Senin, 12 Januari 2015


arteriogram showing coronary arteries of healthy h

Bring up heart disease, and most people think of a heart attack. But there are many conditions that can undermine the heart's ability to do its job. These include coronary artery disease, cardiomyopathy, arrhythmia, and heart failure. Keep reading to find out what these disorders do to the body and how to recognize the warning signs.
Heart disease is the No. 1 killer of U.S. men and women, accounting for 40% of all U.S. deaths. That's more than all forms of cancer combined.
Why is heart disease so deadly? One reason is that many people are slow to seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to call 911. But heart symptoms aren't always intense or obvious, and they vary from person to person and according to gender.
Because it can be hard to make sense of heart symptoms, doctors warn against ignoring possible warning signs, waiting to see if they go away, or being quick to blame them on heartburn, muscle soreness, or other less serious, noncardiac causes. That's especially true for people over 65, as well as for people with heart risk factors, such as high cholesterol, high blood pressure, obesity, smoking, diabetes, or a family history of heart disease.
"The more risk factors you have, the higher the likelihood that a symptom means something is going on with your heart," says David Frid, MD, a cardiologist at the Cleveland Clinic. "People often don't want to admit that they're old enough or sick enough to have heart trouble. Putting off treatment for other medical problems might not be so bad, but a serious heart problem can mean sudden death."

12 Heart Symptoms Never to Ignore

Here are a dozen symptoms that may signal heart trouble.
1. Anxiety. Heart attack can cause intense anxiety or a fear of death. Heart attack survivors often talk about having experienced a sense of "impending doom."
2. Chest discomfort. Pain in the chest is the classic symptom of heart attack, and "the No. 1 symptom that we typically look for," says Jean C. McSweeney, PhD, RN, associate dean for research at the University of Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer in research on heart symptoms in women. But not all heart attacks cause chest pain, and chest pain can stem from ailments that have nothing to do with the heart.

Heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. The pain has been likened to "an elephant sitting on the chest," but it can also be an uncomfortable sensation of pressure, squeezing, or fullness. "It's not unusual for women to describe the pain as a minor ache," McSweeney says. "Some women say the pain wasn't bad enough even to take a Tylenol."
Atrial fibrillation, also known as AFib, happens when your normal heart beat or rhythm is changed and may not be able to pump enough blood. About 1% of Americans have AFib.
Millions of people with long-lasting AFib live quite well, said Gordon F. Tomaselli, MD, director of the Division of Cardiology at Johns Hopkins University School of Medicine and a past president of the American Heart Association. "It's very possible to live a normal life for many years."
If you or someone you know has been diagnosed with AFib, it’s important to separate the myths from the facts. Here’s what you need to know:
Myth: People with atrial fibrillation shouldn't drive.
Fact:  "This is not true," Tomaselli says. "It really depends on your symptoms. If you have dizziness, lightheadedness, and are passing out, then clearly you shouldn't drive until your symptoms are cared for." Once your condition is under control through medication or other treatments, it's OK to drive, he says.
Myth: People with atrial fibrillation shouldn't have sex.
Fact: "That's false," says Dr. Richard Wu, MD, a professor of internal medicine at the University of Texas Southwestern Medical Center. "There is no medical reason for them not to. Simply having AFib does not mean having to give up intimacy."
Myth: You can get AFib from drinking coffee.
Fact:  There's no link between drinking coffee in moderation and AFib, Wu says. "Actually, it's the opposite. A moderate amount of caffeinegives you a lower risk."
Myth: Eating ice cream or drinking something cold always leads to AFib.
Fact: Some people’s heart rhythms do change after having cold drinks or eating ice cream, Wu says. This is because your food pipe, oresophagus, which can be sensitive to cold, runs right behind the top part of your heart, which is where the heartbeat gets changed in AFib, Tomaselli says. Because the esophagus and the heart are close together, you might have an irregular heartbeat.
This doesn’t mean you can’t eat your favorite ice cream again. Many people with AFib aren’t affected this way, and even in many who are, it won’t be a trigger every time, Tomaselli says. 

A new anti-clotting drug to reduce the risk of dangerous blood clots and strokes in people with a type of heart rhythm disorder has been approved by the U.S. Food and Drug Administration.
Savaysa (edoxaban) is approved to treat people with atrial fibrillationthat's not caused by a heart valve problem. Atrial fibrillation -- the most common type of heart rhythm disorder -- increases the risk of developing blood clots that can travel to the brain and cause a stroke.
Savaysa pills are also approved to treat deep vein thrombosis andpulmonary embolism in people already treated with an injected or infused anti-clotting drug for five to 10 days, according to the FDA.
Deep vein thrombosis is a blood clot that forms in a deep vein, usually in the lower leg or thigh. Pulmonary embolism is a potentially deadly condition that occurs when a deep vein blood clot breaks off and travels to an artery in the lungs, blocking blood flow.
"In patients with atrial fibrillation, anti-clotting drugs lower the risk of stroke by helping to prevent blood clots from forming in the heart," Dr. Norman Stockbridge, director of cardiovascular and renal products in the FDA's Center for Drug Evaluation and Research, said Thursday in an agency news release.
"It is important to have a variety of these types of drugs available as options for patients," he added.
The FDA approval of Savaysa is based on clinical trials that included more than 29,000 people.
In patients with atrial fibrillation, Savaysa reduced stroke risk as well as warfarin, a commonly used blood thinner, but with less major bleeding, the agency reported.
In the treatment of pulmonary embolism and deep vein thrombosis, slightly more patients taking warfarin had a recurrence compared to those taking Savaysa (3.5 percent versus 3.2 percent, respectively), according to the news release.
Savaysa carries a "boxed warning" alerting doctors that the drug is less effective in patients with poor kidney function. It recommends these patients be given another type of anti-clotting medication.
Savaysa is made by Daiichi Sankyo Co., Ltd. of Japan.

What Is a Normal Heart Rhythm?

The heart has four areas, or chambers. During each heartbeat, the two upper chambers (atria) contract, followed by the two lower chambers (ventricles). This is directed by the heart's electrical system.
The electrical impulse begins in an area called the sinus node, located in the right atrium. When the sinus node fires, an impulse of electrical activity spreads through the right and left atria, causing them to contract, forcing blood into the ventricles.
Then the electrical impulses travel in an orderly fashion to areas called the atrioventricular (AV) node and HIS-Purkinje network. The AV node is the electrical bridge that allows the impulse to go from the atria to the ventricles. The HIS-Purkinje network carries the impulses throughout the ventricles. The impulse then travels through the walls of the ventricles, causing them to contract. This forces blood out of the heart to the lungs and the body. The pulmonary veins empty oxygenated blood from the lungs to the left atrium. A normal heart beats in a constant rhythm -- about 60 to 100 times per minute at rest.

What Is Atrial Fibrillation?

Atrial fibrillation (also referred to as AF or Afib) is the most common type of irregular heartbeat. It is found in about 2.2 million Americans. Its frequency increases with age. If you have AF, the electrical impulse does not travel in an orderly fashion through the atria. Instead, many impulses begin simultaneously and spread through the atria and compete for a chance to travel through the AV node.
The firing of these impulses results in a very rapid and disorganized heartbeat. The rate of impulses through the atria can range from 300 to 600 beats per minute. Luckily, the AV node limits the number of impulses it allows to travel to the ventricles. As a result, the pulse rate is often less than 150 beats per minute, but this is often fast enough to cause symptoms.

What Are the Symptoms of Atrial Fibrillation?

You may have atrial fibrillation without having any symptoms at all. If you have symptoms, they may include:
  • Heart palpitations (a sudden pounding, fluttering, or racing feeling in the chest)
  • Fatigue or lack of energy
  • Dizziness (feeling faint or light-headed)
  • Chest discomfort (pain, pressure, or tightness in the chest)
  • Shortness of breath (difficulty breathing during normal activities or even at rest)

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