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Cardiovascular Issues - Health is Easy to Reach

Ischaemic Heart Disease and Lifestyle

Introduction
Ischaemic heart disease (IHD) is the disease that caused by insufficient blood flow in order to meet heart muscle demands of the energy, thus causing symptoms, and myocard injury.

IHD is the most common cause of death worldwide, especially in developed nations. The changing trend of disease from infectious disease to non-communicable disease, and degenerative disease, have been thought to be related with the changing lifestyle of human.

What cause the IHD?
As previously stated that IHD is non-communicable disease mostly related to changing of human lifestyle. Thus we could identify the habits that correlates with the occurance of IHD. These factors include:

- Smoking
- High levels of certain fats and cholesterol in the blood
- High blood pressure
- High levels of sugar in the blood due to insulin resistance or diabetes
- Obesity
- Physical activity

Another factors, that we should consider such as family history, age, and sex. These factors are considered non-modified.
Love your Heart

When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged. The buildup of plaque in the coronary arteries may start in childhood. Over time, plaque can narrow or block some of your coronary arteries. This reduces the flow of oxygen-rich blood to your heart muscle.

How Is Coronary Heart Disease Managed?

Management for coronary heart disease (CHD) may include lifestyle changes, medicines, and medical procedures. The goals of treatments are to: Relieve symptoms, Reduce risk factors in an effort to slow, stop, or reverse the buildup of plaque, Lower the risk of blood clots forming, Widen or bypass clogged arteries, Prevent complications of CHD, Lifestyle Changes.

Encouraging cardiovascular health is not only about preventing ischaemic heart disease but also how to manage person with IHD. Health entails the ability to exercise, and enjoying vigorous activity is one of the best ways of achieving health, not just because the heart likes it, but it also can prevent osteoporosis, improve glucose tolerance, and augment immune function.

People who improve and maintain their fitness live longer: age-adjusted mortality from all causes is reduced by >40%. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more benefits. But before starting new exercise plan, health consultations is needed especially for those that have IHD.

Avoiding obesity helps too, but weight loss is only useful in reducing cardiovascular risk and the risk of developing diabetes when combined with regular exercise. Moderate alcohol drinking may also promote cardiovascular health. Alcohol also reduces gastric infection with Helicobacter pylori, a known risk marker for cardiovascular disease.

Smoking is the chief risk factor for cardiovascular mortality. You can help people give up, and giving up does undo much of the harm of smoking. Simple advice do works. Most smokers want to give up (unlike the eaters of unhealthy diets who are mostly wedded to them by habit, and the pleasure of the palate).
Just because smoking advice does not always work, do not stop giving it. Ask about smoking in consultations, especially those concerned with smoking-related disease.

Manage Stress
Stress have been overlooked by many clinicians, but recently research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress—such as drinking, smoking, or overeating—aren't healthy.

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress. Physical activity, medicine, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.
Smoking and Heart Disease

Follow a Healthy Diet
A healthy diet maybe stressful for some people, as previously described in my blog, healthy diet depends on individual state, such activity, and so on.
Diet that suits someone, can't suits the others that easy.
Pleasure of the tongue and palate determine most in someone preference in choosing diet. Thus make dietary intervention is difficult.

Anyway, there are several types of diet that have been suggested to lower the risk of having IHD. A diet rich in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber.
A healthy diet also includes some types of fish, such as salmon, tuna (canned or fresh), and mackerel. These fish are a good source of omega-3 fatty acids. These acids may help protect the heart from blood clots and inflammation and reduce the risk of heart attack. Try to have about two fish meals every week.

Medicines
Medicines are used to treat CHD if lifestyle changes aren't enough. Medicines can:
- Reduce your heart’s workload and relieve CHD symptoms
- Decrease your chance of having a heart attack or dying suddenly
- Lower your cholesterol and blood pressure
- Prevent blood clots
- Prevent or delay the need for a procedure or surgery (for example, angioplasty or coronary artery bypass grafting (CABG))

Medicines used to treat CHD include anticoagulants, also called blood thinners; aspirin and other anticlotting medicines; ACE inhibitors; beta blockers; calcium channel blockers; nitroglycerin; glycoprotein IIb-IIIa; statins; and fish oil and other supplements high in omega-3 fatty acids.

Procedures and Surgery
You may need a procedure or surgery to treat CHD. Both angioplasty and CABG are used to treat blocked coronary arteries. You and your doctor can discuss which treatment is right for you.



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October 11th 2011 @ 16:23

Posted By: yulius hermanto - Category: Cardiovascular Issues
   


Diet that Protect from Heart Disease

Modern civilization recently has brought us to a new lifesytle that we called it sedentary lifestyle. With the technology, someone don't need to waste time and less physical activity. This lifestyle is associated with increased of degenerative disease, such as cardiovascular disease, and stroke.
Heart Disease

During the last few decades, the technology, and peaceful condition, life expectancy has increased significantly. This also caused a problem, since the increased of elderly populations, the prevalence of degenerative diseases also increased.

The increased of degenerative diseases has become the concern in medicine. Therefore a lot of scientific study are done, whether about its treatment, diagnostic, and prevention.

The prevention of the disease is one of the important part of disease management. Keeping the man to be stay healthy is easier than treat a man that already has a disease.
Disease isn't simple problem for someone, in some situations the person lost his/her productivity, and increased of dependency, such as in stroke and heart failure.

Nowadays, our understanding about stroke and cardiovascular disease have already improved, but not yet complete. Lot of researchs still need to be done. Recently on March 2011, there was a publication of study about diet and stroke incidence. This study is about identifying protective factors of stroke and cardiovascular diseases.

"A diet rich in foods that are loaded with potassium can reduce your risk for a stroke by 21 percent and may also lower your risk of heart disease, a new study suggests".

Good sources of potassium include bananas and other fruits and vegetables, as well as fish, poultry and dairy, the researchers noted.
And ounce per ounce, sweet potato and tomato paste top the list, according to the U.S. Department of Agriculture.

"The average dietary potassium intake in most countries worldwide is much lower than recommended by health authorities, and increasing potassium intake may provide protection against stroke and other cardiovascular disorders,"

They found that people who consumed 1.64 grams of potassium or more a day had a 21 percent lower risk of stroke and also tended to have a lower risk of any cardiovascular disease.
Potassium Rich Foods

That five or more servings of fruits and vegetables will provide the amount of potassium needed to get this protective effect. The protective effect of potassium against the risk of stroke and other vascular events may in part be traced to its blood pressure-lowering effect, particularly in hypertensive individuals and in those with elevated sodium intake.

Potassium may be involved in slowing the process of atherosclerosis and preventing the thickening of the walls of arteries, all of which can lead to cardiovascular disease. A high-potassium diet was shown to exert a protective effect against the development of vascular damage induced by excess salt intake, thus counteracting, to some extent, the dangerous effects of eating too much salt. This large body of evidence from experimental studies provides biological plausibility to the protective effect of dietary potassium against cardiovascular events.

A higher potassium intake is safe for most people, but that there might be some concern about elevated potassium for patients with kidney failure or those taking medicines that lower potassium. In those cases, patients should speak with their doctors.

Well, from above we can see potassium-rich foods mostly are vegetables and fruits. Thus maybe the effects of protection from cardiovascular diseases isn't only come from the potassium but also from the contents of the vegetables and fruits such several vitamins, anti-oxidants, and fibers.

Vitamins and anti-oxidants may help our body maintain our metabolism, and protecting our vessels from oxidative stress that leads to atherosclerosis formation. Fibers in diet also important in preventing cardiovascular diseases because its role in limiting absorption of fats and cholesterol by increasing the food transit in gut, also helping in excretion of cholesterol.

I my opinion, potassium-rich foods gives protection directly because its potassium content but also by others contents inside the foods, but it can be debatable.

After all, the potassium-rich foods is good for your health, since our body need the potassium, and our body have own regulations to keep potassium at normal level.

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April 12th 2011 @ 08:12

Posted By: yulius hermanto - Category: Cardiovascular Issues, Healing Herbs And Plants
   


Atrial Septal Defect at a Glance

Introduction
Atrial septal defect (ASD) is an opening in the atrial septum allowing blood to shunt between left and right atria or shunt between two upper heart chambers.

ASD is a common type of congenital heart disease, though their precise incidence is not well understood. ASD is estimated about 10% of all congenital heart disease. An isolated ASD may found at any age, since the resulting murmur is often overlooked, and often asymptomativ through infancy and childhood.

In children with congenital heart disease, it is estimated that as many as 33-50% will have an associated ASD as part of their complex of disease. Interestingly, the prevalence of ASDs increases in populations living at higher altitudes.

Classifications
There are three kinds of ASD, that determine by location of the defect on the atrium wall.
- Primum ASDs belong to the family of atrioventricular canal defects, also referred to as endocardial cushion defects or atrioventricular septal defects (AVSDs). Those defects are typically moderate to large in size and therefore allow significant shunting. Like the complete atrioventricular septal defect, these defects are almost universally associated with abnormalities of the left atrioventricular valve including clefts, mitral regurgitation and other complicating features.

- Sinoseptal defects involve the area of the atrial septum derived from the sinus venosus. This includes defects at the junction of the superior vena cava and the right atrium. The right upper pulmonary veins typically enter the left atrium superiorly just to the left of the atrial septum and sinus venosus region. When a defect of the superior sinus venosus exists, the flow from these veins may be directed toward the right atrium through the sinus venosus defect. These defects are known as sinus venosus defects.
Atrial Septal Defect

- The ostium secundum atrial septal defect is the most common type of atrial septal defect, and comprises 6-10% of all congenital heart diseases.
The secundum atrial septal defect usually arises from an enlarged foramen ovale, inadequate growth of the septum secundum, or excessive absorption of the septum primum.

Normal Physiology
In normal cardiac development, the septum primum grows downward from the top of the atria toward the central endocardial cushion tissue. As this process completes itself the primary foramen becomes smaller and is eventually closed. Prior to its closure however, perforations of the septum primum occur and these coalesce to form the ostium secundum in the central portion of the septum primum. The septum secundum then begins to grow downward to the right of the septum primum and toward the central portion of the heart. This growth continues until the septum secundum covers the superior rim of the ostium secundum or foramen ovale.

During fetal life, systemic venous return from the lower part of the body, including the newly oxygenated blood returning from the placenta, is directed toward the foramen ovale by a flap of tissue called the Eustachian valve. This allows the relatively well-oxygenated blood to enter the left heart circulation so that it may be delivered to the coronary arteries as well as those vessels supplying the developing central nervous system.

The foramen ovale is maintained patent in the fetus because right atrial pressure is higher than the left atrial pressure. At birth, the organ of oxygenation is transferred from the placenta, which is removed, to the lungs which become aerated. This results in a dramatic increase in the volume of blood delivered to the lungs. As a result, the volume of blood return from the lungs to the left atrium through the pulmonary veins increases, and this leads to an increase in left atrial pressure which forces the septum primum against the septum secundum, thus effectively closing the foramen ovale. This fusion is complete in most infants by a month of age, although as many as 20% of adults may have a probe patent, or intermittently patent foramen ovale.

In the transition from fetus to neonate, the relative compliance of the right ventricle and left ventricle are similar. As a result, the right and left atrial pressures are relatively equal and any flow that results from a communication between the right and left atrium may be bidirectional, with a slight net left to right shunt predominately.
Physiology of ASD
During infancy, the right ventricle gradually becomes more compliant than the left due to the markedly lower pulmonary vascular resistance. This allows the more compliant right ventricle to accept more volume than the left ventricle and there is a marked increase in left to right shunting through any given atrial septal defect.

Clinical Manifestation
Patients with an ASD are generally asymptomatic through infancy and childhood. Only rarely are symptoms of pulmonary overcirculation, frequent respiratory infections and congestive heart failure seen in infants who have no other cardiovascular abnormality. Patients diagnosed later in childhood usually come to the cardiologist because of a systolic murmur appreciated by the primary care provider. Symptoms typically are more apparent in the older adolescent and young adult and these usually involve dyspnea on exertion, easy fatigue compared to peers, palpitations or sustained atrial arrhythmias.

The physical exam usually reflects the size of the ASD and the relative compliance of the right and left ventricle. Small ASDs are extremely unlikely to be associated with any historical or physical findings. If the defect is of moderate to large in size, the precordium may demonstrate a hyperactive impulse. With inspection, there may be a prominence of the left chest if the volume of shunt is large. On palpation of the chest wall, there may be a ventricular lift, particularly apparent with expiration, in the patient with a large volume shunt. The first heart sound may be accentuated or normal and the second heart sound is widely split without significant variation with respiration. This is in contrast to the normal child in whom the second heart sound splitting varies with respiration. It is thought that the wide split in the patient with an ASD results from a relative delay in emptying of the volume loaded right ventricle. The lack of variation of the split most likely results from the free communication between the two atria, which allows for equalization of the influence of respiration on both the right and left ventricle.

There is often a systolic murmur (grade 3 or less) that has an outflow quality mimicking that of pulmonary stenosis, and may in fact emanate from the turbulence across the pulmonary valve resulting from the increased flow imposed by the ASD. The murmur is typically loudest at the mid to upper left sternal border, and may radiate posteriorly. With a large left to right shunt through an ASD, there may be an early to mid diastolic rumble at the lower left sternal boarder, which results from turbulence across the tricuspid valve.

Supporting Diagnosis
Chest X-ray may demonstrate a normal cardiac size in the patient with a small or moderate atrial septal defect. Pulmonary vascularity is likely to be increased in these patients. With increasing size of the atrial shunt, the right atrium and right ventricle may appear dilated. The former is best seen on the posteroanterior view, while the latter is most evident on the lateral view with a noticeable reduction in the retrosternal clear space. As the volume of left to right shunting increase, the pulmonary vascularity will become more prominent and the main pulmonary artery segment will be enlarged.

ECG typically shows a sinus rhythm with a normal P wave axis in patients with a secundum ASD. The P wave axis may be abnormal when there is a sinus venosus ASD. The normal regression of relative right ventricular forces with age does not typically occur in children with an ASD. There is usually right axis deviation and there is often an incomplete right bundle branch block. In older children and adults, complete or incomplete right bundle branch block pattern is seen in 90% of patients. Patients with a primum atrial septal defect typically have a superior frontal QRS axis in addition to the findings noted above.

Once an atrial septal defect has been detected, it should be closed at a convenient time for the family. Usually this is prior to school age for young children. Exceptions to this are the primum atrial septal defect and sinus venosus defects that may be associated with morbidity by preschool age, and are thus usually closed in the first few years of life. The primary indication to close an atrial septal defect is to prevent eventual right ventricular dysfunction from chronic volume overload, risk of paradoxical thrombus and pulmonary vascular obstructive disease. Ostium secundum defects in isolation do not require antibiotic prophylaxis.
Risk factor of congenital anomaly

Treatment
Two methods of closure currently exist for the common secundum atrial defect - surgical or transcatheter closure. Surgical repair should carry an extremely low mortality and should yield few incomplete closures. More recently, techniques employing transcatheter devices have been developed. With this procedure, patients can undergo ASD closure on an outpatient basis or with a short inpatient stay. Factors negating the transcatheter approach include large atrial defects, close proximity of the defect to the atrioventricular valves and sinoseptal defects. In addition, patients must be of sufficient size and weight to accommodate the transvenous sheath delivery system.
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March 8th 2011 @ 14:13

Posted By: yulius hermanto - Category: General Health Issues, Cardiovascular Issues
   


Recent Evidence about Coronary Stent Technology

Introduction
Coronary Heart Disease is still leading cause of death in developed nations, and also causing lot of morbidity and long term complications such as heart failure, impaired daily activity, etc. Because of that, cardiovascular disease is one of the major concern of the modern medicine. Many technology and knowledge have been developed recently about cardiovascular.
Heart Disease

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March 5th 2011 @ 08:51

Posted By: yulius hermanto - Category: Emerging Diseases, Novel Technology, Cardiovascular Issues
   


Proper Management Of Diabetes Slow Down the Atherosclerosis

Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
Understanding Diabetes

Diabetes mellitus affects about 100 million persons worldwide. Five to ten percent have type 1 (formerly known as insulin-dependent) and 90% to 95% have type 2 (non–insulin-dependent) diabetes mellitus. It is likely that the incidence of type 2 diabetes will rise as a consequence of lifestyle patterns contributing to obesity. Cardiovascular physicians are encountering many of these patients because vascular diseases are the principal causes of death and disability in people with diabetes. The macrovascular manifestations include atherosclerosis and medial calcification. The microvascular consequences, retinopathy and nephropathy, are major causes of blindness and end-stage renal failure


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February 27th 2011 @ 13:29

Posted By: yulius hermanto - Category: General Health Issues, Cardiovascular Issues
   


Sleep Duration and Cardiovascular outcomes

Introduction
Nowadays, our modern society and lifestyle requiring longer hours of work, more shift-work, and 24-7 availability of commodities thus reducing the average duration of sleep with increased of fatique, tiredness and excessive daytime sleepiness. In addition, the job stressor, and other emotional stressors impact to quality and quantity of sleep.

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February 15th 2011 @ 11:17

Posted By: yulius hermanto - Category: General Health Issues, Cardiovascular Issues
   


Sodium Restriction and Cardiovascular Disease

Introduction
Blood pressure (BP)-related diseases, specifically, stroke, coronary heart disease, heart failure, and kidney disease, are leading causes of morbidity and mortality in the United States and throughout the world. In the United States, coronary heart disease and stroke are the leading causes of mortality,
whereas heart failure is the leading cause of hospitalizations


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February 8th 2011 @ 14:49

Posted By: yulius hermanto - Category: Cardiovascular Issues, Healing Herbs And Plants
   


Dietary approach in Hypertension Management

Introduction
Hypertension or elevated blood pressure has been associated with cardiovascular and renal diseases, thus become important risk factor of having vascular related diseases such as stroke, heart-attack, heart failure and renal failure.

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Resynchronization Therapy in Heart Failure Patient

Introduction
Heart failure is the inability of the heart to perfuse metabolizing tissues adequately. The most common cause of this is myocardial failure, which can be caused by a wide variety of disease states.

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November 28th 2010 @ 02:39

Posted By: yulius hermanto - Category: Novel Technology, Cardiovascular Issues
   


Percutaneus Coronary Disease vs Coronary Artery Bypass Grafting in Severe Coronary Artery Disease

Background
Cardiovascular disease (CVD) has risen world consent about it. Since cardiovascular disease is the leading cause of death worldwide. According to WHO data, it's estimated about 17.5 millions people die from CVD annually.

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November 13th 2010 @ 12:52

Posted By: yulius hermanto - Category: General Health Issues, Novel Technology, Cardiovascular Issues
   


Dual Inhibiton: New Strategy for Lowering Cholesterol

Intro
Cardiovascular disease (CVD) has risen world consent about it. Since cardiovascular disease is the leading cause of death worldwide. According to WHO data, it's estimated about 17.5 millions people die from CVD annually.

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November 8th 2010 @ 14:08

Posted By: yulius hermanto - Category: General Health Issues, Novel Technology, Cardiovascular Issues
   


VItamin E increase risk of Stroke. Fact or Hoax?

Introduction
Dietary supplementation is very common in United States, it's estimated about more than half of adult population consume dietary supplements. And about 12.7% from those, consume vitamin E supplement.
Vitamin E supplement become popular, since publications from observational studies that showed Vitamin E may protect against cardiovascular disease and offers others health benefits such as fertility, lowering cancer risk, and for skin usage


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November 6th 2010 @ 13:44

Posted By: yulius hermanto - Category: General Health Issues, Cardiovascular Issues, Neurology
   


Childhood obesity as a Risk factor for Cardiovascular disease

How big is the problem?
Obesity itself is a medical condition in which excess body fat accumulated to the extent and it may have effect to the heart. Early obesity alone, is linked to certain abnormalities in the blood that can predispose individuals to developing cardiovascular disease early in adulthood.

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October 29th 2010 @ 09:27

Posted By: yulius hermanto - Category: Diet, Emerging Diseases, General Health Issues, Cardiovascular Issues
   


When to Drink Blood Pressure Drugs?

High Blood Pressure
Hypertension has been increasing in incidence, recently. About one in every four adults, around 50 million people in the USA alone have high blood pressure. But many people are unaware that they have the condition. Because it doesn't cause significant symptoms.

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October 25th 2010 @ 12:31

Posted By: yulius hermanto - Category: Emerging Diseases, General Health Issues, Cardiovascular Issues
   


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