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Myocardial Infarction
Myocardial Infarction
Myocardial Infarction (MI) is also referred to as a heart attack or coronary thrombosis. It is a condition where a part of the heart muscle suddenly loses blood supply. Typically, a heart attack occurs due to a thrombosis (blood clot) formed within a coronary artery. This obstructs normal blood flow to some part of the heart. If left untreated, myocardial infarction can cause damage to the heart. Besides a severe myocardial infarction can be fatal. There is shortness of breath and profuse sweating. It is essential to seek immediate medical help if you feel that you are suffering a myocardial infarction. Sudden overwhelming stress or laborious exertion or physical activity might bring on a myocardial infarction.
A heart attack is felt as a sudden and severe chest pain that may also travel up and down both arms. The pain felt during myocardial infarction lasts longer than that felt during an angina. In rare cases, a person does not feel any noticeable symptoms and is even unaware that he has suffered a heart attack. Smoking, diabetes, hypertension, high cholesterol and obesity puts a person at increased risk of heart attacks. Heart attacks are more noticed in older men and women, though there is an increasing trend for younger persons to suffer heart disease too. Female sex hormones protect women from heart disease till menopause. Heart ailments and coronary heart disease is sometimes genetic.
An ECG (electrocardiograph) can help trace your heart activity and whether you have suffered a heart attack. A Doppler ultrasound helps examine the heart valves, muscles and blood flow. A coronary angiogram is a special x-ray procedure that tests the severity of the blood vessel block with the help of a dye. The presence of certain enzymes like Troponin-I and Creatinine Kinase (CK) are indicative of a heart attack.
Hospital treatment is esential for a person suffering from a MI. The nature of the treatment hinges on the extent of damage of the heart muscle as well as the blockage of the blood vessels. Medication for dissolving the blood clot is administered. The patient is given drugs to reduce the pain and breathe easier. Beta-blocker drugs may be given to reduce the chances of another heart attacks. ACE Inhibitors may be prescribed to prevent heart failure. Balloon angioplasty may be recommended to improve blood flow to the heart.
Diabetes Mellitus : Type 1 and Type 2
Diabetes can manifest itself in two different forms and severities. When there is an occurence of diabetes due to an inadequate production of insulin by the pancreas, it is a condition of Diabetes mellitus. Insulin is a hormone which regulates the level of glucose (sugar) in the blood stream. Glucose serves as a vital source of energy for all organs in the body and is the only source of energy that can be utilized by the brain. But insulin is needed to control the glucose levels in the blood so that the body can effectively use it for regulation of metabolism. Insulin is critical in the transport of glucose to the cells for energy metabolism.
The two forms of diabetes are discussed below:
TYPE 1 Diabetes: Diabetes of this kind usually manifests in childhood or adolescence. Patients suffering from this type of diabetes are dependent on insulin injections to maintain normal body chemistry. This type of diabetes can be inherited. If this is not tackled with insulin, diabetic ketoacidosis and death can result. Type 1 Diabetes is referred to as insulin dependent diabetes.
TYPE 2 Diabetes: Usually, middle aged and overweight people suffer from this type of diabetes when their blood sugar is higher than normal. This manifestation of diabetes is also known as adult onset diabetes. Insulin injections are not needed to conrol this form of diabetes but a suitable diabetes diet and weight reduction can help. But this form of diabetes can lead to long term diabetic complications.
Complications arising out of long-term diabetes
1. Diabetic Retinopathy: There is damage to the retina (perceptive structural tissue of the eye). This condition results in decreased vision and sometimes leads to blindness.
2. Kidney Disease: Impaired kidney function can be a resultant of long term diabetes. It can even lead to overt kidney failure.
3. Stroke: Diabetics have an increased risk of stroke.
4. Heart Disease: Increased risk of myocardial infarction (heart attack).
5. Peripheral Vascular Disease
6. Poor Wound Healing: Ulcers and foot problems are common
7. Decreased immunity to infection
8. Peripheral Neuropathy: Patients suffering from Diabetes face damage to the peripheral nerves and altered sensation. It is also accompanied by numbness, tingling and/or burning pain to the extremeties.
9. Females who are diabetic need to be carefully monitored during pregnancy
Type I Diabetes manifests itself in symptoms such as increased frequency of urination, increased thirst and hunger. Type I Diabetic patients also experience weight loss and increased fatigue. Read up the symptoms of diabetic ketoacidosis
Type II Diabetes is characterized by increased hunger and thirst and increased fatigue. Persons suffering from this form of diabetes face numbness or tingling in the hands and feet as well as frequent infections along with slow healing of cuts, ulcers and sores. Impotence is yet another resultant condition.
Random and fasting blood sugar testing can help in revealing any indications of diabetes. Examining the medical history combined with a physical examination is also done by a physician. To confirm the diagnosis, a Glucose tolerance testing is also done. Blood tests for kidney profile and blood counts are also done. Urinalysis will show the excess presence of glucose.
Treating Diabetes
1. Controlling the symptoms of diabetes.
2. Achieving and maintaining a desirable weight.
3. Achieving and maintaining a healthy level of physical activity.
4. Achieving and maintaining a nearly-normal blood glucose level (between 70 mg/dl and 140 mg/dl).
Treatment of type 1 diabetes requires adherence to a strict diabetes diet and regular doses of insulin. Failure to take care of the diabetic condition can lead to potentially serious outcomes. Blood glucose levels must be monitored so that complications are avoided. Diabetics must be trained to check their own blood and urine glucose levels. They can use the newer forms of ambulatory glucose monitors that can give you automatic readings and help in diabetes management. Avoiding sweets is an elementary precaution that needs to be followed. Many a time, oral hypoglycaemic agents (Orinase, Glucatrol) may be used for regulating blood sugar levels. Find out more on a diabetes diet (in total calories). You can seek help from an Internist or Endocrinologist
Use of Steroid medications (i.e. Prednisone and Medrone) can increase blood sugar levels. They can affect the control and treatment of diabetes. Beta-blocker antihypertensive medications are yet another set of medicines that can cause serious complications for the diabetic patient and should be avoided.
Angina
Angina or chest pain is a typical symptom associated with coronary artery disease. Angina is a sign that the heart is not getting sufficient blood flow. This is usually due to narrowing of the arteries (atherosclerosis. It can also be the result of extreme hypertension, hypertrophic cardiomyopathy or valvular heart disease. Stable angina ia a pain that occurs when there is extra load on the heart and occurs in a regular pattern. This type of angina pain can be tackled with medication and rest. On the other hand, unstable angina can be dangerous as it may the precursor to a heart attack. The pain in such a case is more prolonged and severe. Prinzmetal's angina or variant angina pectoris occurs due to transient spasm of the coronary artery. This does not get trigerred due to physical exertion.
The pain associated with angina is uncomfortable pressure and squeezing on the chest. There is pain or discomfort in the neck, shoulder and arms. But not all chest pains are signs of angina. ECG (electrocardiograph) helps in tracing heart activity. Exercise-ECG assesses your heart condition when you are on a treadmill. Beta-blocker drugs help prevent angina pain. Potassium channel blockers and calcium channel blockers aid in improving blood flow to the coronary arteries. Glyceryl Trinitrate or GTN tablets work instantaneously by relaxing blood vessels and easening the blood flow to the heart muscles. Aspirin is prescribed to reduce the probability of blood clots and reducing blood viscocity. Statin medicines are prescribed to reduce cholesterol levels. Angioplasty involves passing a tiny balloon into a large artery and then blowing it up inside to widen the artery. Bypass surgery is done to bypass the narrowed section of arteries and provide the heart with blood vessels that are not obstructed. Angina can be controlled with medication and lifestyle changes in diet and exercise.
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