Monthly Archives: May 2016

Tips to Tooth Decay and Heart Disease

unduhan-9Tooth decay, also known as dental caries or dental cavities is a disease of the teeth, which finally results in the damage of the teeth. Tooth decay is caused by bacteria which are present in the plaque. This bacteria extracts sugars from the food particles and converts it into lactic acid and stores them in the cavities present in the teeth. This can lead to the decaying of teeth. There have been many researches which show the connection between decayed tooth and heart disease.

The bacteria that is present in the dental plaque can cause blood clots in the arteries. When these potentially fatal blood clots are released into the bloodstream, they can induce heart attacks. The formation of plaque in the gums leads to chronic inflammation of the gums, which can also cause inflammation in the walls of blood vessels, thus leading to the accumulation of plaque in the arteries. If an individual has a very severe decay and experiences pain in the left arm or in the chest region, then he may be having a heart attack. It is advisable not to ignore any signs and symptoms of tooth decay, as it can lead to problems in the cardiovascular system.

Conditions Related to Tooth Decay and Heart Disease

Healthy gums are pink in color, firm and elastic. Diseased gums appear swollen, red and sometimes bleed. Given below are some gum problems that may be related to heart diseases:Genetics is responsible in some cases, when it comes to tooth and gum disorders.

► Gingivitis is a disease of the gums, where a gap between the gums and teeth is formed due to the infestation of bacteria. The primary symptoms of this condition, being mild in the beginning, are swelling, redness and bleeding of the gums.
► Pericoronitis is another disorder of the gums that is caused when the wisdom teeth do not emerge out completely from the gums, causing a gap. When food particles get accumulated, they start decaying and weaken the roots of the teeth causing discomfort and pain. When this condition becomes severe it can cause swelling on the cheeks and neck.
► When the gum disease has become severe, it causes periodontitis, where the infection goes deeper into the gums and affects the roots of the teeth. This infection can also cause damage to the bones, below the gums and make the gums recede.

Causes

► One of the most common causes is the accumulation of plaque in the cavities of the teeth. The bacteria that are present in the mouth break down the food and convert them into lactic acid.
► Excess of lactic acid in the mouth may cause cavities in the teeth, leading to decay.
► Improper brushing and flossing of the teeth and poor oral health are some other causes. In order to prevent tooth caries, one must brush the teeth properly and pay a regular visit to the dentist for an overall examination of the mouth.

Symptoms

Since decaying of tooth is a slow process, it does not show any immediate symptoms. Only when the nerve is exposed and the pain is aggravated, only then the signs of tooth decay are noticed. Given below are some signs of dental caries as observed in children as well as in adults:
➀ The most common symptom is toothache which is caused due to infection or irritation of the tooth pulp. This pain may aggravate due to eating sweets and hard food, consuming hot or cold drinks, and while brushing your teeth.
➁ Experiencing sensitivity due to pressure on the affected tooth.
➂ The individual may also experience bad breath and foul taste in the mouth.
➃ If there is an infection in the gums, then the tooth may break in splinters and may also be shaky.
➄ Appearance of spots — brown, black or yellow — on the infected teeth.
➅ Severe decay may be caused due to the accumulation of pus in the abscess may cause symptoms like fever, swollen jaws, inflamed glands followed by excruciating pain.

It is essential to undergo prompt treatment, in the initial stages. Delaying the treatment can only make the condition worse, where the person may experience intense pain and the affected tooth may also have to extracted. If you want to stay away from tooth decay and heart disease, pay more attention to your oral health. Healthy teeth means a healthy heart.

Right Atrial Enlargement

The heart weighs around 200 – 400 gm and is about the size of a fist. It’s primarily composed of 4 parts, known as chambers. The functioning of the human heart is related to the proper coordination between these 4 chambers. These four chambers are called left atrium and right atrium (lie in the upper part of the heart), and left ventricle and right ventricle (located in the lower part of the heart). Blood circulation between these 4 chambers takes place with the help of heart valves that transport blood from one chamber to another.

Now, after having a general idea about the 4 chambers of the heart, we are in a position to understand right atrial enlargement (RAE). It is a condition of the heart where there is an enlargement of the right atrium, due to some infection. This increase in size of the right atrium is nothing but a deviation from its normal size, and is referred to as right atrial enlargement. Fatigue, chest pain and breathing problems are some of the common symptoms of RAE.

Functioning of the Heart

The heart is an organ that provides fresh oxygenated blood to the different parts of the body. However, the heart also receives impure (deoxygenated) blood. Impure blood from the legs and upper body gets accumulated in the right atrium, which is then transferred to the right ventricle through the tricuspid valve. From the right ventricle, the blood moves through the pulmonary artery to the lungs, for purification. Once the lungs complete their designated task, fresh oxygenated blood is then transferred to the left atrium. The blood is then passed down to the left ventricle through the mitral valve. The blood then flows out of the left ventricle and is distributed throughout the body.

RAE Causes

Why does the size of the right atrium increase abnormally? When the size of the right atrium increases, it is a symptom of an underlying medical problem. People suffering from high blood pressure have a higher chance of suffering from this heart disease. Other reasons that could trigger enlargement in right atrium are given below:

Lung Disease
As lungs play a very important role for normal functioning of the heart, any lung disorder may cause this heart problem. Disorders such as bronchitis or chronic obstructive pulmonary disease (COPD), can cause high blood pressure in the pulmonary artery that collects blood from the right ventricle. High blood pressure may ultimately lead to RAE.

Tricuspid Stenosis
This is a problem associated with the heart valve in which the tricuspid valve is unable to perform its job properly. As we all know, the valve that is between two chambers located on the right side of the heart, is the tricuspid valve. This valve ensures normal circulation of de-oxygenated blood from the right atrium to the right ventricle. Tricuspid stenosis is a heart valve disease in which the opening of the tricuspid valve is partially blocked, thus decreasing the flow of blood between these 2 chambers. In order to restore normal blood flow, the right atrium has to send the blood with more force, so that it passes through the narrowed opening of the tricuspid value. In case the blood is not pushed forward with extra force, there is a high probability that the blood may start moving backwards and cause further complications. So, this extra workload on the right atrium, often manifests in the form of RAE.

Mitral Stenosis
As aforementioned, the mitral valve lies between the left atrium and the left ventricle. Thus, one can say that the mitral valve is involved in the management of proper blood flow between the atriums and the ventricles. Any issues with this valve such as narrowing of the mitral value can cause RAE. In most cases, tricuspid stenosis is followed by mitral stenosis that leads to this problem.

Pulmonary Embolism
The pulmonary artery connects the right ventricle to the lungs. Now, this artery transports impure blood to the lungs for purification. Pulmonary embolism interferes with free flow of blood between the heart and the lungs, as a blood clot is formed somewhere in the pulmonary artery. Thus the heart has to work harder to try to normalize the blood flow in the pulmonary artery. As a side effect of these extra efforts, the heart may show RAE.

Tricuspid Regurgitation
This condition is related with the malfunctioning of the tricuspid valve. It is observed that the tricuspid valve opens only when there is a need of transfer of blood from the right atrium to the right ventricle. When the right ventricle fills completely, the tricuspid valve must close immediately. If the valve does not close after the ventricle is full, the blood may start moving backwards (tricuspid regurgitation), towards the right atrium. This excessive pressure of blood flow reversal can cause RAE.

Mitral Regurgitation
Mitral regulates blood circulation between left atrium and left ventricle. If the mitral valve fails to close itself after the left ventricle is full, the blood may flow in the opposite direction i.e towards the left atrium. These disturbances in normal blood flow in the heart may lead to RAE.

Right Ventricular Hypertrophy (RVH)
RVH refers to abnormal increase in the size of right ventricle. As aforementioned, pulmonary arteries allows blood to move from the right ventricle to the lungs. However, poor blood circulation from these arteries can put a lot of strain on the heart. To be precise, when the blood flow moving towards the lungs is below normal, the right ventricle is subjected to excessive stress. As a response to this undue strain, the right ventricle shows abnormal enlargement. It is observed that people with RVH also tend to develop RAE. High blood pressure in pulmonary arteries, traveling at high altitude and pulmonary valve stenosis are some of the factors that trigger development of RVH.

Congenital Heart Disease
This is an inborn abnormality in the heart’s structure. The heart does not get properly developed during the 9 months of pregnancy. This defect interferes with the normal functioning of the heart. When we talk about the structure of the heart, we cannot forget to mention about the tricuspid valve, pulmonary valve and the mitral valve. All these valves form an integral part of the heart’s structure. Any deformity in the structure of the heart can affect any one or all the valves and disturb the blood flow through the heart, eventually causing RAE.

RAE treatment focuses on correcting the underlying cause. Taking a 2D echocardiogram of the heart is a reliable way to detect enlargement of the right atrium. Regulating the blood pressure is the key to control heart problems. So doctors may prescribe medications to control high blood pressure. Diuretics may be used to stop the build up of blood in the mitral or tricuspid valve. Respiratory disorders like COPD are treated with appropriate medications like bronchodilators (inhalers) and antibiotics to reduce COPD symptoms.

Left Atrial Enlargement

Left atrial enlargement is the result of genetic defect (hereditary) or conditions like obesity, congestive heart failure and high blood pressure.

Left Atrial Enlargement (LAE)

The left atrium is one of the four chambers of the heart, the other three being the right atrium, left ventricle and the right ventricle. All these four chambers are connected by valves. The left atrium does the job of pumping fresh oxygenated blood (stored in lungs) to the left ventricle, which is then circulated throughout the body. Left atrial enlargement is a term that is used to describe a condition in which the left atrium no longer appears in its original size. In other words, the upper left chamber is found to be enlarged. The heart muscles in this region also appear thick and swollen.

Symptoms

The occurrence of symptoms will depend upon the degree of enlargement of the left atrium. If the increase in size is significant, then the person is bound to experience its side effects immediately. On the other hand, a minor change in the size of left atrium is a harmless condition and the symptoms go unnoticed. On the whole, following are the symptoms noticed in people with LAE.

  • Chest pain
  • Extreme tiredness
  • Difficulty in breathing
  • Abnormal heartbeat

People who suffer from this heart problem find it difficult to perform exercises like running, swimming and cycling. Exertion is something that cannot be tolerated by these people as they experience frequent episodes of shortness of breath.

Causes

Disruption in normal blood flow is one of the most common causes of inflammation of the left atrium. Also known as left atrial dilation, the condition may occur due to the following reasons:

Obesity
This is one of the leading causes of swollen left atrium in children. Recent reports suggest that obesity is increasing at an alarming rate in children, thus making them prone to this condition. Obese people are often found to be overweight and inactive. Excessive body weight can trigger heart problems like LAE, wherein the muscle wall of the left atrium thickens. New research has also revealed that enlarged chambers of the heart are often the result of obesity.

Treatment: You need to get rid of your couch potato lifestyle in order to lose weight and excess fat. Eat healthy foods and make exercise your top priority. These healthy lifestyle habits can go a long way in keeping obesity at bay.

Stress
Increased workload in the office can certainly put a person under tremendous pressure and negatively affect the heart, which may manifest in the form of swollen left atrium.

Treatment: For better stress management and to get quick stress relief, deep breathing meditation and yoga are beneficial. These techniques are a great stress reliever and help to promote a peaceful mind.

High Blood Pressure (HBP)
The main function of the heart is to pump fresh oxygenated blood to different parts of the body through veins, capillaries and arteries. A specific pressure is maintained by the heart to regulate normal blood flow, which is known as blood pressure. However, when there is too much pressure inside the arteries, the condition is referred as high blood pressure. This happens because the arteries get slightly compressed. As a result, the heart has to increase its efficiency and work harder to push the blood through the narrow passages of the arteries. This overburden can be strenuous for the heart. The size of the heart increases due to excessive strain on the heart muscles. No wonder people with high blood pressure are diagnosed with left atrial enlargement.

Treatment: In order to ease the symptoms of left atrial enlargement, it is necessary to bring blood pressure under control. Medications that are commonly prescribed to treat HBP are beta-blockers and ACE-inhibitors.

Mitral Regurgitation
The mitral valve allows blood to circulate from left atrium to left ventricle. To be precise, it regulates blood flow between these two chambers of the heart. The mitral valve opens when left atrium is filled with pre-determined amount of blood and it closes only after the left atrium has squeezed enough to push all the remaining blood to the left ventricle. However, if the mitral valve is not working correctly, it does not close properly even after all the blood has been moved to the left ventricle. The inability of the mitral valve to close tightly causes the blood to flow in the opposite direction – from left ventricle to left atrium. This phenomenon of backward flow of blood is called mitral regurgitation and can lead to inflammation of the left atrium.

Treatment: Surgery is advised that aims at correcting the defects in the mitral valve. However, if it is not possible to repair the deformities, the mitral valve is swapped for a prosthetic one.

Hypertrophic Cardiomyopathy (HCM)
This condition is typically marked by unnatural thickening of the heart. This can bring excessive strain on the heart as it has to take more efforts in delivering sufficient blood to different parts of the body. This unexpected work overload on the heart can trigger abnormal enlargement of the left atrium. HCM is an inherited disorder and runs in families. Due to HCM, one area of the heart wall appears to have more thickness than the rest.

Treatment: In order to improve heart efficiency, beta-blockers and calcium-blockers may be recommended. Antiarrhythmic medicines may also be prescribed to stop heart palpitations.

Stenosis
Diagnosis of enlarged left atrium can also mean that you are suffering from aortic valve stenosis. Stenosis literally means unnatural constriction of the passageway, in this case the most important valve of the heart. It is observed that the fresh oxygenated blood in the heart exits from the aortic valve. The abnormal narrowing leads to malfunctioning of the valve, thereby reducing the amount of blood moving out of the heart. Thus, the incapability of aortic value to ensure adequate outgoing blood flow from the heart can also lead to LAE.

Treatment: After undergoing the blood tests, the doctor may decide whether it is necessary to take medications to manage cholesterol and blood pressure. In any case, surgical intervention is necessary to dilate the narrowed aortic valve. However, usually surgical procedure involves removing the aortic valve and fixing a mechanical valve.

Narrowed Mitral Value
The mitral valve of the heart connects chambers located on the left side of the heart (left atrium and left ventricle). In case of heart problems, the mitral valve constricts or stiffens. In such cases, more pressure is exerted on the left atrium to pump blood in sufficient amounts to the left ventricle. The left atrium has to work harder to maintain proper blood flow between the two chambers. This excessive load can also cause inflammation of the left atrium.

Treatment: Surgery is the first line of treatment to clear narrowed mitral valve. The surgical procedure, referred to as balloon valvuloplasty is often used to widen the mitral valve.

Lung Disease
As the left atrium takes fresh oxygenated blood from the lungs and then passes it on to the left ventricle, any infection or a disease that considerably decreases the functionality of lungs, may also cause LAE.

Treatment: Severe lung infections that are typically marked by breathing problems and frequent bouts of cough, may be treated with antibiotics or antivirals, depending upon the nature of the infection. Medications alone won’t cure the infection unless adequate rest is taken. Also, make sure your surrounding environment is clean and free from lung irritants.

Congestive Heart Failure (CHF)
In CHF, the heart loses its ability to pump sufficient amount of oxygenated blood to meet the body requirements. This happens because the heart is unable to contract or relax properly with every heartbeat. As a result the heart is unable to exert enough force to ensure normal blood circulation. This causes the fluid in the blood to back up and accumulate in different organs. This reduced cardiac output due to impaired pumping action accompanied by fluid accumulation in different tissues of the body, may cause enlargement of the left ventricle or the left atrial chamber.

Treatment: Diuretics are often the first choice of treatment for removal of fluid buildup. CHF patients may also be treated with ACE-inhibitors that help to dilate the blood vessels and increase the blood flow.

Coronary Artery Disease
Coronary artery disease is typically marked by clogging of arteries due to buildup of plaque on the arterial wall. The plaque is nothing but hardened deposits of cholesterol that accumulate over the years due to consumption of unhealthy foods. In such a scenario, the heart has to struggle to maintain normal blood flow, because the arteries have become narrower. As a response to this cardiac overload, the left or right atrial enlargement may be observed.

Treatment: A healthy diet and exercise is crucial for optimal functioning of the arteries. Use of cholesterol controlling medicines such as statins and blood thinners (aspirin) may be necessary in conjunction with lifestyle changes. For severe blockages in the arteries, angioplasty or coronary artery bypass surgery may be advised to restore normal blood circulation.

Alcoholism
If you thought that excess alcohol consumption only affects the liver, then it’s time to rethink. Alcohol addiction can also have a negative impact on the heart function. The heart’s pumping action may weaken considerably due to excess alcohol intake and this may lead to dilated cardiomyopathy, a condition in which the size of left ventricle or the left atrium increases.

Treatment: In order to improve heart health, it is very important to stop alcohol consumption. Heart failure arising from alcoholism may be treated with diuretics and beta-blockers that help to control blood pressure and improve blood circulation

Heart Infection
Myocarditis, a viral infection in which the heart muscle is inflamed, can also cause dilation of left atrium. In case the infection is not serious, it may not cause any bothersome symptoms but a severe myocarditis can lead to chest pain, heart failure and heart enlargement. Endocarditis, caused by bacteria and that strikes the inner lining of the heart chamber, can interfere with the functioning of the heart valve. Thus, if the infection damages the mitral or the aortic valve, it can disrupt the outgoing blood flow from the left atrium. This may eventually cause the left atrium to enlarge abnormally.

Treatment: Antivirals may be prescribed to treat myocarditis. In some cases, the inflammation of the wall is the result of a bacterial infection and so the treatment may involve use of antibiotics. Doctors may also recommend digoxin (digitalis) to strengthen heart contractions, which may help to improve blood flow.

Consequences of Left Atrial Enlargement

Initial studies suggest that enlargement of left atrial chamber and occurrence of stroke are related. Increased LA size could be one of the risk factors in the development of stroke. Although the exact link between enlarged LA and stroke is not yet established, there are speculations that LAE may slow down blood circulation, thereby increasing the risk of clot formation and subsequent stroke. The risk of stroke is greater, if LAE patients also suffer from high blood pressure. Untreated LAE may also lead to atrial fibrillation, a condition that is typically marked by abnormal heartbeats (racy heart), poor blood circulation, breathing problems and chest pain. Due to rapid heart, an unusual sensation of pounding or thumping is experienced in the chest. Depending upon how severe the underlying cause of LAE is, this heart rhythm disorder can be either chronic or an occasional phenomenon.

Diagnosis

In order to detect abnormalities in the heart such as left atrium enlargement, the patient is advised to undergo an echocardiogram to closely inspect the heart in 2D. The test employs ultrasound waves that provides advanced imaging of the heart. The sophisticated images help to evaluate the size of the heart chambers as well as the functionality of the valves.

Decreased Cardiac Output

The diminished cardiovascular yield causes, manifestations and medicines are examined in the accompanying articles. Low cardiovascular yield identified with CHF (Chronic Heart Failure) and other therapeutic conditions make it a genuine wellbeing issue.

The medical condition of decreased or low cardiac output is the result of many different causes and is exhibited in the form of various symptoms. Decreased cardiac output related to hypertension, aging and many other causes is discussed in the article. Cardiac output decreases with slowing down of heart beats. Another reason behind low cardiac output is the inability of heart muscles to pump blood in a proper manner; many a time, a damaged heart muscle is responsible for this condition. The following write-up discusses the pathophysiology, causes and the treatment or care plan for this medical condition.

What is Cardiac Output?
It is the amount of blood pumped by the heart (ventricle) in a single minute. The unit that is used for measuring cardiac output is cubic dm/min. The average rate of cardiac output for men and women is 5 cubic dm/min. and 4.5 cubic dm/min. respectively. This medical condition is described as the reduction in outflow of blood from ventricles of the heart. There could be a variety of reasons behind the condition of low cardiac output; details of the causes are given below.

Causes
The common causes behind this medical condition are hypertension, myocardial infarction, congenital heart disease, valvular heart disease, cardiac arrhythmias, pulmonary disease, cardiomyopathy, fluid overload, drug effects, electrolyte imbalance and decreased fluid volume. Geriatric patients are at a high risk of suffering from decrease cardiac output due to the reduced compliance of ventricles that results from aging.

Symptoms
The symptoms of this medical condition include arrhythmias, electrocardiogram changes, variations in hemodynamic parameters, tachypnea, orthopnea, dyspnea, frothy sputum, abnormal arterial blood gases, edema, weight gain, decreased urine output, dizziness, syncope, restlessness, anxiety, fatigue, weakness, cold clammy skin, decreased peripheral pulses, change in mental status, confusion, pulsus alternans, angina, etc. Decreased cardiac output and blood pressure are interrelated since the decrease in cardiac output results into low blood pressure.

Treatment Measures
The medications recommended for decreased cardiac output depend on the etiological factors. However, common medications used in the treatment include diuretics, digitalis therapy, vasodilator therapy, ACE inhibitors, antidysrhythmics and inotropic agents. Maintaining the optimum fluid balance is also a part of treatment. Administration of the prescribed fluids helps increase the extracellular fluid volume thereby, raising the cardiac output. It is also important to maintain the hemodynamic parameters. Patients with increased preload need to restrict sodium and fluids, which helps in decreasing the extracellular fluid volume. Maintaining perfusion and ventilation is also an important part of the treatment. Placing the patient in a high-Fowler position helps in reducing the ventricular filling and preload. The patient should be placed in the supine position to promote diuresis and to increase vanous return. Restricting the physical activities of patients helps in reducing the oxygen demands of the body. A quiet and peaceful environment must be provided to patients, since emotional stress may lead to increased cardiac demands. Stool softeners should be given to patients because if the body gets strained owing to bowel movements, there arises a possibility of further decrease in cardiac output. The decreased or low cardiac output interventions or nursing interventions include hemodynamic regulation and cardiac care. Decreased cardiac output RT (Respiratory Therapy) is useful from the point of increasing fluid volume and reducing bilateral ankle edema & clammy skin.

Factors Affecting Cardiac Output
The volume of blood leaving the heart i.e. cardiac output is dependent on the volume entering it. In the condition of decreased or low cardiac output, volume of blood entering the heart is less than usual. The ventricle from which blood is released doesn’t contract in a forceful manner and therefore, the cardiac output is low. Thus, the output depends on the degree to which muscles of ventricles are stretched by the incoming blood flow.

Negative inotropic effect is one of the factors responsible for low cardiac output. Alteration in the contraction of muscles and especially the heart muscles caused by intake of certain medications is termed as inotropic effect. Medications that have a negative inotropic effect are responsible for weakening the force of heart required to contract its muscles; it is therefore, responsible for low cardiac output. The positive inotropic medications are recommended for conditions like myocardial infarction.

The medical condition of decreased cardiac output is a result of a variety of health problems. Therefore, the treatment measures must be devised on the basis of specific cause. Some of the common treatment measures listed in the article should be helpful for readers.