>Acute Myocardial Infarction (MI)

Acute Myocardial Infarction

Of all the different types of heart diseases in this cardiovascular diseases list, acute myocardial infarction, which is commonly known as a heart attack, is one of the most common medical emergency conditions, which comes with a high mortality rate. A large number of myocardial infarction cases occur at rest, during sleep or sometimes after heavy exertion.

Causes:

• Coronary artery blockage is by far the most common cause of acute myocardial infarction. Partial or complete blockage of one or more coronary arteries leads to an attack of myocardial infarction which may even culminate in sudden cardiac arrest and death.
• Other factors that may lead to an acute myocardial infarction attack include unstable angina, variant angina and hypoglycemia.

Warning sign of MI

Warning Sign of MI:

Most heart attacks are also asymptomatic in nature and are known as silent heart attacks. Such attacks are common in patients suffering from diabetes mellitus.

The most common warning signs of a heart attack are related to chest discomfort. This discomfort if accompanied with or without breathing difficulty, demands emergency medical attention. This may include crushing pain due to extreme force on and squeezing of the chest. The person may have a feeling of fullness in his chest and this is accompanied by a chest pain or heart burn.

Before a heart attack, certain kinds of discomforts arise in the upper part of the body. The person may feel the pain extending into the jaw and to the left arm or shoulder. There will be pain in the back and feeling of uneasiness in one or both the arms and also in the neck area and stomach.

Severe heart attack warning signs include loss of consciousness and absence of pulse. The pupils of the person may get dilated; and cyanosis ( a bluish discoloration of the skin and mucous membranes. It a sign that oxygen in the blood is critically diminished ) or pallor (Unnatural lack of color in the skin) may also occur. These symptoms are usually 'not-to-be-avoided' alerts for a full cardiac arrest.

Symptoms:

• Chest pain, which is severe, constricting and resembles an angina attack. Also, the patient may seem restless, profusely sweating and be in a state of panic. These also sometimes manifest as heart attack warning signs.
• There maybe symptoms of left heart failure, cardiac arrhythmias, ventricular tachycardia, fibrillation or supraventricular tachycardia.
• Weak peripheral pulse, with cold and sweating extremities and visible pallor, accompanied by hypotension. The heart sound maybe muffled.

Treatment:

• The first line of action in heart attack treatment is pain relief. A subcutaneous injection of pain reliever is given. If that fails to act, then a slow intravenous or subcutaneous injection of morphine is given.
• Oxygen is given via a mask. Continuous oxygen administration provides relief by improving myocardial oxygen supply.
• Certain drugs are used for the cure and treatment of heart attack.This includes low dose aspirin, certain sedative drugs, and even anti-anxiety drugs.
• Fibrinolytic therapy is given to patients so as reduce the infarct size. These agents reduce the infarct size and the ventricular damage. They help restore coronary blood flow, thus, salvaging the myocardium. Streptokinase is the most commonly used fibrinolytic agent.
• Complete bed rest is enforced for the first 48 hours after an attack. Also, the patient should be preferably on a low fat diet, which should be a liquid diet for the first few days, and then should be slowly shifted to a semi-solid diet.
• If all these measures fail, then the only option left for a patient of myocardial infarction is surgery. The various surgery options include angioplasty and coronary artery bypass surgery.

>New Anti-cancer Therapy

Anti-cancer Therapy

Chemotherapy

Presently, there are three primary ways of treating cancer at present, and these have undergone very little fundamental change in 30 years. In the case of solid tumors, surgery is used to cut out the cancerous tissue, while radiation therapy can kill the malignant cells, and chemotherapy stops them dividing. An enzyme called Topoisomerase IB that plays a key role in some of the molecular motors involved in the processes of DNA and RNA copying during cell division targets cancer cells much more specifically than traditional chemotherapy, can cut off the genetic information flow that tumors need to grow.

Chemotherapy

... molecular copying machinery, constructed mostly out of proteins, in effect walks along the DNA double helix reading the genetic code so that it can be copied accurately into new DNA during division. Other components of the machinery are responsible for slicing and assembling the DNA itself. All of these are potential targets for anti-cancer therapy, providing it is possible to single out the tumor cells. Most existing chemotherapy targets all dividing cells, and the aim to find more sensitive techniques.

>Congestive Heart Failure(CCF)

Congestive Heart Failure

Congestive heart failure is one of the most common conditions affecting the heart, thus, cementing its place in one of the top slots of cardiovascular diseases list. It is the failure of the heart to meet the body demands of adequate circulation for its metabolizing tissues. The different types of congestive heart failure are acute or chronic heart failure, high output or low output heart failure and left sided or right sided biventricular failure. There can also be compensated or decompensated heart failure.

Causes:

• Myocardial causes, where there is myocardial dysfunction leading to reduced contractile force of the heart. The causes of this include viral infections like viral pneumonia, rheumatic fever, beri-beri, coronary heart disease, hypertension, diphtheria, amyloidosis, and degenerative diseases involving the heart.
• Mechanical lesions of the heart where there is a volume overload, as seen in valvular heart disease (aortic and mitral disease), syphilitic heart disease, as seen in the third stage of syphilis.
• Diseases interfering with diastolic filling of the heart, like constrictive pericarditis, pericardial effusion restrictive cardiomyopathy.
• Rhythm disturbances, especially in a compromised heart, since they reduce the end diastolic volume due to reduction in diastolic interval. These include atrial tachycardias, atrial flutter, atrial fibrillation and heart block.
• Conditions where there is an increased pressure on the heart to pump out more blood, like high fever, pregnancy or thyrotoxicosis.

Signs of Congestive Heart Failure:

One of the earliest signs of congestive heart failure is fatigue, accompanied by the affected person’s diminished capacity to exercise. In fact, most people don’t even realize this reduction, with them usually compensating subconsciously by reducing their activities in order to adapt to this limitation.

With the body becoming congested with fluid, and the lungs becoming affected, resulting in shortness of breath, which impairs the ability to exercise and also when lying down flat. Sometimes, the affected person may wake up at night gasping for breath. Some even have to sleep sitting in an upright position. The excessive fluid in the body also results in an increase in urination, especially at night. When the fluids accumulate in the intestines and liver, it may result in a decrease in the appetite, pain in the abdomen, and nausea.

Symptoms:

Left Heart Failure Symptoms

• Progressive breathlessness, that is more marked on exertion.
• Paroxysmal nocturnal dyspnea attacks.
• Weakness, fatigue, palpitation and pain in the chest.
• Acute left heart failure is characterized by basal crepitations, tachycardia, cold extremities, facial pallor, hypertension and a galloping rhythm.

Right Heart Failure Symptoms

• Generalized fatigue and weakness including cough, breathlessness, anorexia, abdominal distension, pain and dragging sensation in the right hypochondrium.
• Headache, restlessness, insomnia, weight gain, swelling of legs and feet, oliguria and nocturia.
• Physical signs include cyanosis, warm extremities, engorged neck veins, elevated jugular venous pressure, enlarged liver and edema over legs and feet.
• The size of the heart is generally within normal limits. Pulmonary diastolic murmur is seen due to pulmonary hypertension. Signs of pleural effusion maybe present.

Treatment:

• Take adequate rest but maintain a certain minimum level of physical activity.
• A nutritious diet that is well balanced and is low in calories and salt is very important. Frequent but small meals should be consumed. Evening meals should be light and adequate time interval should be maintained between the evening meals and the time of sleep.
• Often after being diagnosed with congestive heart failure, the patient is confined to bed and the diet is either light and semi-solid or liquid. So a daily movement of bowels is desirable. Straining at stools must be avoided.
• In most cases there is need to take to drug therapy. They are mostly inotropic drugs that have a direct effect on the myocardium, by increasing the systolic contraction of the heart and thus increasing the cardiac output. Other drugs that are also used include diuretics and vasodilators.