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High Cholesterol

High Cholesterol

Cholesterol is a lipid - a vital material necessary for the body to build cell walls as well as produce hormones. Other than the cholesterol produced by the liver, we receive cholesterol when we eat animal products. Small amounts of cholesterol are used by the body to meet the needs of production of hormones and Vitamin D. When there is too much cholesterol in the bloodstream, it gets deposited in arteries leading to blockage. This condition is called hypercholesterolemia. High fat diet, smoking, high blood pressure, diabetes, obesity and heredity are factors affecting blood cholesterol levels. Mental stress and age and lifestyle factors also have a bearing on blood cholesterol levels.

LDL or low-density lipoproteins are called 'bad choleterol'. HDL or high-density lipoproteins are beneficial since they aid in clearing excess cholesterol from the blood. Total Blood cholesterol of less than 200 milligrams per decileter of blood is desirable. If the LDL levels are less than 130, you are at risk for heart disease. HDL levels of 40 and above are good for your heart. High cholesterol has a direct bearing on the condition of your heart. High levels of cholesterol can lead to CHD (coronary heart disease). It can result in atherosclerotis and increase the risk of a heart attack.

High cholesterol is noticed during routine blood screening. A lipid profile showing your LDL, HDL and triglyceride levels are indicative of the blood cholesterol status. Triglycerides are a form of fat that is found in the bloodstream. Lifestyle changes are imperative in the control and reduction of high cholesterol. Healthy diet and regular exercise regimen can help in controlling high cholesterol.

Statins are used to treat high cholesterol. These drugs deplete cholesterol levels in the liver. Statins such as atorvastatin, fluvastatin, lovastatin and pravastatin are prescribed to lower cholesterol levels. Medication to alter cholesterol profiles such as fibrates, nicotinic acid and cholesterol absorption inhibitors are also used to reduce blood cholesterol. But it is essential to monitor any side effects on the liver.

Cardiac Stress Test

A cardiac stress test aids in assessing how the heart can cope during exercise, especially when the body need for oxygen puts extra demands on the heart. A cardiac stress test is called a graded test or exercise tolerance test, exercise stress test or exercise electrocardiography. It helps to primarily evaluate the heart and vascular systems during the exercise. In fact, the American Heart Association has recommended the Cardiac stress test (EKG treadmill in particular) as the first choice to be tried on patients with medium risk of coronary heart disease and who exhibit certain risk factors of smoking, family history of coronary stenosis, high blood pressure, and high cholesterol.

It helps to determine whether coronary arteries are clogged or blocked.

To find the cause of chest pain.

To assess the heart's capability after a heart attack or heart surgery.

To discover the presence of any heart disease.

To set limits on a person's exercise.

To detect arrhythmias, that is extra heart beats, during the exercise.

To assess the capacity of medicine used to control chest pain or extra beats during exercise.

The cardiac stress test can be done in a clinic or a hospital. The patient may be asked to exercise using a bicycle, treadmill or arm ergometer. The patient is attached to an ECG machine. The blood pressure cuff is placed on any one arm. The patient's heart is usually monitored using a 12 - lead EKG or ECG machine. A heart monitor may be used during and after exercise. After a baseline ECG is obtained, the patient begins to perform a low level of exercise, either by walking on a treadmill or pedaling or a stationary bicycle.

At each stage the exercise, the pulse, the blood pressure and ECG are recorded along with any symptoms that the patient may be experiencing. The level of exercise is gradually increased until the patient cannot keep up any longer because of fatigue or until symptoms like chest pain, shortness of breath or lightheadedness prevent further exercise. The goal of this stress test is to diagnose the presence or absence of coronary artery disease. In a sub maximal stress test, the patient exercises only until a pre-determined level of exercise is attained. These tests are used in patients with known coronary artery disease, to measure whether the patient can perform a specific level of exercise with relative safety.

The side effects of a cardiac stress test also include palpitation, chest pain, and shortness of breath, headache, nausea and fatigue. The hypertension caused by stress testing is always considered abnormal and it may lead to severe coronary disease. In stress tests, false positive results are not uncommon. There can be occasions when the patient's ECG changes could suggest ischemia, even in the absence of coronary artery disease. Similarly, in stress test, false negatives are also not uncommon. In some patients, no significant ECG changes will be seen even in the presence of coronary artery disease. Presently, a new concept called nuclear perfusion study is added to the stress test. This factor has helped to minimize the limitations and improve the diagnostic capability of stress tests.

Atrial Fibrillation

Atrial Fibrillation is a heart condition that is characterized by abnormal rhythm of the heart originating in the atria. The heart beats irregularly and ofen rapidly. Persons suffering from AF. High blood pressure or hyperthyroidism can bring on atrial fibrillation. Those suffering from asthma or COPD are at higher risk for developing atrial fibrillation. Atrial fibrillation increases the chances of a person suffering a stroke. Cardiomyopathy, pericarditis and pulmonary embolism can lead to development of AF.

Brief episodes of AF last from a few minutes to a few hours whereas in chronic AF, the atria fibrillate all of the time. Chronic atrial fibrillation reduces the pumping capacity of the heart and might lead to its failure. In many cases, patients are not even aware that they suffer from atrial fibrillation. Symptoms of AF are dizziness, fainting and fatigue. The person suffering from atrial fibrillation is likely to experience shortness of breath and angina pain. Heart palpitations and chest discomfort are other symptoms of atrial fibrillation.

Abnormal heartbeats are felt by taking the patient's pulse or with a stethoscope. An electrocardiogram and echocardiography aid in assessing the heart's rhythms. A holter monitor records the heart's rhythm over a period of about 24 hours to detect any intermittent AF. Treatment for AF is geared towards restoring normal heart rhythm, controlling the heart rate and preventing blood clots. Drugs to slow down the rapid heart rate such as digoxin, beta blockers, amiodarone, sotalol, flecainide, procainamide and quinidine are used in the treatment of AF. Atrial pacemakers may be implanted to regulate the heart arhythmias. High blood pressure must be controlled. Hyperthyroidism, if any must be corrected. Anticoagulant medications reduce the chances of blood clots and strokes. Excessive use of alcohol or other stimulants must be avoided.