Heart Rhythm and Arrhythmia

A normal resting heart beats about 60 to 100 times a minute. Heart rhythm problems or medically referred to as arrhythmia is a condition where the heartbeat of a person is unbalanced – implying it is either too fast or slow or too early or irregular. Arrhythmias occur when the electrical impulses that coordinate the heartbeats malfunction, causing racing heartbeats or fluttering. Many arrhythmias are harmless and do not cause any problems unless these episodes occur frequently or for a long period of time or are abnormal and caused by a weak heart – such cases require serious medical attention and could also be fatal. 

Types of Arrhythmias

Premature Atrial Contractions: Extra beats originating early in the upper chambers of the heart cause this type of irregularity in a heartbeat, which is often harmless.

Premature Ventricular Contractions: Often referred to as skipped heartbeat and one of the most common types of arrhythmias experienced by people. This can happen to people with or without heart problems. 

Atrial Fibrillation: In this condition, the atrial chambers beat irregularly – mostly too fast. This is a very common type of arrhythmia and usually happens to people of an older age.

Atrial Flutter: This condition occurs when the irregularity in a heartbeat is from a particular area of the heart, because of that area of the atrium not functioning properly. Hence, this arrhythmia has a consistent pattern instead of random quivers like fibrillation. This can be a serious condition and would need medical help.

Supraventricular Tachycardia (SVT): In this type, the patient experiences abnormally racing heartbeats (approximately 160-200 per minute) that can last for minutes or hours. This begins and ends abruptly.

Accessory Pathway Tachycardia: A condition where one experiences rapid heart rate because of an abnormal connection between the lower and upper chambers of the heart.

Ventricular Tachycardia: Abnormality in the functioning of electrical impulses in the ventricles (lower chambers of the heart) can cause irregular, fast heartbeats usually because of scars or injuries from a previous heart attack. This problem does not let the heart pump enough blood in the body, causing a lot of problems.

Ventricular Fibrillation: In this condition, the lower chambers of the heart quiver, unable to pump blood due to improper contractions leading to erratic heartbeats. This is a case of a medical emergency.

Long QT Syndrome: When the heart muscles take longer than usual to contract and recover, this causes an absence of a heartbeat for a long time resulting in a life-threatening form of ventricular tachycardia that can cause sudden death.

Brady arrhythmias: This condition occurs when the person experiences slow heartbeats than usual due to a problem in the heart’s conduction system such as a heart block or a sinus node dysfunction.

As mentioned, most arrhythmias are momentary; however serious cases can put a person to a risk of stroke or a cardiac arrest. 

Causes of Arrhythmia

Arrhythmias occur when the electrical impulses of the heart are disturbed, leading to improper functioning of the heart. This disturbance in the functioning of the heart can be caused due to several factors such as:

  • Excessive alcohol
  • Diabetes
  • Substance abuse
  • Excessive consumption of caffeine
  • Heart diseases
  • High blood pressure
  • Overactive or underactive thyroid gland
  • Stress
  • Scarring of the heart tissue (from a previous heart attack)
  • Smoking
  • Dietary supplements
  • Certain medications and treatment
  • Changes in the heart’s structure
  • Heart attack
  • Blockage in the arteries
  • Genetics
  • Obstructive sleep apnea
  • Imbalance of electrolytes in the blood
  • Injury from a heart attack

The heartbeat of a healthy person does not fluctuate often and also resumes normal rate within seconds; hence, a healthy person is very unlikely to experience long-term arrhythmias unless it is triggered by an external factor such as drugs, alcohol, stress, etc. 

Symptoms of Arrhythmia

Some arrhythmia may be really short-lived and show no symptoms, while others may have loud symptoms that must be taken into consideration. Some common arrhythmia symptoms include:

  • Abnormal heartbeat (fast, slow, missing, early)
  • Breathlessness
  • Dizziness
  • Loss of consciousness
  • Fluttering
  • Acute chest pain
  • Weakness
  • Difficulty in conduction normal every day activities
  • Difficulty during exercise
  • Palpitations
  • Excessive sweating
  • Fatigue
  • Confusion, troubled mind

In many cases, arrhythmias can go unnoticed and may be detected upon examination by a doctor through an EKG. 

Complications from Arrhythmia

Most arrhythmia last for a very short period of time and often resolve on their own, but in cases where the abnormality is experienced consistently or intensely, immediate medical help must be taken. Severe arrhythmia cases can lead to complications such as:

Stroke: When the heart’s electrical impulses are not coordinated, it is unable to pump blood effectively causing blood clots. These blood clots when break loose can travel to the brain blocking blood flow and resulting in a stroke, which can be fatal.

Heart Failure: A heart can fail to function if it is been malfunctioning – beating too fast or too slow – for a prolonged period of time. Heart failure can result in death, provided immediate medical attention is not received.

Prevention from Arrhythmia

It is possible to prevent arrhythmia provided you take proper care of the heart by adopting a healthy lifestyle and diet.

Some of the preventive measures that work are:

  • A healthy diet enriched with minerals, vitamins, fibres, etc.
  • Physical activity of at least 30 minutes
  • Quitting smoking
  • Limited or no alcohol
  • Maintaining a healthy weight
  • Avoiding caffeine
  • Reducing stress
  • Avoid harmful medications including over-the-counter medications for cold, flu, cough, etc.

Further, a critical factor to prevent complications from arrhythmia is to get regular heart check-ups and consultations done. Some tests that can indicate an arrhythmia include electrocardiogram, holter monitor, event monitor, stress IQ test, echocardiogram, cardiac catheterization, and electrophysiology study. 

That said, it is advisable to consult your doctor if you experience frequent or consistent episodes of arrhythmia. Moreover, in cases of severe problems, one must seek medical help immediately. 

Tips to follow after Balloon Angioplasty surgery

Balloon Angioplasty also known as percutaneous transluminal coronary angioplasty or precutaneous coronary intervention – is a very effective surgical procedure performed directly after a heart attack to restore the flow of blood in the heart by removing the blockages from the coronary arteries.  Balloon angioplasty is a very effective surgical treatment and has proven success rates. The procedure involves the insertion of a catheter mounted with a tiny balloon into the blocked artery through an incision in the arm or groin. This catheter is then guided to the exact spot of blockage by using special dyes, X-rays, etc. and once it’s in the right position – the tiny balloon is inflated to remove the blockage from the artery and clear the passage to allow blood flow by pushing the plaque build-up to the walls of the artery. Once the blood supply is regulated, the balloon is deflated and removed from the body. This procedure is often time followed by the placement of a stent – a stainless steel mesh – in the heart of the patient to ensure the arteries do not clog again in the future. In fact, some stents (such as drug-eluting stents) are medically coated to keep the arteries from narrowing again.

balloon angioplasty surgery is a widely used technique of treatment in cases of heart attacks and can minimize the chances of a heart failure or other complications, provided this treatment is initiated within the first hours or in some cases immediately after a heart attack. While the condition of the heart and survival is dependent on the success of the balloon angioplasty surgery procedure, it is also very critical to understand the tips to follow post the balloon angioplasty procedure, to ensure there are no complications or a revival of the situation.

It takes about 3-4 weeks or more (depending on the severity of the condition) to recover after a balloon angioplasty surgery. Once exiting the hospital, it is necessary to discuss precautions, medications, routine activity exemptions, diet, recovery process, post-operative tests, etc. to ensure maintain good heart health. However, some of the tips that one must consider after a balloon angioplasty surgery are:

Healthy Diet: An unhealthy diet consisting of food high in saturated fats, trans fat, sodium, cholesterol, sugar, etc. should be avoided. Instead, a healthy diet including green leafy vegetables, fiber, whole grains, fish, nuts, seeds, low-fat dairy, etc. should be adopted. Water intake should be increased, while consumption of oil, sugar and especially sodium should be minimized to barely any.

Medications: Post the balloon angioplasty surgery, the doctor will recommend certain medications to ensure steady heart health. It is vital to take all medications and follow all the precautions suggested by the doctor. Some of the medications that may be recommended include blood thinners (to restore blood flow), thrombolytics (to dissolve clots), nitroglycerin (to widen blood vessels), antiplatelet (to prevent new clots), and pain killers (to cub the pain). During the intake of these medicines, the body might experience a few negligible changes such as sensitivity to bruise easily, longer bleeding from clots, etc.

Improve Life State: After the balloon angioplasty surgery procedure, it is very important to take steps to prevent all chances of another heart attack.One must lower blood pressure levels, reduce high cholesterol, lower sugar levels, reduce weight, increase physical activity, quit smoking, limit alcohol intake, and reduce stress.

Regular check-ups: It is very critical to be aware of the heart’s health after a balloon angioplasty surgery by getting regular check-ups and examinations done. Heart-health screenings are necessary to keep a check on the level of blood glucose, cholesterol, blood pressure, heart rate, body mass index and more. If the results indicate any variation from the normal range, one must consult the doctor and also practice stricter lifestyle changes to bring the values within normalcy.

Ease into the normal life: One thing to remember after a balloon angioplasty surgery is that there should be no rush to swing back to the normal life with the same intensity. Instead, slow methods should be undertaken to eventually resume everyday activities and physical load. Driving and travelling are two activities that can be immediately resumed after a balloon angioplasty surgery. However, weight lifting and strenuous physical workout should be given some due time.

Exercise Daily: A balloon angioplasty surgery guidelines advises to refrain from intense physical workouts or stress whereas slow, distributed exercises are suggested to be adopted. These low-to-moderate exercises need to be done till the level of comfort only. No excessive pressure of performance needs to be out on the patient. These light exercises help to regain fitness, control blood pressure, maintain cholesterol levels, maintain healthy sugar levels, etc. Once the comfort is achieved, the length and intensity can be increases bit-by-bit.

If these tips post a balloon angioplasty surgery are not followed sincerely, there may be many risks and complications that might arise. Some of these include:

  • Bleeding, clotting or painful bruising at the insertion point
  • Blood clots or scar tissue in stent
  • Irregular heartbeat
  • Anxiety
  • Damage to heart vessel or heart valve
  • Tear in the artery (artery dissection)
  • Hole in the artery (artery perforation)
  • Damage to kidney
  • Post-surgery infection or complications
  • Medication side-effects
  • Stroke
  • Heart attack

However, all risks involved vary as per personal circumstances. Most of these are easily manageable with proper care. A Balloon Angioplasty can be 100 percent successful if it is followed by a disciplined and dedicated post-surgery care and lifestyle amendments.

Acute Rheumatic Fever: What You Need to Know

Acute Rheumatic Fever is an inflammatory complication or a disorder that is caused by inadequate treatment of a strep throat or scarlet fever. In cases of acute rheumatic condition, the organs of the body start to attack their own tissues, which results in inflammation and severe reaction in the entire body.

A strep throat or scarlet fever is an infection in the throat or tonsils which is caused by bacteria called Astreptococcusor Streptococcus pyogenes. As strep throat or scarlet fever is highly contagious and leads to acute rheumatic fever, if untreated or undertreated. However, this does not imply that all strep throat or scarlet fever conditions cause development of an acute rheumatic fever, but in conditions when it does lead to a rheumatic fever complication – the symptoms start showing within a few weeks.

Acute rheumatic fever is more widely spread in children above 5 years and below the 15 year age mark, though it can also occur in younger children, as well as adults. As of today, acute rheumatic fever is widely common in developing nations, including India. As per an Indian study, the ratio of acute rheumatic fever in Indian school children aged 5-15 years is approximately 6 per 1000.

One of the major complications caused because of acute rheumatic fever is rheumatic heart disease (RHD) – chances of which happening are more than 30%. It is also one of the major causes of cardiovascular diseases, contributing to more than 40% of the acquired heart disease issues. Both acute rheumatic fever and rheumatic heart disease can permanently affect the heart, damaging its valves overtime, causing disability, heart failure and even premature death in many cases. Globally, rheumatic heart disease is the cause of approximately 5, 00,000 deaths annually. That said, if treated adequately and timely, the damage can be reduced and the recurrence can be curbed.

More important is to know what causes an acute rheumatic fever, how to detect the symptoms of a rheumatic fever, treatments, and prevention.

Causes of Acute Rheumatic Fever

Acute rheumatic fever is caused by a severe and untreated strep throat or scarlet fever which is a result of the Group A streptococcus bacteria. The bacteria is composed of protein which is similar to that of other body tissues; when the bacteria enters the body, it triggers the immune system, which starts attacking the body’s own tissues assuming  them to be bacterially infected. This causes inflammation in the body especially heart, joints, skin and nervous system. The inflammation can be resolved in 6 weeks without any permanent damage. However, it is important to know the symptoms of acute rheumatic fever to ensure prevention and adequate cure.

Symptoms of Acute Rheumatic Fever

Symptoms of acute rheumatic fever depend on the severity of the condition, and hence vary person-to-person. Some of the most common causes include:

  • High fever
  • Sore throat
  • Severe headache
  • Swollen and tender joints
  • Bumps under the skin often painless
  • Heart murmur
  • Acute chest pain or discomfort
  • Fatigues and dizziness
  • Red rash
  • Swollen tonsils
  • Uncontrolled movements
  • Unexplained nosebleeds
  • Excessive sweating
  • Cheat palpitations
  • Vomiting

A person may experience a few, all or no symptoms at all. The problem may worsen and cause chest ache, palpitations, disturbed heart beat, and shortness of breath. These symptoms are further aggravated by certain risk factors including:

  • Family history
  • Congenital heart problems
  • Poor sanitization
  • Poor living standard

On the other hand, inflammation caused by the acute rheumatic fever can last for months or shorted. However, a rheumatic heart disease attacks the person after years (nearly 10-20) of an acute rheumatic fever and causes permanent heart damage, especially narrowing of the valves, leakage in the valve and weakened heart muscles – all of which affect the normal functioning, heart pumping of the blood. In severe cases or prolonged damage to heart, acute rheumatic fever can also lead to heart failure and atrial fibrillation. It is thus, important to consult the doctor and do as told. The doctors might suggest an echocardiogram, electrocardiogram, or blood tests to determine the problem and suggest a planned approach the situation.

For treatment of the problem, contacting the concerned doctor would the best call. However, the only way to prevent an acute rheumatic fever is to ensure you identify a strep throat or scarlet fever problem and get adequate treatment till it is completely eradicated from the human body. More so, proper hygiene and a few precautions such as maintaining distance from sick people, avoiding sharing food with ill people, covering the mouth while coughing/sneezing and washing hands can go a long away in prevention of acute rheumatic fever. Some methods to treat the problem include:

  • Antibiotics (as suggested by the doctor)
  • Anti-inflammatory treatment
  • Anticonvulsant Medications
  • Bed rest
  • Keep distance from sick person

Further, vigilance and attentive care are very critical to determine the intensification of the acute rheumatic fever problem. In India, 75% of people with acute rheumatic fever recover and lead a normal life. Thus, it is important to know everything – causes, symptoms, treatment – to ensure that the problem is not neglected and is treated adequately, promoting a healthy heart and healthy body.

Living with a pacemaker- what patient feels

One of the most common diseases associated with mortality are cardiovascular problems. Due to the lack of physical activity, urbanized lifestyle, unhealthy eating habits, lack of nutrition, and various other socio-economic conditions – cardiovascular problems have steeply risen. While there are multiple medical treatments available for heart problems, a pacemaker remains one of the most important advances in providing care for patients. A pacemaker is not merely a device that lowers heart problems but is also essential in retaining the patient’s peace of mind, ensuring them a quality of life and providing assurance of safety. Technically, a pacemaker is a device that continuously monitors the heartbeat to record any erratic movements and sends electrical impulses to the heart muscle to maintain a healthy heart rate. Your doctor may recommend you a pacemaker in conditions such as arrhythmia, fainting spells and congestive heart failure. Depending on the severity of the heart problem, an appropriate pacemaker from the three types is recommended:

  • Single chamber: Carries electrical impulses to the right ventricle
  • Dual chamber: Carries electrical impulses to the right ventricle and atrium
  • Biventricular: Corrects abnormal electrical systems by stimulating lower chambers of the heart.

A pacemaker is temporarily or permanently implanted (depending on patient’s condition) under the skin of the chest via a minor surgery. Pacemakers are usually fitted in about an hour but work for as long as eight to ten years, powered by a battery. With minor precautions and safety measures, a pacemaker grants you a second lease of life and functions effectively to provide you all the support needed. While living with a pacemaker could be slightly challenging at first for some patients due to mental expectations, minor change in quality of life, emotional disorders, and psycho-social compatibility issues – eventually the idea settles in. Though on the other hand, some patients might not feel any major change at all and continue swiftly with their everyday lives without stressing about the pacemaker.

Once the pacemaker is implanted, a patient might feel worried about safety measures, precautions, medications, change in lifestyle, and other perceived problems. Patients should, however, feel confident and free to ask all questions from the doctors and get clarifications on anything that could possibly cause trouble. As days’ advance, most patients might not even feel the presence of a pacemaker and go about their daily lives, without thinking about it. However, it is vital for the patients to understand that a certain change in their routine and lifestyle would be demanded by the pacemaker to keep the heart healthy.

While some patients might feel that they would need to refrain from physical activities post implantation of a pacemaker, it is not the case. Instead, being physically active is what is required, once eight to ten weeks post the pacemaker implantation have passed. During this time, the patient must allow the pacemaker to settle in, avoid sudden movements, and refrain from creating any pressure on the pacemaker. Once this term ends, your pacemaker will support you in carrying on all normal activities of a person your age.

For patients who fear the pacemaker safety, you must know that it is implanted in the chest and cannot be harmed unless specific actions directed specially for the cause are undertaken. So, you can take a shower, go swimming, and travel via car, train or flight – because the pacemaker is protected against all of it. Though one thing you must stay away from is strong magnetic force and electrical fields. Some patients also feel the need to restrain from sexual activity to avoid damaging the pacemaker but the case is not so. A pacemaker is a medical innovation that cures heart problems while maintaining a good quality of life; hence, sexual activities are completely allowed and one does not need to feel scared or stay troubled worrying about the pacemaker.

That said, a patient might sometimes feel the spotlight, when the security checks at various places – such as the malls, movie theatres, airports, etc. – detect the pacemaker in the security devices. Hence, it is advisable to make the security personnel aware of the pacemaker in advance and also mentally prepare yourself for the entire process. You might even be asked to go through a different security check but one must not let it bother.

While living with a pacemaker, you do not have be alert and vigilant always. You can let your guards down and need not doubt everything that you are likely indulge in. While precaution is always advisable, it is still more strengthening to get all information needed beforehand and once thorough the process, aim to spend a quality life.

Further, it is vital to check with the doctor periodically to assess the pacemaker functioning. The patient should not neglect any medications or specific alterations in lifestyle suggested by the doctor. More so, it is always recommended that one must carry a pacemaker ID as it helps in cases of accidents, diagnosis, medical examinations, etc.

Even after so many successful implantations, a pacemaker still remains a grey area for many patients; however, it is one the most important medical advancements that not only assures fit survival but also help retain a quality of life. A pacemaker is a second strike at life.

Hypertensive and high blood pressure heart disease

Blood pressure of a body is determined by the blood pumped by the heart and the resistance to blood flow in the arteries. High blood pressure is an alarming condition and also the prime cause of death due to hypertensive heart diseases. High blood pressure or high BP raises the heat of the body to extreme levels which when functioning under extreme pressure leads to acute heart disorders such as heart failure, thickening of the heart muscle, coronary heart disease, and several other serious conditions. Hypertensive heart diseases are very critical and could also lead to death. High blood pressure causes excessive strain on the blood causing the coronary arteries to become narrowed over time due to the build-up of fat, cholesterol and other substances. This build-up of plaque is also called atherosclerosis. Due to build-up of plaque over time, the arteries serving the heart harden, and blood clots tend to block the proper flow of blood through the heart leading to deprivation of oxygen and essential nutrients in the heart creating possible conditions for a heart attack.

Today, hypertensive heart diseases are one of the major causes of heart attacks and also have a very high record of heart attacks leading to death. Hence, it is very important to get a deeper knowledge of hypertensive heart diseases, its types, risk factors, symptoms, diagnosis and treatment.

Types of hypertensive heart diseases

The various kind of hypertensive heart diseases associated with high BP includes:

Narrowed arteries: High blood pressure causes the arteries to become blocked due to the formation of blood clots caused by excess build-up plaque over time. These blocked blood vessels lead to a slow or stoppage of blood flow in the heart causing critical damage. The restricted blood flow of the heart interferes in its proper functioning and affects other organs simultaneously, leading to a heart attack in many cases.

Thickened and enlarged heart:  Also known as ventricular hypertrophy (LVH), this condition occurs when due to excessive pressure the heart faces difficulty in pumping blood leading to improper functioning of the heart. The heart has to work more to pump blood and hence, becomes more stressed. This leads to thickening and enlargement of the heart, while at the same time compresses the coronary arteries putting the person at extreme risk of heart failure, arrhythmia, ischemic heart disease, heart attack, sudden cardiac arrest, stroke or sudden death.

That said, today hypertensive heart diseases cause a large number of deaths in the country and need more awareness and vigilance. High blood pressure also causes increased risk to your brain and can lead to problems such as stroke, dementia, cognitive impairment, etc. It is also very harmful for the kidneys, eyes, and decreases your sexual ability. High blood pressure combined with factors listed below can increases the risk of hypertensive heart disease.

  • Overweight or obesity
  • Lack of physical activity
  • Smoking
  • Excessive alcohol
  • Unhealthy eating habits
  • High cholesterol
  • Excessive salt in the diet
  • Lack of potassium
  • Stress

Also, hypertensive heart diseases are likely to occur if it runs in the family. The risk of hypertensive heart disease also increases with the passing of age for both – men and women.

While it is important to know the cause of hypertensive heart diseases it is also very critical to identify symptoms to know when to seek medical help. You could have high blood pressure for years and not witness any symptoms, while on the other hand, you might experience the below symptoms quite early if you have high BP.

Symptoms of hypertensive heart disease include:

  • Acute chest pain
  • Pressure or tightness in the chest
  • Breathlessness
  • Fatigue
  • Nausea
  • Intense and persistent cough
  • Lack of appetite
  • Excessive sweating
  • Bloating
  • Increased urination at night
  • Swelling in leg or ankle
  • Excessive pain in body parts such as the neck, back, arms or shoulders
  • Sudden erratic heartbeats
  • Irregular pulse rate
  • Weakness

These are some common symptoms that vary depending on person-to-person and severity of the condition. One should always be cautious lookout for symptoms, as well as get regular check-ups and doctor consultation to check on health especially the blood pressure. A doctor might use any of such tests – electrocardiogram, coronary angiography, stress test, and nuclear stress test – to determine the condition of the heart.

Diagnosis of hypertensive heart problem

  • High blood pressure
  • Enlarged heart
  • Irregular heartbeat
  • Build-up of fluid in the lungs
  • Heart murmurs

The kind of treatment suggested for hypertensive heart disease depends on the seriousness of the condition, age, and medical history. Foremost, the doctors will treat the high blood pressure that is the main problem causing hypertensive heart diseases and otherwise advice medications or suggest surgery in serious cases. More importantly, a lot of lifestyle changes such as a healthy diet, right weight, no smoking, no alcohol, and regular health check-ups go a long way in detecting and curing hypertensive heart diseases. 

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