The Heart

What Is Heart Disease?

The human heart is built for amazing endurance -- billions of beats in an average lifetime. But like any other part of the body, it is vulnerable to breakdowns. Heart problems vary widely in their nature and severity. They may be transient or chronic, slow-developing or sudden, inconvenient or deadly.

Some types of heart disease, closely linked to diet and lifestyle choices, are preventable; others are due to genetic inheritance, infections, or other uncontrollable factors. Two of every five Americans will ultimately die of heart disease. The daily toll is approximately 2,500 people. Fortunately, the death rate is declining steadily (by about 40% since 1960), thanks largely to improved medical care and widespread public education about risk factors.

The following is a list of the most common types of heart disease:

Coronary Artery Disease

Coronary artery disease, the most common of all heart problems, is characterized by blockages in the coronary arteries that result in a reduction in blood flow to the heart muscle, depriving it of vital oxygen. Usually, the disease stems from atherosclerosis, a condition sometimes called hardening of the arteries.

Severe coronary artery disease can lead to heart failure. Coronary heart disease can also result in painful episodes of angina (chest pain due to coronary disease) or a heart attack or, in the worst case, sudden death.

There are many things that can put a person at higher risk of developing coronary disease:

• Family history
• Gender -- Men are more apt to be affected than women.
• Genetics
• Age -- For both men and women, the likelihood of heart disease increases significantly after the age of 65. The risk rises sharply in women after menopause.
• Abnormal cholesterol levels -- high blood levels of "bad" (LDL cholesterol) or low levels of "good" (HDL cholesterol)
• High blood pressure (hypertension)
• Smoking
• Obesity
• Sedentary lifestyle
• Stress

Heart Arrhythmias

• Arrhythmias are disturbances in the heart's normal beating pattern. The irregularities occur in many forms, each with its own potential causes and treatments. Serious arrhythmias are a frequent consequence of other heart diseases but may also occur independently.

Heart Failure

• The term heart failure does not mean that the heart has "failed" or stopped working. Rather, it means that the heart does not pump blood as well as it should. Heart failure is usually caused by coronary artery disease, but it can also be caused by thyroid disease, high blood pressure, or heart muscle disease (cardiomyopathy) among other conditions.

Heart Valve Disease

The heart has four valves (the pulmonary, mitral, tricuspid and aortic) that open and close to direct blood flow between the heart's four chambers, the lungs and connected blood vessels. A defective valve may fail either to open properly, obstructing blood flow (stenosis or obstruction), or to close properly (regurgitation or insufficiency), allowing blood leakage. Congenital heart disease and various infections, including rheumatic fever, are among the causes of valve disorders.

Endocarditis is an inflammatory condition that affects heart valves. This disease is an infection or inflammation of the endocardium, the innermost layer of heart tissue that lines the chambers and valves. It is usually caused by bacterial infection, with the staphylococcus and streptococcus bacteria. Bacteria may enter the blood and take root in the heart during illness, after surgery, or as a result of intravenous drug use. Endocarditis tends to strike people with pre-existing valve problems. The disease can be fatal if left untreated, but it can generally be cured with antibiotics. If heart valves are seriously damaged as a result of endocarditis, valve replacement surgery may be needed.

Rheumatic heart disease, another type of heart disease affecting valves, was very common earlier in this century but is now largely preventable with antibiotic treatment, although it still occurs. The disease stems from damage to the heart muscle and valves caused by rheumatic fever, which itself is associated with strep throat and scarlet fever. Symptoms of rheumatic heart disease are usually delayed for many years after infection.

Pericardial Disease

• Any disease of the pericardium, the sac surrounding the heart, is called a pericardial disease. One of the more common is a condition called pericarditis. It is usually caused by viral infection, diseases such as lupus or rheumatoid arthritis, or trauma to the pericardium. Pericarditis often follows open-heart surgery.

Cardiomyopathy (Heart Muscle Disease)

• Diseases of the heart muscle, or myocardium, are collectively referred to as cardiomyopathies. When diseased, the myocardium becomes abnormally stretched, thickened or stiff. Among the many potential causes of cardiomyopathy are genetic heart conditions, reactions to certain drugs or toxins such as alcohol and viral infections. Sometimes, chemotherapy for cancer causes cardiomyopathy. Often, the precise cause of cardiomyopathy is unknown. In any event, either the heart muscle becomes too weak to pump efficiently or stiffening prevents adequate filling of the heart.
• When cardiomyopathy progresses to the point of causing serious arrhythmias or heart failure, the outlook for long-term survival is poor. Sudden death is another outcome associated with some cardiomyopathies, including idiopathic (meaning a disease with no known cause) hypertrophic subaortic stenosis, which has claimed the lives of a few prominent young athletes.
• If cardiomyopathy can be detected and treated early enough, either with drugs or with transplant surgery, symptoms can often be controlled and heart failure averted for many years.

Congenital Heart Disease

• Should anything go wrong in the formation of the heart during prenatal development, a baby will be born with one or more congenital heart defects. Such defects are quite common, occurring in about seven of every 1,000 babies.
• The exact causes of defects are generally hard to pin down; genes and environmental factors inside the mother's body may both contribute. Chromosome abnormalities, including the one that causes Down syndrome, have been linked to many congenital heart defects. Infections contracted during pregnancy by the mother, such as rubella, may also result in congenital heart defects for the child. Congenital heart defects range widely in their effects. Some are apparent immediately, but others do not produce noticeable symptoms until adulthood.
• Among the most common types are septal defects, or holes in septum, which is the wall dividing the left and right sides of the heart. If a septal defect is big enough to cause problems, it can be patched surgically. Another frequently seen defect is pulmonary stenosis, a condition in which one of the four heart valves -- the pulmonary valve -- is so narrow that blood flow to the lungs is restricted. With surgery, the valve can be pried open or replaced. In some babies, a small fetal blood vessel known as the ductus arteriosus fails to close at birth as it should. This condition, known as patent ductus arteriosus, allows some blood that is headed for the body via the aorta to leak back into the pulmonary artery, placing the heart under added strain. This problem can also be corrected surgically or sometimes with medication.
• Some so-called blue babies are born with a combination of four heart defects, which basically results in oxygen-poor blood flow to body tissues. The excess of poorly-oxygenated blood gives the baby a bluish tinge. Unless treated, most people with this condition would not survive to middle age. However, surgery successfully corrects the condition 90% of the time.

Inside the heart

Inside the heart, there are four clearly separate sections or chambers. The right side of the heart, consisting of the right atrium and right ventricle, receives oxygen-poor blood. On the left side of the heart, the left atrium and left ventricle receive oxygen-rich blood.

STATISTICS	FUNCTION	ANALYSIS
… Weight: Less than .45 Kg (one pound) … Length: 13 Cm (5 inches) … Width: 9 Cm (3.5 inches)	Muscular pump sending blood to all parts of the body though a highly intricate network of blood vessels called capillaries.	The heart beats on average 70 times every minute and 100,000 times a day without rest.

Your heart beats more than once a second every day of your life. As blood flows into your heart, the muscles contract, and the blood flows out again. The heart is made of a special muscle, which never tires. This muscles contracts and relaxes 60 to 80 times a minute and during exercise the rate can increase to over one hundred times per minute.

What causes heart failure

Heart disease can occur at any age. However, chronic heart disease becomes more common with advancing age. When your dog starts to age and becomes less active, you may consider having his heart checked.

The heart is a four-chambered pump whose role is to receive blood that needs oxygen and pump it into the lungs, where carbon dioxide is exchanged for oxygen. Then the heart pumps the oxygen-rich blood throughout the body.

Heart failure is a condition in which a heart, weakened by disease, cannot receive and pump blood adequately to meet the needs of the body. As a result, blood starts to pool, fluids build up (congestion) and causes coughing, weakness and breathing difficulties, which may result in death.

What causes heart failure?

There are many causes of heart failure. However, among the most common are:

Acquired heart disease (e.g. chronic disease of the heart valves)

Congenital heart disease

Acquired heart disease in older, small breeds of dogs usually involves degeneration of the valves which results in leakage and loss of pumping efficiency of the heart. There are some breeds which are very at risk such as Maltese, miniature and Toy Poodles, Pomeranians and Yorkshire Terriers.

In large breeds of dogs, such as Doberman, Great Danes, Boxers and Labrador Retrievers the disease usually involves a weakness in the heart muscle and is typically found in middle-aged male dogs.

Both conditions result in an increased workload on the heart, which gradually enlarges in size as the heart muscle stretches in an effort to pump more blood. As efficiency drops, fluid begins to build-up in the lungs
and/or abdomen. Dogs of any size can become affected by heart disease.

Congenital heart disease occurs more rarely and results from birth defects of the heart muscle and/or valves.

Physical examination - with careful exam-ination including listening to the heart and lungs with the stethoscope, your vet can detect heart murmurs, irregular beats, weak pulse, and the presence of congestion in the chest or abdomen.

What are the warning signs?

Rapid or difficult breathing
Cough (especially when the dog rises in the morning)
Tires easily, puffs and pants more
Appetite loss
Weight Loss
Pot-bellied appearance
Pale or grey/blue gums

These signs may be caused by other factors, not just heart failure. Be sure to have your dog checked by a veterinarian if you notice these changes.

How does the veterinarian determine the existence and cause of heart failure?

Electrocardiogram (ECG) - this simple test detects irregular and abnormal heart beats, called arrhythmia, and provides information that helps the veterinarian determine the type of treatment needed.

Chest X-ray - evaluates the size and shape of the heart, lungs and blood vessels. Heart en-largement and fluid congestion in the lungs can be detected and helps to make a correct diagnosis and an assessment of the severity of the condition.

Echocardiogram - this test uses sound waves to harmlessly examine the inside of the heart and blood vessels. It can also detect how strongly the heart beats, show abnormalities which cause heart murmurs, cancer and congenital birth defects.

What can be done if my dog has heart failure?

Exercise: may have to be limited to below the level that provokes signs of discomfort ­ fatigue, laboured breathing, or coughing.

Diet: Together with drug therapy, a change in diet is essential to help maintain heart function. Restricted salt content helps prevent excessive blood pressure, one of the dangerous effects of heart disease. Added Taurine and L-carnitine also helps to improve heart muscle contraction, thereby improving blood flow. All the above requirements are met in Hill№s® Prescription Diet® h/d®, a therapeutic pet food which is also low in protein and phosphorous to help the kidneys function at a time when they are under stress due to lack of blood flow.

Excess weight can exacerbate heart disease, so keep your pet№s weight under control by feeding correctly.

Drug therapy: Most heart conditions have traditionally been controlled by drug treatments that remove congestion (fluid build up), control irregular heartbeats (arrhythmia), or improve the action of the heart muscle (contraction). The latest advance in the treatment of heart failure in dogs is a drug that actually intervenes in the compensatory processes that the body instigates when the heart cannot adequately receive the pumped blood. These processes are initially beneficial to the dog. However in a chronically ill dog, the process eventually perpetuates the cycle of heart failure.

What can I do now?

Talk to your vet:

If your dog exhibits any of the signs indicating underlying heart disease, such as difficulty in breathing, chronic coughing, lethargy and appetite or weight loss, you should consult your veterinarian

exercise and decreased risk of heart disease

Women Who Walk Reduce Their Risk of Both Heart Disease and Stroke

A recent study has found that women who walk at least three hours a week can reduce the risk of heart attack and stroke by 40%, and the reduction is even greater for women who walk faster. The research was led by Dr. JoAnn Manson, director of women's health at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School. Findings were presented at the American Heart Association (AHA) annual meeting in New Orleans on November 12, 1996.

The researchers studied 84,000 female nurses aged 40 to 65 who had no evidence of heart disease. The participants were surveyed about their walking habits once in 1986 and then twice more over the next eight years.The researchers found that for 50% of the participants, the only form of exercise that was performed was walking, while 10% of the participants did not exercise at all. During the eight years, 590 heart attacks and 456 strokes were reported.

The results of the study indicated that women who walked briskly (3 to 4 miles an hour) reduced the risk of heart disease by 54%, and those women who walked more slowly reduced their risk by 32% compared to women who did not walk at all. There were similar findings for the risk reduction of stroke.

Dr. Manson noted that there have been very few studies connecting physical activity to cardiovascular disease and stroke in women. The research is also important in light of recent federal exercise guidelines which recommend at least 30 minutes a day of moderate exercise. As of 1992, the AHA has identified a lack of physical activity as a risk factor for heart disease, and therefore recommends at least moderate intensity activity for those people who can not exercise more strenuously or who are inactive.

Dr. Manson also stressed the overall benefit exercise plays in a variety of other health concerns including lowering blood pressure and cholesterol, reducing weight, and reducing the risk of diabetes, osteoporosis and certain kinds of cancer. It also helps to reduce stress.

The link between exercise and decreased risk of heart disease and stroke is not simply theoretical, and this is one more study demonstrating the positive benefits of exercise. Importantly, it was done on women, on whom much less information is available. The good news is that the exercise need not be strenuous; even regular walking decreases risk. So if you're not in the habit--well, time to get moving!

Facts on Heart Disease

Physicians in on time have pointed out some factors that can put individuals at risk for heart disease. The following consist of family history, high blood pressure, high blood cholesterol level, cigarette smoking, diabetes mellitus, sedentary lifestyle, obesity, advancing age and being male.

What people with high blood pressure can do is to make some changes on diet and lifestyle, or using medication to lower it. In addition to that, individuals should make a detailed exercise plan, focusing on aerobic activities that increase lung capacity and the heart’s ability to work at higher levels.

People who are aware of this danger have checkups and take medication before high blood pressure damages their heart and blood vessels. Those who have high levels of cholesterol in the blood should have regular checkups and make sure to take proper medication before it damages one’s heart and blood vessels.

The best way to make each member of the family become aware of the threat is to educate the children at home regarding the harm that a heart disease could be brought to them. More importantly, parents must have the basic knowledge on how to prevent such an illness from getting into them.

Periodontitis & Heart Attack

Coronary heart disease is the leading cause of death worldwide, and Periodontitis, which leads to the loss of connective tissue and the bone support of teeth, is the major cause of tooth loss in adults over 40 years.

Periodontitis is very common, and around 90% of people aged over 60 suffer from it. Research has already shown a genetic basis for both diseases.

Scientists have discovered a genetic relationship between the two conditions, a researcher told the annual conference of the European Society of Human Genetics.

Because of its association with CHD, periodontitis should be taken very seriously by dentists and diagnosed and treated as early as possible

Both CHD and periodontitis are propagated by the same risk factors – most importantly:

• smoking



• diabetes
  
• obesity – and there is also a gender relationship, with men possibly more liable to these diseases than women.

Researchers have also shown similarities in the bacteria found in the oral cavity and in coronary plaques, and both diseases are characterised by an imbalanced immune reaction and chronic inflammation.

Patients with periodontitis should try to reduce their risk factors and take preventive measures at an early stage

Patients With Moderate To Severe Periodontitis Need Evaluation For Heart Disease Risk: (Jul/1/2009)

Patients should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), now there is a strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD – the accumulation of lipid products within the arterial vascular wall.

The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is

• Inflammation caused by the immune system.
• Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking, diabetes mellitus, genetics, mental anxiety, depression, obesity, and physical inactivity.

Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis.

Patients should consider a medical evaluation if they have not done so in the past 12 months.

See also: Periodontal Disease: How To Protect Your Teeth And Gums

Sources:
European Society of Human Genetics
The American Journal of Cardiology
The American Journal of Periodontology

Heart Disease: Symptoms

Coronary artery disease, heart attack -- each type of heart disease has different symptoms, although many heart problems have similar symptoms. The symptoms you experience depend on the type and severity of your heart condition. Learn to recognize your symptoms and the situations that cause them. Call your doctor if you begin to have new symptoms or if they become more frequent or severe.

Coronary Artery Disease

The most common symptom is angina. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the shoulders, arms, neck, throat, jaw or back.

Other symptoms that can occur with coronary artery disease include:

• Shortness of breath
• Palpitations (irregular heart beats, skipped beats or a "flip-flop" feeling in your chest)
• A faster heartbeat
• Weakness or dizziness
• Nausea
• Sweating

Heart Attack (Myocardial Infarction or MI)

Symptoms can include:

• Discomfort, pressure, heaviness, or pain in the chest, arm or below the breastbone
• Discomfort radiating to the back, jaw, throat or arm
• Fullness, indigestion or choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting or dizziness
• Extreme weakness, anxiety or shortness of breath
• Rapid or irregular heartbeats

During a heart attack, symptoms typically last 30 minutes or longer and are not relieved by rest or oral medications (medications taken by mouth). Initial symptoms can start as a mild discomfort that progresses to significant pain.

Some people have a heart attack without having any symptoms (a "silent" MI). A silent MI can occur among all people, though it occurs more often among diabetics.

If you think you are having a heart attack, DO NOT DELAY. Call for emergency help (dial 911 in most areas). Immediate treatment of a heart attack is very important to lessen the amount of damage to your heart.

Arrhythmias

When symptoms of arrhythmias are present, they may include:

• Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops," or feeling that your heart is "running away").
• Pounding in your chest.
• Dizziness or feeling light-headed.
• Fainting.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

Atrial Fibrillation

Atrial Fibrillation(AF) is a type of arrhythmia. Most people with AF experience one or more of the following symptoms:

• Heart palpitations (a sudden pounding, fluttering, or racing feeling in the heart).
• Lack of energy; tired.
• Dizziness (feeling faint or light-headed).
• Chest discomfort (pain, pressure, or discomfort in the chest).
• Shortness of breath (difficulty breathing during activities of daily living).

Some patients with atrial fibrillation have no symptoms. Sometimes these episodes are briefer.

eart Valve Disease

Symptoms of Heart valve disease can include:

• Shortness of breath and/or difficulty catching your breath. You may notice this most when you are active (doing your normal daily activities) or when you lie down flat in bed.
• Weakness or dizziness.
• Discomfort in your chest. You may feel a pressure or weight in your chest with activity or when going out in cold air.
• Palpitations (this may feel like a rapid heart rhythm, irregular heartbeat, skipped beats or a flip-flop feeling in your chest).
• If valve disease causes heart failure, symptoms may include:
• Swelling of your ankles, feet or abdomen. Swelling may also occur in your belly, which may cause you to feel bloated.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).

Symptoms do not always relate to the seriousness of your valve disease. You may have no symptoms at all and have severe valve disease, requiring prompt treatment. Or, as with mitral valve prolapse, you may have severe symptoms, yet tests may show minor valve disease.

Heart Failure

Symptoms of Heart failure can include:

• Shortness of breath noted during activity (most commonly) or at rest, especially when you lie down flat in bed.
• Cough that is productive of a white mucus.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).
• Swelling in ankles, legs and abdomen.
• Dizziness.
• Fatigue and weakness.
• Rapid or irregular heartbeats.
• Other symptoms include nausea, palpitations and chest pain.

Like valve disease, heart failure symptoms may not be related to how weak your heart is. You may have many symptoms, but your heart function may be only mildly weakened. Or you may have a severely damaged heart, with little or no symptoms.

Congential Heart Disease

Congenital heart defects may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. Sometimes it can be diagnosed because of a heart murmur on physical exam or an abnormal EKG or chest X-ray in an asymptomatic person.

In adults, if symptoms are present, they may include:

• Shortness of breath.
• Limited ability to exercise.
• Symptoms of heart failure (see above) or valve disease (see above).

Congenital Heart Disease in Infants and Children

Symptoms can include:

• Cyanosis (a bluish tint to the skin, fingernails and lips).
• Fast breathing and poor feeding.
• Poor weight gain.
• Recurrent lung infections.
• Inability to exercise.

Heart Muscle Disease (Cardiomyopathy)

Many people with heart muscle disease have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which progress and worsen as heart function worsens.

Symptoms can occur at any age and may include:

• Chest pain or pressure (occurs usually with exercise or physical activity, but can also occur with rest or after meals).
• Heart failure symptoms (see above).
• Swelling of the lower extremities.
• Fatigue.
• Fainting.
• Palpitations (fluttering in the chest due to abnormal heart rhythms).

Some people also have arrhythmias. These can lead to sudden death in a small number of people with cardiomyopathy.

Pericarditis

When present, symptoms of pericarditis may include:

• Chest pain. This pain is different from angina (pain caused by Coronary artery disease. It may be sharp and located in the center of the chest. The pain may radiate to the neck and occasionally, the arms and back. It is made worse when lying down, taking a deep breath in, coughing or swallowing and relieved by sitting forward.

• Low-grade fever.

• Increased heart rate.

Because many of the symptoms associated with each type of heart disease are similar, it is important to see your doctor so that you can receive a correct diagnosis and prompt treatment.

Heart disease

Heart disease is an umbrella term for a number of different diseases which affect the heart and as of 2007 it is the leading cause of death in the United States,and England and Wales.

Types of heart disease

Cardiomyopathy

Cardiomyopathy literally means "heart muscle disease". It is the deterioration of the function of the myocardium (i.e., the actual heart muscle) for any reason. People with cardiomyopathy are often at risk of arrhythmia and/or sudden cardiac death.

• Extrinsic cardiomyopathies - cardiomyopathies where the primary pathology is outside the myocardium itself. Most cardiomyopathies are extrinsic, because by far the most common cause of a cardiomyopathy is ischemia. The World Health Organization calls these specific cardiomyopathies:
• Alcoholic cardiomyopathy
• Coronary artery disease
• Congenital heart disease - see below
• Nutritional diseases affecting the heart
• Ischemic (or ischaemic) cardiomyopathy
• Hypertensive cardiomyopathy
• Valvular cardiomyopathy
• Inflammatory cardiomyopathy
• Cardiomyopathy secondary to a systemic metabolic disease
• 
  
• Intrinsic cardiomyopathies - weakness in the muscle of the heart that is not due to an identifiable external cause.
• Dilated cardiomyopathy (DCM) - most common form, and one of the leading indications for heart transplantation. In DCM the heart (especially the left ventricle) is enlarged and the pumping function is diminished.
• Hypertrophic cardiomyopathy (HCM or HOCM) - genetic disorder caused by various mutations in genes encoding sarcomeric proteins. In HCM the heart muscle is thickened, which can obstruct blood flow and prevent the heart from functioning properly.
• Arrhythmogenic right ventricular cardiomyopathy (ARVC) - arises from an electrical disturbance of the heart in which heart muscle is replaced by fibrous scar tissue. The right ventricle is generally most affected.
• Restrictive cardiomyopathy (RCM) - least common cardiomyopathy. The walls of the ventricles are stiff, but may not be thickened, and resist the normal filling of the heart with blood. ** Noncompaction Cardiomyopathy - the left ventricle wall has failed to properly grow from birth and such has a spongy appearance when viewed during an echocardiogram.

Cardiovascular disease

Cardiovascular disease is any of a number of specific diseases that affect the heart itself and/or the blood vessel system, especially the veins and arteries leading to and from the heart. Research on disease dimorphism suggests that women who suffer with cardiovascular disease usually suffer from forms that affect the blood vessels while men usually suffer from forms that affect the heart muscle itself. Known or associated causes of cardiovascular disease include diabetes mellitus, hypertension, hyperhomocysteinemia and hypercholesterolemia. Research has shown that a low fat,vegetarian diet can reduce the chance of cardiovascular disease and may also reverse conditions such as restriction of the blood vessels or "clogging."

Types of cardiovascular disease include:

• Atherosclerosis

Congenital heart disease

Congenital heart disease, existing primarily at birth, refers to any of a number of heart diseases caused by unavoidable genetic factors.

• Aortic valve stenosis

Coronary heart disease

Coronary heart disease is a disease of the heart caused by the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium. Angina pectoris and myocardial infarction (heart attack) are symptoms of and conditions caused by coronary heart disease.

• Ischaemic heart disease - another disease of the heart itself, characterized by reduced blood supply to the organ.

Heart failure

Heart failure, also called congestive heart failure (or CHF), and congestive cardiac failure (CCF), is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body.

• Cor pulmonale, a failure of the right side of the heart.

Hypertensive heart disease

Hypertensive heart disease, heart disease caused by high blood pressure, especially localised high blood pressure. Conditions that can be caused by hypertensive heart disease include:

• Left ventricular hypertrophy
• Coronary heart disease
• (Congestive) heart failure
• Hypertensive cardiomyopathy
• Cardiac arrhythmias

Inflammatory heart disease

Inflammatory heart disease involves inflammation of the heart muscle and/or the tissue surrounding it.

• Endocarditis - inflammation of the inner layer of the heart, the endocardium. The most common structures involved are the heart valves.
• Inflammatory cardiomyopathy
• Myocarditis - inflammation of the myocardium, the muscular part of the heart. It is generally due to infection (viral or bacterial). It may present with chest pain, rapid signs of heart failure, or sudden death.

Valvular heart disease

Valvular heart disease is any disease process involving one or more valves of the heart. The valves in the right side of the heart are the tricuspid valve and the pulmonic valve. The valves in the left side of the heart are the mitral valve and the aortic valve.

• Aortic valve stenosis
• Mitral valve prolapse
• Valvular cardiomyopathy

CATCH UP! – Stem Cell Research Effective in Heart Disease Patients at Northwestern | Culture11

CATCH UP! – Stem Cell Research Effective in Heart Disease Patients at Northwestern | Culture11

In ALL ARTICLES on March 30, 2009 at 9:51 am

With hundreds if not thousands of successful adult stem cell treatments around the world for cardiovascular patients, the US is s..l..o..w..l..y.. realizing the benefits of adult stem cells and posting headlines like

“Stem Cell Research Effective in Heart Disease Patients”

Great news! and you are only a full five years late. CATCH UP! – dg

Stem Cell Research Effective in Heart Disease Patients at Northwestern

by Don Margolis, March 29, 2009

Stem Cell Research for Coronary Artery Disease a Success

Dr. Douglas Losordo, the director of Northwestern University’s Cardiovascular Institute is reporting that his stem cell research Phase II study of 170 heart disease (severe coronary artery disease) patients treated with using Adult Stem Cells was a success.

Adult Stem Cells Give Impressive Results

Patients receiving their own Adult Stem Cells had improved tolerance to exercise and less discomfort after their follow up at 6 months.

From the stem cell treatment article:
Dr. Losordo says “The six-month, phase II data provide the first evidence that a patient’s own stem cells could actually be used as a treatment for their heart disease.”

How Adult Stem Cells Work for Heart Disease

It is believed the stem cells help rebuild damaged heart tissue as well as create new blood vessels helping more blood flow through out the body.

5 more years until Stem Cell Therapy Available for Heart Patients?

The results were so promising that Dr. Losordo and Baxter, the stem cell research company that sponsored the study will move forward with a Phase III trial.

After the Phase III trial is completed, Baxter would be able to submit the results to the US FDA for approval. However, before heart disease patients start celebrating, keep in mind that this will take at least 5 more years.

And Stem Cell Research for Other Diseases?

5 more years for Adult Stem Cell treatment to be available to heart patients in the United States- and stem cell therapy for the heart is the most advanced as far as clinical trials using Adult Stem Cells go. So for Diabetes, Emphysema, Peripheral Artery Disease and others…we are probably looking at 10+ years before Adult Stem Cell research will be put to use.

Better Late Than Never for Adult Stem Cells? Is this the best we can hope for? Wait for these endless clinical trials to be completed for each particular disease? Wait for the use of our own cells, something already proven safe? Or is there something we can do to speed things up? A group of US doctors for Adult Stem Cell Therapy are trying to change things. What do you think we can do?

Preventing Carbon Monoxide Poisoning After an Emergency

Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death if inhaled.

When power outages occur during emergencies such as hurricanes or winter storms, the use of alternative sources of fuel or electricity for heating, cooling, or cooking can cause CO to build up in a home, garage, or camper and to poison the people and animals inside.

Every year, more than 400 people die in the U. S. from accidental CO poisoning.

CO is found in combustion fumes, such as those produced by small gasoline engines, stoves, generators, lanterns, and gas ranges, or by burning charcoal and wood. CO from these sources can build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can die from breathing CO.

How to Recognize CO Poisoning

Exposure to CO can cause loss of consciousness and death. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. People who are sleeping or who have been drinking alcohol can die from CO poisoning before ever having symptoms.

Important CO Poisoning Prevention Tips

• Never use a gas range or oven to heat a home.
• Never leave the motor running in a vehicle parked in an enclosed or partially enclosed space, such as a garage.
• Never run a motor vehicle, generator, pressure washer, or any gasoline-powered engine outside an open window, door, or vent where exhaust can vent into an enclosed area.
• Never run a generator, pressure washer, or any gasoline-powered engine inside a basement, garage, or other enclosed structure, even if the doors or windows are open, unless the equipment is professionally installed and vented. Keep vents and flues free of debris, especially if winds are high. Flying debris can block ventilation lines.
• Never use a charcoal grill, hibachi, lantern, or portable camping stove inside a home, tent, or camper.
• If conditions are too hot or too cold, seek shelter with friends or at a community shelter.
• If CO poisoning is suspected, consult a health care professional right away.

When Your Infant or Child Has a Fever

What is a normal temperature?

A normal temperature is about 98.6°F when taken orally (by mouth). Temperatures taken rectally (by rectum) usually run 1° higher than those taken orally. So a normal temperature is about 99.6°F when taken rectally. Many doctors define a fever as an oral temperature above 99.4°F or a rectal temperature above 100.4°F.

How should I take my child’s temperature?

The most accurate way to take your child’s temperature is orally or rectally with a digital thermometer. In a child younger than about 4 years, take the temperature rectally. In an older child, take it orally.

• Mercury thermometers should not be used. Mercury is an environmental toxin, and you don’t want to risk exposing your family to it. If you have a mercury thermometer at home, you should remove it and use a digital thermometer.
• Don’t bundle your baby or child up too tightly before taking his or her temperature.
• Never leave your child alone while taking his or her temperature.
• Be sure you use the right thermometer. Read the package instructions to see if you have an oral or rectal thermometer.
• If you’re taking your child’s temperature rectally, coat the tip of the thermometer with petroleum jelly (brand name: Vaseline) and insert it half an inch into the rectum. Hold the thermometer still and do not let go. When the thermometer beeps, remove it and check the digital reading.
• If you’re taking your child’s temperature orally, place the end of the thermometer under the tongue and leave it there until the thermometer beeps. Remove the thermometer and check the digital reading.
• After you’re done using the thermometer, wash it in cool, soapy water.

When should I try to lower my child’s fever?

Fevers are a sign that the body is fighting an infection, so you may want to avoid giving medicine if your child is running a low-grade (up to 100.2°F) fever. The main reason to treat your child is to make him or her feel better. When your child is achy and fussy or his of her temperature is above 100.2°F, you may want to give him or her some medicine.

What kind of medicine and how much is needed to lower a fever?

Acetaminophen (one brand name: Children’s or Infants’ Tylenol) relieves pain and lowers fever. How much acetaminophen your child may need depends on his or her weight and age. Check the package label or ask your doctor about the correct dosage for your child.

Talk to your doctor before giving ibuprofen (brand names: Children’s Advil, Children’s Motrin) to your child. Your doctor will tell you the correct dose for your child.

Tips on giving medicine

• Don’t give more than 5 doses in 1 day.
• Don’t give a baby younger than 3 months old medicine unless your family doctor tells you to.
• Read labels carefully. Make sure you are giving your child the right amount of medicine.
• If using drops, fill the dropper to the line.
• For liquid elixir, use a liquid measuring device to make sure you give the right dose. Get one at your drug store or ask your pharmacist.

Why not use aspirin to lower my child’s fever?

In rare cases aspirin can cause Reye’s syndrome in children. Reye’s syndrome is a serious illness that can lead to death. Doctors recommend that parents avoid giving aspirin to children under 18 years of age.

Are there other ways to help my child feel better?

• Give your child plenty of fluids to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself.
• Make sure your child gets plenty of rest.
• Keep the room temperature at about 70°F to 74°F.
• Dress your child in light cotton pajamas so that body heat can escape.
• If your child is chilled, put on an extra blanket but remove it when the chills stop.

Will a bath help lower my child’s fever?

Used together, acetaminophen and a lukewarm bath may help lower a fever. Give the acetaminophen before the bath. If the bath is given alone, your child may start shivering as his or her body tries to raise its temperature again. This may make your child feel worse. Don’t use alcohol or cold water for baths.

When should I call the doctor?

If your child has any of the warning signs listed in the box below, call your family doctor.

Less than 3 months old. Call your doctor right away if your baby’s temperature goes over 100.4°F rectally, even if he or she doesn’t seem sick. Babies this young can get very sick very quickly.

Three to 6 months old. Call your doctor if your baby has a temperature of 101°F or higher (even if your baby doesn’t seem sick).

Six months and older. If your child has a fever of 102°F, watch how he or she acts. Call your doctor if the fever rises or lasts for more than 3 days. In children 3 months to 2 years of age, if the temperature is 103°F, call your doctor even if your child seems to feel fine.

Call your doctor if your baby or child has any of these warning signs

• Constant vomiting or diarrhea
• Dry mouth
• Earache or pulling at ears
• Fever comes and goes over several days
• High-pitched crying
• Irritable
• Not hungry
• Pale
• Seizures
• Severe headache
• Skin rash
• Sore or swollen joints
• Sore throat
• Stiff neck
• Stomach pain
• Swelling of the soft spot on the head
• Unresponsive or limp
• Wheezing or problems breathing
• Whimpering

Dysphagia

People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.

How do we swallow?

Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to move food from the mouth to the stomach. This happens in three stages. First, the tongue moves the food around in the mouth for chewing. Chewing makes the food the right size to swallow and helps mix the food with saliva. Saliva softens and moistens the food to make swallowing easier. During this first stage, the tongue collects the prepared food or liquid, making it ready for swallowing.

The second stage begins when the tongue pushes the food or liquid to the back of the mouth, which triggers a swallowing reflex that passes the food through the pharynx (the canal that connects the mouth with the esophagus). During this stage, the larynx (voice box) closes tightly and breathing stops to prevent food or liquid from entering the lungs.

The third stage begins when food or liquid enters the esophagus, the canal that carries food and liquid to the stomach. This passage through the esophagus usually occurs in about 3 seconds, depending on the texture or consistency of the food.

How does dysphagia occur?

Dysphagia occurs when there is a problem with any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage of air.

Other problems include not being able to start the swallowing reflex (a stimulus that allows food and liquids to move safely through the pharynx) because of a stroke or other nervous system disorder. People with these kinds of problems are unable to begin the muscle movements that allow food to move from the mouth to the stomach. Another difficulty can occur when weak throat muscles cannot move all of the food toward the stomach. Bits of food can fall or be pulled into the windpipe (trachea), which may result in lung infection.

What are some problems caused by dysphagia?

Dysphagia can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight.

Sometimes, when foods or liquids enter the windpipe of a person who has dysphagia, coughing or throat clearing cannot remove it. Food or liquid that stays in the windpipe may enter the lungs and create a chance for harmful bacteria to grow. A serious infection (aspiration pneumonia) can result.

Swallowing disorders may also include the development of a pocket outside the esophagus caused by weakness in the esophageal wall. This abnormal pocket traps some food being swallowed. While lying down or sleeping, a person with this problem may draw undigested food into the pharynx. The esophagus may be too narrow, causing food to stick. This food may prevent other food or even liquids from entering the stomach.

What causes dysphagia?

Dysphagia has many causes. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson’s disease, often have problems swallowing. Additionally, stroke or head injury may affect the coordination of the swallowing muscles or limit sensation in the mouth and throat. An infection or irritation can cause narrowing of the esophagus. People born with abnormalities of the swallowing mechanism may not be able to swallow normally. Infants who are born with a hole in the roof of the mouth (cleft palate) are unable to suck properly, which complicates nursing and drinking from a regular baby bottle.

In addition, cancer of the head, neck, or esophagus may cause swallowing problems. Sometimes the treatment for these types of cancers can cause dysphagia. Injuries of the head, neck, and chest may also create swallowing problems.

How is dysphagia treated?

There are different treatments for various types of dysphagia. First, doctors and speech-language pathologists who test for and treat swallowing disorders use a variety of tests that allow them to look at the parts of the swallowing mechanism. One test, called a fiber optic laryngoscopy, allows the doctor to look down the throat with a lighted tube. Other tests, including video fluoroscopy, which takes videotapes of a patient swallowing, and ultrasound, which produces images of internal body organs, can painlessly take pictures of various stages of swallowing.

Once the cause of the dysphagia is found, surgery or medication may help. If treating the cause of the dysphagia does not help, the doctor may have the patient see a speech-language pathologist who is trained in testing and treating swallowing disorders. The speech-language pathologist will test the person’s ability to eat and drink and may teach the person new ways to swallow.

Treatment may involve muscle exercises to strengthen weak facial muscles or to improve coordination. For others, treatment may involve learning to eat in a special way. For example, some people may have to eat with their head turned to one side or looking straight ahead. Preparing food in a certain way or avoiding certain foods may help other people. For instance, those who cannot swallow liquids may need to add special thickeners to their drinks. Other people may have to avoid hot or cold foods or drinks.

For some, however, consuming foods and liquids by mouth may no longer be possible. These individuals must use other methods to nourish their bodies. Usually this involves a feeding system, such as a feeding tube, that bypasses the part of the swallowing mechanism that is not working normally.

What research is being done on dysphagia?

Scientists are conducting research that will improve the ability of physicians and speech-language pathologists to evaluate and treat swallowing disorders. All aspects of the swallowing process are being studied in people of all ages, including those who do and do not have dysphagia. For example, scientists have found that there is great variation in tongue movement during swallowing. Knowing which tongue movements cause problems will help physicians and speech-language pathologists evaluate swallowing.

Research has also led to new, safe ways to study tongue and throat movements during the swallowing process. These methods will help physician and speech pathologists safely reevaluate a patient’s progress during treatment. Studies of treatment methods are helping scientists discover why some forms of treatment work with some people and not with others. For example, research has shown that, in most cases, a patient who has had a stroke should not drink with his or her head tipped back. Other research has shown that some patients with cancer who have had part or all of their tongue removed should drink with their head tipped back. This knowledge will help some patients avoid serious lung infections and help others avoid tube feedings.

Where can I get help?

If you have a swallowing problem, you may need to consult with an otolaryngologist (physician with special training in disorders of the ear, nose, and throat) or a speech-language pathologist trained in dysphagia. You may need to consult with a neurologist if a stroke or other neurologic disorder causes the swallowing problem. Other trained professionals who may provide treatment are occupational therapists and physical therapists.

Mind/Body Connection: How Your Emotions Affect Your Health

What is good emotional health?

People with good emotional health are aware of their thoughts, feelings and behaviors. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves and have healthy relationships.

However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety. These things include:

• Being laid off from your job
• Having a child leave or return home
• Dealing with the death of a loved one
• Getting divorced or married
• Suffering an illness or an injury
• Getting a job promotion
• Experiencing money problems
• Moving to a new home
• Having a baby.

“Good” changes can be just as stressful as “bad” changes.

How can my emotions affect my health?

Your body responds to the way you think, feel and act. This is often called the “mind/body connection.” When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. The following can be physical signs that your emotional health is out of balance:

• Back pain
• Change in appetite
• Chest pain
• Constipation or diarrhea
• Dry mouth
• Extreme tiredness
• General aches and pains
• Headaches
• High blood pressure
• Insomnia (trouble sleeping)
• Lightheadedness
• Palpitations (the feeling that your heart is racing)
• Sexual problems
• Shortness of breath
• Stiff neck
• Sweating
• Upset stomach
• Weight gain or loss

Poor emotional health can weaken your body’s immune system, making you more likely to get colds and other infections during emotionally difficult times. Also, when you are feeling stressed, anxious or upset, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco or other drugs may also be a sign of poor emotional health.

Why does my doctor need to know about my emotions?

You may not be used to talking to your doctor about your feelings or problems in your personal life. But remember, he or she can’t always tell that you’re feeling stressed, anxious or upset just by looking at you. It’s important to be honest with your doctor if you are having these feelings.

First, he or she will need to make sure that other health problems aren’t causing your physical symptoms. If your symptoms aren’t caused by other health problems, you and your doctor can address the emotional causes of your symptoms. Your doctor may suggest ways to treat your physical symptoms while you work together to improve your emotional health.

If your negative feelings don’t go away and are so strong that they keep you from enjoying life, it’s especially important for you to talk to your doctor. You may have what doctors call “major depression.” Depression is a medical illness that can be treated with individualized counseling, medicine or with both.

How can I improve my emotional health?

First, try to recognize your emotions and understand why you are having them. Sorting out the causes of sadness, stress and anxiety in your life can help you manage your emotional health. The following are some other helpful tips.

Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation–such as your family doctor, a counselor or a religious advisor–for advice and support to help you improve your emotional health.

Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.

Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change, and keeping things in perspective.

Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.

Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.

Calcium and Bone Health

Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.

For more information on bone health and osteoporosis please visit the National Osteoporosis Foundation.

Peak Bone Mass

Peak bone mass refers to the genetic potential for bone density. By the age of 20, the average woman has acquired most of her skeletal mass. A large decline in bone mass occurs in older adults, increasing the risk of osteoporosis. For women this occurs around the time of menopause.

It is important for young girls to reach their peak bone mass in order to maintain bone health throughout life. A person with high bone mass as a young adult will be more likely to have a higher bone mass later in life. Inadequate calcium consumption and physical activity early on could result in a failure to achieve peak bone mass in adulthood.

Osteoporosis

Osteoporosis or “porous bone” is a disease of the skeletal system characterized by low bone mass and deterioration of bone tissue. Osteoporosis leads to an increase risk of bone fractures typically in the wrist, hip, and spine.

While men and women of all ages and ethnicities can develop osteoporosis, some of the risk factors for osteoporosis include those who are

• Female
• White/Caucasian
• Post menopausal women
• Older adults
• Small in body size
• Eating a diet low in calcium
• Physically inactive

To find out more about the prevalence and risk factors associated with osteoporosis, please visit the National Osteoporosis Foundation.*

Calcium

Calcium is a mineral needed by the body for healthy bones, teeth, and proper function of the heart, muscles, and nerves. The body cannot produce calcium; therefore, it must be absorbed through food. Good sources of calcium include

• Dairy products—low fat or nonfat milk, cheese, and yogurt
• Dark green leafy vegetables—bok choy and broccoli
• Calcium fortified foods—orange juice, cereal, bread, soy beverages, and tofu products
• Nuts—almonds

Recommended amount of calcium vary for individuals. Below is a table of adequate intakes as outlined by the National Academy of Science.

Recommended Calcium Intakes

Ages	Amount mg/day
Birth–6 months	210
6 months–1 year	270
1–3	500
4–8	800
9–13	1300
14–18	1300
19–30	1000
31–50	1000
51–70	1200
70 or older	1200
Pregnant & Lactating	1000
14–18	1300
19–50	1000

Source: Dietary Reference Intakes for Calcium, National Academy of Sciences, 1997

Vitamin D also plays an important role in healthy bone development. Vitamin D helps in the absorption of calcium (this is why milk is fortified with vitamin D).

For more information on calcium and children visit the National Institute of Child Health and Human Development (NICHD).

Weight-Bearing Physical Activity

Regular physical activity has been associated with many positive health benefits including strong bones. Like proper calcium consumption, adequate weight-bearing physical activity early in life is important in reaching peak bone mass. Weight-bearing physical activities cause muscles and bones to work against gravity. Some examples of weight bearing physical activities include

• Walking, Jogging, or running
• Tennis or Racquetball
• Field Hockey
• Stair climbing
• Jumping rope
• Basketball
• Dancing
• Hiking
• Soccer
• Weight lifting

Incorporating weight-bearing physical activity into an exercise plan is a great way to keep bones healthy and meet physical activity recommendations set forth in the Dietary Guidelines for Americans.

Adults: Engage in at least 30 minutes of moderate physical activity [on] most, preferably all, days of the week

Children: Engage in at least 60 minutes of moderate physical activity [on] most, preferably all, days of the week

10 Important Questions to Ask Your Doctor About Back Pain

.	What is causing my back pain?
2.	What can I do to prevent my back pain from getting worse?
3.	Why is my back vulnerable to pain and injury?
4.	Could stress be a contributing factor, and what can I do about it?
5.	What are my treatment options?
6.	If surgery is recommended, is it really necessary and what are the risks?
7.	What are the potential risks and benefits of other available treatments?
8.	What lifestyle changes do I need to make to keep my back healthy?
9.	How can I be sure that my work does not negatively affect my back?
10.	What are the chances that my back pain will result in permanent disability?

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Chlamydia

What is chlamydia?

Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman’s reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur “silently” before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.

How common is chlamydia?

Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2006, 1,030,911 chlamydial infections were reported to CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. Also, testing is not often done if patients are treated for their symptoms. An estimated 2,291,000 non-institutionalized U.S. civilians ages 14-39 are infected with Chlamydia based on the U.S. National Health and Nutrition Examination Survey. Women are frequently re-infected if their sex partners are not treated.

How do people get chlamydia?

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

Any sexually active person can be infected with chlamydia. The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is probably more susceptible to infection, they are at particularly high risk for infection if sexually active. Since chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection.

What are the symptoms of chlamydia?

Chlamydia is known as a “silent” disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.

Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

What complications can result from untreated chlamydia?

If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences. Like the disease itself, the damage that chlamydia causes is often “silent.”

In women, untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.

To help prevent the serious consequences of chlamydia, screening at least annually for chlamydia is recommended for all sexually active women age 25 years and younger. An annual screening test also is recommended for older women with risk factors for chlamydia (a new sex partner or multiple sex partners). All pregnant women should have a screening test for chlamydia.

Complications among men are rare. Infection sometimes spreads to the epididymis (the tube that carries sperm from the testis), causing pain, fever, and, rarely, sterility.

Rarely, genital chlamydial infection can cause arthritis that can be accompanied by skin lesions and inflammation of the eye and urethra (Reiter’s syndrome).

How does chlamydia affect a pregnant woman and her baby?

In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.

How is chlamydia diagnosed?

There are laboratory tests to diagnose chlamydia. Some can be performed on urine, other tests require that a specimen be collected from a site such as the penis or cervix.

What is the treatment for chlamydia?

Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible.

Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple infections increases a woman’s risk of serious reproductive health complications, including infertility. Retesting should be encouraged for women three to four months after treatment. This is especially true if a woman does not know if her sex partner received treatment.

How can chlamydia be prevented?

The surest way to avoid transmission of STDs is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.

CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STD infection. If a woman has any of these symptoms, she should stop having sex and consult a health care provider immediately. Treating STDs early can prevent PID. Women who are told they have an STD and are treated for it should notify all of their recent sex partners (sex partners within the preceding 60 days) so they can see a health care provider and be evaluated for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary, treated.

Eye Injuries

You can treat many minor eye irritations by flushing the eye with water, but more serious injuries require medical attention.

Injuries to the eye are the most common preventable cause of blindness, so when in doubt, err on the side of caution and call your doctor for help.

What to Do:

Routine Irritations
(sand, dirt, and other foreign bodies on the eye surface)

• Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
• Do not touch, press, or rub the eye itself, and do whatever you can to keep your child from touching it (a baby can be swaddled as a preventive measure).
• Do not try to remove any foreign body except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
• Tilt the child’s head over a basin or sink with the affected eye down and gently pull down the lower lid, encouraging the child to open his or her eyes as wide as possible. For an infant or small child, it’s helpful to have a second person hold the child’s eyes open while you flush.
• Gently pour a steady stream of lukewarm water (do not heat the water) from a pitcher or faucet over the eye.
• Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
• Because a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if there continues to be any irritation afterward.
• If a foreign body is not dislodged by flushing, it will probably be necessary for a trained medical professional to flush the eye.

Embedded Foreign Body
(an object penetrates or enters the globe of the eye)

If an object, such as a piece of glass or metal, is sticking out of the eye, take the following steps:

• Call for emergency medical help.
• Cover the affected eye with a small cup taped in place. The point is to keep all pressure off the globe of the eye.
• Keep your child (and yourself) as calm and comfortable as possible until help arrives.

Chemical Exposure

• Many chemicals, even those found around the house, can damage an eye. If your child gets a chemical in the eye and you know what it is, look on the product’s container for an emergency number to call for instructions.
• Flush the eye (see above) with lukewarm water for 15 to 30 minutes. If both eyes are affected, flush them in the shower.
• Call for emergency medical help.

Call your local poison control center for specific instructions. Be prepared to give the exact name of the chemical, if you have it. However, do not delay flushing the eye first.

Black Eye, Blunt Injury, or Contusion

A black eye is often a minor injury, but it can also appear when there is significant eye injury or head trauma. A visit to the doctor or an eye specialist may be required to rule out serious injury, particularly if you’re not certain of the cause of the black eye.

For a black eye:

• Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, make sure it’s covered with a towel or sock to protect the delicate skin on the eyelid.
• Use cold compresses for 24 to 48 hours, then switch to applying warm compresses intermittently. This will help the body reabsorb the leakage of blood and may help reduce discoloration.
• If the child is in pain, give acetaminophen — not aspirin or ibuprofen, which can increase bleeding.
• Prop the child’s head with an extra pillow at night, and encourage him or her to sleep on the uninjured side of the face (pressure can increase swelling).
• Call your doctor, who may recommend an in-depth evaluation to rule out damage to the eye. Call immediately if any of the following symptoms are noted:
  • increased redness
  • drainage from the eye
  • persistent eye pain
  • any changes in vision
  • any visible abnormality of the eyeball
  • visible bleeding on the white part (sclera) of the eye, especially near the cornea

If the injury occurred during one of your child’s routine activities, such as a sport, follow up by investing in an ounce of prevention — protective goggles or unbreakable glasses are vitally important.

What Is Bronchitis?

Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes, the tubes that carry air to your lungs, become inflamed.

People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.

Overview

There are two main types of bronchitis: acute (short term) and chronic (ongoing).

Acute Bronchitis

Infections or other factors that irritate the lungs cause acute bronchitis. The same viruses that cause colds and the flu often cause acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis.

Acute bronchitis lasts from a few days to 10 days. However, the cough that occurs may last for several weeks after the infection is gone.

Several factors increase the risk for acute bronchitis. Examples include tobacco smoke (including secondhand smoke), air pollution, dust, and fumes. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.

Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that need medical care.

Chronic Bronchitis

Chronic bronchitis is an ongoing, serious condition. It occurs when the lining of the bronchial tubes is constantly irritated and inflamed.

Bronchitis is “chronic” if you have a cough with mucus on most days for at least 3 months a year and 2 years in a row (without another apparent cause). Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. When this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis also have periods when symptoms get much worse than usual.

Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting cigarette smoking and avoiding secondhand cigarette smoke, can help people live better with this condition. The chance of complete recovery is low for people who have severe chronic bronchitis.

What Causes Bronchitis?

Acute Bronchitis

Infections or other factors that irritate your lungs cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition.

Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to cigarette or cigar smoke, air pollution, dusts, vapors, or fumes raises your risk. These lung irritants also can make symptoms worse.

Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis.

Chronic Bronchitis

Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of this condition.

Breathing in air pollution and dust or fumes from the environment or the workplace also can lead to chronic bronchitis.

People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis.

Who Is At Risk for Bronchitis?

Bronchitis is a very common condition. Millions of cases occur every year.

Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can get chronic bronchitis, but it occurs more often in people who are older than 45. Women are more than twice as likely to be diagnosed with chronic bronchitis as men.

Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with chemical fumes, vapors, and dusts from certain jobs—such as those in coal mining, textile manufacturing, and grain handling—also increases your risk for the condition.

Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke.

What Are the Signs and Symptoms of Bronchitis?

Acute Bronchitis

Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea.

The main symptom of acute bronchitis is a cough. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks.

Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain.

If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity.

Chronic Bronchitis

The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough is often called “smoker’s cough.”

How Is Bronchitis Diagnosed?

Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you’ve had it, what you’re coughing up, and how much you cough.

Your doctor also will likely ask:

• About your medical history
• Whether you’ve recently had a cold or the flu
• Whether you smoke or spend time around others who smoke
• Whether you’ve been exposed to air pollution, dust, or fumes

Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may:

• Look at your mucus to see whether you have a bacterial infection
• Test the oxygen levels in your blood using a sensor attached to your fingertip or toe
• Order a chest x ray, lung function tests, or blood tests

How Is Bronchitis Treated?

The main goals of treating acute and chronic bronchitis are to relieve symptoms and help make breathing easier.

If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever.

Antibiotics usually aren’t prescribed for acute bronchitis. This is because they don’t work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics.

A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go right to your lungs.

Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists).

To lower your risk of getting bronchitis, your doctor also may suggest a flu shot and/or a pneumonia vaccine (if you’re aged 60 or older).

If you have chronic bronchitis and have also been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form).

Sometimes people who have chronic bronchitis need oxygen therapy to help them breathe better and get enough oxygen to their bodies.

One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to the lungs. If you smoke cigarettes, it’s very important to quit. Talk to your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke. Also, try to avoid places with a lot of dusts, fumes, vapors, or air pollutants.

How Can Bronchitis Be Prevented?

You can’t always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both types of the condition. The most important step is to quit smoking or not start smoking.

Try to avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other things with strong fumes. This will help protect your lungs.

Wash your hands often to reduce exposure to germs and bacteria. Get a flu shot every year, especially if you have lung problems. Get a pneumonia vaccine as your doctor advises if you’re aged 60 or older.

Living With Chronic Bronchitis

If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition.

Lifestyle Changes

The most important step is to quit smoking or not start smoking. Avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. This will help keep your lungs healthy.

Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu.

Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.

For more information on following a healthy diet, see the National Heart, Lung, and Blood Institute’s Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” and “Your Guide to Lowering Your Blood Pressure With DASH.” All of these resources include general advice about healthy eating.

Ongoing Care

See your doctor regularly and take all your medicines as prescribed. Also, talk to your doctor about getting a yearly flu shot and/or a pneumonia vaccine.

If you have chronic bronchitis, pulmonary rehabilitation (rehab) may help improve your breathing. Pulmonary rehab is a breathing exercise program that’s supervised by a respiratory therapist. This is a health care worker who knows about lung treatments. Talk to your doctor about whether rehab may benefit you.

People who have chronic bronchitis often breathe fast. Talk to your doctor about a breathing method called pursed-lip breathing. This breathing method may help you feel better because it slows down your breathing. To do pursed-lip breathing, take a deep breath. Then, slowly breathe out through your mouth. At the same time, hold your lips as if you’re going to kiss someone.