Diagnosing and Treating an Enlarged Heart

In continuation of our last blog on what is an enlarged heart, today we would discuss ” how to diagnose an enlarged heart and treatment options for the same

Enlarged Heart, treatment options
Enlarged Heart, treatment options
Early diagnosis is critical to managing an Enlarged Heart.
Upon a physical examination, a cardiologist may hear a murmur in the heart, unusual heartbeats, water retention in the legs, abdomen, fluid retention in the lungs.
After a physical examination, a few tests that may be carried out are :
  • Angiogram or catheterization, checks for blockages in the heart. A flexible tube is inserted via the groin, dye injected and pictures of the heart taken to check for blockages and heart function. In case of blockages, stenting or angioplasty is carried out at the same time.
  • ECG uses electrodes to detect heart activity.
  • Echo, uses sound waves to detect heart activity and take pictures of the heart.
  • MRI is used to take pictures of the heart and blood vessels to detect anomalies.
  • CT Scan is also used to take pictures of the arteries in the heart and is often used for patients with pacemakers and other implanted devices.
  • Stress Echo: The patient is made to exercise and then heart tests are administered. Along with ECG, Stress Echo shows heart rate, rhythm, and activity.

 

  • Some of the common treatment options are:

 

  • Angioplasty or Stenting are often carried out when blockages or fat, calcium deposits are found in the arteries.Stents can be bare metal or drug-eluting which help open up the arteries.
  • CABG or an open heart surgery in case of multiple blockages also help.
  • Heart Valve surgeries, such as single valve repair,  DVR( Double valve replacement ),  MVR(Mitral valve replacement, Mital valve repair), VSD, ASD  help take care of valve-related heart problems which impair blood flow and lead to an enlarged heart over time.
  • VAD or Ventricular assist devices, help in heart failure by helping a weak heart pump blood. VAD can be, LVAD( left ventricular assist device) or RVAD( Right ventricular assist device). ICD combo devices and Pacemakers also help weak hearts or a heart with impaired function.
  • Heart Transplant is the very last option when all else fails to support patients with extreme heart failure.
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Enlarged Heart

We often hear of an enlarged heart, what does it mean? How does one’s heart get enlarged? And how does it affect our health?

Heart Disease
Heart Disease
Our heart is a pear-shaped muscle pumping oxygen-rich blood throughout the body.
Sometimes due to certain factors, birth defects- congenital heart defects, our heart muscle has to work much harder causing it to enlarge or become bigger in size.
Once the heart becomes enlarged, it is almost impossible to get it back to the original size.Therefore timely detection and management is the key.
Let’s try and explore factors which lead to an enlarged heart, a medical condition, which is impossible to cure but can be managed medically.
  • Congenital heart defects or heart defects one is born with us as PDA, VSD, ASD, Mitral valve defect, left untreated lead to high pulmonary pressures, which in turn lead to thickening of the arterial wall and also an enlarged heart.Though most babies are routinely scanned for congenital heart defects in developed countries, treatment upon detection and early intervention and management still remains the key.Many parents despite detection, are often scared to get surgical interventions without realizing that they are hampering both mental and physical growth and putting children at risk of enlarged heart and other complications later on in life.

 

  • Lifestyle-related complications such as hypertension or high blood pressure also lead to an enlarged heart over a period of time.In case of high blood pressure, the heart has to pump harder to deliver blood to the rest of your body, thereby thickening and enlarging the heart muscle.High blood pressure may also enlarge the upper chambers of the heart, the left ventricle and also weaken the heart long-term.

 

  • Coronary artery disease or CAD (blocked arteries requiring stenting, angioplasty) can also lead to a heart attack. A part of the heart muscle dies during a heart attack, causing the heart muscle to work harder to supply blood to the entire body which over long-term leads to an enlarged heart.

 

  • Abnormal Heart Beat or Arrhythmia is often ignored but may cause an enlarged heart over a period of time.

 

  • Anemia or low level of iron in the body, where the body doesn’t have enough Red Blood Cells to carry blood to the body, leads to rapid, irregular heartbeat causing the heart to pump harder to make up for lack of sufficient oxygen in the blood.Sicklers or patients suffering from sickle cell anemia are at an increased risk and despite hearsay, a Bone Marrow Transplant or a BMT remains the only curative treatment for Sickle Cell Anemia, Thalassemia Major.

 

  • Thyroid disorders, also lead to various heart diseases over a period of time leading to an enlarged heart.
The biggest complications arising from an enlarged heart are heart failure,  SCA or SCD (sudden cardiac arrest or sudden cardiac death) or what is known as a silent heart attack in laymen language.
Heart Failure: During heart failure, the heart muscle weakens and the ventricles, stretch or dilate to a point that the heart cannot pump blood efficiently, leading to a sudden cardiac arrest.
Silent heart attack or SCD: An enlarged heart causes the heart rhythm to be so slow that the muscle is unable to move blood or it may cause a heart rhythm, so fast that the muscle is unable to beat properly resulting in sudden death.
More on diagnosis and treatment options in our next post.
Stay tuned in for more.
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Your Poop-Is it telling you something ?

Poop comes in all shades, often a result of what we eat and chemical changes due to bile as our food gets digested.

Normal poop color is brown though sometimes if we eat green leafy vegetables it could be on the greener side. A sudden color change could be indicative of a health problem.

 

Know what your poop color indicates and when it could mean trouble:
Green: Green colored stool could be due to iron supplements, green leafy vegetables, however, it could also mean that the food is moving too quickly through the large intestine as a result of which bile doesn’t have the time to break down the food completely.
White, Clay or Grey: Whitish, grey or clay-colored stools indicate lack of bile and often indicate a problem with gallbladder or liver. The problems could be as varied as liver cirrhosis needing a liver transplant or liver failure due to hepatitis A, Hep B or Hep C.
Yellow: Unless, you are having too many yellow colored liquids, yellow stools indicates, excess fat or poor fat absorption.
Poor fat absorption could be due to blocked bile ducts, a problem with the pancreas, and may indicate lack of enzymes for food digestion or may even point towards chronic pancreatitis, celiac disease.
Red: Unless you have been eating beets, carrots, tomatoes, cranberries, food with red coloring, bright red colored stool may indicate bleeding due to hemorrhoids, anal fissure, and even colon cancer or cancer of the rectum or even bowel cancer.
Black: Black colored stools, may indicate bleeding from the intestines, stomach which may even indicate stomach cancer and need an immediate follow-up call with a doctor.
A diet rich in blueberries or black licorice, iron supplements, bismuth subsalicylate could be other exceptions.
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Decoding PET CT

The PET CT Scan is one of the sought after diagnostic tests. Let’s find out more about what is a PET CT and why is it preferred over other diagnostic tests, such as an MRI, CT Scan or an ultrasound.

What is a PET Scan?

A PET Scan is a nuclear medicine technique which produces images of the human body at a molecular level.

A PET CT uses radioactive tracers in conjugation with isotopes such as oxygen, nitrogen, carbon etc. These radioisotopes act at a molecular level and work as probes which seek out disease, cancer in the body while giving out radio signals which are captured to produce an image.

PET CT Scan
PET CT

 

This can help in the diagnosis of even the tiniest lesions, thus increasing the accuracy of the investigation, subsequent diagnosis and hence cancer treatment.

A PET CT Scan, therefore reveals a lot more about the body than standard diagnostic tests such as MRI, CT Scan or an ultrasound.

What happens during a PET Scan?

A PET CT Scan, is always on a price appointment basis as the radioisotopes, having a very short half-life need to be brought in just before the scan.

A PET CT, is usually carried out empty stomach on overnight or at least 6 hrs fasting.

The creatinine levels, need to checked prior to conducting the PET CT by simple blood tests called KFT or Kidney function test

If the creatinine levels are in order, the patient is tested for blood sugar and if found in order, the patient is given an injection of glucose with a radioactive tracer.

After the injection, the patient is made to rest for about 90 mins and then taken for the actual scan which takes about 30 mins to 45 mins depending on the imaging required.

During the scan, the patient is made to lie on a comfortable table that moves slowly through the ring like PET scanner.

After the scan, the patient can leave immediately. However close contact with others especially children and pregnant women is best avoided for the next 4-6 hrs.

It is also good to drink a lot of water, to flush out the radioactive tracer from the body.

The imaging can be seen by the doctors and the nuclear medicine specialists almost immediately for evaluation, though a formal written report takes a day to be handed over to the patient.

Are there any side effects or discomfort due to the scan?

There are no side effects or discomfort due to the PET  CT Scan, except the minor prick while injecting the tracer.

The PET CT scanner also does not make any sounds while the scan is going on, unlike a few other diagnostics tests.

What are the diseases for which a PET CT Scan can be used?

The most common use case for a PET CT Scan is for detecting and treating cancer. However other applications, include diagnosing cardiac or heart problems and also neurology.

Cancer/Oncology :

During the initial stages of the disease, a PET CT helps distinguish between benign and malignant disease and also cancer staging, that is knowing and determining the stage of the disease and also its characteristics, which further helps oncologists decide the best treatment option for the patient.

During the course of treatment, it helps determine response to therapy or cancer treatment and if the metabolic activity decreases on the PET CT Scan, the oncologists know that the drugs being administered are working.

On the other hand, if the metabolic activity on the scan increases, it indicates that the treatment option is losing its efficacy or is not working and helps oncologists change the line of treatment to benefit the patient.

Cardiac Care: Post a heart attack, a PET CT Scan can be used to determine myopathy, need for CABG or open heart surgery and if there would be any benefit from CABG or would a heart transplant or an LVAD be a better treatment option.

Neurology: Alzheimer’s at an early stage can be diagnosed using a PET Scan leading to early intervention.

A PET CT Scan helps locate tumors, distinguish between benign and malignant tumors and also scar tissue for brain surgery.

A PET CT  is also useful for the treatment of epileptic seizures. It can help locate the origin and focus of seizures and assess sites for intervention if any is required.

What is the difference between a PET CT and an MRI or a CT ?

A CT or an MRI works on the physical level and can give the size and location of the tumor with accuracy.

However since both tests do not work on the molecular level, they cannot indicate metabolic activity of the tumor which only a PET CT Scan can indicate, thereby making a PET CT, a diagnostic test of choice for oncologists, cardiologists, cardiac or heart surgeons and interventional neurologists.

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Is your tooth pain, an indicator of disease ?

 

Tooth ache,Ddental problems
Tooth Ache, Dental Problems, Health Problems

Teeth: As per Merriam Webster, teeth are defined as the hard bony appendages that are borne on the jaws in the mouth or pharynx and exist for eating food and as weapons of offense and defense.
Over the years, modern physicists have discovered that there is indeed a direct relationship between teeth and Qi ( Energy ). The Chinese found a way to measure Qi and map the pathways – this led them to the conclusion that if Qi was normal, there was good blood flow in the body ; however, if there was disturbed Qi – it symbolised disease and disturbed blood flow.

According to them, teeth are indicative of the state of internal organs in the body and hence pain often indicates trouble in the connected body organ. One’s lips are related to the spleen, teeth are related to various organs in the body, the gum is related to the stomach, and the tongue is related to the heart.

Below are a few health problems which our teeth, gums and tongue indicate :

  • The normal colour of lips is bright red and moist. Dry lips indicate pathogenic dryness, Pale lips indicate blood shortage or anemia, and purple lips indicate coldness or poor circulation.
  • Dry teeth indicate insufficient liquid in the kidneys.
  • Pale gums indicate blood deficiency, Red and swollen lips indicate stomach fire, and Bleeding from the swollen gums indicates the blood vessel damage. Furthermore, the various teeth in the mouth also indicate the state of various organs.

    Dental
    Teeth, how tooth pain is an indicator of poor health
  • Bladder, Kidney and Ears : Link to Upper and Lower Incisors
  • Liver and Gall Bladder: Canine Teeth
  • Lungs: Pre Molars
  • Stomach Heart, Pancreas and Spleen : Molars

But, does this mean that the damage of the teeth is responsible for all internal damages?
Thankfully, no. However pain in various teeth may indicate problems with specific body organs.

Given below are the connections between the teeth and the organs :

  • As the top and bottom 4 incisors are directly related to the kidney and bladder. Pain in upper and lower incisors could mean infection or inflammation in the kidney, inflammation of the prostate gland or even middle ear infection.
  • As top and bottom 2 canines are directly related to the liver and bladder. Thus pain in your canines could indicate a Hepatitis A,B. C infection or inflammation of the gall bladder.
  • Lungs and large intestines are related to the top and bottom 4 bicuspids or premolars, pain may indicate, inflammation of the colon, bronchitis, asthma, other lung problems such as COPD.
  • The first and second molars are directly related to the spleen and stomach and pain could indicate gastric problems, pancreatitis and even ulcers.
  • The third molars or the wisdom teeth are directly related to the small intestine and the heart and pain may indicate cardiac disease, coronary heart disease and even congenital heart defects such as PDA, TOF, Fontan, VSD, ASD , ASO,  AV Canal and may even pre empt a CABG or an Angioplasty
  • Build up of plaque in the arteries, problems with arteries, varicose veins may be the actual trouble spots if you have pain in the sixth lower teeth.
  • Thyroid problems such as hypothyroidism, sinus, spleen and even inflammation of ovaries may be the real reason behind pain in sixth upper teeth.
  • Arthritis, problems with colon, pain in joints such as knee, elbow and shoulder may be the reasons for pain in the upper and lower fourth teeth.

So next time you have tooth pain, look for the real reason before heading for a tooth extraction or  ( RCT) root canal treatmentA tooth pain, may be a warning in disguise for you to watch out and take care of the impending health problem?

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Heart Disease -Stuff you must know !

open heart bypass surgery
open heart bypass surgery

Heart disease kills more people than any other disease. Over 30% of deaths across the world are due to heart disease as per WHO estimates.

Ignorance, lack of awareness, refusal to get basic routine checkups, account for the high mortality rate.

Unhealthy dietary habits, alcohol abuse, use of tobacco, lack of exercise, obesity, diabetes, hypertension and genetics are the primary reasons for developing heart disease.

Most cases go undiagnosed till the patient suffers a heart attack.

Here is a list of types of heart disease which we should all know about.

Clogged Arteries: Fat and cholesterol build up in the arteries leads to plaque and mineral deposits which restricts or blocks blood flow to the heart. Usually clogged arteries are not diagnosed unless one gets chest pains or gets breathless. An angiography is often carried out for diagnosis. Stenting or an angioplasty takes of blocked arteries. A surgeon may insert a balloon or a wire mesh to open up your arteries. If the blockage is severe, a CABG or open heart bypass surgery may be required. In CABG, or open hear bypass surgery, blood vessels from other parts of the body are taken and damaged blood vessels of the heart are replaced or bypassed.

Arrhythmia: Irregular heart beat can either be too slow or too fast. Although rarely fatal, arrhythmia increases pre disposition to heart attack, heart failure and even stroke.
An ICD  detects irregular heart beat and send electric impulses to takes care of Arrhythmia.

Hole in the heart :  PDA, VSD, ASD, Mitral Valve Defects,  commonly known as hole in the heart, sometimes congenital heart defects are not diagnosed even till adulthood. Growth milestones may be compromised and problems may persist later in life.
Serious defects require surgical intervention however some can be managed with medical management.

Heart Muscle Disease: Our heart is a muscle which weakens due to obesity, high blood pressure, diabetes and hence the heart struggles to pump blood in the body.
Heart muscle disease or cardiomyopathy can lead to heart failure.

A Pacemaker is implanted to take care of heart muscle disease.

Enlarged Heart: As the heart muscle becomes weak, the heart enlarges in order to pump blood and the rhythm increases. However the heart also becomes weaker and consequently it leads to decreased blood flow.

Heart Attack: Clogged arteries can restrict and even stop blood flow to the heart. Without blood flow, our heart doesn’t get the oxygen required which damages the heart and this is what is known as a heart attack. The more restricted the blood flow, the more life threatening and severe, the heart attack.

Heart Failure: Failure of the heart to pump blood to the body is known as heart failure and this can lead to death.

Without surgical intervention or medical management as may be required, heart disease progresses and even post diagnosis and surgical intervention, drastic life style changes are required for managing the medical condition.

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