Cardiomyopathy is also known as congestive heart failure which can be either chronic or acute. Difficulty in breathing, extreme tiredness, repeated cough, loss of appetite, irregular pulse rate and palpitation are some of the common symptoms of congestive heart failure.
The following page will help you to learn the basics about coronary artery disease, also known as CAD and Coronary Heart Disease. Coronary artery disease is the leading cause of death in the United States for both men and women. Plaque is made up of fat, cholesterol (ko-LES-ter-ol), calcium, and other substances such a fibrin that circulate in the blood. When your coronary arteries are narrowed or blocked, oxygen-rich blood can’t reach your heart muscle.
Heart attack occurs when blood flow to an area of your heart muscle is seriously compromised or completely blocked. Over time, CAD can weaken the heart muscle and lead to heart failure and arrhythmias (ah-RITH-me-ahs). With the continued rise of artery disease anyone with a functioning brain should be asking WHY because the rise in artery disease would definitely suggest that mainstream medicine strategies simply aren’t working very well. There are quite a few risk factors that come into play in regards to coronary heart disease. The main or most common symptoms of coronary artery disease are angina (chest pain) and shortness of breath. Coronary artery disease treatment of course depends upon who your doctor is and what he or she thinks is the best approach. Lower Blood Pressure Grape seed extract lowers blood pressure and this is great news for those who wish to lower moderately high blood pressure without toxic heart drugs.
Congestive heart failure (CHF) is the result of insufficient output because of cardiac failure, high resistance in the circulation or fluid overload. Left ventricle (LV) failure is the most common and results in decreased cardiac output and increased pulmonary venous pressure. In the lungs LV failure will lead to dilatation of pulmonary vessels, leakage of fluid into the interstitium and the pleural space and finally into the alveoli resulting in pulmonary edema. Right ventricle (RV) failure is usually the result of long standing LV failure or pulmonary disease and causes increased systemic venous pressure resulting in edema in dependent tissues and abdominal viscera. In the illustration on the left some of the features, that can be seen on a chest-film in a patient with CHF. Increased pulmonary venous pressure is related to the pulmonary capillary wedge pressure (PCWP) and can be graded into stages, each with its own radiographic features on the chest film (Table). In daily clinical practice however some of these features are not seen in this sequence and sometimes may not be present at all.
This can be seen in patients with chronic heart failure, mitral valve disease and in chronic obstructive lung disease. Views of the upper lobe vessels of a patient in good condition (left) and during a period of CHF (right).
In a normal chest film with the patient standing erect, the pulmonary vessels supplying the upper lung fields are smaller and fewer in number than those supplying the lung bases.
The pulmonary vascular bed has a significant reserve capacity and recruitment may open previously non-perfused vessels and causes distension of already perfused vessels.
First there is equalisation of blood flow and subsequently redistribution of flow from the lower to the upper lobes.
The term redistribution applies to chest x-rays taken in full inspiration in the erect position. In daily clinical practice many chest films are taken in a supine or semi-erect position and the gravitational difference between the apex and the lung bases will be less. In the supine position, there will be equalisation of blood flow, which may give the false impression of redistribution. Normally the vessels in the upper lobes are smaller than the accompanying bronchus with a ratio of 0.85 (3). At the level of the hilum they are equal and in the lower lobes the arteries are larger with a ratio of 1.35. When there is redistribution of pulmonary blood flow there will be an increased artery-to-bronchus ratio in the upper and middle lobes.
Stage II of CHF is characterized by fluid leakage into the interlobular and peribronchial interstitium as a result of the increased pressure in the capillaries. When fluid leaks into the peripheral interlobular septa it is seen as Kerley B or septal lines. Kerley-B lines are seen as peripheral short 1-2 cm horizontal lines near the costophrenic angles. When fluid leaks into the peribronchovascular interstitium it is seen as thickening of the bronchial walls (peribronchial cuffing) and as loss of definition of these vessels (perihilar haze).
There is an increase in the caliber of the pulmonary vessels and they have lost their definition because they are surrounded by edema. The lateral view nicely demonstrates the increased diameter of the pulmonary vessels and the hazy contours. Subtle ground glass opacity in the dependent part of the lungs (HU difference of 100-150 between the dependent and non-dependent part of the lung). In a patient with a known malignancy lymphangitic carcinomatosis would be high in the differential diagnostic list.
Ground glass opacity is the first presentation of alveolar edema and a precursor of consolidation.
This stage is characterized by continued fluid leakage into the interstitium, which cannot be compensated by lymphatic drainage.

This eventually leads to fluid leakage in the alveoli (alveolar edema) and to leakage into the pleural space (pleural effusion).
After treatment we can still see an enlarged cardiac silhouette, pleural fluid and redistribution of the pulmonary blood flow, but the edema has resolved.
On the left another patient with alveolar edema at admission, which resolved after treatment.
When you scroll through the images and go back and forth, you will notice the difference in vascular pedicle width and distribution of pulmonary flow.
Both on the chest x-ray and on the CT the edema is gravity dependent and differences in density can be measured. This is not seen when the consolidations are the result of exsudate due to infection, blood due to hemorrhage or when there is a capillary leak like in ARDS.
A possible explanation for this phenomenon could be, that the patient had been lying on his right side for a while before the x-ray was taken. The cardiothoracic ratio (CTR) is the ratio of the transverse diameter of the heart to the internal diameter of the chest at its widest point just above the dome of the diaphragm as measured on a PA chest film. An increased cardiac silhouette is almost always the result of cardiomegaly, but occasionally it is due to pericardial effusion or even fat deposition. An increase in left ventricular volume of at least 66% is necessary before it is noticeable on a chest x-ray. Other signs of CHF are visible, such as redistribution of pulmonary flow, interstitial edema and some pleural fluid. On a supine film the cardiac silhouette will be larger due to magnification and high position of the hemidiafragms. Exact measurements are not that helpful, but comparison to old supine films can be of value. Because of the recent cardiac surgery, the possibility of pericardial effusion was taken into account, which is nicely demonstrated on the CT-image. On the left another patient with a large cardiac silhouette on the chest x-ray due to pericardial effusion. There has to be at least 175 ml of pleural fluid, before it will be visible on a PA image as a meniscus in the costophrenic angle.
If pleural effusion is seen on a supine chest film, it means that there is at least 500 ml present. A subpulmonic effusion may follow the contour of the diaphragm making it tricky to discern. In these cases, the only way to detect pleural effusion, is when you notice that there is an increased distance between the stomach bubble and the lung. The stomach is normally located directly under the diaphragm, so, on an erect PA radiograph, the stomach bubble should always appear in close proximity to the diaphragm and the lung. At first glance you might get the impression that there is a high position of the diaphragm. However when you notice the increased distance of the stomach air bubble to the lung base, you realize that there is a large amount of pleural fluid on both sides (arrow). The vascular pedicle is bordered on the right by the superior vena cava and on the left by the left subclavian artery origin (6).
A vascular pedicle width less than 60 mm on a PA chest radiograph is seen in 90% of normal chest x-rays. An increase in width of the vascular pedicle is accompanied by an increased width of the azygos vein. The VPW is best used as a measure to compare serial chest x-rays of the same patient, as there is a wide range of values for the VPW. Dilation of the azygos vein is a sign of increased right atrial pressure and is usually seen when there is also an increase in the width of the vascular pedicle. The difference of the azygos diameter on an inspiration film compared to an expiration film is only 1mm. This means that the diameter of the azygos is a valuable tool whether or not there is good inspiration.
RV failure is most commonly caused by longstanding LV failure, which increases the pulmonary venous pressure and leads to pulmonary arterial hypertension, thus overloading the RV.
The indication for ultrasound examination in many of these patients is abnormal liver function tests.
It is therefore important to consider the possibility of RV failure when a patient presents with liver enzyme abnormalities. These changes in caliber can be attributed to variations in blood flow in the IVC in accordance with the respiratory and cardiac cycles.
Pulmonary artery-bronchus ratios in patients with normal lungs, pulmonary vascular plethora, and congestive heart failure.
Pulmonary hypertension secondary to left-sided heart disease: a cause for ventilation-perfusion mismatch mimicking pulmonary embolism. I do not claim to be a person who "knows everything," But I have been delt a few jokers in my life so who know's maybe we can relate! Enhance the selective excretion of various electrolytes and water by affecting renal mechanisms for tubular secretion and reabsorption.
When heart suddenly cannot pump blood to other parts of the body, it may lead to congestive heart failure. It is easy to detect failure of heart function through advanced testing procedure like MRI of heart, heart catheterization, and heart scan. Nowadays it is easy to monitor pulse rate and blood pressure at home to keep a check on changes in body metabolism.
When plaque builds up in the arteries, the condition is called Atherosclerosis (ATH-er-o-skler-O-sis).

This blockage, most often caused by a clot or plaque rupture, prevents oxygen-rich blood from reaching that area of heart muscle and causes it to die. Heart failure is a condition in which your heart can’t pump enough blood throughout your body. Some like aging and genetics are without solutions but the majority can be eliminated with lifestyle changes. A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. High blood levels of LDL cholesterol can increase the risk of atherosclerosis and plaque formations.
Unrelieved stress may damage arteries as well as worsen other risk factors for coronary artery disease.
This disorder causes you to repeatedly stop and start breathing while you’re sleeping. C-reactive protein (CRP) is a normal protein that appears in higher amounts when there’s inflammation in your body. Homocysteine is an amino acid your body uses to make protein and to build and maintain tissue. This substance forms when a low-density lipoprotein (LDL) particle attaches to a specific protein.
Both angina and shortness of breath usually occur during or right after exercise however, your first symptom could be a heart attack. First line of defense is usually life style changes however lifestyle changes could also be coupled with drug therapy.
Potassium-sparing diuretics have weak diuretic and antihypertensive properties and are used mainly to conserve potassium in patients receiving thiazide or loop diuretics. Groups commonly used are thiazide diuretics and thiazide-like diuretics (chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide, and metolazone), loop diuretics (bumetanide, furosemide, and torsemide), potassium-sparing diuretics (amiloride, spironolactone, and triamterene), and osmotic diuretics (mannitol). Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes.
Monitor frequency of prescription refills to determine compliance in patients treated for hypertension. When this happens, the excess of blood and body fluids gets accumulated in lungs and liver. Congestive heart failure can cause other disorders like swelling in legs (edema), swelling of liver, collection of fluid in lungs and distended neck veins.
Limited quantity of salt and fluid intake, following healthy lifestyle by doing regular exercises can prevent you from congestive heart failure. Coronary artery disease is a condition in which plaque (plak) builds up inside the coronary arteries. Angina is chest pain or discomfort that occurs when there is NOT enough oxygen-rich blood flowing to an area of your heart muscle. Without quick treatment, a heart attack can lead to serious heart damage that ends up causing more complications such as ventricular tachycardia (V-tach or VT), heart failure and even death. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55, or your mother or a sister developed it before age 65.
Carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. When grouped together, certain risk factors put you at an ever greater risk of coronary artery disease. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease. But too much may increase clumping of platelets, the type of blood cell largely responsible for clotting. Sometimes doctors skip the lifestyle changes and drugs and go straight to the surgical procedures in advanced cases where the other therapies look to be useless. Women who smoke at least 20 cigarettes a day have a ¬†six times greater risk than do women who’ve never smoked. For example, metabolic syndrome, a cluster of conditions that includes elevated blood pressure, high triglycerides, elevated insulin levels and excess body fat around the waist, increases the risk of coronary artery disease. High levels of lipoprotein (a) may be associated with an increased risk of cardiovascular disease, including coronary artery disease and heart attack. Then there are those who think outside the box and learn how to not only prevent coronary artery disease but how to reverse it, get rid of it! Coronary Artery Disease (CAD) is the major cause of heart failure in which the blood vessels that supply oxygen to the heart becomes narrow and shrink. Whenever you observe sudden increase in weight, it may be indication of accumulation of extra fluid in lungs. The pain also may occur in your shoulders, arms, neck, jaw, or back (between the shoulder blades). Potassium-sparing diuretics may cause hyperkalemia when used with potassium supplements or ACE inhibitors. Other causes which results in heart failure are infection in heart valves, heart attack and congenital (by birth) heart disease.
In some cases diseases like anemia, emphysema and thyroid problem can cause failure of heart.

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