Common cardiovascular diseases in elderly - Infectious endocarditis eight times greater in men than women

SPECIFIC HEART PROBLEMS IN ELDERLY (Old age)

ENDOCARDITIS

Infective endocarditis is more common among the elderly. More than a quarter of all cases occur in people 60 years. The prevalence has increased because the number of elderly and those with artificial valves increased nosocomial bacteremia has become more widespread, and people suffering from valvular heart disease survive longer. infective endocarditis affecting eight times as many older men, older women.

Underlying cardiac lesions that predispose elderly endocarditis usually differ from those of younger patients. Mitral annular calcification or aortic insufficiency is more prevalent with the elderly, and congenital heart defects are more common in younger subjects. increased atherosclerosis in the elderly may be a factor, because the atheromatous deposits in the valves may cause turbulence, which is endothelial damage and thrombus formation. About 30% of elderly patients with rheumatic endocarditis is damaged, about 25% of calcified valves, and about 5% of mitral valve prolapse, but about 40% are unknown or valvular lesions. Any valvular heart disease increases endocarditis.

Antibiotic prophylaxis is indicated in elderly patients with valvular heart disease, especially in patients with prosthetic heart valves or calcified, especially before procedures. The optimal treatment requires the use of microbicides drugs. For critically ill patients, empirical therapy should start immediately after obtaining blood cultures, as valvular heart disease may be limited. Initially, the choice of antibiotic is based on micro-organism is more likely in the specific clinical context. If the onset is subacute in patients who use intravenous drugs and has a native valve endocarditis, infection with streptococci or enterococci is likely. The standard treatment is empirically high doses of IV penicillin G (or ampicillin) with an aminoglycoside such as gentamicin. If the onset is acute or if the patient is using drugs intravenously, the treatment should target S. aureus.

If the first is acute or if the patient used drugs IV, treatment should be subjected to S. aureus. If the first is an acute patient does not use IV drugs and who is a native valve endocarditis, penicillinase-resistant penicillin (eg nafcillin) or a cephalosporin (eg cefazolin) is appropriate as initial therapy. If the patient is a prosthetic valve, vancomycin-resistant strains can be addressed to S. aureus and S. epidermidis. After the micro-infected have been identified, antimicrobial therapy should be amended accordingly, that the more effective, less toxic and less expensive treatment . Treatment should be continued for at least 2 weeks longer than patients with prosthetic valves.

In some patients with infective endocarditis with valve replacement. Indications for valve replacement is due to the deterioration of blood flow to valve dysfunction, fungal endocarditis, during infection despite appropriate antimicrobial therapy, repeated relapses at the end of the beginning of treatment or surgery complicated by valve endocarditis prosthetic extension extravalvular infection and recurrent emboli.

Common cardiovascular diseases in elderly - Aortic valve stenosis -Mitral calcification ( mitral valve prolapse)

SPECIFIC HEART PROBLEMS IN ELDERLY ( OLD AGE )  . 

AORTIC SCLEROSIS IN ELDERLY .

The incidence of aortic valve stenosis, clinically significant valvular lesion in elderly increases with age. Stenosis severity is often underestimated because of its progression is so gradual and because symptoms may be due to normal aging. Elderly aortic valve stenosis is usually caused by calcification of congenital bicuspid aortic valve and degenerative aortic stenosis. rheumatic heart disease is the cause of 20%, mitral valve disease often coexist. Whatever the cause, calcification occurs in patients with aortic stenosis 65 years congenital bicuspid valve, if present, tends to become calcified in patients aged 45-60, and in general, the semilunar aortic tricuspid aortic valve calcification in patients  with age > 75 .

Elderly patients with critical aortic stenosis do not require a series of control, because the stenosis progresses often unpredictable pace. Asymptomatic elderly patients with severe aortic stenosis can usually be treated with medical therapy, surgery is only justified if the risk of perioperative mortality is less than sudden death. However, a detailed history is very important to verify that the patient is active and asymptomatic until it can be concluded that the patient can safely drug.

Aortic valve replacement in symptomatic patients with hemodynamically significant aortic valve stenosis, because their life expectancy decreases. 3-year mortality of untreated symptomatic patients is about 50%, life expectancy is shorter for these patients, if they have heart failure, and longer if they have angina pectoris. Elderly patients with severe aortic stenosis may be worse than expected. Together with the series, the mortality rate was 50% at 1 year and 65% for 2 years. Percutaneous balloon valvuloplasty is used only for the relief of symptoms of seriously ill patients who are not candidates for surgery because of restenosis valvuloplasty and high mortality after hospital discharge. Ultrasonic cleaning of football is no longer performed.

MITRAL ANNULUS CALCIFICATION .

Mitral annular calcification occurs predominantly in elderly women. It is diagnosed as a chest x-ray and usually does not match any of the symptoms. mitral annular calcification (MAC) is a common degenerative process of the fiber and the mitral valve. It is generally a casual observation associated with aging, although it is occasionally associated with significant mitral regurgitation, and may rarely cause symptoms of mitral valve stenosis. Furthermore, the MAC associated with atrial fibrillation, conduction disease, atherosclerosis and cardiovascular adverse events, such as stroke and mortality. Diagnosis, clinical significance and cardiovascular risk associated with MAC MAC management and related disorders discussed here.

Mitral annular calcification - mitral annular calcification (MAC) to develop a progressive accumulation of calcium along and around the mitral valve. MAC usually followed by C-shape of the mitral valve at the lower front of the mitral leaflets is usually (but not always) spared. MAC is usually identified echodense echocardiography until the ring structure to which the mitral valve and the associated noise cloudy. Calcification is often irregular, beautiful appearance. Although the leaflets of the mitral valve and tendinae ropes are not generally involved, calcification may gradually accumulate in the subvalvular area around the back of the booklet, in the absence of leaflet. Savings usual commissures sheet and the sheet was separated from the previous Mac-rheumatic mitral involvement.

Common cardiovascular diseases in elderly -Congestive heart

SPECIFIC HEART PROBLEMS IN ELDERLY (OLD AGE)

With age, many systems in the body to experience normal wear and can not work as they did before. This also applies to one of the major muscles of your body, your heart. Due to genetics, heredity and bad habits, heart problems can occur at any age. But they tend to become more common in the elderly. The good news is that once people become aware of common problems inside the elderly may have, there are steps they can take to minimize many of these conditions.
Elderly, making it an increased risk of heart problems, reducing the pumping capacity of the blood. There are several problems to humans due to a deterioration of cardiac function.

Heart disease such as hypertension and cerebrovascular diseases, and cardiovascular diseases such as coronary artery disease, arrhythmia and heart failure, increased incidence increases with aging age.w1 also affects the cardiovascular system. It difficult to distinguish between normal aging, which is inevitable if the age-related disease that is potentially preventable or treatable.age-related changes are more likely to see Old,who left their heart disease earlier in life. This group shows two processes that often interact with biological aging, cardiovascular disease and age-related disease 

 

CONGESTIVE HEART FAILURE IN ELDERLY.

One of the most common problems of heart for the elderly, congestive heart failure. There are many elderly are facing this problem. The main reason for this problem is to extend a heart to operate at a higher interest rate. This enlargement of the heart requires more blood to be pumped continuously. There are special treatments that are available for this condition. There are also several other types of procedures to verify, because the effects can attenuate the disease. Heart failure, which is more common in older people with heart problems is shown below. The information and advice in this section are useful in the fight against this disease. This is one of the most common problems that occur in the elderly. The reason for this to be implemented because of the greater work with hypertrophy of the heart to pump more blood in different parts of the body.

The treatment must be followed religiously on a consistent basis. Home care activities include the cultivation of food intake, reduce salt and fluid intake is one of the main requirements. It is also important that the person should be the activities of the low voltage will be limited and may not give rise to a high load at all. There are many people who do not contribute to the plan and purpose to aggravate heart disease. One of the most common symptoms of heart failure is ankle and knee swelling. There will be many other symptoms that may be typical of normal cardiac function problems such as lack of scale, scope faster and much more. The absence of duct width at the level of conscious efforts to increase the pump more air into the body. Rapid breathing is a common problem that other people who are already associated with cardiovascular problems.

Signs ,symptoms and treatments of right sided heart failure

RIGHT SIDED HEART FAILURE .

SIGN AND SYMPTOMS OF RIGHT HEART FAILURE  .

SYMPTOMS .
Symptoms of heart failure are traditionally and somewhat arbitrarily divided into "left" and "right" but recognizing the unilateral right and left ventricles of the heart supply the various parts of the circuit. But the heart is not only failed to return (in this part of the turnover, which takes place in the ventricle). historic failure of the right ventricle leads to congestion of systemic capillaries.

This creates the excessive accumulation of fluid in the body. This causes swelling under the skin (known as peripheral edema or anasarca) and generally affects the incriminating the first body (foot and ankle swelling because people who get up and sacral edema in individuals who are mainly located at the bottom).

Nocturia (frequent urination at night) can occur when fluid in the legs is returned to the bloodstream while lying down at night. In severe cases, progressive, ascites (accumulation of fluid in the abdominal cavity causing swelling) and hepatomegaly (enlarged liver) may develop. significant liver congestion can cause jaundice and liver failure and even coagulopathy (decreased blood clotting problems) may occur.


SIGN .
Physical examination may reveal peripheral pitting edema, ascites and hepatomegaly. jugular venous pressure is usually assessed as a marker of fluid, which can be aggravated by reflux hepatojugular. If the pressure increases ventriclar good, an increase in parasternal may be present, which means the compensatory increase in force of contraction.


TREATMENT .

Heart failure requires periodic monitoring of your health care provider. Aims of treatment include control of symptoms, reduce cardiac workload and improves cardiac function. All the underlying conditions and causes must be considered, if possible. The most common therapy for treatment of heart failure right on the left side of heart failure. valve surgery and procedures such as coronary artery bypass grafting (CABG) and angioplasty are the solution for some people.

CHANGES IN LIFE STYLE  .
Generally, you must reduce the salt in food, and drink lots of liquids. You should also consider slimming, if you are overweight, quit smoking, and avoid too much alcohol.

MEDICATIONS .

Diuretics (water pills) may help reduce fluid buildup. Furosemide or bumetanide can help moderate to severe symptoms. Hydrochlorothiazide, chlorthalidone, and chlorothiazide may be used for mild symptoms. Another drug, spironolactone, can prevent salt retention and help patients with severe heart failure.

Drugs that reduce the workload of your heart are ACE inhibitors, ARBs, and drugs such as hydralazine and nitrates of prolonged action. You can extend patients lives very patient with heart failure. Beta-blockers (like metoprolol or carvedilol) can help prevent death in some patients with heart failure. Digitalis may be prescribed to increase the contraction of heart muscles and help prevent hospitalization.

IMPLANTED DEVICES.

Some patients with ECG abnormalities may benefit from aa biventricular pacemaker, which helps both ventricles contract at the same time (CRT, cardiac resynchronization therapy). defibrillation device, such as implantable cardioverter defibrillator (ICD) helps some patients. CRT and ICD may be combined and implanted in a single device (biventricular pacemaker-ICD).


TRANSPLANT .

Patient with severe heart failure, which does not meet these treatments may require a heart transplant.

PROGNOSIS .

Heart failure is a severe disorder that has a possibility of reduced life expectancy. There is no cure, but many forms of heart failure can be controlled with medication and correction of underlying illnesses. Heart failure may take the form of a chronic disease, and is aggravated by an infection or other physical stressors.

Some related stuff

• Symptoms of heart (cardiovascular ) diseases - Fainting , Fatigue ,Pain in the limbs

  Hypertension is a silent killer without sign and symptoms
• Sudden cardiac death ( cardiac arrest ) people die within minutes after onset of symptoms
• Symptoms of heart ( cardiovascular ) disease -Shortness of breath ,cheyne-stokes breathing ,limitations in physical activity
• Symptoms of heart ( cardiovascular ) disease - Chest pain stress ,edema
• Cardiovascular diseases in elderly are major cause of expiry
• Causes of essential and secondary hypertension and pathophysiology
• Causes of heart failure
• Life saving procedures for heart conditions ( diseases ) Cardiopulmonary resuscitation CPR
• Symptoms of heart ( cardiovascular disease ) Heart palpitations
• 
  

Major cause of right sided heart failure is left sided heart failure

RIGHT SIDED HEART FAILURE .

Heart failure (HF) is generally defined as the heart's inability to provide sufficient blood flow to meet needs.It agency has several criteria for the diagnosis, and the period of heart failure is often used incorrectly to describe d other heart disease, such as myocardial infarction (heart attack) or cardiac arrest. heart's pumping action moves the ;used blood back to the heart through the veins to the right atrium to right ventricle. The right ventricle pumps blood, and then return to the heart to the lungs to be filled with oxygen.

Right or right ventricular (RV) heart failure usually occurs as a result of the failure of the left. When the left ventricle, increased fluid pressure is, in fact, donated by the lungs, ultimately damaging the right side of the heart. If the right loses pumping power, blood pools in the veins of the body. This often causes swelling of the legs and ankles.

Heart failure does not mean the heart has stopped. This means that the heart can not follow the work needed to pump blood adequately all parts of the body (the workload). However, this definition is a bit simplistic. Heart failure is extremely complex and there is no simple definition can encompass its multiple causes, aspects, forms and consequences. pooling of blood in the left side of the heart causes congestion in the lungs, making breathing difficult.

Accumulation of blood coming from the right side of the heart causes congestion and fluid accumulation in other body parts like legs and liver. Heart failure usually affects both left and right sides of the heart, to some extent. However, one side can be affected by the disease in more than the other. In such cases, heart failure can be described as heart failure or right heart failure, the left side.

CAUSES .

The right heart failure, occurs in about 1 / 20 people. Coronary heart disease is the most common cause of heart failure in the United States, but can be a complication of other conditions.

Heart failure may affect the right heart (right ventricle), left (LV), or on both sides. In right heart failure, right ventricle loses its pumping function, and blood may back up other areas of the body, producing congestion.

Congestion affects the liver, gastrointestinal tract and extremities. Moreover, the right ventricle may be able to pump blood efficiently to the lungs and left ventricle. Causes of right heart failure are on the left side of heart failure and lung diseases like chronic bronchitis and emphysema. Other causes include congenital heart disease, blood clots in blood vessels, lung, pulmonary
hypertension and heart valve disease ........ Read more

Heart failure

Classification of heart failure

Hallmarks of heart failure

Signs ,Symptoms and treatments of right sided heart failure

Heart failure - Hallmarks ,Classification ,symptoms

HEART FAILURE . 

HALLMARKS  OF  HEART FAILURE .                         

• FLUID CONGESTION .

        If the heart becomes less efficient than normal as a pump, your body will try to compensate. One way he tries to do this is via hormones and nerve signals to increase blood volume (by water retention in the kidneys). Decreased blood flow to the kidneys also lead to fluid retention. The blood and fluid pressure behind the sustained cardiac outcome in excess of salt water in the lungs and other body tissues. But it is important to note that all swelling due to fluid accumulation is a reflection of heart failure.

Clinical symptoms due to fluid overload: 

1. Breathlessness .
2. Edema  (pooling of fluid in the lungs and body).

• REDUCED BLOOD FLOW TO THE BODY .

        The heart's inability to pump blood to muscles and organs is not always evident in the early stages of heart failure. Often, it appears that the increase in physical activity. In advanced heart failure, many organs and tissues are not even the oxygen they need to function at rest.

Symptoms due to lack of circulation in the body : 

1. The difficulty of the exercise. 
2. Fatigue.
3. Dizziness (due to the low pressure of the blood ).

CLASSIFICATION OF HEART FAILURE .

Symptoms and physical changes in heart failure, there are many different classifications based on their location and mechanism.

• RIGHT HEART FAILURE - the inability to appropriate the right side of heart pumps venous blood into the lungs into the bloodstream. This causes a backup of fluid in the body, when the swelling and edema. 

• LEFT HEART FAILURE  - a failure of the left side of the heart to pump into the systemic circulation. Back-up behind the left ventricle causes fluid in the lungs. 

SYSTOLIC HEART FAILURE  -  The left ventricle can't contract vigorously, indicating a pumping problem.

DIASTOLIC HEART FAILURE   (also called heart failure with normal ejection fraction) The left ventricle can't relax or fill fully, indicating a filling problem.

In consequence of these errors may be symptoms caused by:

• BACKWARD HEART FAILURE  - the heart's ability to pump blood at a sufficient rate ONLY when heart filling pressures are abnormally high.

• FORWARD HEART FAILURE - Inability of the heart to pump blood adequately to meet the oxygen demands of the body at rest or exercise. 

• CONGESTIVE HEART FAILURE - fluid in the lungs or body, which is a consequence of the lack of heart pumping and a big heart and the venous filling pressures.

Isolated heart failure are projected based on several factors. These include age, severity of symptoms, causes, behind heart failure, general health, history of disease and family history also. Lifestyle factors can dictate the prediction of heart failure largely. Otherwise healthy organs for the chance to fight the negative aspects of heart failure, and far more positive and aggressive in the manner of those who have loads of other diseases such as diabetes or high cholesterol or hypertension. As the heart moves in a higher stage of any physical movement difficult. Reduced the amount of blood the heart pumps, the system begins to affect other organs as well as time and the patient is able to fend for themselves. The lack of sufficient time to influence the flow of blood to other body organs and complications begin to make treatment more difficult.

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Heart failure prognosis depends on lifestyle factors of the past

HEART FAILURE .

Heart failure (HF) is generally defined as the heart's inability to provide sufficient blood flow to meet the needs of the organization. It has different criteria for diagnosis of heart failure and the term is often incorrectly used to describe other cardiovascular diseases such as myocardial infarction (heart attack) or cardiac arrest. Common causes of heart failure include myocardial infarction (heart attack) and other forms of ischemic heart disease, hypertension, valvular heart disease and cardiomyopathy. Heart failure can cause a variety of symptoms such as shortness of breath (most usually when lying flat, called orthopnea), cough, swelling of the ankles and exercise intolerance. Heart failure is often undiagnosed due to the absence of a consensus on the definition and the challenges in a definitive diagnosis. Treatment usually consists of lifestyle measures (such as reduced salt intake) and medication, and sometimes the equipment or even surgery.

Heart failure is a common, costly, disabling and potentially lethal condition. In developing countries, approximately 2% of adults suffer from heart failure, but more than 65 years, this will rise 60-10%. Mainly the cost of hospitalization, is linked to high health care costs, the cost is estimated at 2% of the total budget for the National Health Service of the United Kingdom, and more than 35 billion U.S. dollars in U.S. bankruptcy States.Heart associated significantly impaired physical and mental health, which clearly decreased quality of life. With the exception of heart failure due to reversible conditions, the condition usually worsens with time. Although some patients survive for many years, a progressive disease associated with total annual mortality rate of 10%.

Heart failure may be due to one or the sum of many reasons. It is a progressive disease that will be managed with regard not only the state of the heart, but the traffic conditions, lung, neuroendocrine system and other organs as well. In addition, when other conditions exist (eg, renal dysfunction, hypertension, vascular disease or diabetes) may be more of a problem. Finally, it can affect a patient psychologically and socially important.

Heart failure is the cumulative result of all the insults seriously in someone's life. An estimated 5 million Americans suffer from heart failure. The prevalence of heart failure approximately doubles with each decade of life. As people live longer, increases the occurrence of heart failure and other conditions that complicate treatment. Even when symptoms are absent or controlled, impaired heart function implies a reduction in the duration of survival. Fortunately, there are many factors that can prevent heart failure and improve outcomes are known and can be applied at any stage.

It has also been observed in some studies that the prognosis of heart failure can be improved by a healthy lifestyle and ensure regular checks. Heart failure prognosis depends on lifestyle factors of the past, but it also depends on how you treat your body when you have been diagnosed with heart failure. Moderate exercise under the supervision of a qualified heart healthy diet low in saturated fat and sodium, weight management and monitoring and other similar factors may increase the likelihood of a longer life. Another very important factor in prognosis is related to stress. The only way the prognosis of heart failure can be improved or made to look positively to ensuring that the scheme is determined by your doctor about diet and activity is strictly maintained.

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Causes of essential and secondary hypertension and pathophysiology

HYPERTENSION .  

Hypertension is often called the silent killer because it usually has no symptoms until serious complications develop. When symptoms occur, they can vary between individuals depending on factors such as amount of blood pressure, age, underlying cause, medical history, onset of complications and overall health.


PATHOPHYSIOLOGY .

Most systems of secondary hypertension are generally quite clear. However, they are linked to the essential (primary) hypertension is much less understandable. However, it is known that cardiac output is presented at the beginning of the disease, of course, entirely peripheral resistance (TPR) normal, and, over time, decrease cardiac output to normal levels, but increased TPR.

Three theories have been proposed to explain this: the difficulty of the kidneys eliminate sodium and natriuretic factors, such as atrial natriuretic factor is secreted to promote salt excretion with the side effect of an increase in total peripheral resistance. Overactive renin-angiotensin system leads to vasoconstriction and sodium and water. Volume of blood lead to hypertension. Overactive sympathetic nervous system, which increases the stress response.

We also know that high blood pressure is highly heritable and polygenic (caused by more than one gene) and some candidate genes have suggested that the etiology of this work is related to the association condition.

Recently essential hypertension and persistent endothelial damage was popular among researchers in hypertension. However, it is unclear whether the endothelial changes precede the development of hypertension or whether these changes are mainly due to long-term high blood pressure.

CAUSES .

ESSENTIAL HYPERTENSION .

Essential hypertension is the most common type of hypertension that affects 90-95% of hypertensive patients. Although no direct cause is identified, there are many factors such as physical inactivity, stress, visceral obesity, a potassium deficiency (hypokalemia), obesity (more than 85% of cases occur in patients with body mass index greater than saline (sodium) consumption of alcohol sensitivity, and a vitamin D deficiency, which increases the risk of developing hypertension. risk increases with age, inherited some genetic mutations and family history of hypertension. An increase of renin, a hormone secreted by the kidneys, is another risk factor that is overactive sympathetic nervous system.

Insulin resistance, which is part of the syndrome X or metabolic syndrome is also thought to contribute to high blood pressure. The consumption of foods containing high levels of corn syrup may increase the risk of developing hypertension. Recent studies have involved low birth weight a risk factor for essential hypertension in adults.

SECONDARY HYPERTENSION .

Secondary hypertension, by definition of an identifiable cause. This type is important to recognize because it is a different treatment of essential hypertension, treating the underlying cause of blood pressure. Hypertension results of a commitment or an imbalance of the pathophysiological mechanisms such as hormonal regulation of the endocrine system that regulate the volume of blood plasma and cardiac function.

Many conditions increase high blood pressure, some are recognized common secondary causes such as Cushing’s syndrome, a condition where the adrenal glands overproduce the hormone cortisol. In addition, hypertension is caused by other conditions that cause hormonal changes, such as hyperthyroidism, hypothyroidism, and cancer of the adrenal glands.

Other common causes of secondary hypertension include kidney disease, obesity and metabolic disorders, pre-eclampsia during pregnancy, the birth defect known as coarctation of the aorta, and certain prescription and illegal drugs.

Hypertension is a silent killer without sign and symptoms

HYPERTENSION .  

High blood pressure (hypertension) or hypertension is a chronic condition in which blood pressure in the arteries is high. It is the opposite of hypotension. It is classified as primary (essential) or secondary. Approximately 90-95% of cases are classified as primary hypertension, which refers to high blood pressure in which no medical cause can be found.The% balance 5-10 (secondary hypertension) is caused by other conditions affecting the kidneys, arteries, heart or endocrine systems.

Persistent hypertension is one of the risk factors of stroke, myocardial infarction, heart failure and arterial aneurysm, and is a major cause of chronic renal failure . moderately elevated blood pressure leads to shorter life expectancy. Both dietary changes and lifestyle and medications can improve blood pressure control and reduce the risk of complications associated with health.

There are three main types of hypertension. Essential hypertension occurs when the state has no known cause. When hypertension is caused by another condition or disease process, it is called secondary hypertension. When only the number of systolic blood pressure (top row) is high, it is called isolated systolic hypertension, which is common among the elderly.

SIGN AND SYMPTOMS OF HIGH BLOOD PRESSURE .

The uncomplicated hypertension usually occurs without symptoms (silent) and if hypertension has been called the silent killer.It is so named because the disease can progress and eventually develop one or more of the many life-threatening complications of hypertension such as heart attack or stroke. uncomplicated hypertension may be present and remain unnoticed for years or even decades. This happens when there are no symptoms, and pretended not to undergo periodic screening for hypertension.

Some people with uncomplicated hypertension, however, may experience symptoms such as headache, dizziness, shortness of breath, and blurred vision. Symptoms may be a good thing that they can quickly people to seek medical care and to make them compatible with and take drugs. Often, however, a person of first contact, the doctor may be, when there was considerable damage at the end of the body. In many cases personal visits or imported into the doctor or clinic, with a heart attack, stroke, kidney failure or impaired (due to back injury in the retina). Raise public awareness, and often blood pressure screening may help identify patients with undiagnosed high blood pressure before significant complications have developed.

Approximately one in every 100 (1%) of people diagnosed with severe hypertension, high blood pressure (accelerated or malignant hypertension) is their first visit to the doctor. In these patients, diastolic blood pressure (minimum pressure) exceeds 140 mm Hg! People often experience headaches, nausea, visual symptoms, dizziness, and sometimes kidney failure. malignant hypertension is a medical emergency and requires urgent treatment to prevent stroke (brain damage).

Rapid life saving needle technique for cardiovascular diseases -Pericardiocentesis ,Indications ,Procedure and Complications

THERAPEUTIC PROCEDURES FOR HEART DISEASES .

PERICARDIOCENTESIS .

Pericardiocentesis is the will pericardial fluid space around the heart. This article describes the benchmark for the blind or syringe and needle technique is used as a measure of relief for the rapid treatment of cardiac tamponade.

Pericardial space normally contains 15-50 ml of fluid acts as a lubricant between the visceral and parietal layers of pericardium. Several systemic conditions may cause a greater amount of fluid in this space. Blood also can collect in this space after trauma.

The clinical manifestations are highly dependent on the size and rate of accumulation of fluid or blood. The worst outcome is the collapse of the ventricle creates a strong decrease in cardiac output, hypotension and cardiac arrest possible.

Echocardiography provides the use of emergency medical beds to rapidly assess the pericardium and identify the presence of a pericardial effusion. Identification of a pericardial effusion causing the collapse of the right ventricle is the diagnosis of pericardial tamponade and pericardiocentesis mandates immediately.

THERAPEUTIC  INDICATIONS .

The signs are cardiac tamponade, and the need to analyze the fluid that surrounds the heart. cardiac tamponade is a condition in which an accumulation of fluid within the pericardium creates excessive pressure, which then prevents the normal filling of the heart blood. This can be crucial to reducing the amount of blood being pumped to the heart, which can be life threatening. Withdrawal of excess liquid to turn this dangerous process. Examples of liquid analysis would be needed to distinguish whether a pericardial fluid collection due to the spread of infection in cancer, or perhaps an autoimmune condition.

CONTRAINDICATIONS .

In hemodynamically unstable patients, the information, the problems are not the type to make a puncture. The withdrawal of a small amount of pericardial fluid can have a dramatic improvement in the patient's hemodynamic status. Contra-indications: bleeding disorders not corrected.

EVALUATION BEFORE PROCEDURE .

Preoperative transthoracic echocardiographic examination should always be done to limit the scope and location of the fluid. At least 1 cm of liquid flowing freely should be achieved by anterior approach. Chest radiography may be useful to demonstrate changes in the mediastinum, pleural effusions, the position of the diaphragm and the size of pericardial shadow.

Any anatomical abnormality should be carefully observed. Patients with cancer may have undergone surgery and radiotherapy before and after these procedures can move or distort normal anatomical location of the structures.

Patients with lung cancer who underwent resection of a lobe may be a change in the anatomical structures. An enlarged left liver lobe extends beyond the midline may be in the path of a needle pericarial xiphoid to the risk of laceration of the liver. abdominal bloating due to a cause can also change the location of vital structures. If there is concern about the anatomy of the patient, the procedure should be performed with echocardiographic guidance.

PROCEDURE.

Previously, this procedure was cardiac catheterization laboratory, but is now usually performed the procedure room, intensive care unit, or even a nightstand. If the line IV fluids or medications must be given. Medication can be given to prevent vasovagal reflex causes bradycardia (slow heart rate) and hypotension (drop in blood pressure). Increase your site under the sternum (breastbone) is cleaned and local anesthetic is given. pericardiocentesis needle inserted later, are always the pericardium. Electrocardiogram (ECG) leads may be connected to the needle clip to help the correct positioning of the needle. However, ultrasound is often used to position the needle and monitor drainage.

Once the needle reached the pericardium, a guide wire inserted. The needle is removed and replaced by a catheter. This fluid is withdrawn and a catheter placed in containers. Usually this pericardial catheter is the place to continue draining for several hours. Surgical pericardiocentesis may be necessary in severe cases. In this procedure, the liquid is drained through a more invasive procedure, which may require anesthesia.


COMPLICATIONS .

Major complications and skin fluoroscopy guided pericardiocentesis achieved through a catheter after surgery, reviewed and holes surgery.Namely non-cardiac, cardiac arrhythmias, arterial bleeding, pneumothorax, especially for children infected and a major vagal reaction. Pericardiocentesis guided by fluoroscopy approach subxiphoid placement of the catheter is a safe way to get the drainage and surgical and nonsurgical pericardial effusions. accidental perforation of the heart with a needle is a small complication, until the needle goes to the front line of the diaphragm and the right ventricle is made reliable drainage catheter.