Showing posts with label complication. Show all posts
Showing posts with label complication. Show all posts

Tuesday, April 2, 2013

Congenital Heart Disease

Congenital Heart Disease
Congenital heart disease is one of the types of heart disease. Congenital heart disease can be developed in a patient since birth that is why it is termed as congenital disease. It can be seen in children and adults. The improper formation of valves and heart muscle give rise to this type of heart disease. The other complications included in this type of disease is the holes in the heart and narrowing of the section of aorta. In most of the cases this disease is detected at the time of the birth while in other cases it comes to know in the later life. According to a research it is found that 1% of the infants are born with some heart problems. Doctors have found many conditions under which the baby is born with a congenital heart disease. Some of the conditions are consumption of alcohol during pregnancy, Congenital heart disease in the baby's mother or father, consumption of cocaine during pregnancy, diabetes in mother, etc. Sometimes the babies are born with heart defects without these conditions. One of the main reasons of heart problems is the improper diet and lack of exercise. In most of the cases the disease is detected in by the doctor at the time of the birth.

Children suffering from congenital heart disease must be given special care must continue with the medications prescribed by the doctor. Taking antibiotics is good which will protect the children from infective endocarditis. In many cases doctor suggest surgery to avoid further complications. There are many types of congenital heart diseases like Persistent truncus arteriosus, Patent ductus arteriosus, Ebstein's anomaly, Ventricular septal defect (VSD), Total anomalous pulmonary venous connection, Tetralogy of Fallot, Atrial septal defect (ASD), Pulmonary atresia, Pulmonary Stenosis, Hypoplastic left heart syndrome, Atrioventricular canal defect, Tricuspid atresia, Aortic Stenosis, Transposition of the great arteries and Coarctation of the aorta. According to a research it is found that eight in every thousand babies are born with heart problems. If the heart problem remains undetected in the early life it can give rise to many risk in future. These days doctors can even detect the heart problem in child before the baby is born. Here are some of the examples of congenital heart disease like abnormal connections between the vessels and chambers of the heart, narrowing of the artery of the body, failure caused by a blood channel, blockages in the pathways between the lung and heart, openings in the internal wall of the heart, narrowing of the heart valves, etc.

In congenital heart disease the blood is obstructed in the vessels of the heart problem sometime leading to heart attack. When the flow of blood is obstructed it puts strain on the patients heart. Sometimes the abnormal blood flow also happens when there is a hole in heart walls. An early diagnose is to be done if the baby is showing the symptoms of congenital heart disease. Diet should be improved to reduce the risk and complications.

Friday, January 4, 2013

Reperfusion injury

Reperfusion injury has been defined as myocardial tissue blood supply after a period of ischemia. Whether reperfusion merely  accelerates the damage that would have occurred during the initial ischemia  or whether there is a additional injury caused by reperfusion itself is still researched. Although the crucial role of reperfusion injury in revascularization procedures has bees recognized, the etiology and pathogenesis of this phenomenon remain unknown.
Myocardial ischemia accompanied by reperfusion injury followed by complete normalization if it took 5 minutes, by diastolic and systolic dysfunction if ischemia took 15-20 minutes and without return contractile function if ischemia took more than one hour.
The most common cause found in patients who died after reperfusion is hemorrhagic infarction. In myocardial infarction of less than 3 days the cellular response is present throughout the myocardial infarction, in contrast to the distinct zones seen in the non- reperfused myocardial infarctions. Reperfusion itself may produce injury.

The mediators of reperfusion injury

Reperfusion injury
One of the mediators of reperfusion injury is oxygen free radicals. The possible role of reactive oxygen species in reperfusion injury has evolved from our knowledge. They elaborate enzyme systems that rapidly detoxify superoxide and peroxide. The metabolism of reactive oxygen also has damaging effects. The investigators of this event have suspected that even physiological quantities of peroxide may inhibit the aerobic oxidation of pyruvate and thus restrict cellular ATP formation.
Another mediator of reperfusion injury is endothelial dysfunction and microvascular injury. Recent reports indicate that endothelium-dependent relaxation  of coronary microvessels is markedly impaired after ischemia with reperfusion. This microvascular endothelium dysfunction may be caused by blood products or myocardial metabolites that are released during the reperfusion period or by oxygen free radicals.
One of the oldest hypotheses about reperfusion injury involved calcium overload. Other mediators involved in reperfusion injury are altered myocardial metabolism and endogenous protective mechanisms.
There are some cardiovascular risk factors influence reperfusion injury. This are  hypercholesterolemia, very high glucose and hypertension.

Pharmacological methods to attenuate reperfusion injury

There are a number of pharmacological methods for attenuate reperfusion injury. In the treatment of myocardial infarction, restoration of coronary flow as soon as possible is a very important thing to prevent and reduce myocardial necrosis and ischemia. By this treatment ensure a reduction of mortality,  complications and a good prognosis in infarction. Early myocardial reperfusion injury prevent necrosis; in this way systolic and diastolic functions are established and are preventable fatal arrhythmias. In the early hours of  infarction,  reperfusion injury offers the greatest benefits: higher thrombus lysis.
Anti-ischemic therapy and lytic therapy has an important role to reduce myocardial energy demand. There are three revascularizations methods: trombembolitic treatment,  coronary angioplasty and coronary bypass. To thrombolytic treatment add anticoagulant and antithrombotic treatment and GP IIb/IIIa blockers. Thrombolytic agents currently used are streptokinase, tissue plasminogen activator and urokinase.

Conclusion for reperfusion injury

In conclusion the beneficial effect of fast recanalization may be offset by reperfusion injury.

Wednesday, November 7, 2012

Flu symptoms in adults

Flu symptoms in adults- different faces of the same disease

In the last years more and more people complain from flu symptoms and every year new vaccines are elaborated. People started to be very worried about flu symptoms in adults especially after the outbreaks of avian flu and AH1N1 virus, even if the “common” flu virus could cause death too. Because of the large number of people vaccinated, contradictory opinions about the efficiency and possible complications coming from the vaccination began to appear  and the result was that many people refused the vaccine.
People also searched for ways to strengthen the immunity system and they choose to use different types of medication based on plants. In clinical practice, because of the large number of patients that died even if they had no risk factors associated, doctors started to treat pneumonia with antiviral and antibiotic medication. But the more the antiviral medication is used, the more the risk of developing resistance to this treatment increases.

Next we will talk about flu symptoms in adults and its complication.

Why are we so concerned about flu symptoms in adults? For many of us, flu is just a common disease; we all had it at some point and as some use to say it lasts 7 days if you treated or one week if you don’t. But are flu symptoms in adults so insignificant that doesn’t worth talking about? This is a false idea among us that flu symptoms in adults are common manifestations. The truth is that in some people flu symptoms in adults can be as devastating as cancer or heart disease.
The main flu symptoms in adults:
  • fever-some wrongly believe that fever is determined only by bacterial infection. It is a wrong idea, both viruses and bacteria can determine high fever and they can disseminate to other organs through blood,
  • shivers- the feeling of body shaking
  • sweating-the body tries to lose some water in order to decrease the temperature,
  • headaches
  • rhinorhea-water discharge from the nose as we call it
  • cough-first it can start as a dry cough, but  in a few days expectoration can appear, considering that even viral infection can determine a secondary bacterial infection,
  • sore throat with pains that increase while trying to swallow
  • severe aches and pains in muscle and joints
  • generalized weakness and fatigue, feeling the need of lying down,
  • being unable to eat,
  • nausea and vomiting.
Flu symptoms in adults usually last a few days (about a week), but in some cases other complication can occur:
  • pneumonia- a flu symptom in adults that seems simple to deal, can  get complicated with a lower respiratory tract infection like pneumonia. In patient with reduced immunity as are those suffering from AIDS, these infections can be fatal, even if for many of us it can be a common disorder.
  • invasion of the virus in other organs through blood flow, which leads to a condition called septicemia, one of the worst flu symptoms in adults and an important threat to patient’s life,
  • meningitis-if the viruses reach the nervous system, they can determine meningitis, which is an infection of the tissues layers that cover the brain and are called meninges.
  • shortness of breath or fast breathing, bluish skin color (the blood hasn’t enough oxygen)
  • neurologic symptoms: dizziness, drowsiness, confusion
  • fulminant myocarditis
  • pulmonary embolism (blood clots in the pulmonary arteries) seems to be linked to the infection determined by AH1N1 virus,
Complications are more common in people suffering from respiratory, cardiac disease obesity and of course, those with diminished immunity (like patients with AIDS).
As we saw, flu symptoms in adults can be common or can be very serious, depending of the aggressiveness of the virus, the immunity system of the host, the risk factors associated, but it is important to remember that it can be fatal (about 40.000 people died every year, in USA, in the past 20 years, because of the flu).

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