Definition:
Cardiac catheterization with coronary angiogram takes pictures of the blood vessels in your heart, to evaluate the health of your heart and detect any narrowing of the blood vessels or other problems. The catheterization is performed by a cardiologist (or sometimes a radiologist) who is a specialist in doing this type of test. CLICK & SEE
This process involves passing a catheter (a thin flexible tube) into the right or left side of the heart. In general, this procedure is performed to obtain diagnostic information about the heart or its blood vessels or to provide treatment in certain types of heart conditions.
Cardiac catheterization can be used to determine pressure and blood flow in the heart’s chambers, collect blood samples from the heart, and examine the arteries of the heart with an x-ray technique called fluoroscopy. Fluoroscopy provides immediate (“real-time”) visualization of the x-ray images on a screen and provides a permanent record of the procedure. Why the Test is Performed ?
Cardiac catheterization is usually performed to evaluate heart valves, heart function and blood supply, or heart abnormalities in newborns. It may also be used to determine the need for heart surgery.
Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and open blocked arteries or grafts in the heart. How the Test is Performed:
You lie on your back as a medical technician connects you to a heart monitor. An intravenous (IV) line is inserted into one of the blood vessels in your arm, neck, or groin after the site has been cleansed and numbed with a local anesthetic.. You may be given a sedative through the IV so that you are relaxed during the test.
First, the doctor injects a local anesthetic into the skin. This might sting momentarily. After the skin is numb, the cardiologist inserts a catheter (a thin, hollow plastic tube) into a large artery-usually in your groin but possibly in your arm or wrist.
Using live x-rays displayed on a video monitor as a guide, your doctor moves the catheter along the artery until it reaches your aorta (the large blood vessel that carries blood from your heart to the rest of your body). The tip of the catheter is pushed up the aorta until it reaches the heart and then gently pushed into the coronary arteries that supply blood directly to your heart muscle.When the tip of the catheter reaches one of the coronary arteries, the doctor injects contrast dye through the catheter. The dye illuminates the artery, allowing the doctor to see if it is blocked or narrowed. The procedure is repeated to visualize the other coronary arteries.
X-ray pictures are taken while the dye travels down the arteries. The arteries look like thick lines on the x-ray; a narrowing or blockage in an artery appears as a thinner line (see Figure 1). Your doctor might also inject some contrast medium into the left ventricle of your heart to show how forcefully your heart is pumping. The entire procedure usually takes from one to several hours.
How you Prepare for the Test:
Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital and you will be asked to wear a hospital gown. Sometimes, admission the night before the test is required. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure.
Your health care provider should explain the procedure and its risks. A witnessed, signed consent for the procedure is required.
Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.
During this procedure, local anesthetics (numbing agents) are used to minimize pain. Tell the cardiologist if you have ever had an allergic reaction to a local anesthetic or to contrast dyes. Also let your doctor know if you could be pregnant, since the x-rays used during this procedure can damage a fetus.
. Tell the cardiologist if you’re taking a nonsteroidal anti-inflammatory drug (NSAID) or other medicines that affect blood clotting and could increase the chance of bleeding from the procedure. You should also tell your doctor if you take insulin shots or blood sugar-lowering pills so that you can take steps to avoid dangerously low blood sugar, or hypoglycemia.
How the Test Will Feel?
The study is carried out in a laboratory by a trained cardiologist or radiologist and technicians or nurses.
You will be awake and able to follow instructions during the catheterization. A mild sedative is usually given 30 minutes before the procedure to help you relax. The procedure may last from 1 to several hours.
You may feel some discomfort at the site where the IV is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site. You may experience some discomfort from having to remain still for a long time.
After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the IV is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.
Risk Factors:
There are several potential risks. First, the catheter can irritate the heart, in rare cases causing a disturbance in the heart rhythm. Should this happen, the doctor can immediately use devices and medicines to restore a normal heart rhythm. The catheter occasionally can cause the coronary artery to go into spasm, temporarily reducing the blood flow and causing chest pain. For this reason, alert the doctors and nurses if you develop any chest discomfort, trouble breathing, or any other problem during the test.
In addition, the contrast medium can sometimes impair kidney function. This effect is almost always temporary, but some people have permanent damage. Another possible complication is bleeding at the place where the catheter was inserted. If blood collects under the skin, it can form a large painful bruise called a hematoma. This usually resolves on its own, without requiring additional treatment. Occasionally, people are allergic to the contrast dye and develop a rash, hives, or difficulty breathing after the dye is injected. If this should occur, the medical staff in the catheterization laboratory have medicines available to treat the allergic reaction.
The amount of radiation from this test is too small to be likely to cause harm.
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.
Generally, the risk of serious complications ranges from 1 in 1,000 to 1 in 500. The risks include the following:
*Cardiac arrhythmias
*Cardiac tamponade
*Trauma to the artery caused by hematoma
*Low blood pressure
*Reaction to contrast medium
*Hemorrhage
*Stroke
*Heart attack Must you do anything special after the test is over?
You should lie flat for a few hours after this procedure. Often, a small plug or stitch is used to prevent bleeding from the artery that was entered to perform the catheterization. If you received a sedative, you might feel sleepy and shouldn’t drive or drink alcohol for one day after the catheterization.
What Abnormal Results Mean
The procedure can identify heart defects or disease, such as coronary artery disease, valve problems, ventricular aneurysms, or heart enlargement.
The procedure also may be performed for the following:
*Primary pulmonary hypertension
*Pulmonary valve stenosis
*Pulmonary embolism
*Tetralogy of Fallot
*Transposition of the great vessels
*Tricuspid regurgitation
*Ventricular septal defect
How long is it before the result of the test is known?
Your doctor will have your results as soon as the test is completed. In particular, the doctor can tell you if you have any blockages in the coronary arteries, how many and how severe they are, and the best way to treat them. In some cases, your doctor is even able to remove any blockages immediately by performing an intervention known as a coronary angioplasty, a procedure that uses a tiny inflatable balloon to reopen the artery.
Young American adults who learn they have a low immediate risk of heart disease may be making a mistake if they sigh with relief and relax – their lifetime risk could be high
A new analysis of heart disease risk studies shows that about half of people under the age of 50 who appeared to have a low risk of heart disease for the next 10 years already had damage to the arteries that could cause trouble later.
“We found that about half of individuals who are 50 years of age or younger and at low short-term risk for heart disease may not remain at low risk throughout their lives,” said Dr Jarett Berry of the University of Texas Southwestern Medical School, who helped lead the study.
Usually, a doctor assesses a patient’s risk of heart disease using the Framingham Risk Score, which takes into account cholesterol levels, blood pressure and other factors to predict cardiovascular risk for the next 10 years. And, almost automatically, anyone under the age of 50 has a low 10-year risk.
But heart disease usually develops slowly, as “plaque” builds up in arteries, reducing blood flow and causing unstable clumps that can break off and cause strokes or heart attacks. Berry’s team looked at the 10-year and lifetime risk scores for nearly 4,000 people age 50 and younger taking part in two clinical studies. They found that 91% of those 50 and younger had a low immediate risk of heart disease.
The volunteers had undergone unusually thorough examinations because they were in the studies, so Berry and colleagues looked at the ultrasound measurements of their carotid arteries and CAT scans for calcium.
Both types of scans can show early evidence of artery disease. They showed that the people who had a high lifetime risk according to cholesterol, blood pressure and other measures also had the beginnings of physical evidence of heart disease – thicker artery linings and hardened plaques.
“What we found was there were significant differences in the presence and progress of atherosclerosis,” Berry said. Usually, doctors just tell patients about their 10-year risk, but if patients knew their lifetime risks they could act right away to change their lifestyles.
Definition: Raynaud’s disease is a condition that causes some areas of your body — such as your fingers, toes, tip of your nose and your ears — to feel numb and cool in response to cold temperatures or stress. In Raynaud’s disease, arteries that supply blood to your skin narrow, limiting blood circulation to affected areas.
Women are more likely to have Raynaud’s disease. It’s also more common in people who live in colder climates. Raynaud’s disease is a vascular disorder that causes intermittent interruption of blood flow to the extremities. The affected body part may turn white or blue and feel cold and numb until circulation improves.A French physician who first described it in 1862.
Treatment of Raynaud’s disease depends on its severity and the presence of associated conditions. For most people, Raynaud’s disease is more a nuisance than a disability.
Symptoms:
Raynaud’s disease is more than simply having cold hands and cold feet, and it’s not the same as frostbite. Signs and symptoms of Raynaud’s depend on the frequency, duration and severity of the blood vessel spasms that underlie the disorder. Signs and symptoms include several cyclic color changes:
*Sequence of color changes in your skin in response to cold or stress .
*Numb, prickly feeling or stinging pain upon warming or relief of stress .
*When the oxygen supply is depleted, the skin colour turns blue (called cyanosis).
*These events are episodic and when the episode subsides, or the area is warmed, blood returns to the area and the skin colour turns red (rubor) and then back to normal, often accompanied by swelling and tingling. Symptoms are thought to be due to reactive hyperemias of the areas deprived of blood flow.
During an attack of Raynaud’s, affected areas of your skin usually turn white at first. Then, the areas often turn blue and feel cold and numb, and your sensory perception is dulled. As circulation improves, the affected areas may turn red, throb, tingle or swell. The order of the changes of color isn’t the same for all people, and not everyone experiences all three colors.
All three colour changes are present in classic Raynaud’s disease. However, some patients do not see all of the colour changes in all outbreaks of this condition.
Occasionally, an attack affects just one or two fingers or toes. Attacks don’t necessarily always affect the same digits. Although Raynaud’s most commonly affects your fingers and toes, the condition can also affect other areas of your body, such as your nose, lips, ears and even nipples. An attack may last less than a minute to several hours.
People who have Raynaud’s accompanied by another disease will likely also have signs and symptoms related to their underlying condition.
Causes:
Doctors don’t completely understand the cause of Raynaud’s attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress:
*Cold temperatures. When your body is exposed to cold temperatures, your extremities lose heat. Your body slows down blood supply to your fingers and toes to preserve your body’s core temperature. Your body specifically reduces blood flow by narrowing the small arteries under the skin of your extremities. In people with Raynaud’s, this normal response is exaggerated.
*Stress. Stress causes a similar reaction to cold in the body, and likewise the body’s response may be exaggerated in people with Raynaud’s. Blood vessels in spasm:
With Raynaud’s, arteries to your fingers and toes go into what’s called vasospasm. This constricts the vessels dramatically and temporarily limits blood supply. Over time, these same small arteries may also thicken slightly, further limiting blood flow. The result is that affected skin turns a pale and dusky color due to the lack of blood flow to the area. Once the spasms subside and blood returns to the area, the tissue may turn red before returning to a normal color.
Cold temperatures are most likely to provoke an attack. Exposure to cold can be as simple as putting your hands under a faucet of running cold water, taking something out of the freezer or exposure to cold air. For some people, exposure to cold temperatures isn’t necessary. Emotional stress alone can cause an episode of Raynaud’s.
Some researchers are studying whether Raynaud’s may be partly an inherited disorder.
Primary vs. secondary Raynaud’s Raynaud’s occurs in two main types:
*Primary Raynaud’s. This is Raynaud’s without an underlying disease or associated medical problem that could provoke vasospasm. Also called Raynaud’s disease, it’s the most common form of the disorder.
*Secondary Raynaud’s. Also called Raynaud’s phenomenon, this form is caused by an underlying problem. Although secondary Raynaud’s is less common than the primary form, it tends to be a more serious disorder. Signs and symptoms of secondary Raynaud’s usually first appear at later ages — around 40 — than they do for people with the primary form of Raynaud’s.
Causes of secondary Raynaud’s include:
*Scleroderma. Raynaud’s phenomenon occurs in the majority of people who have scleroderma — a rare disease that leads to hardening and scarring of the skin. Scleroderma, a type of connective tissue disease, results in Raynaud’s because the disease reduces blood flow to the extremities.
*Lupus. Raynaud’s is also a common problem for people with lupus — an autoimmune disease that can affect many parts of your body, including your skin, joints, organs and blood vessels. An autoimmune disease is one in which your immune system attacks healthy tissue.
*Rheumatoid arthritis. Raynaud’s may be an initial sign of rheumatoid arthritis — an inflammatory condition causing pain and stiffness in the joints, often including the hands and feet.
*Sjogren’s syndrome. Raynaud’s phenomenon can also occur in people who have Sjogren’s syndrome — an autoimmune disorder that may accompany scleroderma, lupus or rheumatoid arthritis.
*Diseases of the arteries. Raynaud’s phenomenon can be associated with various diseases that affect arteries, such as atherosclerosis, which is the gradual buildup of plaques in blood vessels that feed the heart (coronary arteries), or Buerger’s disease, a disorder in which the blood vessels of the hands and feet become inflamed. Primary pulmonary hypertension, a type of high blood pressure that affects the arteries of the lungs, is frequently associated with Raynaud’s.
*Carpal tunnel syndrome. The carpal tunnel is a narrow passageway in your wrist that protects a major nerve to your hand. Carpal tunnel syndrome is a condition in which pressure is put on this nerve, producing numbness and pain in the affected hand. The affected hand may become more susceptible to cold temperatures and episodes of Raynaud’s.
*Repetitive trauma. Raynaud’s can also be caused by repetitive trauma that damages nerves serving blood vessels in the hands and feet. Some people who type or play the piano vigorously or for long periods of time may be susceptible to Raynaud’s. Workers who operate vibrating tools can develop a type of Raynaud’s phenomenon called vibration-induced white finger.
*Smoking. Smoking constricts blood vessels and is a potential cause of Raynaud’s.
Injuries. Prior injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud’s phenomenon.
*Certain medications. Some drugs — including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine; medications containing estrogen; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications — have been linked to Raynaud’s.
*Chemical exposure. People exposed to vinyl chloride, such as those who work in the plastics industry, may develop an illness similar to scleroderma. Raynaud’s can be a part of that illness.
*Other causes. Raynaud’s has also been linked to thyroid gland disorders.
Risk factors Risk factors for primary Raynaud’s include:
*Your sex. Primary Raynaud’s affects women more than men.
*Your age. Although anyone can develop the condition, primary Raynaud’s often begins between the ages of 15 and 25
*Where you live. The disorder is also more common in people who live in colder climates.
*Your family history. Additionally, a family history appears to increase your risk of primary Raynaud’s. About one-third of people with primary Raynaud’s have a first-degree relative with the disorder.
Risk factors for secondary Raynaud’s include:
*Associated diseases. These include conditions such as scleroderma and lupus, and smoking.
*Certain occupations. People in certain occupations, such as workers who operate tools that vibrate, also may be more vulnerable to secondary Raynaud’s.
Complications:
If Raynaud’s is severe — which is rare — blood circulation to your fingers or toes could permanently diminish, causing deformities of your fingers or toes.
If an artery to an affected area becomes blocked completely, sores (skin ulcers) or dead tissue (gangrene) may develop. Ulcers and gangrene can be difficult to treat.
See your doctor right away if you have a history of severe Raynaud’s and develop an ulcer or infection in one of your affected fingers or toes.
Diagnosis:
If your doctor suspects Raynaud’s, he or she will ask for a detailed description of your signs and symptoms.
Most doctors can diagnose Raynaud’s directly from a description of your signs and symptoms. But it may be more difficult for them to identify whether you have Raynaud’s alone or whether another disease, or some aspect of your lifestyle, is causing your symptoms.
Your doctor will also examine you to rule out other medical problems that may cause similar signs and symptoms, such as a pinched nerve. Your doctor may perform an in-office cold-simulation test. This test may involve placing your hands in cool water or exposing you to cold air, to invoke an episode of Raynaud’s.
Sorting out primary vs. secondary Raynaud’s
To distinguish between primary and secondary Raynaud’s, your doctor may perform an in-office test called nail fold capillaroscopy. During the test, the doctor examines your nail fold — the skin at the base of your fingernail — under a microscope. Tiny blood vessels (capillaries) near the nail fold that are enlarged or deformed may indicate an underlying disease. However, some secondary diseases can’t be detected by this test.
If your doctor suspects that another condition, such as an autoimmune or connective tissue disease, underlies Raynaud’s, he or she may order blood tests, such as:
*Antinuclear antibodies (ANA) test. A positive test for the presence of these antibodies — produced by your immune system — indicates a stimulated immune system and is common in people who have connective tissue diseases or other autoimmune disorders.
*Erythrocyte sedimentation rate (ESR). This blood test determines the rate at which red blood cells settle to the bottom of a tube in the space of an hour. A faster than normal rate may signal an underlying inflammatory or autoimmune disease. Autoimmune diseases are commonly associated with secondary Raynaud’s.
There’s no single blood test to diagnose Raynaud’s. Your doctor may order other tests, such as those that rule out diseases of the arteries, to help pinpoint a disease or condition that may be associated with Raynaud’s.
Treatments and drugs
Self-care and prevention steps usually are effective in dealing with mild symptoms of Raynaud’s. If these aren’t adequate, however, medications are available to treat more severe forms of the condition. The goals of treatment are to:
*Reduce the number and severity of attacks
*Prevent tissue damage
*Treat any underlying disease or condition
Medications:
Depending on the cause of your symptoms, medications may prove effective at treating Raynaud’s. To widen (dilate) blood vessels and promote circulation, your doctor may prescribe:
*Calcium channel blockers. These drugs relax and open up small blood vessels in your hands and feet. They decrease the frequency and severity of attacks in about two-thirds of people with Raynaud’s. These drugs can also help heal skin ulcers on your fingers or toes. Examples include nifedipine (Adalat, Procardia), amlodipine (Norvasc), diltiazem (Cardizem, Dilacor), felodipine (Plendil), nisoldipine (Sular) and isradipine (DynaCirc Cr).
*Alpha blockers. Some people find relief with drugs called alpha blockers, which counteract the actions of norepinephrine, a hormone that constricts blood vessels. Examples include prazosin (Minipress) and doxazosin (Cardura).
*Vasodilators. Some doctors prescribe a vasodilator — a drug that relaxes blood vessels — such as nitroglycerin cream to your fingers to help heal skin ulcers.
You and your doctor may find that one drug works better for you than another. Some drugs used to treat Raynaud’s have side effects that may require you to stop taking the medication. A drug may also lose effectiveness over time. Work with your doctor to find what works best for you.
Some medications actually can aggravate Raynaud’s by leading to increased blood vessel spasm. Your doctor may recommend that you avoid taking:
*Certain over-the-counter (OTC) cold drugs. Examples include drugs that contain pseudoephedrine (Actifed, Chlor-Trimeton, Sudafed).
*Beta blockers. This class of drugs, used to treat high blood pressure and heart disease, includes metoprolol (Lopressor, Toprol), nadolol (Corgard) and propranolol (Inderal).
*Birth control pills. If you use birth control pills, you may wish to switch to another method of contraception because these drugs affect your circulation and may make you more prone to attacks.
If you have questions about how best to manage Raynaud’s, contact your doctor. Your primary care doctor may refer you to a physician who specializes in treating Raynaud’s.
Other treatments
Sometimes in cases of severe Raynaud’s, approaches other than medications may be a treatment option:
*Nerve surgery. Nerves called sympathetic nerves in your hands and feet control the opening and narrowing of blood vessels in your skin. Sometimes it’s necessary in cases of severe Raynaud’s to cut these nerves to interrupt their exaggerated response. Through small incisions in the affected hands or feet, a doctor strips away these tiny nerves around the blood vessels. The surgery, called sympathectomy, may reduce the frequency and duration of attacks, but it’s not always successful.
*Chemical injection. Doctors can inject chemicals to block sympathetic nerves in affected hands or feet. You may need to have the procedure repeated if symptoms return or persist.
*Amputation. Sometimes, doctors need to remove tissue damaged from a lack of blood supply. This may include amputating a finger or toe affected by Raynaud’s in which the blood supply has been completely blocked and the tissue has developed gangrene. But this is rare.
Research
Scientists are evaluating the use of new drugs to treat Raynaud’s. Some examples of drugs under study include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra), the antidepressant medication fluoxetine (Prozac), and a class of medication called prostaglandins.
Pathophysiology:
Raynaud disease is an exaggeration of vasomotor responses to cold or emotional stress. More specifically, it is a hyperactivation of the sympathetic system causing extreme vasoconstriction of the peripheral blood vessels, leading to tissue hypoxia. Chronic, recurrent cases of Raynaud phenomenon can result in atrophy of the skin, subcutaneous tissues, and muscle. It can also rarely cause ulceration and ischemic gangrene.
Prevention:
Patients with Raynaud’s disease are advised to keep warm by wearing gloves and socks. They should also avoid stress, medicines that can constrict blood vessels such as decongestants and touching cold objects. Patients are also advised to avoid foods and activities that may constrict blood vessels such as drinking caffeinated drinks and smoking. Avoiding artificially cold environments, such as refrigerated or highly air conditioned spaces, can also help prevent episodes from occurring.
Raynaud’s is a condition that you may need to manage for life once it develops. But there are ways to help prevent attacks:
*Dress warmly outdoors. In winter, wear a hat, scarf, socks and boots, and mittens or gloves under mittens when you go outside. Put them on before you go outside. A hat is important because you lose a great deal of body heat through your head. Wear a coat with fairly snug cuffs to go around your mittens or gloves, to prevent cold air from reaching your hands. Wear earmuffs and a face mask if the tip of your nose and your earlobes are sensitive to cold. Run your car heater for a few minutes before driving in cold weather.
*Take precautions indoors. Wear socks. When taking food out of the refrigerator or freezer, wear gloves, mittens or oven mitts. Some people find it helpful to wear mittens and socks to bed during winter. Because air conditioning can trigger attacks, setting your air conditioner to a warmer temperature may help prevent attacks. You also may find it helpful to use insulated drinking glasses.
*Consider moving to a location with a milder climate. Moving to a warmer climate may help people with severe Raynaud’s. However, Raynaud’s can occur even in warmer climates when the temperature decreases.
Lifestyle and home remedies:
A variety of steps can decrease Raynaud’s attacks and help you feel better overall:
*Don’t smoke. Nicotine in cigarettes causes skin temperature to drop by constricting blood vessels, which may lead to an attack. Inhaling secondhand smoke also may aggravate Raynaud’s.
*Exercise. Your doctor may encourage you to exercise regularly, particularly if you have primary Raynaud’s. Exercise can increase circulation, among other health benefits.
*Control stress. Because stress may trigger an attack, learning to recognize and avoid stressful situations may help control the number of attacks.
*Avoid caffeine. Caffeine causes your blood vessels to narrow and may increase the signs and symptoms of Raynaud’s.
*Take care of your hands and feet. If you have Raynaud’s, guard your hands and feet from injury. Don’t walk barefoot. Take care of your nails to avoid injuring sensitive toes and fingertips. In addition, avoid wearing anything that compresses blood vessels in your hands or feet, such as tight wristbands, rings or footwear.
*Avoid workplace triggers. Avoiding tools that vibrate the hand may reduce the frequency of attacks.
During an attack: What should you do?
What should you do if you’re experiencing an attack of Raynaud’s? The first and most important action is to warm your hands or feet or any other affected areas of skin. The following steps can help you gently warm your fingers and toes:
*Move to a warmer area.
*Place your hands under your armpits.
*Wiggle your fingers and toes.
*Make wide circles, or windmills, with your arms.
*Run warm — but not hot — water over your fingers and toes.
*Massage your hands and feet.
If a stressful situation triggers an attack, you can help stop the attack by getting out of the stressful situation and relaxing. If you’re trained in biofeedback, you can use this technique along with warming your hands or feet in water to help lessen the attack.
Alternative medicine: Lifestyle changes and supplements that encourage better circulation may be effective alternatives for managing Raynaud’s. If you’re interested, talk to your doctor about:
*Biofeedback. Biofeedback — using your mind to control body temperature — may help decrease the severity and frequency of attacks. Biofeedback includes guided imagery to increase the temperature of hands and feet, deep breathing and other relaxation exercises. Your doctor may be able to suggest a therapist who can help you learn biofeedback techniques. Books and tapes also are available on the subject.
*Niacin. Niacin, also known as vitamin B-3, causes blood vessels to dilate, increasing blood flow to skin. This has led scientists to believe that niacin supplements may be useful in treating Raynaud’s, although niacin supplements may have side effects.
Coping with the stress and nuisance of Raynaud’s takes patience and effort. Work with your doctor to manage your condition and maintain a positive attitude. The majority of people with Raynaud’s respond to treatment.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Avoiding bad cholesterol may help burn extra flab more than anything else.
If you’re obese and also high on cholesterol, there is some bad news for you. Scrimping on food or hitting the gym regularly will be less helpful in dislodging the fat tucked away in the tummy if the level of low-density lipoprotein (LDL), or bad cholesterol, increases considerably in your body.
The nexus between LDL and reduced burning of fat was discovered recently by a team of researchers from the Swedish medical university Karolinska Institutet, Stockholm.
Higher order animals like humans retrieve energy stored as fat — free fatty acids — in a layer under the skin when there is a drop in the availability of glucose, the body’s primary source of energy. But the process gets hampered badly when there are higher levels of bad cholesterol in the body, showed the Swedish scientists who studied the inhibitory role of cholesterol in fat turnover in lab-cultured human human tissues and mice.
“Our study clearly shows that bad cholesterol inhibits the breakdown of fat stored in the adipose cells in the body,” said Johan Björkegren, who led the study. The study appeared recently in the journal PLoS ONE.
“Scientists have long known that when food intake is restricted, the liver sends signal to the white adipose tissues to release free fatty acids at higher rates.” Such fat is processed in the liver to meet the energy requirement of the body. The process also results in the production of cholesterol. In a healthy person, there is always a fine balance between the production of cholesterol and the release of fats from the adipose tissues.
But, much to their surprise, the Swedish scientists found that when there is a higher level of cholesterol, the release of fat from the tissues may remain the same but the liver will process less fat. The excess fat, then, will remain in the bloodstream, triggering the synthesis of more cholesterol. “This forms a vicious cycle,” Björkegren told Knowhow.
But, the Swedish researcher said, there is no need to lose heart. Cholesterol-busting medication such as statins can increase the turnover of fat. Similarly, cutting the intake of bad cholesterol from food may benefit an obese person on two counts: he or she may be able to reduce the risk of heart diseases such as atherosclerosis, and it enhances the process of weight reduction.
While the Swedish study clearly indicated the negative role played by cholesterol in obesity, another study reported at a recent meeting of the American Heart Association showed how cholesterol clogged the arteries of obese children, making the blood vessels look more like those of 45-year-olds.
…………………………………………. WHY DIETING FAILS:Dieting summons ready energy from fat deposits in the body but the liver lacks the ability to process more fat. The result: the extra fat stays in the blood, producing more cholesterol.
“There’s a saying that ‘you’re as old as your arteries,’ meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke,” said Geetha Raghuveer, associate professor of paediatrics at the University of Missouri-Kansas CitySchool of Medicine. The scientists, who used ultrasound to measure the thickness of the inner walls of the carotid arteries in the neck that link the brain to the heart, were surprised to see the fatty build-up of plaque. Such plaque deposit — called carotid artery intima-media thickness (CIMT) — within arteries feeding the heart muscle and the brain can lead to heart attacks and strokes, Raghuveer, who led the study, said.
The scientists studied 70 boys and girls with an average age of 13. Most of these children had abnormal levels of one or more types of cholesterol — elevated levels of LDL or low levels of good cholesterol (HDL) or high triglyceride levels.
The children’s “vascular age” — the age at which level of thickening would be normal for their gender and race — was about 30 years more than their actual age, she said.
“Vascular age was advanced the furthest in the children with obesity and high triglyceride levels. So the combination of obesity and high triglycerides should be a red flag to the doctor that a child is at high risk of heart disease,” Raghuveer said.
She said further studies are needed to determine whether artery build-up will decrease if children lose weight, exercise or are treated for abnormal lipids.
One factor that gives rise to hope, according to Raghuveer, is that unlike in adults these plaques haven’t hardened or calcified in children. So the same treatments that help improve vessel walls and blood flow in adults can help children even more, she observed.
Q: My uncle has started to suspect that everyone is against him. It started with his job where he felt he was being victimised. He then decided that the rest of his family (wife and children) is poisoning him. He has also become involved with a woman in his office, who encourages his beliefs and wants to cut all of us out of his life.
A: It sounds like your uncle is slowly becoming paranoid, suffering from delusions and maybe becoming schizophrenic as well. This is very difficult to treat as he will suspect that the medication is poison as well.
The “other woman” may be mildly schizophrenic herself. People with these illnesses tend to gravitate together. She may have an ulterior motive for encouraging your uncle’s beliefs. You could try to speak to him and try to encourage him to see a psychiatrist.
Preventing pimples Q: I have pimples on the back below the neck. It looks ugly when I wear low-necked outfits. I have tried prickly heat powder to no avail. ………………… A: Pimples or acne on the back of the neck can be itchy and leave disfiguring dark scars. It is aggravated by dandruff. Anti dandruff shampoos will help. Also, do not use powder. Talc blocks the pores and makes the pimples worse. Try to use soap with the correct TFC (total fat content) and TCC (tricholorohexidine) like Neko. If applied using a loofah, it kills the skin bacteria that aggravate acne.
Relief from arthritis Q: I have arthritis and I have been prescribed capsules containing chondroitin sulphate. Will it help?
………………….
A:Chondroitin sulphate is a natural ingredient found in joint cartilage. The question of whether it actually reaches damaged cartilage and repairs it is not proven. Many people who take it feel that it does reduce the symptoms of arthritis. It has to be taken for 3-6 months before its effects are seen. It needs to be taken 2-3 times a day or as recommended. It is relatively expensive. It is often combined with NSAIDs (non-steroidal anti-inflammatory drugs) and physiotherapy. It is difficult to say exactly which of these three ingredients plays the maximum role in reducing the arthritis.
Pop a pill daily Q: I have mild hypertension and have been prescribed 2.5 mg of amlodipin once a day. I check my BP myself with an electronic machine. Whenever I find it is normal I stop the tablet. I take it again only if I have a headache or the reading is high. Is this all right?
… 2.5 mg of amlodipin>.…..
A: Once hypertension has been diagnosed and the treatment started, you have to take the medication every day at the same time, as this particular drug acts for 24 hours. Once you start the treatment the blood pressure will get controlled. Even if you stop the tablets the BP (blood pressure) will remain under control for 2-3 days before it starts to rise again. Therefore, you can’t start and stop medication based on headaches and BP readings. Unlike diabetes where the sugars are controlled on a day-to-day basis, in BP the control is usually monthly. Take the tablets regularly as prescribed to prevent unnoticed elevations in the BP.
Try surgery : Q: I have an umbilical hernia and the doctor told me that as it is small I can leave it alone. I am 47 years old.
………………..
A:Umbilical hernia is a generic term and can be used for a defect exactly at the umbilicus, or above (paraumbilical). Intestines or other contents from the abdomen can pass through the defect. As long as the contents pass freely there is no problem. However the contents can get stuck as they pass outwards. This compromises the blood supply to that area and it can even be fatal.You are young and healthy. It is probably better to have surgery while there are no risk factors.
Brittle-boned babe : Q: My daughter who is 18 years old has weak bones and cannot do any work or lift weights. What can I do?
……………………
A: An 18 year old should not have weak bones unless there is an underlying kidney, intestinal, blood or bone disease. You need to get the diagnosis sorted out first. Remove the cause and the disease will be cured.
![Reblog this post [with Zemanta]](https://i0.wp.com/img.zemanta.com/reblog_e.png?w=580)
