Heart Attack Risk factors
Most common risk factors of heart attack are having coronary heart diseases, already had angina episode, and have high cholesterol, high pressure, diabetes, and/or overweight.
Controllable Heart-attack risk factors
- Smoking – plan to quit
- High blood pressure – try to keep it near normal range
- Hyperlipidemia - try to keep it at the safe range
- Overweight and obesity – workout to reduce in steps
- Physical inactivity – increase physical activity by exercising regularly
- Diabetes – keep it in control with medication and therapeutic lifestyle changes
Uncontrollable Heart-attack risk factors
- Age – growing older increases the risk for men over 45 years and for women over 55 years (mostly after menopause)
- Family history of early coronary heart disease - risk increases if father or brother diagnoses with coronary heart disease before age 55, and mother or a sister was diagnoses before age 65.
A person with metabolic syndrome has twice the chance to develop heart disease and five times the chance to develop diabetes as someone without metabolic syndrome.
Heart Attack Causes
Mostly, heart attacks happen due to coronary artery disease; it is the buildup of plaque on the inner walls of the coronary arteries. Hardened plaque can break open, and attracts blood clot to form at the surface. A heart attack occurs if the blood clot is large enough to block most or cut off all the blood supply to the artery.
Heart Attack Causes
Due to blockage oxygen, rich blood cannot reach some parts of the heart muscle fed by the artery. Inadequate oxygen supply damages the heart muscle. If the blockage is not clear quickly, the damaged heart muscle starts to die.
Heart attack may also happen due to problems with the microscopic blood vessels of the heart called micro-vascular disease. It is more common in women than in men.
Fewer common causes of heart attack are a sudden contraction (spasm – tightening) of the coronary artery, that blocks blood flow through the artery. This contraction can occur in coronary artery that has or does not have coronary heart disease. It is still unknown what causes this coronary artery contraction, but mostly common cause may be:
- When taking cocaine
- Cigarette smoking
- Mental stress or pain
- Exposing to cold temperatures
Kidney Disease Symptoms
Kidneys work harder to make up for the drop in capillaries so kidney disease produces no symptoms until almost all of its function is gone.
Common symptoms of kidney disease
The symptoms of kidney disease are not specific. Some of the kidney disease symptoms are as follows:
- Urine appears dark or redness
- Offensive odor from urine
- Foamy urine
- Frequent urination may be with pain or burning during urination.
- Urinating too much or little
- Persistent thirst
- Swellings notable in the legs, hands and face
- Raised blood pressure
- Back pains around the renal area with fever.
- Anemia, low hemoglobin in the blood
- Shortness of breath
- Tiredness or weakness without apparent cause
- Dark puffy look under the eyes
- Backache, headache, and fatigue
- Itchy skins (pruritus.)
Other symptoms of kidney disease include:
- Loss of sleep
- Poor appetite
- Upset stomach
- Weakness
- Difficulty concentrating
If you have any of the above-said kidneys, disease symptoms immediately consult your doctor and go for diagnosis.
Heart Attack Symptoms
Not all heart attacks start suddenly, warning symptoms of heart attack are different for all. Mostly, it begins slowly with mild pain or discomfort. Some even do not have symptoms at all called as silent heart attack.
Some heart attack develops very slowly it takes many hours, days, and even weeks before it occurs.
Most common heart attack symptoms
- Chest pain or discomfort – mostly involve discomfort at the center of the chest that may go away and come back again or last for few minutes.
- Discomfort can be like an uncomfortable pressure, squeezing, or fullness, may be mild or severe. Sometimes it appears to be like an indigestion or heartburn.
Other common heart attack symptoms
- Pain or discomfort in one or both arms, back, neck, jaw, or stomach.
- Shortness of breath occurs before or during the chest pain or discomfort.
- Nausea, vomiting, lightheadedness, fainting, or cold sweat
Heart attack experience between two persons may vary; even it may be entirely different. In addition, if you have already had a heart attack, your symptoms will not be the same for the next attack.
Acting faster at the first sign of heart attack can save the life and avoid or limit damage to the heart. Treatment gives excellent results if started within one hour of the beginning of symptoms.
Important if feel heart attack symptoms
If you or someone has heart-attack symptoms, immediate medical care is a most:
- Start treatment within 5 minutes of the start of symptoms to avoid complications.
- If the symptoms disappear completely in less than 5 minutes, still need to consult doctor to avoid or postpone the second episode.
- Only take an ambulance to the hospital, it helps to start the treatment immediately without any delay.
- Take a nitroglycerin medication if your doctor suggested this type of medicine.
Kidney Disease Risks
Diabetes is the first most common risk factors leading to kidney disease. Other leading risk factors for kidney diseases are heredity and high blood pressure.
Diabetic nephropathy risk factors
- Heredity – family history of kidney disease,
- Diet you have,
- Other medical conditions, such as high blood pressure
- Alcoholism
- Not drinking enough water
- Smoking
High blood pressure and high blood-glucose level increase the risk that chance of CKD and kidney failure.
Prevent or stop the progression on kidney disease
The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease.
Diabetic nephropathy can be prevented or stop progression by keeping blood-glucose in your target range. Studies have shown that tight glucose control reduces the risk of microalbuminuria by one third. If people already have microalbuminuria, the risk of developing macroalbuminuria can be reduced by fifty percent. Other studies have suggested that tight blood-glucose control can even reverse microalbuminuria.
Gastroparesis Complications
Food stays too long in the stomach causing bacterial overgrowth, and it becomes hard called bezoars. End up with malnutrition and weight loss.
Complications of gastroparesis
- Bezoars are hard-undigested food in the stomach, a solid mass that is similar to a hairball in a cat. Bezoars are likely to cause nausea and vomiting and may be life threatening if they prevent food from passing into your small intestine.
- Blood-glucose control, Gastroparesis can make diabetes worse by making diabetes control more difficult. Because of delayed stomach emptying and entry into the small intestine, the glucose absorption is unpredictable; person’s glucose levels can be erratic and trouble to control.
- Weight loss and malnutrition, delayed stomach emptying affects the body's ability to digest and absorb nutrients effectively. Bacterial overgrowths can also contribute to poor absorption, the dangerous growth of harmful microorganisms that inhabit the gut. Beneficial bacteria's usually keep these organisms in check, but food fermentation in the stomach disrupts the balance of good and bad bacteria.
CAD Treatments
Treatment for coronary artery disease may include lifestyle changes, medicines, and medical procedures.
Lifestyle Changes for coronary artery disease
It can often help prevent or treat coronary heart disease.
- Avoid saturated fat and include unsaturated fats.
- Limit fatty and sweet foods
- Add some fibers; whole-grain cereals such as oatmeal and oat bran, Fruits such as apples, bananas, oranges, pears, and prunes and Legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans.
- Fish is a heart-healthy food - A good source of omega-3 fatty acids, which can help protect the heart from blood clots, inflammation and lower the risk of heart attack.
- Limit the amount of sodium salt - choose low sodium salt foods.
- Properly manage high pressure, high cholesterol, and diabetes. They are the risk factors of coronary heart disease.
- Increase physical activity – consult doctor for your suitable plan.
- If over weight and obese - losing weight in steps, helps a lot.
- If smoking – plan to quit. Furthermore, avoid exposing to second-hand smoke.
- Limit alcohol – too much alcohol raises blood pressure and serum triglycerides.
- Plan to reduce or avoid stress – because stress triggers many cases of heart attack.
For more detail, information and tips visit Therapeutic Lifestyle changes section.
Medicines for CAD
Medicines are requiring treating, if lifestyle changes cannot do the needful. Coronary heart disease medication can:
- Reduce heart’s workload and clear coronary heart disease symptoms
- Reduce the chances a heart-attack
- Reduce cholesterol and blood pressure
- Prevent clotting of blood
- Prevent or at-least delay the need for a special procedure such as angioplasty or artery bypass.
Medications used in the treatment of coronary heart disease include anticoagulants, aspirin, antiplatelet medicines, nitroglycerin, glycoprotein IIb-IIIa, statins, ACE inhibitors, beta-blockers, calcium-channel blockers and fish oil or other sources of omega-3 fatty acids.
Medical Procedures and Surgery for CAD
- Angioplasty is to open up blocked or narrowed coronary arteries, by inserting a tube into the blocked arteries and slowly inflate it to open up the blockage and if needed a small mesh tube called a stent is placing in the artery to keep it open after the procedure. Angioplasty help to regain normal blood flow in arteries.
- Coronary artery bypass grafting (CABG) is a surgical procedure, using the arteries or veins from other areas in the body to bypass, that go around the blocked arteries. CABG can normalize the blood flow to the heart, relieve chest pain, and possibly prevent a heart attack.
- Bypass grafting in peripheral arteries, in this surgery, a healthy blood vessel is useful to bypass a narrowed or blocked blood vessel in the legs. It improves blood flow to the leg.
- Carotid artery surgery is similar to angioplasty, and it removes plaque buildup from the carotid arteries in the neck. It improves blood flow to the brain and helps to prevent stroke.
Cardiac rehabilitation as CAD
The cardiac rehabilitation team contains many specialists; they include doctors, nurses, exercise specialists, physical therapists, dietitians, and psychologists or behavioral therapists.
Rehabilitation has two parts:
- Training for exercise – teaches safe exercising, strengthens muscles, and improves stamina. Exercise plan based on the individual abilities, needs, and interests.
- Education and counseling - helps to understand the heart condition and tips to avoid or reduce the risks of future heart problems. Educate to handle the stressful situation or plan to reduce its instances and deal with the fear of future.
Gastroparesis Diabetes Control
The primary treatment goals for gastroparesis related to diabetes are to improve stomach emptying and regain control of blood-glucose levels.
Gastroparesis and diabetes control
Treatment includes dietary changes, insulin, oral medications, and, in severe cases, a feeding tube and parenteral nutrition.
Dietary changes for diabetes control
Dietitian may suggest six small meals a day instead of three large ones. If fewer foods enter the stomach each time, emptying made easy. Dietician may prescribe a liquid or pureed diet for more severe cases of gastroparesis. It helps to restore your blood-glucose to more normal levels.
It is better to avoid high-fat and high-fiber foods. Fat naturally slows digestion and fiber is difficult to digest. Some high-fiber foods like oranges contain material that cannot be digestible. Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
Insulin for Blood-glucose Control
Gastroparesis cause the food absorbed more slowly and at unpredictable times. So to control blood-glucose,
- having insulin more often or change suitable insulin type
- having insulin after eating instead of before
- check blood-glucose levels frequently after eating and have insulin when necessary
Consult doctor for specific instructions for taking insulin based on your particular needs.
CAD Diagnosis
Coronary artery disease diagnosis is starts on medical and family histories, risk factors, and diagnostic tests.
CAD - Diagnostic Tests and Procedures
- Blood Tests to examine the level of fats, cholesterol, glucose, and proteins in the blood. Any abnormal levels may indicate risk factors for Coronary heart disease.
- EKG (Electrocardiogram) record hearts electrical pulses its strength and timing, helps to find previous or current heart attack and risk of Coronary heart disease.
- Chest X-ray is the picture of heart, lungs, and blood vessels. It helps to reveal indication of a hear failure.
- Echocardiography produces actual moving picture of the heart. It provides information about the size and shape of heart, heart chamber and valve functioning. It is useful to pinpoint the areas of poor blood flow, contraction abnormalities and any injury in heart muscles.
- Computer tomography (CT) scans – produces images of the heart. It helps to identify hardening and narrowing of arteries.
- Stress Testing is performing by making the heart work hard and beat faster; by exercising, if not able to do exercise, then medication is useful to speed up heart. When heart work harder it needs more blood and oxygen, if the arteries are narrowing it cannot provide enough blood or oxygen. Any abnormality such as heart rate, heart rhythm, blood pressure, shortness of breath, and chest pain are helpful in the diagnosis.
- Other stress tests use a radioactive dyes, positron emission tomography, or cardiac magnetic resonance imaging (MRI) to get pictures of the heart during hard working and at rest. This test helps to examine how well heart pumps and blood flowing to the different parts of the heart.
- Coronary angiography - A catheter (thin, flexible tube) is inserting into a blood vessel in the arm, thigh, or neck. Inject a special dye that can be visible on X-ray into the arteries. By seeing this picture, doctor can diagnose any blockage in the arteries and its severity.
- Electron-Beam Computed Tomography measures calcium deposits in and around the coronary arteries. If more calcium detected, then more chances to have coronary heart disease. However, its accuracy is still not provable.
Gastroparesis Treatments
There is no known cure for gastroparesis; it is usually a chronic condition. Treatment helps to manage the condition, maintain healthy and comfortable life.
Medication for gastroparesis treatment
Several medications are there to treat gastroparesis. Doctor may try different medications or combinations to find the most effective treatment. Discuss about the side effects of any medication with your doctor is important.
- Metoclopramide (Reglan) - It stimulates stomach muscle contractions to help emptying; it also helps reduce nausea and vomiting. Take Metoclopramide 20 to 30 minutes before meals and at bedtime. Side effects of this drug include fatigue, sleepiness, depression, anxiety, and problems with physical movement.
- Erythromycin - Antibiotic also improves stomach-emptying, works by increasing the contractions that move food through the stomach. Side effects include nausea, vomiting, and abdominal cramps.
- Domperidone - It works like metoclopramide to improve stomach emptying and decrease nausea and vomiting. Use of the drug is restricted in the United States.
- Other medications - may be useful to treat symptoms and problems related to gastroparesis. An antiemetic can help with nausea and vomiting; Antibiotics will clear up a bacterial infection. If you have bezoars in the stomach, the doctor may use an endoscope to inject medication into it to dissolve it.
Dietary changes in gastroparesis treatment
Doctor or dietitian may prescribe six small meals a day instead of three large ones. If less food enters the stomach each time, it may not become overly full. In more severe cases, your healthcare professional may prescribe a liquid or pureed diet.
It is better avoiding high-fat and high-fiber foods. Fat naturally slows digestion and fiber is difficult to digest. Some high-fiber foods as if oranges contain material, cannot digest. Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
Feeding Tube
If liquid or pureed diet does not work, then need surgery to insert a feeding tube. The tube, called a jejunostomy, is inserted through your abdominal skin into the small intestine straightaway bypasses stomach and places nutrients and medication directly into the small intestine. A special liquid food is useful with this tube; small intestine digests and absorbs nutrients from this food and delivered to your bloodstream quickly. Jejunostomy is helpful only when gastroparesis is severe or the tube is necessary to stabilize blood-glucose levels in people with diabetes.
Parenteral Nutrition
Parenteral nutrition is delivering nutrients directly into the bloodstream, bypassing the digestive system. Doctor places a thin tube called a catheter in a chest vein, leaving an opening to it outside the skin. For feeding, attach a bag containing liquid nutrients or medication to the catheter. The fluid enters your bloodstream through the vein. Doctor will tell you what type of liquid nutrition to use.
It is an alternative to the jejunostomy tube and is usually a temporary method to get you through a difficult period with gastroparesis. Parenteral nutrition is useful only when gastroparesis is severe and is not manageable by other methods.
Gastric Electrical Stimulation
A gastric neuro-stimulator is a surgically implanted battery-operated device that gives mild electrical pulses to help control nausea and vomiting associated with gastroparesis. This option used only if your nausea and vomiting do not improve with medications.