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Learning

Weight Management

Weighing too much or too little can be a problem. In the United States, weighing too much is the more common situation. It can be unhealthy to be underweight or overweight. Of growing concern, many Americans are becoming obese, which means very overweight. Weight can influence how you look and feel about yourself.

Weighing too much can lead to many health problems, including heart disease and diabetes. Weighing too little can also lead to illness. Weight management means keeping your body weight at a healthy level. You can achieve and maintain your ideal weight by eating a healthy diet and getting regular exercise.

Risk of Associated Disease According to BMI and Waist Size

Body Mass Index

BMI Waist less than or equal to
40 in. (men) or
35 in. (women)
Waist greater than
40 in. (men) or
35 in. (women)
18.5 or less Underweight N/A
18.5 – 24.9 Normal N/A
25.0 – 29.9 Overweight Increased High
30.0 – 34.9 Obese High Very High
35.0 – 39.9 Obese Very High Very High
40 or greater Extremely Obese Extremely High Extremely High

It is also important to know your body mass index (BMI). BMI is frequently used by health care professionals to determine if a patient is overweight or obese. The BMI is also used to estimate how much body fat a person has. Your doctor, a nutritionist, or an exercise physiologist can measure your body mass. BMI percentages are used to determine your risk for certain diseases.

Ideal Weight Range

STANDARD WEIGHT CHART FOR MEN

Height In Feet
& Inches

Small Frame

Medium Frame

Large Frame

5’2″

128-134

131-141

138-150

5’3″

130-136

133-143

140-153

5’4″

132-138

135-145

142-156

5’5″

134-140

137-148

144-160

5’6″

136-142

139-151

146-164

5’7″

138-145

142-154

149-168

5’8″

140-148

145-157

152-172

5’9″

142-151

148-160

155-176

5’10”

144-154

151-163

158-180

5’11”

146-157

154-166

161-184

6’0″

149-160

157-170

164-188

6’1″

152-164

160-174

168-192

6’2″

155-168

164-178

172-197

6’3″

158-172

167-182

176-202

6’4″

162-176

171-187

181-207

STANDARD WEIGHT CHART FOR WOMEN

Height In
Feet & Inches

Small Frame

Medium Frame

Large Frame

4’10” 102-111 109-121 118-131
4’11” 103-113 111-123 120-134
5’0″ 104-115 113-126 122-137
5’1″ 106-118 115-129 125-140
5’2″ 108-121 118-132 128-143
5’3″ 111-124 121-135 131-147
5’4″ 114-127 124-138 134-151
5’5″ 117-130 127-141 137-155
5’6″ 120-133 130-144 140-159
5’7″ 123-136 133-147 143-163
5’8″ 126-139 136-150 146-167
5’9″ 129-142 139-153 149-170
5’10” 132-145 142-156 152-173
5’11” 135-148 145-159 155-176
6’0″ 138-151 148-162 158-179

 

You can learn what your ideal weight range is by looking at a chart or asking your doctor or nutritionist. Ideal weight ranges are calculated for males and females, and adults and children. Ideal weight ranges are based on your height and bone size. People can be small, medium, or large boned.

How do People Become Overweight?

People can become overweight if they consume more calories from food and drinks than they burn off through exercise and activity. A calorie is a unit of measure for energy. Your body needs a daily amount of calories to use for energy. However, when people eat too much or make unhealthy food choices, they can consume more many calories than their bodies need. If they fail to get enough activity to burn off the extra calories, the excess calories add up to extra pounds.

How do People Become Underweight?

People can become underweight if they do not consume enough calories from food and drinks. People can become underweight if they exercise too much and burn off too many calories. Eating disorders, such as anorexia nervosa and bulimia, can cause people to become severely underweight and lead to serious medical complications.

Weight Management

Weight management entails knowing what your target weight and BMI goals are and participating in a plan to attain and maintain your goals. People that are overweight should eat a balanced diet and get regular exercise. People that are underweight should eat a well balanced diet designed to achieve an ideal weight and prevent losing weight that has been gained. Exercise is important for people that are underweight, but their exercise recommendations are different from those for people that are overweight.

Your doctor can make recommendations for a weight management program that is specific for your health needs. You may be referred to a nutritionist that can help you plan daily meals. ChooseMyPlate.gov (www.choosemyplate.gov) presents helpful guidelines for healthy eating and exercise. Counseling may help if you have an eating disorder.

It is important to have your doctor examine you before embarking on an exercise regime. Your doctor may refer you to an exercise physiologist that can help you formulate and gradually increase an exercise program specifically designed for your body. By managing your weight responsibly, you can improve your health and reduce your risk for future health concerns.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Valvular Heart Disease – Heart Valve Disease

Introduction

Heart valve disease occurs when the valves that control the direction of the blood flow through the heart do not open and close, as they should. This can cause the heart to work harder and enlarge. Eventually, heart valve disease can lead to heart failure and death. Fortunately, surgical heart valve replacement is highly successful for treating valvular heart disease.

Anatomy

The heart is the core of the cardiovascular system. Your cardiovascular system consists of your heart and the blood vessels that carry blood throughout your body. Your heart is located to the left of the middle of your chest. Your heart is a large muscle is about the size of your fist. It works as a pump. The blood carries nutrients and oxygen that your body cells need for energy. It also carries waste products away.
Your heart is divided into four sections called chambers. The chambers are separated by the septum, a thick muscle wall. The two top chambers are called atria, and they receive blood coming into the heart. The two bottom chambers are called ventricles, and they send blood out from the heart.

Your heart contains two pumping systems, one on its left side and one on its right side. The left-sided pumping system consists of the left atrium and the left ventricle. Your left atrium receives blood that contains oxygen, which comes from your lungs. Whenever you inhale, your lungs move oxygen into your blood. The oxygenated blood moves from the left atrium to the left ventricle. The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.

The heart’s right-sided pumping system consists of the right atrium and the right ventricle. Your right atrium receives deoxygenated blood, blood that has circulated throughout your body and does not have high levels of oxygen in it anymore. The deoxygenated blood moves from the right atrium to the right ventricle. The right ventricle sends the blood to the lungs where it receives oxygen when you breathe.

As the blood travels through the heart chambers, four valves keep the blood from back flowing. The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles. The aortic valve and the pulmonary valve control blood as it leaves the ventricles.

Your doctor will listen to your heartbeat with a stethoscope. A healthy heart makes a lub-dub sound each time it beats. The first sound in your heartbeat occurs when the mitral valve and the tricuspid valve close. The second sound in your heartbeat occurs when the aortic valve and the pulmonary valve close after the blood leaves your heart.

Causes

Valvular heart disease can affect all four valves of the heart. The heart valves normally open and close to control the way blood flows through your heart. The regular opening and closing of the valves produces a regular heartbeat. With valvular heart disease, the valves do not open and close properly. The valves may leak or the blood may back up into the heart chambers. This can cause the heart to work harder to pump the blood out of the heart. This may cause a heart murmur and overtime, lead to an enlarged heart or heart failure.

Symptoms

The symptoms of heart valve disease are similar to those of congestive heart failure. You may experience shortness of breath after activities or lying down. Your arms, legs, abdomen, and ankles may swell and feel cool. You may develop an irregular heartbeat. You may have indigestion, nausea, vomiting, and loss of appetite. You may feel weak, faint, or very tired. You may feel the beat of your heart (palpitations) and have an irregular or fast pulse. You may have difficulty sleeping, remaining alert, concentrating, and remembering things. You may sweat a lot. You may cough, especially at night. You may produce smaller amounts of urine than usual and may need to urinate more frequently at night.

Diagnosis

Your doctor can begin to diagnose heart valve disease by reviewing your medical history and conducting a physical examination and some tests. Your doctor will use a stethoscope to listen to your heart to hear if you have a heart murmur. There are several tests that can be used to diagnose heart valve disease.

Your doctor may order a chest X-ray to view an image of your heart and the size of your heart chambers. An electrocardiogram (ECG) is used to record your heart’s electrical activity and detect abnormal heart rhythms. An echocardiogram uses sound waves to produce an image of the heart on a monitor. An echocardiogram can show the amount of heart valve leakage. Cardiac catheterization involves inserting a long narrow tube through a blood vessel into the heart to see and evaluate the heart valves, muscles, and arteries.

Treatment

The type of treatment that you receive depends on the severity and extent of your valvular heart disease. In some cases, treatment may not be necessary and the condition is carefully monitored. Medications may be used to improve heart functioning, but medications do not cure valvular heart disease. Heart valve surgery may be necessary to treat narrowed or leaking heart valves.

Heart valve surgery is an open-heart surgery that is performed under general anesthesia. Heart valves may be replaced or repaired. Replacement valves may be artificial or from donors. Heart valve surgery is highly successful. It can relieve your symptoms and help you to live a longer life.

Prevention

Depending on the type of surgery you receive, you may need to take antibiotics before you have dental procedures or future surgeries. Your doctor will let you know what to expect.

Am I at Risk
Heart valve disease can be present from birth. It may result from rheumatic heart disease, endocarditis, or weakened heart muscles. The valves may be injured as the result of a heart attack. Valve problems may be caused by certain medications, such as Fen-Phen.

Complications

Untreated heart valve disease can lead to heart failure and death. It is important to contact your doctor immediately if you experience the symptoms of heart valve disease. Surgical treatment is highly effective for treating this condition.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

The Heart: How It Works

The heart is the core of the cardiovascular system. Your cardiovascular system consists of your heart and the blood vessels that carry blood throughout your body. Your heart is located to the left of the middle of your chest. Your heart is a large muscle is about the size of your fist. It works as a pump. The blood carries nutrients and oxygen that your body cells need for energy. It also carries waste products away.
Your heart is divided into four sections called chambers. The chambers are separated by the septum, a thick muscle wall. The two top chambers are called atria, and they receive blood coming into the heart. The two bottom chambers are called ventricles, and they send blood out from the heart.

Your heart contains two pumping systems, one on its left side and one on its right side. The left-sided pumping system consists of the left atrium and the left ventricle. Your left atrium receives blood that contains oxygen, which comes from your lungs. Whenever you inhale, your lungs move oxygen into your blood. The oxygenated blood moves from the left atrium to the left ventricle. The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.

The heart’s right-sided pumping system consists of the right atrium and the right ventricle. Your right atrium receives deoxygenated blood, blood that has circulated throughout your body and does not have high levels of oxygen in it anymore. The deoxygenated blood moves from the right atrium to the right ventricle. The right ventricle sends the blood to the lungs where it receives oxygen when you breathe.

As the blood travels through the heart chambers, four valves keep the blood from back flowing. The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles. The aortic valve and the pulmonary valve control blood as it leaves the ventricles.

The heart has several large arteries and veins connected to it that branch out and become smaller as they travel throughout your body. Your arteries and veins deliver blood throughout your body in a process called circulation. Arteries are blood vessels that carry oxygenated blood away from your heart. The aorta is the largest blood vessel in your body. The aorta carries all the blood that is pumped out of your heart and through its many branches, distributes blood to all of the organs and throughout the body. Two main coronary arteries branch off the aorta to supply the heart with oxygen, blood, and nutrients to keep it healthy. Veins are vessels that carry blood from your body and lungs back to your heart. Your two largest veins are the superior and inferior vena cava.

Small blood vessels called capillaries connect your arteries and veins. Capillaries deliver oxygen and nutrients at a cellular level. They also remove waste products, such as carbon dioxide. Carbon dioxide is produced after your cells have used oxygen. Additionally, about 20% of your blood flows through your kidneys. Your kidneys filter waste products from your blood.

Your doctor will listen to your heartbeat with a stethoscope. A healthy heart makes a lub-dub sound each time it beats. The first sound in your heartbeat occurs when the mitral valve and the tricuspid valve close. The second sound in your heartbeat occurs when the aortic valve and the pulmonary valve close after the blood leaves your heart.

Your doctor will check your pulse. Your pulse is the beat that is felt each time your heart contracts. You pulse can most easily be felt my lightly pressing on the skin that covers your large arteries, such as at your wrist or the side of your neck. Your pulse increases when you are excited, active, or exercising because your body needs more oxygen to function. Your pulse is slower when you are relaxed and resting.

It is important to keep your heart healthy. You need a heart to survive. Keep your heart muscle healthy and strong with regular exercise. Eat healthy well-balanced meals. Avoid foods that contain unhealthy fats, such as saturated fats and trans fats. Do not smoke; smoking can damage the heart and blood vessels.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Syncope – Fainting

Introduction

Syncope is the medical term for fainting. Syncope results from a drop in blood pressure or heart rate. It may occur because of certain triggers, such as dehydration, stress, or exhaustion. Recurrent syncope may be the sign of a heart condition. You should contact your doctor to determine the cause of your fainting and receive treatment.

Anatomy

The heart has several large arteries and veins connected to it that branch out and become smaller as they travel throughout your body. Your arteries deliver and veins return blood throughout your body in a process called circulation. Arteries are blood vessels that carry oxygenated blood away from your heart. Veins are vessels that carry deoxygenated blood from your body and lungs back to your heart.

The aorta is the largest blood vessel in your body. The aorta carries all the blood that is pumped out of your heart and through its many branches, distributes blood to all of the organs and throughout the body. The carotid arteries branch off of the aorta and deliver blood to your head and brain. Two coronary arteries branch off the aorta, which supply the heart with oxygen, blood, and nutrients to keep it healthy.

Causes

Syncope occurs when a reduction in blood flow to the brain causes a temporary loss of consciousness. The fainting is brief and followed by a complete recovery of consciousness. Syncope can happen because of many reasons. It can result from a sudden drop in blood pressure, which may occur from being dehydrated, exhaustion, heavy sweating, blood loss, or from standing up quickly. Pain, emotional stress, or fear can cause fainting. Certain medications, hyperventilation, and alcohol or illegal drug use can cause syncope. Further, it may occur with urination, a bowel movement, coughing, or after standing or sitting for too long.

In some cases, syncope may be associated with a disorder called neurally mediated syncope (NMS), also referred to as neurocardiogenic, vasovagal, vasodepressor, or reflex mediated syncope. It is more common in children and young adults, but may occur at any age. A drop in blood pressure or heart rate causes the fainting.

In some cases, syncope may be the sign of a serious disorder. Syncope that occurs with exercise, heart palpitations, or irregular heartbeats may be related to a heart problem. People with a family history of recurrent syncope or sudden death may have a higher risk of cardiac related syncope. Syncope related to heart disease can cause stroke, heart attack, or sudden death.

Symptoms

You may feel weak, dizzy, lightheaded, or nauseated prior to fainting. You may turn pale and sweat. You may have a ringing in your ears and sounds may seem like they are fading out. You may have a visual disturbance, such as everything is “graying out.” These symptoms may last for a few seconds before a brief loss of consciousness. Recovery from fainting is rapid, although you may feel nauseous and sweating initially.

Diagnosis

Your doctor will start to determine if you simply fainted, had a seizure, or if you have a heart condition. Your doctor will review your medical history and conduct a physical examination and some tests to determine the cause of your fainting. Your doctor may examine your heart, lungs, and nervous system. Your blood pressure will be measured while you are in different positions.

Cardiac tests may be performed if you have recurrent syncope or if your doctor suspects a heart problem. The tests may include a chest X-ray, electrocardiogram (ECG), and echocardiogram. An ECG records the heart’s electrical activity. An echocardiogram uses sound waves to produce an image of the heart on a monitor. An exercise stress test involves monitoring your ECG and blood pressure while you exercise on a treadmill. The exercise stress test provides information about how your heart works with an increased blood flow. You may wear a Holter monitor for periods of 24 hours or more. A loop recorder can also be used to detect for rhythm abnormalities over a long period of time.

Tilt table testing is used to check for sudden drops in blood pressure or heart rate that can cause syncope. For this procedure, you are secured to a table, which will be positioned at different inclines for various periods of time. Your blood pressure and ECG will be recorded.

Treatment

People with NMS may be treated with medication and may be advised to eat a high-salt diet and drink plenty of fluids. They should sit or lie down when they feel the warning signs of fainting. Wearing compression stockings may help improve circulation. Orthostatic training exercises can be helpful as well. In some cases, a pacemaker may be necessary to help regulate heart function.

Prevention

You should follow your doctor’s recommendations if you have NMS. If you feel the warning signs of fainting, you should lie down and elevate your legs. It is important to follow your doctor’s guidelines and attend all of your doctor appointments

Am I at Risk

You should talk to your doctor about what triggers your fainting. In some cases, the trigger may be avoided. People with a family history of recurrent syncope or sudden death have an increased risk for syncope caused by a heart condition.

Complications

Prolonged syncope may lead to a seizure. Fainting may also be the sign of a serious condition such as a stroke or heart attack. You should call an ambulance, usually be dialing 911, if you suspect that you or someone else is experiencing a stroke or heart attack.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Symptoms of Heart Disease, Heart Attack, and Stroke

Heart Disease

Heart disease is termed “a silent threat” because many people do not experience symptoms until a heart attack or stroke occurs. Cardiovascular symptoms that require immediate emergency medical attention include chest pain, shortness of breath, pain or numbness in your arms or legs, confusion, loss of consciousness, and blurred vision.

Heart Attack

A heart attack is a life and death medical emergency. You should call the emergency medical services in your area, usually 911, if you or someone else experiences one or more signs of a heart attack. A heart attack can be fatal, and receiving emergency medical treatment as soon as possible is vital for sustaining life. The more time that passes before a person receives emergency treatment, the more likely a person is to experience permanent heart damage or death.

Some heart attacks occur suddenly and intensely. Others may start out slowly. A heart attack can cause chest pain, pressure, squeezing, fullness, or pain that lasts for more than a few minutes. The chest discomfort may come and go. It may feel like you have bad indigestion, a tight band around your chest, or that “an elephant is sitting on your chest.” You may experience pain that radiates to your jaws, neck, shoulder, teeth, arms, back, or abdomen. A heart attack can cause shortness of breath, nausea, vomiting, lightheadedness, nausea, and a cold sweat.

Women and men may experience different symptoms of a heart attack. For both men and women, chest discomfort is the most common symptom of a heart attack. However, women are more likely than men to experience back or jaw pain, overwhelming fatigue, dizziness, nausea, vomiting, and shortness of breath.

Stroke

A stroke is a medical emergency. You should call the emergency medical service provider in your area, usually 911, for ambulance transport to a hospital emergency room. It is important that you receive treatment immediately after you start experiencing the symptoms of a stroke – ideally within the first three hours of when your symptoms began. You should not ignore your condition if some of your symptoms go away—you should still seek immediate emergency medical treatment. Doctors can provide treatments to reduce disability and save lives.

The symptoms of a stroke begin suddenly. The symptoms may be more severe at the beginning of a stroke. The symptoms may get continually worse or fluctuate for the first couple of days. Some symptoms may go away; however, you should not ignore the signs of a stroke even if your symptoms go away. A stroke is considered complete when the symptoms stop getting worse.

You may experience one or more symptoms. You may have a severe headache. One side of your body or one part of your body— the face, an arm or a leg may feel week or paralyzed. The affected body parts may feel numb or tingly. It may be hard to walk. You may lose your balance or coordination. It may feel like the room is spinning, and you may feel dizzy. You may feel tired all of the time. A stroke can also cause a person to lose consciousness.

You may experience uncontrollable eye movements, changes in vision, such as double vision, blurred vision, or loss of vision. Your eyelids may droop. You may drool and have difficulty swallowing.

You may have trouble thinking and feel confused. You may have difficulty remembering things that you could before. It may be difficult to understand what others are saying, and you may have problems talking. A stroke can cause personality and behavioral changes. You may feel depressed, agitated, or apathetic.

Symptoms of a TIA are similar to that of a stroke. They may include one or more of the symptoms described above. However, the symptoms of a TIA last less than 24 hours.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Stroke – CVA

Introduction

A stroke or a “brain attack” is an emergency medical condition. It occurs when the blood supply to the brain is stopped or reduced for a period of time. Your brain controls the life sustaining functions of your body. It also controls the way you think, act, and feel. A lack of oxygen rich blood causes brain cells to become damaged or die. Without oxygen, the section of the brain containing the affected cells can temporarily or permanently lose function. It can also result in coma or death.

Emergency medical treatments may sustain life and prevent disability, if they are received in the first few hours following the onset of stroke symptoms. A stroke can result in temporary or permanent disability and impairments. Recovery from stroke can take a long time, usually over a year.

Rehabilitation therapists help people to regain skills and live as functionally independent as possible. Many people with stroke never fully recover, but with assistance and adjustments, they can lead full and happy lives.

Anatomy

Your brain is the control center of your body. Your brain controls the way you think, behave, and feel. It communicates with the nerves in your body for functions you can control, such as moving your arms and legs. Your brain also controls the life-sustaining functions that you cannot control. This includes your heartbeat, body temperature, blood pressure, and body metabolism.

The cells in your brain, like all your cells, need oxygen to function and survive. Oxygen is carried to your brain by red blood cells. Your red blood cells travel to your brain in tubes called arteries.

The main arteries to your brain branch off to transport blood to areas throughout your brain. The branches of the internal carotid artery supply blood to the front and top areas of your brain. These branches include the anterior cerebral, anterior communicating, middle cerebral, and posterior communicating arteries.

The vertebral artery branches into the anterior spinal artery and supplies blood to your brain and spinal cord. The junction of your two vertebral arteries forms your basilar artery. Your basilar artery branches into the cerebellar and posterior cerebral arteries that supply blood to the lower and back areas of your brain.

The arterial branches form a circular formation in the center of your brain called the Circle of Willis. The Circle of Willis and small branches of the middle cerebral arteries, near the internal carotid arteries, are common sites of strokes. These areas are especially vulnerable to strokes at places where the arteries join each other.

Causes

A stroke occurs when the blood flow to the brain is stopped or reduced. When the blood flow is impaired, the brain cells do not receive oxygen for nourishment. Without oxygen, brain cells can be damaged in just a few seconds. Brain cells can die in a few hours without oxygen. This can cause the section of the brain containing the affected cells to temporarily or permanently lose function. It can also result in death.

During a stroke, the brain may not receive blood for a couple of reasons. The brain cannot get blood if an artery is blocked or if an artery has broken open. An ischemic stroke results when an artery is blocked. A transient ischemic attack (TIA) is a “mini stroke” that occurs when the blood supply is briefly interrupted. A hemorrhagic stroke happens when the artery wall bursts and leaks blood.

An ischemic stroke is the most common type of stroke. An ischemic stroke results when an artery is clogged or blocked, and blood cannot flow through it. A clot that forms and remains in the brain is called a cerebral thrombus. A clot may form in other parts of the body and travel to the brain. This type of clot is called a cerebral embolism.

Atherosclerosis, “hardening of the arteries” is the most frequent cause of blood clots and ischemic stroke. High blood pressure, diabetes, and high cholesterol cause atherosclerosis. Atherosclerosis results when fat and blood platelets stick to the wall of the arteries. This causes the build-up of a sticky substance called plaque. Plaque causes blood to flow abnormally through the arteries, which can result in blood clots.

There are several other causes for cerebral embolisms. Atrial fibrillation is a cause of cerebral embolisms. Atrial fibrillation is a condition that causes a fast and irregular heart beat. Embolisms may also result from endocarditis, a disease that affects the lining of the heart. Heart valve problems are another source of cerebral embolisms. People with artificial heart valves, repaired heart valves, heart valve disease, or narrowed heart valves are at risk for blood clots. Blood-clotting disorders and blood vessel inflammation can also cause blood clots. Further, a heart attack can contribute to an ischemic stroke.

A TIA is a stroke that usually lasts for a few minutes. A TIA occurs when the blood flow to an area of the brain is briefly and temporarily blocked. Atherosclerosis and blood clots most commonly cause TIAs. TIAs can be an indicator that a person is at risk for a more serious stroke.

A hemorrhagic stroke occurs when an artery bursts, causing bleeding in or around the brain. The outflow of blood damages the brain cells. Blood pools can build up and increase the pressure inside of the brain. Because the brain is enclosed in the skull, it does not have room to swell or expand. This can compress and damage brain tissue.

The most common cause of hemorrhagic stroke is long-term high blood pressure. It can also be caused by a ruptured aneurysm, head injuries, radiation treatment for cancer in the neck or brain, and blood vessel disorders. Bleeding inside the brain is called an intracerebral hemorrhage. Bleeding outside of the brain is called a subarachnoid hemorrhage.

Symptoms

The symptoms of a stroke begin suddenly. The symptoms may be more severe at the beginning of a stroke. The symptoms may get continually worse or fluctuate for the first couple of days. Some symptoms may go away, however you should not ignore the signs of a stroke even if your symptoms go away. A stroke is considered complete when the symptoms stop getting worse.

You may experience one or more symptoms. You may have a severe headache. One side of your body or one part of your body — the face, an arm or a leg may feel weak or paralyzed. The affected body parts may feel numb or tingly. It may be hard to walk. You may lose your balance or coordination. It may feel like the room is spinning, and you may feel dizzy. You may feel tired all of the time. A stroke can also cause a person to lose consciousness.

You may experience uncontrollable eye movements, changes in vision, such as double vision, blurred vision, or loss of vision. Your eyelid may droop. You may drool and have difficulty swallowing.

You may have trouble thinking and feel confused. You may have difficulty remembering things that you could before. It may be difficult to understand what others are saying, and you may have problems talking. A stroke can cause personality and behavioral changes. You may feel depressed, agitated, or apathetic.

Symptoms of a TIA are similar to that of a stroke. They may include one or more of the symptoms described above. However, the symptoms of a TIA last less than 24 hours.

Diagnosis

A stroke is a medical emergency. You should call 911 for ambulance transport to a hospital emergency room. It is important that you receive treatment immediately after you start experiencing the symptoms of a stroke – ideally within the first three hours of when your symptoms began. You should not ignore your condition if some of your symptoms go away—you should still seek immediate emergency medical treatment. Doctors can provide treatments to reduce disability and save lives.

Your doctor can diagnose a stroke by reviewing your medical history and performing an examination. You or the person accompanying you should tell your doctor all of the symptoms that you experienced, even if the symptoms have gone away. Your doctor will order tests to help determine the cause, type, location, and severity of the stroke that you had. Your blood will be tested for immune conditions and abnormal blood clotting conditions. Your doctor may also order tests to rule out other conditions with similar symptoms.

Your doctor will examine you to look for signs that an area of your brain has been affected by the stroke, since certain areas of the brain control certain functions. Your doctor will perform a neurological evaluation to see how the nerves in your body and your brain are communicating. Your doctor will test the strength, sensation, coordination, and movement of your muscles. Your doctor will assess your cognitive or “thinking skills” by asking you simple questions or to follow simple directions. Your doctor will also check your vision and eye movements. A stethoscope, the instrument that allows the doctor to hear your heartbeat, will be placed over the carotid arteries at the front of your neck. Your doctor will listen for abnormal sounds or signs of atrial fibrillation.

Imaging tests help your doctor determine if bleeding or a clot caused your stroke. Imaging tests can identify the location and magnitude of the stroke. Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) scans are used to provide a picture of the brain. These imaging scans evaluate brain structures, but do not directly assess brain functioning.

CT scans provide a view of the brain in layers, like the slices that make up a loaf of bread. The CT scan shows the structures in your brain. A CT scan is useful for identifying large clots or areas of bleeding. The MRI scan is very sensitive. It provides detailed images of the brain structures. Both scans are painless procedures.

Heart tests will help your doctor determine if an underlying heart condition caused your stroke. An electrocardiogram (EKG) assesses the electrical activity of the heart. It can identify if a heart attack has occurred, what part of the heart is damaged, irregular heartbeats, and if there is a lack of blood and oxygen in the heart. The test is simple to conduct. Sticky patches attached to electrodes are placed on your skin. The electrodes transmit records to a machine for your doctor to interpret. This test is painless and only takes about 5-10 minutes to conduct.

There are various types of ultrasound devices that can provide your doctor with pictures of your heart and arteries. A stroke can occur if pieces of a blood clot in the heart break away and travel to the brain. An echocardiogram can determine if a blood clot is in your heart. An echocardiogram takes an image of the heart using ultrasound. A transthoracic echocardiogram uses a device that is placed on your chest. The device transmits images of your heart. A transesophageal echocardiogram uses a scope that is placed inside of your esophagus to take pictures. You will receive a light sedative for the test. A carotid duplex ultrasound can determine if the carotid arteries are blocked by plaque, clots, or narrowing of the arteries. For this test, an ultrasound device is gently placed on your neck to take images.

A cerebral angiography or arteriography is a medical imaging test that provides views of the arteries and veins in your brain. It is considered the gold standard for identifying vascular conditions in the brain. For this test, a catheter is passed through a large artery and advanced through the carotid artery. A fluid is injected that travels throughout the vasculature. The fluid enhances the images and provides a good depiction of the blood supply routes.

Treatment

Treating a TIA or stroke is a medical emergency. You should call 911 for ambulance transport to a hospital. The emergency room doctors will assess what type of stroke is occurring or has occurred and provide treatments to sustain life and achieve medical stability. Treatments for stroke differ and depend on the type of stroke, the severity of a person’s condition, and any associated medical conditions.

It may be difficult for emergency personnel to determine if a person is having a TIA or a stroke. However, prompt evaluation and treatment is necessary for both. Ideally, TIAs need to be treated within 60 minutes from the start of symptoms. Doctors can use medication or surgery to reduce the risk of stroke for people experiencing a TIA.

If a clot causes a stroke, thrombolytic medication to break up clots can be provided—but this medication has strict administration criteria. The clot dissolving medication should be given within three hours of when the stroke symptoms started. This can save your life and help prevent disability. Other blood thinning medications may be used for people that are not candidates for thrombolytic medication.

If bleeding in the brain causes a stroke, the emergency room team will carefully monitor a person’s vital signs and pressure in the brain. They will provide medical treatments to control blood pressure, blood sugar levels, brain swelling, and seizures. In some cases, surgery may be required to remove the excess blood in the brain, repair a brain aneurysm, and repair blood vessels.

Sometimes a stroke results in a coma, a condition when a person is not alert and does not respond to stimuli. Some people may not be able to breathe on their own and will require a respirator, a machine that breathes for them. Other people may remain alert, but be medically fragile. In most cases, people are transferred from the emergency room department to the Intensive Care Unit (ICU) of a hospital. The ICU staff carefully monitor individuals for vital signs and brain swelling. The goals of the ICU staff are to maintain life and medical stability, while preventing further medical complications.

Occupational and physical therapists may work with people in the ICU to provide preventive treatments. The therapists use passive range of motion (PROM) exercises to gently move and stretch a person’s muscles to improve circulation and to keep the muscles healthy. This prevents the muscles from contracting, which can result in deformities. The therapists may also provide splints or casts to help maintain body positioning.

Recovery from stroke is different for everyone. It depends on many factors including the severity of the stroke, the location of the stroke, the functions of the brain area affected by the stroke, the condition of your brain and nervous system at the time of the stroke, and your other medical conditions.

Treatment and rehabilitation will differ for everyone. It takes a long time to recover from a stroke. Generally, the fastest progress takes place within the first year, although healing continues to take place after that. Many people never fully recover from a stroke, but with assistance and adjustments, they can lead full and happy lives.

It is common for people to have partial or complete impairments following a stroke. Depending on the deficit, they may need assistance, such as a cane to help them walk or another person to help them figure out their bills. Some people may be able to return to living in their home or others may need the help of others at a care facility. It is common for people to transfer from various facilities and levels of care during their recovery process.

When a person is medically stable and able to remain alert and follow simple instructions, they are transferred from the hospital to an acute inpatient rehabilitation unit for therapy. People typically stay in an inpatient rehabilitation center for days to several weeks. Because a stroke can affect how a person thinks, acts, moves, and feels, rehabilitation may be necessary to help a person attain abilities that were lost or impaired by a stroke.

In rehabilitation, a team of healthcare professionals with expertise in stroke care help people achieve their highest level of independent functioning for Activities of Daily Living (ADLs). ADLs include basic tasks such as walking, dressing, swallowing, and talking. It also includes behavioral and thinking skills necessary for independent living and socialization. The rehabilitation team works together on goals and meets regularly to monitor a person’s progress.

A rehabilitation team includes several healthcare professionals. The team is usually lead by a Physiatrist, a doctor who specializes in physical rehabilitation medicine. Physical Therapists work on improving muscle strength, flexibility, and coordination. They focus on skills such as walking and balance. Occupational Therapists use purposeful activities to help people obtain independent and meaningful daily living. They focus on physical, emotional, and cognitive challenges, including feeding, dressing, thinking skills, and visual training. Speech Language Pathologists work to improve a person’s ability to talk and comprehend what is seen or heard. Speech Language Pathologists or Occupational Therapists work with people to improve swallowing abilities.

Other rehabilitation team members include Rehabilitation Nurses, Recreational Therapists, Neuropsychologists, and Case Managers or Social Workers. Rehabilitation Nurses work with people on goals to improve functioning and monitor their medical status.

Recreational Therapists provide goal oriented leisure activities to improve social skills, muscle movement skills, and enhance self-esteem. They regularly plan activities in the community where people may apply the skills they learn in rehabilitation. Types of recreational therapy include pet therapy, wheelchair sports, and special social functions.

Neuropsychologists focus on the way the brain functions. They assess the way the brain processes thoughts, emotions, and behavioral information. They work with people to help them improve brain functioning and adjust to setbacks. Their reports are important for discharge planning, return to school, and return to work.

Case Managers or Social Workers communicate with individuals and their families regarding treatment goals and planning. They work with individuals and their insurance companies to assure cost-effective treatment. Case Managers or Social Workers also facilitate discharge planning.

The discharge destination from rehabilitation varies and depends on an individual’s skill level, safety awareness, and the level of care that they need. Some people may return to their homes to live independently or with supervision or a little help from their family or friends. Other people may need more time to heal and are discharged to a subacute rehabilitation center to continue to work on therapy. For people that need assistance or are completely dependent on the aid of healthcare professionals, discharge destinations may include skilled nursing homes, nursing homes, assisted living centers, supervised living centers, or Veterans’ homes.

In addition to rehabilitation after a stroke, your doctor will manage your health to help prevent another stroke. This may include monitoring and treating atrial fibrillation, high blood pressure, diabetes, and cholesterol. Your doctor may also monitor and treat you for depression. Depression is common for people that have experienced a stroke. Depression is a real medical condition that is treatable. Depression may cause you to feel sad, irritable, tired, and uninterested in activities that you used to find enjoyable. You may also experience appetite changes, sleeping problems, and have trouble remember things or concentrating. You should discuss any symptoms of depression with your doctor. Your doctor will be able to provide you with medications or a counseling referral to help you.

The experience of stroke can be an emotional process for the patient and their loved ones. It is important that you receive support. Some people find comfort in their family, friends, co-workers, and place of worship. Stroke support groups are another good option. They can be a good source of information and support from people who understand what you are experiencing. Ask your doctor for stroke support group locations in your area.

Prevention

You should seek immediate emergency medical care if you suspect you are having a stroke. It is important to be evaluated by a doctor as soon as possible. Prompt treatment can save lives and reduce disability.

You should eliminate the risk factors for stroke that you can control. Have regular physical examinations to check for high blood pressure, high cholesterol, diabetes, and atherosclerosis. Learn what you can do to prevent these conditions. Ask your doctor to check your medications to see if any of them promote blood clotting or blood thinning. Women that take birth control pills should talk with their doctors about the risk of associated blood clots.

It is helpful to maintain a healthy weight and eat a balanced diet. It is also important to quit smoking and limit alcohol. You should not use illegal drugs.

Am I at Risk

Risk factors may increase your likelihood of developing a stroke. People with all of the risk factors may never develop a stroke; however, the chance of developing a stroke increases with the more risk factors you have. You should try to eliminate the risk factors that you can control to help prevent a stroke. You should tell your doctor about your risk factors and discuss your concerns.

Risk factors for stroke:

  • Hypertension “high blood pressure” is the top risk factor for stroke.
  • Smoking increases the risk of stroke. Smoking can contribute to coronary artery disease and blood clots.
  • The risk of stroke increases with age. Most strokes occur after the age of 65.
  • African Americans and Hispanics have the highest risk of stroke.
  • High cholesterol can contribute to plaque build-up in arteries, coronary artery disease, and heart attacks that can lead to stroke.
  • More men than women get stroke; however, women are more likely to die from a stroke.
  • Your risk is greater if you have a family history of stroke or TIA.
  • People that have had one stroke are at risk for another stroke.
  • Diabetes can cause blood circulation problems that lead to stroke.
  • Heart conditions such as atrial fibrillation, endocarditis, heart valve conditions, or cardiomyopathy increase the risk of stroke.
  • Some medications can increase the risk of blood clots, including birth control pills for females.
  • Women have an increased risk of stroke during pregnancy and the weeks immediately following pregnancy.
  • A lack of physical activity can increase the risk of stroke.
  • Street drugs, such as cocaine, and alcohol abuse contribute to stroke.
  • Trauma or a head injury can cause bleeding in the brain.
  • Some blood clotting disorders or bleeding disorders can increase the risk of stroke.

Complications

There are many complications associated with stroke. A stroke can cause disability, coma, or death. People that have had one stroke are at risk for future strokes. People that have had a TIA have an increased risk for more TIAs or stroke. Doctors carefully monitor people that have had a TIA or stroke.

A stroke may require a person to be dependent on others, need some help, or need supervision for living. Functional impairments can affect several parts of the body. Such impairments may be partial, full, temporary, or permanent. Listed below are some main complications resulting from neurological injury to the brain.

A stroke can affect thought processing, emotions, and behavior. People may experience difficulty with thinking skills including memory, problem solving, judgment, and safety awareness. People’s personality may change. They may laugh or cry at inappropriate times. This is called mood lability. They may also be depressed, agitated, apathetic, or be frustrated easily. Behavior may be affected by stroke as well. People may become impulsive, sexually inappropriate, aggressive, and socially inappropriate. People that lack such skills may require 24-hour supervision to prevent harm to themselves and others.

A stroke can affect the way muscles work and move. A stroke can cause partial or complete paralysis. Spasticity can cause muscle to have increased tone and be unable to function. Strokes typically affect one half of the body; however, some people are able to perform tasks with the functioning side of their body. For instance, a person may walk with an assistive device, such as a cane and leg bracing. People can also dress and bathe themselves using assistive devices and one-handed techniques. Cars can even be adapted so people can drive. It is important that you discuss your life goals with your therapists and work on the skills that are priorities for you.

A stroke can affect the way that people communicate. People may not be able to speak or have difficulty forming words. This is called expressive aphasia. People that are unable to speak may use a variety of assistive devices to communicate including picture boards, letter boards, and electronic keyboards. Another type of aphasia, receptive aphasia, is the inability to understand what other people say making it more difficult to compensate.

Vision can be affected by stroke. Stroke can cause “visual neglect.” Visual neglect is a condition that causes a person to only be aware of half of things. Individuals with severe visual neglect may ignore half of their body because they are not aware of it. This leaves them vulnerable to injury, as they may not be aware of their arm or leg placement. A NeuroOptometrist and an occupational therapist with expertise in visual therapy can help people learn to compensate for visual impairments.

A lack of sensation associated with stroke can compound visual impairments. Some people lose the feeling in the affected side of their body. A lack of sensation can also include an impaired or absent temperature awareness. People are vulnerable to injury if they cannot gauge temperatures or detect the placement of their limbs.

A stroke can also affect the senses of taste and smell. People may report that food tastes differently. This can be a safety issue if people cannot smell fire or taste and smell spoiled food. Therapists have many ways to help people compensate for such deficits.

It is very common for people to experience a loss of bladder and bowel control. This condition is typically temporary. In the interim, people generally wear protective undergarments.

Advancements

Carotid artery stenting is a preventative option for select people. During surgery, a stent, a small metal tube, is placed in the carotid artery. The stent allows for increased blood flow in areas that may be blocked by plaque. In some cases, the stent may be coated with a medication that helps to reduce further blockage.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Sleep Apnea

Introduction

Sleep apnea is a common and under-diagnosed sleep disorder. It causes repeated episodes of stopped breathing (apneic episodes) and startling or gasping for air during sleep. People with sleep apnea frequently do not realize that they have it. The consequences of untreated sleep apnea can be severe or life threatening therefore early diagnosis and treatment is essential. Sleep apnea may be treated or managed with lifestyle changes, use of a breathing assist device at night, or surgery.

Anatomy

Sleep is vital for life, just like eating and breathing. Sleep allows your body to rest. It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals.

In a way, your body goes on “auto-pilot” while you sleep. Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure. Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning.

Causes

Sleep apnea occurs when breathing stops in repeated episodes during sleep. Apnea means lack of breathing. The majority of sleep apnea cases are caused by obstructions in the nose or throat that block a person’s breathing airway. During sleep, the airway muscles relax and the airway closes or is blocked.

Central sleep apnea is less common. It is caused by a low blood carbon dioxide level. Carbon dioxide is a powerful breathing signal and if it is too low, the brain fails to signal the lungs to breathe.

Symptoms

People may have sleep apnea and not be aware of it. People with sleep apnea may stop breathing numerous times during the night and not fully awaken to realize it. In many cases, a household member is the first to notice that a person snores loudly, stops breathing for periods of time, and gasps or snorts during sleep. Daytime drowsiness, headache upon awakening, weight gain, depression, irritability, leg swelling, sexual dysfunction, and difficulty thinking or remembering may be signs of sleep apnea. Sleep apnea can contribute to high blood pressure, and researchers suspect that up to half of all people with sleep apnea have high blood pressure. Sleep apnea can contribute to stroke, heart attack, or death.

Diagnosis

You should contact your doctor if you suspect that you have sleep apnea. Your doctor will examine your nose and throat for structural abnormalities. Your doctor may recommend a sleep study to help diagnose sleep apnea and determine its severity.

A sleep study may be performed at a sleep disorders clinic or in some cases, in-home equipment may be used. Polysomnography testing is used to record a variety of body functions while you sleep. During this test measurements of your brain activity, blood oxygen levels, airflow, heart rate, breathing, eye movements, and muscle movements will occur. A multiple sleep latency test may be used to determine how quickly you fall asleep. A multiple sleep latency test is helpful for identifying the extent of daytime sleepiness.

Treatment

Treatment for sleep apnea depends on the cause and extent of the condition. Treatment may include lifestyle changes, use of an air device, dental appliance, and surgery. Some people may use more than one type of treatment.

Lifestyle changes may treat mild cases of sleep apnea and help reduce the number of apneic episodes for others. Achieving and maintaining a healthy weight can help. Even small weight loss amounts can reduce the amount of apneic episodes. You should avoid using alcohol, tobacco, sedatives, or sleeping pills. Additionally, it may be helpful to sleep on your side instead of your back.

Continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea. CPAP entails wearing a device over the nose during sleep. The nasal device is connected to a small machine that creates airflow and gentle air pressure to keep the airway open. CPAP is an effective way to treat sleep apnea.

Dental devices are another method of treatment. Dental appliances are used to position the lower jaw and tongue during sleep. Such devices may be appropriate for people with mild to moderate sleep apnea.

In some cases, surgery may be used to increase the size of the airway. Common surgeries include removal of the tonsils, adenoids, and excess throat or palate tissue. Nasal surgery may be used to remove obstructions, such as polyps. Children appear to benefit more from surgery for sleep apnea than adults do.

Prevention

You may be able to prevent sleep apnea by reducing the risk factors that you can control, such as maintaining a healthy weight and avoiding smoking, alcohol, and sedatives. Early diagnosis and treatment may help reduce the serious consequences that may result from sleep apnea.

Am I at Risk

Sleep apnea most frequently occurs in people over the age of 40, although individuals of all ages, including children, may experience it. In adults younger than 65, sleep apnea is more common in African Americans than Caucasians. Sleep apnea is more common in the elderly and obese populations.

Risk factors for sleep apnea include:

  • Being overweight, especially with a large collar (neck) size is a risk factor for sleep apnea. However, many people that are not overweight have sleep apnea.
  • Consuming alcohol increases the risk of sleep apnea.
  • People with blocked nasal passages, a large tongue, narrow throat, or other structural problems have an increased risk of sleep apnea.
  • High blood pressure and other medical conditions are associated with sleep apnea.
  • Sleep apnea appears to run in families, and researchers are studying a possible genetic pattern of inheritance.
  • People that snore loudly are more likely to have sleep apnea than people that do not snore.

Complications

It is very important to treat sleep apnea. Sleep apnea has recently been identified as a contributor to high blood pressure and other medical conditions. Sleep deprivation from sleep apnea can cause personality changes, hallucinations, and confusion. Sleep apnea can contribute to serious and life threatening medical complications, including stroke, irregular heartbeat, heart attack, and sudden death.

Advancements

Recent research on sleep apnea is focused on the effects of signaling chemicals, called cytokines, that may be responsible for regulating immune responses to inflammation. Cytokines may be the reason we become more sleepy when we are sick. Sleep apnea increases the amount of cytokines circulating in the body. These cytokines, along with the poor quality sleep, may cause the daytime sleepiness seen in patients with sleep apnea.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Sclerotherapy for Varicose Veins & Spider Veins

Introduction

Sclerotherapy is a treatment for small varicose or spider veins. Sclerotherapy involves the tiny injections of a medication into affected veins. The solution used causes the veins to shrink and eventually dissolve. Sclerotherapy may improve the appearance of veins and reduce symptoms of vein malformation.

Your veins carry deoxygenated blood back to your heart. Varicose veins develop when the blood that should move toward the heart develops a back flow. Such veins may contain faulty valves, a lack of valves, or deformities which impairs the normal flow of blood. Varicose veins can hurt. They often look like blue swollen areas beneath the skin. Smaller veins, dilated capillaries, produce finer purple colored lines that are commonly known as spider veins.

Treatment

You can receive sclerotherapy at your physician’s office. Your doctor will carefully inject medication into your affected veins. There are several types of medications that your doctor has to choose from – clinical studies have shown them to be equally effective. You can return to work or activity following the procedure. You will need to wear bandages for a period of time. It is helpful to wear compression stockings after treatment. You may need repeated injections to attain your desired result.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Peripheral Artery Disease – Poor Circulation

Introduction

Peripheral artery disease (PAD), also referred to as arteriosclerosis of the extremities and peripheral vascular disease, is a condition that causes poor blood circulation to the kidneys, intestines, arms, legs, and feet. Blood flow may be reduced or blocked by narrowed or hardened blood vessels. This can lead to tissue and nerve injury or damage. You may decrease your risk of PAD by reducing the risk factors that you can control. PAD is treated with medications and surgery. In severe cases, amputation may be necessary.

Anatomy

The heart has several large arteries and veins connected to it that branch out and become smaller as they travel throughout your body. Your arteries and veins are blood vessels that deliver blood throughout your body in a process called circulation. Arteries carry oxygenated blood away from your heart. Veins carry deoxygenated blood from your body and lungs back to your heart.

Causes

PAD results when the arteries that supply the kidneys, intestines, arms, legs, or feet become narrow and hard. Hardening of the arteries usually develops first in the legs and feet. The arteries become less elastic, narrow, and hard because of calcium deposits on the wall of the artery. The artery may completely close, preventing blood flow. The artery may be unable to dilate (become larger) to carry more blood especially during periods of exercise. The lack of blood flow can contribute to nerve and tissue injury and damage.

Symptoms

The early symptoms of PAD usually begin in the legs and feet. It may affect one leg or both legs to different extents. The symptoms of PAD are often mistaken for something else. Leg or hip pain, cramping, and tiredness are the most common symptoms of PAD. These symptoms typically occur while walking or climbing stairs and go away with rest. You may have difficulty walking. Your legs and feet may feel numb at rest. You may experience muscle pain in your thighs, calves, and feet. Your legs and feet may feel cold and appear pale or blue. Your legs and feet may lose hair. The pulse in your affected limb may be weak or absent.

Diagnosis
A doctor can begin to diagnose PAD by reviewing your medical history, conducting a physical examination, and testing your blood. Your doctor will check the pulse and blood pressure in your limbs. Imaging tests are used to view the condition of your blood vessels.

Your doctor may perform a simple non invasive measurement in the office called ankle-brachial index (ABI) where the blood pressure is measured to determine how elastic your arteries are. A Doppler ultrasound is used to create an image of your blood vessels when a device is gently placed on your skin. Intravascular ultrasound allows a view from inside of the blood vessel walls by using a catheter device. A dye and X-ray are used to show an image of the blood vessels with an angiography. Magnetic resonance angiography (MRA) produces extremely detailed views of the blood vessels.

Treatment

PAD is treated with medications and surgery. The purpose of treatment is to relieve symptoms and improve circulation. Medications may be used to thin the blood and open the arteries to increase blood flow. Surgery may be used to repair the lining of an artery, replace the affected artery with a graft, or bypass the affected area with a synthetic blood vessel or a vein. Balloon angioplasty, stents, and laser treatments may help as well.

Prevention

You may prevent PAD by reducing the risk factors that you have control over including your weight, blood pressure, diabetes, cholesterol, and activity level. You should quit smoking. It can be helpful to exercise regularly and eat a well-balanced diet. You should make and attend all of your doctor appointments.

Am I at Risk

Risk factors may increase your likelihood of developing PAD, although some people that develop the condition do not have any risk factors. People with all of the risk factors may never develop PAD; however, the chance of developing the condition increases with the more risk factors you have. You should tell your doctor about your risk factors and discuss your concerns.

Risk factors for PAD:

  • Cigarette smoking is a major risk factor for PAD. People that smoke may develop PAD 10 years earlier than nonsmokers.
  • People with a personal or family history of stroke or heart disease have a higher risk for PAD.
  • Obesity is a risk factor for PAD.
  • Diabetes is a high risk factor for PAD.
  • High blood pressure is a risk factor for PAD.
  • High cholesterol is a risk factor for PAD.
  • People with kidney disease involving hemodialysis are at risk for PAD.
  • PAD most frequently affects men ages 50 years old and older.
  • People that are physically inactive have a higher risk of developing PAD.

Complications

PAD may lead to foot or leg infection, sores, or ulcers. In some cases, especially among people
with diabetes, amputation may eventually be necessary. PAD can lead to impotence. PAD can cause dangerous embolisms, blood clots that travel in the bloodstream.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Pericarditis – Inflammation of the Heart Sac

Introduction

Pericarditis is an inflammation of the sac that surrounds the heart. When a cause can be found an infection, systemic disease, or autoimmune disorder most commonly causes it. Pericarditis can cause sharp stabbing chest pain and difficulty breathing. You should contact your doctor immediately if you suspect that you have pericarditis. It may be treated with medications or minor surgery. If left untreated, pericarditis can be life threatening.

Anatomy

The pericardium is a thin sac-like membrane that covers the outside of the heart and the roots of the blood vessels that are attached to the heart. The pericardium has an inner and outer layer. The layers have a small amount of lubricating fluid between them. The lubricant allows the layers to move easily when the heart contracts.

Causes

Pericarditis is an inflammation of the pericardium. In most cases, the exact cause of pericarditis is unknown. However, a viral, bacteria, or fungal infection may cause it. It can result from a heart attack, cancer that has spread, radiation treatment, injury, or surgery. It is associated with some medical conditions, including rheumatoid arthritis, lupus, kidney failure, tuberculosis, cancer, leukemia, HIV, AIDS, and hypothyroidism. In children, adenovirus or Coxsackie virus most frequently causes pericarditis.

Symptoms

Chest pain is a common symptom of pericarditis. The pain may spread to your neck and shoulder, back, or abdomen. The pain may be sharp and stabbing. Deep breathing, coughing, lying flat, and swallowing may cause your pain to increase. Sitting up or leaning forward may reduce the pain.

It may be difficult to breathe when you lay down. You may need to bend over or hold your chest while you breathe. You may not feel well in general and have a fever, dry cough, and anxiety. You may feel tired all of the time. Additionally, your ankle, feet, and legs may swell.

Diagnosis

You should contact your doctor immediately if you suspect that you have pericarditis. A doctor can begin to diagnose pericarditis after reviewing your medical history and conducting a physical examination and some tests. You should tell your doctor about your risk factors and symptoms. Your doctor will listen to your heart and lungs. Your blood will be tested for signs of infection or inflammation markers that may indicate pericarditis. In some cases, tests may be conducted to rule out a heart attack or the fluid from around the heart may be collected and cultured.

Imaging tests may be used to see if you have fluid buildup in the pericardium, signs of inflammation, scarring, or an enlarged heart. A chest X-ray, magnetic resonance imaging (MRI) scans, or computed tomography (CT) scans are common imaging tests. An echocardiogram uses sound waves to produce an image of the heart on a monitor. An electrocardiogram (ECG) can record the heart’s electrical activity which can be altered by pericarditis. Radionuclide scanning involves using a harmless radioactive dye that is detected by special scanners to create an image of the heart.

Treatment

The treatment that you receive depends on the cause of your pericarditis. Medications may be used to relieve pain, reduce fluid buildup and treat infections. In some cases, the fluid may need to be drained from the sac with a minor surgical procedure. The outcome for pericarditis is good if it is treated promptly.

Prevention

You should contact your doctor immediately if you suspect that you have pericarditis. Untreated pericarditis can lead to life-threatening medical complications.

Am I at Risk

Pericarditis most frequently affects men that are between the ages of 20 and 50 years old following a respiratory infection. People with influenza, systemic diseases, or autoimmune conditions have a risk of developing pericarditis. In some cases, pericarditis may occur as a result of a heart attack.

Complications

Chronic or untreated pericarditis can cause life-threatening medical problems. It can lead to irregular heart beats and heart failure.

 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.