Rheumatic heart, also known as rheumatic heart disease, heart disease causes mitral stenosis accounts for more than 90%. Valvular thickening swelling of the vegetation on the surface of small blood clots, in the thickening, deformation, rough valves, also can produce mural thrombus, the thrombus breaking off the tank with the blood flow into the brain of cerebral embolism occurs. Read More »
A study suggests that researchers will have to find a better way to identify who is more likely to develop heart disease.
This is the VOA Special English Health Report.
Cardiovascular disease is the world’s leading cause of death. It includes heart attack, stroke and high blood pressure.
Over the years, researchers have identified several substances in the blood that can serve as what they call cardiac biomarkers. These are used to measure the presence and development of cardiovascular disease.
Researchers have increasingly tried to use these biomarkers to identify people who are at high risk of developing heart disease. But a new study has found that they offer little help in this way.
A team from Massachusetts General Hospital and Sweden’s Lund University studied how effective the biomarkers are as predictors. Thomas Wang at the Mass General Heart Center was the senior author of the study.
THOMAS WANG: “What we found is that, in fact, even after measuring those additional biomarkers that there wasn’t a great deal of benefit in terms of understanding who was more likely to develop heart disease.”
Doctor Wang says they did identify some combinations of biomarkers that improved predictions of heart attacks and strokes. But, he says, there is not enough evidence to justify measuring these in everybody.
THOMAS WANG: “It’s still possible that in certain patients, measuring these biomarkers would be helpful. There are some patients for whom physicians are really on the fence about whether to give one therapy or another. And in those cases having the biomarker which adds a little bit of information may be helpful in terms of decision making. But for the majority of patients, having the information of the biomarker probably wouldn’t make a difference.”
Doctor Wang hopes future research will discover biomarkers that are better able to predict the risk of cardiovascular disease. But for now, he says, doctors should depend on traditional risk factors. These include a history of high blood pressure, high cholesterol, tobacco use, diabetes, obesity, physical inactivity or poor nutrition.
A separate study found no support for a theory that a biomarker called C-reactive protein causes heart disease. Earlier research suggested that the more of the protein in people’s blood, the more likely they are to develop heart disease. The new study confirmed a link, but did not find evidence that the C-reactive protein causes the disease.
Both studies appeared in the July 1st issue of Journal of the American Medical Association.
The World Health Organization estimates that cardiovascular disease killed seventeen and a half million people in 2005. That was 30 percent of all deaths. Eight out of ten happened in low and middle income countries. At current growth rates, the W.H.O. expects the number to reach 20 million by 2015.
And that’s the VOA Special English Health Report, written by June Simms. I’m Steve Ember
New York, December 27 (Reuters Medical News), according to Finnish scientists in January next year, the journal Epidemiology, published reports, tea, wine, fruit and vegetables can reduce the number of anti-oxidants male non-fatal heart attack risk However, these compounds for the fatal heart attack, and there is no protection.Antioxidants are food that can resist the role of free radical compounds. Free radicals are naturally occurring body particles, and the occurrence of chronic diseases and aging. Previous studies have shown that antioxidants, such as alcohol and flavonoids flavone can eliminate free radicals, thereby reducing the risk of stroke and to reduce low-density lipoprotein (LDL) role.
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Answer:
About 30% of all deaths from heart disease in the U.S. are directly related to cigarette smoking. Smoking is a major cause of atherosclerosis.
Among other things, the nicotine present in smoke causes:
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Decreased oxygen to the heart.
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Increased blood pressure and heart rate.
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Increase in blood clotting.
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Damage to cells that line coronary arteries and other blood vessels, triggering atherosclerosis and heart disease.
Blood pressure is the force your blood makes against the walls of your arteries. The pressure is highest when your heart pumps blood into your arteries – when it beats. It is lowest between heart beats, when your heart relaxes. A doctor or nurse will write down your blood pressure as the higher number over the lower number. For instance, you could have a blood pressure of 110/70 (read as “110 over 70″). A blood pressure reading below 120/80 is usually considered normal. Very low blood pressure (lower than 90/60) can sometimes be a cause of concern and should be checked out by a doctor.
High blood pressure, or hypertension, is a blood pressure reading of 140/90 or higher. Years of high blood pressure can damage artery walls, causing them to become stiff and narrow. This includes the arteries carrying blood to the heart. As a result, your heart cannot get the blood it needs to work well. This can cause a heart attack.
A blood pressure reading of 120/80 to 139/89 is considered prehypertension. This means that you don’t have high blood pressure now but are likely to develop it in the future.
Most patients, especially patients with stable angina pectoris after treatment, the symptoms can be eased or disappeared after the establishment of adequate collateral circulation for a long time without pain in the early attacks of angina pectoris may be worsening angina pectoris and angina decubitus Central syndrome can occur as part of another heart attack, so that they “pre-infarction angina pectoris referred” Read More »
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A clinical-like syndrome:
According to their clinical coronary heart disease-like disease can be divided into five types: 1 angina type: performance as a sternum pressing a sense of nausea after the swelling sense of anxiety associated with significant sustained 3-5 minutes often diverge to the left arm shoulder lower jaw and throat can also radiate into the back of his right arm. Sometimes involving these areas After the area without affecting the breastbone. forcefully emotional catch cold meal such as increase in myocardial oxygen consumption under attack is called angina pectoris with nitroglycerin for rest and ease the sometimes atypical angina pectoris can be expressed as gas-tight syncope Weakness belch, especially in the elderly according to the frequency and severity of attacks are divided into stable angina and unstable angina. stable angina refers to the onset of angina pectoris in January over parts of the frequency of their seizure severity continued to time to onset of labor-inducing size can ease the pain of nitroglycerin dosage is basically stable unstable angina refers to the original stable angina attack frequency increase in the duration of the severity or new onset of exertional angina pectoris ( occurred within 1 month) or when the onset of resting angina with unstable angina pectoris is a precursor of acute myocardial infarction is why, once discovered should be immediately to the hospital. Type 2 myocardial infarction: infarction often occurs about a week before the prodromal symptoms such as resting and mild physical activity during the onset of angina pectoris with obvious discomfort and fatigue infarction presenting with persistent severe oppressive sense of boredom or even a knife-like plug After the pain in the sternum often affect the entire chest to the left as the most important part of the patient can extend his left arm caused by radiation down the left side of the wrist ulnar palm and fingers, tingling and some patients may be radiation to the upper jaw to the left shoulder and neck pain-based site location consistent with previous angina pain, but continued much longer with more emphasis on rest and nitroglycerin does not relieve the performance of upper abdominal pain is sometimes easy to be confused with abdominal disease, irritability accompanied by low-heat, and cold sweat, nausea, sweating vomiting, dizziness, palpitations very weak sense of difficulty in breathing for 30 minutes or more near-death for several hours often find this situation should seek medical attention immediately How the early detection of coronary artery disease? Coronary heart disease is the common diseases and frequently-occurring disease in the elderly in this age group phase of the people in their daily lives if the following conditions must be promptly for medical treatment early detection of coronary artery disease (1) fatigue or mental stress or after sternum when precordial Mentong or contraction-like pain in left shoulder and left upper arm to the radiation lasting 3-5 minutes after the break on their own remission (2) physical activity, chest tightness, palpitation and shortness of breath when at rest on their own remission (3) The emergence and exercise-related leg pain such as headache, toothache (4) eat too much cold or watching a movie thriller palpitations chest pain who (5) night of sleep to feel chest tightness, low pillow suffocating pillow lying side require a high comfort persons; sleeping supine position during the day when a sudden chest pain or palpitations shortness of breath requiring immediate sit or stand can be reduced by (6) sexual life or forceful defecation flustered when shortness of breath or chest pains, chest discomfort (7) heard the noise they were chest tightness caused by flustered (8) recurring pulse arrhythmia of unknown causes too fast or too slow heart rate were For the early detection of coronary heart disease over 40 years of age who regularly do the following test: If the test results are not normal or have other risk factors for susceptibility to coronary heart disease should be one or more times every five years for blood cholesterol tests Blood pressure checks every year to make a A year to make a blood glucose testing If it is a high risk of coronary heart disease should ask the doctor to see if you need to receive ECG if you need further examination will be arranged for a doctor to do an exercise test to measure a fixed pin in the foot car or foot treadmill ECG machine Coronary angiography is the surest method of diagnosis of coronary heart disease 3 silent myocardial ischemic: Many patients have a wide range of coronary artery occlusion did not feel that some patients who had angina pectoris or even myocardial infarction angina when some patients did not feel that the occurrence of sudden cardiac death in heart attack routine physical examination found that before being discovered. some patients with ischemic ECG manifestations because the arrhythmia occurred or because the exercise test positive for coronary angiography being done only to find that such patients are sudden cardiac death and myocardial infarction and angina patients the opportunity to, like it should be Note that usually the heart of the health-care 4 heart failure and arrhythmia type: some patients with angina pectoris after the original lesion due to extensive myocardial fibrosis in a wide range gradually reduced to the disappearance of angina heart failure have occurred in the performance such as air-tight edema, fatigue, etc. There are a variety of arrhythmias manifested as palpitations. There are some patients with angina pectoris has never directly expressed as heart failure and arrhythmias 5 sudden death type: that due to coronary heart disease caused by unpredictable sudden death in patients with acute onset of symptoms occurred within 6 hours after cardiac arrest due to mainly due to myocardial ischemia caused by abnormal electrophysiological activity lead to serious arrhythmia 2. Signs: In general no clear positive signs of early heavy can determined to expand the sector to the left under the first heart sound can be heard when the weakened with arrhythmias such as atrial fibrillation with heart failure, and premature beats when the two can be heard under the lungs and wet rales can be heard and the apical gallop, etc. |
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So you’ve done an assessment of your risk of developing heart disease, and it turns out to be high. (Click here for information on assessing your cardiac risk.) What needs to happen now?
Step 1: Take this seriously
If you have sufficient risk factors for cardiac disease to place you in a high-risk category, this means one of two things. Either your risk of developing heart disease within the next few years is high, or you already have heart disease and don’t know about it.Unfortunately, a substantial proportion of individuals upon learning that they’re in the “high risk” category turn out to already have significant coronary artery disease – they just don’t know about it because, so far, they are not having symptoms. The fact a high-risk patient is not having symptoms is no reason to relax, especially since, in 30% of patients with coronary artery disease (CAD), the very first symptom is sudden death.
Being at high risk is very serious stuff, and requires a very serious response.
Step 2: Make sure your doctor is taking this seriously
Finding that a patient is at high risk for a serious cardiac event (such as myocardial infarction or sudden death) ought to elicit a certain type of response from a doctor. The doc should act with alacrity to accomplish two things: a) evaluate whether you may already have coronary artery disease, and if so, institute appropriate therapy, and b) modify all the risk factors that are producing the high risk in the first place.Because some high-risk patients will already have heretofore unknown but significant CAD, a non-invasive evaluation ought to be done to rule out this possibility. This evaluation generally will consist of a stress/thallium study. In some cases a cardiac calcium scan might be appropriate.
If the non-invasive evaluation strongly suggests CAD, then steps should be taken to reduce the chances of developing Acute Coronary Syndrome (ACS).
At the same time, the doctor should also lay out a clear plan for attacking all modifiable risk factors – including diet, weight loss, smoking cessation, hypertension, and cholesterol – and should initiate therapy immediately. The doc should offer you all the resources at his/her disposal to encourage and assist in exercise, weight loss, and smoking cessation, and should ride you pretty hard about accomplishing these things.
He/she should display an especially aggressive attitude toward reducing LDL cholesterol, increasing HDL cholesterol, and controlling the blood pressure, since accomplishing these tasks is usually primarily the doctor’s responsibility, and since doing so often requires using the right drug therapy in the right doses. In general, controlling cholesterol and hypertension will require fairly frequent office visits and frequent measurements of blood pressure and/or cholesterol levels, as well as many medication adjustments. This all should be done on a fairly aggressive schedule, with clear targets in mind.
Beware of the doc who puts you on a medication or two, pats you on the back, and then considers his job done. The doctor should clearly understand what “high risk” implies, and should behave accordingly. If this lackadaisical physician is also the one who neglected to mention assessing your cardiac risk in the first place, it’s time to go to someone who will actually care whether you live or die.
However, also keep in mind that doctors are human, and human nature makes it difficult to pull out all the stops for a patient who is refusing to act in his/her own best interests. It’s hard to motivate yourself as a doctor to go the extra mile for the patient who just won’t make a genuine and persistent effort to exercise, lose weight, or stop smoking. Which brings us to -
Page 2 – Start your own Manhattan Project
Step 3: Start your own Manhattan Project
While it is important that your doctor take appropriate action to make sure you are not at imminent risk and to guide you to appropriate risk factor modification, the real responsibility rests with you. Successfully reducing your risk is something that happens only with your dedication, and it’s not easy. Doing what needs to be done often involves fundamental changes in both attitude and lifestyle of the sort that many people seem not to be able to accomplish. The degree of effort required is akin to the effort the US made to develop an atomic bomb during WWII. It was something that seemed to be barely possible, yet, if we did not do it the risk was high that either the Germans or the Japanese would beat us to the punch. So, against all the odds, we marshaled the resources and did it. And it’s a good thing we did.
This is exactly the kind of effort you need to make. Against the odds, you need to change your life. If you don’t you will suffer the consequences – possibly decades earlier than is necessary.
That the vast majority of patients who are in the high risk category end up making only half-hearted efforts to modify their risk may be related to the failure of primary care docs and cardiologists to stress the utter life-and-death importance of changing their lifestyles, to their use of “you really should” instead of “you must, or your children will be orphans.”
Is there any group of docs who have succeeded in getting their patients to stop whatever they’re doing, to suddenly focus every ounce of energy on regaining their health? Yes. The oncologists. Patients who are told they have cancer often put everything else on hold and steel themselves to doing whatever is necessary (whether surgery, radiation, or chemotherapy, often painful, and often lasting for months or years) to attempt a cure. This is the same attitude that patients ought to adopt who are told they are at high risk for heart attack, sudden death, or stroke. After all, being told you are at high risk for a cardiac event is not all that much different than being told you have cancer. Heart disease is often no less fatal, and the outcome no less dependent on your attitude and your active participation in doing what’s necessary. If anything, you have a much better chance of favorably altering the ultimate outcome than the average patient with cancer.
In general, the high-risk patients who are most successful are the ones who adopt a “change it all now” attitude – the ones who accept that a complete change in lifestyle is needed. They’ll stop smoking, adopt an exercise program and change their diet all at once. And they do it by making risk factor modification the central organizing theme of their lives. One day they’re a high-risk-lifestyle kind of person, and the next day they’re not. They take on all the modifiable risk factors at once – it becomes the chief focus of their lives until the new lifestyle is an ingrained habit (and they are a different person.) DrRich seen several of these patients achieve remarkable success.
The sort of lifestyle changes that are necessary to reduce the high risk we’re talking about here essentially amount to a complete transformation of attitude, something like the transformation of attitude Americans experienced at about 9 AM on 9/11/01. America became a different kind of country. These patients must become a different kind of person.
The more gradual approach to lifestyle changes, while seeming quite reasonable on its face, often does not work. If diet and exercise are postponed until smoking is stopped, for instance, think about what that means. The patient is essentially living the same kind of life they always did except they’re trying to stop smoking. Somehow the smoking never really stops, and and the diet and exercise never get addressed at all, and pretty soon a year or two or five go by – and then it’s too late.
There’s no a priori reason the gradual approach can’t work. The theory here, however, is that gradualism here simply reflects a constitutional failure to accept the deep-rooted changes that are really necessary. Gradualism, in other words, may reflect a lack of the sort of battle-ready attitude that is necessary to achieve the desired end.
Which risk factors need to be modified?
All the risk factors are important, and it is important to improve all the modifiable risk factors that count against you. Here is information on what those modifiable risk factors are, and what you can do to improve them: The cardiac risk factors and what you can do about them
