Patients with congestive heart failure (CHF) may have an associated problem of anemia, a decrease in the number of red blood cells (RBC) - the component of blood that carries oxygen. Even by itself, anemia can cause symptoms of shortness of breath and fatigue, similar to the symptoms of heart failure. A low RBC count (hematocrit) limits the amount of oxygen being carried to the body, which makes the heart work harder. In fact, as the severity of CHF progresses, the findings of anemia increase; and severe anemia due to any cause can worsen CHF. Because of this relationship, anemia treatment may be an important part of CHF.
Two medications erythropoietin and darbepoetin alfa, stimulate RBC growth and production in the bone marrow. These medicines require being given by a shot (like insulin) usually every 1-4 weeks. This can help people with heart failure correct their anemia, when it is due to inadequate bone marrow production.
In general, severe anemia may also be treated with vitamins or blood transfusions.
Friday, December 17, 2010
Reducing side effects of heart treatment
Take medications exactly as your doctor orders.
- Do not stop taking them unless prescribed by your doctor.
- Do not alter the dosage without checking with your doctor.
- Take your medications at the same time each day.
- Check with your doctor before taking any over-the-counter medications.
- Do not take outdated/expired medications. Check with your pharmacist if you have questions about the age of your medications.
- Inform your doctor of other medications you are taking to ensure there are no unfavorable drug interactions with your new prescription.
Diet for health care
Sodium is a critical issue for patients with heart failure. A high sodium intake can cause fluid retention and therefore contribute to edema. Fluid accumulation puts more strain on the heart and can lead to shortness of breath. Salty foods cause the body to hold on to fluids contributing to congestion. Most people consume much more salt than they need. Salt (sodium) is required by the body, but only in small amounts. Try to keep your sodium intake to no more than two grams per day.
Cholesterol
High blood cholesterol levels have been linked to coronary artery disease, the leading cause of heart failure. A diet high in saturated fats leads to a high level of LDL or "bad" cholesterol. If you are at risk for coronary artery disease, reduce your intake of saturated fats such as those found in red meats and whole milk products and reduce cholesterol levels by limiting egg yolks and animal products.
Fluids
In advanced cases of heart failure, your doctor may wish to restrict your fluid intake to reduce the stress on your heart. Check with your doctor to see how much fluid he or she recommends each day.
Cholesterol
High blood cholesterol levels have been linked to coronary artery disease, the leading cause of heart failure. A diet high in saturated fats leads to a high level of LDL or "bad" cholesterol. If you are at risk for coronary artery disease, reduce your intake of saturated fats such as those found in red meats and whole milk products and reduce cholesterol levels by limiting egg yolks and animal products.
Fluids
In advanced cases of heart failure, your doctor may wish to restrict your fluid intake to reduce the stress on your heart. Check with your doctor to see how much fluid he or she recommends each day.
Symptoms of heart failure
Shortness of Breath
Shortness of breath can be caused by congestion in the lungs. This congestion is known as pulmonary edema. One sign to watch out for is whether your shortness of breath is worse when you lay flat. Orthopnea is the shortness of breath which occurs when blood kept in the legs by gravity returns to the chest when you lay down.
Shortness of breath can also occur at night. Shortness of breath that comes on suddenly at night is known as paroxysmal (par-ox-iz-mal) nocturnal dyspnea.
Fatigue
Fatigue is often attributed to getting old or being out of shape. However, if this condition persists for long periods of time, it may be the result of heart failure. Sluggishness may be the result of your organs not getting enough oxygen. You may feel as tired after getting up in the morning as you did when you went to bed. Let your doctor know if this happens on a regular basis.
Loss of Appetite
Fluid accumulation in the digestive organs can cause you to feel full. You may also feel bloated. You may want to try eating smaller more frequent meals instead of the traditional three large meals a day.
Weight Gain or Loss
Excess fluid in the body may cause an increase in weight. Similarly, when excess fluid is excreted, your weight may fall. Weight increases by about two pounds for each extra quart of fluid. You may notice that your weight has risen before you notice swelling of the ankles or extremities. Inform your doctor of changes of more than five pounds.
Shortness of breath can be caused by congestion in the lungs. This congestion is known as pulmonary edema. One sign to watch out for is whether your shortness of breath is worse when you lay flat. Orthopnea is the shortness of breath which occurs when blood kept in the legs by gravity returns to the chest when you lay down.
Shortness of breath can also occur at night. Shortness of breath that comes on suddenly at night is known as paroxysmal (par-ox-iz-mal) nocturnal dyspnea.
Fatigue
Fatigue is often attributed to getting old or being out of shape. However, if this condition persists for long periods of time, it may be the result of heart failure. Sluggishness may be the result of your organs not getting enough oxygen. You may feel as tired after getting up in the morning as you did when you went to bed. Let your doctor know if this happens on a regular basis.
Loss of Appetite
Fluid accumulation in the digestive organs can cause you to feel full. You may also feel bloated. You may want to try eating smaller more frequent meals instead of the traditional three large meals a day.
Weight Gain or Loss
Excess fluid in the body may cause an increase in weight. Similarly, when excess fluid is excreted, your weight may fall. Weight increases by about two pounds for each extra quart of fluid. You may notice that your weight has risen before you notice swelling of the ankles or extremities. Inform your doctor of changes of more than five pounds.
Conditions for Heart Failure
Hypertension
This is more commonly known as high blood pressure. It is a condition that is treatable and simple to diagnose with a blood pressure cuff. Although most individuals will not have symptoms, hypertension is detected by a simple measurement with a blood pressure cuff and stethoscope. It is also a risk factor for CAD, stroke, peripheral vascular disease, or kidney impairment.
Cardiomyopathy
A disease of the heart muscle. This can be one of many varieties. It can arise because of genetic causes, a viral infection, or consumption of toxins (lead, alcohol, etc.). In peripartum cardiomyopathy, women who have recently given birth can develop heart muscle impairment. In many cases, the condition is called "idiopathic", which means it has occurred of uncertain origin or cause.
This is more commonly known as high blood pressure. It is a condition that is treatable and simple to diagnose with a blood pressure cuff. Although most individuals will not have symptoms, hypertension is detected by a simple measurement with a blood pressure cuff and stethoscope. It is also a risk factor for CAD, stroke, peripheral vascular disease, or kidney impairment.
Cardiomyopathy
A disease of the heart muscle. This can be one of many varieties. It can arise because of genetic causes, a viral infection, or consumption of toxins (lead, alcohol, etc.). In peripartum cardiomyopathy, women who have recently given birth can develop heart muscle impairment. In many cases, the condition is called "idiopathic", which means it has occurred of uncertain origin or cause.
Heart Failure Causes
For heart failure to occur, there must be an unresolved impairment of the heart that compromises its ability to work as a pump. The source of this can be a cutoff of blood supply, an increase in workload due to high blood pressure caused by non-functioning valves or a genetic predisposition. Heart failure can be worsened by a poor diet and lifestyle. Its development follows the scheme below:
Heart Failure
Once the heart has been injured, the body will attempt to compensate for reduced blood flow. Unfortunately, many of the countermeasures actually increase strain on the heart and further the development of heart failure.
The heart, after suffering damage or being placed under physical stress by high blood pressure, will begin to change its own shape. This deforming of the ventricles' shape is known as remodeling or hypertrophy.
For comparative terms, the normal heart essentially looks like a football. When the wall thickens in concentric circles (lower left), The heart works less effectively and takes on the shape of a large fist. This may be caused by hypertension, a blocked aortic valve, or underlying genetics. Dilation of the ventricle walls (lower right) gives the weakened heart a beach-ball shape and an inefficient contraction. This prohibits blood from leaving the heart as it normally would. This remodeling pattern follows damage from a heart attack, sustained hypertension, viral infection, or genetic causes.
The heart, after suffering damage or being placed under physical stress by high blood pressure, will begin to change its own shape. This deforming of the ventricles' shape is known as remodeling or hypertrophy.
For comparative terms, the normal heart essentially looks like a football. When the wall thickens in concentric circles (lower left), The heart works less effectively and takes on the shape of a large fist. This may be caused by hypertension, a blocked aortic valve, or underlying genetics. Dilation of the ventricle walls (lower right) gives the weakened heart a beach-ball shape and an inefficient contraction. This prohibits blood from leaving the heart as it normally would. This remodeling pattern follows damage from a heart attack, sustained hypertension, viral infection, or genetic causes.
working of neuroendocrine system
This system works as a complex series of checks and balances on the heart and circulatory system in a way similar to the action of a thermostat. A thermostat detects transient changes in temperature and has a maximum and minimum temperature range allowed. When the room temperature falls below the minimum, the thermostat signals to the furnace to turn on and raise the temperature in the room. When the addition of heat causes the maximum temperature to be reached, the thermostat signals to the furnace to turn off. Much the same way, the neuroendocrine system monitors certain variables in the body and makes adjustments when variables aren't in the needed range.
Unfortunately, the changes made by the system are not necessarily beneficial in the long run. Imagine that the thermostat in the above example is reset to a higher than desirable level. Once the furnace turns on, it will not receive any input that the room is too hot and will continue to pump heat into the room until the new threshold temperature is reached. In a similar sense, if the brain doesn't receive a proper "off" signal, it will continue to raise blood pressure unnecessarily. Going one step further, impaired heart function will lead to ineffective, sustained signalling activity by the nervous system, which will further create conditions that strain the heart, driving it towards failure.
Unfortunately, the changes made by the system are not necessarily beneficial in the long run. Imagine that the thermostat in the above example is reset to a higher than desirable level. Once the furnace turns on, it will not receive any input that the room is too hot and will continue to pump heat into the room until the new threshold temperature is reached. In a similar sense, if the brain doesn't receive a proper "off" signal, it will continue to raise blood pressure unnecessarily. Going one step further, impaired heart function will lead to ineffective, sustained signalling activity by the nervous system, which will further create conditions that strain the heart, driving it towards failure.
neuroendocrine system
The heart utilizes electrochemical signals to control the rate at which it contracts. It accomplishes this using bundles of "pacemaker cells" whose signals maintain an internal rhythm independent of the body. However, at rest the rhythm it maintains is slightly faster than what is ordinarily required. The neuroendocrine system usually dampens this rate, but it can elevate it as well using electrical or chemical signals (during exercise or stress).
The neuroendocrine ( neuro-nerve; endocrine-hormone) system is a compilation of inputs from the nervous system as well as glands throughout the body that secrete chemicals. Both usually work together to account for transient or even chronic changes in the body. Using nerve signals or hormones, the neuroendocrine system changes cell activities that alter the diameter of blood vessels, the heart's rate and strength of contraction, and even the amount of fluid the body retains.
The neuroendocrine ( neuro-nerve; endocrine-hormone) system is a compilation of inputs from the nervous system as well as glands throughout the body that secrete chemicals. Both usually work together to account for transient or even chronic changes in the body. Using nerve signals or hormones, the neuroendocrine system changes cell activities that alter the diameter of blood vessels, the heart's rate and strength of contraction, and even the amount of fluid the body retains.
working of lungs
WE BREATHE BECAUSE OUR TISSUES BREATHE! The lungs basically work as a pair of bellows - as the chest expands they draw in air (of which oxygen is a component). Upon exhaling the chest uses its elastic properties to passively "snap back" to its original size.
Oxygen and carbon dioxide can travel between the lungs and bloodstream because the capillaries that surround the air sacs are permeable to gases. In essence, this means that oxygen and carbon dioxide molecules are small enough to passively diffuse through the tissues that compose both the blood vessels and alveoli. This same principal applies to gas exchange between the blood in the capillaries and tissues in the body. In heart failure conditions, however, if the blood is leaving the lung against a high pressure downstream in the left atrium, fluid can actually diffuse into the lungs. This condition, known as pulmonary edema, can inhibit gas exchange and make it very difficult and uncomfortable to breathe.
Oxygen and carbon dioxide can travel between the lungs and bloodstream because the capillaries that surround the air sacs are permeable to gases. In essence, this means that oxygen and carbon dioxide molecules are small enough to passively diffuse through the tissues that compose both the blood vessels and alveoli. This same principal applies to gas exchange between the blood in the capillaries and tissues in the body. In heart failure conditions, however, if the blood is leaving the lung against a high pressure downstream in the left atrium, fluid can actually diffuse into the lungs. This condition, known as pulmonary edema, can inhibit gas exchange and make it very difficult and uncomfortable to breathe.
How does the circulatory system work?
Contractions from the heart eject blood into the lungs and body. The vascular network must be vast in complexity and length to cover all of this volume. The combined length of all of the tubing would cover nearly 60,000 miles (100,000 kilometers) - more than TWICE around the earth - if plumbed in a straight line! The vascular system, with the help of neuroendocrine input, can contract and relax different arteries and veins to guide both the speed and destination of blood flow, depending on the needs of the body. This facilitates circulation in performing more specialized tasks.
During physical exertion, the vessels going to muscles can dilate to deliver more oxygen to those tissues. Furthermore, blood also serves as a method to distribute our body heat. By dilating blood vessels at our skin surface, the body allows conductive heat loss during exercise, while contracting their diameter conserves body heat when the environment becomes colder.
As mentioned before, the circulatory system is a closed loop. If there are any serious blockages or changes in vessel resistance along the line, it is like putting a bend or kink in a garden hose - flow through the bend is slowed and pressure to push through the reduced opening may increase. This resistance to flow is of concern in heart failure, not only because of the workload it imposes on the heart, but because it hampers delivery of blood's precious cargoes (food, oxygen, etc.). Placing the heart under such stressful conditions (i.e. increased heart rate and contraction force with a curtailed oxygen supply) will reduce its ability to compensate for the needs of the body.
During physical exertion, the vessels going to muscles can dilate to deliver more oxygen to those tissues. Furthermore, blood also serves as a method to distribute our body heat. By dilating blood vessels at our skin surface, the body allows conductive heat loss during exercise, while contracting their diameter conserves body heat when the environment becomes colder.
As mentioned before, the circulatory system is a closed loop. If there are any serious blockages or changes in vessel resistance along the line, it is like putting a bend or kink in a garden hose - flow through the bend is slowed and pressure to push through the reduced opening may increase. This resistance to flow is of concern in heart failure, not only because of the workload it imposes on the heart, but because it hampers delivery of blood's precious cargoes (food, oxygen, etc.). Placing the heart under such stressful conditions (i.e. increased heart rate and contraction force with a curtailed oxygen supply) will reduce its ability to compensate for the needs of the body.
circulatory system
Our circulatory system can be thought of as a network of living pipes that allows our body to transport oxygen as well as nutrients to the tissues. Chemical wastes produced by our cells enter the blood to be filtered and eliminated by our body (largely by the kidney and liver). Our body circulates about 5 liters (5.3 quarts) of blood; at rest, the heart moves it at a rate of 5 liters per minute. In summary, even without activity, blood can run the entire circuit of the body in one minute. During heavy exercise, the whole loop can be completed in ten seconds.
The main components of the circulation are pictured on the left:
The main components of the circulation are pictured on the left:
- Arteries - the red vessels represent arteries. Hemoglobin, the oxygen carrying chemical in red blood cells, takes on blood's distinctive red color when it is combined with oxygen. Arteries carry blood away from the heart and branch into smaller vessels (first arterioles, then capillaries) in order to facilitate delivery of its cargo to the organs and other tissues.
- Veins - the blue vessels represent veins. This bluish tint is also due to hemoglobin. After releasing oxygen to living cells, hemoglobin undergoes a chemical change that gives it a distinctive reddish-blue tone. Veins also have a series of one-way valves built into their structure. This is crucial for proper circulation, as gravity could cause blood to pool below the heart otherwise!
Latex allergies
Allergic reactions to exposure to natural rubber latex (NRL) have increased significantly over the last ten years, particularly within healthcare occupations.
The proteins naturally present in NRL cause the allergies either through direct contact with the skin or by inhalation of powder from powdered latex gloves.
This website will tell you more about NRL allergies and how you can protect yourself and others against them. It gives advice on single-use glove selection, taking account of the importance of infection control. It does not cover protection against chemicals. The site applies particularly if you are an employer/work in healthcare occupations or are a patient. The site will be expanded in the future to cover other workers.
The proteins naturally present in NRL cause the allergies either through direct contact with the skin or by inhalation of powder from powdered latex gloves.
This website will tell you more about NRL allergies and how you can protect yourself and others against them. It gives advice on single-use glove selection, taking account of the importance of infection control. It does not cover protection against chemicals. The site applies particularly if you are an employer/work in healthcare occupations or are a patient. The site will be expanded in the future to cover other workers.
Cross-section of normal bronchiole
During an asthma attack the muscle wall contracts and the lining of the airways becomes swollen and inflamed. These changes cause a narrowing of the airways which is further aggravated by an increase in secretions from the mucus membrane, which may actually block the smaller airways. All these give rise to an obstruction to airflow. This leads to a significant increase in the effort needed to move air in and out of the lungs, giving rise to wheezing and breathlessness.
Lungs
An asthma attack occurs when the airways of the lung become narrowed causing an obstruction to the flow of air. Symptoms include coughing, wheezing, breathlessness and a tightness in the chest.
Lungs
While the larger airways have cartilage in their walls to prevent their collapse, the smaller bronchi and bronchioles do not have this support. These smaller airways are muscular tubes and their lining contains many mucus secreting cells.
Occupational asthma
Occupational asthma is an allergic reaction that can occur in some people when they are exposed to substances, for example flour or wood dust in the workplace.
These substances are called 'respiratory sensitisers' or asthmagens. They can cause a change in people’s airways, known as the 'hypersensitive state'.Not everyone who becomes sensitised goes on to get asthma. But once the lungs become hypersensitive, further exposure to the substance, even at quite low levels, may trigger an attack.
The main causes of occupational asthma are set out in Section C of HSE's Asthmagen Compendium.
This list of substances is a useful summary. Also look for the risk phrase R42 ‘May cause sensitisation by inhalation’ on product labels or safety data sheets.
Symptoms of asthma
Asthma is a serious health problem. Thousands of people in Britain have to face the challenges of this disease every day.
Symptoms include severe shortness of breath that can stop you from doing the simplest tasks. Imagine not being able to carry your shopping or walk up the stairs or even play with your children. Some sufferers are unable to work again.Other symptoms include:
- Wheezing
- Coughing
- Chest tightness
Other associated conditions are:
- rhinitis (sneezing/runny nose)
- conjunctivitis (itchy and inflamed red eyes).
Asthma
Breathing in certain dusts, gases, fumes and vapours within the workplace can cause asthma. Asthma is a very serious health problem that can ruin lives. Shortness of breath, wheezing and painful coughing are just some of the symptoms that occupational asthma sufferers may have to deal with every day.
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