Untitled Document

ANGINA PECTORIS

What is angina pectoris?

Angina Pectoris is the chest pain associated with coronary heart disease. Like any other body muscle, your heart muscle needs oxygen carried by the blood in order to work at a given level of demand. If you put an increasing demand on your heart muscle, such as running, heavy work, emotional stress, extremes in temprature, your heart will need more blood supply than at rest. Insufficient blood supply "ischemia" to the heart could trigger Angina Pectoris, which is felt as a chest pain.

People diagnosed with coronary artery spasm may experience an attack while at rest. This can signify severe coronary atherosclerosis (plaque) in at lease one major coronary artery.

Diagnostic Testing:

Ergonovine is a drug which is administered to actually induce a coronary spasm. This test is sometime used to help your cardiologist diagnose Coronary Spasm Angina.

Common Treatment:

Angioplasty and Cardiac Revascularization, Transmyocardial Revascularization (TMR)

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

ARRHYTHMIA

What are arrhythmias?

The heart is composed of four chambers, the two top chambers are the atria, and the lower two are the ventricles. When your heart beats normally, it is pumping the blood from one chamber to another, then out back to the body, in a rhythmic fashion. What the heart is doing is taking the blood after it had circulated in the body, oxygenating it through the lungs, then returning the oxygenated blood for use again by the body. When this rhythm becomes irregular, the condition is called arrhythmia.

Click to hear normal heart beat sounds

The regular rhythm of the heart is managed by paced electrical impulses causing the heart chambers to contract in sequence. A concentrated node of specialized cells in the right atrium (the sinoatrial node or SA node) initiates the rhythm by firing an electric charge which causes the atria to contract. This electric current is then picked up by another group of specialized cells located between the atria and the ventricles (the Atrioventricular node or AV-node) and is spread down a path of specialized fibers (the Hiss-Purkinje system) to the both left and right ventricles simultaneously causing them to contract. This exact route must be followed for the heart to work normally.

Under some conditions, any part of the heart can become the pace maker i.e. initiate the electric impulse normally initiated by the SA node. When the SA node does not fire normally, or when another part of the heart takes over as pace maker, an arrhythmia occurs. These problems can result in various conditions such as:

Bradycarhdi, when the hart beat is too slow. Symptoms can include fatigue, dizziness, lightheadedness, or fainting spells. Implanting a pacemaker under the skin is used to speed the rate the heart beat and alleviate the symptoms.

Tachycardia, is when the heart is beating rapidly. Symptoms are palpitations, rapid heart beat, dizziness, lightheadedness, and fainting spells. Rapid heartbeat is treated with medications.

Atrial Fibrillation is when the two upper chambers (atria) contract too rapidly (quiver) to effectively pump empty out the blood received. Pooling of the blood in the atria occurs, which may cause a clot to form. A clot thus formed may travel to the brain causing a stroke; about 15% of the strokes occur in people with Atrial fibrillation.

Ventricular Tachycardia, is when the ventricles are rapidly contracting (quivering) on their own, too ineffective to pump any blood volume. This is the most serious of cardiac arrhythmia and death follows unless medical attention is provided immediately. Vernacular Tachycardia is treated by using electric shock to convert the heart beat into a normal rhythm.

Today one effective way of correcting these life-threatening rhythms is by using an electronic device called an implantable cardioverter /defibrillator.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

ATHEROSCLEROSIS

What is Atherosclerosis?

Hardened build up of fatty substances, cholesterol, calcium, and cellular waste that are deposited on the inner walls of arteries, is known as plaque. In addition to hardening of the arteries, the plaque build may reduce or totally block the blood flow to the organs, including the heart. As the blood continues to press through clogged vessels, hemorrhage (bleeding) inside the arterial walls may occur. A blood clot (thrombus) is then formed on the surface of the plaque, further aggravating the blockage. If this occurs in the coronary arteries, a heart attack may result, while atherosclerosis of the cerebral arteries can precipitate a stroke.

Atherosclerosis knows no age. It is a slow, progressive disease that may start at childhood, and can become threatening as early as mid thirties for some people. In others it does not become threatening until they are in their fifties or sixties. Factors contributing to the progression of Atherosclerosis include elevated blood cholesterol and triglycerides, high blood pressure, and tobacco smoke. These factors combine to cause damage to the inner most layer of arteries (endothelium), causing the formation of lesions on the inner arterial walls. The lesions act to trap more fatty deposits, cellular debris, and calcium. The innermost layer of the affected arterial wall thickens with the accumulating deposits. As you can imagine, this reduces the diameter of the blood vessel, and therefore the volume of oxygen carrying blood flowing through it. When the blood supply to the heart is materially reduced, a heart attack can occur. If the blood supply to the brain is cut off, a stroke can occur.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

ATRIAL FIBRILLATION

What is Atrial Fibrillation?

This condition occurs when the two upper chambers (atria) contract too rapidly (quiver) to effectively empty out the volume of blood they received. Pooling of the blood in the atria occurs, which may cause a clot to form. A clot thus formed may travel to the brain causing a stroke; about 15% of the strokes occur in people with Atrial fibrillation.

Treatment:

Treatment is preventive and is nested into interfering with blood clotting. Anticoagulants, Aspirin and warfarin are medications that interfere with clotting, thus help reduce the risk of stroke in people with Atrial Fibrillation.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

BUNDLE BRANCH BLOCK

What is a bundle branch block?

When an electric current is fed through a muscle, the muscle will contract. Maybe you remember your high school biology experiment where you put an electric current through a frog's leg muscle and watched it contract! This is how our heart muscle manages to rhythmically pump throughout our lifetime. Special group of cells in the Atrium of the heart (sinoatrial node) initiate a small electric current causing the two upper chambers (atria) to contract. As the atria contract, the small electric current is then picked up by another center located between the atria and the ventricles (AV-node), and transmitted to the two ventricles simultaneously along two (left & right) fiber pathways, causing both the right and left ventricles to contract (pump). The current going to the ventricles travel at the same speed. When a blockage to the transmission of this current occurs, it causes a small delay between the contractions of the right and left ventricles.

Usually of there is nothing else wrong, people may be diagnosed with left or right bundle branch block and feel just fine. However, there is something wrong and you must regularly see your doctor.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

CARDIOMYOPATHY

What is Cardiomyopathy?

Cardiomyopathy is a serious disease in which the heart muscle becomes inflamed and doesn't work as well as it should. Reasons leading to Cardiomyopathty are many. In Primary Cardiomyopathy, the disease progresses because of a cardio-vascular condition such as hypertension, pathology in the valves of the heart, or congenital heart defects. In Secondary Cardiomyopathy, the disease is a result of pathology in other organs as well as in the heart. The types of Cardiomyopathy that can be diagnosed are: dilated (congestive), enlarged due to thickening of the walls (hypertrophic), and restrictive.

Congestive Cardiomyopathy is the most common type, in which the heart cavity is enlarged and walls of the heart are stretched. The heart muscle is weakened and therefore does not pump as well as that of a healthy heart. Electrical disturbance and Arrhythmia can accompany this condition.

As the force of the pump action of the heart weakens, the blood circulation slows to the extent that clots may form and attach themselves to the walls of the various chambers of the heart. Clots that break free from the walls of the right ventricle are carried by the pulmonary artery into the lungs where they may lodge in the small vessels causing pulmonary emboli. Clots dislodged from the left chambers of the heart can enter the body's circulation and may become lodged in the brain causing a brain stroke, kidney, or even the coronary arteries causing a heart attack.

If the dilation of the heart cavity is advanced, the valves between the heart chambers (mitral, and tricuspid) may not be able to close completely, and a murmur can be heard.

Treatment of Congestive Cardiomyopathy include anti-clotting drug therapy, and when arrhythmia is present, antiarrhytmic drugs are prescribed. More rarely, "heart block" may develop, requiring an artificial pacemaker.

Hypertrophic Cardiomyopathy is when the walls of the left ventricle, which pumps blood to the Aorta, are enlarged. In one form of the disease," hypertrophic obstructive Cardiomyopathy", the wall of the septum separating the right and left ventricles becomes enlarged and obstructs the blood flow from the left ventricle. This may further affect the mitral valve causing it to leak and a murmur may be heard. For over half the cases, this disease is hereditary.

Treatment of Hypertrophic Cardiomyopathy may include a beta blocker such as propranolol, or a calcium channel blocker. Surgical treatment to cut away the extra heart muscle may be indicated in the case of the obstructive form of the disease. A new treatment, alcohol ablation, practiced in few centers in the United States, is showing encouraging results. This treatment involves injecting alcohol down a small artery into the enlarged heart muscle. The treatment results in reducing the extra muscle without having to cut it out surgically.

Restrictive Cardiomyopathy is the least common form of Cardiomyopathy. In this case, the muscle tissue of the ventricles becomes rigid and loses its ability to relax after contraction. This does not allow the ventricles to fill up with blood between heartbeats. This reduces the circulation of the blood in the body causing difficulty breathing and edema (fluid build up) in the extremities.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

LONG Q-T SYNDROME

What is Long Q-T Syndrome?

The heart muscle contractions are synchronized by electric impulses that are discharged by specialized heart cells and carried along certain pathways through the heart muscle. These impulses can be recorded and measured by an electrocardiogram (EKG, or ECG). The electric impulse is shown on an EKG as a repeating wave form. Cardiologists divide this wave into specific, individually measurable, segments that correspond to specific actions from the myocardium. The wave segments are separated by the letters P Q R S T. Distances between the letters measure time it takes for the impulse to travel through the heart from initiation of a heartbeat (P) to its completion and rest of the muscle (T).

The "Q-T" segment interval represents the time elapsed from the activation to the deactivation of the ventricles (the two lower chambers of the heart). A long QT segment means that it takes longer than normal for this ventricular action to occur. The disease is hereditary and usually affects children and young people. Individuals may have the syndrome and not exhibit symptoms. People who do have symptoms may suffer from fainting, abnormal heart rate and/or arrhythmia (disturbance of the normal heart beat (rhythm).

It should be emphasized that people suffering prolonged Q-T segment, do not have it all the time, and therefore it may not show up in a routine EKG. Family history, and unexplained fainting episodes may cause your physician to suspect the condition.

Treatment includes medications such as beta blockers, or surgical intervention. Some affected individuals may benefit from an implantable defibrillator.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

PREMATURE VENTRICULAR CONTRACTIONS (PVCs)

What are PVCs?

Premature ventricular Contractions (P.V.C.), are extra heartbeats, often felt as a "missed beat". This occurs because of an extra electrical discharge from the ventricles (the two lower chambers of the heart). This electrical firing disrupts the normal heart rhythm.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

Back to top

PRINTZMETAL ANGINA

What is Printzmetal Angina?

It is not a rock star from Minnesota! Unlike other angina, Prinzmetal's Angina does not follow a period of increased demand on the heart, and almost always occurs when the person is at rest. Usually attacks happen in the middle of the night and can be quite painful. The attack may be associated with a heart attack (acute myocardial infarction) and severe cardiac arrhythmia.

SILENT ISCHEMIA AND ISCHEMIC HEART DISEASE

What is Ischemic Heart Disease?

The word Ischemia refers to temporary shortage of oxygen to a part of the body. This occurs when a narrowing or a blockage of a blood vessel prevents oxygenated blood from reaching that part of the body. When it occurs in the brain, some of the brain tissue die and a stroke may result. When Ischemia happens in the heart, some of the heart tissue die and the individual may suffer a heart attack. Individuals who suffer ischemic episodes without feeling any pain are said to have silent ischemia. These individuals may suffer a heart attack without the classic warnings of chest pain. Tests to diagnose silent ischemia include stress tests and wearing of Holter monitors to record EKG on a continuous basis.

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.

VENTRICULAR FIBRILLATION

What is Ventricular Fibrillation?

The regular rhythm of the heart is managed by paced electrical impulses causing the heart chambers to contract in sequence and with a certain force. Under certain conditions, centers in the tissue of the ventricles begin to fire electrical impulses rapidly and disorderly, causing the ventricles to quiver. The rapid disorderly contractions of the ventricles are without much force, and the ventricles are unable to pump any blood volume. Medical help must be provided immediately or collapse and sudden death may follow.

This irregular activity of the ventricles can be stopped and coverted back to the normal rhythm through the use of electric shock. These days one effective way of correcting these life-threatening rhythms is by using an electronic device called an implantable cardioverter-defibrillator .

Information provided by this Web Site is not intended as a substitute for medical advice or to treatment from your medical doctor.