Pinched nerve symptoms and locations

Pinched nerve symptoms depend on the location of nerves in human body. These appear in the part of the body that is affected. There are some pinched nerve symptoms that are common regardless of the nerves. This are pain (patient feels pain in the region innervated by that nerve), burning feeling (patients complain of burning sensation in the affected region) and change in symptoms based on body position (if the patient changes position the pain may disappear). Another pinched nerve symptoms are fecal incontinence (patient can control the stool) and urinary incontinence (inability to control urination). Also may appear decreased sensation in the affected area or numbness (patients feel affected region with tingling, feel that region asleep) and weakness (loss of strength). Feeling of weakness may occur in the whole body or a part of the body.

Other locations of pinched nerve symptoms

This may occur in the upper limb and can be caused by carpal tunnel syndrome (compression of the median nerve) or by cubital tunnel syndrome (compression of the cubital nerve). They are two nerves that innervate the upper limbs. Sometimes the pain may be to the neck and then the pinched nerve symptoms appear in the arm. If the nerve affected is in the low back, the pain can usually down to the leg. Usually can identify which nerve is affected because of where the pain occurs. One of the affected nerves is the sciatic nerve and this is a disease called sciatica.

When a person has some of the symptoms that have been discussed above, he must go to the doctor to diagnose a possible pinched nerve. The doctor will begin by asking the patient about the symptoms, work history and family medical history. Then the doctor will exam the affected part of the body involved for more information. Depending on these results the doctor can do additional tests.  If the pain is on the back or in the neck, the patient must make an X-ray of the spine for a possible differential diagnosis of arthritis.

Pinched nerve symptoms may be treated with rest or ice applied to the affected region. Various medications can be used for treatment of pinched nerve. Anti-inflammatory medications may reduce the inflammation. Another treatment for pinched nerve symptoms is physical therapy and as an extreme solution is surgery

Pinched nerve symptoms may persist and can give severe complications. These are peripheral neuropathy, carpal tunnel syndrome or cubital tunnel syndrome and tennis elbow (commonly found in tennis players and that is a condition in which the outer part of the elbow becomes painful).

              In conclusion pinched nerve symptoms may appear in different situations and patients with  this condition can be totally recovered.

What is cardiovascular disease

A question that scientists succeeded to answer but failed to cure.

Nowadays, when more and more people are suffering from heart disease we may wonder what is cardiovascular disease and why is it the first cause of death in most of the countries. We invest millions of dollars on research, looking and testing a lot of drugs, we even found out what is causing AIDS (and we succeeded to transform it in a „chronic” disease) and many other disease with strange names. But all the time there is a new disease, a new virus or bacteria that gives us trouble to treat and sometimes it feels that the more drugs we discover, the more diseases occur. Even so, the most frequent cause of death are cardiovascular disease, a group of diseases that seem to be entirely understood, with lots of article and medical research, that could make some wonder what else is left to discover. The truth it is far from being so, as with the medical treatment we have at this moment we can only slow down these disease and not cure. Even the prophylaxis of cardiovascular disease is not very promising as we live in the century of unhealthy foods, McDonald’s food, alcohol consumption, smoking, stress, sedentariness and we spend all out time watching TV and working on computer.

After we established how important these diseases are, now let’s finally find out what is cardiovascular disease.

What is cardiovascular disease? A group of disorders that affect heart, brain and blood vessels.

The most frequent cardiovascular diseases:

• hypertension: high blood pressure affects both brain and heart as it can determine bleeding (stroke) or small infarcts in the brain and also determine or worsen heart failure. Beside heart and brain, hypertension also affects eyes and kidneys.
• heart valve disease: valves fail to close or open properly and in time they can cause heart failure,
• irregular heart beats can cause fainting, shortness of breath, chest pain, fatigue or even heart failure,
• other heart tissues disorders: infection, metabolic disorders that affect heart (different disorders that can determine deposits of some substances in heart tissues like iron, copper etc)
• strokes: a blood cloth can block one of the brain blood vessels and make a variable brain area to die or a blood vessel may break and let blood flow into the brain (this usually occurs in patients with hypertension or with blood vessel malformations).
• atherosclerosis: fat deposits in the blood vessels wall that in time can determine strokes, heart attack, chest pain, arterial disorder with legs pain during walking and even during rest, in advanced cases, neurologic symptoms: dizziness, fatigue, fainting, drowsiness, memory and concentration dysfunction etc.

Now that we found out what is cardiovascular disease, let’s see how is treated. As we’ve seen, it is easy to answer what is cardiovascular disease, but is difficult to treat it. Treatment has two parts and two partners: the patient and the doctor. The patient should respect a healthy diet, with no salt, fats and sweets, attend regular exercise (jogging, running or any kind of sport), no smoking or alcohol consumption, keep a normal weight, control blood pressure and blood sugar. Doctors have a large number of drugs they can use, the purpose of this treatment is to slow down the disease and treat other disorders that may worsen cardiovascular diseases like high blood pressure, diabetes, high level of fats in the blood, infections, irregular heart beats etc. It is also important to prevent other cardiovascular events from happening, that’s why antiplatelet medication like aspirin is prescribed in patients that are suffering from cardiovascular disease.

We hope this article can offer a brief answer to the question what is cardiovascular disease and why this medical problem is so important in nowadays society.

In the last years more and more people complain from flu symptoms and every year new vaccines are elaborated. People started to be very worried about flu symptoms in adults especially after the outbreaks of avian flu and AH1N1 virus, even if the “common” flu virus could cause death too. Because of the large number of people vaccinated, contradictory opinions about the efficiency and possible complications coming from the vaccination began to appear  and the result was that many people refused the vaccine.

People also searched for ways to strengthen the immunity system and they choose to use different types of medication based on plants. In clinical practice, because of the large number of patients that died even if they had no risk factors associated, doctors started to treat pneumonia with antiviral and antibiotic medication. But the more the antiviral medication is used, the more the risk of developing resistance to this treatment increases.

Next we will talk about flu symptoms in adults and its complication.

Why are we so concerned about flu symptoms in adults? For many of us, flu is just a common disease; we all had it at some point and as some use to say it lasts 7 days if you treated or one week if you don’t. But are flu symptoms in adults so insignificant that doesn’t worth talking about? This is a false idea among us that flu symptoms in adults are common manifestations. The truth is that in some people flu symptoms in adults can be as devastating as cancer or heart disease.

The main flu symptoms in adults:

• fever-some wrongly believe that fever is determined only by bacterial infection. It is a wrong idea, both viruses and bacteria can determine high fever and they can disseminate to other organs through blood,
• shivers- the feeling of body shaking
• sweating-the body tries to lose some water in order to decrease the temperature,
• headaches
• rhinorhea-water discharge from the nose as we call it
• cough-first it can start as a dry cough, but  in a few days expectoration can appear, considering that even viral infection can determine a secondary bacterial infection,
• sore throat with pains that increase while trying to swallow
• severe aches and pains in muscle and joints
• generalized weakness and fatigue, feeling the need of lying down,
• being unable to eat,
• nausea and vomiting.

Flu symptoms in adults usually last a few days (about a week), but in some cases other complication can occur:

• pneumonia- a flu symptom in adults that seems simple to deal, can  get complicated with a lower respiratory tract infection like pneumonia. In patient with reduced immunity as are those suffering from AIDS, these infections can be fatal, even if for many of us it can be a common disorder.
• invasion of the virus in other organs through blood flow, which leads to a condition called septicemia, one of the worst flu symptoms in adults and an important threat to patient’s life,
• meningitis-if the viruses reach the nervous system, they can determine meningitis, which is an infection of the tissues layers that cover the brain and are called meninges.
• shortness of breath or fast breathing, bluish skin color (the blood hasn’t enough oxygen)
• neurologic symptoms: dizziness, drowsiness, confusion
• fulminant myocarditis
• pulmonary embolism (blood clots in the pulmonary arteries) seems to be linked to the infection determined by AH1N1 virus,

Complications are more common in people suffering from respiratory, cardiac disease obesity and of course, those with diminished immunity (like patients with AIDS).

As we saw, flu symptoms in adults can be common or can be very serious, depending of the aggressiveness of the virus, the immunity system of the host, the risk factors associated, but it is important to remember that it can be fatal (about 40.000 people died every year, in USA, in the past 20 years, because of the flu).

Stents in the heart are usually made of metal mesh or fabric (these ones are used in larger arteries). Some of these stents contain a special substance that prevent blood from coagulating and are called drug-eluting stents.

How are stents in the heart placed? 

Doctors use a balloon inside the artery to compress the plaque (deposits of fats in the arteries wall, also called atherosclerosis) and widen the passage (the arterial lumen through which will flow blood). After this, they place the stent in order to maintain the passage (the artery lumen) opened.

How do we prepare patients before placing stents in the heart?

Patients should be well informed about the stents in the heart procedure, about the risks and the special precautions. These are a few questions u must always ask your doctor about:

•  Why is it performed?
•  How is it performed?
•  What are the risks and precautions of this procedure?
•  Is there any other alternative?
•  What happens if I refuse this procedure?
•  Always sign a consent paper.

Why are stents in the heart placed for?

The purpose for stents in the heart placement is to keep the arterial lumen opened and allow blood to flow, in this way tissues will receive enough blood and the symptoms of ischemia (oxygen deprivation) will be relieved.

• For carotid arteries blockage: fat deposits in carotid arteries wall (also called plaques, they are a manifestation of the disease named atherosclerosis) can determine neurologic symptoms like dizziness, fainting, headache, memory and concentration problems and in severe cases even stroke.
• For coronary vessels (blood vessels that supply blood for heart tissues): a special tube called catheter is introduced in the femoral artery (the main artery of the lower limb) and it is conducted in the arterial system until it reaches the coronary arteries. In that moment, a special substance is pumped into the catheter in order to view the arteries and the blockage. This catheter has a tiny balloon on its tip, which is inflated in the narrowed area, compressing the atheroma (the plaque of fats from the artery wall that blocks blood flow) and enlarging the lumen. After this a stent may be placed to keep the lumen opened.
• For kidney or leg arteries, aneurysm of the aorta.
  

What are the common precautions after placing stents in the heart?

•  blood clotting precautions: in order to prevent blood clotting, patients with stents in the heart have to take antiplatelet medication (aspirin, clopidogrel)
•  if the stent is made of metal, than the patient can’t have MRI (magnetic resonance imaging)
•  avoid vigorous effort early after the stent placement procedure.
  

What risks are related to stents in the heart?

•  restenosis- blood vessel becomes blocked and narrow again, despite the angioplasty procedure
•  about 1 or 2 percent of the patients with a stented artery are at risk of developing a cloth at the stent site; the consequence of this complication can be a heart attack. This complication is more frequent in the first year after stent placement and can be prevented by antiplatelet medication (like aspirin, clopidogrel).
•  bleeding at the site of the catheter insertion into the skin
•  damage of the blood vessel produced by the catheter
•  irregular heart beats
•  infection or allergic reaction (due to the substance used to view the arterial lumen)

Stents in the heart brought a significant contribution in cardiology, saving and improving life in patients with heart attack and coronary disease.

How can estrogen hormones prevent heart pain in women?

It is simple. Estrogen has an important role in lipid metabolism: these hormones decrease the level of LDL-cholesterol and increase the HDL cholesterol (also called „the healthy” cholesterol as it protects against atherosclerosis). Estrogens tend to decrease serum cholesterol concentrations and to increase serum triglyceride concentrations. The overall effect of these changes, together with the effects on blood vessels, is to protect against atherosclerosis and heart pain in women before menopause. As atherosclerosis is the most important cause for heart attacks and chronic heart ischemia (heart disease caused by insufficient oxygenation of the heart tissues, which occurs when blood vessels are blocked by atherosclerosis) it is clear now why estrogen is so important and how can this hormone prevent heart pain in women.

Heart pain in women, what does it mean?

Heart pain in women or chest pain are very often among old patients and challenge the doctor to consider a lot of differential diagnosis, although sometimes it is almost impossible to separate them. For example, a pathology of the spine that presses nerve roots can determine an intense pain, sometimes unbearable, radiating towards the abdomen or chest and can easily mimic a heart pain. An esophagitis with burning sensation in the chest, can be mistaken as a heart symptom, but it responds well to the medication used in ulcer treatment and the duration of symptoms is variable. Heart pain in women doest mean necessary that it is a heart attack, sometimes it is caused by a heart muscle infection or disorder. Other causes for heart pain are abnormal dilated blood vessels called aneurism or chest trauma. In some patients, during heart attack, the pain is felt in the upper part of the abdomen and it can be confused with a stomach or liver disease (like ulcer, gastritis etc.).

How do we manage heart pain?

Heart pain it is always a very disturbing symptom, described by patients as a sensation of pressure on the chest or constriction, but sometimes, associated with palpitations (irregular heart beats), shortness of breath, fatigue, sweating, agitation or even fainting. In conclusion, heart pain in women and men  can be treated with beta-blockers (drugs that increase heart tissues oxygenation, an example of such a drug is metoprolole), calcium channels blockers (make heart blood vessels larger; e.g. amlodipine) or the well known nitroglycerin.

This article is mainly about the 7 weeks pregnant symptoms but we should specify that many times women find out they are pregnant after they are investigated for tiredness, morning sickness, nausea and vomiting (many times confused with a digestive disorder). Once they find out they are pregnant they begin to be worried about what is going to happen next, “is the baby all right?” ”doesn’t he/she suffering from a malformation”, “when will he/she move?”, “how does it feel when u have contractions”, “how will I gave birth, where?” etc. These are only a few questions young mother ask more often, but there are many others.

The main 7 weeks pregnant symptoms

What are the 7 weeks pregnant symptoms ? Before we enumerate  the 7 weeks  pregnant symptoms we should mention some information about the baby. At this age, your baby will measure about 4-5 mm, but by the end of the week he/she will grow significantly to about 13 mm. Even if the changes in your body aren’t so obvious, you will feel pregnant as other symptoms occur. One of the 7 weeks pregnant symptoms is weight gain, even if at this point it is just 1 or 2 pounds.

Other 7 weeks pregnant symptoms-the baby’s growth: the uterus has doubled its size, the neural tube is closed and the development of brain begins in this week, also nasal cavities and mouth are forming. The heart is already formed and the heart valves are about to be completed, the future lungs are growing and the intestines and digestives system begin to take shape, as other glands. By the week 7, limbs are visible on the echography, even the future fingers and toes and by the end of the week a smooth layer of skin will develop.

The 7 weeks pregnant symptoms include varied signs and symptoms as we will see next. One of the most frequent manifestations among 7 weeks pregnant symptoms is morning sickness (a symptom that usually occurs between 2-8 weeks after conception). This is one of the 7 weeks pregnant symptoms but can occur even from the first week and will diminish in time. As it happens frequently in medicine, there are exceptions: some women don’t have morning sick, nausea or vomiting during pregnancy, while others deal these symptoms throughout all of their pregnancy. The morning sickness will grow stronger in  weeks, the nausea will be moderate, also vomiting frequently occurs. Digestive symptoms must be carefully managed, as pregnancy is often associated with appendicitis, cholecystitis (inflammation of the gallbladder) or urinary stones.

Other manifestations among 7 weeks pregnant symptoms:

• fatigue-a symptom that can occur early in the pregnancy, even from the first week. Pregnant women feel more tired, even if they don’t make any effort, and the need of lying down and sleep is more intense, but this doesn’t mean they are sick; it is simply one of the changes related to pregnancy.
• headaches-hormonal imbalance related to pregnancy is the cause of these symptoms that can occur early in the pregnancy and usually tend to go away in the second trimester. Lack of sleep or dehydration, smoking, strong odors, chocolate, coffee, stress tends to play also a role in this. Some of the women experience intense headaches or even migraine (before taking any medication, you should consult your doctor to see the risks and benefits)
• excessive salivation-it is more frequent in women that experience morning sick.
• metallic taste-it is a less frequent 7 weeks pregnant symptoms, caused by hormones imbalance, and usually goes away in the second trimester.
• frequent urination- it is normal and it is caused by hormones imbalance. Also the amount of blood is larger in pregnant women, so the kidneys have a lot more to work.
• swollen or tender breasts, darkening of areolas -may start after 1-2 weeks after conception.
• lower backaches
• food craving or food aversion to certain types of food that can last the entire pregnancy not just for 7 weeks pregnant symptoms.

As we saw above, 7 weeks pregnant symptoms vary from one woman to another and seem unbearable for outsiders, but these symptoms are all forgotten once the mother holds her “miracle” in her arms.

In the next part of the article we will discuss about fibrillation of the heart, one type of irregular heart rate and what are the consequences for our body. Our heart is an organ that has a so called „automatism”, an intrinsic property of the cardiac tissue to create its own electric impulse, a signal that allows changes in cell metabolism in order to generate cardiac muscle contraction and therefore pumping blood into the arteries. This electric signal is generated in the sinus node (a structure capable of generating electric signal, located in right atrium) and then conducted through special structures until it reaches the ventricles (heart chambers that pump blood into the arteries). If these structures called pacemakers, can’t function normally, irregular heart rate occurs and one of them is fibrillation of the heart.

 What is fibrillation of the heart ?

What is fibrillation of the heart? And how many types of fibrillation of the heart exist? There are two types of fibrillation of the heart: one is called atrial fibrillation and another ventricular fibrillation. The difference between these types of fibrillation of the heart is not just in name, but also in origin and prognostic. The first type of fibrillation of the heart-the atrial fibrillation-is an irregular heart rate generated in multiple atrial cells (but not in the sinus node which is the „natural” heart pacemaker).

Patients with atrial fibrillation may experience palpitations, shortness of breath, chest pain, dizziness, drowsiness, fainting, but there are some patients that don’t complain of any symptom and they are diagnosed with the occasion of a routine medical check or when the complications occur. Usually, atrial fibrillation allows blood clots to form and they can flow in the arteries and block them, causing a condition known as ischemia: the tissues won’t receive enough blood and oxygen and cells start to die. In this situation, strokes, pulmonary embolism (clots in the pulmonary arteries that can lead to death), limbs ischemia (if untreated it can lead to amputation) can occur and can lead to patient’s death, if immediate  measures aren’t taken. On the electrocardiogram, in atrial fibrillation there is an irregular heart rate, without „P” waves (which are a mark of  heart rate generated by the sinus node) and the frequency of the heart beats can vary: low, average or rapid.

If this arrhythmia was discovered at its beginning, a conversion to the normal heart rate called sinus rhythm can be tried (either using medication or with electric shocks). After this procedure succeeded, other medication is needed in order to maintain the normal heart rate, to control the normal frequency of the heart beats and prevent blood clotting. In some patients, when the beginning of this arrhythmia is unknown, doctors will use only drugs to control the heart rate (beta blockers like metoprolole, atenolol; digoxin-a drug that increases heart contractility and also has antuarrthymic properties, very often used in the treatment of atrial fibrillation, calcium channel blockers like amlodipine, verapamil, diltiazem) and prevent blood clotting. Atrial fibrillation associated with rapid heart rate can be a severe medical condition affecting the level of consciousness and the only way to save patient life is the electrical conversion to the sinus rhythm using electric shocks.

The other type of fibrillation of the heart-ventricular fibrillation is an irregular heart rate generated in the ventricular cells and is not compatible with life, meaning that is one of the heart rate that generates cardiac arrest. Heart stops from beating and emergency measures of resuscitation are needed-cardiac massage alternating with artificial oxygenation of lungs, using facial masks with balloons or orotracheal intubation (which is preferred if it is possible to perform), electric shocks, specific medication like adrenaline, vasopressin, amiodarone. If in 30-45 minutes all these maneuvers are unsuccessfully, then the patient is declared dead.

As we saw above, fibrillation of the heart is a major heart disorder, that requires  special attention, knowledge, maneuvers and skills, since ventricular fibrillation is the most frequent cause of cardiac arrest in adults.

Before we discuss the matter of heart palpitations at night, we have to clarify the meaning of the word “palpitation” in general. Palpitations refer to irregular heart beats, usually the heart beats to fast, or with pauses from time to time and gives us an abnormal sensation, sometimes associated with dizziness, light-headed sensation, shortness of breath, chest pain etc.

We all had palpitation at least once in our life, and this doesn’t mean we have a heart disease, because these symptoms occur in healthy people during exercise or associated to stress, smoking, coffee. Even so, if the palpitation persist or are associated with shortness of breath, chest pain, fainting, dizziness, a doctor should be consulted as soon as possible.

Some patients complain they have heart palpitations at night, which prevent them from falling asleep or wake them up in the middle of the night.

Heart palpitations at night -causes:

Normal heart rate for an adult is 60-90 beats/minute. If the heart rate is higher the 90 beats per minute, then the condition is called tachycardia and can provoke palpitation. Not only rapid heart rate can cause palpitation but also irregular heart beats, known as arrhythmia, which is the main cause behind palpitation. Why some patients experience heart palpitations at night, during rest, when heart labor is smaller?

Heart palpitations at night can be determined by one of the following cause:

• too much stress and anxiety gathered during the daytime. It is a habit now that every time we go to sleep, we think again at the daily problems and try to find a solution, as it is said night is a good adviser. If your mind is concerned about certain problems happening in your life, you may be lying down and think about it over and over again, but the emotions and the psychical tension can generate palpitation.
• excessive consumption of caffeine before sleeping can generate insomnia and palpitation, if you drink a lot of coffee, especially before sleeping, you may consider giving up.
• smoking
• alcohol consumption
• medication-some drugs used to treat different diseases (like asthma, heart diseases, high blood pressure, cold) can determine palpitation: pseudoephedrine used in cold medication, theophylline for asthma etc.
• pregnancy
• fever-it is well known that body temperature elevation is associated with rapid heart beats and sometimes with palpitations
• vigorous exercise before sleeping
• breathing problems determined by lung diseases determine a low level of oxygen in the body, which can lead to heart palpitations at night
• heart problem-patients with heart failure may develop paroxysmal nocturnal dyspnea (shortness of breath that occurs suddenly during night in patient with left heart failure) and palpitations, forcing them to wake up and search for an open window to get fresh air
• hyperthyroidism (a higher level of thyroid hormones can determine irregular or rapid heart beats)
• elevated blood pressure

If I have heart palpitations at night-how can my doctor discover if there is something wrong in my body?

Yes it is possible. For patients that have these symptoms only during night it is difficult to  diagnose them during a simple medical visit, but if a special device called holter ecg is used, then this is no longer a problem. Holter ECG is a portable medical device that the patient “wears” for 24 hours and it records heart activity during this period of time.

Heart palpitations at night-treatment

Heart palpitations at night can be treated only after proper tests are made in order to establish the correct diagnosis. In many cases, palpitations have no serious cause and a short time treatment associated with a life style change can be the “cure”.

Special precaution in patients with heart palpitations at night:

• avoid consumption of alcohol, coffee, drugs (marijuana, cocaine) or smoking
• avoid stress and anxiety-there are many types of techniques used against anxiety (psychotherapy, sports, taking vacation, travelling etc.)
• sometimes medication is needed in order to control anxiety
• respect your hours of sleep
• avoid if possible the intake of medication that stimulate palpitations

Heart palpitations at night can be very uncomfortable, but sometimes a simple change in the  daily habits can make them disappear.

Replacement heart valve surgery basics

There are four valves in our heart: mitral valve, aortic valve, pulmonary valve and tricuspid valve. These valves may have opening of valve problems (stenosis) or closing of valve problems (regurgitation). Interventional treatment (especially replacement heart valve surgery) is necessary when patients have symptoms for these lesions.

We can not expect that valve lesions consists have a spontaneously regressive evolution and therefore the most common method of treatment is the replacement hear valve surgery. There are cases when multiple heart valves are affected. The surgery is performed by repairing or replacing the heart valve. Replacement heart valve surgery is surgery that is performed when the valve can not be repaired and the heart valve is replaced with a prosthetic valve. Before replacement heart valve surgery patients will receive general anesthesia during which they will be asleep and will not feel pain. The most replaced valves are mitral valve and aortic valve. There two kinds of valves used for the replacement heart valve: mechanical valves and biological valves. Biological valves may come from pigs, cows or human donor. Biological valves from human donor may be heart valves or pulmonary valve especially for aortic valve replacement. Mechanical valves are much better then biological valves. After replacement heart valve surgery with mechanical valve patients must follow treatment with anticoagulants or with aspirin for the rest of his life.

Mitral stenosis and mitral regurgitation

Replacement heart valve surgery for mitral stenosis is indicated in patients suffering from medium or large stenosis (mitral valve orifice of less than 1 inch or symptomatic patients and mitral valve opening more than 1 inch).  The most common cause of mitral stenosis is rheumatic disease. Prophylactic replacement heart valve surgery for mitral stenosis may be made to women who want to have a child.

Replacement heart valve surgery can also be done for mitral regurgitation. But this can have some disadvantages: first because replaced valve can not function as original valve and second because may be some complications of surgery (embolism, infection in the body, coagulation changes or endocarditis – infections of heart valve).

Aortic stenosis and aortic regurgitation

Aortic valves are different from mitral valves such as structure and function. Replacement heart valve surgery is done both for congenital aortic stenosis and for acquired aortic stenosis. Indications for surgery can be done to symptomatic patients or to patients with moderate aortic stenosis who have other heart surgery.

Replacement heart valve surgery for aortic regurgitation is an easy surgery to replace aortic valve. Mortality of this intervention is quite high.

Complications related to valve replacement are increasingly rare lately and when they occur is necessary a new surgery.

In conclusion replacement heart valve surgery is a very good technique to solve valvular heart problems.

When we hear talking about   exertional dyspnea or in other words “shortness of breath” one must think to the difficulty of breathing when is doing an exercise or easier said, lack of comfort in breathing. But isn’t it normal to experience some kind of dyspnea when we are exercising? Apparently not! In the next article I’m going to explain what is exertional dyspnea, when it appears, when we say this condition is pathological or not and what causes it.

The word “dypnea” is originally composed from two greek words: “dysp” which means hard, heavy, difficult and “pnoia” that means breathing. If we combine these two words we have “hard breathing”also said dyspnea. Dyspnea is a breathing disorder characterized by changing the pace and intensity of respiratory movements.

Exertional dyspnea is frequently overlooked because it can occur to healthy people and is frequent confused with fatigue. It isn’t always a pathological symptom. You can experience exertional dyspnea when you are exercising more than your body is used to, if you have a weight problem (you weigh to much or you are obese), if you are an active smoker, or if the air around you is polluted.

Exertional dyspnea becomes pathological and that means that we should worry and go see a doctor when even if we make the same exercise as we did before we feel like our lungs aren’t getting enough air.

 But how does exertional dyspnea appear ?

Dyspnea due to illness can occur when there is an imbalance between tissue oxygen demand, and the amount of oxygen that the body can provide. Many diseases can give exertional dyspnea , the most common being:

• anemia (lack of blood) - Shortness of breath is accompanied by pale skin

• disease with increased energy consumption (as in cancers with different locations, hyperthyroidism, and uncompensated diabetes
• lung disease (dyspnea by lack of oxygen) of various causes, dyspnea is accompanied by coughing and / or wheezing and  sputum
• heart disease – exertional dyspnea occurs first and then it can occur during  rest or lying down, the patient can also feel palpitations and chest pains
• serious liver disease (cirrhosis) - liver as “laboratory” of the body, shortness of breath occurs in cirrhosis by multiple mechanisms
• severe kidney disease - shortness of breath occurs with changes in fluid and electrolyte balance or anemia (erythropoietin synthesized by  kidney, substance that stimulates the bone marrow to manufacture red blood cells that are the cells that  transport oxygen around the body)
• hypertension – exertional dyspnea  occurs by forcing the heart and the  blood vessel
• obesity (fat in the chest and abdomen pressed, preventing the movement of breath, plus a larger amount of tissue needs a greater amount of oxygen).

As you can see there are many conditions that can  manifest as exertional dyspnea, some of them  really serious diseases and that’s why is very important to go see a doctor whenever you notice changes in your breathing rhythm or you experience respiratory problems.