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Atrial Fibrillation

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.

Hypertension

Hypertension or high blood pressure is a major problem afflicting one out of four adults in the United States alone. It is a precursor to other serious health complications - kidney disease, atherosclerosis, stroke and eye damage to name a few.

Normal Blood Pressure

For normal adults normal blood pressure is below 120/80 mmHg. In other words, the systolic pressure (when the heart pumps) should be below 120 and the diastolic pressure (when the heart relaxes) should be below 80. A reading between 120/80 and 140/90 might be seen as pre hypertension stage and in some cases may indicate the need for further investigation.

A reading above 140/90 indicates hypertension and requires a thorough investigation into the cause and treatment.

Cause of HyperTension

Many factors have been implicated in the development of hypertension - obesity, genetics, sodium sensitivity, glomerulonephritis and other kidney diseases, among other etiologies. Elevated levels of blood pressure can be also due to drug interactions. There are 2 kinds of hypertension - the primary hypertension where it occurs due to unknown etiology and the secondary hypertension which is the result of another underlying condition.

Diagnosis: Blood tests:

Renal Function - Creatinine
Electrolytes Level
Glucose - Glucose Tolerance Test
Cholesterol Level

In addition ECG may be ordered to check for left ventricular hypertrophy.

Treatment Options

Diuretics: bendroflumethiazide, chlortalidone, hydrochlorothiazide
Angiotensin Converting Enzyme (ACE) inhibitors: creatine captopril, enalapril, fosinopril, Monopril, lisinopril , quinapril, ramipril
Angiotensin II receptor antagonists: telmisartan, irbesartan, losartan, valsartan, candesartan
Alpha blockers: prazosin, terazosin.
Beta blockers: atenolol, labetalol, metoprolol, propranolol.
Calcium channel blockers: nifedipine, amlodipine, diltiazem, verapamil
Direct renin inhibitors: aliskiren

Preeclampsia

Preeclampsia is a condition that affects some pregnant women and affects the mother and unborn baby. This condition is characterized by high blood pressure and excess protein in the urine after 20 weeks of pregnancy. Preeclampsia is also known as pregnany induced hypertension and toxemia. This condition can either develop over time or come on rapidly. Preeclampsia is noticed more often in the last few weeks of pregnancy. Women suffering from preeclampisa are likely to give birth to low birth weight babies since this condition hampers the placenta from receiving enough blood.

Pregnant women over the age of 40 or those carrying multiple babies are at higher risk for developing preeclampsia. Women who are already suffering from hypertension or kidney disease are more susceptible for developing preeclampsia. Lack of magnesium or calcium can lead to preeclampsia. This can occur due to poor diet or immune problems. Hormonal disruption can also lead to preeclampsia. Symptoms of preeclampsia include sudden weight gain and swelling. The pregnant women is likely to experience headaches and vision problems. There might be upper abdominal pain, dizzines and vomiting.

In most cases, the woman is relieved of this condition on delivering the baby. If the symptoms of preeclampsia are noticed early in pregnancy, care must be taken to keep blood pressure under control. The physician will advice the pregnant woman on the amount of salt to be consumed as well as the amount of water to be taken in a day. Often this may require hospitalization. The baby is closely monitored with ultrasound. Aspirin or additional calcium may be prescribed to prevent preeclapsia in women who are more susceptible to developing it. Magnesium sulfate is given to women suffering from preeclampsia when they go into labor.