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    • Interventional Cardiology >
      • Watchman Device
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    • Billing Questions
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PATIENT EDUCATION

Did You Know?

Learning About Your Heart Can Help
We find ways to manage your health, so you can live well with your condition. 
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PATIENT EDUCATION VIDEOS
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National Library of Medicine

​How Does My Heart Work?

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The heart’s primary function is to pump oxygenated blood out to the body. The heart has four chambers. The upper chambers are called the left and right atria, and the lower chambers are called the left and right ventricles. The heart has four valves that regulate blood flow through your heart. The tricuspid valve regulates blood flow between the right atrium and the right ventricle. The pulmonary valve controls blood flow from the right ventricle into the pulmonary arteries, which carry blood to your lungs to pick up oxygen. The mitral valve lets oxygen-rich blood from your lungs pass from the left atrium into the left ventricle. The aortic valve opens the way for the oxygen-rich blood to pass from the left ventricle into the aorta and out to your body.

CONDITIONS WE TREAT

ANGINA​
​ANGINA
Angina refers to pain or discomfort in the chest. Angina is not a disease itself, but rather a symptom of another underlying heart problem.

WHAT CAUSES ANGINA?
Angina occurs when the heart doesn’t get all of the oxygen-rich blood it needs to work properly. This often happens when one or more of the arteries that feed the heart—the coronary arteries—are narrowed or blocked.

WHAT ARE THE SYMPTOMS OF ANGINA?
Angina typically causes pain or discomfort in the shoulders, arms, chest, neck, jaw or back. They may also feel short of breath, profoundly fatigued, nauseous or experience pain between their shoulder blades. Angina pain can also feel like indigestion the symptoms of angina can vary from person to person.

WHAT HEART CONDITIONS CAN CAUSE ANGINA?
Angina is not a disease.  It’s a symptom of an underlying heart condition. Often this condition is coronary heart disease (CHD), which occurs when plaque builds up in the heart’s arteries. Angina can also signal coronary microvascular disease: damage to the walls and lining of the blood vessels branching off from the arteries that provide blood to the heart.

Other conditions that can cause chest pain include:

Pulmonary embolism (a blockage in a lung artery)
Cardiomyopathy (diseases of the heart muscle)
Aortic dissection (a tear in the aorta)
Aortic stenosis (narrowing of the aortic valve)
Pericarditis (inflammation of the heart’s surrounding tissue)
Lung infection
Gastroesophageal disease (GERD)
HOW IS ANGINA DIAGNOSED?
Your doctor will first want to determine whether the angina is stable (a regular pattern of the heart overworking) or unstable (unexpected chest pain, that does not follow an expected pattern). Because unstable angina can signal a heart attack, your doctor may order the following tests:

Blood tests
Chest X-rays
Computed tomography (CT) angiography
Electrocardiogram (EKG)
Stress testing
Echocardiogram
HOW IS ANGINA TREATED?
Treatment for angina depends on the type and underlying cause. Lifestyle changes, medication and cardiac rehab may be used to treat stable angina and decrease your risk for heart attack.

If you have unstable angina, your doctor will first need to find the blocked parts of the coronary arteries by performing a cardiac catheterization. Depending on the extent of the blockages, you may need surgery.
​Aortic Dissections
​AORTIC DISSECTIONS
An aortic dissection is a tear in the inner layer of the aorta that lets blood surge through the tear causing the inner and middle layers of the wall, to separate. If the blood-filled channel ruptures through the outside aortic wall layer, then aortic dissection is often fatal.

WHAT CAUSES AN AORTIC DISSECTION?
The aorta is an artery that runs up through the chest toward the head and then down through the chest, where it divides into a blood vessel that supplies blood to each leg. The walls of the aorta are made up of three layers:

The innermost layer, the intima, is smooth to allow blood to flow across it
The middle layer, the media, is made up of muscular and elastic fibers that let the aorta expand and contract with every heartbeat
The outer layer, the adventitia, includes vessels that supply the aortic wall with oxygen-rich blood 
Aortic dissections are divided into two groups:

Type A: this is the more common and dangerous type involving a tear in the part of the aorta where it exits the heart or a tear in the upper aorta( ascending aorta) which  may then extend into the abdomen
Type B: this involves a tear in the lower aorta only (descending aorta) which may then also extend into the abdomen.
Most of the time, an aortic dissection occurs because of a tear or damage to a weakened area within the inner wall of the aorta. The exact cause is usually hard to pinpoint, but there are a number of risk factors:

Aging
Blunt trauma to the chest
Uncontrolled high blood pressure (hypertension)
Hardening of the arteries (atherosclerosis)
Weakened and bulging artery ( pre existing aortic aneurysm)
Narrowing of the aorta at birth (coarctation)
Disorders of the connective tissue
Heart surgery or procedures
Pregnancy
High-intensity weightlifting
WHAT ARE THE SYMPTOMS OF AN AORTIC DISSECTION?
The symptoms of an aortic dissection usually begin suddenly and include severe angina (chest pain). It is often described as a sudden tearing, ripping or shearing sensation that radiates to the neck or down the back. You may experience pain below the chest bone, under the shoulder blades, or in the back, though it may move to your shoulder, neck, arm, jaw, abdomen or hips.

Other symptoms of an aortic dissection include:

Fainting or dizziness
Loss of consciousness
Heavy sweating
Nausea and vomiting
Pale or clammy skin
Shortness of breath
Heart palpitations
Anxiety
Difficulty swallowing
Abdominal pain
HOW IS AN AORTIC DISSECTION DIAGNOSED? DETECTING AN AORTIC DISSECTION IS DIFFICULT BECAUSE THE SYMPTOMS ARE SIMILAR TO THOSE OF A VARIETY OF HEALTH PROBLEMS. DOCTORS MAY SUSPECT AN AORTIC DISSECTION IF THE FOLLOWING ARE PRESENT:
Sudden tearing or ripping chest pain
Widening of the aorta on chest  X-ray
Blood pressure measurement difference between right and left arms
Your doctor may order tests to confirm the diagnosis, including the following:

Aortic angiography
Chest X-ray
Echocardiography
Computerized tomography (CT) with dye
Magnetic resonance imaging (MRI)
Trans esophageal echocardiogram (TEE)
HOW IS AN AORTIC DISSECTION TREATED?
Treatment for an aortic dissection depends on which part of the aorta is affected and whether other structures in the heart are damaged, such as the aortic valve or the heart arteries.

Surgery is recommended for a dissection in the part of the aorta that ascends from the heart. Dissections in the chest or abdominal sections of the aorta may be managed with surgery and medication.
​Arrhythmia
​ARRHYTHMIA
Arrhythmia is a disruption in the heart’s normal beating rhythm.

WHAT CAUSES ARRHYTHMIA?
The heart relies on an electrical impulse from the sinoatrial node to beat properly. Normally, the electrical impulse begins in the heart’s right atrium and spreads throughout the atria to the atrioventricular (AV) node, which acts as the heart’s “natural pacemaker.” From there, the impulses travel to the left and right ventricles of the heart. This exact route is followed when the heart beats normally (about 60 to 100 times a minute in an adult).

An arrhythmia occurs when any change disrupts this normal sequence of electrical impulses. The sequence can happen too quickly, too slowly or erratically. A fast rate (more than 100 beats per minute) is called tachycardia, while a slow rate (less than 60 beats per minute) is called bradycardia.

An arrhythmia can be triggered by a number of things, including:

Drug use
Smoking
Caffeine
Stress
Exercise
Problems with any of the nerve impulses or hormones that influence the heartbeat
Other heart conditions (coronary artery disease, heart valve disease, heart failure)
WHAT ARE THE SYMPTOMS OF ARRHYTHMIA?
Symptoms of arrhythmia include:

Fast( may feel rapid pounding in chest) or slow heartbeat or skipping a beat(fluttering sensation)
Lightheadedness or dizziness
Chest pain
Shortness of breath
Sweating
HOW IS ARRHYTHMIA DIAGNOSED?
During a physical exam, your doctor will listen to your heart with a stethoscope, evaluating the rate and rhythm of your heartbeat and checking for a heart murmur. Other tests that may be used to diagnose arrhythmia include:

Blood tests
Chest X-ray
Coronary angiography
Echocardiography
Electrocardiogram (EKG)
Electrophysiology study (EPS)
Halter monitor or an event monitor
Implantable loop recorder
Stress testing
Tilt table testing
HOW IS ARRHYTHMIA TREATED?
Treatment options will vary depending on the kind of arrhythmia that you have and whether another health condition is causing the arrhythmia. Some mild arrhythmias require no treatment, while others require medication or more aggressive treatments, such as:

An artificial pacemaker
An implantable cardioverter defibrillator (ICD) device
Cardiac defibrillation  
Catheter ablation
Surgery for underlying conditions causing arrhythmia
​Atherosclerosis And Plaque
​ATHEROSCLEROSIS AND PLAQUE
Atherosclerosis is the narrowing of an artery caused by a build-up of plaque – a waxy substance made of fat, cholesterol, calcium and other substances.

WHAT CAUSES ATHEROSCLEROSIS?
Arteries are blood vessels that move oxygen-rich blood throughout the body. If these arteries become narrowed by plaque, blood flow can be partially or totally blocked. This can cause serious health problems, including heart attack and stroke.

Atherosclerosis can affect any artery in the body, including the arteries that supply blood to the heart, brain, arms, legs and kidneys. Various health conditions can develop depending on which arteries are affected.

The exact cause of the buildup of plaque isn’t known, but risk factors for atherosclerosis include smoking, high blood pressure and high cholesterol.

WHAT ARE THE SYMPTOMS OF ATHEROSCLEROSIS?
Often, you may not notice any symptoms of atherosclerosis until an artery becomes severely blocked. However, depending on where the blocked artery is in your body, you may experience varying symptoms.

For example:

Atherosclerosis in the coronary arteries, which supply oxygen-rich blood to the heart, may cause the following symptoms:

Angina (chest pain)
Shortness of breath
Arrhythmia (abnormal beating of the heart)
Atherosclerosis in the carotid arteries, which supply oxygen-rich blood to the brain, may cause symptoms of a stroke, includes:

Sudden weakness, paralysis or numbness in the face, arms or legs
Trouble speaking and seeing
Difficulty breathing
Confusion
Dizziness or loss of balance
Loss of consciousness
Atherosclerosis in the peripheral arteries, which supply oxygen-rich blood to the pelvis, arms and legs, can cause the following symptoms:

Numbness
Pain
Infection
Atherosclerosis in the renal arteries, which supply oxygen-rich blood to the kidneys, can cause the following symptoms as it progresses:

Fatigue and difficulty concentrating
Changes in frequency of urination
Loss of appetite
Nausea
Numbness or swelling in the hands or feet
HOW IS ATHEROSCLEROSIS DIAGNOSED?
During a physical exam, your doctor will use a stethoscope to listen for an abnormal sound in the affected artery. Your doctor may also check to see whether any of your pulses are weak or absent, which can signal a blocked artery.

The following tests may also help to diagnose atherosclerosis:

Angiography
Ankle/Brachial Index
Blood tests
Chest X-ray
Computed Tomography (CT) scan
Echocardiography
Electrocardiogram (EKG)
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Stress testing
HOW IS ATHEROSCLEROSIS TREATED?
Treatment options for atherosclerosis include medication, lifestyle changes, and surgery.

Lifestyle changes include:

Following a healthy diet to reduce high blood pressure and high cholesterol
Being physically active
Quitting smoking
Maintaining a healthy weight
Managing stress and coping with emotional difficulties
If your case of atherosclerosis is severe, your doctor may recommend one of the following medical procedures to reduce your risk of heart attack or stroke:

Coronary angioplasty
Coronary artery bypass grafting
Carotid endarterectomy
Atrial Fibrillation
​ATRIAL FIBRILLATION
Atrial fibrillation occurs when the heart’s two upper chambers (the atria) beat chaotically and irregularly. This can cause blood to pool in the atria because it isn’t pumped regularly into the heart’s two lower chambers (ventricles). As a result, the upper and lower chambers don’t work in sync.  

WHAT CAUSES ATRIAL FIBRILLATION?
Atrial fibrillation is an arrhythmia—a problem with the electrical signals that cause the heart to beat.

Normally, the electrical impulse that acts as the heart’s “natural pacemaker” begins in the heart’s right atrium and spreads throughout the atria. From there, the impulses travel to the left and right ventricles of the heart.

In atrial fibrillation, the signals don’t start in the right atrium like they should. Instead, they start in another part of the atria or in the pulmonary veins, which makes the signals disorganized. This can cause problems between the upper and lower chambers of the heart.

Atrial fibrillation can happen every once in a while or become a long-term heart condition that lasts many years. Possible causes of atrial fibrillation include:

High blood pressure
Heart attacks
Coronary artery disease
Abnormal heart valves
Heart defects you are born with ( congenital)
Overactive thyroid gland or other metabolic imbalance
Exposure to stimulants including  medications ,caffeine, tobacco and  alcohol
Sick sinus syndrome
Lung diseases
Previous heart surgery
Viral infections
Stress due to  pneumonia ,surgery or other illnesses
Sleep apnea
WHAT ARE THE SYMPTOMS OF ATRIAL FIBRILLATION?
The lower chambers of the heart, the ventricles, are responsible for pumping blood to the lungs and body. Atrial fibrillation can disrupt their normal rhythm and lead to the following:

Shortness of breath
Chest pain
Heart palpitations
Dizziness or fainting
Fatigue (feeling tired)
Confusion
Fatigue
Sometimes atrial fibrillation doesn’t cause any symptoms and is caught when your doctor does a test for another condition.

HOW IS ATRIAL FIBRILLATION DIAGNOSED?
Your doctor can diagnose atrial fibrillation using a combination of your medical history, a physical exam (pulse check and listening to heart sounds), and the results of the following tests:

Blood tests
Chest X-ray
Echocardiography
Electrocardiogram (EKG)
Holter and event monitors
Stress testing
Transesophageal echocardiography (TEE)
HOW IS ATRIAL FIBRILLATION TREATED? GENERALLY, THE TREATMENT GOALS FOR ATRIAL FIBRILLATION ARE TO:
Reset the rhythm or control the rate
Prevent blood clots
If atrial fibrillation isn’t caused by an underlying heart condition, it may not need any treatment and could go away on its own. However, repeat episodes can permanently damage the heart and increase your risk of a stroke, so your doctor may treat it in one of several ways:

Blood thinners to prevent blood clots
Medicines to control the heart rate (beta blockers, calcium channel blockers, or digitalis)
Electrical cardioversion
Anti-arrhythmic medications  to prevent  future episodes of atrial fibrillation after electrical cardioversion
Atrioventricular  (AV) node ablation
Maze surgery
​Cardiomyopathy
​CARDIOMYOPATHY
Cardiomyopathy refers to diseases that affect the heart muscle, making it enlarged, thick or rigid. In some rare cases, heart tissue is replaced with scar tissue. The main types of cardiomyopathy include dilated, hypertrophic and restrictive cardiomyopathy. There is a rare type called Arrhythmogenic right ventricular dysplasia

As cardiomyopathy worsens, the heart muscle weakens and becomes unable to properly circulate blood throughout the body and keep a normal electrical rhythm. This can cause heart failure or arrhythmia. 

WHAT CAUSES CARDIOMYOPATHY?
Cardiomyopathy can be “acquired” due to another disease or “inherited” through your genes. There are four main kinds of cardiomyopathy, each caused by various disorders or genetic factors.

Dilated cardiomyopathy: The most common type, it causes the heart’s chambers to dilate and enlarge. Sometimes the exact cause is unknown, but certain diseases can cause it, including coronary artery disease, heart attack, high blood pressure, diabetes, thyroid disease, HIV and infection.

Hypertrophic cardiomyopathy: This occurs when the heart’s cells enlarge and thicken the walls of the ventricles. This kind is usually inherited but can also develop as a result of high blood pressure, diabetes or thyroid disease.

Restrictive cardiomyopathy: Affecting mostly older adults, this kind stiffens the ventricles and reduces the flow of blood through the heart. It’s usually caused by a buildup of iron in the blood (hemochromatosis), inflammation of certain organs (sarcoidosis), abnormal protein buildup in the body’s organs (amyloidosis), tissue disorders and some cancer treatments.

Arrhythmogenic right ventricular dysplasia: The rarest type, it causes scar tissue to replace the healthy tissue in the right ventricle, which causes arrhythmia. It’s most likely an inherited disease.

WHAT ARE THE SYMPTOMS OF CARDIOMYOPATHY?
Cardiomyopathy doesn’t always cause symptoms. As it progresses, you may notice the following signs that signal the beginning of heart failure:

Shortness of breath
Fatigue
Swelling in the ankles, feet, legs or abdomen
Dizziness or lightheadedness
Fainting
Chest pain
Poor exercise tolerance manifested as breathlessness with minimal exertion
HOW IS CARDIOMYOPATHY DIAGNOSED?
Your doctor will listen to your heart and lungs with a stethoscope to look for sounds that suggest cardiomyopathy.

The following tests and procedures can also help diagnose cardiomyopathy:

Blood tests
Cardiac catheterization
Chest X-ray
Coronary angiography
Echocardiography
Electrocardiogram (EKG)
Genetic testing
Holter and event monitors
Myocardial biopsy
Positron emission tomography (PET) scans
Stress test
HOW IS CARDIOMYOPATHY TREATED?
Sometimes cardiomyopathy requires no treatment at all and may go away on its own. Other times, treatment is necessary depending on the kind and severity that you have. The treatment varies depending on the type of cardiomyopathy present.

To manage a condition that’s causing cardiomyopathy, your doctor may recommend:

Quitting smoking
Eating a healthy diet
Getting physical activity
Reducing stress
Avoiding alcohol and drugs
Getting plenty of rest
Treating high blood pressure or diabetes
Taking medication to lower your blood pressure or heart rate, treat arrhythmia, balance electrolytes, prevent blood clots, or reduce inflammation
You may also require a surgery or medical procedure to treat cardiomyopathy, including:

Alcohol septal ablation( a small portion of the thickened heart muscle is destroyed by injecting  alcohol  through a long ,thin tube( catheter) into the artery supplying blood to that area
Septal myectomy (The surgeon removes part of the thickened heart muscle wall known as the septum that separates  the two bottom heart chambers( ventricles) Removing part of the  heart muscle improves  functional blood flow  through the heart and reduces mitral regurgitation
Pacemaker
Left ventricular assist device (LVAD)
Implantable cardioverter defibrillator (ICD)
Heart transplant as a last resort
​Carotid Artery Disease
​CAROTID ARTERY DISEASE
Carotid artery disease is a blockage in the arteries that supply the brain and face with oxygen-rich blood. This disease causes more than half of the strokes in the United States.

WHAT CAUSES CAROTID ARTERY DISEASE?
Arteries are blood vessels that move oxygen-rich blood throughout the body. The carotid arteries supply blood to the brain, neck and face. Plaque, a waxy substance made of fat, cholesterol, calcium and other substances, can build up in the carotid arteries and partially or totally restrict the flow of blood.

Plaque can also rupture, forming a clot that restricts the flow of blood to the brain. This can lead to a stroke, which occurs when blood is cut off to part of the brain.

Risk factors for carotid artery disease include:

Smoking
High cholesterol
High blood pressure
WHAT ARE THE SYMPTOMS OF CAROTID ARTERY DISEASE?
Some people with carotid artery disease don’t experience symptoms until they have the signs of a stroke. When warning signs of carotid artery disease do occur, they may include:

Bruit: An abnormal “whooshing” sound your doctor may hear when listening to your carotid arteries with a stethoscope
Transient Ischemic Attack (TIA): A “mini-stroke” that may cause sudden numbness in the face or limbs, trouble speaking, dizziness, loss of balance and difficulty seeing
HOW IS CAROTID ARTERY DISEASE DIAGNOSED?
Carotid artery disease can be diagnosed using a combination of your medical history, a physical exam, and the results from several tests, including:

Carotid ultrasound
Carotid angiography
Magnetic resonance angiography
Computed tomography (CT) angiography
How is carotid artery disease treated?
Carotid artery disease can be treated through lifestyle changes, medication and medical procedures. Lifestyle changes that may prevent or treat coronary artery disease include:

Maintaining a healthy diet to lower high blood pressure and high blood cholesterol
Quitting smoking and avoiding secondhand smoke
Increasing your physical activity
Managing your weight
You may be prescribed medication to treat high blood pressure, high cholesterol and diabetes, which can worsen carotid artery disease. Medications such as aspirin and clopidogrel can also prevent blood clots from forming in the carotid artery, which may reduce your risk of having a stroke (always talk to your doctor before starting yourself on a medication, even aspirin).

Blocked carotid arteries may require one of the following procedures if lifestyle changes aren’t enough:

Carotid endarterectomy
Carotid artery angioplasty
​Chest Pain
​Chronic Venous Insufficiency
​CHRONIC VENOUS INSUFFICIENCY
Chronic venous insufficiency (CVI) is a condition that causes blood to pool or collect in the leg’s veins, making it difficult for blood to return to the heart from the legs. This pooling is also known as ‘stasis’

WHAT CAUSES CHRONIC VENOUS INSUFFICIENCY?
Veins function to return blood to the heart from the body organs. Blood must flow upward from the veins in the legs. Both calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push blood upward. The veins contain one way valves that help keep blood flowing upward. CVI occurs when there is a  blood clot in the deep veins of the legs, a disease known as deep vein thrombosis (DVT)
Pelvic tumors, vascular malformations A congenital (present from birth) defect in the vein’s valves
Failure or weakening of the vein valves leads to inability to move blood upward against gravity and leads to sluggish blood flow out of the veins

WHAT ARE THE SYMPTOMS OF CHRONIC VENOUS INSUFFICIENCY?
Symptoms of chronic venous insufficiency include:

Swollen legs and  ankles most noticeably after extended periods of standing
Leathery skin on the legs
Restlessness, fatigue or achiness in the legs
New varicose veins (swollen veins visible through the skin)
Venous stasis ulcers
IF CVI remains untreated, the pressure and swelling continue until the tiniest blood vessels (known as capillaries) burst. The overlying skin takes on reddish brown color and is at risk for being broken if bumped or scratched

HOW IS CHRONIC VENOUS INSUFFICIENCY DIAGNOSED?
Your doctor can diagnose CVI by performing a complete medical history and physical exam including a leg exam. Vascular Ultrasound is used to examine blood circulation in the legs.  During the test, a small transducer (hand held wand) is placed on skin over the vein to be examined. The transducer emits sounds waves that will bounce off the vein. The sound waves are recorded and translated into an image that can be displayed in real time on a monitor

HOW IS CHRONIC VENOUS INSUFFICIENCY TREATED?
CVI is most treatable in its early stages. Strategies include lifestyle changes, medication, and medical procedures or surgery. The goal of treatment is to reduce blood pooling and prevent leg ulcers

Lifestyle changes that may help relieve your symptoms include:

Wear compression stockings
Avoid standing or sitting for long periods of time
Maintain a healthy body weight
Exercise regularly
Elevate your legs while sitting and lying down
Practice good skin hygiene
You may also be prescribed medication, including:

Antibiotics to clear skin infections
Medicated wraps and creams
Medication to prevent blood clots from forming
More severe cases may require a medical or surgical procedure, including:

Endovenous thermal, ablation and sclerotherapy
Valve repair surgery
Vein ligation and stripping
Vein bypass
​Congenital Heart Diseases
​CONGENITAL HEART DISEASES
Congenital heart defects are abnormalities with the heart’s structure that are present from birth. Defects can affect the heart muscle’s walls, valves, arteries or veins.

More than 35,000 babies in the United States are born with congenital heart defects each year. Though many of these problems are simple and require little or no treatment, more complex problems will often require special medical care soon after birth.

WHAT CAUSES CONGENITAL HEART DEFECTS?
Doctors often don’t know why heart defects occur, though heredity may play a role. Children with genetic disorders such as Down syndrome are far more likely to be born with congenital heart disease.

WHAT ARE THE SYMPTOMS OF CONGENITAL HEART DEFECTS?
Not all congenital heart diseases cause symptoms. Depending on the severity and type of defects, parents may notice the following symptoms in young children:

Rapid breathing
Fatigue
A bluish tint to the skin and lips
Poor circulation
Inability to gain weight properly
Heart defects often cause heart murmurs (extra sounds heard during a heartbeat); though not all heart murmurs signal a congenital disease.

HOW ARE CONGENITAL HEART DEFECTS DIAGNOSED?
Severe heart defects can often be detected during pregnancy or soon after birth. Less serious defects are typically diagnosed when the child is older—often using the results from a physical exam or tests done for another reasons.

Tests that help doctors diagnose a congenital heart defect include:

Cardiac catheterization
Chest X-ray
Echocardiography
Electrocardiogram (EKG)
Pulse oximetry
HOW ARE CONGENITAL HEART DEFECTS TREATED?
Sometimes congenital heart disease requires no treatment at all. It may go away on its own or never cause any problems. Other times, treatment is necessary depending on the kind and severity of the defects.

Some congenital defects must be repaired using catheter procedures or surgery, including:

Atrial septal defect (ASD) repair
Pulmonary valve stenosis repair
Open heart surgery
Heart transplant (very rare)
​Coronary Artery Disease
​CORONARY ARTERY DISEASE
Coronary artery disease occurs when blockages form in the arteries that supply the heart with oxygen-rich blood. This is the most common type of heart disease in the United States and is a leading cause of death in both men and women.

WHAT CAUSES CORONARY ARTERY DISEASE?
Arteries are blood vessels that move oxygen-rich blood throughout the body. The coronary arteries run along the surface of the heart and supply it with blood. Plaque – a waxy substance made of fat, cholesterol, calcium and other substances – can build up in the coronary arteries and partially or totally block the flow of blood.  

Over time, coronary artery disease can weaken the heart muscle and cause heart failure or arrhythmia, an abnormal heart rhythm or rate. It can also lead to a heart attack, which occurs when blood flow is cut off to a part of the heart.

WHAT ARE THE SYMPTOMS OF CORONARY ARTERY DISEASE?
Some people with coronary artery disease don’t experience symptoms until they have the signs of a heart attack or heart failure. If you do experience symptoms of coronary artery disease, you may feel:

Chest pain or discomfort (angina)
Shortness of breath
Pressure or pain in the upper body
Nausea
Profound  fatigue
Pain between the shoulder blades
HOW IS CORONARY ARTERY DISEASE DIAGNOSED?
Your doctor can diagnose coronary artery disease by using your medical history, a physical exam and the results from several tests, including:

Blood tests
Chest X-ray
Coronary angiography
Echocardiography
Electrocardiogram (EKG)
Stress test
Coronary calcification scan
HOW IS CORONARY ARTERY DISEASE TREATED?
Coronary artery disease can be treated through lifestyle changes, medication and medical procedures. Lifestyle changes that may prevent or treat coronary artery disease include:

Maintaining a healthy diet
Increasing your regular  physical activity
Maintain  a healthy weight
Quitting smoking
Reduce stress
Blocked coronary arteries may require one of the following procedures if lifestyle changes aren’t enough:

Percutaneous Coronary Intervention (PCI)
Coronary Artery Bypass Grafting (CABG)
​Coronary Calcification
​CORONARY CALCIFICATION
Coronary calcification refers to the build-up of calcified plaque within the walls of the coronary arteries. This can detect early stage of atherosclerosis (build-up of plaque in the arteries) and coronary artery disease.

WHAT CAUSES CORONARY CALCIFICATION?
Arteries are blood vessels that move oxygen-rich blood throughout the body. In the early stages of arterial disease, the lining of the arteries becomes inflamed, allowing plaque (made up of fat, cholesterol, calcium and fibrous tissue) to form on the wall of the artery.

Calcium build-up is one of the best ways to detect the beginning of atherosclerosis.

WHAT ARE THE SYMPTOMS OF CORONARY CALCIFICATION?
Often, coronary calcification will not cause any symptoms or pain. Annual exams are important to catch and treat coronary calcification, especially if you’re high risk for heart disease.

HOW IS CORONARY CALCIFICATION DIAGNOSED?
Your doctor will look for specks of calcium in the walls of the coronary arteries using a multislice computerized tomography, helical computed tomography or electron beam tomography to scan for coronary calcium.

HOW IS CORONARY CALCIFICATION TREATED?
You can minimize buildup of plaque by making lifestyle changes, including:

Following a healthy diet
Quitting smoking
Maintaining a healthy weight
Taking medication including cholesterol lowering agents ,one coated 81 mg  aspirin daily and medication to control blood pressure
​Diabetes
​DIABETES
Diabetes is a disease in which your blood sugar levels are too high. It affects 29 million Americans, or about 1 in 11. An additional 86 million people—more than 1 out of 3 adults—have prediabetes, a condition that eventually leads to diabetes in about 30 percent of people.

WHAT CAUSES DIABETES?
Food contains glucose, a form of sugar, which powers the body’s cells. In a healthy person, a hormone called insulin helps to turn glucose from food into energy the body needs. But if the body produces too little insulin or doesn’t use it efficiently, that sugar stays in the blood and can cause serious problems involving the cardiovascular, nervous and other systems. People with diabetes are at a higher risk for heart disease and stroke.

Type 1 diabetes occurs when your body doesn’t produce any or enough insulin. Sometimes called “juvenile diabetes” because it’s usually diagnosed in children and teens, this type of diabetes accounts for just five percent of all diabetes patients.

Type 2 diabetes occurs when the body cannot use insulin properly and is much more common in adults. Risk factors for Type 2 diabetes include:

Being overweight or obese
Family history of diabetes
High blood sugar levels
High blood pressure
High cholesterol
WHAT ARE THE SYMPTOMS OF DIABETES?
Some people with diabetes don’t have any symptoms, but many do. Common symptoms of diabetes include:

Urinating often
Feeling hungry or thirsty often
Losing weight without trying
Dry or itchy skin
Feeling pins and needles in your feet
Fatigue
Blurry vision
HOW IS DIABETES DIAGNOSED?
Diabetes can be diagnosed using a combination of your medical and family history, a physical exam, and the results from a blood test.

HOW IS DIABETES TREATED?
Diabetes can’t be cured, but it is manageable. You can keep your blood sugar levels under control by maintaining a healthy weight, exercising, eating well, and taking medication or insulin, if needed. 
​Dyspnea (Shortness Of Breath)
​DYSPNEA (SHORTNESS OF BREATH)
The heart and lungs provide oxygen to your body’s tissues and remove carbon dioxide. Difficulty breathing can be caused by a problem with either of these organs. Depending on the cause, you may have a sudden onset of shortness of breath or recurring episodes of shortness of breath that can become chronic

WHAT CAUSES SHORTNESS OF BREATH?
Many conditions can cause shortness of breath, including the following:

Heart attack or heart diseases
Asthma
Pneumonia
Emphysema
Low blood pressure
Pulmonary embolism
Cardiomyopathy
Arrhythmia
Heart failure
Pericarditis
Carbon Monoxide poisoning
Pneumothorax
Upper airway obstruction
Anemia
Interstitial lung disease
Lung Cancer
WHAT ARE THE SYMPTOMS OF SHORTNESS OF BREATH?
Breathing may become difficult, labored or uncomfortable. You may also feel as though you’re not getting enough air. Other symptoms include:

Wheezing
Coughing
Chest or neck pain
Dizziness or fainting
HOW IS SHORTNESS OF BREATH DIAGNOSED?
Shortness of breath is not a disease in and of itself, so your doctor will look for an underlying lung or heart disease. Common tests for these diseases include:

Blood gases tests
Blood oxygen saturation
Chest X-ray
Computed Tomography (CT) scan
Electrocardiograph (ECG)
Echocardiogram
Stress test
Pulmonary function tests
HOW IS SHORTNESS OF BREATH TREATED?
Treatments for shortness of breath will vary depending on what’s causing it. If an underlying condition is causing difficulty breathing, treatment will address that problem.

Your doctor may also recommend medication, physical activity and breathing exercises to help you manage the sensation of breathlessness.
​Fainting (Syncope)
​FAINTING (SYNCOPE)
Fainting is a temporary loss of consciousness. Though temporary, fainting can signal a more serious condition. You may injure yourself when you lose consciousness. Vasovagal syncope is a common cause of fainting. It occurs when your body overreacts to specific triggers, for example, the sight of blood or extreme emotional distress

WHAT CAUSES FAINTING?
Fainting usually occurs when the heart isn’t able to pump a normal amount of oxygen-rich blood to the brain. This can be caused by many things, including:

Pain
Overheating
Dehydration
Emotional distress
Exhaustion
Some medicines
Rapid changes in blood pressure or body position
Underlying medical conditions
WHAT ARE THE SYMPTOMS OF FAINTING?
The primary symptom of fainting is a temporary loss of consciousness. People who experience fainting may also experience the following symptoms:

Skin paleness
Feeling lightheaded or dizzy
Nausea
Cold clammy sweat
Feeling drowsy or groggy
Changes in vision, such as tunnel or blurred  vision
Headaches
HOW IS FAINTING DIAGNOSED?
Fainting can be a symptom of serious underlying heart, metabolic, neurologic and lung conditions. To help rule out underlying heart issues, your doctor will give you a physical exam and may recommend one or more of the following tests to rule out more serious causes of fainting:

Echocardiogram
Electrocardiogram (EKG)
Holter or event monitor
Stress testing
Tilt table test
Electrophysiologic testing
HOW IS FAINTING TREATED?
Treatment for fainting will vary depending on what is causing it. You may need to make adjustments to your lifestyle, including changes to medications or diet and avoiding things that trigger fainting.

Common triggers for vasovagal syncope include:

Standing in one place for long periods of time
Heat exposure
Straining, such as what occurs when having a bowel movement
If your doctor finds that an underlying condition such as arrhythmia (abnormal beating of the heart) is causing your fainting, you may need to consult with an electrophysiologist to determine if  you need an implanted pacemaker or a cardiac defibrillator.
​Heart Attack (Myocardial Infarction)
​HEART ATTACK (MYOCARDIAL INFARCTION)
A heart attack is a life-threatening condition that occurs when blood flow to a part of the heart is blocked, often by a clot. Heart attacks affect men and women equally and are the leading cause of death in the United States.

WHAT CAUSES A HEART ATTACK?
Most heart attacks occur when an artery that leads to the heart (a coronary artery) becomes blocked. This denies the heart the oxygen-rich blood it needs. Blockages are often caused by a build-up of plaque in the coronary artery. If a blockage is not cleared quickly, heart muscle can be damaged or die.  

Another cause of heart attack is a severe tightening (vasospasm) of a coronary artery, which cuts off blood flow. This can happen even in coronary arteries that haven’t been narrowed by plaque. Smoking, drug use or exposure to extreme cold can cause this kind of tightening.

WHAT ARE THE SYMPTOMS OF A HEART ATTACK?
The classic heart attack symptoms are sudden and severe chest pain. However, symptoms can vary from person to person. They can range from mild to severe and may differ each time you have a heart attack.

Common symptoms of a heart attack include:

Pain or discomfort in the center or left side of your chest
Discomfort in your arms, back, shoulders, neck or jaw
Shortness of breath
Sweaty or clammy skin
Severe fatigue that can last several days
Indigestion like symptoms
Nausea and vomiting
Lightheadedness or dizziness
Note that heart attack symptoms may be different in women. In some cases, women may experience no chest pain at all. Women may attribute symptoms like nausea, sweating, or lightheadedness to stress or the flu, but these can be signs of a heart attack.

HOW ARE HEART ATTACKS DIAGNOSED?
Doctors diagnose a heart attack by evaluating your symptoms, your medical history, and the results from several tests such as:

Blood tests
Coronary angiography
Electrocardiogram (EKG)
HOW ARE HEART ATTACKS TREATED?
Treatments for heart attacks work best when given soon after symptoms occur, sometimes even before a diagnosis is confirmed.

Treatment options include:

Oxygen therapy
Aspirin
Nitroglycerin
Percutaneous Coronary Intervention (PCI)
Coronary Artery Bypass Grafting (CABG)
​Heart Failure
​HEART FAILURE
Heart failure (sometimes known as congestive heart failure) occurs when the heart muscle is weakened or damaged and can’t effectively pump blood to the rest of the body.

WHAT CAUSES HEART FAILURE?
Heart failure is a chronic disease that can be caused by many heart conditions. It may affect only one side of the heart or both sides. When heart failure affects the left side (left-sided heart failure), the heart muscle cannot pump blood out of the heart well, also, it can be caused by a stiff heart muscle which prevents it from filling up with blood properly in between each contractions of the heartbeat. You may notice some shortness of breath if the fluid backs ups into your lungs. When it affects the right side( Right –sided heart failure)—often as a result of failure on the left side—it can cause blood to back up in the body’s veins(fluid may back up into your abdomen, legs and feet, causing swelling) instead of moving into the heart to pick up oxygen.

Conditions that can weaken the heart muscle and lead to heart failure include:

Coronary artery disease
Heart attack
High blood pressure
Arrhythmia
Valvular heart diseases
Cardiomyopathy
Excess alcohol use
Infection
Emphysema
Overactive or underactive thyroid
WHAT ARE THE SYMPTOMS OF HEART FAILURE?
Symptoms of heart failure include:

Fatigue or weakness
Loss of appetite
Cough or sudden onset severe shortness  of breath or wheezing ( with white or pink blood-tinged phlegm)
Heart palpitations
Shortness of breath, even while sleeping
Sudden weight gain
Swollen feet and ankles
Increased need to urinate at night
Chest pain
HOW IS HEART FAILURE DIAGNOSED?
Your doctor can diagnose heart failure using a physical exam and the results of several tests, including:

A chest X-ray
Electrocardiography (EKG)
Echocardiography
Magnetic resonance imaging (MRI)
Nuclear stress test
Blood tests ( including N-terminal pro-B-type natriuretic peptide or BNP )
HOW IS HEART FAILURE TREATED?
Treatments to manage heart failure include lifestyle changes, medications, medical procedures and surgery.

Your doctor may recommend the following lifestyle changes:

Quitting smoking
Eating a heart-healthy diet
Limiting alcohol
Increasing physical activity
Medications may improve your heart function and make it easier for you to get physical activity. You may be prescribed:

Diuretics – to help your body get rid of extra fluid
Inotropes – to strengthen you heart’s ability to pump
Vasodilators – to open up narrowed blood vessels
Beta-blockers – to prevent deleterious effect of adrenalin
ACE inhibitors – to keep blood vessels open and reduce blood pressure
Angiotension II receptor blockers – many of the same benefits as ACE inhibitors, may be an alternative  for people who cannot tolerate ACE inhibitors
If lifestyle changes and medication is not enough, you may need a medical procedure or surgery to restore heart function. Surgical options include:

Percutaneous coronary intervention
Heart valve repair or replacement surgery
Biventricular pacing  or cardiac resynchronization therapy(CRT)
ICD implantation
Coronary artery bypass surgery
Mechanical assistance devices
Heart transplantation
​Heart Murmur
​HEART MURMUR
A heart murmur is an extra or unusual sound that occurs when your heart beats. These sounds can be heard with a stethoscope.

WHAT CAUSES HEART MURMURS?
As your heart beats, valves open and close to move blood through the heart. If a valve is defective, your heartbeat may include an extra or unusual noise known as a heart murmur. Some heart murmurs are faint, while others are quite loud.

A heart murmur is not necessarily a symptom of an underlying problem. Harmless (innocent) heart murmurs are fairly common in healthy children. Abnormal heart murmurs in children are usually a sign of a heart defect, such as problems with the interior walls of the heart muscle, valves, veins or arteries.

In adults, an abnormal heart murmur is usually caused by age-related changes or heart valve disease which develops as a result of another cardiac condition, such as:

Damage or scarring after a heart attack 
Heart failure
High blood pressure
Rheumatic fever
Infections in the heart
WHAT ARE THE SYMPTOMS OF A HEART MURMUR?
A harmless heart murmur will not cause any other symptoms besides the unusual sound that can be heard when a doctor listens to your heart with a stethoscope.

An abnormal heart murmur is often a sign of another cardiac condition and may be one of many symptoms of that condition. Other warning signs to watch for include:

Shortness of breath
Skin that appears blue, especially on your fingertips and lips
Chest pain
Dizziness or fainting
Excessive sweating
Chronic cough
Enlarged neck veins
Enlarged liver
Poor appetite and failure to grow normally(in infants)
HOW ARE HEART MURMURS DIAGNOSED?
Heart murmurs are often detected when your doctor listens to your heart with a stethoscope. Your doctor will listen to the volume, location and timing of the murmur to help determine what is causing it.

A few tests may help to determine the underlying cause of an abnormal heart murmur:

Chest X-ray
Electrocardiogram (EKG)
Echocardiography
HOW ARE HEART MURMURS TREATED?
Because a heart murmur is not a disease in and of itself, it may not require treatment. In the case of an abnormal heart murmur, your doctor will treat the underlying disease or condition causing it. Treatment will vary depending on whether the abnormal heart murmur is caused by a congenital defect, heart valve disease, or another condition.
​Heart Palpitations
​HEART PALPITATIONS
Heart palpitations refer to the feeling that the heart is skipping a beat, fluttering or beating too quickly.  

WHAT CAUSES HEART PALPITATIONS?
Heart palpitations are commonly caused by exercise, some medicines, nicotine, caffeine or anxiety. They can also be caused by fever, hormone changes associated with menstruation, pregnancy or menopause. They are relatively harmless.

However, palpitations may also be caused by a more serious condition that requires medical care. For instance, you may experience them if you have arrhythmia, heart disease, heart valve disease, thyroid disease or abnormal levels of oxygen in your blood.

WHAT ARE THE SYMPTOMS OF HEART PALPITATIONS?
Heart palpitations feel like your heart is fluttering, skipping a beat, or beating too hard, too quickly, or too slowly. You may feel these sensations in your chest, throat or neck.

Seek immediate medical attention if you experience heart palpitations with other symptoms that signal a serious cardiac condition. Look for symptoms like:

Dizziness or fainting
Difficulty breathing
Unusual sweating
Pain or pressure in your chest, jaw or arms
HOW ARE HEART PALPITATIONS DIAGNOSED?
If you’re experiencing heart palpitations, it’s important to determine whether they’re harmless or caused by a more serious heart problem. Your doctor will perform a physical exam and may recommend several tests to look for underlying causes:

Echocardiography
Electrocardiogram (EKG)
Holter or event monitor
Stress test
HOW ARE HEART PALPITATIONS TREATED?
Most heart palpitations will go away on their own. In some cases you may need treatment if an underlying heart condition is causing them. The treatment will be focused on correcting the condition.  Your doctor may also recommend avoiding things that trigger heart palpitations, including:

Anxiety and stress
Stimulants such as caffeine and nicotine
Over-the-counter medications that act as stimulants, such as cold medicine
​Heart Valve Disease
​HEART VALVE DISEASE
Heart valve disease affects the valves that make sure blood flows correctly through the heart and to the rest of the body.

WHAT CAUSES HEART VALVE DISEASE?
The heart has four valves that open and close with each heartbeat, helping to regulate how blood moves through the heart. A problem with one of these valves can be caused by birth defects, age-related changes, infections or other conditions.

Three kinds of problems can affect heart valves:

Regurgitation – Backflow of blood that occurs if a valve doesn’t close tightly enough. Instead of flowing forward through the heart or into an artery, blood leaks backward into the heart chamber. This is usually caused by prolapse, which occurs when the flaps of the valve flop or bulge back into the heart chamber. Valve regurgitation is sometimes referred to as “leaky valve.”
Stenosis – Thickening or stiffening of a valve that keeps it from fully opening to let blood flow through.
Atresia – A condition from birth that occurs when a valve forms without an opening for blood to flow through.
WHAT ARE THE SIGNS AND SYMPTOMS OF HEART VALVE DISEASE?
The main sign of heart valve disease is a heart murmur—an extra or unusual sound during a heartbeat that can be detected when your physician listens to your heart using a stethoscope.

Some people with heart valve disease don’t experience any symptoms until later in life after the disease has progressed. Symptoms may include:

Fatigue
Shortness of breath
Swelling in your ankles, feet, legs or abdomen
HOW IS HEART VALVE DISEASE DIAGNOSED?
Your doctor may hear a heart murmur when listening to your heartbeat with a stethoscope. To diagnose heart valve disease, your doctor will give you a physical exam and one or more of the following tests:

Cardiac catheterization
Cardiac magnetic resonance imaging (MRI)
Chest X-ray
Echocardiography
Electrocardiogram (EKG)
Stress test
How is heart valve disease treated? Treatment varies depending greatly on the specific type of valve disease you have and which specific valve is affected.
Lifestyle changes and medicine may help manage the symptoms of a heart valve problem. Improving your diet, lowering your blood pressure, quitting smoking, and limiting strenuous exercise may help. Your doctor may also prescribe medication to treat heart failure, lower your blood pressure, prevent irregular heartbeats, or thin your blood to prevent clots.

In some cases, a faulty valve may need to be repaired or replaced with surgery. These surgeries can include:  

Balloon valvuloplasty
Valve replacement
Transcatheter aortic valve repair
The Ross operation
​High Cholesterol
​HIGH CHOLESTEROL
High cholesterol occurs when the level of LDL cholesterol in the blood is too high, leading to a buildup of plaque in the arteries.

WHAT CAUSES HIGH CHOLESTEROL?
Cholesterol is a waxy, fat-like substance your body naturally produces to make hormones, vitamins and substances that help with digestion. Your body produces all the cholesterol it needs, but it also gets it from food.

Cholesterol moves through the bloodstream in packages made of fat surrounded by proteins. Two kinds of packages move cholesterol throughout the body: low-density lipoproteins (LDL or “bad” cholesterol) and high-density lipoproteins (HDL or “good” cholesterol).

HDL cholesterol moves cholesterol to the liver to be removed from the body, while LDL can lead to a buildup of cholesterol in the arteries.

Cholesterol is one of the substances found in plaque, which can harden and narrow your arteries. The higher your levels of LDL or “bad” cholesterol in the blood, the higher your risk of building up plaque in the coronary arteries. The higher your levels of HDL or “good” cholesterol, the lower your risk of plaque build-up.

WHAT ARE THE SYMPTOMS OF HIGH CHOLESTEROL?
High cholesterol usually causes no symptoms. Many people don’t know that their cholesterol levels are too high. Regular screenings can help catch high cholesterol and give you a chance to manage it.

HOW IS HIGH CHOLESTEROL DIAGNOSED?
Your doctor can diagnose high cholesterol using the results of a simple blood test called a lipid panel, lipid profile or lipoprotein panel.

HOW IS HIGH CHOLESTEROL TREATED?
Lifestyle changes and medication can help you manage high cholesterol. Your doctor may recommend the following to manage your cholesterol levels:

Quitting smoking
Eating a healthy diet
Managing your weight
Increasing your physical activity
Your doctor may also prescribe medication to help lower your LDL cholesterol level, including:

Statins
Bile acid sequestrates
Nicotinic acid
Fibrates
Cholesterol absorption inhibitors (ezetimibe)
Combination cholesterol absorption inhibitor and statin (ezetimibe-simvastatin)
Injectable medications. A new class of drugs can help the liver absorb more LDL cholesterol which lowers the amount of cholesterol circulating in your blood. The Food and Drug Administration recently  approved alirocumab (Praluent) and evolocumab ( Repatha)
​Hypertension
​HYPERTENSION
Hypertension (also called high blood pressure) occurs when blood pumps through your arteries with too much force. Blood pressure is naturally high when you first wake up, after exercising, and when you are under stress. Consistent high blood pressure can increase your risk of serious medical conditions like stroke, heart attack or heart failure. 

WHAT CAUSES HYPERTENSION?
Hypertension can be caused by another medical condition. When there is a secondary cause of the hypertension we call this Secondary hypertension. However, most of the time it has no underlying causes (Primary hypertension). Risk factors for hypertension include:

Obesity
Diabetes
Smoking
Stress and anxiety
Family history of hypertension
Excessive alcohol use
WHAT ARE THE SYMPTOMS OF HYPERTENSION?
Usually there are no symptoms of hypertension. Most patients are diagnosed with hypertension when their doctor checks their blood pressure during a routine screening.

HOW IS HYPERTENSION DIAGNOSED?
Hypertension is diagnosed using a blood pressure measurement. It is taken with an inflatable cuff placed around your upper arm and then a measurement is recorded with a pressure-measuring gauge, which measures the force of blood against the walls of your arteries as your heart beats. Blood pressure readings are given as two numbers (for example, 120 over 80). If you have hypertension, one or both of these numbers will be too high. Your blood pressure should be measured in both arms.

HOW IS HYPERTENSION TREATED?
Lifestyle changes and medication can help you lower your blood pressure and reduce your risk of complications. Lifestyle changes include:

Eating a heart-healthy diet and reducing sodium (salt)
Drinking plenty of water
Exercising regularly
Quitting smoking
Limiting alcohol
Reducing stress
Many different medications are available to manage hypertension. Sometimes a single medication may not be enough to reduce your blood pressure, and you will be prescribed two or more drugs. 
​Infective Endocarditis
​INFECTIVE ENDOCARDITIS
Infective endocarditis is an infection in the heart’s lining or valve. Left untreated, it can cause valve damage or heart failure.

WHAT CAUSES INFECTIVE ENDOCARDITIS?
Infective endocarditis is primarily caused by bacteria in the bloodstream that then travel to your heart and attaches to abnormal heart valves or damaged heart tissue.  Infection can occur if a heart valve becomes damaged and the body’s healing process allows bacteria to become trapped in the layers of heart tissue.

WHAT ARE SOME OF THE SIGNS AND SYMPTOMS OF INFECTIVE ENDOCARDITIS?
Symptoms of infective endocarditis include:

Dark, splinter-like lines under your fingernails
Burst blood vessels in your retinas
Red spots on your palms and the soles of your feet
Painful sores on your fingertips and toes
Heart murmur
Fever and night sweats
Muscle ache
Fatigue
Weight loss
Joint pain
WHO IS AT HIGHEST RISK FOR ENDOCARDITIS?
Artificial heart valves: Bacteria are more likely to attach to an artificial ( prosthetic) heart valve than to a normal valve
Congenital heart defects: if you were born with certain heart defects, your heart may be more susceptible to infection
A history of endocarditis: prior episode of endocarditis damages heart tissue and valves, increasing the risk of future heart infection
Damaged heart valves: Certain medical conditions including rheumatic fever or infection which can damage or scar one or more of your heart valves.
History of intravenous (IV) illegal drug use: The needles used to inject illegal drugs can be contaminated with bacteria and cause endocarditis

HOW IS INFECTIVE ENDOCARDITIS DIAGNOSED?
Your doctor may suspect endocarditis based on your medical history and physical exam signs and symptoms, including fever and new or changed heart murmur. Your doctor can diagnose infective endocarditis with a blood test. Other tests that may be used to evaluate your heart valve structure and function include:

Computed tomography (CT) scanning
Echocardiography
Magnetic resonance imaging (MRI)
Transesophageal echocardiography
Electrocardiogram
Chest X-ray
How is infective endocarditis treated?
Intravenous antibiotics are often the first treatment for infective endocarditis. If trapped bacteria have damaged your heart valves, your doctor may recommend surgery to repair or replace the valves.
​Leg Swelling
​LEG SWELLING
Leg swelling is not a disease in and of itself, though it can be a sign of a serious underlying medical problem.

WHAT CAUSES LEG SWELLING?
Leg swelling can be caused by medication or pregnancy, but it can also occur as a symptom of an underlying condition such as heart disease, kidney disease or a blood clot. Congestive heart failure and deep vein thrombosis are two common conditions that may lead to leg swelling.

WHAT ARE THE SIGNS/ SYMPTOMS OF LEG SWELLING?
If you experience leg swelling, you may also notice the following signs and /or symptoms:

Swelling or puffiness right under the skin
Stretched or shiny skin
Leg pain
Shortness of breath
Chest pain
Chest pain and shortness of breath can signal a dangerous underlying condition. Seek emergency medical treatment right away if you experience either of these symptoms.

HOW IS LEG SWELLING DIAGNOSED?
To look for an underlying cause of your leg swelling, your doctor will give you a physical exam and may also use the following tests:

X-rays
Ultrasound
Blood tests
Urine analysis
HOW IS LEG SWELLING TREATED?
Treatment for leg swelling depends on what is causing it. You may need to adjust your medication or take medicines that help your body eliminate excess fluid. If a condition such as heart failure is causing leg swelling, you may need a medical procedure or medication to manage it.

 
​Pericarditis
​PERICARDITIS
Pericarditis is inflammation of the thin, sac-like membrane that surrounds the heart (the pericardium). The membrane has two layers separated by a thin layer of fluid that lets the heart move as it beats.

WHAT CAUSES PERICARDITIS?
Pericarditis can be caused by a viral or bacterial infection, a heart attack, and radiation treatment, an injury to the chest or esophagus, or certain medications that suppress the immune system. In some cases, the exact cause of pericarditis is hard to pinpoint.

WHAT ARE THE SYMPTOMS OF PERICARDITIS?
Most people with pericarditis experience a sharp or stabbing pain in the center or left side of their chest. Sometimes the pain spreads to the neck or left shoulder and may be worse when you take a deep breath or change position.

Other symptoms of pericarditis may include:

Cough
Fever
Difficulty breathing
Difficulty swallowing
HOW IS PERICARDITIS DIAGNOSED?
Your doctor can diagnose pericarditis by listening to your chest with a stethoscope and by reviewing the results from several tests, including:

Chest X-ray
Electrocardiography
Echocardiography
CAT scan of chest
HOW IS PERICARDITIS TREATED?
Your doctor will prescribe anti-inflammatory medication and pain relievers to treat pericarditis. You may also need antibiotics if your pericarditis is caused by an infection. Your doctor may also need to perform a pericardiocentesis – a procedure that removes fluid from the pericardium. This reduces the pressure on your heart. In some rare cases, your doctor may recommend more involved surgery.
​Peripheral Artery Disease
​PERIPHERAL ARTERY DISEASE
Peripheral artery disease is a narrowing of the vessels that supply the limbs, head and stomach with blood.

WHAT CAUSES PERIPHERAL ARTERY DISEASE?
Peripheral artery disease is caused by atherosclerosis – a buildup of plaque on the inner walls of the arteries. Plaque narrows or blocks the arteries that feed the arms or legs, preventing them from receiving enough blood to function correctly.

If peripheral artery disease is severe enough, it can lead to tissue death in a foot or leg. It also increases your risk of heart attack and stroke.

WHAT ARE THE SYMPTOMS OF PERIPHERAL ARTERY DISEASE?
The primary symptom of peripheral artery disease is leg pain, cramping or tiredness when walking. The pain usually goes away when you stop walking, and comes back when you start walking again.

Other symptoms include:

Weak or absent pulse in the feet or legs
Sores on the toes, feet or legs
A lower temperature in one leg than the other
A change in the color of your legs (pale or bluish)
Poor nail growth on the toes
Decreased hair growth on the legs
HOW IS PERIPHERAL ARTERY DISEASE DIAGNOSED?
To diagnose peripheral artery disease, your doctor will conduct a physical exam and run some tests, including:

Ankle-brachial index (ABI)
Arteriogram
Blood tests
Catheter angiography
Computed tomography (CT) angiography
Magnetic Resonance Angiogram (MRA)
Ultrasound
HOW IS PERIPHERAL ARTERY DISEASE TREATED?
Your doctor will recommend lifestyle changes and medication to treat your peripheral artery disease. In more severe causes, a medical procedure or surgery may be needed to restore proper blood flow.

Lifestyle changes include:

Quitting smoking
Eating a heart-healthy diet
Lowering high blood pressure and high cholesterol
Getting more physical activity
If these changes aren’t enough to reduce blockages, you may need a medical procedure or surgery, including:

Angioplasty
Atherectomy
Bypass grafting surgery
Catheter-directed thrombolysis
​Sudden Cardiac Arrest
​SUDDEN CARDIAC ARREST
Sudden cardiac arrest (SCA) occurs when the heart stops beating suddenly and without warning. It is different than a heart attack, which is caused by blocked blood flow to a part of the heart. During a heart attack, the heart keeps beating.

WHAT CAUSES CARDIAC ARREST?
In most people, ventricular fibrillation (v-fib) causes cardiac arrest. In v-fib, the lower chambers of the heart don’t beat normally and pump very little or no blood to the rest of the body.  V-fib is a type of arrhythmia

Sudden cardiac arrest can also occur if the heart’s electrical signal slows or stops or if the heart muscle doesn’t respond to the electrical signals that trigger a heartbeat.

Risk factors for sudden cardiac arrest include coronary artery disease, inherited disorders, or structural issues with the heart muscle. However, sudden cardiac arrest can occur in otherwise healthy people.

WHAT ARE THE SYMPTOMS OF CARDIAC ARREST?
The first sign of sudden cardiac arrest is usually fainting (syncope). Prior to losing consciousness, you may also feel:

Chest pain
Shortness of breath
Nausea
Dizziness or lightheadedness
After losing consciousness, the heart will stop beating. Once that happens, blood stops flowing to the brain and other vital organs, which can cause death in minutes. Automated external defibrillators (AEDs) can be used by bystanders to save the life of a person having SCA.

HOW IS CARDIAC ARREST DIAGNOSED?
Sudden cardiac arrest is usually diagnosed after it happens by ruling out other causes of fainting. Several tests can detect factors that put you at risk for cardiac arrest:

Blood tests
Cardiac catheterization
Cardiac MRI
Echocardiography
Electrocardiogram (EKG)
Electrophysiology study
Multiple gated acquisition (MUGA) test
HOW IS CARDIAC ARREST TREATED?
Sudden cardiac arrest is a medical emergency that must be treated immediately with a defibrillator. This device shocks the heart and can restore a normal rhythm. As time passes, the chances of a defibrillator restoring normal sinus rhythm rapidly decrease.

You’ll need to be hospitalized following cardiac arrest. Your doctors will try to determine what caused the cardiac arrest and begin treatment to prevent another episode. You will need to see a cardiologist that specializes in problems with the heart’s electrical system. They are called electrophysiologists.

An implantable cardioverter defibrillator (ICD) can be placed to terminate v-fib in the future.

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