Pediatric cardiology

There are number of heart conditions that can affect children. Few children have structural differences by birth others involve the electrical system that controls the heartbeat. Pediatric cardiologists mainly treat, diagnose and manage the problems in the child.  Pediatric heart problems in children, includes congenital heart disease and Arrhythmias. Congenital heart disease refers to heart structural variation by birth in child which include holes between chambers of the heart, abnormal blood vessels and valve problems. Arrhythmiasis know as abnormal heart rhythms caused by the system that controls the heart beat electrically. Pediatric cardiologists will treat pulmonary hypertension and systemic hypertension. Systemic hypertension means high blood pressure in the body. But in few regions pulmonary hypertension is treated by pediatric pulmonologists and systemic hypertension is treated by pediatric nephrologists

In Food industries generally, Pediatric cardiologists work closely with primary care pediatricians to provide coordinated and comprehensive care. Heart Problems can arise due to various other symptoms in the body so pediatric cardiologist will team up with health care providers. For child care there are pediatric heart surgeons, cardiac anesthesiologists, neonatologists, cardiac pediatric intensivists, pediatric radiologists, as well as pediatric nurses, nutritionists, and speech, occupational, and physical therapists. There are various Tools to diagnose cardiac conditions in children. Based on Physical and cardiac examination. For Physical examination: Vital signs and Cardiac examination will be carried out. For Laboratory examination: Electrocardiography, Chest X-ray , Pulse oximetry, Blood counts, Echocardiography, Magnetic resonance imaging (MRI and MRA), Computed tomography, Exercise testing, Cardiac catheterization are done. Environmental and genetic conditions associated with heart disease in children also plays major role. There are various Unusual forms of congenital heart disease in children, Unique cardiac conditions in newborn infants, cardiac conditions acquired during childhood, Abnormalities of heart rate and conduction in children and Congestive heart failure in infants and children. For preventing follow the treatment and precautions given by pediatric cardiologist and have a healthy lifestyle

Nanotechnology in Cardiology

Nanotechnology is a field of science which deals with materials in nano scale. Nano-materials display unique mechanical, electrical, chemical, and optical properties. By understanding the properties of nano materials; we can use in research, diagnosis and therapy of heart, lung, blood and sleep. Nanotechnology will offer novel techniques in the treatment of a multitude of diseases, including cardiovascular disorders. Ischemic heart conditions are some of the most prevalent disorders in many parts of the world. In each year death rate is increased significantly due to heart disease. Even-though ischemic and infarct heart disease are treated in advanced methods, it mainly leads to heart failure.

Death mainly occurs due to the inability to provide medication to the affected area, lack of stem cell implantation, tissue regeneration, and additional damage in ischemic tissue. The promising results have been shown in therapeutic environment by application of nanotechnology. Several nanotechnology based treatments for ischemic heart diseases including simple and modified drug/stem cell delivery systems ranging from magnetic, antibody-linked, and mesoporous silica nano-particles.

Nano-particles vehicles have emerged on an approach for the site-selective delivery of therapeutic agents to areas of the injured or dysfunctional vascular wall including vascular segments at risk for restenosis following per-cutaneous coronary interventions. This approach infusion allows for a targeted delivery of compounds to sites of vascular dysfunction or injury. Components of the technology include a combination of known / approved ultrasound contrast vascular imaging agents complexed with therapeutic agents. A number of therapeutic agents have been explored for incorporation into the nano-particle delivery vehicle and for efficacy on re-stenosis

Is there any connection between heart and brain?

Your heart and your brain are more intricately connected than you may realize. Brain signals the heart to pump its oxygen-rich blood through autonomic nervous system, and heart responds by delivering blood to the entire body, including to brain. If brain does not receive enough oxygen from the heart, you may experience symptoms ranging from fuzzy thinking to a life-threatening stroke. When blood flow to the brain is interrupted or blocked by a blood clot or plaque that has broken away from an artery or valve and is floating in the bloodstream leads to stroke. The lack of oxygen can cause brain cells to die, leading to symptoms of dementia, disabilities, or even death. The major step to the heart is also ways to protect brain. The steps to prevent from the stroke: Managing your blood pressure is especially important, because high blood pressure is the leading cause of stroke. It also may cause tiny lesions in the brain that can slow your thinking and progress to a loss of brain function in the future.

Steps to Take during Heart Surgery: When your Heart Surgery includes the value replacement, it is all the more important to consider ways to protect your brain. Valve replacement procedures, such as transcatheter aortic valve implantation (TAVI), can be lifesaving interventions. It will correct restricted blood flow caused by a narrowing or obstruction of the heart valve. However, during valve replacement, small particles of debris can break loose and find their way into the blood vessels of the brain.

What is good for the heart is good for the brain. Understanding the unique relationship between the heart and brain, and taking steps to protect both of these vital organs throughout life, is important for lifelong health.

Devices and Procedures to Treat Heart attack

The Heart devices which are used to treat Failure Implantable cardioverter defibrillator (ICD), Cardiac Resynchronization Therapy (CRT), Left ventricular assist device (LVAD) and many more. The procedures generally followed to treat the Heart Failure is Heart transplantation, percutaneous coronary intervention (PCI, also referred to as angioplasty), Coronary artery bypass, Valve replacement. The various techniques used during Heart Valve Replacement is replacing a narrowed valve, replacing a leaky valve whereas surgical options for valve replacement include: Mechanical valve, Tissue valve, Ross Procedure, TAVI/TAVR procedure, newer surgery options.

The various implantable devices for heart is mainly for Rhythm Control (Implantable cardioverter defibrillator and Pacemaker) and to Support the Heart and Circulation (Left Ventricular Assist Device).For each devices the implantable procedure, Usage and need various depending on the heart condition, when? , how? , why it is used?

The Common Heart attack warning signs are pain or discomfort in chest, light-headedness, nausea or vomiting, Jaw, neck or back pain, Discomfort or pain in arm or shoulder and shortness of breath. The major 5 ways to prevent Heart attack up taking of medications properly, Follow up with the doctor, participate in Cardiac Rehab, Manage risk factors, and Get support from others.

The commonly used cardiovascular medications Anticoagulants, Antiplatelet Agents and Dual, Antiplatelet Therapy, ACE Inhibitors,  Angiotensin II Receptor Blockers, Angiotensin-Receptor Neprilysin Inhibitors, Beta Blockers, Calcium Channel Blockers, Cholesterol-lowering medications, Digitalis Preparations, Diuretics and Vasodilators.

Major consideration is none of the patient is supposed to vary the dose concentration without concerning the doctor.

The major treatments for heart attack done in hospitals are Thrombolysis and Coronary angioplasty/coronary artery bypass graft surgery (CABG), Artificial heart valve surgery, Atherectomy, Bypass surgery, Cardiomyoplasty, Heart transplant, Minimally invasive heart surgery, Radiofrequency ablation, Stent procedure, Transmyocardial revascularization (TMR).

Sports Cardiology

The athlete management is complex and requires a concerted collaboration among nutritionists, coaches, exercise physiologists, physicians, nurses, physical educators, and psychologists, among others. For the best interest of the athlete physician is expected to pursue medical decisions. The coach who is responsible of decision making requires the input of a multidisciplinary team, the athlete, and family. The physician’s role starts with pre-participation screening (history, physical examination, and testing as needed) , as well as deciding on immediate participation or return to play; involvement in the elaboration of policies promoting wellness of athletes; and supervision of exercise intensification in cardiac rehabilitation, promoting prevention and management of sudden cardiac death in athletes, maximizing cardiovascular performance without the use of drugs for Performance enhancing, and ensuring the safety of sports arena (e.g., availability of automated external defibrillators).

The sports medicine includes not only competitive athletes but also anyone who exercises (amateur or professionals). Although sports can confer the fitness to athletes, there is a risk of sports-related sudden cardiac death. The tragic death of athlete leads to negative response amoung society and media, although the general benefits of exercise outweigh the risk. Commonly, sudden cardiac death is triggered by a ventricular fibrillation (VF) or ventricular tachycardia degenerating into VF(malignant tachyarrhythmia). The hypertrophic cardiomyopathy, channelopathies, arrhythmogenic cardiomyopathy, or coronary congenital abnormalities, among others are typically an underlying substrate for arrhythmia trigger.

Sports Cardiology has attained clinical and research advances in cardiac imaging, electrophysiology and exercise physiology to enable better diagnostic and therapeutic management of our patients. One recent advancement has been to try and better differentiate athletic cardiac remodelling from inherited cardiomyopathies and other pathologies.

Highlights of recent advances in pediatric cardiology

In past two years, considerable advances have been made in the field of pediatric cardiology which includes evaluating the mechanism responsible for cardiovascular disease and the development of diagnostic techniques and treatment strategies. We should other factors like genetic and environmental factors and their interactions involved in the mechanisms for a variety of pediatric cardiology  diseases, which is yet to be cleared. The techniques and treatment are needed to be standardized and developed further.

The highlights of recent advancement:

The mortality period of Truncus arteriosus remains high. Children who undergo the state have a high risk for mortality within the first year of life, with an operative mortality rate of 7% and a late mortality rate of 5.8%.Congenital heart disease is increasing the risk for dementia. People who survived with congenital heart disease in their adulthood had an elevated risk for dementia, particularly early-onset dementia. Death because SIDS more likely in siblings of victims. Children with a sibling, who died from sudden infant death syndrome, or SIDS, are more prone to SIDS than general population. Mortality risk has been increased in adults with congenital heart disease Compared with other patients for heart transplantation. Children with congenital heart defects may have increased late CV risk in their mother. Exposure to statin during pregnancy increases risk for ventricular septal defects in infants. The FDA announced the approval of a heart valve designed for pediatric patients has been expanded to include a size small enough to be used in newborn patients. Shorter childhood height increases risk for future stroke. Patients who were short at age 7 to 13 years have an increased risk for ischemic stroke. The risk for intracerebral hemorrhage was also increased in men who were short at age 7 to 13 years, but not in women.

Women and Heart Disease

Heart Diseases are faced in both men and women. But for Women symptoms and risk factor varies. If unique symptoms of women are understood, the risk of heart disease can be reduced. Most commonly observed heart attack symptoms for women. The usual one is of pain, pressure or discomfort in the chest rarely women may have heart attack without any symptom. The other symptoms unrelated to chest pain Neck, jaw, shoulder, upper back or abdominal discomfort, Shortness of breath, Pain in one or both arms, Nausea or vomiting, Sweating, Lightheadedness or dizziness and Unusual fatigue. The chest pain as pressure or a tightness because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or coronary micro vascular disease

Heart disease risk factors for women: The traditional risk factors are high cholesterol, high blood pressure and obesity: Diabetes, Mental stress and depression, Smoking, Inactivity, Menopause, Broken heart syndrome, certain chemotherapy drugs and radiation therapy for cancer, Pregnancy complications. To reduce their risk of heart disease, Quit or don't start smoking, Exercise regularly, Maintain a healthy weight, Eat a healthy diet that includes whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats, and Avoid saturated or trans fat, added sugars, and high amounts of salt. The above mentioned factors reduce the condition for Heart Disease and Heart Surgery.

The Regular exercise, maintaining the body mass index (BMI) reduced the risk factors. For few women routine use of daily aspirin therapy to prevent heart disease in low-risk women younger than 65 years old isn't recommended by American Heart Association (AHA). The intake of aspirin without doctor recommendation is not welcomed.

Role of Drug in Heart Disease and Stroke

Pharmaceutical research companies are developing large amount of medicines for two of the leading causes of death in Americans—heart disease and stroke.Later, therapies promise to build on the progress made by existing treatments, which have helped cut deaths from heart disease.

                 Medicines designed by type and phase of development (For cardiovascular Diseases)

The death rates due to cardiovascular Disease were on the rise and doctors had few tools to treat their patients. Now, latest treatments are done for cardiovascular disease. New tools helped to decrease the number of death rates. Advancement in medicine leads to 30% decrease in death rate.

Progress against cardiovascular disease has had a profound impact on helping to control health care costs. Based on the survey in health affairs, 70% of the money is spent for congestive heart failure.

Two cases :

• ·         The people who were treated with atrial fibrillation (AFib)—the most common form of arrhythmia will be at risk for a stroke than people without AFib. Intake of AFib requires continuous monitoring of blood, dosage adjustments and food restrictions

While the new drugs use different mechanisms of action—both have an easy treatment regimen—with one or two dosages daily

• ·         Lipid Disorders—High Cholesterol -side effects by decreasing the average cholesterol level.

CARDIOVASCULAR DISEASE RISK FACTORS

Studies published last year, found lifestyle factors have a huge impact on lowering the risk of heart disease and stroke, and in helping people extend their lives. People with “ideal cardiovascular health,” measured by health behaviours (not smoking, regular exercise and healthy diet) and health factors (ideal body mass index, cholesterol, blood pressure and blood glucose) had the lowest risk. Even with adequate cardiac care, prevention is still the most important factor in reducing cardiovascular disease.

Major risk factors include: • Family history and genetics • Smoking • High Blood Cholesterol and Other Lipids • Physical Inactivity • Overweight/Obesity

To know more about the issue reach us @Heart 2019