

Fourth leading cause of death in U.S.
100,000 American deaths each year
15-20% of chronic smokers develop COPD
2.5% mortality for COPD hospital admissions
COPD with acute respiratory failure:
24% in hospital mortality
59% one year mortality
If you have COPD and PaCO2 > 50mmHg:
67% chance of being alive in 6 months
57% chance of being alive in 12 months

Sputum production (especially in the morning)
Recurrent acute chest illnesses
Headache in the morning possible hypercapnia
Cor pulmonale (Right heart failure)

Goals Of Management
Identifying and ameliorating (if possible) the cause of the acute exacerbation
Optimizing lung function by administering bronchodilators and other pharmacotherapy
Assuring adequate oxygenation and secretion clearance
Averting the need for intubation, if possible
Preventing complications of immobility, such as thromboemboli and deconditioning
Addressing nutritional needs at the time of the acute illness, most patients are in negative nitrogen balance, which is exacerbated by steroid therapy

Prolonged expiratory time
Expiratory wheezes
Increased AP diameter of chest
Decreased breath sounds (especially upper lung fields)
Distant heart sounds
End stage: accessory muscles, pursed lip breathing, cyanosis, enlarged liver and pedal edema (in case of cor pulmonale).

Chest X-ray
Hyperinflated lung fields more radiolucent
Bullae, often bilateral upper lobes in smokers
Flat diaphragms (best seen on lateral) and retrosternal airspace can indicate air trapping
High Resolution CT of Chest
Most sensitive to detect above changes
No role in routine care of COPD patients
Can be useful for giant bullous disease surgeries or lung volume reduction surgery planning

Pulmonary Function Testing
Spirometry: Decreased FEV1/FVC
FEV1 percent predicted defines severity
Lung volumes: Increased TLC, RV, RV/TLC
DLCO: Decreased

Gold Staging Criteria
Stage O: Normal spirometry; chronic sx
Stage 1 (Mild):
FEV1/FVC 80% predicted
Stage 2 (Moderate):
2A: FEV1 50-80% predicted
2B: FEV1 30-50% predicted

Stage 3 (severe):

American Thoracic Society Spirometry
Low FEV1/FVC defines obstruction
FEV1%predicted Category

35-50% Severe
50-60% Moderately Severe
60-70% Moderate
70-80% Mild
80-100% Mild vs. Normal variant
> 100% Normal

Managing Stable COPD
Smoking Cessation Is KEY!
YOUR intervention will make a difference must address at each visit
Two therapies ONLY have been shown to improve mortality in stable COPD:
1) Smoking Cessation
2) Oxygen Therapy

Bronchodilator Technique
MDIs get better drug deposition than nebs
Use a spacer device with MDIs
Technique is key important for patient and doctor
Inadequate dosing can hamper treatment

Beta-2 selectivity is good
Some additive vs. slightly synergistic effects of combining beta-2 agonist and ipratropium (Combivent)
Some data to support decreased H.influenzae pneumonia incidence with Serevent
Anticholinergic Agents (Atrovent, glycopyrrolate)
Similar ability to bronchodilate (in appropriate doses) as beta-agonists
Also reduces sputum volume; no change in viscosity
Usually under dosed
Recommend 2 (36 mcg) puffs qid
glycopyrrolate which is manufactured for IV/IM use for other indications, is available only “off label” for nebulized use in COPD (1 to 2 mg every two to four hours).
Aminophylline and theophylline are not recommended for the management of acute exacerbations of COPD. Randomized controlled trials of intravenous aminophylline in this setting have failed to show efficacy in excess of that afforded by therapy with inhaled bronchodilators and corticosteroids

Mucokinetic agents
There is little evidence supporting the use of mucokinetic (mucolytic) agents, such as N-acetylcysteine or iodide preparations, in acute exacerbations of COPD. In fact, some drugs of this class may worsen bronchospasm.

Oxygen. Yes.
Demonstrated to improve exercise performance, symptom indices and mortality
Goal in hypercapnic patients for SpO2 need not be greater than 88-90%
Always test COPD patients for oxygenation with ambulation if baseline at rest room air SpO2 ok

Systemic Corticosteroids
Never demonstrated to significantly impact mortality or exercise capacity
Slight improvements in symptom indices
Significant side effects
Rarely of benefit, generally of harm to your patient
Occasionally useful in a small subset failing other therapies AND with demonstrated bronchodilator response on PFTs

Inhaled Corticosteroids
Jury still out
Lots of recent research with some favorable data supporting its use
May be part of standard regimens in the future

Pneumovax, annual flu shots
Chronic antibiotic therapy BAD IDEA
Nutritional status Important
Pulmonary Rehabilitation
Improved exercise capacity, symptom scores
Lung Volume Reduction Surgery

Managing Acute Exacerbations of COPD
Common precipitants:
Infection esp viral or bacterial
Acute bronchospasm

Who To Admit
Countless studies, few definite answers
Worsening hypoxemia and/or hypercapnia
Otherwise, mostly a clinical decision
Key points to consider:

Neb or MDI neb MAY be better in acute setting, but MDIs have better drug deposition overall
Continuous nebulizer treatments confer no benefit over treatments every 1-2 hours
Generally should avoid subcutaneous beta-agonists
BEWARE: Hypokalemia, tachycardia (occasional)
Levalbuterol still with weak clinical data few situations where it is clinically indicated

ATROVENT (anticholinergic bronchodilator)
May decrease secretions
Few significant side effects
Usually significantly under dosed emerging data supports much higher doses than usually used currently

Corticosteroids Parenteral corticosteroids are frequently used in treating acute exacerbations of COPD. Methylprednisolone (60 to 125 mg intravenously, two to four times daily) or the equivalent glucocorticoid dose of other steroid preparations commonly is given.
Corticosteroids Utilization in this setting was initially based upon small randomized trials in which only a minority of patients benefit and the degree of improvement is modest
A randomized, placebo-controlled trial of 271 patients has confirmed the benefits of systemic corticosteroids given for up to 2 weeks to hospitalized patients with COPD exacerbation

Winnipeg Criteria (give for 2-3 of the following):
Increased cough
Increased purulence
Increased sputum production
Antibiotics accelerate improvement in peak expiratory flow rates and lessen the rate of recrudescence in this setting
Amoxicillin, Doxycycline, TMP/SMX, Azithromycin, Clarithromycin, Levaquin for 10 days

Mucokinetic Agents JUST SAY NO.
N-acetylcysteine is actually contraindicated in patients with airway obstruction
No significant clinical benefit ever demonstrated
Chest PT, intermittent positive pressure breathing and postural drainage may actually be harmful in the setting of acute obstruction

Methylxanthines (Theophylline, Aminophylline)
Not recommended for acute exacerbations
No significant benefit ever demonstrated in large, prospective trials

Oxygen: YES!
Generally a good thing cells like that stuff
If requiring a significant increase in FiO2 over baseline requirement, start hunting for something other than just COPD exacerbation
BEWARE of CO2 RETAINERS! (goal SpO2 90%, PaO2 of 60 to 65 mmHg )
1) Altered V/Q relationships
2) Haldane effect (Hgb*O2 holds less CO2 goes out into plasma)
3) Decreased ventilatory drive (least impt mechanism)

Non-Invasive Positive Pressure Ventilation
Set FiO2, inspiratory (IPAP) and expiratory (EPAP)
Difference between IPAP and EPAP augments tidal volume, therefore improving minute ventilation. CO2 then gets blown off
MORTALITY BENEFIT in patients who will tolerate

Mechanical Ventilation
Respiratory distress
Acidemia that does not correct quickly with therapy
Inability to oxygenate adequately
Often a clinical decision relative to patients work of breathing

The Benefits Of Using A Treadmill For Older People

The Benefits Of Using A Treadmill For Older People

There are many benefits to getting more exercise, and this is especially true for older people. As we get older, we tend to do less exercise and become more sedentary. By using a treadmill, you can easily incorporate more exercise into your daily routine with the minimum of inconvenience.

By taking up cardiovascular exercise on a treadmill, you will help reduce the risk of heart disease, diabetes, high blood pressure and cancer.

Walking or jogging on a treadmill can also be a way to improve mobility and coordination. This can be particularly important for older people. If you are concerned about being a little unsteady on your feet, exercise using a treadmill can be safer than jogging on the streets.

Exercise has been demonstrated to improve people’s mood and outlook on life. It can help you beat depression and anxiety. By setting and accomplishing simple health goals, it can also give people a great sense of achievement.

By using exercise equipment, older people can find that their muscle strength and density is improved. This can help counteract the effects of aging, when many people find that their muscles waste away and their bones lose density.

By using a treadmill, many people find that their mobility is improved. The range of movement of their joints can be increased and they generally feel that it is easier to get about.

If you are an older person and worried about starting an exercise program, you can ask your doctor for advice. This is especially important if you have pre-existing heart disease, diabetes or high blood pressure.

There are many benefits for older people wishing to exercise using a treadmill. These benefits can be important in allowing older people to live an independent live.

Know About The Types Of Heart Disease

Know About The Types Of Heart Disease

Heart disease is a category of illnesses that affects the regular functionality of the heart that can start from different causes. These diseases cause damage the different muscles and blood vessels connected to the heart and affects its ability to work properly. Since the 1900’s, cardiac disease has been recorded as the leading cause of death in the United States, England, Wales and Canada. Cardiac disease is responsible for killing someone every 34 seconds in America and over 60 million Americans have some form of cardiovascular disfunction. There are many individuals who are uneducated about its causes, symptoms and ways of preventing it affecting you and your family.

There are several category of cardiac disease which all have the same type of symptoms and treatment methods. Ischaemic Heart Disease affects the heart by minimizing the blood circulation to the cardiac muscle. Ischaemic Heart Disease displays symptoms such as chest pain, difficulty breathing, swelling of the legs and can also reduce an individuals ability to exercise.

Coronary Heart Disease is a disease that causes the artery and the blood vessels leading to the heart to tighten. This takes place as a result of plaque accumulation made up from fatty material, scar tissues and calcium. These vessels transport precious blood and oxygen to other vital organs so when they become obstructed the cardiac muscle is not properly fed with enough blood to perform its usual function. Warning signs include severe chest pain, heart attacks and even cardiac arrest. There are particular factors that maximizes the possibility of developing Coronary Heart Disease. Obesity, High blood pressure, Diabetes, smoking, high stress level, insufficient physical activity, high cholesterol level and in some women menopause.

A valvular Heart Disease is any disease which affects one or more of the valves in the heart. This illness can either be contract from birth or it can be attained over the course of a person’s life. If the disease does not turn out to be severe then medications are available to correct the ailment, but if it becomes critical then an operation will have to take place in order to either repair the valve or replace it. Valvular heart disease can be caused from rheumatic fever, hypereosinophilic syndrome, bacterial infection and cancer, just to name some.

Hypertensive Heart Disease includes any problems that cause high blood pressure. Symptoms of hypertension include, bloating, irregular pulse rate, fatigue, unexpected weight gain, frequent urination at nights, shortness of breath. Cardiovascular disease affects the cardiovascular system by causing damage to the arteries and veins.

Other forms of these diseases are Inflammatory heart disease which inflames the heart’s surrounding tissues, Cardiomyopathy which deteriorates the muscles of the heart, and congestive heart failure which occurs when the heart is unable to provide sufficient amounts of blood throughout the body to fulfill its needs. Maintaining a healthy lifestyle which includes regular exercise, upkeeping a nutritious diet and eliminating bad habits such as smoking, can lower the chances of someone developing cardiac disease. Various treatments can also be used to monitor the functions of the heart and sometimes depending on how devastating the damage is, surgery may be required.

My Old And Frail Grandpa Had Open Heart Surgery And Was Home In Two Days!

My Old And Frail Grandpa Had Open Heart Surgery And Was Home In Two Days!

It does sound like a StarTrek movie but it is definitely not!! Many elderly patients can rapidly return to their valuable lives and families after a minimal invasivecardiac operation. There is a widespread belief among well-meaning sons or daughters and sometimes even their own doctors that patients in advanced age with a severe heart ailment are too old and frail to withstand open heart surgery.The reverse is actually true: they are too old and frail to withstand their heart disease without the help of a surgeon! Our statistics are showing this important truth. The most common problems that can be corrected to save these patients’ lives are heart valve malfunctions, aneurysms and coronary artery disease. Elderly patients can live longer AND better if they are offered a minimally invasive cardiac surgical solution for their heart problem. If you or someone you care for are caught in this predicament, you can learn what to ask for and what to look for.
1.How old is too old? Age is truly a relative concept! I have seen innumerable patients in their 80’s and 90’s who had beautifully lucid minds and productive life styles and were nevertheless denied lifesaving surgery just because of their age. These patients are often physically younger than their real age and do absolutely fantastic with their heart surger procedures. In my experience, the fact that they are looking forward to a better life is by itself a strong predictor of surgical success.

2.Can your level of energy be restored by an operation? Heart disease and symptoms of chest pain, shortness of breath and weakness tend to deteriorate elderly patients by gradually taking away their life style. This is the time to have a “heart to heart” with a cardiac surgeon who can offer an effective surgical therapy to restore energy levels and a better life style.

3.Can minimally invasive heart surgery be performed in your case? Most elderly heart patients can now be helped with minimally invasive techniques and will be walking the hospital halls in less than 24 hours after their operation. Most patients can return to their lives and families in two to three days. You owe it to yourself: find out if the surgeon specializes in minimally invasive techniques and don’t be shy about asking how many of his patients can enjoy a minimally invasive approach.If necessary ask for a second opinion. An expert minimally invasive surgeon uses these techniques in the majoritymost of his patients.

I’ll conclude with a line from my 84 year old father-in-law, a recently retired internist: “Many elderly patients are young minds trapped in an old body”. Well…it’s your body, it’s your heart, it’s your life!! Help yourself to what modern medicine can offer.

How Does Coronary Heart Disease Affect The Body

How Does Coronary Heart Disease Affect The Body

As more people become aware of just how widespread heart conditions really are, as well as how deadly they can be, topics like how does coronary heart disease affect the body will continue to garner more attention. Here are a few quick numbers for you to drive home this point. This year over 1 million Americans will have a heart attack, of those half will die. This number accounts for 1 out of every 5 deaths caused by all diseases. Also, it is estimated that 41 million women in America have heart disease, debunking the myth that it is primarily a condition that affects men.

But how does coronary artery disease affect the body?

For me this has always been a fascinating topic. When I was a kid I used to see a lot of men over 40 who showed many of the symptoms of coronary artery disease such as excessive sweating, shortness of breath, occasional lapses in mental clarity, chest and back pain, and numbness in their legs, arms, and fingers. At the time I had no idea what I was observing and simply thought this was a natural part of getting older.

Most of them were inactive, smoked, and ate a diet high in foods that we now know contribute to heart disease such as high saturated fat foods like stick butter, burgers, cheese, breakfast gravy, sausage, whole milk, and franks. But in their defense at the time it was not well understood as how does coronary heart disease affect the body.

The main component of heart disease is a reduction, and ultimately a blockage of blood flow in the arteries supplying blood to the heart. The primary cause of this is arterial plaque which can start to form in the arteries as early as the age of 3 (that is not a misprint). Over the course of time more and more plaque accumulates reducing blood flow to the heart thus forcing the heart to have to work harder and harder to supply your body with the essential nutrients and oxygen necessary for life. This shortage of oxygen can cause breathing to become labored, as the body struggles to get the necessary amount of oxygen to the muscles and cells.

Can anything be done to halt the progression or reverse this condition?

The answer is yes! A recent study involving over 20,000 individuals found that a combination of a low saturated fat diet, moderate daily exercise, maintaining a healthy weight, not smoking, and a glass of red wine a day reduced the chances of heart attack by ninety percent.

Additionally, many are finding that by combining the natural lifestyle choices above with a
natural cholesterol reduction supplement they are able to improve heart and artery health even more.

In summary, rather than asking how does coronary heart disease affect the body one should really be asking what can I do about it to avoid becoming just another heart attack statistic.

How To Prevent And Treat Heart Disease

How To Prevent And Treat Heart Disease

Heart disease is a general term for a number of different diseases, all of which influence the heart in some way. Heart disease is in fact considered as being the leading reason of death nowadays in the United States. Heart disease indeed possesses serious threat to many people. Therefore, it is important to understand the methods to prevent and treat heart disease.

Prevention methods

There is reason to be hopeful because according to experts, heart disease prevention is promising. Even though some risk factors including sex, genetics, and age of a person are not within our control, one can still make an alteration in lifestyle and also change diet so that the odds of heart disease are significantly reduced.

There are also other methods by which heart disease prevention can be achieved. According to what the American Heart Association proposes, one must control obesity even in children and also make a determined attempt to take proper diet that contains enough nutrition. One of the better nutritional supplements you may want to try for heart disease prevention is mangosteen puree that is rich in antioxidants which aid in destroying free radicals that are the reason behind damage to cells and which in turn will result in heart disease.

Good heart disease prevention may also mean controlling the blood pressure and having LDL cholesterol at low levels. The best way to attain these goals is by making appropriate changes to diet and even by taking medications if so recommended by the doctor. Clearly, having low blood sugar levels will consider as heart disease prevention.

Another alternative is to exercise because it is a well known fact that regular exercise can reduce the risks of heart disease. Experts have a tendency to recommend as much exercise as humanly possible at least an hour per day. For many people, this seems like a never-ending task but the truth is this amount of exercise can be attained in ways other than going to the gym. Basically changing some habits, such as walking to work, can make people healthier. Walking is perhaps the easiest, cheapest, and healthiest type of exercise for most people and therefore should be taken advantage of.

The best heart disease prevention may not be a solitary course of action; rather, one may decide to have many strategies combined into one that will prove to be more effective. You can select approaches such as changes in diet, together with reducing excess weight and also maintaining blood sugar levels as well as taking nutritional supplements that are suggested by health experts.

Treatment options for heart disease

If you have heart disease then you will have to have some types of heart disease treatment in order to solve your problem. There are various heart disease treatment options that are available nowadays. The first treatment is of course prevention as explained previously.

However, if your heart disease is serious, than most probably you will also have to use more serious techniques of heart disease treatment. This includes medical treatment, which will usually be started straight away, even before an exact diagnosis of a heart problem is made.

This medical treatment may comprise of oxygen from a tube in the nose, oxygen through a face mask, nitroglycerin under the tongue, pain medicines, and aspirin. There are also clot dissolving medications which are often given, and the earlier these drugs are given, the higher the chances of opening the blocked artery and defending the cardiac muscle from further injury.

Cellular therapy, for example, is considered as being a potential treatment for heart disease. This is due to cellular products have been revealed to hold great potential for the treating of injured and diseased tissues in the body. They come from many sources, such as stem cells from bone marrow, peripheral blood, and myoblasts from skeletal muscle cells. The research so far has shown that this cellular therapy offers amazingly positive results, and so with additional research and more advancement, in the future this just may be known as the cure for heart disease.

Surgery can be executed on those who experience heart disease at any age although other methods are preferable. Surgery is necessary for those who do not react to their medications or whose condition worsens radically. In some situations, surgery is the only method to amend the problem and give the patient a probability of good health. In uncommon cases, repeat surgery is needed afterward to rid the body of excess fluids that have developed in the chest.

Heart surgery can be wearing and the healing period can be slow so it is no surprise to find out that a huge number of people who suffer from heart disease which needs surgery are interested in less invasive surgery. Less invasive surgery for heart disease can involve smaller incisions, less pain, and a much faster healing period. Not only does this type of surgery involve shorter hospital stays, it can also reduce the risks of complications to the patient during and after the operation.

There are many resources that are available if you want more information on the treatment of heart disease. The most significant thing of all is to keep a healthy lifestyle, a healthy and nutritious diet, and plenty of exercise. By keeping a healthy lifestyle you will not only be guarding yourself against heart disease but as well against all illnesses and health conditions in general.

Know More About Heart Disease And Its Treatment Options

Know More About Heart Disease And Its Treatment Options

Heart is considered as the most important part of body. The heart muscle umps blood, oxygen and other vital nutrients to all part of the body. An impediment in this pumping mechanism can lead to vital parts of our body like brain and kidneys being negatively affected. And this can lead to heart ailments that can definitely affect your lifestyle. Heart disease is a serious illness that takes a person in surprise. There are loads of symptoms and signs that portray the beginning of these ailments.

Symptoms of heart disease

Chest pain
Uneven beating of the heart
Shortness of breath

Factors that contributes an ailing heart are

High cholesterol
Life style risk factors

Among different types of coronary cardiac ailments coronary artery disease is the most common. To avoid such severe ailment there are different types of coronary artery disease treatment are available. Usually when the arteries get blocked due to plaques, heart fails to pump blood in the entire body. This can lead to heart attacks or strokes.

Treatments options available to overcome this situation are

Bypass or surgery

At times one might face shortness of breath even while taking rest anyone facing this symptom should immediately consult with a cardiologist. This can lead to a condition called heart failure. It is a condition when the heart muscle fails to pumps blood as they become weak. There are different types of coronary artery disease symptoms; they seem to develop slowly but certain time it is seen there is sudden leading to heart failure and other heart problems.

Some Symptoms that shows failure of heart are

Shortness of breath
Weight gain
Decreased urines production

There are different types of heart failure treatment options available nowadays that can help one to stay healthy and live much longer life. The factors that can contribute to treatment of the patients having heart that is unable to pump blood and oxygen into the entire body.

Factors that are responsible are

Change in lifestyle

One needs to have a healthy diet with low sodium and fat. Aside this there is many surgical treatments that can be adopted by a cardiac surgeon to cure heart defects. If the condition is not too severe then by having medication you can get relief from these awful ailments.

We live in a society that places enormous value on the ability to recover rapidly after a medical intervention to return to a normal life style. Minimally Invasive Cardiac Surgery techniques have truly revolutionized the way our patients perceive their surgical experience and their heart surgery recovery. Singapore offers the most effective medical care in the world. Some of the most sought after treatments facilities that one can get here is orthopedic surgery, cardiac surgeries, neurology and neuro surgery. Are you suffering from severe cardiac problems and looking forward for a good cardiologist in Singapore then get in touch with Dr. Lim Ing Haan a leading consultant cardiologist known for cardiac surgery in Singapore. She is known for her treatments regarding heart and vascular diseases. So if you want to avoid any unnecessary consequences, its better you take precautions.

Stress- Can It Really Cause Heart Disease

Stress- Can It Really Cause Heart Disease

Stress- were all aware of the feeling- overburdened, overwhelmed, and at times ready to pull our hair out. Yet, can it really be damaging physically? Can it lead to heart trouble?

A recent heart patient illustrates this question. John, a middle-aged man with a ruddy complexion and large eyes, had been admitted to the hospital on my cardiology practice because of terrible pains that gripped his chest. The pain was in fact a heart attack, quite a large one.

Oddly, he possessed no real risk factors for heart disease. He didn’t smoke, have high blood pressure, or admit to a family history of heart disease. Even his cholesterol was normal.

After taking a detailed history, the only thing I could come up with as a cause of his heart attack was stress. His dog, the only real thing in life he cherished, had recently died. He wasn’t married, and didn’t have children. Even his parents were gone. His pet golden retriever had recently been hit by a car.

His grief following the loss was so encompassing, so burdensome that it had created an anvil like weight across his chest. When the pain became unbearable he’d scurried to the Emergency Department.

Is it possible that stress alone- in this case overwhelming grief, can cause actual heart disease?

All of us are familiar with the stress of modern day living. With both adults frequently working, the typical American family must juggle shopping, work, kid’s activities, and a host of other essential tasks. It isn’t unusual to rise early, perform under pressure for long hours at work and then come home to face even more duties.

The constant and seemingly endless hectic pace can numb the body and the mind. Such stress is all too familiar, but can it actually lead to illness? Can it truly be bad for your heart?

A publication in the British Medical Journal has given undeniable proof that stress is indeed harmful to our heart health. They followed hundreds of research participants for up to seven years and found that people who had subjective feelings of being “over burdened” at work, or performed repetitive activities with no chance for advancement- these people developed nearly three times the heart disease as people who didn’t have this type of stress.

They also found that the chances of suffering a life ending heart attack were also 2-3 times higher.

So what can we do about the feeling of being, “overwhelmed,” or “not being able to take it any more?” Is there hope for hearts that are crying?

The answer is “Yes.” You don’t have to become a medical statistic and suffer a heart attack because of stress.

The first step for avoiding this tragedy is to acknowledge your troublesome feelings. Recognize that you are exhausted or have difficulty.

Next, seek help. One of the reasons I’ve created this web site is to provide a resource for who people with psychological and emotional difficulties.

Know More About The Ischaemic Heart Disease

Know More About The Ischaemic Heart Disease

The heart is one of the most important organs and holds the job of pumping blood to other organs. Ischaemic heart disease also referred to as myocardial Ischemic is a heart disease that affect the way how the blood goes to the heart. Ischaemic heart disease occurs when there is a plaque formation that restricts the arteries from sending precious blood and oxygen to the heart. The heart becomes affected when there is not enough in the blood circulation to the heart muscle which injures the heart muscle. Ischaemic heart disease has become one of the leading causes of death in the western hemisphere.

Ischaemic heart disease is very unlikely to show any signs in its first when it starts to take effect however, produces various symptoms can be seen based on the codition of the disease when it is diagnosed. Some the most identifiable symptoms are acute chest pain and angina prectoris. Acute chest pain can be described as an extreme pain felt in chest and is dealt with an emergency situation.

Angina precoris causes persons to feel chest pain behind the breast bone or slightly to the left of the chest, there may also be a crushing sensation, squeezing or heavy pressure spreading to the jaw, back, shoulder or event the arms. This symptom also causes indigestion, light headedness, vomiting, shortness of the breath. Its a possibility that angina precoris will not show any of these symptoms even when in effect; this is known as silent ischaemia. Ischaemic Heart Disease can also lead to heart failure gradually over time. Heavy coughing, shortness of breath with after resting or while exercising, fatigue, loss of appetite, irregular pulse, swelling of the ankles and feet are all signs that a heart failure may be impending.

There are certain particular habits that makes it easier of you getting heart diseases. Individuals who have particularly bad eating habits and suffer from obesity automatically increase their chances of being affected by these heart disease. These situations cause high cholesterol levels that make the heart overwork to keep up with the needs of the body and so leads to various heart diseases.

Individuals experiencing situation should maintain healthy eating patterns and exercise for at least three times during the week and maintain your body mass. These habits can greatly minimize stress levels, massages the muscles and keeps the body in check. Individuals that suffer from poor sleep, and dont work out are more prone to feel highly stressed. Cigarette smoking is also a huge contributing factor of heart diseases. If persons hope to minimize their chances of getting Ischaemic heart Disease, smoking will have to be stopped. High stress levels can also lead to ischaemic heart disease,Persons who have experienced a stroke or heart attack or who have a family history of heart diseases or other illnesses such as diabetes are more likely to experience a heart diseases. So Persons should make it their duty to research their medical history and seek a heart specialist when necessary to test the condition of their blood pressure and cholesterol levels. They should also be conscious of what they eat. Individuals may require medications to regulate these conditions. In severe cases of Ischaemic heart Disease, operation may also be required to treat ischaemic disease but the best remedy is prevention by exercising healthy lifestyle habits.

Heart Disease – Public Enemy Range 1

Heart Disease – Public Enemy Range 1


Heart disease is a number of abnormal conditions affecting the guts and its blood vessels. Also called cardiovascular disease, it mainly affects older people and indicates that there are problems with the center and blood vessels. It’s become the leading reason behind death in the United States, is a major reason behind disability, does not go away, however by working along with your doctor, you can live longer and feel better. Types of cardiovascular disease embody: Coronary artery disease (CAD), the foremost common type and is that the leading cause of heart attacks.

In 2003, nearly twice as several girls died of cardiovascular disease (both heart disease and stroke) than from all cancers combined. The older a woman gets, the more likely she is to develop cardiovascular disease; however women of all ages ought to be concerned. African Yankee and Hispanic American/Latina ladies are a lot of probably to get heart disease as a result of they tend to own more risk factors such as obesity, lack of exercise, high blood pressure, and diabetes than Caucasian women. Women of color are more possible to die of the disease.

Having diabetes raises your chances of getting heart disease and high levels of triglycerides are linked to the disease in some people. Additionally Being overweight will increase your risk. Chest or arm pain or discomfort can be a signal of cardiovascular disease and a wake-up call of an actual or impending heart attack. If your dad or brother had a heart attack before age 55, or if your mom had one before age 65, you’re more seemingly to develop heart disease. Birth management pills will pose risks for a few ladies, especially women older than 35; ladies with high blood pressure, diabetes, or high cholesterol and girls who smoke.

Almost 700,000 folks die of heart disease within the U.S. every year. You’ll find out additional about heart disease by contacting the National Ladies’s Health Information Center at one-800-994-9662. The risk of coronary disease can be reduced by taking steps to stop and management those factors that put folks at greater risk for cardiovascular disease and heart attack. The very best ways that to stop heart disease are to regulate high blood pressure, diabetes or a high cholesterol level and, if you smoke, STOP SMOKING.


What does high cholesterol have to do with heart disease? Cholesterol can clog your arteries and keep your heart from obtaining the blood it needs. Individuals with high blood cholesterol or high blood triglycerides often haven’t any symptoms, so have your blood cholesterol and triglyceride levels checked regularly. If your levels are high, speak to your doctor regarding what you can do to lower them. You’ll be able to lower your levels by eating higher and exercising a lot of, if not, your doctor may prescribe medication to lower and bring it under control.

When there’s an excessive amount of cholesterol in your blood, it will build up on the walls of your arteries, forming plaque and causing blood clots. There are basically two varieties of cholesterol: Low-density lipoprotein (LDL) is usually called the “dangerous” type because it can clog the arteries that carry blood to your heart. High-density lipoprotein (HDL) is called the “good” kind as a result of it takes the dangerous cholesterol out of your blood and keeps it from increase in your arteries. All girls age twenty and older should have their blood cholesterol and triglyceride levels checked a minimum of once every five years. If you’re overweight, losing weight can facilitate lower your total cholesterol and LDL (“bad cholesterol”) levels.

Strive to eat additional foods low in saturated fats, trans fats, and cholesterol. Skim (fat-free) or low-fat (one%) milk and cheeses, and low-fat or nonfat yogurt, Fruits and vegetables (try for 5 daily), Cereals, breads, rice, and pasta created from whole grains (like “whole-wheat” or “whole-grain” bread and pasta, rye bread, brown rice, and oatmeal), Eat less organ meats (liver, kidney, brains), Egg yolks, Fats (butter, lard) and oils, Packaged and processed foods.

There are two diets that may facilitate lower your cholesterol: Heart Healthy Diet and Therapeutic Lifestyles Changes (TLC) Diet. Exercise can facilitate lower LDL (“unhealthy cholesterol”) and raise HDL (“good cholesterol”). If your doctor has prescribed drugs to lower your cholesterol, take it specifically as you have been told to.


Heart disease is not contagious – you cannot catch it like you’ll the flu or a cold. It is a general term that refers to a variety of acute and chronic medical conditions that affect one or more of the parts of the heart. The symptoms you describe to your doctor will help to come to a decision if you would like to be tested for heart disease. Your doctor will additionally check if you’ve got any conditions that can increase your chance of obtaining the disease. These conditions embody: high blood pressure, diabetes, smoking, high cholesterol level, menopause in girls, relations who have had heart disease at a young age. If you have got cardiovascular disease, your angina will be treated by treating the heart disease. Maintaining a healthy diet and weight and a regular exercise program will facilitate your avoid heart disease.