health matters

Living with CML

Learning that you have a blood disorder can be the most challenging part or situation in your life.

Just last month, I had my bone marrow test done due to the elevated white blood cell  count when I had my CBC on June. Alarmed that it reached up to 100,000 , my mom and I decided to seek a hematologist as recommended by my other doctor.

The bone marrow aspiration/biopsy test result revealed what I had and it’s CML or what we call chronic myelogenous leukemia/chronic myeloid leukemia. Never expected to have this kind of serious condition other than my thyroid problem.

To be honest, I had no clue as to how and where I got this illness and to be exact, my white blood cell count started to elevate just last year, but this case has been always ruled out until such time I had my bone marrow test done that it confirmed that I have this blood problem.

I didn’t even know if this CML is what had caused my on and off fever as well as difficulty in breathing last month which also led to my hospitalization.

So ,  I and my parents started to process the requirements and papers needed for the O.A.T.H (Organized Assistance to Treatment and Healthcare) program to avail of the medicines I was prescribed to take. We visited Can-Care Adxto in Makati and Vanguard Screening Solutions, Inc. in Ortigas to submit the requirements that we had. I just hope and pray that the one in charge of these would approve of my request . The trip was quite tiring but we had to finish what needed to be done.

I’ve been battling this blood problem or cancer this year for a month (since July 25) . At first, I didn’t want to think that this is really a cancer or a serious illness since the day I’ve been diagnosed. I was in denial at first since I’ve never had one in my family member with leukemia but then, family history plays no role in this type of chronic illness (or so I thought – please correct me if I am wrong).

I just really hope and pray that by the time I get back home from the province, I’ll be able to avail of the donated medicine from the Novartis oncology, with the help of the PCSO and the O.A.T.H program.

Just then, I had this on and off fever again last Tuesday– September 6,2016, the day I was about to travel to my mom’s province. I thought to myself that maybe this wasn’t the Lord’s plan yet to let me travel as He doesn’t want me to be harmed or even get too tired. Dark, red spots would start to appear on both my left and right hand, increasing as they would. This might either be a symptom of my illness , or a side effect of the medications I’m taking for my chronic myeloid leukemia.

 

 

 

 

 

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health matters

Health Talk: Chronic Myelogenous Leukemia

 

Normal blood vs. Leukemia
Normal blood vs. Leukemia

What Chronic Myelogenous Leukemia Is

Chronic Myelogenous Leukemia or CML is a type of a cancer affecting one’s blood cells and bone marrow. This condition is also called chronic myeloid or chronic granulocytic leukemia. Chronic myelogenous leukemia is an uncommon type of cancer of the blood cells, which progresses more slowly than acute forms of leukemia and affects older adults.

There are 3 phases of chronic myelogenous leukemia:
1) Chronic phase – this is the earliest phase which generally has the best response to treatment.

2) Accelerated phase – this is a transitional phase wherein the disease or condition gets aggressive.

3) Blastic phase  – this type of phase is the most severe and can be life-threatening.

How Is CML being diagnosed?

A series of laboratory tests is being performed to determine if a patient has CML. These tests are: 1) blood tests (complete blood count), 2) physical exam, 3) tests to look for Philadelphia chromosomes and 4) bone marrow tests (bone marrow biopsy and bone marrow aspiration).

What Are the Symptoms of Chronic Myelogenous Leukemia?

CML signs and symptoms may include the following: 1) fatigue , 2) weight loss, 3) loss of appetite, 4) pale skin, 5) night sweats, 6) fever , 7) easy bleeding and 8) pain or fullness below the ribs on the left side.

What Causes Chronic Myelogenous Leukemia?

There are several factors that possibly cause this type of condition: 1) development of an abnormal chromosome, 2) genetic mutation of abnormal chromosomes, 3) diseased blood cells created by the new gene

A human cell normally contains 23 pairs of chromosomes which hold the DNA that contains the instructions in controlling the cells in the body. In CML patients, chromosomes in the blood cells swap sections with each other wherein a section of chromosome 9 switch places with a section of chromosome 22, creating an extra short chromosome 22 (Philadelphia chromosome) and an extra long chromosome 9.

This Philadelphia chromosome then creates a new gene called BCR-ABL from the genes of chromosome 9 combined with genes from chromosome 22. This new gene contains instructions that command the abnormal blood cell to produce too much of a protein which we call tyrosine kinase, thus promoting cancer by allowing certain blood cells to go out of control.

A human blood cell originates in the bone marrow (a spongy material inside the bones). When a bone marrow functions normally, it produces immature cells in a controlled manner. These blood stem cells then mature and specialize into various types of blood cells circulating in a human body – red blood cells, white blood cells and platelets. In CML, this doesn’t work properly as the tyrosine kinase caused by BCR-ABL gene produces too many white blood cells which most, or all, contain the abnormal Philadelphia chromosome. The diseased white blood cells would build up in huge numbers, crowding out the healthy white blood cells and damaging the bone marrow.

Who  are at risk of CML?

There are 3 risk factors having this condition: 1) older age , 2) being a male, 3) exposure to radiation (e.g. radiation therapy) . Family history is certainly not a risk factor of this .

What Are Or Maybe The Possible Complications?

When left untreated, Chronic Myelogenous Leukemia may cause a variety of complications such as: 1) pain (bone or joint), 2) infection, 3) fatigue, 4) enlarged spleen and 5) death.

Treatment

CML treatments such as Dasatinib (Sprycel), Imatinib (Gleevec), Ponatinib (Iclusig), Nilotinib (Tasigna) and Bosutinib (Bosulif) are designed to attack cancer by focusing on a specific type of cancer cells that allow them to grow and multiply. In CML, the target or goal of these drugs is the tyrosine kinase , a protein produced by the BCR-ABL gene.

Aside from these targeted drugs, there are also different treatments for CML like chemotherapy, biological therapy, blood stem cell transplant, clinical trials and even alternative medicines such as relaxation techniques, aromatherapy, massage, meditation and acupuncture

Image Source:

http://cancerhawk.com/2012/10/19/got-chronic-myelogenous-leukemia-get-to-the-national-cml-society/

 

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Health Talk: Chronic Lymphocytic Leukemia

What Chronic Lymphocytic Leukemia Is

Chronic Lymphocytic Leukemia or CLL is a type of cancer affecting the blood and bone marrow (a spongy tissue inside the bones where blood cells are made).

“Chronic” comes from the fact that this type of cancer typically progresses more slowly than any other types of leukemia do while “lymphocytic” comes from the cells being affected by this disease which can most commonly affect older adults.

What the Symptoms Are

Many patients with CLL may have no early symptoms. Those who do may experience fatigue, fever, enlarged but painless lymph nodes, night sweats, frequent infections , weight loss and pain in the upper left portion of the abdomen which may be caused by an enlarged spleen.

What Causes CLL?

Even doctors cannot be certain what process usually causes this type of disease to occur except that something happens in order for the cancer cells to mutate genetically in the DNA of these blood-producing cells which may possibly cause the blood cells to produce abnormal and ineffective lymphocytes.

When these abnormal lymphocytes are beyond ineffective, they continue to live and multiply when the normal ones would die, accumulating in the blood and certain organs where they could cause complications. These abnormal lymphocytes would crowd healthy cells out of the bone marrow and interfere with the production of normal blood cells.

What Are The Risk Factors?

What could possibly put you at risk for having this illness are your race, exposure to chemicals, age, gender, and most importantly , your family history of blood and bone marrow cancers.

White people are more likely prone to develop CLL than people of other race do, most especially men. People who are 60 years of age are mostly diagnosed with this kind of disease. Chronic lymphocytic leukemia is mostly inherited- your family history of blood and bone marrow cancers may increase your risk.

Exposed to chemicals? They can also put you at risk, including certain herbicides and insecticides.

What Are The Complications?

Untreated CLL may possibly cause complications such as immune system problems, frequent infections, switch to a more aggressive form of cancer and lastly, increased risk of other cancers.

Note: I may not have this condition, but I still am curious to the point that I decided to research about CLL and make a write up.

 

 

 

 

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Health Talk: Broken Heart Syndrome

Ever wondered if it’s possible that you could die of a broken heart? It is … whether you’ve received a bad news (most especially death of a loved one) , got rejected by the person you like or have been crushing on, or whatever stressful situation you’re facing right now, you could or might experience this kind of condition called “Broken Heart Syndrome” or otherwise known as “Stress Cardiomyopathy and “Takotsubo Cardiomyopathy.

A broken heart syndrome or Takotsubo Cardiomyopathy is characterized by the weakening of the heart’s left ventricle. This could be misdiagnosed as a heart attack as the test results and symptoms are similar. There’s  good news and bad news about this syndrome: the good one is a broken heart syndrome can be treated well while the bad news is that this condition can lead to severe, short-term heart muscle failure.

This kind of condition may be brought about by the heart’s reaction to a surge of stress hormones. Takotsubo Cardiomyopathy is a temporary heart condition and people who have this may experience sudden chest pains or even think that they have a heart attack. In this stage, a temporary disruption occurs in a person’s normal heart pumping function where as the remainder of the heart normally functions or even contracts more forcefully.

Common symptoms that people with this condition might experience are shortness of breath and chest pain. A sign that a patient with a broken heart syndrome is having a heart attack is usually a long-lasting or persistent chest pain.

What usually causes this kind of condition is unclear to anyone though stress hormones or a temporary constriction of the heart’s small or large arteries may be possible factors. A broken heart syndrome may even be preceded by an intense emotional or physical event such as a frightening medical diagnosis, news of an unexpected death of a loved one, natural disasters, job loss, public speaking, physical stressors (e.g. asthma attack , majory surgery or car accident), divorce, loss of money,  domestic abuse or even a surprise party. Other possible causes of this syndrome are drugs such as Duloxetine,  Levothyroxine, Epinephrine and Venlafaxine.

Women are most likely to experience this heart condition than men do, especially those who are 50 years and above.There are rare cases that a broken heart syndrome is fatal but most people who have or experienced  this condition recover quickly. Some patients with this condition may need or require to have a coronary angiography test done, depending on the doctor’s order.

heart

Health Talk: Mitral Valve Stenosis

What Mitral Valve Stenosis Is

Mitral Valve Stenosis is a type of heart condition in which the mitral valve does not open wide, in contrast to that of a mitral valve prolapse. With mitral valve stenosis, the valve becomes stiff or scarred, or rather, the flaps are partially joined together.

When a mitral valve fails to open properly, blood flowing through the left ventricle is being blocked. A patient with this kind of condition may feel tired and experience shortness of breath.

What Causes Mitral Valve Stenosis

A possible cause of mitral valve stenosis is an infection called rheumatic fever which may scar the mitral valve. Other possible causes of this condition are congenital heart defect, endocarditis, hardening of the valve or other parts due to aging or severe kidney disease and even conditions causing the scarring of valve such as lupus or rheumatoid arthritis.

What Are The Symptoms of Mitral Valve Stenosis?

Though this type of condition is a lifelong disease, some symptoms won’t seem to show or usually take 10 to 20 years to develop. Early symptoms of mitral valve stenosis are often mild, however, in the later stages, this type of heart condition may damage the left atrium when left untreated, making the symptoms even worse.

Some symptoms that a patient with mitral valve stenosis may experience fatigue or weakness, palpitations, shortness of breath, and an irregular heart rhythm, as well as skin discoloration, trouble swallowing, chest pain and even hoarseness or vocal cord paralysis.

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Health Talk: Alcoholic Cardiomyopathy

Are you fond of drinking liquor or alcoholic beverages? Do you feel like it would help you relax and solve problems?

What Alcoholic Cardiomyopathy Is

Alcoholic cardiomyopathy is a type of heart condition caused by abuse of alcohol, most especially when it is long term as it weakens and causes the heart muscle to become thin, resulting to failure of the muscle to pump blood and depriving the body tissues of oxygen. This could also lead to other health problems or death. Alcohol cardiomyopathy is a form of a heart muscle disorder called dilated cardiomyopathy.

This type of heart disease affects both men between 35 and 50 years of age and women who have typically smaller body sizes and drink less alcohol.

Causes

Alcohol abuse can possibly affect many internal organs, most especially the heart, by causing physical and chemical change in one’s body. There are several ways in which alcohol abuse can affect or damage one’s heart, such that the damaged heart muscle fails to pump enough blood which then causes the heart to enlarge in order for it to hold extra blood.

Abuse of alcohol can also cause the blood pressure to increase and further stress the heart and blood vessels , causing further damage to the heart muscle , valves as well as the blood vessel itself due to overwork.

Symptoms

A person with this type of heart condition is likely to experience symptoms like a rapid and irregular heartbeat, swelling of legs, an enlarged liver, cough (producing a  frothy, pink mucus), rapid and irregular pulse, fatigue, weakness, dizziness and fainting. Worse, alcoholic cardiomyopathy could result to congestive heart failure and death.

Diagnosis

A person with alcoholic cardiomyopathy may be asymptomatic at the first place or would not even experience the symptoms until the disease gets critical. During physical examination, a patient’s pulse and blood pressure are being checked first before listening to his or her lungs and heart.

Signs of congestive heart failure that can be detected by a doctor during examination are swelling of the vein in the neck, swelling of legs, ankle and feet, enlarged heart, sounds of congestion in the heart and lungs and sounds of heart murmur due to valve damage.

Though lab tests may not be that useful when it comes to diagnosing this type of heart disease, they can help check or look out for damages in a patient’s other body system and organs and these tests involve liver function, cholesterol level and blood chemistry.

Diagnostic imaging tests such as echocardiogram, ECG, chest x-rays, and catheterization are also being done to examine a patient’s heart and lungs.

Treatment

This condition may be partially reversible if the condition is being treated properly and when the patient completely abstains from alcohol use, giving room for recovery. This depends on how long the patient has been using alcohol and how much is being consumed. However, if the heart is already damaged, the prognosis for complete recovery is poor.

heart

Health Talk: Aortic Dissection

What Aortic Dissection Is

Aortic Dissection is a serious type of heart condition wherein a tear is found at the inner layer of the aorta, allowing the blood to surge through it and causing the aorta’s inner and middle layers to dissect or separate. This type of condition can become fatal when the blood-filled channel ruptures through the aorta’s outer wall. This type of condition may seem relatively uncommon and frequently occurs in men in their 60s and 70s.

Aortic dissection may be classified into two groups : Type A – a more common and dangerous type wherein a tear is involved in the part of the aorta and exits the heart or even a tear in the ascending aorta extending to the abdomen and Type B- a type of aortic dissection in which a tear is found only in the descending aorta which may also extend into the abdomen.

Symptoms

Just like any other heart conditions,  symptoms of aortic dissection are sudden severe pain in the chest and back, loss of consciousness, shortness of breath,  difficulty in speaking, loss of vision, weakness or paralysis on one side of the body, weak pulse in one arm and mostly, heart attack.

Causes

A possible cause of aortic dissection is a weakened aortic wall in which the aortic tissue is susceptible to tearing due to stress caused by chronic high blood pressure. Other types of heart conditions such as bicuspid aortic valve, an enlarged aorta, Marfan syndrome and even rare illness associated with weakening of walls in the blood vessels may possibly cause this kind of heart problem. Aortic dissection is rarely caused by traumatic chest injuries, most especially brought about by motor vehicle accidents.

Risk Factors

Possible risk factors for this type of heart condition include atherosclerosis (hardening of arteries) , hypertension, bicuspid aortic valve, aortic coarctation (narrowing of aorta) , and pre-existing aortic aneurysm.

These risks are increased by certain genetic diseases like Marfan syndrome, Turner’s syndrome, inflammatory or infectious conditions and other connective tissue disorders (e.g. Ehlers-Danlos syndrome –a disease in which a group of connective tissue disorders are characterized by skin that is easily bruised or teared, fragile blood vessels and loose joints.)

Other potential risk factors for aortic dissection involve high-intensity weightlifting, cocaine use, pregnancy, sex and age.

Complications

When not treated properly,  this type of heart condition may lead to complications such as organ damage (e.g. kidney failure and life-threatening intestinal damage) , stroke, aortic valve damage (aortic regurgitation) /rupture into the heart’s lining (cardiac tamponade) , stroke and worse, death due to severe internal bleeding.

Treatments and Drugs

Treatment for aortic dissection include surgery and medications, depending on its type or classification. For Type A aortic dissection , much of the dissected aorta is removed by surgeons in order to block the entry of blood through the aortic wall and reconstruct the aorta with a graft. The aortic valve may be replaced at the same time , should a leak occur in the aortic valve as a result of a damaged aorta. As for the medication, beta-blockers and Nitropress may be taken to reduce the heart rate and lower the blood pressure, in order to prevent worsening of aortic dissection. These medications are used for patients with Type A aortic dissection so as to stabilize blood pressure before establishing a surgical operation.

For Type B aortic dissection, on the other hand, a type of surgery done is somehow similar with that of Type A aortic dissection, only that sometimes small wireless tubes called stents which act as scaffolding are being used or placed in the aorta to repair this complicated type of condition. However, the medications used in treating Type A aortic dissections may also be used  to treat patients with Type B aortic dissection without performing any surgery.

After the treatment, patients with this type of condition  are required to take blood pressure lowering medication for their entire life and have follow up CT scans or MRIs in order to monitor their illness.

Prevention

To further reduce or prevent the risk of aortic dissection, patients should coordinate with their doctor, control their blood pressure, maintain an ideal weight, wear seat belt (for safety purposes),  and avoid smoking.

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Health Talk: Tachycardia

What Tachycardia Is

Tachycardia (Tak-ih-kahr-dee-uh) is a type of heart rhythm disorder wherein the or heartbeat is faster than its normal pace, wherein the heart rate in either the upper or lower chamber is increased. This type of heart rhythm disorder occurs when an abnormally in the person’s heart produces fast electrical signals. Tachycardia is rather the opposite of bradycardia wherein the person’s heart beats slower than its normal.

There are three types of tachycardia : atrial or supraventricular tachycardia, sinus tachycardia, and ventricular tachycardia. In atria or supraventricular tachycardia, the fast heart rate starts from the upper chambers of the heart. There are two forms of atrial or supraventricular tachycardia (paroxysmal atrial tachycardia and paroxysmal supraventricular tachycardia). An atrial or supraventricular tachycardia occurs when electrical signals in the heart are being sent abnormally, causing a disruption or interference with these signals coming from the sinoatrial node.

Atrial or supraventricular tachycardia may simply be caused by either heart attack or a serious mitral valve disease whereas symptoms are dizziness, lightheadedness, palpitations, angina, shortness of breath, unconsciousness and cardiac arrest. People who are probably more likely at risk for this are children, women (but may also occur in men), anxious young adults, physically fatigued people, coffee drinkers, heavy alcohol drinkers and heavy smokers.

This type of heart rhythm disorder may be treated by or with carotid sinus massage, gentle pressing on eyeballs (with eyes closed), Valsalva maneuver, dive reflex, sedation, lessened coffee intake, lessened alcohol intake, abstain from tobacco use, and more rest.

Sinus tachycardia, on the other hand, is a fast but steady heart rate which occurs when the sinoatrial node sends out electrical signals to the heart faster than usual. Causes of sinus tachycardia include fever, anxiety, medications and street drugs, severe emotional distress, fright and strenuous exercise or even anemia, increased thyroid activity, heart muscle damage due to heart attack or heart failure and hemorrhage, whereas its symptom is faster heart rate.

Ventricular tachycardia,  last but not the least, is a fast heart rate starting in the lower chambers of the heart. This type of tachycardia may be life-threatening heart rhythm which requires diagnosis and treatment. Ventricular tachycardia occurs when electrical signals are sent to the heart abnormally, intervening the flow of electrical signals and restricting the heart from properly pumping the blood. This type of heart rhythm disorder may be caused by the following: lack of oxygen to heart areas due to lack of coronary artery blood flow, cardiomyopathy, medications and sarcoidosis (a type of inflammatory disease affecting the skin or other body systems). Its symptoms include dizziness, lightheadedness, unconsciousness and cardiac arrest.

This type of heart rhythm disorder may be treated by or with immediate electrical defibrillation, medications, radiofrequency ablation, or surgery.

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Health Talk: Sinus Bradycardia/Bradyarrhythmia

  1. What Sinus Bradycardia/Bradyarrhythmia Is

    Bradycardia (bray-dee-card-dee-uh) is defined as an irregular heartbeat or a heart rate of less than 60 minutes which consists of different types ( collectively known as bradyarrhythmia):
  • Sinus Bradycardia – an unusually irregular heartbeat caused by heart disease, reaction to certain medications or even normal causes (e.g. excellent fitness or relaxation)
  • Sick sinus syndrome – known or referred to as an unusually slow heartbeat caused by a malfunctioning of the heart’s pacemaker.
  • Heart block or AV block – it is an unusually slow heartbeat caused by slowing or blocking of electrical impulses through the heart’s system.

From the term itself, the term “sinus” refers to the sinus node, which is the heart’s pacemaker that creates a normal regular heartbeat of a person. Brady from the Greek word, ‘bradys’ which means slow and cardia or kardia meaning heart.

II. How Is Sinus Bradycardia/Bradyarrhythmia diagnosed?

Before going through any test, your doctor would simply review the patient’s symptoms and family and medical history, as well as conduct a physical examination. A series of tests may be recommended by the doctor to measure a patient’s heart rate in order to establish the link between the slow heart rate and his/her symptoms and identify the conditions that could possibly cause the problem.

An echocardiogram is one of the tests used or recommended by the doctor to evaluate bradycardia. This type of test uses small sensors or electrodes that are being attached to a patient’s chest and arms to record the electrical signals being sent through the heart, allowing the doctor to look for the patterns and determine the kind of bradycardia that a patient may have.

Other device(s) used in measuring a person’s heart rate are:

  • Holter monitor – this is a portable type of ECG that can be carried around in a pocket, or even worn around the belt or strap or shoulder strap, recording the activity of a patient’s heart for 24 hours and providing the doctor with a prolonged look at his or her heart rhythms.
  • Event recorder – another portable ECG device which is intended to monitor the heart’s activity from over a week and lasting to a few months and can only be activated when the symptoms related to slow heart rate seem to act up.
  • Tilt table test – a kind of test that helps the doctor or attending physician understand how bradycardia or slow heart rate could cause fainting spells. This is type of test is done wherein a doctor asks the patient to lie flat on a special table then tilting it as if the patient is standing up.
  • Exercise test – another type of test wherein a patient’s heart rate is being monitored while walking on a treadmill or riding a stationary bike, checking whether the heart rate increases appropriately in response to the activity.

Apart from these tests, the doctor may also recommend some laboratory examination in order to screen some underlying conditions that may possibly be causing bradycardia (e.g. infection, underactive thyroid, or electrolyte imbalance). 

III. What Causes Sinus Bradycardia/Bradyarrhythmia?

There are several possible causes of sinus bradycardia or arrhythmia and these are : heart tissue damage related to aging, damage to heart tissues brought about by heart attack, hypertension, congenital heart defects, myocarditis, complication of heart surgery, hypothyroidism, electrolyte imbalances, disruption of breathing during sleep, inflammatory disease (e.g. lupus, rheumatic fever), hemochromatosis, certain medications for heart rhythm disorders, high blood pressure, and psychosis. Other than this, sinus bradycardia may also be caused by problems in the sinus node (which may disrupt the electrical impulse traveling through the heart) and even heart block wherein electrical signals are not being transmitted to the heart’s ventricles.

IV. What Are The Symptoms of Sinus Bradycardia/Bradyarrhythmia?

A patient who has bradycardia may experience lack of oxygen supply needed by his or her brain and other organs , as well some of the symptoms like syncope, dizziness, weakness, shortness of breath, fatigue, chest pains, confusion/memory problems, and tiredness from activity.

V. Who Are At Risk of Sinus Bradycardia/Bradyarrhythmia?

There are at least two risk factors of bradycardia: age and heart disease. Older adults and those with poor lifestyles (e.g. smoking, heavy alcohol abuse, use of recreational drugs) , as well as psychological stress and anxiety are prone to this type of heart rhythm disorder.

VII. What Are The Possible Complications of Sinus Bradycardia/Bradyarrhythmia?

Sinus bradycardia may take a toll on a person’s health, especially the heart wherein electrical conduction problems may occur and damage the heart tissue when left untreated. Patients having this may experience frequent fainting spells, heart failure and even sudden cardiac arrest/death.

VIII. What Are The Medications and Treatments for Sinus Bradycardia/Bradyarrhythmia?

The doctor may either recommend treatments , depending on the type of problems in electrical conduction in the heart, severity of the symptoms, and cause of bradycardia , change in prescribed medications for the heart rhythm disorder , or even a pacemaker.

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Health Talk: Cardiomegaly

What Cardiomegaly Is

Cardiomegaly refers to a condition in which the heart becomes larger than its normal size, due to a heart disease. This is brought by high blood pressure, or even by other heart conditions and other non-cardiac matters such as long-term anemia.

There are two types of cardiomegaly namely: dilated cardiomegaly and hypertrophic cardiomegaly. In dilated cardiomegaly, the heart becomes enlarged brought about or caused by the dilation of the heart muscle. It could also cause the heart to become weakened and enlarged, followed by a congestive heart failure. DCM signs and symptoms include those of left and/or right heart failure. An example of this condition would be dilated cardiomyopathy, a most common form of non-ischemic cardiomyopathy

Hypertrophic cardiomegaly, on the other hand, the heart muscle undergoes hypertrophy when placed under a tedious workload for a prolonged period. An example is the left ventricular hypertrophy (LVH) which is the most common form or type of hypertrophic disease. LVH is caused by chronic hypertension. This is where the left ventricle increases contractility and/or preload in order to maintain the same stroke volume.

A. Dilated Cardiomegaly/Cardiomyopathy

B. Hypertrophic Cardiomegaly/Cardiomyopathy

How Is Cardiomegaly Diagnosed?

Cardiomegaly can be diagnosed through a physical exam and test recommended by a doctor. These tests include chest x-ray (images would help the doctor see your heart and lung condition) , electrocardiogram (records the heart’s electrical activity by means of attaching electrodes in your body. This also helps in diagnosing heart rhythm problems and damage), echocardiogram (ultrasound image of the heart and helps the doctor see how your heart efficiently pumps blood, examine which heart chamber is enlarged, look for evidence of heart attack and even determine if you have a congenital heart problem) , stress test (also known as exercise stress test which provides information on how well the heart progresses during a physical activity. This type of test involves a treadmill stress test or even riding a stationary bike in which your heart rhythm, blood pressure and breathing is being monitored), cardiac computerized tomography or magnetic resonance imaging (these types of test require you to lie down on either doughnut shaped machine/gantry or on a table in a long tube machine. In a cardiac CT, images of your heart and chest gets collected through a use of an X-ray tube inside the machine which rotates around your body. While in a cardiac MRI, a magnetic field and radio waves are used in order to produce signals that would create images of your heart.) , blood tests (another test done that checks the levels of certain blood substance that may possibly point out to a heart problem and this helps the doctor rule out other conditions that may be causing the symptom) and cardiac catheterization and biopsy (a type of test or procedure done wherein a thin tube or catheter is being attached or inserted in your groin area and threaded through your blood vessel going to the heart, extracting a small sample of your heart for a laboratory analysis. 

A. Chest x-ray

B. Electrocardiogram

C. Echocardiogram 

D. Stress Test 

E. Computerized tomography and MRI 

D. Cardiac catheterization and biopsy

What Causes Cardiomegaly?

There are several possible causes of an enlarged heart or cardiomegaly. It may be an idiopathic (unknown) cause, congenital heart problem, damage from a heart attack or an arrhythmia. It may also be associated with other conditions such as high blood pressure, heart valve disease, heart muscle disease/cardiomyopathy, pulmonary hypertension, pericardial effusion, anemia, thyroid disorder (e.g. hypothyroidism/hyperthyroidism) , hemochromatosis and other rare disease that may affect the heart (e.g. amyloidosis).

Cardiomegaly may also be brought about by the viral infection of the heart, peripartum cardiomyopathy, kidney disease, alcohol or cocaine abuse and even HIV infection.

What Are The Symptoms Of Cardiomegaly?

A cardiomegaly may or may not have any signs or symptoms in some people. Some possible signs or symptoms of an enlarged heart include shortness of breath, abnormal heart rhythm, increased abdominal girth, weight gain, fatigue, swollen leg, palpitations or skipped heartbeats, cough, edema, and chest pain.

Who Are At Risk of Cardiomegaly?

Possible risk factors of an individual to develop an enlarged heart or cardiomegaly include: having a family history of cardiomyopathy, valvular heart disease, coronary artery disease, hypertension (high blood pressure) , congenital heart disease, heart attack, obesity and cardiac ischemia.

What Are The Possible Complications of Cardiomegaly?

When left untreated, cardiomegaly may pose life-threatening complications on an individual. Some of these include heart failure, blood clots, heart murmur, or worst.. cardiac arrest and sudden death.

What are the Medications and Treatments for Cardiomegaly?

A doctor may possibly recommend certain medications or surgical treatments to be done for cardiomegaly.

A. Medications

Certain medications for cardiomegaly include diuretics (lowers the amount of sodium and water and helps in lowering the pressure of arteries in the heart) , angiotensin-converting enzyme inhibitors (lowers the blood pressure and improves the heart’s pumping capability), angiotensin-receptor blockers (provides the ACE inhibitor’s benefits for those patients who can’t take them) , beta-blockers (lowers blood pressure and improves the heart function) , Digoxin (helps to improve the heart’s pumping function and lessens the need for hospitalization for heart failure) , anti-coagulants (reduces the risk of blood clot that possibly causes heart attack or stroke), anti-arrhythmics (keeps the heart beating normally).

B. Treatments

When the medications don’t seem to help enough, surgical treatments may be needed. These surgical treatments are: medical devices to regulate the heartbeat (e.g. ICD – continuously monitors the heart rhythm and delivers electrical shocks, should there be a need to control abnormal heartbeats) , heart valve surgery, coronary bypass surgery, left ventricular assist device or LVAD (an implantable mechanical pump used to help a weakened heart to pump) and heart transplant (a final yet critical option when all else fails)