Cardiac Sciences & Cardiology

The presence of blood pressure readings above the accepted normal values is known as Hypertension (HTN). Blood pressure more than 140/90mmHg is accepted as HTN. Hypertension is the leading cause of kidney damages, paralysis, bleeding in the brain, heart attack, and heart failure. The long-term presence of HTN leads to thickening of heart muscles, damage of eye vessels, and abnormal kidney function. Lifestyle modification including salt restriction along with medication is the mainstay of the treatment.

The chest pain or discomfort associated with exertion or exercise and relieved by rest or Sublingual nitroglycerine is known as Angina. Patients commonly complain of chest tightness, burning, choking, or squeezing sensations in the chest during episodes of angina. Angina is caused by insufficient blood supply to the heart muscle as a result of a critical blockage in one or more arteries supplying blood to the heart. Patient with angina should immediately consult their Physician to prevent future untoward events.

The heart is made up of muscles only. Cardiomyopathy is the disease of heart muscles. It is mainly classified into 3 types. Dilated cardiomyopathyis characterized by abnormal dilation or enlargement of heart chambers, leading to decrease contractile function. The main symptoms are breathlessness, fatigue, and swelling of the body. In Hypertrophic Cardiomyopathy, heart muscles are abnormally thickened and may lead to obstruction to the outflow of blood from the heart. It may cause sudden cardiac death during strenuous exercise or even otherwise. Restrictive cardiomyopathy causes Abnormality in the filling of heart chambers. It mainly causes swelling of neck veins, swelling of the abdomen and limbs. Cardiomyopathies are diagnosed by Echocardiography, CT, and MRI of the heart.

It is a disease of aging. The accumulation of calcium on the Aortic valve leaflets and adjoining structures leads to the restrictive opening of leaflets. The patient commonly complains of shortness of breath, chest pain, and dizziness. Infiltration of calcium into the electrical conduction system of the heart may lead to slow heart rate or abnormal heart rate. Nowadays, Trans catheter Aortic wall implantation (TAVI) is the preferred mode of treatment over surgical aortic wall replacement (SAVR) for this condition.

DVT is the formation of blood clots in the deep veins of the body, commonly affecting the veins of the legs, pelvis, and arms. The risk factors for DVT are prolonged immobilization after surgery/hospitalization, Cancer, pregnancy, trauma, plasters of limbs, heart failure, etc. The affected limb is usually swollen and painful. The diagnosis can be confirmed by the ultrasound study. Anticoagulant therapy is the mainstay treatment of DVT.

Pulmonary embolism is the leading cause of in-hospital deaths. Pulmonary embolism occurs, when a clot in a deep vein is dislodged and migrates into the pulmonary artery. CT pulmonary angiography is the gold standard for establishing the diagnosis of pulmonary embolism. Blood clots in the pulmonary artery, completely or partially block the blood flow to one or both lungs, leading to chest pain, breathlessness and, and a fall in blood pressure in severe cases. Pulmonary embolism requires urgent thrombolytic or mechanical thrombolytic therapy to save the life.

Pericardial effusion is the accumulation of fluid in the pericardial space formed by two layers of the pericardium. Normally, there is little or no fluid in the pericardial space. The collection of fluid in the pericardial space compresses the heart thus hampering its filling capacity. The common symptoms of pericardial effusion are chest pain, breathlessness, and low blood pressure. Tuberculosis is a common cause of pericardial effusion. Pericardial effusion can be diagnosed with the help of echocardiography. Percutaneous or surgical pericardiocentesis is required in cases affecting heart function and causing low blood pressure.

Rheumatic heart disease is the sequela of recurrent rheumatic fever in childhood. Rheumatic fever is caused by the recurrent sore throat in childhood and is usually associated with overcrowding and low socioeconomic strata. RHD causes thickening, scarring, and deformity of valve leaflets and their associated structures. This leads to either leaking or obstruction of the heart valve alone or in combination. RHD commonly affects mitral and aortic valves. Rheumatic fever can be prevented by monthly injections of long-acting penicillin. The main symptoms of RHD are shortness of breath, fatigue, and palpitations. RHD affected heart valve can be treated percutaneously or by surgical intervention.

Abnormality in the heart rate or rhythm is known as cardiac arrhythmia. The normal heart rate is between 60-100 beats per minute. Bradyarrhythmia is a heart rate less than 60 beats per minute. It causes fatigue, heart failure, dizziness, and syncope. A heart rate of more than 100 beats per minute min is called tachyarrhythmia. A heart rate of more than 100 beats per minute with exercise or fever is known as sinus tachycardia and not as tachyarrhythmia. The heart rhythm may become irregular in arrhythmia. Atrial fibrillation is the most common arrhythmia, and it is associated with aging. Atrial fibrillation increases the risk of stroke. Ventricular tachycardia and fibrillation are life-threatening conditions and required immediate hospitalization and treatment.